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HomeMy WebLinkAbout0162 TERN LANE 11v� T��-� 1.�r�. t. ,. _ � iY^ .. .� �. �i _ _ r,: , . Town of Barnstable Building Post;This Card So That it�sVisible From the Street*=A .rouedPlans Must beRetamed on Job andthisCad Must be�Ke"t `' ann+sewea a b ,. E pp. KAM Posted Until Final Inspection Has Been Made Permit f Where a Certificate;of„Occu anc !is Re wired su,ch,Buldm shall Notbe Occu ied until a'Enalnlris ectionhas be"enmade� �'ere., *�,..a., .,�...�....«...�... p .�:' ,zv,,p..ra��..,u� �awl......' 's. g <��dr.�.,�i,. .,.: .3�;;u�a�. .,, �,,,.a.u�.<w3�, �1p4.. .« . ,�, ,s� •��.,_� .?� :a'� Permit NO. B-19-3146 Applicant Name: Henry Cassidy . Approvals Date Issued: 09/25/2019 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 03/25/2020 Foundation: Location: 162 TERN LANE,CENTERVILLE Map/Lot: 212-016 Zoning District: RD-1 Sheathing: Owner on Record: MCPEAKE,-EVELYN A&FRANK 1 TRS Contractor.Name` CASSIDY framing: 1 Address: 162 TERN LANE ContractorLicense CS-100988 2 CENTERVILLE, MA 02632 � Est Protect Cost: $7,000.00 Chimney: Description: Insulation/Weatherization ermit Fee: $85.70 Insulation: Project Review Req: Fee Paid.> $85.70 Date 9/25/2019 Final: Plumbing/Gas Rough Plumbing: �MBuilding Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized bq this permit is commenced within'six months afterissuance. All work authorized by this permit shall conform to the approved application and'theiapproved construction documents for which�this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zonin by,la is and codes. This permit shall be displayed in a location clearly visible from access s road treet or and shall be maintained open for putilir m'spection for the entire duration of the Final Gas: work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by:the B uildmg and Fire Officals&areprovided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work _ = . 1.Foundation or Footing 2.Sheathing Inspection F Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy . Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Perso on ng with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: ice: 4 i - � .. APR 1 1 2014 E."fii laced Job Cost: $ _ Pamit Fee: K I.'f..uis itlbmit.Cccl: YES 1 d' N ®�BAR S Y/i �'_ evic vvecl: ' NO husinc s, License #t ' Applica-11 Cicense t. usiness :Lafur�.uatiort: Prope.Cty OWLIer/Job Location lntornlatiorE t ,. Sum. I �T .��I v� La-ne- City/'luwu: �A City/To�vr1: �Qr�� (�)1 II I A— Telephone: �.� - � � Telephone: Plroo L.D. required/ Copy of Photo I.D. attached: YES- )/N0 -- sL•rr r11rrral I / Nil-t-unrestricted license fv -2-restricted to dwellings }-stories or less a.nd.comniercial tip to 10,000 sq. :tt. /2-stories or less t➢: :1.-2 family f/ Nlulti'tainily Concto /'.l'ownhouses Other d 'uysy�lutes cil�all: Office Retait lnchtstrial Educational Institutional Other' Sglua •e. t ootage: under 10,000 sq. ft. r/over 1.0,000 sq. ft. Number of Stories: Sheet uv➢ci cl wart to lac cot><>lpiked: New Work � Renov.ation: I.I�/A _ 11r cral W,,-aershecl Roofinb I ac !1 E�:h„tst SysCem IVYet.al Chimney/Vents Air Balancing Provide detailed.description of work to �e done: INSURANCE COVERAGE: 1 have a current liability insurance policy or its equivalent which meets the requirements of M.G.L.Ch.112 Yes[g No❑ If you have checked Yes, indicate the type of coverage by checking the appropriate box below: A liability insurance policy ] Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only i' Owner ❑ Agent Signature of Owner or Owner's Agent By checking this box[],I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Duct inspection required prior to insulation installation:YES NO Protzl-ess Inspections Dati Cornments Final Inspectio-ti Date Comments Type of License: ay-- Master Title (Vl • • ❑ asier-Restricted City/Town._ ' ❑Journeyperson Signature of Licensee Permit tt — ❑Journeyperson-Restricted License Number: Fee$ ❑ Check at vv4vaa.rr� �s:.ca�uv/t11 Inspector Signature of Permit Approval epartinent of IndustrialAccidents Office of Investigations 600 Washington Street +' s: Boston,MA 02111 wwm mass gov/dia t Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information q:�� - Please Print Legibly Name(Business/Organizafion/fndividual) Address: City/State/Zip: 4hbne#: Are you an employer?Check the appro ate bog: Type of project(required): , 1.9 I am a employer with 4: � I am a general contractor and I 6. .O 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 3. [&emodeling -----ship_and.have.no-.employees__--- _. These sub-contractors have--,--. - 8. ❑Demolition_ workingfor in an capacity.. employees and have workers' Y t 9. ❑Building addition [No workers' comp.insurance comp.insurance. 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.E Plumbing repairs or additions myself [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required-] c. 152 1(4),and we have no . employees.[No workers' 13.0 Other comp.insrnance required.] *Any.applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sbeet 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'camp.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: e- .( Policy#or Self-ins.Lic.#: X k-- (404 l : 13 i Expiration Date: --�( I s• Job Site Address: L \ ' City/State/Zip 3 __2ET` Attach a copy of the workers' compensation policy declaration page(showing the policy number and ex ation 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$1,500.90 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 penalties ofperjury that the information provided above is true and correct, Signature: r Date: Phone#: ofj�ciat use only. Do not write�ut this area,to be corrrpleted 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 Inspectory,5.Plumbing lnspector 6.Other Contact Person: Phone#: miurmauon anct ias Ms 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 employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in'a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the perfoffiance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants PIease fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required..Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or.license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to.obtain a workers' compensation policy,please call.the Department at the number 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 complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of.Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture. (Le.a dog license or permit to burn leaves etc.)said person is.NOT required to complete this affidavit. The Office of.Iavestigatious would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number. The Commonwealth of Massachusetts Department of Industrial Accidents Office of 1avestigations 600 Washington Street. Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFB Fax#617-727-7749. Revised 4-24-07. wwW.ma1 s.gGv1dia OP ID:JF acoR©� CERTIFICATE OF LIABILITY INSURANCE F DATE(MIWDOVYY-n 1 04/0912014 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 1NSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. It 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 cerfificate holder in ilea of such endorsemen s. PRODUCER CONTACT American Ins Agency Inc PHONE FAX 122 Quincy Shore Drive ipic,ft anw. �tac No North Quincy,MA 02171 E-R11UL James J.Farren,CPCU,CRM ..ADDRESS: c Ro ID 4.COMFMA INSURER(S)AFFORDING COVERAGE NAIC tt INSURED The Comfort Man Inc INSIRiERA_Trayelers Prop CaS Corp 67Industrial Drive - - - __ .. _ INSURERS___ ' Mashpee,MA 02649 - — INSURER C: INSURER O:INSURERS: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS- INSR AMB POLICY EFF POLICY EXP LTR TYPEOFBISURANCE POLICY NUMBER D YY LIMITS GENERAL LIABILITY EACH OCCURRENCE S COMMERCIAL GENERAL LL40LITY .,_(2EMISES t£anawrrence).. S ^�CLASOS4ME OCCUR MEDEXP(Aetiyensperson) S PERSONAL 8 ADV INJURY S Gt7tERALAGGREGATE :S CIE N'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG S POLICY PRO- LOC _ S AUTOMOBILE LIASRM COMBINED SINGLE LIMIT (Ea accident} $ ANY AUTO BODILY INJURY(Per person) ,S ALL OWNED AUTOS - :• ,BODILY INJURY(PglBrxidenf),S SCHEDULEDAUTOS - -' PROPERTY 6AA4AGE S HIRED AUTOS (PIER ACCIDENT) NON-OWNEDAUTOS i s UMBRELLA UAS OCCUR EACH OCCURRENCE S EXCESS LIAR CLAIMS-MADE F BAGGREGATE S I _ DEDUCTIBLE Ii RETENTION 3 $ 4ra4tl(GIiS CONIM'EN$ATION X WC STA=I1- OTFL Ate EMPLOYERS'LIABILITY A ANY PROPRIETOWPARTNI=R/ExECUTIV> Y(""""'"�:N!A E.L EACH ACCIDENT.._ S �,DO OFFICERIMEMSER EXCLUDED? O XOUB7444Y23•A-13 OW0912013 08109/2014 Ir�ndatory in NH) E:L.DISEASE=EAEMdPLO S 300,0 yes,describe urdar DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I S 50,00 DESCFD,nON OF OPERATIONS I LOCATIONS I VEHICLES(AtUch ACORD 1Dt.Addltlonal R SoAedida Itmore span is m4L4red) Operations of insured .CERTIFICATE HOLDER CAKELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE OEUVERM IN Ttte Town Of Barnstable ACCORDANCE VMM THE POLICY PROVISIONS- Building Dept 200 Main autrteet AUTHORIZED REPRESBNTATNE Hyannis,MA 02601 (y' I ®19884VI09 ACORD CORPORATION. All rights reserved. ACORD 26(2009") The ACORD name and logo are registered marks of ACORD F : i oFTME Ta,� Town of Barnstable Regulatory Services . • �+ansrwst.$, • MASS. g, Richard V.Scali,Interim Director Building Division Tom Perry,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 20 13 3 o-Z."I I, �T �l; L U ,asaCQner of the subject property hereby authorize )N t - '1►� ? �Z"FO,(•'-j MPfy-J to act on inp behalf, in all matters relative to work authorized by this building permit TEE-Kr 1 , L7 iRVti1.Li (Address of Job) **Pool fences and�alarms--a-r-e the-�res o _ - - Pools are not to be d or ze a o en-ee4s­4ast ed and all final inspections are performed and accepted. �-- / Q Cce , clU2S) 1c Signature of Owner �— Signature of Applicant r � �6rQQ= 5WLQ�. 4c- b�lei , /y /-0 Print Name Print Name Date Town of Barnstable _' -. Regulatory Services oft roy Richard V.Scali,Interim Director °-� Building Division anxwsrasra Tom Perry,Building Commissioner 9� MAM ��� 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION - l J Please Print DATE: JOB.LOCATIQIcI: c � number street village 'HOMEOWNER": r i-C A M e 02a-ko r7n:3 r,-;lO 3 6 d 1 name home phone# work phone# CURRENT MAILING ADDRESS: c�MaA.C,-Is .l u —rcty/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 Persons)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 requirements. Signature of Homeowner Appioval 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:\WPFUES\FOPIZ\buildhigpcmitformsEURESS.doc . r � � 3. l� -DRi_VEf}�LL'GEN SE ; 77 56 37767 Y f \\ 04 On7 2015`04 07 1536 � � ��� CLASSY REST No SEX DM.. 6 00 M nl mmalum .. i` r l NAICOR' ;� 5 ;' DAVID A °I Mas"NdHusE�1T 400POPPONESSETTRD -jc` ��� �+ �%COTUIT MA 02 i -3216 , w T i i of�INAON�IE ►LTH OF MASSAGE l3SE �OARDIF SHEET METAL WQRKERS SUES THE FOLLOWI'N0 L IS ICENSE, , UNRESTRICTED ems: r: DAU.k D A 3''NA I-LOR n £ N # ' 400 PAlRONSSETT RD' CIA ,02635. 32t6 �TUIT 1. 41�' ,565g 04/28/16 955 ,� 3 ,E TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # 1 d� - Health Division Date Issued Z Conservation Division y Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address TgP141i L. ,Je Village Cewltry a Owner EyEL"(tJ A. ��`�" Address 17�%v e Telephone A 1 bi Q"- 'o G"s Permit Request �`Remp\ N,� ' �.�cE I vso i~X�ERIb2 T)ec�, z�RewIa t'i51wC, &10 AOCaL RWE t71x5 IME M©4E �IS�,�ly,tr►r� h -�4i►►�c; C Y�(C)b2��b�� '#� I��nnavt� hy,3b REftl i a E)tTuvtfb a rx54< wd�n�'i�s (Shvvid a y6H 0&4*4'e,s1 s)�gym 0&,L quare feet: 1 st floor: existing proposed 2nd floor: existing r� :proposed *��� Total new C7 N Zoning District Flood Plain Groundwater Overlay" w Project Valuation Of/ 13, � � Construction Type LTbm'.) c�� Zi � ! Lot Size ZD (aoo S,F: Grandfathered: ❑Yes ❑ No If yes, attac supportOg dpumentation. Dwelling Type: Single Family 1. Two Family ❑ Multi-Family (# units) Cal= 00 :;� Age of Existing Structure 3 `� "� Historic House: ❑Yes X No On Old K ng's Hig i&ay: Yes,.XNo ti Basement Type: ❑ Full )kCrawl ❑ Walkout ❑ Other Basement Finished Area(sq.ft.) wit Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new_ Number of Bedrooms: 3 existing 0 new Total Room Count (not including baths): existing _ . new First Floor Room Count Heat Type and Fuel: �3,as ❑ Oil ❑ Electric ❑ Other Central Air: )kYes ❑ No Fireplaces: Existing LX46 New Existing��yyw/�ood/coal stove: ❑Yes �KNo Detached garage: Coexisting ❑ new size_Pool..��:�6 existing ❑ new size _ ga'r . ❑ existing ❑ new size_ Attached garage existing ❑ new size _Shed ❑existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes A No If yes, site plan review # Current Use 3:iJ4a f�Mll-`t Proposed Use S t1mG ' r i lia1.d APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name E /PAA)CAerM&wwr>i Tx Telephone Number C��� `�y8 ©oo 1?,D •3V"- Address i bt S 040%, %-r License # U_"rr MN Home Improvement Contractor# I DD 131 o V 4,-aa A e'yt,rooJ®E+9TNorker's Compensation # ps:14 ,J�'6- I ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE �41�'Yrl69K. " FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED Y• T: MAP/PARCEL NO. Mss 1fi ADDRESS VILLAGE OWNER k i » DATE OF INSPECTION: -FOUNDATION .: ovjos r t" FRAME a Co ! INSULATION ° FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL " GAS: ROUGH FINAL F FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 600 Washington Street Boston, MA 02111 �Y www.mass.gov/did Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lezibly Name(Business/Organization/Individual): �];�1 I`.AbC* i I/PAQ6'1=TT VQ Ur DjEeS TpJC Address: PD. Zn>( City/State/Zip:��l� MA - O Z6- Phone.#:�`j'a) q z3- 0001 Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. I am ageneral contractor and I 6. '❑New construction employees(full and/or part-time).* have hired the sub-contractors .2.0 I am a sole proprietor or partner-' listed on the'attached sheet. T.�]Remodeling ship and have no employees These sub-contractors have 8.'0 Demolition working for me in any capacity. employees and have workers' 9. 0 Building addition [No workers'comp.•insurance comp.insuraace.t required.] 5. We are a corporation and.its 10.❑ Electrical repairs or additions °.3.❑ I am a homeowner doing all work officers have exercised their I I E1 Plumbing repairs or additions myself o work 'co right of exemption per MGL y � workers �• 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.[ Other �i�Cl� ff comp.insurance required.] *Any applicant.that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such. xContractors that check this box must attached an additional sheet showing the name of the sub-conhwtors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. Iam an employer that is providing workers compensation insurance for my employees Below is'thepolicy andjob site information Insurance Company Name: ir.W --A tlp.(dICll� Policy#or Self-ins. Lic.M U j3.-,0 5 q q M4LJ0 — l3 Expiration Date: Job Site Addresa:J_1J� rs (ggti 1 iwer City/State/Zip: 6-w—la'z1 luc oL �JL 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 DIA for insurance coverage verification.' I do hereby certify u Uere ths7ape allies of perjury that the information provided above is true and correct Si afore: Date: 8 -Xi j 3 A►eZf /Z. Pb`'Y�ict7 Ws FAC E-11 001L.0US Ott:., Phone#: ' -000 t Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one); L Board of Health '2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Rightfax N2-2 6Y6/2013 5:54:29 AM PAGE 2/002 Fax Server �^ CERTIFICATE OF LIABILITY INSURANCE DATE(MM1203 rn .1 TIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE OLDER. 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 WANED,subject to he terms and conditions of the policy,certain policias may require and endorsement. A statement on this certificate does net confer rights to the certificate holder in lieu of such endorsements. PRODUCER CONTACT NAME: i M YCOCK 1NS AGENCY PHONE FAX STREET 20 SCHOOL (A/C,No,Ext): (A/C,No): E-MAIL COTUI'T,NLA 02636 ADDRESS: 297SH INSURERS)AFFORDING COVERAGE NAIC N INSURED INSURER A: .AWFIUCAN ZTEUCH INSURANCE==ANY PADGETT BUILDERS INC INSURER B: INSURER C: INSURER D: PO BOX 133 INSURER E: COTUIT,MA 02635 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS 15 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVEHEEN 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 PA®CLAM. - NISR ADD SUB POLICY EFF DATE POLICY EXP DATE - LTR TYPE OF INSURANCE - L R POLICY NUMBER (MNMODIYYYY) (NUMMYYYY) LIMITS. GENERAL LIABILITY ACH OCCURRENCE g COMMERCIAL GENERAL LIABILITY $ CLAIMS MADE OCCUR. DAMAGE TO RENTED EMISES(Ea occurrence) ED EXP(Arty one person) $ RSONAL S ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: ENERAL AGGREGATE $ POLICY O PROJEC 1 E]LOC IRODUCTS-COMPlOP AGG $ AUT061061LELIABIUTY COMBINED SINGLE $ ANY AUTO LIMIT(Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Per-parson) HIRED AUTOS BODILY!NJURY $ NON•OWNEC AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION$ $ A WORKER'S COMPENSATION AND X WC STATUTORY of HER EMPLOYER'S LIABILITY YIN UB-0574N646.13 0610V2013. 06101/2014 U! ANY PROPeRITOF?,PARTNERIEXECUTIVE MN NIA E L.EACH ACCIDENT $ 100,000 OFFICERAMEMEER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 M yes,describe under DESCRIPTIDN OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 - DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES)RESTRICTIONSISPECIAL ITEMS THUSREPLA^_E3 ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER-PFFECTINO WORKERS COMP COVERAGE. CERTIFICATE HOLDER CANCELLATION TOWN OF BARNSTABLB,BUILDING INSPECTOR SHOULD ANY OF THEABOVE DESCRIBED POLICIES BE CANCELLED 367 MAIN STREET BEFORE THE EXPIRATION DATE THEREOF,NOTICC WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. / [ YANMS,MA 02601 AUTHORIZED RQ' .;2 ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD 1988-2010 ACORD CORPORATION. All fights resmed. Padgett Builders Inc. Subcontractor Insurance Information 11/14/13 McPeake Proiect 162 Tern Lane, Centerville, MA 02632 Framer D&M Construction, Inc. 5 Beaver Dam Way, P. O. Box 190 S. Dennis, MA 02660 WC2-31 S-3 51409-023 Roof/Sidewall Todd DeBerry 228 Wood Street Middleboro, MA 02346 UB-4422P 154-13 Electric Mike Ostrowski, Inc. dba Barnstable Electric 40 Village Drive East Sandwich, MA 02537 WC5-315-383855-013 Plumbing Spencer Hallett Plumbing& Heating, Inc. P. O. Box 61 Cotuit, MA 02635 WC 15494F HVAC The Comfort Man 67 Industrial Drive Mashpee, MA 02649 KDLB7444Y23-A-11 Drywall Century Drywall Inc. P. O. Box 572 Hyannisport,MA 02647 08WECLB4776 Carpentry Gary Fontes 33 Redlands Rd. E. Falmouth,MA 02536 WCC0095678 Painting New Look Painting, Inc. P. O. Box 841 Marston Mills, MA 02648 VWC07612662008 Padgett Builders, Inc. Pagel updated. 11/5/13 EVE r° Town of Barnstable ' Regulatory Services 9anaXAS& Eg Thomas F. Geller,Director fn,39+p Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder c - I, � � E' -� ,as Owner of the subject property hereby authorize !? '/ Q5 to act on my behalf, in all matters relative to work authorized by this building permit application for: Nq Luz (Address of Job) ignature f Owner Date 14, Print Name Q:FORMS:OWNERPERMISSION ' 1 Massachusetts-Department of Public Safety Restricted-One-and two-family dwellings or any ill Board of Building Regulations and Standards accessory building thereto, irrespective of size. Cnnstructiun Supcn'isur I & 2 Farnil� v, License: CSFA-048859 }' ` �`\. rTS of s; d ROBERT R PADGET V*''T-_` �i f ' 184 SCHOOIUST/ O; O COTUIT Mrs 026 01 Failure to possess a current edition of the Massachusetts �r• tt4��a 1 State Building Code is cause for revocation of this license. Commissioner Expiration f 02/22/2014 For DPS Licensing information visit: www.Mass.Gov/DPS Office of Consumer Affairs&B siness Regulation License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: �100131 Type: Office of Consumer Affairs and Business Regulation ' a p 10 Park Plaza-Suite 5170 Expiration: 4679/2014 Private Cor oration ~-== Boston,MA 16 kVG BUILDI S� �J ,1 Robert Padgett ' c PO Box 133/184 SchooS � /r. Y Cotuit, MA 02635 ".� - Undersecretary Not valid without signatu. f Massachusetts Department of Environmental Protection o�ctFro Bureau of Resource Protection-Wetlands WPA Form 2 - Determination of Applicability B,RAl9I48L� Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 and § 237-1 to § 237-14 Town of Barnstable Code DA- 13043 A. General Information Important: When filling out From: forms on the Barnstable computer, use Conservation Commission only the tab key to move To: Applicant Property Owner(if different from applicant): your cursor- do not use the Evelyn McPeake return key. Name K; Name 18 Thames Way 7eb Mailing Address Mailing Address Madison CT 06443 Cityrrown State Zip Code City/Town State Zip Code B 1. Title and Date (or Revised Date if applicable)of Final^Plans and Other Documents: Site Plan by Stephen A.Wilson, P.E. (stamped) 5/28/2013 Title Date Title Date Title Date 2. Date Request Filed: May 31, 2013 `s, B. Determination Pursuant to the authority of M.G.L. c. 131, § 40 and §237-1 to§ 237-14 Town of Barnstable Code, the Conservation Commission considered your Request for Determination of Applicability, with its supporting documentation, and made the following Determination. Project Description (if applicable): Remove existing outdoor shower; remove and reconstruct two decks; new roof and siding. Project Location: 162 Tern Lane Centerville Street Address Village 212 016 Assessors Map Number Assessors Parcel Number wpaform2.doc•Request for Departmental Action Fee Transmittal Form-rev.10/6/04 Page 1 of 2 r Massachusetts Department of Environmental Protection Qgsl+sr.Q� , Bureau of Resource Protection -Wetlands WPA Form 2 - Determination of Applicability , $ � Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 16.iq and § 237-1 to § 237-14 Town of Barnstable Code DA- 13043ax� B. Determination (cont.) The following Determinations)is/are applicable to the proposed site and/or project relative to the Wetlands Protection Act and regulations: Positive Determination Note: No work within the jurisdiction of the Wetlands Protection Act may proceed until a final Order of Conditions (issued following submittal of a Notice of Intent or Abbreviated Notice of Intent)or Order of Resource Area Delineation (issued following submittal of Simplified Review ANRAD)has been received from the issuing authority(i.e., Conservation Commission or the Department of Environmental Protection). ❑ 1.. The area described on the referenced plan(s)is an area subject to protection under the Act. Removing,filling,dredging,or altering of the area requires the filing of a Notice of Intent. ❑ 2a. The boundary delineations of the following resource areas described on the referenced plan(s)are confirmed as accurate. Therefore, the resource area boundaries confirmed in this Determination are binding as to all decisions rendered pursuant to the Wetlands Protection Act and its regulations regarding. such boundaries for as long as.this Determination is valid; ❑ 2b. The boundaries of resource areas listed below are not confirmed by this Determination, regardless of whether such boundaries are contained on the plans attached to this Determination or. to the Request for Determination. ❑ 3. The work described on referenced plan(s)and document(s) is within an area subject to protection under the Act and will remove, fill, dredge, or alter that area. Therefore, said work requires the filing of a Notice of.lntent. ❑ 4. The work described on referenced plan(s)and document(s) is within the Buffer Zone and will alter an Area subject to protection under the Act. Therefore, said work requires the filing of a Notice of Intent or ANRAD Simplified Review (if work is limited to the Buffer Zone). ❑ 5. The area anal/or work described on referenced plan(s)and document(s) is subject to review and approval by: Barnstable Name of Municipality Pursuant to the following municipal wetland ordinance or bylaw: § 237-1 to §237-14 Town of Barnstable Code Chapter 237 Name Ordinance or Bylaw Citation wpaform2.doc-Request for Departmental Action Fee Transmittal Form•rev.10/6/04 Page 2 of 2 Massachusetts Department of Environmental Protection, ag� FrQ Bureau of Resource Protection -Wetlands ���' ��o,� WPA Form 2 — Determination of Applicability . ► � � .i Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 316 and § 237-1 to § 237-14 Town of Barnstable Code DA- 13043 °'` " B. Determination (cont.) ❑ 6. The following area and/or work, if any,.is subject to a municipal ordinance or bylaw but not subject to the Massachusetts Wetlands Protection Act: ❑ 7. If a Notice of Intent is filed for the work in the Riverfront Area described on referenced plan(s) and document(s),which includes all or part of the work described in the Request, the applicant must consider the following alternatives. (Refer to the wetland regulations at 10.58(4)c.for more information about the scope of alternatives requirements): ❑ Alternatives limited to the lot on which the project is located. ❑ Alternatives limited to the lot on which the project is located, the subdivided lots, and any adjacent lots formerly or presently owned by the same owner. ❑ Alternatives limited to the original parcel on which the project is located, the subdivided parcels, any adjacent parcels, and any other land which can reasonably be obtained within the municipality. ❑ Alternatives extend to any sites which can reasonably be obtained within the appropriate region of the state. Negative Determination Note: No further action under the Wetlands Protection Act is required by the applicant. However, if.the Department is requested to issue a Superseding Determination of Applicability, work may not proceed on this project unless the Department fails to act on such request within 35 days of the,date the request is post-marked for certified mail or hand delivered to the Department. Work may then proceed at the owner's risk only upon notice to the Department and to the Conservation Commission. Requirements for requests for Superseding Determinations are listed at the end of this document. ❑ 1. The area described in the Request is not an area subject to protection under the Act or the Buffer Zone. ❑ 2. The work described in the Request is within an area subject to protection under the Act, but will not remove, fill, dredge, or alter that area. Therefore,:said work does no`rrequire the filing of a Notice of Intent. ® 3.The work described in the Request is within the Buffer Zone, as defined in the regulations, but will not alter.an Area subject to protection under the Act. Therefore, said work does not require the filing of a Notice of Intent, subject to the following conditions (if any). ❑ 4. The work described in.the Request is not within an Area subject to protection under the Act (including the Buffer Zone).Therefore, said work does not require the filing of a Notice of Intent, unless and until said work alters an Area subject to protection under the Act. wpaform2.doc•Request for Departmental Action Fee Transmittal Form•rev.10/6/04 Page 3 of 2 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands ` WPA Form 2 — Determination of Applicability l ' �dasr�rss>J :: Massachusetts Wetlands Protection Act M.G.L. c. 131, §40IL and § 237-1 to § 237-14 Town of Barnstable Code DA- 13043 B. Determination (cont.) ❑ 5. The area described in the Request is subject to protection under the Act. Since,the work described therein meets the requirements for the following exemption, as specified in the Act and the regulations, no Notice of Intent is required: Exempt Activity(site applicable statuatory/regulatory provisions) ❑ 6. The area and/or work described in the Request is not subject to review and approval by: Barnstable Name of Municipality Pursuant to a municipal wetlands ordinance or bylaw. §237-1 to § 237-14 Town of Barnstable Code Chapter 237 Name Ordinance or Bylaw Citation C. Authorization This Determination is issued to the applicant and delivered as follows:. ❑ by hand delivery on by, certified mail, return receipt requested on . JUL 2 4 7013 Date Date This Determination is valid for three years from the date of issuance (except Determinations for Vegetation Management Plans which are valid for the duration of the Plan). This Determination does not relieve the applicant from complying with all other applicable federal, state, or local statutes, ordinances, bylaws, or regulations. This Determination must be signed by a majority of the Barnstable Conservation Commission.A copy must be sent to the appropriate DEP Regional Office (see http://www.mass.q ov/dep/about/region.findyour htm)and the property owner(if different from the applicant). Signal u Date wpaform2.doc•Request for Departmental Action Fee Transmittal Form•rev.10/6/04 Page 4 of 2 MOW Mill Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 2 Determination of Applicability Baa�IrrasLg :� y MA68. Massachusetts Wetlands Protection Act M.G.L. c..131, §40 and § 237-1 to § 237-14 Town of Barnstable Code DA- 13043g�,Y, ` } D. Appeals The applicant, owner, any person aggrieved by this.Determination, any owner of land abutting the land upon which the proposed work is to be done, or any ten residents of the city or town in which such land is located, are hereby notified of their right to request the appropriate Department of Environmental Protection Regional Office(see http://www.mass.gov/dep/about/region.findyour.htm)to issue a Superseding Determination of Applicability. The request must be made by certified mail or hand delivery to the Department, with the appropriate filing fee and Fee Transmittal Form (see Request for Departmental Action Fee Transmittal Form)as provided in 310 CMR 10.03(7)within ten business days from the date of issuance of this Determination. A copy of the request shall at the same time be sent by certified mail .or hand delivery to the Conservation Commission and to the applicant if he/she is not the appellant. The request shall state clearly and concisely the objections to the Determination which is being appealed.To the extent that the Determination is based on a municipal ordinance or bylaw and not on the Massachusetts Wetlands Protection Act or regulations, the Department of Environmental Protection has no appellate jurisdiction. wpaform2.doc'Request for Departmental Action Fee Transmittal.Form•rev.10/6/04 Page 5 of 2 Assessor's map and lot number �02 .................. /,....... THE tO�y Sewage Permit number .... ... ....................... '......- Z SARISTa LE, MAB i House number ......7..../. ........................ ...... 90 O 039• 0� MAY A, TOWN; . 'OF 'BARN�STABLE BUILDING ' IHSPE•CTOR .-Ji APPLICATION FOR PERMIT TO ........................ .1. .....` ...... . ....:.. .. ..:................................ TYPE OF CONSTRUCTION ............................Jw.)V.."....................................................................................... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: /... ...Location ..... .... i7........kae ii.,. ...........CeAl/..ee.. ...................................... ...................... ProposedUse ..... . ..�1..`.. ..I.................................. ...................................................... ......................................... Zoning District ... ......Fire District Name of Owner '. � .�c,l 'f../..(......�aJ�L�'1.1��.�1........Address ....�.:7�..1 �a�. .4AI �.�Ii...: ... ....:....... Name of Builder .0.......Address ....1..v...9.es..G.......M.axA. r jo. Name of Architect a .1: .s`.:.✓4..�1.�. .. .... Address ........:............................................................................ Number of Rooms .....6.........................................................Foundation Exterior ...... �L�/.e.......6-e—da-i^...........:.................Roofing .......... Floors .....C.O.%'' ...................................................Interior .........................................:.......................................... Heating ...............................................Plumbing ................ Fireplace ......, 'x..�,�..2`f.. ...................................... Approximate Cost ..... 0B ............................. .. Definitive Plan Approved by Planning Board----------------_---------------19________ . Area 6 Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH 1� y F17 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Nam .. .. ... .. .............. Cannon, Evelyn A. 20515 add to & remodel No ............; ... Permit for .................................... 1r7 "N .dwelling � Tern Lane Location ............................................ ................... Centervillei' 4 ............................................................................... Owner. ....................E.velynA.....Cdnn.?.n............ . ............... . ........ . .. Type of Construction .........frame........... ................................................................................. Plot ............................. Lot ..................... ........... Permit Granted ..............19 78 Date of Inspection ...... ... ..................... ...19 Date ,Completed 9 PERMIT REFUSED ........................................................ 19 7 ............. .............. ............... ........ ..................... W4 ............................................. .......... ....... ........ -41 .................... ................. .................... ............... Approved 19 '0ioved,....- . ...................................... I.......... .......................................0.......... ...................................................... ............ t639- TOWN OF BARNSTABLE � BUILDING � 0N 0 N �� N �� INSPECTOR ���� �� �� -- -- - ---- - -- ~~ ~ ~~ ~~ ~ ~~~~ ~ ~~ ~~ APPLICATION FOR PERMIT TO ......................... .................................. TYPE OF CONSTRUCTION ......................... ..:+�Y��.����---..--.-.---_--..-.--.------.--.--. v TO THE INSPECTOR OF BUILDINGS: ' The undersigned hereby applies for o permit according to the following information: ^ � � �� �, Lo�ohon -'�..�..�°��--..*`..^^./n-----.. ................................................................................. ° _�� � Use --��oy.�!.��"{.��. ^�-------.~.-.'-----_.-.---.---....--.----~----^-.--. Proposed -^' �� �� � Zoning District -{l- .i ... ......................................................Fire District -------..--.----------..----. � Y�Name of Owner . . . ��` � - Q. �-^---- ^� _ Name of Builder ���:eX -A -��.y-1 �������......-'A66,mo .... &�.^�x. --Map........O^t----.. Nome of Architect ....... --'A66res -------------------.-------- - Number of Rooms .....All�.........................................................Foundation -------------------------- . �� Ex/o,ior -' ........... ....................................Roofing -----------------------'---.' Floors ....�-����'����.��-----------------..Interior ---------------.----________. Heating ---------------..F1um6 Plumbing ---------------_-_,________.. . / Fireplace '^. �1»� /� -� ' -------------.. pp Approximate . . .. ________.^_ Definitive Plan Approved by Planning 800v6 lQ-_--. Area .... Diagram of Lot and Building with Dimensions Fee .........../A��.0_��_____, SUBJECT TO APPROVAL OF BOARD OF HEALTH X �� /� ' � - \J 4�l �`7� � u / � o ��� O� , ' ^ " ' � . � . � - � | hereby agree to conform to all the 8o|as and Regulations of the Town of Barnstable regarding the above construction. ' ........................... Cannon, Evelyn A. A"-2,.,I.2-16 20515 add to- & remoder No ................. Permit for .................................... /..emod dwelling ........................................................................... ... Tern Lane Location ....ZQ..................................... ..... ...... Centerville ............................................................................... Evelyn A. dannon Owner ...... ........................... frame Type of Cdnstruction ...........I.............................. ................................................................................ tPlot ............................ ......... .... Permit Granted ......... ..&W�L aa............1978 Date of Inspection ....................................19 Date Completed ..... ...............................19 A PERMIT REASED .................. 19 .. . . .... .. ............. . . ................................ z;-, ................. .. . ........ ... ..... . .. —Aj.IL P ......I.......... .............. ........... .................. ................I............................. AppV ..... ............. .... ....................... 19 .............. ov i............ .. ......... V..... ............................................................................... ............................................................................... -- GAS GATE , ----------- � ------------------- 212/017-001 0 / / MARK E. EBERT & , SHARON JOHNSTON /6"W ���AA 2 MA 12 \F ; PARCEL 6 NCE POLE KPo�FE 20,6 00 S.F. UPy 1/10 APPROXIMATE -- LOCATION OF, LEACHING- 21 N/022 AREX/ , � PERI S. yP tK�. WENTWORTH D-BOX ` . . PAVED DRIVEWAY. _- - �fPUMP TANK.Q p , I 26.4'\ SEPTIC .TANK; -- --- - i. c nl GARAGE N ° Go D i ' ♦ N N / U i i eW O) n 77 J IW) ,� UP to ;' 29.1 00 PORCH 3 UGE olv 212/015 GE O N/F N aUj w C. ��� % WILLIAM B. . \ �. � z & NATALIE ,r #162 BOGERT w SINGLE 6' -DECK w STORY WOOD DWELLING �4, OUTDOOR OUTDOOR SHOWER TO BE - 6, SHOWER REMOVED, LOWER DECK TO BE _ HECK RAISED, NEW DECK TO BE A 1,851 S.F. ONE LEVEL. 7 DECK RECONSTRUCT 30 p EXISTING DECK --------------- FLAGPOL 10 EXISTING SEASONAL. DOCK (ART-0106) WATER LINE CERTIFICATE OF COMPLIANCE ISSUED: 1/22/92 ,'EL. = 86.4 LOCATION DATE: MAY 16, 2013 WEQUA QUEF LAKE WETLANDSPERMIT PLAN RDA 162 TERNLANE CENTERVILLE,, MA RECORD OWNER: EVELYN A. MCPEAKE 18 THAMES WAY MADISON, CONNECTICUT 06443 DEEC BOOK .20762; PAGE 23-24 PREPARED BY. BAXTER NYE ENGINEERING & SURVEYING DATE: MAY 28, 2013 Registered Professional Engineers and Land Surveyors 78 North.Street- 3rd Floor,Hyannis,Massachusetts 02601 SCALE: 1."= 20' Phone - (508) 771-7502 Fax- (508) 771-7622 ,JOB. No. 2013=027 lit NOTES: 1_) CONTRACTOR IS TO VERIFY ALL EXISTING CONDITIONS &DIMENSIONS IN THE FIELD + 2.) CONTRACTOR TO VERIFY ALL INTERIOR&EXTERIOR MATERIALS, DETAILS,&FINISHES IN THE FIELD WITH OWNER 3.) ALL CONSTRUCTION TO CONFORM TO 780 CMR MASSACHUSETTS ' STATE BUILDING CODE,8TH EDITION AMENDEMENT&IRC2O09 4.)"SEE CERTIFIED PLOT PLAN DEVELOPED BY JC ENGINEERING FOR ALL PROPOSED&EXISTING DETAILS 5.) FOLLOW ALL MANUFACTURER'S SPECIFICATIONS FOR INSTALLATION OF ALL. SIMPSON COMPONENTS ' 6.) 'ALL CONCRETE USED FOR FOUNDATION WALLS,FOOTINGS&SLABS TO BE 3000 PSI. ' lV INSTALL SIMPSON DTT2Z - i ` • f DECK TENSION TIES W/. 12•THREADED ROD(2) I INSTALL FLASHING UNDER PLACES EVENLY SPACED 1 :.HOUSEWRAP&DECKING - - - - EXIST. . APART ON THE NEW DECK io . I DECKING _ 'a STEP DOWN 7- ------------- Y EXISTING HOUSE P.T.2 x 8's @ 16-o.c. + FLOOR JOISTS INSTALL PEEL&STICK - - RUBBER MEMBRANE * k y' - • . I BETWEEN LEDGER 8 -SHEATHING - „ - , +1 - _ - .. zl'"_. P.T.2 x 10 LEDGER BOARD LAG BOLTED TO - - SOLID BLOCKING W/(1)LEDGERLOK BOLTS • _ F - .. ' 16"o.c.W/JOISTS HANGERS DECK DETAIL r f 'EXIST. RE-BUILT zs HOUSE DECK • - (AZEK DECKING). . .EXIST. EXIST. - -EXIST:_ _ '� - EXIST. ,EXIST. EXIST. RE-BUILT DECK r: (AZEK DECKING) . • A . A 3'S 16'-0• •' '� 32'B' FLOOR PLAN r COTUIT BAY DESIGN. ��c . RE BUILT DECKS. FOR: THE DESGNERSNALLSE NOTIFIED START ANY SCALE : DRAWING 'ERRORS ORI NISSIONSMEFOUND R _ THESE S OR OI,U S IONS TO STMTOF ucTIOR 43 BREWSTER ROAD CONSTRUCTION.THESUIRTHE ONTRxcTOR 1/4" - 1 -0.1 WILL BE RESPONSIBLE FOR THE CONTENT MASHPEE ,MA: 02649 McPEAKE RESIDENCE INTHESEURANANGRROONORMIS ODIIAM NGSAUTNOI_ELy FGT"E • DESGwERES LIT ERRORSOROS1153GN3. PH. (508)) 274-1166 ; - THESE OI—ER LELYFOR THE USE DATE FAX (508) 539-9402 y OF THE TOFTHEOTED ER UNNERUSE OF '!62 TERN LANE CENTERVIL�_E, MA THESE SREOUIRESTNEWRITTEN Al6/24/2013 CONSENT OF THE DESIGNER UNDER THE ART OFI TURAL COPYRGHT PROTECTION / -:AZEK DECKING + r - • PROVIDE ICEM/ATER SHIELD - P.T.2 x Vs @.16"o.c. • r e AT DOORS DUE TO DECK 8 --FASTEN JOISTS TO BEAM —• FASTEN JOISTS TO BEAM DOOR THRESHOLD_ AT SAME HEIGHT W/SIMPSON H2.5 TIES W/ _ 1 SIMPSON H2.5 TIES -AZEK 1 x 8 FASCIA - P.T.2 x 17s @ 16"o.c. ' r 3-P.T.2.17s IS . 3-P.T.2 x 175 • - d - 12 FASCIA STEP DOWN 7" Y w P.T.8 x 6 POSTS ON 17 DIA. - q _ ._.. - - - • - CONCRETE SONOTUBES TO - 4'0'BELOW GRADE.USE - .. • 3'6" SIMPSON ZMAX ABLI66 POST - - - BASE 8 ZMAX ACS/ACE6 POST CAPS - - 73" P.T.6 x 6 POSTS ON 18"DIA. - - CONCRETE SONOTUBES TO - } P.T.2 x 10 LEDGER BOARD LAG BOLTED TO - 4'0'BELOW GRADE.USE - ' SOLID BLOCKING W/(1)LEDGERLOK BOLTS SIMPSON ZMAX ABU66 POST ' .. 16'o.c.W/JOISTS HANGERS BASE 8 ZMAX AC6/ACE6 - - - .. , .POST CAPS A SECTION @ RE-BUILT DECK B SECTION @ RE-BUILT DECK ' 4 r J Y _ - •� _ B AV - - ' P.T.2 x 10 LEDGER BOARD LAG BOLTED TO' ' EXIST. P.T.2 x 10 LEDGER BOARD LAG BOLTED TO _ q - ` SOLID BLOCKING W/(2)LEDGERLOK BOLTS - SOLID BLOCKING W/(2)LEDGERLOK BOLTS 16"o.c.W/JOISTS HANGERS HOUSE' 16'o.c.W/JOISTS HANGERS P.T.6 It 6 POSTS ON I Z'DUI. 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