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HomeMy WebLinkAbout0635 PHINNEY'S LANE �z6 7 .o .. a o o � _ a . o Town of Barnstable .�. ..�. a - - . Building 'Post This'Card SoThat it is Visible From.the Street Approved.Plans.Must,be Retained on.Job andahis Card Must be Kept d, MASS. -Posted, l Tina eOn Where a Ceirt�ficate of Occupancy Bs Required,� such Buildm shall Not be Occu ied until a Final Inspection has been made • iLL erHBBi Permit No. B-20-2069 Applicant Name: Chris Macfaden Approvals Date Issued: 08/17/2020 Current Use: Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 02/17/2021 Foundation: Residential Map/Lot:,, 2517161 Zoning District: RD-1 Sheathing: Location: 635 PHINNEY'S LANE,CENTERVILLE - Contractor'Name:. CHRISTOPHER S MACFADEN Framing: 1 Owner on Record: WIXSOM, RICHARD S&CHRISTINA R Contractor License: CS-083874 2 Address: 263 ALLENGATE AVENUE - ` Est. Project Cost: $ 20,000.00 Chimney: PITTSFIELD, MA 01201 Permit Fee: $ 152.00 Description: Remodel Bathroom 1 Insulation: =:Fee Paid:. $ 152.00 - Project Review Req: Date: 8/17/2020 Final ` Plumbing/Gas Rough Plumbing: ufficial This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuan Final Plumbing: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Rough Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. ! Final Gas: The Certificate of Occupancy will not be issued until all applicable signatures by the.Building and Fire Officials are provided on this permit. - Electrical Minimum of five Call Inspections Required for All Construction Work: 1.Foundation or Footing Service: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed .` Rough: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Rough: 7.Final Inspection before Occupancy Low Voltage final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT n Di"'� Final: Town of Barnstable Building Post This Card So That it is`Visible From the Street Approved'Plans`IVlust be`Retamed on'Job and,this Card Must be Kept Posted Until'Final.l,nspection'Has:Been Made �: h4 3 N~ ,s" �• Where a Certificate of Occupancy isRequired;suchBuildmg shall Not be Occupied until a,Final Inspection,lias been madey Permit Permit No. B-18-2664 Applicant Name: William McCluskey Approvals Date Issued: 08/1S/2018 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 02/15/2019 Foundation: Location: 635 PHINNEY'S LANE,CENTERVILLE Map/Lot 2S1-161 Zoning District: RD-1 , Sheathing: Owner on Record: Richard Wixsom Contractor Name`:";,WILLIAM J MCCLUSKEY Framing: 1 y Conteacto License CSSL-102776 Address: 635 Phinney's Lane 2 Centerville, MA 02632 � Est Project Cost: $5,000.00 Chimney: Description: Add R-38 fiberglass, R-37 cellulose,and R-10 rigid risulatiOn to the Permit,Fee: $85.00 attic.Air seal the attic plane with expanding foam::,General Insulation: Fee Paid ! $85.00 weatherization. ') Final: 4.LiZ Date. 8/15/2018 Project Review Req: z qv Plumbing/Gas iyd Rough Plumbing: - :Building Official 5 Final Plumbing: �1 Rough Gas: This permit shall be deemed abandoned and invalid unless the work authonied by}this permit is commenced within sii months after issuance. Final Gas: All work authorized by this permit shall conform to the approved application'and the:approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall tie in compliance with t-he local''zon ng by-laws and codes. Electrical This permit shall be displayed in a location clearly visible from access street or road arid shall tie maintained open for public inspection for the entire duration of the work until the completion of the same. ' y Service: The Certificate of Occupancy will not be issued until all applicable signatures by the Building an Fire Officials a4ISovidecltn this permit. Rough: Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing Final: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Low Voltage Rough: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection S.Prior to Covering Structural Members(Frame Inspection) Low Voltage Final: 6.Insulation Health 7.Final Inspection before Occupancy ' Ile Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. -04%" Work shall not proceed until the Inspector has approved the various stages of construction. Fire Department "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Cape Save Inc. 7-D Huntington Avenue. South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 T 3UILDING DEFT "JAN 02 2016 12/6/18 TOWN OF BARNSIABL, Brian Florence CBO Town of Barnstable Building Division 200 Main St. Hyannis,MA 02601 RE: Insulation Permit 18-2664 P Dear Mr. Florence: This affidavit is to certify that all work completed for,635 Phinneys Lane;:Centerville has been inspected by a third party Certified Building Performance Institute.(BPI)Inspector. All work performed meets or exceeds Federal and State Requirements. Sincerely; William McCluskey, Y { =3 Town of Barnstable arnstoble �41 Regulatory Services tj (612,341 Bullr3inc.D.ivi i:7n •b ?ES:IL. NT.d_-A.:.F_: ONLY Y -- - �------� �--�lam- �-__--------�-_----------- -=- omz�S Fu Ile fv ._ Q-/" .C�Onl� e�ycesN� ;"AiV L �o�l�e ei �..v.� iC� _ 1 'fX 1,1. , `� :r• -PRESS PERMIT v & W- 31 I/(/ C� /_ 'TOWN- OF B RNSTABLE :TI r1 i) . �) Pei i7iL---------`------ _ -�'��i' rr :.. •1.. ny �.• '��i. ;l�1`J..i%ni ,c�� _ _ ._ic: A:"0J - r uT C Y i ��.i�_ti�: :0 .w:.-,-...::-..1 .,:.^ice r_: �'l., .. f_'_ _. ., /c•) V A J V _ -rt:.._.i- .__.�A il: Z. ,�,\,r�.J..-2/'/ , Ji a L'(G;iS..,J_l. - ,. o A 'Du'; 8i: Di �''i" :`,".. .. (�^� '8C ._ i 4 'Se a C^il ';a [iOP, �i f i":_:, i_C;ij�. -i: Jtrc JI The Commonwealth of Matssachus.e 's Depaai taent of Industrial Accidents Office of Investigations _ 600 Washington Street - Boston, lldA 02111 www.maass gov/din Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/.Plumbers A licanf InformationPlease Print Lg bl Nagle (Business/Organization/Individual): 0 m�..r Address: � L2 5 f rr ED A-E> City/State/Zip: l�w �o - 30*;j Phone#: � - Are you an employer? Check the Appropriate b Type of project(required): 1.Qf I am a employer with j ID 4. I am a general contractor and I 6. Q Ne construction employees(full and/or part-time).* have hired the sub-contractors 2.El I am a sole proprietor or partner- f listed on the attached sheet. 7. emodeling ship and have no employees These sub-contractors have g, (�Demolition workingfor mein 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 3. I am a homeowner doing all work officers have exercised their 11.F1 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.E] Other comp.insurance required.] *Amy applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homedwers 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 my employees Below Is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lie.#: W C 0( 736 6 Expiration Date: ebb Site Address: Al City/State/Zip: vlecrVnjc, Attach a copy of the workers'compensation policy declaration page(showing the policy number and iration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties,of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil'penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. ' I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. signaturez Phone,#• f O lotal use only. Do not write in this area,to be`completed by city or town ofjklaZ 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.OtherIN Contact Person: Phone#: Office of Consurner Affairs Bgsaaess Regasaraoa ! OME IMPROVEMENT Cot4TRACTOR Type: ary Regis�tiOn'-92f893 s 47 Expiration. -. 12 12 Suppiernei C The tome Depot f t4 f 0e,Services DARREN 2690 CUMBERLAND PARKWAY S GA 30339 Undersecretary I License or registration valid for indiv turfs a Only n ` before the expiration date, if fors -�tk�+n Office of Consumer Affairs and Bossiness Regis 10 Park Plaza-Suite 5170 :ard Boston,MA 021.16 Not valid witbout signature , OP ID: MC CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 01125112 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER 401-769-9500 NAME: Hunter Insurance,Inc. 401-769-9502 PHONE FAX No: 389 Old River Road,P.O.Box 1 AIc No Ext: Manville,RI 02838-0001 EMAIL ADDRESS: PRODUCER CUSTOMER,,,:B&LCO-1 INSURERS AFFORDING COVERAGE NAIC A INSURED B&L Construction INSURERA:Merchants Insurance Group 23329 Brian LaRoche INSURER B:Beacon Mutual Insurance Co. 145 Phenix Ave,2nd FI INSURER Cranston,Rl02920 IN C: INSSUURER 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. LTR TYPE OF INSURANCE POLICY NUMBER MMIDDIYYW MMIDDIYYYY LIMBS GENERAL LIABILITY EACH OCCURRENCE $ 500,00 DAMAGE TO RENTED A X COMMERCIAL GENERAL LIABILITY X BOP9093646 04123/11 04/23112 PREMISES Ea occurrence $ 500,00 CLAIMS-MADE ®OCCUR r MED EXP(Any one person) $ 15,00 A BOP9093646 04/23/11 04/23/12 PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 1,000,00 POLICY JE PRO T El LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (Per accident) NON-OWNED AUTOS $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS' CLAIMS-MADE AGGREGATE4 $ DEDUCTIBLE RETENTION $ WCSTATU- OTH- WORHERS COMPENSATION TORY LIMITS ER AND EMPLOYERS'LIABILITY YIN 01119N 2 01119113 E.L.EACH ACCIDENT $ 100,00 B ANY PROPRIETOR/PARTNEREXECUTIVE ❑ NIA 63653 OFFICERAMEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 100r00 (Mandatory in NH) If yyes,describe under E.L.DISEASE-POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Carpentry. THD At Home Services, Inc. and The Home Depot are included as Additional Insureds as respects the General Liability policy as per written contract/agreement in effect. Completed Operations is included in the dditional Insured endorsement. CERTIFICATE HOLDER CANCELLATION THDATHO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN THD At Home Services,Inc. ACCORDANCE WITH THE POLICY PROVISIONS. DBA The Home Depot At Home Services AUTHORIZED REPRESENTATIVE 3200 Cobb Galleria ParkwayS200 Atlanta,GA 30339 ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD G- License or registration valid for lnu►viuu, u���•••J o rrvri `�"`" ' u a io n a►rs osiness eg before the expiration date. If found returin to: Office o�o�mer irs and Business Reputation HOME IMPROVEMENT CONTRACTOR Type Office of Consumer Affa Registration 7152612 10 Park Plaza-Suite 5170 Expiration: g/14/2012 DBA Boston;MA 02116 B . CONSTRUCT,I l- BRIAN LAROCHE 17 COLLEEN DR j Not valid without signature SEEKONK, MA 02774 Undersecretary i M F Ul �,.Iassa.chusatts - Departme-ni. -public Sa4et; egulations and Standards Board of BuilMing R, •a Construction Su pe iso'y 4pe clafa �,s � ...'�r„Pkj'. t.•,�-1 Lea= ; CSSL 100478 BRIAN K LAR-OCHE sd 17 COLLEEM-.Ib SEEKONK NSA 0277I f - 'Omrnissio9ler 02/08/2014 r HOME BOIROVEMENr CONTRACT _ PLEASE READ THIS Sold,Furnished and Installed by_ Branch Name: Boston Date: t� L C J THiD At-liome Services;Inc. d/b/a The Home Depot At-Houle Services 908 Boston Turnpike.Unit 1,Shrewsbury,MA 01545 Toll Fine(NO)657-5182;-.Fax.(S08).84570017 Branch Number:31 Federal ED#75-2698460.ME lac#C.024'49-,,RI Cont.110 t 0427., CT Uc#HIC.OS S22.2.,[MBA TT'lurw T rovem�e it Cauractor Reg_#'11226893,' Installation Address: _�1�„ ne-J dap q City State Zip Pure�aser(s) Work Phone: Home Phone:- Cen Phone: [ Home Address: •(If.different from installation Address) City State zip. E-mail Address(to receive project communications and Borne Depot updates); ❑1 DO NOT wish to receive any marketing emails from The Home Depot Project Informatioin::Undersigned("Custon>eer'),the-owners of the:property located at the above installation address,agrees to buy, and THD At-Homes Services,Inc.(`"Phe dome Depot-)agrees to furnish;deliver and arrange for the instaliaticm("installation")of aU materials,described:on the.below and on the referenced Spec._Sheet(sl~all of which are incorporated-into tbis•Cootract.hy:.this reffe(enoe,along with any applicable State Supplement and Payment Summary attached hereto and any Change Orders(collectively; ^Contract");. lab#:'pine vd Rd_ ) add Spec Sheet(s)# Prolect Amount (roofing Siding Windows 'insulation ❑Gutters{Cgvers 01mtry 15oors ❑ ' su+ Roofin idina U Windows U lnsulation ' ❑Gutters/Covers ❑Entry Docas n � e£t R6ofrng USiding Windows U lasvtatiem 'f ❑Gutters I Covers❑Entry Doors❑ Roofing LjSiding U Windows insulation ❑Gutters{Covers.monY Doors [] MGn;mum25°1.negxrdt.�ContractAmooatdvenppooe a£tas act Total Contract Amount li'laioa�¢'P C�/. urchagersmaynotdgxo tmoreSean one nxt�dirdortheContractA Customer agrees that,iiumediaWy.upon completion of the work.for each Product,Customer will execute a•Completion Certificate (arm for each Product as defined by an individual Spec Sheet)and pay any balance due. As applicable;'each Customer.under this Cootiact agrees to be jointly and severally obligated and liable hereunder. 'Me'Ilome Depot re$erves the right to issue a Change Order or teminate this Contract or any individual Product(s)included.herein,at its discretion,if The Home Depot or its authorized service provider determines that it cannot perform its obligations clue to u structural problem with the home,environmental hazards such as mold,asbestos or lead paint,other safety concerns,pricing c7urs or because work required to complete the job was not includedin Jhc Contract. Pavment Summary: The Payment Summary'# La included as part of this Contract, sets forth-thc total Contract amount and payment%required forlhe deposits and final payments by Product(as applicable)_ NOTI(X TO CUSTOMER You are entitled to a completely flUed-in copy of the Contract at the time yaei sign Do not sign a Corripletiou Certificate(note-.. there is one Completion Certificate for each listed Product as defined by individual Spec Sheets)before work on that Product is complete. In the event of termination of this Contract,Customer agrees to pay The home Depot the costs of materials,labor,expenses and services provided by The Home Depot or Authorized Service Provider through the date of termination,plus any other amounts set forth in this Agreement or allowed tinder applicable law. THE HOME DEPOT MAY WITHHOLD AMOUNTS OWED TO THE .HOME DEPOT FROM THE DEPOSIT PAYMENT OR OTHER PAYMEMS MADE, WITHOUT LIMITING THE HOME DEPOT'S OTHER REMEDIES FOR RECOVERY OF SUCK AMOUNTS. ACeentance and Authorization: Customer agrees and understands that this Agreement is the entire agrcxmcat between Customer. and The Home Depot with regard to the Products and.Installation services and supersedes all prior discussions and agreements,either oral or written,Mating to said Products and Installation.This Agreement cannot be assigned or amended except by a writing signed by Customer and The dome Depot.Customer acknowledges and agrees that Customer has read,understands,voluntimly accepts the terms of and has received a copy of this Agreement. A d by. S ✓ -r X X - — Cast s Signal V / Sales Con tant's Si re }. Dam Telephone No.---- t—�`-T Cu. er's Signat Date Sales Consultant T:tcense No. CANCELLATI N- CUSTOMER MAX CANCEL THIS tse applicable) AGREEMENT WITHOUT PENALTY OR OBLIGATION BY DELIVERING WRITTEN NOTICE TO THE HOME DEPOT.BY MWNIGHT ON THE TIMM BUSINESS DAY AFTER SIGNING THIS AGREEMENT. THE ; STATE ' SUPPLEMENT ATTACHED HERJUI'O CONTAINS A FORM TO USE IF ONE IS SPECWICALLY PRESCRIBED BY LAW IN CUSTOMER'S SPAT& NO'TICLe:ADDM0 NAL't'LTRMS AND CONDITIONS ARE STAi%D H ON THE REVEM SIDEAND ARE PART OF THIS CONTRACT 03.30-12 c-Sc White-Branch File Yellow-Customer , l:d WdTtl:T 800Z 8ti 'aa(i ILZZZ9£80S: 'ON XHJ pF6wt[:_W021j' Town ofBarnstoble -permit# Regulatory L Sp1v7tGS r 16 FPS . IaLAF q",I�LE.i:IE .. t YQ 1 Gei!er; L'`irect3r Buildina Division ?c,m Ferry, CB0, B:.ritding>✓`orn;nissiof;er %10 1iai _: �r =Iyann s, 02601, m.bA Dst P b I e.an,a.us Office: :t8=862 F?x: jC':8-i4J- 230 EXPRESS PERMIT APPLICATION HSIDEN'T.IAL OI�'1.Y ivW YnL, !s'l,;:G.'t/�iutfi-.�ies.SIm;?T•�/ Pp ,acre �s;Cae ]Tia:' Yar irOifC / � --- �i.i.)!t7t _,. iee Jf S33.00 Fe r work un d,ar S6000.00 Ow;tr s airte a sss _ —pJl'� � �h �✓Yl Coniracror's 'Nan-JL 7J I�t1 �m'� �'e�'2'� t'S �A/i. �l Ir D l,N IV Tel � JTIC ITnPr0VCrr';_j COi:.rcCi r�.: = l (It iCaD:e' � 3J G�J 1�-9 _9 C:,),ri =u=ti^n S�tp rvisoi- PERMIT -- _ '.r orrCn'lan S CompeiisaE1C7 irSUWCJ 'Check ur,e: JIJN 20 2012 a.,. 11:�i.ii r'(tiGcLVri GI I hw i��or r,, Compersa­is it ra ,_c TOWN OF BARNS-TABLE �w; r:ce. CO3 spa.�y:`aa, -f JAVS opy of Insurance Compliance Certifl,Ente rrz.st accornp.an f each permit. 'tQLICsL'C'ted'. J ..'-roof/,urricane nailed) lstr 1ppin7 oi0 shingle) All constructi6 1 Cetbns will be taktin i0 L,7 -r-a ihUl'r';C1II T'r<3i1Cd) fn0t St ppf:ig. .voing Ove x'si ng lavers of roJf). !Ze-StCe r= OF Lt7vrs inn-axinn u'P: .135) t wit ntlu^ 'S - i :'s;. = tWwli v,'.Di;f:T:t�eli iiot�lS:IC,S, t. `izslaf ml. �s7Ti�CC1"r.ii Q:!,tic. To:ery L.Y S Si1gi—I e-ty D} ner I e.terof Pernitssl�in. Cop; of the.'{0F!,8 TJ-n i'LY'v,:1C'l7t Cr]7irlCtor$ T�?Ce!ISE :'k Construction SuperYtsors License reo aired. "ATUT - �' The Commonwealth of MassachuseVIs Department of Industrial Accidents Office of Investigations . _ 600 Washington Street Boston, MA 02111 , www.muss gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers �1 licant Informlation Please Print L1gft Name (Business/Organization/Individual): 0 {'1'Z Address: 01 5�7 sxz 5 eerrvE7 City/State/Zip: ttfil - 3° �' Phone#: Are you an employer? Check the kppropriateib : Type of project(required): 1. I am 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 listed on the attached sheet. 7. ❑Remodeling 2.❑ I am a sole proprietor or partner- These sub-contractors have Demolition ship and have no employees 8. ❑ working for me in any capacity. employees and have workers' 9 ❑Building addition .[No workers' comp. insurance co $ 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 12.0 Roof repairs insurance required.]t c. 152, §1(4),and we have no q ] 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 Homedwners who submit this affidavit indicating they are doing all work and then hire outside contractors must submiaa new affidavit indicating such. tContractars that check this box roust 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 podicy and job site information. •�',,t Insurance Company Name: P.tt) -- = Ca • Policy#or Self-ins.Lic.#: vJc o t q 13 6 5 Expiration Date: Job Site Address: City/Stateizip: 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 under the pains and penaltdes of perjury that the information provided above is true and correct Si afar Date: L Phonet O j,jYcial use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Phone#: Contact Person: �, R Office of COUSUmrr Affairs & Business Re.9111 ion 4I0ME IMPROVEMENT CQNTRACTUR Registration 12fi893 Type ' Supp*,meat 4he Home Depot At..NDme SefYtCes r_ DARREN DEMERS 2690 CUMBERLAND pARKWAY A GA 30339. UndersecretirY Use License or registration valid for iudividul u� �oalr _ before the expiration date. If found latian Office of Consumer Affairs and Business Regu 10 Park Plaza-Suite 5170 ;arts Boston,MA o311.6 Not valid without signature and 3 �s�tn+ ss IZ.� l�ttaun U Park 1'l<�i•..t Srrllte 5170 13o.'stoli, jar'. assacl SettS Ur. ,.1t Contractor 1�.e�i�trat>u>i Regi Aration'. 152.7 1 Type. C)BA 1r# �?Q•:193 IME- pOVEMENT l'A1-;�",f�INQil111CZ 1 )f �SO I I ;;)i'J AVE tl¢tsi�.i+ ;icidrssS.And retura, a,9rt1. 'Ma`r1< r% s.ntl for c2ra�me�c. :tclttress Rznewsal },tnptoymsnt Lost Cf"J L.icsrtsc Or reotrrlios, valit) for individul use only betort the cxPiraettnti date. 11 Cnund return tta: Oi:icel6tt-"io-6111C :SC(aul� Type:i t�P�iff_ )MNriC?1i:t�11 N i (;ON f2ACi UIZ 0frIce of(,Olt, tnar.r Affairs t+t►�l ►1 business Regulation f2t.�{gtratiUr� T°laan •Suita 5I i0 - J,.„ i3natan, .(diF_C', Yy 1 :u 1 i C r•. .,,6. _ ._�_ Not to Id without-if;nnturc �I:r•.;►rhu,�tt� Ucirurtniriit of Pultlk Salvt! Board ��I' Dkiiltling, Regulations Mill �tetttd;trtl, o (construction Supervisor Specialty License License-. CS Sl. 101205 Restricted to: WS GRZEGORZ pARAFINOWICZ 152 SUTTON AVENUE OXFORD, MA 01540 F.xp�ratlon�,7130/2012 _._.... __..._ — T r4l; 101205 . r gnt:t•ax GL-2 9/3`0/2612 5:59: 23 `A41-1 PA(;E ?..IbO'L Fax fSrvE r ACC3RD. CERT[FICATE OF LIABILITY INSURANCE Qsr�i iu;i THIS CER11FICATE iS ISSUED AS A OATTER OF WFORKIATION ONLY AND CONFEF;S NO RIGHTS UPON THE GkRTIFICATF HOLDER, 1H1S CERTIFICATE DOES NOT AFFIRMATIVELYOIt NEGATIVkY ALtEND,EXTEND OR ALTER-HE COVERAGE AFFORDED RY'T1TE POLICIES BELOW. CCRTiFiCA7E OF.}hSURANC£DOES NOT CONSTITUTE A CONTRACT HE'TWFEN,THE issUING INSLIRFR{St,AUTHORIZED RE PRFSE TTA'T}VE OR PRODUCER,AND THE CERTIFIC ATE HOE.DrR.. IMPORTANT,:it the cwtiftcaA'o holder is an ADDIIIDNAL INSURED,.the P011cY(ies)ntust be endorsed, It SUBROGATION IS WAIVED,..subject to ftz teens and catxf'rtions 61-the Policy,certain policies may require and end0i'semerk, A Stdtement On.this certificMe does not r.tanTer rights to the cartihcate iwlder in.liau.of such endorreinehtfs; - - _ PRODUCER r ornaeT NAME: PHONF- FAX INS AC EN`(Y p' ,No,Ext}: FAX (AtC,No,: I s 4t'ES';'MIN fi7� L-asA€L ADDRESS: PRODUCER cusrOmERAD r; iNSURER(S),AFFORDIN.I_,COVERAGE° NAIC.a INSURLD INSt1RLR A: IJ AR`TF€RD GKf Ul— $• NuUR!'R[a: PA 2ARINDWICZ OREGDBA G'+lT GS TIM,J I INSURERC: [AIPC€.(WE'llvit'N"r INSURER D; 2 ?$X`mEY°CITi,t1}N7LT IN5URTR E. €.AE^ORD M 0154 « NSURF:"RF: COVERACES CERTIFICATE NILRA tEW REVISION NUArF1ER; 7HtS tc GCE ;'try'rNAT iHE=OLCIE3 0G N":I44M, E.:9TE,:SELOVI HAVE SEEN ISSUE 1'TC TK IN,URED NAMED A86V E FCa'tiE P©UCY PEMOG IN=-AT€�,. > 'htYT4Y?H5Tdi�lS"NG rsNY tiFCu1R£MEhtT TERwI CR.CONGiTI0N 4F'AkY COS:i,A.'t)R Cr HER GOCUMENi WITII.RESPEC'TTCwHICH TN IS CERTI E't•<AT F,'4gAV FEtSCL<EG C&}AAY PERTAIN.W �NSdIPA NGF AFfOd0E3"t3`f THE PO%iF,IES GES'CRIRFc63fERC'IRI.M�u13JECT�T'CA..LT};ETE�NE,EXCCU99Oti6 dtiO CONOiTIk3N9 OF 0UC!?PC,ACi� . P;frTSSHDWkv:NarN�t.E:EGEa.REAs3t:ED.BYAAtuCLAI#5, NSA AGCLyUER POLICY EFF RATE POL'CY EXF DATE 'vtlECF NSURAINCE POLL^Y Nti.!J6L:Z (JV%A;-WY'J+i ciN.ROavfY'i) LIMITS GENERA.L LIADILITY. EACH OCCURRENCE Cf3.FA gECtC3iLG'a PJ«R-'<t,;:IAE3ii.i7`i' . rAkA. GE TO RE' C.� CLAIMS MACE OCCUR, p,EO EXF(Ai iy Rarrr.(3er"ti) $ PERSOtd-kL 94 Ah IiNJURY S C-fh{'t,ACaG;R EGA TF,LiE"BTAPPLl�,:iPER;. GENE RALAGOWECATF. tC . a T'Cucy PROJECT LC t ERODUCTS...Gq,4Pigi;1GO S AUTOMOBILE UAG3tLITY Com8I'iE0 SING.I'E� S AW AUTO ' Lm!T(! :at0civnt) A",L,C;WNEU AUTOS BdDI:Y INJURY $ SCHEDULE.AUTOS Met;misvny. HIRED AUTOS BFat7lLY tv-..t.1RY . (Pet uicichafiv, :Orr GSvwtlEu:".' :T 5 PRI)PERT`1 D41.1AGE S UG'I kEL(A.LAS OCCUR EACH URRE(h.E. S E?t.G' :s.LiA9 CC:i1; -I+A%€tE ACCREdATE "s DEDUCTISLE 0' t 'ur�ti AtvrcVry.II'nlvS r:tyE,R `., 'rriJRKEP•sCQRtPf;`.ti`SATIONAr6t1. .. UIPLOYER'S'LIADILITY YIN 1;8-5E3o'.6iC It IC'C12alI1 T€y1G1241412 E.L,.LA!:H:ACCIDEI T $ iCC1. Gv ANY y E:t.,UST A:;(:: CA E MP LOIYEE: 5 100.000 t;YrfiD:RPaLr'•4C+.pa:ix +. DE.tt,Ptlt+TiLA'C'F i PEF'±.+t?1--i a nv - DESCRIPTION OF OPERA'TiONS10CATIONS VEHICLES..,RES1RFCTICINS S P ECIA L ITEMS '('kTa?.It LAC I'a ANY PRIOR ry;6E"t'1rCA P I&SUEM-0171CF C:MT1 .-VrL IlOLDL'n.,FFE_=t:`!'(.NE;WORKERS COMP COVIi.R'AUP 't(F(NSVAIT)SLi,AIVCTiEtK.RSC r'1.-Icy AND I'ISITEM;TL4-_y 141"kSTATE E:hI?If.d;�::Y*,AUTHORIZES 1'11v PAY.VIEKT Of'84�ia KJK.i.:l.�it!"IS tEA.DCHaT'r.^,'! SURF:'S Li1S„(U.?f.5[;-SGATES0riEF..WN ;A Nt)r11:.f.C, (Zx4`J'ta>p,I.SC?(1";3d'fC,':r 'i'(.t.U,I S W;IRbi_''fzl1'S.t.S.AT v>.:I'PHR I'Es':N K>;IF`a _Ld I;TFIa,..a.ti:kJl tL'oE Ev EFL>E:.LSFFS'Vt.r.StJF IE'.Mii ';EE:SPt?t.h7'IX) NOT AN Y S4W%11;rfh ^:ff+`.>t:t CERTIFICATE HOLDER CANCELLATION ' HD SEI ''IC'ES:I N.C. SHOULD ANY 0f THE ABOVE DESCRIBED POLICIES.HE CANCEL LE,D BEFORE TFif EXPIRATION DATE THEREOF,NOTICE:NIt.,t.lm:I:EI_IVERED t1v ACCOROANG E. 26910 C C''NTIii:Cil.stiPr O FAY WY.ST, IT-3U(? v11 TN THE POLICY PROVISIONS. AUTHORIZE(1 REPIRCS(KTATIVC All 1WA.[•.� ,<3s„: Ram t*v Ave e ACORt}25(201 09109), 19IM2009 ACOR©COOP€RNTION. All rights rest rV & HOME IMPROVEIVlr CONTRACT PLEASE READ THIS ✓� Sold,Furnished and Installed by: Branch Name: Boston Date,. `3 t Z G — THD At-Home Services,Inc, d/b/a The Home Depot At-Hoare Services' 908 Boston Turnpike.Unit 1,Shrewsbury,MA 0154.5 Toll Free(800)657-5182,.Nix.(508).845017 Branch Number:31 Federal ID##75-2698460;Ml;Lic#C 02439;RI Cont..Lic#1027 CT Dc#IRC.05 S22;MA itiune irn ppn�vement Contractor Regg.#12689.3 Installation Address: G QatO �— City State Zip Purdjaser(s): Work Phone: Hem PtKme: Cell Phase Home Address: (If.different.from Installation Address) City State Tap E-mail Address(to receive project communications and Horne Deport updates): _ El T DO NOT wish to t>ceive any marketing emails from The Home Depot Project Information::Undersigned(-tustomer"),the-owners of the property located at the ahove installation address,agrees to buy, and THD At-Home Services,Inc.('The Home Dep9C)agrees to furnish;deliver and arrange for the installation("Inshallatiun")of. all materials.described:on the below and on the referenced Spec..Sheet(s),all of which are incorporated into:this•Contract.by-.this refe>egce,along with any applicable State Supplement and Payment.Summary axtached hereto and any Change Orders(cohectaveily; Job#: (yrdcrnw acres) odncY� Svec Sheet(s)#: Project Amount Roofing Siding WiyxkiwS Luulatiott I - ❑Gutters 7 vers De-try boors 0 Z t/ R.cwfin idinp LJ Windows. I Insulation❑ / .. Gutters/Carvers 0Eatry Docts 0. (ter ✓ �' °eel S 1Roofjng LjSiding Windows EJ insulation `J ❑Gu&rs/Covers©Entry i)oots❑ $ Roofing OSiding U Windows Insulation $ []Gutters/Covers.QEntry Doors 0 NUrii tim25%,.DepmdtorConh'actAmountduenpouexBmdiaaotdis Total Contract Amount $ � �j MaW Pumbasets may not deptrbit mare thaw ontthird of the CwtradAmount. lX Customer agrees that,immediately upon completion of the work.fur each Product,Customer will execute a•Ctinion npiet C.. ficat'c :.. (one for each.Product as defined by.an individual Spec Sheet)and pay any halamc c due. As applicable;each Cuustgmca.undo'this Contract agrees to be jointly and severally obligated and liable hereunder. The Home Depot re:;erves the right to issue a Change Order or terminate this Contract or any individual Products)included herein,at its discretion;if The Home Depot or its authorized service provider determines that it cannot perform its obligations due to a structural problem with the home,environmental hazards such as mold,asbestos or lead paint,other safety concerns,pricing errors or because work squired to complete the job was not included.injhc Contract. Ppgment Summary: The Payment Summary'# 40 included-as part of this Contract, sets forth'.-the ltital Contract amount and payments required for'the deposits and final payments by Product(as applicable)- NOTItX TO CUSTOMER you are entitled to a completely(Plied-in copy o$the Contract at the time you ern- Do not sign a Cotripletiun'('erlifirstc(acre:. there is one Completion Certi 0cate for each listed Product as defined by individual Spec Sheets)before work nn that Product is complete. In the event of termination of this Contract,Customer agrees to pay The Home Depot the casts or materials,labor,experims and services provided by The Home Depot or Authorized Service Provider through the date of termination,plus any other amounts set forth in this Agreement or allowed under applicable law. THE HOME DEPOT MAY WITHHOLD AMOUNTS OWED TO THE .HOME DEPOT FROM THE DEPOSIT PAYMENT OR OTHER PAYMENTS MADE, WITHOUT LIMITING THE HOME DEPOT'S OTHER REMEDIES FOR RECOVERY OF SUCII AMOUNTS. ACee, nce and Authorization: Customer agrees and understands that this Agreement is the entire agree-meal between Customer. and The Home Depot witty regard to the Products and.tnstallatim services and supersedes all prior discussions and agreements,either oral or written,relating to said Products and Installation.This Agreement cannot be assigned or amended except by it writvig signed by Customer and The Home Depot.Customer acknowledges and agrees that Customer has read,understands,voluntarily accepts die terms of and has received a copy of this Agreement. A by Suomi bye �} fj.. Cos s Sigriat Sales Con tant's Si re } Date X aIn / Telephone No. i�"= Cu. er's Signa M Date Sales Consultant License No. CANCELLATI t CUSTOER MAY CANCEL THIS (ssapplt(eble) AGREEMENT WITHOUT PENALTY OR OBLIGATION BY DELIVERING WRITTEN NOTICE TO THE HOME DEPOT-BY MIDNIGHT ON THE THIRD BUSINESS DAY AFTER SIGNING THIS AGREEMENT. THE STATE ' SUPPLEMENT ATTACHED HERETO CONTAINS A FORM TO USE IF ONE IS SPECIFICALLY PRESCRIBED BY LAW IN CUSTOMER'S STATE. NO'rICH;ADDITIONAL TERMS AND CONDIVONS ARE STATED ON TFrE REVERS$SIDF.AND ARE PART(;1F THIS C.ONT.RA(�' 03•30.12 asc white-BranohFde Ye)low-Custome# Id WdTh:T 800Z 8T 'oaQ T2=9£80S: 'ON Xtid pe&ue(: W021d i ti 4p , oFZHE ram, own of Barnstable *Permit#' 4 12 L� Expires 6 months from issue date k rt BAMSTABLE, : Regulatory Services Fee { MA 9 ,e$ Thomas F.Geiler,Director A'E01AP`A Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 .AYiU1U5 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press ImprintTOWN _ Map/parcel Number n Property Address J 1 ►'� v� e j �Gi to Cea6��olj/p XResidential Value of Work Minimum fee of$25.00 for work under$6000.00 A Owner's Name&Address ro Contractor's Name �q i v�-�f/I a i� �pt�'/'i, i�-ttr t�s LL-'/—Telephone Number S�dg �?-71"/ Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) IA ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name Workman's.Comp.Policy# L-J Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) Re-roof(stripping old shingles) All 66nstruction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑.Re-side rt ' ❑ Replacement Windows: U-Value (maximump.,_•.�,,.,,,�,v_-.�, ✓1. �o2nmeoreiuea ol✓I/�aaaac�iuveCta *Where required: Issuance o this permit does not exempt compliance with oth it{ Bnxrd of)3unlding Regulatfons.and Standardic ' ***Note: caner Property Owner �f HOME INIf R�OVEMiENT CONTRACTOR e I pr menf C actors License is rei t Registr�la:t�iy 44149 � 2006 Signature tiability Corporation RAIN -MAN L.L.C. Q:Forms:expmtrg Revise063004 ` ADAM COX III zc lr- I 2 AMOS RD L. 1i4,ti yy,b l MASHPEE,MA 02649 i Administrator The Commonwealth of Massachusetts } ,►�� - = Department of Industrial Accidents Office of Investigations 600 Washington Street, 7'�4 Floor Boston,Mass. 02111 r Workers'Compensation Insurance Affidavit:Buildin lumbin /Electrical Contractors an name: ( ,.-4e f`S L L C address V"A 60)C1 . 3- / JG,.oC �ri�[G f' �-c:'� city -e e— state: M 4 zim d U7 / ohone# �5 02' 0?7 U work site location(full address): ❑ I am a homeowner performing all work myself. Project Type: ❑New Construction(Remodel ❑ I am a sole proprietor and have no one working in any capacity. ❑Building Addition y, * .!�;.F�.,'. "'fi"° •.c c t'€: "':z. �.,y.;: �y. s y?.., �,` e';4, s.ti..t�.... ,v - 7P+.`+..�'� .SFi`• - : .+iZ' '.'' dL A:,t.viYi. .a d..:.}. �� � .S"_.. ...,?"„K"'..t�- .' �L'�i:..`!,.•.::...'.. �.Y.� I am an employer providing workers' compensation for my employees working on this job. company name, satrh 'NCRa��ri' 3 Crwi.d`S address: r X city: 5. . . ........7 ..... . oc .1�.l......:..... . . .........ohone#: �d g f—.. Z � insurance co. nolicy# w C 6 g o 9 1 ❑ I am a sole proprietor,general contractor,or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: coumny.name: address: city Phone#• ; insurance co. Dolig# Company name: address: city: ohone#• insurance co. o1 Failure to secure coverage as req red der Section 25A of MGL 152 can lead to the imposition of criminal penalties.of aline up to S1,500.00 and/or one years'imprisonment as we s d 1 penalties in the form of s STOP WORK ORDER and a fine of$100.00 a day against me. ]understand theta copy of this statement may,b o rded to the OM of Investigations of the DIA for coverage verification. I do hereby certify and th and n' ry that the information provided above is true and correct Signature Date , { Print name Phone# .50 9— 1 Ll'q07 official use only, do not write in this area to be completed by city or town official' city or town: permit/lic6se# ❑Building Department ❑Licensing Board ❑check if immediate response is required []Selectmen's Office ❑Health Department contact person: phone#; ❑Other (revised Sept.2003) - �• - 'Al. - Information and Instructions Massachusetts General Laws-chapter 152 section 25 requires all employers to pr vide workers' compensation for their employees. As quoted fr the"law",an employee is defined as every perso the service of another under any. contract of hire,express or''' plied,oral or written. An employer is defined as an i ivi dual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint nterprise,and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partne hip,association or other legal entity employing employees. However the owner of a dwelling house having not more th` three apartments and who resid s therein,or the occupant of the dwelling house of another who employs persons to do intenance,construction or re air work on such dwelling house or on the grounds or building appurtenant thereto shall because of such employm nt be deemed to be an employer. MGL chapter 152 section 25 also states `'at every state or loca licensing agency shall withhold the issuance or renewal of a license or permit to opera 'a business or to co struct buildings in the commonwealth for any applicant who has not produced accepta le evidence of co pliance with the insurance coverage required. Additionally,neither the commonwealth no ny of its politi al subdivisions shall enter into any contract for the performance of public work until acceptable e i ence of co pliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit co l tely,by checking the box that applies to your situation. Please supply company name, address and phone numbers a o g th a certificate of insurance as all.affidavits may be submitted to the Department of Industrial Acciden for o innation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be return d.to th c or town that the application for the permit or license is being requested,not the Department of Industrial ccident ould you have any questions regarding the"law"or if you are required to obtain a workers' compensati n policy, e _e call the.Department at the number listed below. City or Towns Please be sure that the affidavit is complete a d printed legibly. e D artment has provided a space at the bottom of the affidavit for you to fill out in the event e Office of Investigatio s h to contact you regarding the applicant. Please be sure to fill in the permit/license number hichwill be used as a re eren a number. The affidavits maybe returned to the Department by mail or FAX unless o r arrangements have been ade. The Office of Investigations would like t thank you in advance for you oope ation 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 600 Washington Street,71h Floor Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617)727-4900 ext. 406 . f Barnstable : ..... _Bar. _ . . Relatory Services er-Director 12 ; # snxxsrne � =Thomas F:. ll , .. MM .B j ii ing'Division ' -To Commissioner Commissioner , - 200 Main Street, $yaaais,.MA 02601 .ta�n.barnstable;ma.us Fax: 508-790-6230 ' offioe: 508-862-403 8 Property Owner Must Complete and Sign This Section , If Using ABuilder (�Ap/L ,as Owner of the subject property �� o aet on my behal hereby authorize: 't hcation for; in all n�atters relative to work authorized by � S Pe a Pp (Add=s of of Own Date tore e � I � _ . . AL r T TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �� ParcelC'N€?r' ` Permit#& [ Health Division ' SALE Date Issued 1L /r '"` f /Conservation Division a a �,:� ��. � � Application Fee Tax Collector Permit Fee Treasurer ®� r .'.S/ SEPTIC SYSTEM MUST BE jy INSTALLILD IN COMPLIANCE Planning Dept. Z WITH TIT Date Definitive Plan Approved by Planning Board ENVIRONMENTAL , 00E AND TOWN REGULATIONS Historic-OKH Preservation/Hyannis ti Project Street Address � :7 l Village0-20-2-2kYlIV16s r Owner _�1Tar�7 � r�o%r� �Gll���i Address i ,Telephone ��� -2 ,Permit Request �eCl` 1 �Q �C ao Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Cla/ Two Family ❑ Multi-Family(#units) Age of Existing Structure � Historic House: ❑Yes 6o On Old King's Highway: ❑Yes U' o Basement Type: &Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half:existing new Number of Bedrooms: existing_ new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: VGas ❑Oil ❑ Electric ❑Other 'Central Air ❑Yes 6d No Fireplaces: Existing _� New Existing wood/coal stove: ❑Yes o .yQetached garage:❑existing ❑new size Pool: ❑'' existing ❑new size Barn:❑existing ❑new size Attached garage: existing ❑new size Shed: 'existing ❑new size Other: `Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No_ If yes,site plan review# Current Use Proposed Use"- BUILDER INFORMATION Name �Y�'7 .e,0�- Os# �e Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING rTHIS PROJECT WILL BE TAKEN TO SIGNATUR DATE b 0 FOR OFFICIAL USE ONLY a PERMIT NO. o DATE ISSUED s ' MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL / PLUMBING: ROUGH— FINAL co N > GAS: ROUq''H� _® FINAL CM- ` FINAL BUILDING �,- 0 OOONNN . ni 7 DATE CLOSED OUT ASSOCIATION PLAN NO .v J R; a- The Commonwealth of Massachusetts Department of Industrial Accidents' -- '`' OA96e efsd�f1� 640'Washington Street v 1 Boston,Mass. -02111. Workers, Com ensation.Insurance Affidavit-General Businesses - i // .sa'a• 'a /:r:i•'t°�;mmtev,. �!;a+M4�fr"T'�••. ,,". '•: ,'._ '� �1dk1 / address; ... - � • • � state: � a hone# .. .. _. . . . .._ work site location full address): (] I am.a sole proprietor and have no one $µsiness'Type: D Retail D Restaurant%Bar/Batiiig'tAablishment working in aDY capacity E]Office❑ Saki Cmcluding.Real Estate,Autos etc.)' ❑I am an em toyer with ern Io ees(full& art time: ❑ er. , %// Oth %%%%%%%% R %///////r/�%/ I am an' �loyer providing workers' compensation for)my employees working on this job. � .r:�, •'..}'.,:.ii Y,7 t.liS:' '•:�: }.iS'h• •!i•�'r .,4j;.' P ._. :i: 1' COIII •j18III •..a.�K. •L,: .t.•;•'s:; +j..t..t:, •�i. i• .. L :l •: �•' _ 5` N. S .!, _ �J •• •f•`+,. '.�. i,s:.,:.5::•::!:i...t��•L.. .ii.:. .•j.i.•• a t,5t+{;}''>ni. ''t.:� i t.; e3dr'essrrV ML '''tl-i +' ,� ':y,�; :� ?f';'Mn Y' }: •t:',,itt�„J.s•r;,. t.• OIfC.•.#' F :.1 r: a"i i DSl1I'aDCe.C�.....x,......S:..iaL .e.•. .. .':,..i ....,,. ... ,. .:.' , ,•..: '.,r.• .:..:.,::• .,:.; ...=, •/� / r / ❑ I am a sole proprietor and have hired the independent contractors listed below who have the following workers' .compensation polices: J .It••� • •''„Y ,l�'�1-'' ':,' '•I:.. ,''. 5�='. •�'. '•1v"�,:'•, '.1•,t nt,,:,,,.{li.•�:'1. .!:':.� .5�`::. •: In an 112am co °�'i J, •.c •47.� _,•.J:.(i 's•" 1^tj h .a•:•.b Y •1., , ... 'riF. .1. ;rs7 r: Z' `r. 'T•i"� address: 4• n• :`'�.ti':r,i: 't a..' �'; .Y' ;5<� •' r: '•a. :�._• :l :7S•'..•!:"e'S•;4G I,.••ri;,'t1 i.q:••:.. ,'' e. .i:s+ ,t' S'.,m•�:'` C,j. :{,�. %, :.fir•':.�"•'':' ''• :i",r r .�`�. J '` `,`,.;: :..�•• ; •,tom •i,'r r. ,�'•�',• - }•.'• `.•Y.f:_',*1�:":.,:A:4 'te- z.l..••.'.`>'•-r•:•L1.ry;i wr'•;•; 5.`!'5... O.1�C ett'•. '.A,.2'i•:•.:,•;t'•.l '°',t` t s• ••+ iusurance,co. V11711171 W. r:r :/ i,.. n' :y,tt 'i:• '{,. a•'J '�'• :S: iai''S' ':'L• ,ti.n.�. }� •a�� :it..'i. P ia. •:+.. �.j '{1'. ,a/!ry 'i'���';..�!�;:'r: :i .f.Y a�•;j •' _ ,Y� ;•r,•i .i:i7',• .t,. ' 8I1• address:. ��� _ • � ' IIoIIe* CI ,;•. ._yi :+�!- •a f!. -�i.{a• ;rt:;•:fit',,: •'{:'. ��, y: •.j.: •u:;'•?.as:'".1.,.•�•:' ,''i i,,': .. :!:?'�: :i:..• .:1,.• •t , }a'. :�. + :.!' •1. .:vs .+: ' �{7 ::'•� .5;.•,v.s.;" �_ „.{• ice',: r{' ';,; ;;:• :9•.+'. .S• y ..j,:- 1' y,.Ll' ;,' • .t" 1r•.'t'•: •:,,:: '>: 4nsur"•ancs " �j FaUure to secMoyer�agersquired under Section 25A of MGL 151 can lead to the imposition of criminal penalties of a fine up to s1,500.00 and/or one years'imprlsoument as well as civU penalties in the foim of a STOP WORK ORDER and a rme orsimoo it day against me..I understand that g copy of this statement maybe forwarded to the 0 e of Investigations of the DIA,for coverage verification. I do hereby erti under th ains nd alde of erjury that the Information provided above is tr a d Co Date !/ 5�igaature . . _ • • _ �J Q Print name �. C Phone# 'oiiicial we only do not write in this area to be completed by city or town official or town: permitllicense# ❑Building Department city ❑Licensing Board ❑-check if immediatE response is required []selectmen's Office Health Department con tact ersoa: phone;r; ❑Other P a (tea9ea Sept 7l103) - r Information and Instructions. ��' comp ; dassachiisetts Geileraj Laws chfapter�152 section 25 requires all employee=stogy in a service of anotherunder any o tract znployees: quot� from the law', an emplayee is.defined as every p )f hire, express or ir�zp Aid; oral or written. " ers , association, corporati or other legal entity, or any two or more of kn employer is defined as an individual,pa hip . he foregoing engaged in a pint enferprise, and including the legal repres fives of a deceased,employer, or the receiver or ers , association or other legal entity, emp oying employees. 'However the owner of a :ustee of an individual,Pam} P. house ha ng'mot'ino}e than three apartments and•whc resides erein, or the.occupant of the dwelling house bf 3welhng �" another who employs•persons tRdo.maintenance, construction or repair work on such dwelling house 6r on the grounds or hereto sh building appurtenant t all not be of such employinent.be eemed to be:an employer. MGL chapter 152 section 25 also*states That every state'or local li nsing agency shall withhold the issuance or renewal of a license or permit to operate Ausiness or to construct buil 'ngs in the.commonwealth for any applicant who has not produced acceptable evidence o compliance with the ins' ance coverage required. Additionally,neither the commonwealth nor.any.of its political�ubdivisions shall enter ' o any contract far the performance of public work until co : e insurance requir ents of this chapter have been presented to the contracting . acceptable evidence of compliance with authority. Applicants Please fill in the workers' compensation affida-A comp tely,by checking the box that applies to your situation.:Please supply company Warne, address and phone numbers al-o- with a certificate of insurance as all affidavits maybe submitted to the Department•of Industrial Accideuts-for con on of insurance coverage. Also'be sure to sign and date the affidavit The affidavit should be returned to the ci or town that the application for the permit or license is being requested, not the Depa• ijneiit of Industrial Accideu hould you have any questions regardin�*ihe" 'lave'or if you ale required to obtain a;workers' compensation policy, lease all the Department at the number'listedbelow. City or Towns . Pleas ebe sure that the affidavit is complete and.printed legibly. Th epa:rt=t has provided a space at the bottom of the fill out in the event the Office of Investigations has o contact you regarding the applicant. Please ' or ou to , affidavit f y_ be sure to fill-in the permit/1rcense number.which will be used as a refer ce number. The.affidavitsM,may.be.returned to• theartment b}�. or FAx.unless othe arrangements have been ma d . . e of Investigations would like to ank you in advance for you cooperation and should you have airy questions, The Office , 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 �e of�res��atiens ' 600 Washington Street Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 7274900 ext:406 • oBarnstable ofTME�, �oTown � • Regulatory.S ervices Thomas F.Geller,Director ' 659, � Building Division Tom Ferry,Building Commissioner' ' • 200 Main Street, Hyannis,MA 02601 , office: 508-862-4038 Fax: 508-790-6230 Pam*to. . A"MAVIT HOM nQP OYEMENT CONTRACTOR LAW SUPPLEMENT TO PERMCx AXPLICATION mm c,142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, • -improvement,rernoval,demolition,or construction of an additionto any pie-existing ovMer-occupied building containing at least one but notmore 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: � Estimated Cost Address of Work, 3 1 s Owner's Name; Date ofApplication; ' ' I hereby certify that: Registration in not required for the following reason(s); []Work excluded bylaw ' [31ab Under S 1,000 ' []Building not owner-occupied • []Owner pulling own permit Notice is hereby given that; OWNERS PULLING THEIR OWN PERMIT 011 DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOM3 ZUROYEMENT WORK 3)0 NOT 31WE ACCESS TO TEE ARBITRATION PRO GRAM OR GUARANTY FUND UNDER MGL c,142A, SIGNBDUNDERPEXALTMS OFFERTORY *I hereby apply for apermit as the agent of the owr}er: Date Contractor Name ReQistrationNo. • OR Town, of Barnstable y�tHE fpk,�C egulatory SPrd ces Thomas F,Geller,Director 9� s639, k, $adding DIA810n pT�o � TomPerry, Building Commissioner 2,00 Main Street, Hyatnis,MA 02601 . . C •- - .-. �rw,tawn.barnstable.ma.us .-- Fa�: 508-790-6230 pffice: 50s462..4038 r Property OW e>`Must , .Complete and Sign This Section _.. If Using A Builder owner of the subject property _ ' to act on mybehalf, _.. hereby authorize e to work authorized by this bung Permit aPPUcation for, _- matters relative 'l�C✓ :_-:..-__ 6K s {Address of o ) Date. _ - --signature of er - r�nt Name • of THE Tp� Town of Barnstable Regulatory Services • snsxsrasM • Thomas F.Geiler,Director Mass. �b i639• .•� Building Division ACE p�.l A 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 EXEMPTION Please Print DATE: JOB LOCATION: 6 //I/ I?yz mj er s��///Zl _/� village "HOMEOWNEIV.L��K/ /6'/l/ !�V U�' D -2;F/ �J U name ome phone# work phone# CURRENT MAILING ADDRESS: 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 mininmim inspection proced and requirements and that he/she will comply with said procedures and r uir ents. ature of Horn;owner 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. 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:forms:homeexempt "201-� Inspecctotl PINIFutter location -ProPe-rt-y: Ce vi bery i I(e 3 . to t- 5 L0t"0 2 S tv rLj M OlweI1 * ro 03 3I • _ 1, flo- o ,, 035 n Wt7 0 porc�i n' ,. : y0 ref 759QZ23& Mood jpanee . 50001 000 5C 7`pod zone; C + 1�of ?�♦ PAUL c�G heresy certify qftat tw tnor inspection wars.PMpatv44o-r o T• �-^ u QR0VER y W0 17 n &•W&)V),?.C. of r),o( 'r's C1 tc Z -r)5 Rd.etzt I Cred it IM i oh 3011 44WUL49 shown, hereon,does v of q&U itv cL special qmmA, #wd �o hazard• aria w0K am eifective d of, 0-19-05 and. lix locahbn, off' suRr�{o the dwelling does confonn *I local ,eoni q 6y-laws in,elfi�-rl At'*tune OFcottstruction Wift xspectto horisontcd dt'me siDt� Scale: 1" setback req, or is �otn vtolaft nm Ct1�t'C�YYLet'L�'' Date: 4 - 2 I -�_ dGtl.urL under �I�lass: General s Ch '4o •Secttort' `7. File No. PLEASE NOTE: The structures as,shown on ihis plot plan are approximate only. An actual survey is necessary for a precise determination of the building location and enc oachments, if any exist. either way across property lines. This plan must not be - used for recording purposes or for use in p eparing deed descriptions -and must not be used for variance or building plan purposes. This plan must not be used to locate property lines. Verification of building locations, property line dimensions, fences or lot configuration can only be accomplished Qy an accurate instrument survey which may reflect different information than what is shown hereon. Please .note that this is "N T A BOUNDARY SURVEY" and is "FOR MORTGAGE PURPOSES ONLY". COLONIAL LAND SURVEYING COMPANY, INC. 269 Hanover Street Hanove Mass. 02339 Phone: 781-826-7186 Fax: 781-8264823 • p ALL NOUSEPLATES ARE TO BE SUPPDRTEU BY 4'.6'OR ENV TRIPLE LAMINATED POSTS AT TiIC HOUSE OR BY A DOUBLE .. 2'vtp'CANTELEYER SYSTEM OFfSE.TM HOUSE,DEPENDING • UPON FIELD CONDITIONS.!SEE OT_TAit Q71 y v 2'.L0-HOUSE PLATE 3/B.4'WASHER HOT DIPPED GALVANIZED ' %ISTNO TOP PLANE l0.G L WASHER P 16`oc RAILING TO BE CONNECTED i0 V2•EXISTING SIffETING---- 2'.4'LEDGER GIRDER BEAM HOUSE USING A 3/0'x4-LAO fzy=ttejl _ 3/0'EXSTNG SIpMS H6�15E BANG ON Mill 3/r.4`DOUBLE HCT DIPPED M4T�W Y.4• i CAULK OR YNM FLASHING GALVAIM LAG T I OM 70P Of Hd%-PLATE 3/r DOUBLE HOT WPED I BIG AROUND GALYANRED WASHERS EXISTING SILL PLATE { { I COMPLETE DECK 3/B`s6'DOUSUE HDt OBroFO { GALVANIZES LAG dG1IE SIpC BAND 3/Bx6•DOUBLE DIPPED M7 3/B•.4'DOUBLE HOT DIPPED HOUSE BAND IS NOT TO SUPPORT GALVANI ED LAG 4 WASHER @k 16-1 I GALVANIZED LAG MY OTHER LOAD OTHER TMAN ITS' Mi•A 1'x4'LEDGER OWN EXIST THE LAG PENETRATIOK THE LAG SPACING B ONE 4'LAG AND (, INiO EXISTDSi HOUSE SAID WD,L BE FINE 6"LAG MI EACH END Of THE r DETAILS A '.AL OF O DOLTS AND A MAXIItiIM OME PLATE AM THEN ONE 4•LAG 2'sf0'HDL'SE PLATE, OF P.All LAN BOLTS TD BE 'IDURRIATWERETE---"'-" INSTALLED WAGNERIT AMIXTOR AND ONE d'lAG EVERY M`oc AL ppµy FCUWA:gNIMPACT NCH WITHAMN TORQUE I {OUSEPLATE OF 110FT-LBS I I B I A B ATTACHMENT s ° t{ffi{'Tb"D MODULE { ( lJ DETAILS 1 04'DCCNNG MMLE RECESSED I (IBIAOERSTRLCTURE— 1 TRUSS PLAT-S SPACED— "PONIED BY WOOD DN WOW - - • {' APPROX.EVERY B'ac COroECTHON WITH UNDER GEAM n LfMAAS AM FASTENED WITH !N Y NAILS EVERY I— ZG-p4 ONZp[�p[2G GAp��p(p�ETT�YPICSA�L FPANIN'u MEMBER ' W1TCS ON BCT1i 50E5 OF NOTCH -ALS \ Z06AUGE GALVAMiG � ��ii/D• TENED vlixw TdH s ' p.p - I &J CANTELEYER AND _ Y.i'LEOGER ON BDTMN EIFDS MUSE°L'`TE i POST DETAILS { —LEDGER { i TW03'GALVANIZED CREW SHAH%NAA�ILSS 2'.4 LEDGER p... { { {t, g K DETAILS TCHED BEAMS FORM A W000 ON WOOD CONNECTION WITH' 3'.4'LEDGERS OF CONNECTING BEANS.IN 3•GALVANIZED SCREW 6H.AN%NAA S TO GE TOE-NA1110INTO EACH MVSEPLATE CR CORBYECTNG BEAM. SI0[TAL NOTE--SEE BEFALL®FOR: - FRONT BARD r.m•OlOS510151 WITH I';N'LEOCEP STAIRWAY (1)POST AND TOOTER LAYOUT Y•4•LEDGER I.m•raDER SFAH4 r.1I' eAW I L.+E D,ETAILS 121 FRAMING AND UNDERSTRU(TURE LAYOUT wrtH r.a•IED(eR wrTx r.. USES \ J !31 RAILING LAYOUT ' Owc MT SRAM W'-0.7 COIRARS TEB ���..__/// FRAMOlG/UNOERSTRUCTURE CONNECTION DETAIL r.v PF.Tam °Pf°E6 p1E (4)STAIR LAYOUT ! a,LIVE Cw-npSi•TpLEO(£11 45- OpN.OiEMA5��5pW�LL�TXfiMARS �AA((((.....TTEEuC�iGEpp♦RE�� 1pZ(E1oNG LATERALLYBET4£ti1 POBt 6 I . GtROkA BEAN A7ttH RiSFOUALLED T`x!0`GND`R BEAM SIRE' NA1ER 00 ���]�t6 " • . 0 BA%O.OR CNOSS JOfvT T�� y sa• LLO(dR BOARD j WITX A 1 TON PRE55. • � • yr.t•DEaIHG - i+ DESIGNER DECK' NOTE FRAMING LUMBER TO BE SOUTHERN PINE N0.1 EXCEPT FOR 2"X10"G RDER BEAMS s 16•nAXRwn LEMrx � �.Zu1 DNE(iOY RYP.1 S .�� lac iJ��)- ', t�i �IZ�T 2 THAT FREE SPAN W OR MORE.THESE MEMBERS rxi•LE •rMD3` vArpzEO SCREW MADE.DEIXS.ENCLO a,AND GAZEBDS ARE NOT NTENDEDTO—T HOT TUBS AM � `� -. ARE TO BE SOUTHERN PINE SELECT STRUCTURAL0 BE sNANIIMYA�se E-E SwiM!ING/BABY WADAD POOLS A SPECIAL SUNWRT PAC%AGE BRFOI&GfORAWITIDIUL WITH =�0STA50OARDS PSI,DECK 0 GRADE SOUTH RTP NE B/4-x4 ��}/„ E SUP-1 BEFORE ARM B i EY iY Ci q PRWIICTS CR AWY.I.1.IRL YY W S y LUMBER IS TREATED WITH ACO NON-ARSENIC p ]gip EtiBLL _._ J/}�CAEE. _EXCEEDS"aLFME tRAD G MM T �N WITH FRAMING �• BASED PRESERVATIVE TO CONFORM TO THE 1 L1®fa®YYELBW a °' REQUIREMENTS OF AWPA C2-92 �C 1. ze NOTE.2040:p SOIL BEARING COMPACITY 1 T"tk (( X-BRACING TO BE USED IN DECKS OVER 14'-V S SEE M'AI(?A%RSDRPBSt r.m•SIOEBBB PLATE MUSE " TREATED LUMBER BELOW GRADE WILL BE [GwrE.[TgxTTC LM TRUCttWE., A.40 OR GREATER RETENTION LEVEL s Y%A'f?KNit RAW (H4/�,3�'pNA yp TOE- fNOKT BAxO K®I tw {_ r '" f CLIVIEtLR EFRI. 3/Y.4.OWBtE HOT S ,AS GALVANIZED Y.6'BALM LIX UG WDH.SHER + } AW fir NAGS Yxa•LEDGER '� : THE MAI PATNM CMRECTNG b'sb' THIPOsiFRMS I e IS TO BE 3 NAILS.- OFEK POST TO OEM Y.'.I-DMBIL HOT AWOODMWOW • NfO T1E ELEIi JA0{ /sa Mau UNOERSINE'CIAE D&?G GALVANIZED CNOE(Ttlb WITH IZF ..v. .: .... w, L�pApMp o FOUR Y GALVANIZED UG WOx MASHER TIT IDIDEASTPU(IB6 ,: Ys6'FA[E JACK ATED HAGS SCREW SMANN MALS AW lA 3'MNLB _ PHOTO OF HOUSE C W0.81LR5 SPACED EVERY W oc CROSTMTR OECI( i {6'I DOUBLE Yx6' ' n CANTELEVER3WA0pT C MTFEEVESpBEAM MtCERBTRIYTURE Mu 0111 UL 980305 - I,. MAILEDYITHiNABS _ •"" AT-HOME ; FULLER EVERY d- TAL OF TO -"�' ! II—TO BE ANCHORED � � :hRf¢t NbOER !.� MAILS PER SLVPORTI INT. �l MN WITH A MINIMUM Of a•OF ,. ;y ,•,B .1 Y.6'NWER JACK POST. REACT M%(IICRElE AT O OB-10-04 THE NIL PATTERN (JIAM 3LOD.a MHORH ST0SE3NAL5 5�x5� ppLE�}� e•.ss•mwsErE mTPGxUE'IE J !'"ail ; '�; _...,. 1635 PHINNEYS LN CENTERVILLE ra INTO FACE JAIX LNW�TfflI POSf6'1 FWTTONi FACTORY c0cli A(TWY %pJ1M PRECAST *I :. NIECASr BB33pop flSl : "`"' :- .S I O N {SPA(iB — UNDER COMMx�K UPPER CONTROLLG �"'""`""""'" '"���" —'"'"""'" F'p'y QUEST � BA INSTABLE MA A02632 ' pFTA p�(pNTELEVER6�5 cwmlTpxsl oETA`OF NpN.tdNTELE[MMBRNI PLEASE CALL US AT, 116•X4•iTRiPtE 2"x6"1 POST CONSTRUCTION �JiPOST�6tNECTTQN-AEHIFdOTEk �KiPOST!fDNFEGTl�75 ANOFOOiER6 X6• POT PLAN-NOT TO SCA E TOLL FREE; 1-C866)-884-5227 VAN BOON 93-52.01 PLEASE SEE ATTACHED DECK DIVISIDN FOR HOME DEPOT NOT TO SEALS E1Sf13SLb.L1YEt.WO - �1 JNOTTO SCALE � 1� E EMC� 1041 CANNERM,CGLBtT WOODBRi➢GE.VA 22191 I PAGEi 1 OF 2 IDCOPYRIGHT 2000 USA DECK INC. ' HORIZMIAL STARTIMGPONI VERTICAL STARTING FORT TIGHT UNDER ODOR 2D'-A•FROM RIGHT CORMER OF HOUSE ` GRASPABLE HAMORAL TO CNt51ST of A r.Y PKXET NOUNIFD BFT1hD.30--38'fcN1 THE STRNfiR 3EBX STAR PAD R TO BE SET LEVEL M THE MAMMAL BRAOSEiS EVERY b'.TOP ARD BOTTDN Of ERNM)ARD HALED Iwo EACH STRNGER - )( ---- --- )( NARRRAR S TO iRROR BAIX Nm RAL RATE. gg 99�� ��II,, pp WRH E NA0.5 • jAl alANVBLT G[OI TAM 5/i•.1'MCNNG Y.1'RAINS CAP IS m& RAAEL'am EA[N PDir WTIM r.l-BARD Y MARS AND XALED Nm ME TOP RAICEG RATE WITH Y.1-TOP X X OHL MAL EYERY HE, RAL PLATE ----- - r.PNKJa•LATr WITH MAN.DWX )( SPACE OF RAL RLAAN . 12'RAII.ING ratr TREAD I ila pALFA SEE OFT AR. 1 STARS RAVE r IPFWS WITHr X X SO, EACR TRGC S FASTFMm I'.'RALNB POST TO THE STPMGEPS WITH 3'HVLS N EACH OLD -THE STAR RALNG POSTS ARE . STEP PAD TO BE MRAPPEO X X. 6fWlE S•IAFDT�B�fi000�JR'T.IEWIITM R-WARY AS \ ME(ESSARY PER fEID CCKNTLNS ' V RAILING 2'.1•TREAD MEATS RATFS WITH 3 RAILS EACH OI X X (SEE DETAIL(a) ?MEADS ARE SUPPWRTEBBT (1 (\ r14-CLEATS WHIRR ARE TO r1IR'STNMGER + - BE ATTACHED TO iME STRNGFAS VITH r NALS AND 1213/r THE STARCASE IS TO NAVE 1E r.V .- .2-vr LAGS PER CLEAT. STR SRMEER ISIXCdPS DXE DN FACM SIDE.EACH ro BE TOE.NAA.m Nro ---- X, X` ST��DP, MATH T MAAAS. N2a THE \t•RALINc RATE,I AWNAT F4LLIIRIATRNR 2`11r sT imm r.10.2r`R�C�AO' (SEE DETAIL�) tNPEM[OD[I rxr RALaG PExrn � A112En XI�O'LAN • SPACED LESS THAN(-APART AMD RARE C VITH(2)2-i/2'MR.PER ISANO LAG BMT (SEE DETAIL STAR PAD® ?- -RALRATE 241`t1EA1 _ (SEE OFTAa P�i ISEE MAIL ) y r14•BA[KER PLAR .6 RSi(3�ANNATEO Cp,1 GRADE 2'�1''II (C•WIOE STAIR. 2 TOTMFRRA�EFRUPOSTWTHY AL$, F'11Y COKNtTE PODTNO "'-� TO GRADE!SEE O ) X X WTO ME RAL PLATES VTH r NALS tFACtORT WE[AST�SPOO "'" NDMiODESTRBWER 3nTH 3'NAL� PSI LNOERCOMTROL:FD CMEMFMS7 6'RAILING `6'RAU NG ''•TWPLE Y 7lidil.STMR�DgR DETAIL A8' - .. (SEE DETAB Qi X X - (SEE BE All 8) LAMELATED IS TAL T \i-f'/7[j(IT T BEAM TRELLI l'RALNG r.V'[RtQE1F A POHNU'M OF 121-r.4'WIND ISEE DETAIL ISEEDETAa©1 rDOrrRSFEMTAL 01 MACES ARE TO RUN DIAGONALLY FROM THE CANTELEVER TO THE FRONT BANE.TXE VND BRACES Q STAIR DETAB.S IW TO V-8'ELEVATION 6 AB'WIDE,WITH EXTENDED PAD _ ARE TO BE NAILED INTO THE BGMM ®NOT TO SCALE 4ffi8/f21�ffi 6mlm ITV EDGE OF EACH OVERLAPPING MEMBER WITH THREE 3'GALVANIZED SCREW SHANK NAILS. . 15, APPROXNATE ELEVATION 33=0• - + AIlING AND STAIR 'E NOT TO SCALE M(NDE9GNEXCEEES bOIb.LIVE LOAD - - 1 THE RAL POST ASSEMBLES AR TD M SPACED ATTra MANNO)I Y.(•RAL CAP ON OF(N PEP1ETEA BAN0. PERIMETER BEATS NARFO WRTH 2 pALS N EACH MOST r.t•PAL[ Y1Y PRESETS RA POST 1'CORNER-5 MOO—RERSIV ILO ER ARO XAL EVERY Ira af0 WOMMOSTRIETOREARD TOP RALDID RATE. 2- -RALPIATE DOLDLE 211'RAL POST . SOPPDRII BYW00D 01 NAAEELLAFF AIRMA FENTEIPkOBETWEEN 06'AV CURE EXAM WITH ORDER BEAM INTIO EACH RAO-POST. 96 EAEH POST R MATED 3/81�r pp�vR��RE�RRppii DPRD LFIXERS AFA FASTFMEp'WIM r.t•RAIL RATE WttMW rMAas lroc GAR.VAlR2FOD1AlW D13-MARSEVEMYTO•W. I•.IO' LAG VETM WISHER fROifT BARD -211,POST)AZ } cMMxcTNG r1E- xALED WITH fKAD MATS EVERT R.PoS1 ro[ACM RALNG P05TD EXTERKW 1.Rp•• 10'a ImIAt Of 6 MATS PFA P051 Y11'MAIL POST 1 - - OWERWBW JAW N . MAILED WRH 24AL5 EVERY ra RD1N OF aXARS PEP PoSi) ;r.Jr MOIBAMO gT0l3E PERB£iFR raR'MIN y1p• - AREMS2RDCmR. - GSpFA REAM ` APPLO, APPHM 1-POST SUPPMT NALGO WITH 2 NALS EYEAT R181('AMO 3lr b' I'-PR3ETS SPA®LESS IMAM v i ::CC 6'a ROTN 6 E MULs PFA DOD%E HOT BIPIRD ('APART ANO NABFD VIIH li12-1/2 "t BARB POST SUPPORT)MID RAL POST. GALYANIIID PLATED LAGS ALVAMZLDMBIGSHAMXEO NALS ' AS ER COM ECTNG 2'.1' TER r.i•R.RATE. All---�-- RIJL FMT TO FRONT DAMS SEE Fw r.IrcoRKMNO� \ rl.-MTA— �P)TRADRDNAL MILINi)DETAILS RALBG LET . [ODNEMVNG ANDKIRJLIRAES TR&LE I]Y®T•.➢P➢ST-� tD o —F]Ef3O—.uvEL610 DORDECTED sMA*K TBAND HiTM� MEEM 5 AEnR)E 3/B•.4•AMD 3/r.b' UEN RSt,Rift3PE�iGTRNS IN 3'SCRW 5MM'N NNIS 26•MF O POST DOUBLE lWI SIPPED OP NAt tlRl1 GALVAxDEO PLAIEo LAGS CORIEAWi R75TALLATDN W/FRAMED OVERVIEW t MATS EVER •a. Wrtx WA51ER ECNMERNG r.t• HOT TO SCALE ®E! m Im Vo RAL POST TO DEX BAND rv-\ k.BEAM TRELLIS FULLER 980305 ` NOT TO SCALE -- AA-- ECK ➢IV S(7N F!'T {�(�ME BEPD PLEASE TALL U Air L�w� AJMIETRS" R91 PAGEI CF 2J ' TOLL _....:..:_._._._.._..____:.__._.._........_..._.._.._....._....—.......—_..�_ ..._._.. ..__.____..._ ....._.._ .—_ _ ------- 000PYRIG4T 2000 USA DECK INC. e o • COMPONENT LEGEND 1. Door 5: . Stair locatio and level 9. Horizontal Staryng'Point(HSP) 1:1. a the hous : 2. Step Pads 6. Any landsc ing obstacles _11> ft. in. 3. Railing style and location. 7. Marking of to utility lines 10: Vertical Starting Point(VSp)s 4. Lay Pattern 8. Deck Acces ones Left: Right: r M z r`- t h h Yn,e - _ x WE F- Checklist Indicate North: ❑Confirmation of material type ❑Location of exterior doors . Approximate Panel Size: ®® L7 Location of concrete footings ' 0 Railing styles ❑Site accessibility Scale: 1 Square=1 Foot ❑Location of step pads and stairways ❑Earth leveling or.grading needed Remember to note any trees,power lines, : ❑Location of underground sprinklers,plumbing,.elec_trical or obstructions.Include dimensions. Electrical access El Referenced VSP is clear of all window,downspouts,other For questions or assistance lease ca I: 1 P r contact your locafHome Depot Store Home Depot U.S.A.Inc.,245 Paces Ferry Road,N.W., B-4 Bridge,Atlanta,Georala 30339 THE INSTALLED DECK DI VISION FOR THE HOME DEPOT USA DECK;INC. 1041 CANNONS COURT WOODBRIDGE, VA 22191 AT-HOME 0 703-492-5220 FAx703-497-1559 E-MAIL: USADECK@USADECK.COM � Q Tor.r. FRFF 1-866--527-169_5 March 29, 2006 To Whom It May Concern: This letter is concerning a deck built on 635 Phinneys Lane in Centerville MA02632. The deck was built per contract with Mr. and Mrs. Fuller. We are having trouble collecting payment from the customer, and are pursuing collection issues. It is our practice to have"proof of final inspection"to - submit to the company handling the collection activity. If you could send a copy of the certificate of occupancy, a letter from the building inspector or a copy of the signed permit to help further our efforts it would be greatly appreciated. If there are fees involved please let t me know Thank you, } Elisha Delorto Office Manager Y US Remodelers 125 Flanders Rd Westborough MA 01581 508-836-3111 Toll free 800-709-4971 Fax 508-836-3690 s h Assessors ma 'and lot number . "a5�....... .fl�..� p Tit ` YS MUST BE L; Ai r CE Sewage -Permit number ........ . ... t.. :T °*T"ET TOWN OF BARNSTA ut, ,f 2WSTODLB,�i " 9 « BUILDING INSPECTOR ��.�YFY!r• r APPLICATION`FOR'PERMIT TO ....... .!f.. �..(... L .!►1. ..... A .PA9.A-.T Cr........................ ,. TYPE OF CONSTRUCTION ...�..�J. I.�, .I......... rAJ..®.... o,.Ry..... R..fi.I .E: 0.W F—k lLL/1!. .. ............................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies rfor a permit according to"the following information: t Location .. .o...t�.4 ... ./...J�.•�. �.�./ `. `..Llj, , FAO..►l.a.:.f'I 1. F �3�!:i .�.. �V s .�.r�.�.�,� . ----9' P..... ./..e�.�........... ..L.L . .�..........................Proposed UseS-1— Zoning District .. .../.......................................................Fire District R..��.!�.4- Name of Owner .�,.�. 1.J�.41�.�...t .. .P �/ (.........Address .�+Tr.�'/� .� . �'.... .a.......... Name of Builder ......trA....N..9..........40. 1 Address .................................................................................... Name of Architect/1//,FRIV.I..+rl.&0.................................:Address 1��Ck.AI�':O..M....H.0.M..�....I Al.e................. Number of Rooms .e..........................................................Foundation ...I...........Po .AK.Q...��11V.�'r:��. ��... Exterior .............................................Roofing A.S.P11.,q.. .� j1..� .�-.g ....................... Floors ....�1.A.�,,.).......�`.�?..... +.�.. ..�..4-:1.4.......................Interior .... .F O-ftl .......LG:jo..�1�,.. y•Wtl.4lo Heating .D.. ..4eJ .'.<T%d .. ��. .o..>d7�. ��: �Plumbing .......:.......................................................................... Fireplace ... ...............................Approximate Cost ... �F 0 0 ® .... r ..... .... ...... Definitive Plan Approved by Planning Board -----------_______-----------19________. Area 41�7� S- ,...........`................. Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH AN 4 TO �a � pi' q �i�,�� ROO R oo m I oo '7G q�j �-7G WED Roo M SF—C oAt P Fi(0 o R I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. IL � . .- Name. 4.tr(�.c,.R.+'1...vs..C'� .. ........... .. Raspante, Luciano No�7202 ... . ................ Permit for .......................tory.......... .....single...fam.i.17..dwelling. ......................... .. .......... . .... . . . ............... .. Location .......Millstone Wa........................ .y & Phinneys Lane Centerville ............................................................................... Owner ..........Luciano...Ras ante......................... . . ...... ....... . ...... Type of Construction ...........f..r.ame..................... ZA . . ........................... ................................................................................ 'Plot .................... Lot ......... 6.................. �;Permit Granted .............Jul-Y..11...........19 74 0z ,Date of Inspection ...71V .........7,,.. -5h Date. Completed ...i 3.6 1r7 19 PERMIT REFUSED ..... 19 ............................................................................... ............................................................................... ............................................................................... ............................................................................... Approved .................................................. 19 ............................................................................... .................. ........................................................... e f FEE TOWN OF BARNSTABLE, MASS. to o� THIS IS TO CERTIFY THAT A PERMIT HEREBY GRANTED TO V O V� V _..................................................................................................................................................__....................... ..........._....._........................................................................_..... __.... O q.� )PROPERTY OWNER) )ADDRESS) 0.0 1.3 TO ..........................................................................................._........................._...._.._......._...... E4 a.8 b IBUILDI (ALTER) (REPAIR) Ocs �R O In>.�' ............................. ................................................................................................................_......._.........._............_ ................................................_.............._...._........ GAW ._.._..__ O R 0.O (TYPE OF BUILDING) (APPROXIMATE SIZE) w o bo4) V LOCATION ....................................................................._................................._..._ ..._....... ...........__.._..._.................................__................................ _.._•______ .'4 (STREET AND NUMBER) / (VILLAGE) 1 w NAME OF BUILDER OR CONTRACTOR ....................... .::.............._......__................_....................._.................................................._................_....._._ �' da APPROXIMATE DST ...._. ...._ ___....._. _ mot I HEREBY AGREE TO CONFORM TO ALL THE RULES AND REGULATIONS OF THE TOWN '� OF BARNSTABLE, REGARDIN/THE BOVE CONSTRUCTION. at o iA c� ,4 ea � cc d h d N 1 NE WRI )CONTRACTOR) Sao Jrio:;3 _._.._..............._._............................._....._._.__...._........................................................................... In BUILDING INSPECTOR { Subject to Approval of Board of Health. A �'r:e,� ai' .�. "P•^���Yg�t"��^�� ,v.`fir' *,/ � /•J9'y1 �`.il�T.$`.i� tic r R h ' a yes - {''F C� � ✓'`_. I * - try v