The URL can be used to link to this page

Home My WebLink About0187 OLD STAGE ROAD a 7�al�t�Z� } a � W 1 _ go _ 3a9� H n n ♦ • a u i Wzl tK 7j, } c c a � a W L "r' .M r • r c , r. e , rt ;p rl r T 7. 4 , , k. p a , f � - .'ADE IN U.S.A, TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map . Parcel dam/ Application Health pivision Date Issued Conservation Division '�'1 Application Fee yCXJ Planning Dept. _: Permit Fee �Z ' Date Definitive Plan Approved by Planning Board D c�l1gJ13 Historic- OKH _ Preservation/Hyannis r Project Street Address Village eW l Me Owner Gulls 0 Address T 7s /4--, Telephone �%7 �� - 7�7s. L �Tuir/ ez-�97� Permit Re uest O-/5 //�ll� X/sl�?y �i /%lOo� ��•�T� �/ p v Square feet: 1 st floor: existing proposed 2nd floor: existing�s'!Z proposed 1[:gtGy Total new Zoning District Flood Plain Groundwater Overlay Project Valuation !Md Construction Type Lot Size /,5'- " S-S'f j"�T Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family iK Two Family ❑ Multi-Family (# units) Age of Existing Structure cf�� Historic House: ❑Yes A No On OldM g's HigMay: Yes )YNo Basement Type: ❑ Full ❑ Crawl Walkout ❑Other WA C> Basement Finished Area(sq.ft.) Basement Unfinished Area( q.ft) �v Number of Baths: Full: existing_ new Half: existing one Number of Bedrooms: 2- existing I new ' Total Room Count (not including baths): existing new First Floor Room Count v Heat Type and Fuel: AGas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes Of No Fireplaces: Existing Z New Existing wood/coal stove: ❑Yes #'No Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: kexisting ❑ 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) ll Name -� �� Telephone Number 1 Address �-��i Z7160 A/I&1 -1--OOJ License # OJW7,,,.3'Y �✓�'� / / H ome.Improvement Contractor# Worker's Compensation # e ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE Z/ i fO DATE 3-3 d"13 j FOR OFFICIAL USE ONLY r APPLICATION# i DATE ISSUED s MAP/PARCEL NO. ADDRESS VILLAGE F OWNER DATE OF INSPECTION: S FOUNDATION h FRAME �o LbV .,~ INSULATION o�I FIREPLACE " ELECTRICAL: ROUGH FINAL } PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ' FINAL BUILDING a ail,43 DATE CLOSED OUT ASSOCIATION PLAN NO.. 7 ® DATE(MMIDDIYYYY ACORO CERTIFICATE OF LIABILITY INSURANCE a4/ou2o113 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(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement, A statement on this Certificate does not confer rights to the certificate holder in lieu of such endorser s- PRODUCER CONTACT RAME: Debbie ... .......... _. _.. Mark Sylvia Insurance Agency,LLC IS 508 957 2125 FAx ro 508.957.2781 404 Main Street -MAIL ADDRESS., nsurance.Com Centerville,MA 02632 INSURER(S)AFFORDING COVERAGE NAIC R _. INSURER A:Farm Family Casualty Insurance _ INSURED INSURER S: _ Timothy Gray Building and Remodeling Inc INSURER C 68 K Nicoletta's Way M2shpee.MA 02649 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN6R POLICY EFF POLICY EXPLIMITS TYPE OF INSURANCE POLICY NUMBER MMIDDIYYYY A OENERALLIABILITY 2001XO540 2/26/2013 2/26/2014 EACHOCCURRENCE $, 1.000.000 DAMAGE TO RFNTED ,L rKe t 50.000 X COMMERCIAL GENERAL L1A9n.ITY PREMLS�J(F,93rp.!0...)... .•.•..- - CLAIMS-MADE L I OCCUR MEP EXP(Any one pereoni— S 5.000 PERSONAL&AOV INJURY S GENERAL_AGGREGATE $ 2,000.000 k-E 'L AOORFGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S 2,000,00.0 POLICY PR T LOC A COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY (Ee eQoIQRDtt 1 ANY AUTO BODILY INJURY(Per pemon) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS 141REDAUTOS NON-OWNED PROPERTY E (OAMAG $ $ UMBRELLA LIAS OCCUR EACH OCCURRENCE_ 3 EXCESS LIAR CLAIMS-MADE AGGREGATE DIED RETENTION$ $ A WORKERS COMPeNSAnDN 2001 W8340 1011512012 10115/2013 wC STATU- 0TH- AND EMPLOYERS'UABILITY Y_LIMIT3._X ANY PROPRIFTOIUPARTNER/EXECt1T1VE YIN E.L.EACH ACCIDENT $ 1.000.000 OFFICERIMEMSER EXCLUDED? I N i N f A (Mandatory In NH) E.L.DISEASE•EA EMPLOYEE 3 1.000.000 If yes.describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE•POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101.Additional Remarks Schedule,It more spate Is raqulmd) Carpentry Timothy Gray is covered by the workers Compensation policy, CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town Of 8arnstaCle THE EXPIRATION DATE THEREOF, NOTICE WILL Be DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE �� 01988.2010 ACORD CORPORATION. All rights reserved. ACORD 23(2010105) The ACORD name and logo are registered marks of ACORD 1 Massachusetts -Department of Public SafetyQ��j`�jzC,c//. Board of Building Regulations and Standards ;�,pffice of Consumer Affairs&Business Regulation Construction Supervisor 1 &2 Famih' .,: - - ME IMPROVEMENT CONTRACTOR r License: CSFA-046234 - egistration 102634 Type \�t ' IN u, xpiration:i 7/2/2014 Private Corporat TIMOTHY GRAY` TIMOTHY GRAY BUILDING&iREMODELING 68K NICOLETTV S VVA MASHPEE MA tP2649 ,, Timothy Gray } 68'K NICOLETTAS WAY Expiration P Mash ee,MA 02649fJ p Undersecretary Commissioner 11/30/2014 ^, o i R y co r 3 c C d „ o * �o f a� 7 {{ d CA 4 V 1 �A` G � C f• .ter-!s'....- — '. o fi o d N U u 0: 7 ►- ° 0 D UA i tO O a iltW �'til�i s\ w o p r_Ott O .Q W ) . N o Y O E. C° f- 7 Mar 11 Z013 12:34:51 16177650960 -> ISHB5393714 ARIAD Pharmaceutical Page 882 otTown of Barnstable Regulatory Services tbamas F.Geller,Director Building Division Tbomae Perry,CBO Building Commimioner 200 Maim Suva, Hyamub,MA 02601 www,lown.bannrlable;rrw,uR Office: 50"62-4038 Fax; 509-790-6230 Property ust Complete and ign This Section . If Using A Builder as Owner of the subject property hereby authorize l t w,oT Nam' U a Ft y to ace on my behalf, in all maner% relative to work authorized by this btulding permit appbeatior for, OL'D S70 &6 t2\.) CENTt-i? Vi1.4G. IWfi (Addrtss of Job) f Si nature of Owner Date t_s m AJ Print Nam QAWPFI ASTORMSUildingpermitfix WEXPRESS.doe ReYW020108 aged 01L.CGGS8051 U89AHI0WIJ.XUJ 13C2J21914-1 dH WUbS :L C102 11 Jew r The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): �l r Address: City/State/Zip: Phone#: Are you an employer?Check the appropriate box: Type of project(required): 0��4 4,1 a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g. ❑Demolition working for me in any capacity. employees and have workers' $ 9. ❑Building addition [No workers' comp. insurance comp.insurance. 10.❑Electrical repairs or additions required.] 5. ❑ We are a corporation and its 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no 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 a new affidavit indicating such. XContractors 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. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify u er the pgins and pen l0 s o perjury that the information provided above is true and correct. Si ature Date: Phone#: z� l Official use only. Do not write in this area,to be completed by city or town official I City or Town: Permit/License# I 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#: d Information and Instructions �- Massachusetts deneral Laws chapter 152 requires all employers to provide workers' compensation for their e loyees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contra of hire, express or implied,oral or written." An employer is define as"an individual,partnership,association,corporation or other legal entity,or y two or more of the foregoing engage ' a joint enterprise,and including the legal representatives of a deceased a ployer,or the receiver or trustee of an in 'vidual,partnership,association or other legal entity,employing emplo es. However the owner of a dwelling house h ing not more than three apartments and who resides therein,or the ccupant of the dwelling house of another wh employs persons to do maintenance,construction or repair wor on such dwelling house or on the grounds or building ap urtenant thereto shall not because of such employment be d med to be an employer." MGL chapter 152, §25C(6)also s es that"every state or local licensing agency shall ithhold the issuance or renewal of a license or permit too erate a business or to construct buildings in th commonwealth for any applicant who has not produced ac ptable evidence of compliance with the insu nce coverage required." . Additionally,MGL chapter 152,§25C )states"Neither the commonwealth nor an of its political subdivisions shall enter into any contract for the performan a of public work until acceptable evide a of compliance with the insurance requirements of this chapter have been pr ented to the contracting authority." Applicants Please fill out the workers' compensation affid it completely,by check' g the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s),ad ss(es)and phone n er(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or imited Liability P erships(LLP)with no employees other than the members or partners,are not required to carry work s' compensati insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this fidavit may a submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Al be sure o sign and date the affidavit. The affidavit should be returned to the city or town that the application for permi or license is being-requested,not the Department of Industrial Accidents. Should you have any questions reg din the law or if you are required to obtain a workers' compensation policy,please call the Department at the b r listed below. 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 complet/for nte egibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the eveff e of Ines ations has to contact you regarding the applicant. Please be sure to fill in the permit/license ich will be us d as a reference number. In addition,an applicant that must submit multiple permit/license as in any given y ,need only submit one affidavit indicating current policy information(if necessary)and undete Address"the ap 'cant should write"all locations in (city or town)."A copy of the affidavit that has beally stamped or mark by the city or town may be provided to the applicant as proof that a valid affidavit is or future permits or licen s. A new affidavit must be filled out each year.Where a home owner or citizen is ob license or permit not rela d to any business or commercial venture (i.e.a dog license or permit to burn leaves,etc.)said person is NOT required to omplete this affidavit. The Office of Investigations would like to thank you in advance for your cooperati and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations L 600 Washington Street. Boston,MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#617-727-7749 www.mass.gov/dia ca. Since 1955 GAco WEsTERN Y Insulation certificate Date..installation completed--- Building address -L. 9C 1� �r City/State/Zip e,;,7", �/'�° I/ v Application Contractor(company name) Ca w, Address City/State/Zip Phone Areas Insulated : Exterior stud wall Average thickness R-Value - Ceiling Average thickness Ll '3144 R-Value Roof deck Average thickness R=Value Crawl space/basement Averagethickness R-Value Additional areas insulated I(print name) Se— 61 �► - "as an independent contractor,certify that the GacoWestern insulation installed on this project was applied in accordance with the GacoWestern recommendations and specif ications as stated'on the product data sheet and the.GacoWestern Application Specifications in the amount as indicated on this certification. _ (signed) Date —J ' r s GacoWestern Aged R-Value chart Dimensional lumber 3„ 4» 5a, bn 811 9n 3:5" 1.15" GacoGreen 4.2 8 12 16 20 24 28 U32 36 14: ZZ 29 GacoFireStop 3.7 7 11 . 15 19, 22 26 30 33 13 20 21. 183M 6.4 13 20 '27 33 40 47 53 60 :'48 184' 6.1 13 20 27 34 40 47 54 60 24' 37 49 193 6.2 13 20 27 34 41 47 54 61 24 37 49 F Based in Initial measured X-values GacoWalafoam SPRAY POLYURETHANE.FOAM INSULATION www.gacowal fdgm.COM I 800.456.4226 PRODUT 1.. System 3 1 Gaio Western Wallfoam 183M is an HFC-blown(zero ozone-depleting)liquid spray system that lures to a medium-density rigid polyurethane insulation material.Gaco WallFoam . 183M contains polyols derived from naturally renewable oils,post-consumer recycled plastics,and pre-consumer recycled materials.Gaco Wallfoam 183M does not contain CFCs, HCFC's or other gases harmful to the environment.This system can be sprayed on clean,dry substrates down to 35°F(2"1).Gaco WallFoam 183M is a class I fire rated foam that meets the requirements of IMES AC377 Acceptance Criteria for Foam Plastic Insulation.Gaco WallFoam183M meets the requirements of A1377 Appendix X for use in attic and, crawl spaces without an additional ignition barrier. ,t TECHNICAL INFORMATION Toensureoptimum performance,a minimum pass thickness 1recommended with the maximum not 1 exceed per pass.for typicalequipment 1 1 Western's Gacofoarn SprayI' PROPERTY TEST TEMPERATURE ASTM TEST UNIT ; VALUE . • - Nominal Density(Sprayed n Place) ` ' 17°F(25"q ' D 1622 03 Ibs/ft; 18 r12 - R value See Note Eielow IS°F(Z3 9°C} C 518 h ftz °f/Btu R 6'4 at 1 h ft= °f/Btu R 23 3 at 3 5 `Compressive Strength(Parallel to,Rae), 71°F(25.°O � r D 1621 04a pst` 32 ; , Tensile Strength 71°F(15"O F`,`: D 1623 psi � 64 ' Water Absorption ]7°F(25"O F WaterYaporTr'ansmisslon' 17°F(25°C} E 96 05 , perm m 111 Dimensional Stability n Days) 158°F(1(1°O/95%RH D 1126 99 °,611near change L 6% W 5% T 3% .,.: Recommended Servue Temperature Range t 17°F(15°{} ,� °F/°C 40'F to 200°F:(40°C to 93°q Closed Cell Content 71°f(15°t) D 6126 05 % 9TlI AIr Permeance'@ 15Pa(Inhitratlon/Exfiltrabon) 11°F(25°Q E 263 04 L/s/mt 0 000/0 000(@ 1 thickness) F�11I1IC. v h 1n�1 tEa �Fa�lll _. 3F �Y Mwl .3!Y�%'ffic..F...._L,••.a'Fi.�•% �-�. - .'�_ �h.. :./!._..,._._ £Fa.__.___a..�3 .fit'-. "�. SURFACE CHARACTERISTICS I 1 kANSINFPAnownUBC1 SYSTEM THICKNESS FLAME SPREAD INDEX SMOKE DEVELOPED INDEX WaIlFoaln183M` 4 (102:cm) 10 s 400 ROOM CORNER FIRE TESTING NFPA 286(AC377 Appendix X) Ir LOCATION FOAM THICKNESS Wails4, Up to 9 5 (2413 cm) , Ceiling j+ Up to 11"(27 94 cm), TYPICAL LIQUID CHEMICAL PROPERTIES 111I Component 1 I I 1 Component 1 I I 1Catalysts and blowing agents. PROPERTY TEST TEMPERATURE , ASTM TEST UNIT VALUE, Viscosity A:Component 77°F(25"C) D 2196 68 cps I80'+20 Viscosity "B'tomponent r 150'+50 Spetlfic Gravity ,A.- S.6 122 Spetific Gravity B (omponent Weight/Gallon,_- A (omponent 17°F(25°C) fi` Ibs/gat 10.2 Weight/Gallon- B [omponent 100 ..- Mixing Ratio ::A & B°Component x77°F�(25°C) � , By;yolume 11 Stablhty When Stored at 50°F to 70°F Months A".Component I year EQUIPMENT PRODUCT CHARACTERISTICS SETTING VALUE CHARACTERISTIC VALUE Pre.-Heat Iso(A) '115°F 130°F(461'C 54 4°O (ream Tlme _ ,;i �, .0 1 sec . Pre-Heat Poly;(B) 115°F =130°F(461°f 54 4°O . Rise Time 3 ,_sec Nose Heat t 115°F 130°F(461°f= 54 4°q; Tack free Tlme 3 5 sec RecommendedSprayPressure 800 1000 psi(dynamic) Cure Tlme 4 hours `r The formation herein is believed to be reliable butunimewo risks mag be premaL&WARRANTIES OF ANY VINO,EXPRESSED OR IMPLIED,INCLUDING WARRANT ES OF FITNESS FOR A PARnCUTAR PURPOSE ANDTHAT 60005 ARE OF MERCHANTABLE QUAUIY,ARE SPEEIFICALiY DISCIAIMED.See Gaco Western forinfin too conreming its Nmitedwamotg and its aMiaboity.: u E �c �h Ai x M PL .� o� PISy G You ' /t{ T\�/��//TF • ""• ENERGYSTAR 1 r W.r..p,w�.4..d�a.�n.a.m mard'fr NAsap�e..N oh.au.4' cot 14cit �- e PARTNER q� t Y.. Gas W_anyo.C.—d-d len...i.sut.- 7 �;,.f..:;�,��,..=,-L'•� LL Toll-Free:877-699-4226 www.gaco.corn ` Products WFDS1 02/12 s . TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel6V Application # 9ov 3� I I Health Division Date Issued I Conservation Division Application Fee Planning Dept. Permit Fee ¢ Date Definitive Plan Approved by Planning Board n Historic - OKH —Preservation/ Hyannis Project Street Address 5-TA& F K X)., Village -Al rERy I L L LE Owner 10romA5 ` S-E LU «son( Address Z-/5 A/ eegeom Sr L<_.1AT69T�-^-( M& 0 Z41 Z. Telephone (DI-1 (0-1 (0 Permit Request 5-,e S ur2 0- S%n�14 �4+� (�r �1 n WL e. �le�;te e h ��dw. i� Ib - i��l 1��, ,-�►�o �;ha WeA a.,,_l fc-Ifele.. �a� rGy►ti�u�� C cr calo S (L C A% Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay ' lv�lS 4d Project Valuation ff> I ck:�O Construction Type ��11 Lot Size /S 7-4S se 101 Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family X Two Family ❑ Multi-Family (# units) Age of Existing Structure 19 6 G Historic House: ❑Yes I No On Old King's Highway: ❑Yes bd No Basement Type: ❑ Full ❑ Crawl I$Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) (� $ Number of Baths: Full: existing Z new o Half: existing O a.- M) new;"-. O _. Number of Bedrooms: existingsI new 4 ., Total Room Count (not including baths): existing new First Floor Room;Count Heat Type and Fuel: 2 Gas ❑Oil ❑ Electric ❑ Other w _ Central Air: ❑Yes M No Fireplaces: Existing Z New a Existing wood/coal stove:.`O Yes'%No Detachled garage: ❑existing ❑ new size—Pool: ❑existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage:)d 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 O HOMEOWNER) Name S W 1,L S o N Telephone Number (c (o-1(0 7 z 1 Z Address 18-T c> L D S T-A (.,E R o License # C.EN r6AV i 4 L 4 MA & z&3 Z Home Improvement Contractor# Z 7S M 13 L-A c o Al s T- cu i4 rERTo w N MA Worker's,Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE J ��s DATE Z2//3 i FOR OFFICIAL USE ONLY , APPLICATION# DATE ISSUED MAP PARCEL NO. r ADDRESS -VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME 'j INSULATION 2 FIREPLACE ELECTRICAL: ROUGH Y FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING LdAsAi� DATE CLOSED OUT ' ASSOCIATION PLAN NO. rr . + The Commonwealth of.Massachusetts t - Department of lndustrial Accidents Office of Investigations' Id- 600 Washington Street Boston, MA 02111 . www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lelnbly Name(Business/Organizatio �Jdu 5 L C,1,L 5 dk/ Address: 16-1 �(d �-��o.e 6Z� City/State/Zip: MA Zz-Phone.#: - (,� 17 676 7 z!Fz Are you an employer? Check the appropriate box: f Type of project(required): 1.❑ I am a employer with 4. 0 I am a general contractor and I employees(full and/or part-time). *- ': have hired the still-contractors: 6: 0 New construction 2.0 I am a sole proprietor or*partner-' .listed on the attached sheet. 7.. 0 Remodeling ship and have no employees These sub-contractors have g, .0 Demolition working for me in any capacity. employees and-have workers' [No workers'comp.-insurance comp.insurance. $ 9.' 0 Building addition required.] 5. We are a corporation and its I -El-Electrical iepairs or additions 3 . officers have exercised.then .� I am a homeowner doing all work 11.0 Plumbing repairs or additions I myself [No workers'comp: right of exemption per MGL 12:❑Roof repairs insurance required.] t c. 152, §1(4),and we have no employees:,[No workers' 13.0 Other comp.insurance required.] c *Any applicant thatchecks box#1 must also fill but the scetion below showing their workers'compensation policy infomrmtion. 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 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 Hr y employees. Below is the policy and job site information Insurance Company Name: Policy#or Self-ins. Lic. #: Expiration Dater Job Site Address: City/State/Zip t, Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). , Failure to secure coverage.as required Lnder.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 r I do hereby certify under the pains and penalties of perjury that the information provided above is true.and correct Signature: Date: 2 2 Phone#: F l use only. Do not write in this area,to be completed by city or fown officiaC Town: Permit/LicenseAuthority(circle one): d of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector r Person: Phone#: i Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as "...every person in the service of another under any contract of hire, express or implied,-oral or written." An em er is defined as "an individual,partnership,association, corporation or other legal entity,or any two or more of the fare oing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the receiver or tee of an individual,partnership, association or other legal entity, employing employees. wever the - owner of a dw g house having not more than three apartments and who resides therein,or thcpedT pant of the dwelling house o other who employs persons to do maintenance,construction or repair wo on such dwelling house or on the grounds o building appurtenant thereto shall not because of such employment be erred to be an employer." MGL chapter.152, §25 6)also states that"every state or local licensing agency sha withhold the issuance or renewal of a license or p mit to operate a business or to construct buildings'in commonwealth for any applicant who has not pro ced-acceptable evidence of compliance with the ins ance coverage required." Additionally,MGL chapter 1 , §25C(7)states "Neither the commonwealth nor an of its political subdivisions shall enter into any contract for•the pe ormance of public work until acceptable evident of compliance vzth the insurance requirements of this chapter have b n presented to the contracting authority." Applicants Please fill out the workers' compensatiV� n avit completely,by checking a boxes that apply to your situation and, if necessary,supply sub-contractors)namess(es)and.phone number )along with their certificates)of " insurance. Limited Liability Companie ) Limited Liability Partu hips (LLP)with no employees other than the members or partners, are not required towor rs'compensation' ance. If an LLC or LLP does have employees, a policy-is required Be advt this davit may be miffed to the Department of Industrial Accidents for confirmation of insurancege. Als be sure to ' and date the affidavit. The affidavit should be returned to the city or town that the aon for the rnut or tense is being requested,not the Department of Industrial Accidents. Should you have astions regar law or if you are required to obtain a workers' compensation policy,please call the Dept at the number ted below. Self-insured companies should enter their self-insurance license number on the appe line. City or Town Officials Please be sure that the affidavit is complete-and prin legibly. Th\cad eat has provided a space at the bottom of the affidavit for you to fill out in the event the 0 ce of Investigh to contact you regarding the applicant Please be sure to fill in the permit/license numbe hich will be usere ence number. In addition,an applicant that must submit multiple permit/license appli bons in any given yed o submit one affidavit indicating current policy information(if necessary)and undo ob Site Address" the nt sho write"all Locations in (city or town).".A copy of the affidavit that has en officially stamped or m by the ci or town may be provided to theapplicant as proof that a valid affida ' is on file for future permits oses. A new davit must be filled out each year. Where a home owner or c' ' en is obtaining a license or permitlated to any b ess or commercial venture (i.e. a dog license or permit um leaves etc.)said person is NOT rd to complete this davitThe Office of Investiga as would like to.thank you in advance for operation and should have any questions, please do not hesitate to give us a call. The Department's address, telephone-and fax number: . The Cor monwWth of Massachusetts Department of Fndttstd.W Accidents Office of Investigations 600 Washingtw Street Boston, MA 02111 Te1. #617-727-4900 ext 406 ar 1-877-MASSAFE Fax#617-727-7749 i .e-,-ised 11-22-06 WWW.Mass.gov/dia ` i Town of Barnstable Regulatory Services L RAY. .rAHLF- : Thomas F. Geiler,Director. KASS. . � �bs¢ Building Division Tom Perry,Building Commissioner 200 M eet,_Hyannis,MA.02601 ._. . . isww.foPrn.barnstable`rna:us •/ - . Office: 508-862-403 8 Fax: 508�-790-6230 IIWIU O r10EXSF EXF-MYrrox Pl=s:e Print DAT-E:— 2 _ � • JOB LOCATION; 8 7 C71. D 's'T A G t5 R D c A/ TER V/G L. number street $ village . "HOMEOWNER S c;Z t.v L S oN �. 1-7 (o?b '7 21 Z. 1 "(0 21. 22 5 3 name hdme phase# y N. EA G O a w ok phone CURRENT MILINGADDRESS: 6 # 13 N $ U.,ATC(LT C�t.�Al °. .O 2-4-7 Z etty/town state :}'` zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who"does not possess a license,provided that the owner acts as supervisor_ DEFIIZI'T DN OF HOMEOWWTER Persons))who owns a parcel of land on which he/she resides or intends to reside, an which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory io such use and/or farm structures. A person who constrgcts more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official,on A form acceptable to the Building Official, that hclshe shall be responsible for all such work perfo--med under the building-permit {Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and rc ,moons, The undersigned"homeowner"certifies that-he/she understands the Town of Barnstable Building Department n'iinimtun inspection procedures and requirements and that.h�lsl,"*. l comply with said procedures and rerzrrrirements. Signature of Homeown4 / at Approval ofBuilding Official f Note: Three-famil dwcllin. s can y g taining 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control: HOh4EOwKER'S EXEMFTION� .The Code states that "Any bomeowner pafommrg work for which a building permit is required shall be exempt from the provisions of this sectign.(Scction 109.1.1 -Liccrrsing of rmistz-uetipn Supenisors);provided that if the horrrcowncr argages a parson(s)for bin:to do such work,that such Homeowner shall act as supavisor." Many homeowners who use this exemption are unaware that they are asAm ing the responsibilities of a supervisor(scc Appendix Q, Rules&Regulations for Licensing C nstmction Super-,isors,Section 2.15) This lack of awareness often results in serious problems,particu)aHy when the homeowner hirrs unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it hvuld with a licensed Supervisor. The horireowncr acting as Supervisor is ultimately rtsponsib)c. 'To ens=that the bomeowncr is fully aware ofhis/hQrispo=bilitirs,many communities require,rs part of the permit application, that the homeowner certify that hdshc understands tine nsporrnbilitics of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a fonnhcrdfucation for use in your community. Q:forties:h omccx crap t tTti Town of Barnstable Regulatory Services n�xxsust:E, F w�aa Thomas F. Geller,Director �rEo � Building Division { Tom Perry, Building Co ssioner 200 Main Street, Hyannis',, 02601 www.to�vn.barnstab e.ma.us Office: 8-862-4038 Fax: 508-790-6230 Prapertye "er Mus Corrrplete�and S gn This Section , 4 If Us in Builder as Owner of the subject.property hereby authorize to act on my behalf, in all matters relative to work a rized by building permit application for. (Addres o Job) Simature of Owner Date Print Name If property Owner,is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS:O WNERPERMIS510N . -,7 r _ r P. LIChimnje Suirs- > s ^door g u rY NO ed 4-: d 4e7 i 187 Old Stage Rd. L -8 "?. zZ 0 Existing Unfinished Attic, no changes� ��°a y' r, _....Deck 'omlyrrnrC.. e � - r f Dining Room Bedroom Kitchen B'th ' -----�Fireplace Living Room 'Bedroom 187 Old Stage Rd. Existing First Floor, no change Bath Living Room Garage ~` Kitchen r F 'Xirepface.. k;l , Bedroom Utility t f Room _ Y floor_ _ . 7 or-St Old Basement 54,,5 Inspection Report— Building Department. Date 'o2� ( �J Address Referred B -e 6W .. Reported to Site with Pur se-e n bAje,-Y)em Observations & Notes �rt (bong Lv ovo i O-bo A) . �� a4l ) v- .�r -►rr� tA � mob Qnc„ me o hpz c,�� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map__.i`!� I Parcel D C BLA <:7, Permit# 9 Tie KE L1 + eiC`"t`�aiABLE Health Divisio `7 a'J o� ^ � Date Issued 1�Q Conservation Division _7 h O Oz 2003 1il.I- 14 P j All5plic3ation Fee ' Tax Collector fill U ��M f Fee Treasurer I EOa�� T sITAf bus IN CAMP Planning Dept. �� j ® � T/Tg�sLANCE Date Definitive Plan Approved by Planning Board TOO! P' T�(• C®OZAAry P 170 s Historic-OKH Preservation/Hyannis Project Street Address l9 ®! a rz ra 4 Village Owner (A�f60_P Address -SazM42. Telephone 77 / /-7 6_ 2 Permit Request R20 vtd lJ '` <e v"— r� !�0 n Square feet: t st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay -_ _Project Valuation 6V Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 53 Two Family ❑ Multi-Family(#units) Age of Existing Structure l 6 Historic House: ❑Yes Id No On Old King's Highway: ❑Yes t;No Basement Type: aFull ❑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: WGas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ONo Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool: 0 existing ❑new size• Barn:❑existing ❑new size Attached garage:51 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 BUILDER INFORMATION Name'` Telephone Number Address License# Home Improvement Contractor# 4.. Worker's Compensation# '• ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ==SIGNATURE DATE Yti x ` FOR OFFICIAL USE ONLY r PERMIT NO. DATE ISSUED MAP/PARCEL NO. j ADDRESS VILLAGE OWNER DATE OF INSPECTION: = FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL : 3 GAS: ROUGH : FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts -` Department of Industrial Accidents „ -_ - . Office offolye$mgomoos 600 Washington Street Boston,Mass. 02111 Workers'.compensation Insurance Affidavit name location: G.O t�L"\ � ©le 1 city C' hon #r.O 7 1 ❑ I am a homeowner performing all work myself. 1r� ❑ I am a sole proprietor and have no one workin in ca acity %/ /// %%%%/%/%%O%%%%%%//%%%/G/GO%%%�%/%%%%%/////////////%/0/%/ I am an e 1 raviding workers' compensation foi my employees working on this job. P :ss.. ............................... ............ p <:»;>:: s: liana �3iisuian ❑ I am a sole proprietor,general contractor,or homeowner(circle on and have hired the contractors listed below who have the following workers' compensation polices;XX , :cam .an ':name:»: :::>::<. ......... .......... :`?<: ai e 6 J : ny ��e•.:'#isiii>;isj:}X;:�4�:;:;:;:;:i':j;:;Y;:�.;i.;ri:;?i:;:;:;:;,;'.::;:y:;Si:iy:i:;�:.,?;...i.�.;`.;:(::Aj;,;Y:i:;�:; •vitxw::::.�:{:.}w::•::::::.�:::v::::::.�::ii:•}i:?}:{.�{{{{}}::4:{::•}::{�i:�:4:h}}::{•}}}:Oi:}}i}}}Y•::^:?ii:!!{i•::•:{^:{:hi:•i:<{•i:+.^iii}}i:{{{+.:......... :......... ........ .........................:..........:.::Jn•:n:v:::.�::::..�::::w:.:�:::w::::::•::::::::::::::.v::::.v::.�::::::::::{.;:::.:�:::•::.�::::.�:.�::::::::'::::;:i{:{::C::�i:{{.}:{•'.•}:•}}�.}}}}:{i{4:.......n..:n::.::...n,..,...v:.. - ::�.Gl:':i::;'i}:�::::i::::i:::::.:.i::?:::is?•: ::::.;e,.::n}};:.;;....:.:?i`•:•::!.i::::::::i:}::ti::ti::ii:i::ii eQ:::i2ii;i:"�}i=::::�:%?is;;:;:;:<;:;:;:c?:is hginrenc X. :address.::. .. ..:. . .... ..... :. e a ainranc - --to secure coverage as required under Section 15A of MGL 152 can lead to the imposition of crhninal penalties of a fine up to S1,500.00 and/or Failureone years'imprisonment as wen as civil penalties in the form of a STOP WORK ORDER and a flne of$100.00 a day against ma I understand that a copy of this statement may be forwarded to the Office of Investigations of the DU for coverage vetiflcatton. I do hereby c the p and penalties of perjury that the information provided above is trrw and correct Signature rr Date Print name A0� official use only do not write in this area to be completed by city or town official city or town: permitNcense# ❑Building Department ❑Licensing Board ❑cheekif immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other Uenud 9/95 PW { ti. Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all a loyers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as ery person in the service of another under any contract of hare, express or implied, oral or written. An em Toyer is defined as an individual, partnership, associati , corporation or other legal entity, or any two or more of the fore ing engaged in a joint enterprise, and including the I al representatives of a deceased employer, or the receiver or trustee o individual,partnership, association or other leg entity, employing employees. However the owner of a dwelling h e having not more than three apartments and w resides therein, or the occupant of the dwelling house of another who ploys persons to do maintenance, constructi n or repair work on such dwelling house or on the grounds or building app thereto shall not because of such emp 'yment be deemed to be an employer. MGL chapter 152 ection 25 also states that every state r local licensing agency shall withhold the issuance or renewal of a license or permit tooperate a business or to con ruct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance wit the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions s enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance equirements of this chapter have been presented to the contracting authority. Applicants , Please fill in the workers' compensati�affdavit ompletely,by checking the box that applies to your situation and supplying company names, address and phone n bers along with a certificate of insurance as all affidavits maybe submitted to the Department of Industrial Acci for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be ed to the city or town that the application for the permit or license is being requested, not the Department of In Accidents. Should you have any questions regarding the "law"or if you are required to obtain a workers' compensati olicy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit iJnb and p ' bly. The Department has provided a space at the bottom of the affidavit for you to fill out in theOffice of Inve ations has to contact you regarding the applicant. Please- Y be sure to fill in the permit/hcenswhich will be us as a reference number. The affidavits may be returned to the Department by mail or FAXer arrangements ha een made. The Office of investigations would like to thank you in advance for y cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Me of Imlesduations 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 �OFTHE I°�'y Town of Barnstable y�P Regulatory Services IABNSMIX, ' Thomas F.Geiler,Director MASS 9�ArE1 3;.�01 Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 r Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date - AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization, conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which_are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. ` Type.of Work: Col 650-�� A�S('rV ` '��./ U I` ..j.�¢ )4&51(_ Estimated Co � Address of Work: R, \ �Owner's Name: I I nV r1_ R.,K J-4 Date of Application: —7 0 D.3 I hereby certify that: Registration is not required for the following reason(s): OWork excluded by law ❑Job Under$1,000 OBuilding not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date ontrac r ame Registration No. Date Owner's Name oFtNE T� Town of Barnstable Regulatory Services anxxsTABr e, Thomas F.Geiler,Director 99, MASS.139. Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Officer-508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: U/v 3 JOB LOCATION:. J d e— tiL (f7, number str et f D village "HOMEOWNER": 4GlI r �! S9 �7 —l�O O p `- 4aZ, I name (� / home phone# work phone# b CURRENT MAILING ADDRESS: 7 �, �` J l-�&Q_ P,0e C �2wi�j P MA o G ? 2 city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends 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 shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and req ' ements. Signature of omeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger,will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing 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);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. hi this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt MORTGAGE 1AIS-PECTION PLAN APPLICANT- FINBAR PHELAN & MARY ROONEY TO WN.• BARNSTABLE O LOT 2 LOT 3 o ' Jleeeeleelel ,,,,,,,,,,,,,, ,,,,,,,,,,,,,,,, ,;:%HO USE eoeo : O ,,,, 18�,,,,, # ,,,,,,,,,,,,,,,, eoeellelee ,,,,,,,,,,,,, ti LOT '"' 5 b LOT PAUL A. - gr MERITHEW �,,= o .a 32098 Q FLOOD PANEL- 250001_0_01_5__C FLOOD ZONE � DATED 08119185 I hereby certify that this mortgage inspection plan was prepared for. Plan is For WORLD SA VINGS Hank Use Only The location of the building shorn does LVJ2Z-- fall within a special flood hazard zone. PLAN REF = _1392/153 The location of the dwelling does ------ conform to the local zoning by-laws in effect Scale 1" — _30 at the time of construction with respect to horizontal dimensional setback requirements — ----- or is exempt from violation enforcement action under Mass General Laws Ch. 40A -Sec. Z Date: g12l 3___ PLEASE NOTE.` The structures on this Inspection were located by tape not instrument and are approximate only. An actual survey is necessary for a precise determination of the building location and encroachment% If any exist, either way across property fines. This inspection must not be used for recording purposes or for use in preparing deed descriptions and must not be used for varience or building plan purposes This inspec(ion must not be used to locate property lines Verification of building locations, property line dimensions, fences or /of configuration can only be accomplished by an accurate Instrument survey which may reflect different Information than what Is shown hereon. This Inspection Is not Lbe used for any purposes other than mortgage. Yankee Survey accepts no responsibility for damages resulting from said reliance. YANKEE' SURVE'Y CONSULTANTS FAX 50B-420-5553 BOX 265, 40 INDUSTRY RD, MARSTONS MILLS, MA 02648 PHONE:508—428—0055 34850 JF i i Lj f }n! 11g 41 1 t I — o j f 7 0 i 1 1 l i i CQ 007 Town of Ba,rnstable *Permit# Fxplres 6 months from issue date . � Regulatory Service_ s F Thomas F.Geiler;Director AVAY ��° BuiYding Divi$ion ��ZY�io 7'0tj/ 4 2010 Tom Perry,CBO,. Building Commissioner 200 Main.Street,Hyannis,MA 02601 www.town.bamstable,ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION. - RESIDENTL&L ONLY Not Valid without Red X-Press In:print Map/parcel Number Property Address 16 1 old � c P dResidential Value of Work �T,' I V`� Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address �Ifi(�1 r clQ n` Contractor's Name imus buU4. Telephone Number e-N 0 T 4� " y Home Improvement Contractor License#(if applicable) . I�`�,31 V Construction Supervisor's License#(if applicable) A 1 1 w ❑Workmen's Compensation Insurance C45A one: [ II am a sole proprietor ❑ I am the Homeowner ❑ I bave Worker's Compensation Insurance Insurance Company Name ; Workman's Comp.Policy# Copy.of Insurance Compliance Certificate.must be on file: Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ' ❑Re-roof(not stripping, Going over existing layers'of roof) []Re-side ' ❑ Replacement Windows/doors/sliders."U-.Value (maximum.44) - *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Prop wne must Property Owner Letter of Permission.; - A c y of the e Impr vement Contractors License is required. SIGNATURE: Q:Forms:expmtrg Kevise06I306 tioF rt+erojs- Town of Barnstable. . Rib gulatory Services i S"NSfABLE. y Wss TThomasF. Geller,Director Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,hTA 02601 wWw.town.b arnstabl e.ma.us Office: 508-862-4038 Fax; 508-790-6230 Property Owner Must Complete and Sign This Section If.Using ABuild'er I, -F U rr. ale-i Q I� , as Owner of the subject property herebyauthorize � to act on my bebalf, in all matters relative to work authorized by this building permit application for: (Addre of Job) Signature of Owner Date Nat Name . WORIM S:O W NERP ERMIS S 10N - The Commonwealth of Massachusetts. Department oflndustrial Accidents Office of-1 vestigations - d 600 Washington Street Boston,AM 02111 www.rn ass..gov/dia Workers" Compensation lusurnnee davit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le 'bl Name (Business/Organization/Individual).;UWW-!�� 4.r •Address: --------------- City/State/Zip: �S� D2A001 Phone.#: Are you an employer? Check the appropriate box: 4: I am a e Type of project(required):. 1.❑ I am a employer with [� general contractor and I employees (full and/or part-time).* ha ,hired the sub-contractors 6 El New construction . 2. am a'sole proprietor or partner- listed on the'attached sheet.: 7. []Remodeling ship and have no employees These sub-contractors have g. Demolition working forme in any capacity. employees and have workers' 9 Building' addition [No workers' comp.insurance comp.insurance.# ❑ g required.] 5. [] We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their g 11.0 Plumbing repairs a'additions amyself [No workers comp. right of exemptionper MGL 12❑ oof repair insurance irequired.]t c. 152, §1(4),and we have no employees. (No workers' .13. Other: 5� comp. insurance required.] *Any applicant that ebecks box#1 must also fill out the section below showing thcirworkm'c cnsation policyinformation t Homeowners who submit °11t' w this affidavit indicating they Oro doing all work and then hire outside contractors must submit a new affidavit ind icating tcatin such. 1Contractms that check B h k this boa must attached an addition showing the name of the sub-contractors and state whether or not those ontities have employees. If the sub-contractors lave employees,they must pravidt their workers'comp.policy nurnbcr. lam 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.Lic.#: Expiration Date: Job Site Address: City/State/Zip: 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 maybe forwarded to the Office of Investigations of the INA for insurance coYera e verification, I do her der e p n nd penalties of perjury that the information provided bovg i true and correct Signature:- c r� Date: Phone #: Official use only. Do not write in this area,Yo be completed by c.hy or town affciaL City or 'own: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Tovyn Clerk 4,Electrical Inspector 5.PlutnbinQlns ector 6. Othor P Contact Person: Phone#: BdaftYol "d"'n°geguTalions a� r License or registration valid for individul use only m HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 124310 Board of Building Regulations and Standards One Ashburton Place Rm 1301 = Expiration:, 6/1/2011 Tr# 284683 Boston,Ma.02108 Type: Individual James Curley _._... Amy: James Curley �... 287 Fuller Rd. Centerville,MA 02632 Administrator dot Valid without signature �- Massachusetts- Department of Public Safet-, Board of Building Regulations and Standards Construction Supervisor Specialty License License: CS SL 99138 4a Restricted.to: .RF,WS JAMES CURLEY I 287 FULLER ROAD.. CENTERVILLE, MA 02632 Expiration: 1/28/2012 ' i Commissioner Tr#: 99138 ,per ✓die:-�a�cn�y� o�,;�.�aa�czc�ic�e� . .. :;" �\ Board of Building Regulations and Standards license orregistration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If.found return-to: Registration�:_1.24310 Board of Building Regulations and Standards Expiration 6[}/2009 Tr# 130873 One Ashburton Place Rm 1301 -'Type -individual Boston,Ma.02108 James Curley = James Curley _ 287 Fuller Rd. . �„��,�,` Centerville,MA 02632 Administrator Not valid without ure i i Town of Barnstable ermit Expires ti montks franc irrue date Regulatory Services Fee Thomas F.Geiler,Director Building.Division Tom PerrY, CBQ, Building Commissioner ' 'Commissio 200 Main Street,Hyannis,MA 62601 , www.town.barnstable ma:us. Office 508-862AO38 Fax:-508-790-6230 EXPRESS PERMIT APPLICATION `_ RESIDENTTAT;ONLY Not Valid without Red X-Press.Imprint Map/parcel Number Property Address ential Value of Work }J 00 y '3y inimum fee of$25 0 0 for work under$6000.00 Owner's Name&Address` Contractor'.s Name Telephone Number• •- Home Improvement Contractor License#(if applicable) L�" f Construction Supervisor's License#(if applicable),,, ❑Workman's Compensationlnsurance �� PERMIT. " Ch�one:,. .. � - , ®'I am a sole proprietor 4 2009 I am the Homeowner A U G-2 ❑ I have Workers Compensation Insurance' SOWN Q'F BARNSTARL �M Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be-on-file. Permit Request(check box) EJ Re-roof(stripping'old shingles) All construction debris will be taken to []Re-roof(not stripping, Going over existing layers of roof)' 1"J Re-si.de - ❑ Replacement Windows/doors/sliders. U-Value ( ,44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Cvyne r�us sign-Property Owner Letter of Permission. � A co of the,-om Improve ent Contractors License is required. SIGNATURE; Q:FonT s:expmtrg Revisc061306 The Commonwealth ofAfassaehusetts Department oflndustriallccidents Y579 Off Ice afInvestigations. 600 Wmhington Street Boston,MA 02Y.11 www.rrt ass.gov/dia Workers'Compensation TnsurAnce.Affidavit<: $uilders/Contractors/Electricians/PIumbers Applicant Information Please Print Le 'bI Name(Business/Orgauization/Individual): •Address: �( City/State/Zip; 8_05 MR 0V00I Phone.#: F ou an employer? Check the appropriate box: am a employer with 4. ❑ I am a general contractor and IType of project(required): loyees (full and/orpart,time).* have hired the sltb-contractors 6. ❑New construction . a sole proprietor or partner- listed on the'attached sheet. 7. Remodeling ship and have no employees These sub-contractors have ❑ working for me in any capacity. employees and have workers' 8' ❑Demolition [No workers'comp.insurance comp.insurance.#' 9. El Building addition required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL insurance required.]t c. 152, §1(4),and we have no 12.❑ oof rep airs,�pp employees. [No workers' 13.�Other ��d I y comp.insurance required.] *Any applicant that checks box#1 must also fin out the scction below showing thcirworkcrs'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew ai$davit indicating such. IContractrn�s 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 Izve employees,they must provide their woT-im,comp.policy number. lam an employer that is providing workers'compensation insurance for my employees Below 1s the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: 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 ofMGL c. 152 can lead to the imposition of criminal penalties of a fine tip 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 D insurance 'Vera e verification. I do h ' e y certify der the -ai andpe a[ties ofperjury that the information provided a ove i true and colrec4 Signature: Phone #: Official use only. Da not write in this area,'fb be completed by city or town affcial City or Town: Permit/License# Issuing Authority(circle One L Board of Health 2.Building Department 3.City/Town Clerk 4;Electrical Inspector, 5.Plumbing Inspector 6.Other Contact Person: Phone#: ; tiofYHEr o .. . Town of Barnstable. Regulator Services s lABNSTABLE, + • Md s ,��` Thomas F. Geller,Director Alfo �a Building Division Toni Perry, Building Commissioner 200 Main street, Hyannis,MA 02601. w�t'w.town.barnstable.ma.us,• k Office: 508-862-403 8 Fax: 508=790-6230 Propexty OwnerMust Complete and Sign This Section If Using A Buil:d-er as Owner of the subject property hereby authorize -'J 6-MjQ.9 GAL to act on my behalf, in all matters relative to work authorized by this building permit application for: (Addres Signature of I er Date Print Name Q TORM S:OWNE"ERMB S JON Bb�fi�n .�� g �o1`1#ui �n e u a io s an an ar s License or registration valid for individul use only _ HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 124310 Board of Building Regulations and Standards Expiration: 6/1/2011 Tr# 284683; One Ashburton Place Rm 1301 Type: Individual Boston, Ma.02108 James Curley James Curley 287 Fuller Rd. ��` Y.-• �, f,� ___.-- Centerville,MA 02632 Administrator "`' tvalid without signature i i . I Massachusetts- Department of Public Safety Board of Building Regulations and Standards Construction Supervisor Specialty License License: CS SL 991384 Restricted.to: ,RF,WS . JAMES CURLEY. . 287 FULLER ROAD_ ` CENTERVILLE, MA 02632 • I �• ��- �yf Expiration: 1/28/2012 Commissioner Tr#: 99138 i Board of Building Regulations and Standards - License or registration valid for individul use only HOME IMFROVEM ENT.CONTRACTOR before the expiration date. If found return to: Registration __1-24310 Board of Building Regulations and Standards Expiratio Tr# 130873 One Ashburton Place Rm 1301 nrS/F/2009 - -J Type_and%vidual Boston,Ma.02108 James Curley James Curley 287 Fuller Rd. Centerville,MA 02632 Administrator, N of valid wit hout o h ut re js i I i Town of Barnstable *Permit Expires 6 montlu from issue date Regulatory Services Fee , � Thomas F.Geiler,Director Building.Division ew4)33f F- Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstab le.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTYA-L ONLY Not Valid without ked X-Press Imprint Map/parcel Number 10 IM Property Address 1 U ®( d CL t [Residential Value of Work U� Minimum fee of$25.00 for work,under$6000.00 Owner's Name&Address old _ Contractor's Name �� t lam? I Telephone Number 1 V✓ Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) I Workman's Coinpensation Insurance Chpck one: X ti'v.F E MOO I I I am a sole proprietor ❑ I am the Homeowner s F P 1 9 2008 ❑ I have Worker's Compensation Insurance OWN OF BARNSI�� y Insurance Company Name Worlman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ZRe-ro.of(stripping old shingles) All:construction debris will be taken to 1��S CL<O,I ❑Re-roof(not stripping. Going over existing.layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) 'Where rcquired: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Histo;7c,Conscn%an,etc **'Note: Prop caner Property Owner Letter of Permission. A c py of#3ie Hom In ement Contractors License is required. `_71 SIGNATURE: o" Q:Fonmsxxpmtrg . . ".." Revised61306 Cg;. Co t`r•i The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance.Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information ' n ,n Please Print Le 'bl Name(Business/Organization/Individual):•\au,u� Q)wM •Address: t� City/State/Zip: Yl �S, Phone.#: �q•0 —4go 0 Are you an employer? Check the appropriate box: Type of project(required): 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 . 2. I am a'sole proprietor or partner- listed on the•attached sheet. 7, ❑Remodeling ship and have no employees These sub-contractors have g• Demolition working for me in any capacity. employees and have workers' [No workers' comp.insurance comp.insurance.# 9• M Building addition 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.RRoofrepairs 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#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this a$idavit indicating they are doing all work and tben hire outside contractors must submit a new affidavit indicating such. ;Contractors that check this box must attached an additionalshect sbowing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors Ian employees,they must providt:their workers'comp.policy number. X am an employer that is proUlding workers'compensation insurance for my employees Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration/Date: Job Site Address: City/State/Zip 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 tip 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'statemeut maybe forwarded to the Office of Investigations of the 1J r ins coverage verification, I do her by ce fy der e pa a d penalties ofperjury that the information provided ab ve i true and correct: Signature: Phone #: C� - -- FOther only. Do not write in this area,'to be completed by city or town affciai n: Permit/License# hority(circle one); Health 2.Building.Department 3.City/Town Clerk 4 Electrical Inspector 5.Plumbing Inspector son: Phone#: Town of Barnstable. . Regulat ry Services,,. sAxNSTABLE, + q nsnss Thomas F. Geller,Director 16.19.4%1%� Building Division Tom Perry, Building Commissioner 200 Main street, Hyannis,Mh 02601 - w�'w.town.barnstable.ma.us Office: 508-862-4038 Fax: 50E=790-6230 PropeAv Owner Must Complete and Sign This Section If Using A Builder nITarr eA Q0 , as Owner of the sub'ect` ro _ J P Peny herebyauthorize \J a-W-g &F to act on my behalf, in all matters,relative to work authorized by this building permit application for: . (Ad s of Job) r Ay 0 Signatur of Owner Date Larr Ph Print Name Q10RIMS:OWNERPERM]SS 10N e f n { - -. � ✓`ie: rran�rrw�z+.�ea� b�./�/laaoac�zuaelt Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Board of Building Regulations and Standards Regisfradon 1.24310 One Ashburton Place Rm 1301 4Xp ration 6%4/2009 , Tr# 130873 Boston,Ma.02108 Type, Individual James Curley James Curley _ 287 Fuller Rd. Centerville,-MA 02632 Administrator Not valid without re �• Massachusetts Department of Public Safety I Board of Building Regulations and Standards Construction Supervisor Specialty License License: CS SL 99138 F' Restricted.to:.,.RFAS . JAMES CURLEY 287 FULLER ROAD_ CENTERVILLE, MA 02632 • c�- Expiration: 1/28/2012 i �� Commissioner Tr#: 991.38 i �tr Town of Barnstable' *Permit#.2 7`'� Expires 6 monthsom issue Regulatory Services Fee snuaszear.E Thomas F.Geller,Director 9�AT0 9. ,•�� Building Division 'f27�° ED MA'I Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number T Property Address 181 OLD S'rhGE "A,) C,---nl FSCVl(,t_, MAr 02lo32 ["Residential Value of Work '619 000 •0 0 Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address F/N/"it A-,0i MA t-Y P 1k&LA4 181 OLD STA(6 40AD7 CSu-rg2ViLl 111A 02.63Z Contractor's Name 960 Q V d L-1T Q Telephone Number (SW� 77/ Home Improvement Contractor License#(if applicable) 13 2-6-q MIT ❑Workman's Compensation.Insurance XlzpRiESS PER Check one: [a'I am a sole proprietor MAR 2 6 2008 ❑ I am the Homeowner. ❑ I have Worker's Compensation Insurance TO, i N.OF BARNSTAf3LE Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be.on file. Permit Request(check box) r ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side D/Replacement Windows.✓doors/sliders.U-Value , 3? (maximum.35) *Where required: Issuance of this permit does'not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors'License is required Li SIGNATURE:: '{ 1l art iv it Q:\WPFILES\FORMS\building permit forms\EXPRESS.doC Revise020108 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations d 600 Washington Street Boston, MA 02111 www.mass.gov/dia. Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): SCOT' I -- Q0 I Lt Address: 3fYa,t,",hf vw 4111 ✓� City/State/Zip: CGNreev G(G , MA- o i6 3Z Phone.#: 771-04'f l Are you an employer? Check the appropriate box: Type of project(required): 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 2. I am a sole proprietor or:partner- listed on the attached sheet. 7...Q Remodeling ship and have no employees 'These sub-contractors have 8. ❑Demolition workingfor me in an capacity. employees and have..workers' Y P tY• $ 9. ❑Building addition [No workers'comp.insurance comp. insurance. 10. Electrical repairs or additions required.] 5.-❑ We are a corporation and its ❑ P 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.[✓]Other(Niwr�ocys 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. TContractors 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. Insurance Company Name: Policy#or Self-ins.Lic. #: Expiration Date: Job Site Address: City/State/Zip: 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 tip 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 der the pains and ltie jury that the information provided above is true and correct.. Simafore: Date:• 3'7-2— Phone#: 77/ Z L Official use only. Do not write in this area,to be completed by city or town of lciaL 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 workers'compensation for their.employees. Pursuant to this statute,an employee is defined as"...every person in.the service of anotl'er under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association,corporation or o er legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee o n individual,partnership,association or other legal entity, mploying employees. However the owner of a dwelling house having not more than three apartments and who resit s therein,or the occupant of the dwelling house of a other who employs persons to do maintenance,construct or repair work on such dwelling house or on the grounds or uilding appurtenant thereto shall not because of such a loyment be deemed to be an employer." MGL chapter 152, §25 6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or p �mit to operate a business or to construct buildings in the commonwealth for any applicant who has not prop uced acceptable evidence of compliance wit the insurance coverage required." Additionally,MGL chapter 1S2, §25C(7)s tes"Neither the commonweal nor any of its political subdivisions shall . enter into any contract for.the P3 rformance f public work until acceptable evidence of compliance with the insurance requirements of this chapter have been pres nted to the contracting autho Applicants i Please fill out the workers' compensation ffidavit completely,by the g the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name ),address(es)and phone n mber(s)along with their certificate(s)of insurance. Limited Liability Companies LC)or Limited Liability artnerships(LLP)with no employees other than the members or partners,are not required to a�ry workers' compensa on insurance. If an LLC or LLP does have employees,a policy is required. Be ad seAhat this affidavit m be submitted to the Department of Industrial Accidents for confirmation of ins uran coverage. Also be sud to sign and date the affidavit. The affidavit should be returned to the city or town that th applicatiin for the permit or license is being requested,not the Department of Industrial Accidents. Should you ha any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the epartment a the number listed below. Self-insured companies should enter their self-insurance license number on the,appropriate lin J City or Town Officials \dh tPlease be sure that the affidavit is complete and printely. The Department has provided a space at the bottom of the affidavit for you to fill out in tie event the Offivestigations has to contact you regarding the applicant. Please be sure to fill in the permit/li�ense number whibe used as a reference number. In addition,an applicant that must submit multiple permit/license applications 'ven year,need only submit one affidavit indicating current policy information(if necessary)atid under"Job Sile s' the applicant should write"all locations in_ (city or town).".A copy of the affidavit th has been officiallyed r marked by the city or townmaybe providedto the applicant as proof that a valid of davit is on file for furmi or licenses. Anew affidavit must be filled out each year.Where a home owner orcitizen is obtaining a licr pe not related to any business or commercial venture (i.e.a dog license or permit ta'burn leaves etc.)said p NOT r quired to complete this affidavit. The Office of Investigationswould like to.thank you ince for yo cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address;telephone and fax number: w . The Commonwealth of Massachus Department of Industrial Accidents Office of Investigations 600 Washington Street. Boston, MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 11-22-06 www.mass.gov/dia Town of Barnstable • BnxxsraBLFE • ' � Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CBO , Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, FiNN A22 PNQ—ArJ ,as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for' 18 7 our STA(SE kOA-b c�N+ Zvi LCc; ,AA-o zb 3 Z_ (Address of Job) , 0 SignatuA of C6iier ate Print Name QA)ATFILES\FORMS\building permit forms\02RESS.doc Revise020108 tH Town of Barnstable �f Regulatory Services snantsrnst.e. Thomas F.Geiler,Director � t1639. ,�� Building Division p Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPyttr,, Please Print DATE: 3- _6i JOB LOCATION: I ADAD ,3 number street village "HOMEOWNER' FIn1Qj/k PA-eLmj 50 771 -176 S05'' 77F—�/azll name home phoney work phone# CURRENT MAILING ADDRESS: city/to state zip code The current exemption for"homeowners"'w extende o include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual hire ho does not possess a license,provided that the owner acts as supervisor. DEFIN ON OF HOMEOWNER Person(s)who owns a parcel of land on which h she esides or intends to reside,on which there is, or is intended to be,a one or two-family dwelling,attached or cJetached ctures accessory to such use and/or farm structures. A person who constructs more than one home 0 a two-year eriod shall not be considered a homeowner. Such "homeowner"shall submit to the Building�fficial on a fo acceptable to the Building Official,that he/she shall be responsible for all such work erformed under the buildin ee *t. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for comph ce with the State Building Code and other applicable codes,bylaws,rules and egulations. The undersigned"homeowner"c 'fies that he/she understands the To f Barnstable Building Department minimum inspection pr Icedures and requirements and that he/she will comp with said procedures and re u' a ents. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required t comply with the State Building Code S�ction 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code stated that. "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 1�X9.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such. work,that such Homeo er shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\homeexempt.DOC � �_ � anvrrearuuectlC/''o��/�pgQ�ueaed {I Board ofBwldmg°Regulati. ons and'Standards , HOME,:IMPROVEMENT CONTRACTOR' I c Registrati.o,n.: i R 132691` _3%232009 Tr# 127243 r? Type Individual SCOTT QUIL'TERA c i SCOTT QUILTER � jf "„ I 247 STRAWBERRY`HILLE�D✓ CENTERVILLE;MA 02632 Administrator i rt { w fR j i License or registration valid for individul use only . beforerthe,expiration,date. If found return to: Board_of Building Regulations and Standards One Ashburton Place Rm 1301 �: p Boston;Ma.:02108 Not i valid wv out signature I °F IHE Tp,, The Town of Barnstable r • MUM 9 MAM Department of Health Safe and Environmental Services �'OTE1 Mp'�a`� P Building Division. 367 Main Street,Hyannis MA 02601 Office: 508-8624038 Ralph Crossen Fax: 508-790-6230 Building Commissioner February 29,2000 , r Thomas Primo 187 Old Stage Road Centerville,MA 02632 Re: 203 Old Stage Road,Centerville Dear Mr.Primo Your recent inquiry to the Town Manager's office has been forwarded to us for research and reply. The above referenced address has been the subject of prior inquiries going back as far as the mid-1980's. In 1992,the Building Commissioner at the time physically witnessed the fact that the kitchen was modified, returning the structure to a single family dwelling. Subsequent to that,and based on other inquiries,our office went out there again. We physically witnessed a single family home and can attest to the fact that the illegal apartment was never reinstated. This inspection by this department took place on July 19, 1999. we have been in contact with the owner of the property,Mrs.Veseskis,this week and have,again,been reassured that the apartment has never been illegally reinstated. At this point,we find no evidence to substantiate taking any further action at this property. If in the future something comes to your attention that would warrant our revisiting this issue,please share it with us and we will be more than happy to reopen the case. Thank you for your inquiry. Sincerely, Ralph A Crossen Building Commissioner RMC/km cc John C.Klimm,Town Manager Royden Richardson,Town Councilor -fl v229b � 6 . ......... °. 1t89.080 y BILDI NG S' '•.:;:..•. '::: . ..... ••`.. >. :;``. •,`:••`:•'. M1''•``}r•`::t••`: % ' t `y ;+.;`::::?`::2j``4 ,`.i 42 M1: ............... ....: . ... ..............::::::: ............................... «::7<' .... ...... .... ..... .... ..... �.. we d. » ; CENTERVILLE z ............................ ::.::::.::::.:.: ................... . . w. oil 11 11 j..- ill....................:..:...::...:.:...:..:...............:...........::.:...: .. .................... ........ ..... > ::<:::1 BLDG.WITHOUT A PERMIT.. low ISO tz>< z REFER TO R.J. FOR MN CH 18. l � 9 F o S va Q o i tn Y ! h e U Cei �� r s S Seam Ir T d •e r o� � �n.r 'n P^ 3 r `y. nn^ is >`<«'M1 ..........................................:<.:::;:.::.:::;... k...... ?::iyy:::j::`: L __ r 172690 STO t; ACCi/ / THOMAS P.RIMQ. A CQ 20;0329S RUCK NO; � DATEs 4tli OLD ''TAQE RO CENT L,tC DATE2s OS JUL 92 BC MTR NO a 153918IZE:240 3ET DATE o �4980• L. T READ a 6466 CURRENT a 1. �! o LOCs, O/6 LFT I ' ORDER:GAS RANGE DISC NECY K' A0i2iVl � 9q�J OFF, LIME:: ��UT E1.a + J HTRs /RNGs /OTN: . / I ENTR INFO: 5/T OR 'D0 R p! EN c'D£ ��:' O 9 I— AGDTL-INFU: �C�:f..rDc�SO tEinne�t-a'�. t�d I REPORT NCW' METER NW /SIlE/ /SET READ/ / 3Z:2GJt223Li0-"I IE_c ` L? u:11t ._�_��_ __.___.._..__ __.___�I- '=:_______.._....__: �fc�.Q..uo:i�su:;�qLz3'��srnoi�,u:i-�uo�:�t,�3� `.#e�tai� • - -ram„;-- --_ I JOB STATUS: COMP/ QMP/ .p xWeiee8 �CdA�IQ dl06!&MESEkMULEVJ :fi lr15m _.__-I -" SVC STATUS: ON/ OFgF/ (I,��GYJ1 r r 1 /EBB/ / I ?- -J;�3C]00 AaAA=$�..-f�O� e� Ht Vi�N'. �t WEEPER- /� DATE.. SvC CONT: G FURN 0 RANG WH 0 DRYR :� 3 LABOR.ACCT: 3743 I ORDER __._._------ MATERIAL-•-_-_____-____ TAX--------- ------------------------I_.- _-_--.______-_ -____ LA80R-___ -- --------- -.` I THIS AMOUNT IS SUBJ CT T RECTION L-TAX EXEMP71' ___. ___ .-________ _ _ -_-_ _ TOTAL-__ . -_: _ I SIGNATURE: RE0 :B.Ys.MR RIM 790-329 T 06JUL92 10:53 TAKEN BY=HNB I OROR: ORDR:S47269 SEOsO22640 5IC: 0 --------------------I__ mISC: a s a i RATE* R3 SVC:. ODR I/S 40-•16-94500OR I/S6--43...92BA-ODOR RNG 6--445-92RN09201"09HB --- -- ----- ---- - .__--`- CUSTOMER COPY - - UNITED STATES POSTAL SERVICE.,' 8q1k- �v F,tv 5. r T Official Business ;�a PENALTY FOR PRIVATE 9 USE TO AVOID PAYMENT ' —OF-POSTAGE,$300 Print your name, address and ZIP Code here • Town of Barnstable Building Dept. • 367 Main Street Hyannis, MA 02601 SENDER: • Complete items 1 and/or 2 for additional services. I also wish to receive the rn • Complete items 3,and 4a&b. following services (for an extra d y - Print your name and address on the reverse of this form so that we can fee): > N'return this card to you. m ! Attach this form to the front of the mailpiece,or on the back if space 1. ❑ Addressee's Address N does not permit. m Write"Return Receipt Requested"on the mailpiece below the article number. Q r 2. ❑ Restricted Delivery .+ 9W The Return Receipt will show to whom the article was delivered and the date c delivered. Consult postmaster for fee. 0 3. Article Addressed to: 4a. Article Number Mr. & Mrs. Thomas Primo P 375 771 504 E a 187 Old Stage Road 4b. Service Type Centerville, NIA 02632 El Registered ❑ Insured rn W [2 Certified ❑ COD 5 LU ❑ Express Mail ❑ Return Receipt for Merchandise Q 7. Date of Delivery o ) 0 T CC K5-. ign ture (Addressee►- 8. Addressee's Address(Only if requested Y * and fee is paid) LU W 6. Si (Agent) F' HPS Form 3811, December 1991 it U.S.G.P.O.:1992-307-530 DOMESTIC RETURN RECEIPT � P 375 771 504 1 . Re,' ipt for Cer�fi� -<1Aail M No Insurance Coverage Provided 0 uro.�st•.�: Do not use for International Mail �.ws�. (See Reverse) Sent to SuTed`61d Stage Road P.O.,State and ZIP Code Postage Certified Fee Special Delivery Fee Restricted Delivery Fee Return Receipt Showing p� to Whom&Date Delivered at Return Receipt Showing to Whom, C Date,and Addressee's Address n TOTAL Postage A c &Fees �1 0 Postmark or Date M E 0 U- a STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE, CERTIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES(see front). 1. If you want this receipt postmarked,stick the gummed stub to the right of the return address leaving the receipt attached and present the article at a post office service window or hand it to your rural carrier(no extra charge). ) 2. If you do not want this receipt postmarked,stick the gummed stub to the right of the return address of the article,date,detach and retain the receipt,and mail the article. rn 3. If you want a return receipt,write the certified mail number and your name and address We c return receipt card,Form 3811,and attach it to the front of the article by means of the gummed ends if space permits.Otherwise,affix to back of article.Endorse front of article RETURN RECEIPT,'` REQUESTED adjacent to the number. OD 4. If you want delivery restricted to the addressee,or to an authorized agent of the addressee, M endorse RESTRICTED DELIVERY on the front of the article. E 5. Enter fees for the services requested in the appropriate spaces on the front of this receipt.If U., return receipt is requested,check the applicable blocks in item 1 of Form 3811. Na.1 6. Save this receipt and present it if you make inquiry. 105603-92-8-0226 5\ W'yoF 1 M[1p�o The Town of Barnstable Inspection Department Tto war�• 367 Main Street, Hyannis, MA 02601 508-790-6227 Joseph D.DaLuz Building Commissioner June 29, 1992 Mr. and Mrs. Thomas Primo 187 old stage Road Centerville, MA 02632 Re: 187 Old stage Road A=189.081 s T Dear Mr. and Mrs." Primo: 9 v . This letter is in reference to our meeting with Town Attorney Smith on Monday, June 22, 1992 in my office. on Tuesday morning, I met with Barnstable Police sergeant Hudick, Tom Gei'ler, Director of Consumer Affairs, and Building Inspector Richard Bearse.4 We inspected the lower level of the dwelling located at 203 Old Stage 'Road. There was no apartment. We also had the opportunity to talk with the owner and r, tenants. Mrs. Souza lives locally and is aware of her responsibilities. t During our meeting in my office we discussed the complaint I received regarding the, apartment in your dwelling. You admitted having an apartment which you stated was legal. Contrary to those thoughts, apartments have never been legal in that RD-1 zoning district. While on the 203 Old Stage Road site, the issue of your pigeon coop and pigeons was addressed. There is no building permit on file to authorize the pigeon coops and it has been alleged that your pigeons are leaving their droppings on the neighborhood properties. r I must advise you that the apartment unit.j must be removed and that the removal must be accomplished within fourteen days of receipt of this letter. This office must be notified for inspection to verify that the apartment unit has been removed. Peace, a \;Joseph D. DaLuz Building Commissioner JDD/km cc: Town Manager 1 "- Certified Mail P 375 771 504 R.R.R. L920629A { f t - w _Z4)ova- 74 472690 STO �; ACCTr 371 � t r �rHVMa� F�FtIM© k� a�ET � TRUCK i4O:. / DATE: ti 1 �, �MTR �tf3� OLD TAt3£ Rfl s . . . CEPfT � �£f� g0329S. DATE2s 09 JUL 92 ®C Attie4S3 94 3IZE:2�0 ; . SET ©AIEo, �� T. REA a 6466-CURRE'�lTs Lvc s arS Lf T � t � +I ORDER.OAS RAi�GE -- DISC t�iPlEtor a6laivt� �►� ..` /R / , :AtlTFI: z rHTR s t�O s. /OTN:.- OF LINE Cps ��E I EMTR INFO S/T OR DOOR Of MN I INFO- REPORT: NEW MET[-:R NU/ /SIDE/ , i /SET READI :1O 4laails DIn'£�:. ip . I JOB STATUS: COMP/ � IS thef't't , 1 SV. TA'TU5 Old/ �Ft I LLA180 0 : T: i►' $ HE-LPER.r aATE:�; _, _ ___.___-._f_ _�._ .•— PVC` GCNT i G FURN 0 RAMG 3 .LABOR FaCCT 37 i3 I ORDER PARTS—�. - -/---_ MATER AL I THIS at°tOutT IS auOJE� T,? RE> TIdP�. L Tex -E7�EM€�°la - RCt B:1f e.MRRQ 7�Q_, 29 y T :4bJUL92 't0:53 TA14EN 8'YHH® " ORQR:S 47269 SEt1:0a�'2f� E? 5Tc r (f MIsC: RATES R3 I—" SVC:. ODR I/S' 40--.•16-91 SODOR I/S6 43•--92BR--ODOR RNG 6-7 4 4 a-92RN0920709HO CUSTOMER COPY- ' - `, .. fi5 R,,..�• S-Y.x1�tf� is ,:fi ,, jt/ _, .,.?� t ;x 'i' ... ,. .. > _�° 0 ; t ?w } a .�4 d p �y a- }�"�.: p tij -'ti� � i^i'.;s-s`i i 3' f ii $ -i �•i .{°'�" � Colonial .GatCompany Cape Cod.Di ision )V i �..3 y t:jd F E3. ,b ib 7+F�t i 4 PM, B 0 HyanmsfiMA "p2601-1005 M NIB _ /Raate\\ ". "ki .Lf..you have..any.questions� gai�f�tng the.,info.rmation contained on .the_. .-- ,. i -face-'�of--this--ticket.,-pleas `� nct our Customer Information Depart merit at the.:r�t r the s_`liste la for. �assestance: A qV L+1�11 � Df�A -� �• - " (a 1'Iiol IN TH kfi17 OR 508 AREA CODE) a Pi r„ S _.._ �r I S��: S. b t�4 'Ss3, e. .- - .. .... F C V '.f.i..r ♦ e. � _,.(aS le� '�, - (... � Y - �/ �� 'R'a �.\ ��'F��K h� :j"6.I�'. if.'� tl � _^9 i;E ik�,* a'.•P'��.1}9✓ �.,1: - _ , '- ve -«t- r4�:. .. :-1 -( - {, .... H sM -'•�F. ., 1`• �"'•�:bii. ;T.,... t _ _,.... -•..-. .- >i R .. :A v ( C.2 7A.{' L"'S 'hf'� 1 y F . t Z.F .) i• ... .... .. .. .. ... _. .. a °`7NEr°�� TOWN OF BARNSTABLE BAHBSTADLE, i 9� ON a�Ar.e� BUILDING INSPECTOR APPLICATION FOR PERMIT TO .. .. S.I.SIC......h..`..... .1.4�.°L /1...................................................................... TYPE OF CONSTRUCTION ...WkftL. M.d..................................................................................................... I ....34. .........................19. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...&I......O ......SA7f... G!9Gi........ 12 t, V.[l/�I . y...AleQ,CS........................... ProposedUse ..1.Q.®.)..........sk4�............................................................................................................................................. ZoningDistrict ........................................................................Fire District .............................................................................. Name of Owner S/�.lP..�.:..' `f�.WG.P..#..........................Address ....(,//.Q....N} ..IJC. .. /Y./.4'�t y;));.../.!/�,(1. Name of Builder .......... ..�f rr «......................I...................•• .............. .......................................Address .................. .................... Nameof Architect r. r� I..................................................................Address .................................................................................... Number of Rooms J...............................................................Foundation C'.94 �....�lGjl,?5......................................... Exterior ........ ............................................Roofing ..A.5-plli4.)T....... �.h1J1.ry ................................... Floors ....................Interior r Heating ... a`Il?�I•�....................... Plumbing ....:...... .................................................. Fireplace ..—r ....!`(We......:........................ 00..............................Approximate Cost .. .................................................................. Difinitive Plan Approved by Planning Board ________________________________19________. Diagram of Lot and Building with Dimensions t� 1bS.V.3 r� J J � hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. O Name ��r ..�a.t. . 7�t�f ............... � . Fawcett, Lester L. i ) ll/ulo tool shed ^ No —...........— Parmk for .................................... ' ------------^--`--^`~—~—^---' 187 OId Road Locationr ^--'----^---^'---^—'----'' Centerville --------.----.--.—~--------- ` Owner ..........Ie.otmr ��..Ial�:att______ Type of Construction ....frame........................... / / -----^-----'------'---'-----'' Plot .......................... Lot ................................ , � . � - � Permit Granted .....Don'endza�..3--'—.]A An ( � Date of Inspection ------------lV ` ! Y � Dote Como��a6 .. ��../��---lq«� �� ' � ' | | ' PERMIT REFUSED � / ....................................... --.—.---. 19 � � .-------------------------- / ) -----.—....—.-------`—,------.- ` , � '-------------^^'—~--^—^----''' ----'—'—^—'—'^^^—^—^---'`—^~--'~— Approved ................................................. lQ . . ~ ---------------~.----..---..— . ` -----------^-----~---^—^^^^'— r: f I NEW 2X6'e G.J,0 16"O.C. NEW IX3 STRAPPING j I/2"WALLBOARD 5 "a , Q IM I NEW NS BEDROOM NEIU N4 KNEE WALL fiKIBTING M4 KNEE WALL I NEW 1/2"WALLBOARD. 2x4'e o 16"O.C. Ta CEILING LINE - II 'V� SO'CEILING LINE I( eo -- C CfiILING LINE I _ I i _ .................. ____________ ___ i NEW Q ' EXISTING �11 4,y fa' BEDROOM ' 11 � � f FIRST FLOOR w � NEW I SEWING 6.1y4 le'�CEILING LINE W - n. — ROOM 101. NEW v ' _x C BATH I '�0-0"CEILINO LINE -� 19 eNOWEIi I I / v I I � •� EXISTING EKIeTING�xd KNEE WALL I �1 BASEMENT ". I � 1 .E PROPOSED SECOND EXISTING 1 SECOND , FLOOR - 1 FLOOR PLAN CROSS 'SECTION lC)%jillwKE DETECTORS � � D �--=-----� . EXISTING WALLS *Ar _1 E BUILDING DEBT. DATE NEW WALLS I �•'=. 7 FIRE DEPARTMENT DATE 4 BOTH SIGNATURES ARE REQUIRED FOR PERMITTING NEW 2x6'E C.J.0 16"G.C. NEW 2X6'e G.J.0 Ir."Q�y ..� 1 NEW NEW :,:° `I }}ISE 1 R38 INSUL. -. _- _ R38 INSUL. Q IX3 STRAPPING •l�'� - BAT m I� NEW I/Z"WALLBOARD NEW IX3 STRAPPIN- SEWING BATH ®® 1/2"WALLBOA sD ,[[�� EXISTING ®O `CJ ROOM 'EXISTING' •IS'O.C.WITH ,• _ IXI6 ING 2X4'e DINING KITCHEN ® O EXISTING — - •� NEW 1/2"WALLBOARD NEW .•- BEDROOM EXISTING BOTH SIDES 1/2"_ ALLBOAR NEU V WALLBOARD S , x 2X4 6 16"O.C. . 2X4'e o 16"O.C. II I I EXISTING FIRST FLOOR - EXISTING FIRST FLOOR 1 EXISTING EXISTING EXISTING BEDROOM 4 .LIVING FOYER _ /-77' ,4., / / c / / { j EXISTING / ^ �J BASEMENT , 1 C BA3T EXISTING FIRST ' rl FLOOR PLAN / CROSS SECTION (A) CROSS SECTION (8) t • I BUILDER JOB ADDRESS DESIGN n ^ n^ �O R =;- REVISION DRAWN BY PAGE SCALE TIMOTHY GRAY BUILDING 161 OLD STAGE ROAD FINISH EXISTING ' (lJ^\�fllL`[% ��)Ml// » JB •�OF� v4".1'0° ✓� D�slgns AND REMODELING CENTERVILLE, MA. SECOND FLOOR rR� �rr� BI NL. `L Wj A ORAWINGB LEAVES PIIRCNA9ER RE9PONSI MAY FOR f4MpLIANLE WRN ALL !U EKALT EISE Atm INW BY LE L OF ALL C MN SfE i00TING9 4)ALL WO71—I eNALL EMEND BELOW ES".LINE VERIFY OEPTN. 1- LOL4 BUILDING LODES AND ORE WIE ES,H D--I MAY NOT BE HELD RESPONSIBLE PR BE DtTERC NED BY LOCAL BOIL CDEE—O IT L AL EN INS . (d)VERIFY BTRIILNRAL ELEFIENi9 FOR DESIGN!SIZE P a �S �gJ 4 �r�,¢ SITE CONDITIONS OR FOR THE USE OF THESE DRAWINGS WRfNG LONSiRUCTION. PRACTICES OF CONSiRIILTION.VERIFY DESIGN WITH LOCAL ENGINEER. WITH LOCAL ENGINEER AND BUILDING OFRLIALB. UEBT BARMlIAEW2/t4 QTRSG