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HomeMy WebLinkAbout0065 THREAD NEEDLE LANE �� �r��cl: � � ., a ., h Lea - _ t _ � s 001411 oFjr Town of Barnstable *Permit# Expires 6 mo t f onr iss«e Regulatory,Services Fee * < sFnsi.s. • Thomas F. Geiler,Director PER%� Uri 4 Building Division .; 7 ® ZO]Q Tom Perry,CBO, Building Commissioner t TOWN OF 200 Main Street,Hyannis,MA 02601 B www.town.barnstable.ma,us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not kalid without Red X-Press Imprint Map/parcel Number Pro 'rtyAddress Residential Value of Work Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address AV-e5kA1. m.�. Contractor's Name X�� Telephone Number Home Improvement Contractor License#(if applicable)- 3, Construction Supervisor's License#(if applicable) 7© K Workman's Compensation Insurance Check one: I am a sole proprietor ❑ I am the Homeowner have Worker's Compensation Insurance Insurance Company Name l env ,AV Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit., Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roofl ;Replacernent-Windows/doors/sliders. eide #of doors U-Value (maximum.44)#of windows � .*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License& Construction Supervisors License is required. F SIGNATURE: QAWPFILES\F0RMSlbuilding permit forms\EXPRESS.doc The Commonwealth of Massachusetts DeP artment of Industrial Accidents W Office of Investigations Id 600 Washington Street Boston, MA 02111 ' www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name(Business/Organization/Individ l): Address: a,a City/State/Zip:O) ON. ® 5' Phone#: LAW—01 AW Are u an employer?Check the appropriate box: Type of project(required): 1. I am a employer with 4. ❑ 1 am a general contractor and I 6. ❑ construction employees(full and/or part-time).* -have hired the sub-contractors. 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have.no employees These sub-contractors have g..❑Demolition working for me in any capacity. employees and have workers' 9 ❑Building addition comp. insurance.; [No workers comp. insurance. 10. Electrical repairs or additions required.] 5. ❑ We are acorporation-and its ❑ P, officers have exercised their 11. Plumbing repairs,or additions 3.❑ I am a homeowner doing all work ❑ g P myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.] t c..152, §1(4), and we have no employees. [No workers' 13.❑ Other -.comp.insurance required.] "Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ;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 ins rance f r my employees Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.M Expiration Date: Job Site Address: �G 1 City/State/ZipC,_�, C !J1/e 0. i -��- 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 penalties of perjury that the information provided above is true and correct Si afore: Date: Phone# 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): 1.Board of Health 2. Building Department.3. City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Kw�-4. MOn ob fn` • R aEr t rat �aidigt):, Lvviosaz CS V. . b • px r. a( SOW. t s.T�'kpZtitisfisi3rY" i t rCl'[I II"IL.,A I C Ur LIAMILI I T 11M%%>Vt /M%J4L.0C o x 03/0 110 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Hunter Insurance, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 389 told River Road, P.O. Box 1 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Manville Rd 02$38-0001 Phone:401-769-9500 E'ax:401-769-9502 INSURERS AFFORDING COVERAGE NAIL# INSURED Moon Associates Inc. IEUSTIR�A national.9=ax�ga insurance Ca 14788 DBA. Gutter Helmet DBA Renewal ley' Anderse4 of RI INSURERS: Beacon Mutual lazuranca Co. A8A Gutter Helmet Roofing I� URERc D,8A. Moon Works 1137 Park East Drive INSI PERD; Woon.SoCket RI 02895 - INSUREP,E: COVERAGE$ THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWT(HSTANDING ANY REQUIP.EMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE M NY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDMONS OF SUCH POLICIES.AGGREGATE LIMITS SHOVM MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSRI, r(TE OF INSURANCE POLICY NUMBER DATE(IVIJ1UDDt1 YY() DATE(MMIDRiYYt17 LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 10 0 0 0 0 0 A MERCLAL GENERAL LIABILITY MPS26619 09/16/09 09/16/10 PREMJS S(EaENIE Ice $500000 CLAIMS MADE a OCCUR MED EXP(Any one perwn) $ 10000 PERSONAL&ADV INJURY $ 1000000 GENERAL.AGGREGATE $2000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMiP/0P AGG $2 0 0 0 0 0 0 POLICY Jt LOC I AVTONOBILE LIABILITY COMBINED SINGLE LIMIT $1000000 A Ix ANY ALUO B1S26619 09/16/09 09/16/10 (Esa0dent) ALL OVOIED AUTOS ` BODILY INJURY $ i SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per eecident) PROPERTY DAMAGE $ (Per sodded) GARAGE LIABILITY AM ONLY-EA ACCIDENT $ H I ANY Atrlo OTHER THAN TeA ACC AUTO ONLY: AGG $ EXCESS/UMBRELLALIABILITY EACH OCCURRENCE $1000000 A X OCCUR CLAIMSMLADE CUS26619 09/16/09 09/16/10 AGGREGATE $ --- . $ DEDUCTIBLE $ Ix RETENTION. $10000 $ WORKERS GOGAPENSATIO 1 AND EMPLOYERS'LIABILITY Y I N XTORY LIMITS ER B ANY PROPRIETOPJPARTNER/ExECUTIVE ❑ 28586 10/01/09 10/01/10 E.L.EACH ACCIDENT $500000 (Mandetory I NBEHR EXCLUDED? E.L.DISEASE-EA EMPLOYEE $500000 It yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $S00000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION' R � DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 . DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO$O SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Renewal By Anderson REPRESENTATIVES. 1137 Earn East Drive Woonsocket RI 02895 AUTHORIZED REPRESErTIATiVE ACORD 25(2009MI) 01980.2009 ACORD CORPORATION. Ail rirghts reserved _ _ /�yL Customer Name: r 8uilr. ��yy p „of RI.CT,be Cape Cad ales A regimen '�tCSs: �� omer IDtt: 1137 Park East Drive City,State'Zip: !/ tS rder Number: Woonsocket,RI 02895 wraoow asrLAfoatiraar a AndoeeaCoveprer � Phone-Home:_A,$-'?l- 9/g`/ license#RI-30839 RI-12259 MA- �,j/ PhoneiWorie- OF , Page:^ of Dam: 119535 CT-362725 , Email: r�b?Xf YflG GRILLES ROM 1,11s : , $ e ; a® a a ski oil In � Its ® t 11 1 111 -11 ti x3 3 e g 14 W p W k vs F' OJOVO Vian(IN X5 X .- T' *i )u S WK K X� SAC L040- 'r 2 2. 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See Reverse Side forT's and Condidom of Sak.=oar r brryerr rmy terra! this traoeaction at aW'lone�m midnight of eLe tbiod brsines■day afmr �d�of this a dim of d3I hcdon. rsseee a ed�nyoLticee of cancellation for an �� G L Acapnl7/9 I r' �4/ /Law (,H+ row tul�diapmar"its a,E�Cxwer w�Now ova rawrAn.dNd (cety wv MA to na.,credit I YYOA POMIt Cost (� ��Rt(Sttonvo Iplrsr titk/IthtcappM Aecup" specie O'&tntntee TmslAmomtef'Apumm 0 19�ya oaw smeweow eaaot. a"owt>,tr ae give!by A n" *s wro / DePesft sagiti'e4 16 $D svrd+*r rrem t o +I�fegrbyAroe,en gpgmd.dK4�bt� wrote na.ewwr.uwlemhmmaP,wgtaLAMon Wmpla 6D one drmt ar ttowkrdow�rwM�ae msaendaopaNaenecNuquteemywt�pr �raM� ry �thMrl hanae watonpiae �'"�' � ro ax6tst�omeiwis � :M pltahtepasttpoeratrePPtara. Peteelndudalabor.toaraik.insmllaia+. +Oare eveinnalbs oYawiuro�d. mnowd Atkwewe��OntonthbtbWlbe rmtoval.andtiispomld tm'o pmd—ftpd r,seomw eustmner cet a a d�+ra ew asa�n se aMaenen Yelbw-it�ltadon wnb I. Assessor's map:and lot number'... `./o...,; `.. * ';SEIaTIC `YSTEM MUST B �F THE r, ..... Y {� RNSTALLED IN COMPL a �� Sewage 'Permit number ..�. '' .. � WITH TITLE 5 , • ST/IDLE, i r 17 VIRONMENTAL CODE House number ................� ............ ....j TO N_ o. Oi639,IIAT 00 YPY a\ • r "TOWN OF: BARNSTABLE A BUILtlDI„NG "INSPECTOR" :APPLI^CATION FOR PERMIT TO :� .? }.fit. .:..:.....�1�1..P/ .Y...�7. .4�..... TYPE OF CONSTRUCTION ...... Os?d Win..:. .G1. 1..�?....1....... ......... ....................:........................:.. 'O G .Q 1. •'� TO THE INSPECTOR.OF BUILDINGS: a The undersigned -herreebby applies fo/r'o permJit according to the-following information: Location J�...:.1.rf ..&/Y. ..... !: ...! ,FL.Y�.�..�. .. .CR�'?.; `'. v.l...l.).c....... ................................... ProposedUse ....... /�P..P.z'1'n. ..... ...:......................:,..........................,................ Zoning District . ....:....... .........Fire District ....1.. Name of Owner �.�l.►1Gj 4z..:.:Y!(L �:ewyl,9. .:........Address �S..I.l�Y.�q.jJ.!! k ls...�}!'7.:.�u2'J.:L y4?1.1/a TName 'of Builder ....... ............................................Address ............... Name of Architect .. �1.!'1?_P................... ......:.......:...:....Address ..............:.....................:::.......:..................................... Number of Rooms . :.:.. ... '...Foundation ...... .................................. l�f...... .ia. ,. .................. Exierior ..:.... Floors .......H ?^d.lvP.P..d...............................: ':................Interior ....: ..Y..4�..,40c,:I1.................................................... Heating ....... �........ ...... ....::Plumbing ........n.,9.n .............................. ....................... - Fireplace ........y'1.Q. .................:...................}.:........ .........Approximate. Cost ..... .J(3UG�.:f�[ ............... Definitive Plan'Approved by Planning Board __ __________________________19--------. Area ....0?14. Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF• BOARD OF .HEALTH" t U OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS r � r I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding'the above construction. Name .... .................... ..... t Construction Supervisor's License .d.40:19°� ' WETHE°RBEE, DANA G. No ... 30640 Permit for . Build Addition ` .Single...Family...Dwelling.......... Lot #9 , 65 Thread Needle Lane- , Location ........................................................ Centerville _ .......... ................................. .`. .......................... ........ ........ Owner ..�i. Dana..G.....Wetherbee r .' T e of Construction' Framre .......... r } Plot ....... f............. -Lot '.'.?............... ......... - _I . April". 17. .• '... 87 "Permit Granted ` '' 19 f Da:te o Inspection .. ....19 v` Date Completed ... ......."I so" ..,tea � � 6,'■:■ ..,,ir = .�` _ � ]. � Wny Cfi i ; t Assessors map Wand Lot riumber, ........ . ...... ........ , THE Sewage Permit number .....,....... ...:. .......�.................. d ,,. .w /� _ Z BARNSTABLE, i House number ................ ............!�....: .:.................. . 90o 1639 �0 TOWN ' OF BARNS-.TABLE _:BUILDING INSPECTOR APPLICATION FOR PERMIT TO .....J...4.?'.G.......�..... ......................................... TYPE OF CONSTRUCTION ......\VOca ...................................................................... LO-7" Q t // ! ........ ........... ...........19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .....�J` l /I YP� Nw ,/ .... G. .!��...... .Q,-.Y?. ��.Y.?�..C...�. ............................................... ProposedUse .. ..4. .L.f�.!1....te. �Q.y7?.!...f. .. ! !. . ................................................................................ Zoning District ...........................Fire District ..... Name of Owner D.61W... .:.. �:f. .� Y .¢"e Address .. (1-,.Y J�' � �P. .:...�°c c�vu.1.Ile— Nameof Builder ......�.:5 .` .�:...........................................Address .................................................................................... . Name of Architect ....J`Gl.r�?�—............................................Address .................................................................................... Number of Rooms ......../*...............•....................................Foundation .....�. ®.C'-1 .................................... Exterior ......1!le......................................................................Roofing ..........ra .. h..4. � ............................................. Floors .......IYA-?: .tezpp..d..................................................Interior ...... ................................................... p Heating ......./l.f? .:�Li/r �i.y... ,..7....(.............................Plumbing ........ .1a.n..a�-. .......................................................... Fireplace .........k1.n.. ,P ..........................................................Approximate Cost s(tea . . .a............... Definitive Plan Approved by Planning Board ________________________________19________ . Area .....a.�.�r'..`i.�:. Diagram of Lot and Building with Dimensions Fee _12f SUBJECT TO APPROVAL OF BOARD OF HEALTH w , 4- 1 S r E4, f � � s ,1 1A 1 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS i I hereby agree to conform to all the Rules and�,Regulations of the Town of Barnstable regarding the above construction. . Name ......1hrle /;� r ? ,!► ^.........:.......:.......... Construction Supervisor's License .n. !� .1.............. / WETIDIRBEE, D2\0A G. A=210-078 No -30�� `.. Permit for ....Build..Ad.ditioo S ' Ie I7amill' DweIlin� ---------.----.----.----~--.. . ' Location ......Lot_.#9.�__6.5 ..�b�ead..0��clle I,o. - Centerville ^—_'-------'--'---'--r--- Ckwnar --..Da���—(��_VVetb�rb���____. . . Type of Construction .. --.-----_. ' ' -^ '^ ° .---.---.—.—.----------.. / Plot ............................ Lot ................................ . ' , ^ . . . �u�ziI l7 87 PermitG,on�ud --^-----..r--'—]V ' Date of Inspection ----------'--l9 Date Completed ...................................... ^ ' . . . , . .- ^ - ^ , ' . , ' . _ . . ~ ' . ^ Y TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Permit# Health Division q JDglo 3 Date Issued 7S - �) Conservation Division 4 ZZ Application Fee Tax Collector �/T Permit Fee_ eD3 Treasurer �� SEPTIC SYSTEM PAUST BE INSTALLED IN COMPUANC. Planning Dept. IIVITH TITLE S Date Definitive Plan Approved by Planning Board ENV'E'�ONMENTAL CODE APB[ Historic-OKH Preservation/Hyannis Project Street Address 60 "T tik A,-b iyao_,�t q L o Village (6?L I/,I,L IV Owner A-in E 5 a?57a ti Address S4 M6:0 Telephone Permit Request 1✓A / 2 UNi1e,o0;r, Tf�,�e� S�,1,yw Square feet: 1 st floor: existing Z(o proposed 2nd floor: existing 166 q proposed Total new Zoning District Flood Plain Groundwater Overlay • Project Valuation 1-4­0 0O, Construction Type Lot Size 201•600 Grandfathered: ❑Yes ZNo If yes, attach supporting documentation. Dwelling Type: Single Family Gd' Two Family ❑ Multi-Family(#units) Age of Existing Structure 5 Y I2 S Historic House: ❑Yes )d No On Old King's Highway: ❑Yes ,�No Basement Type: Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 1y�� Number of Baths: Full: existing `L new '— Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas V it ❑Electric ❑Offier Central Air: ❑Yes U'No Fireplaces: Existing New Existing wood/coal stove: ❑Yes 0 No Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:W existing Q new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization O Appeal# Recorded❑ Commercial ❑Yes OrNo If yes,site plan review# Current Use 4&gZP',✓f1A1_ Proposed Use 4g&4451!t-7-//9— �Od�1W�T S Me-INA4 D7-,fER FORMATION Name,dg,A Telephone Number Address 22 1.y Or���f! �QD License# 0/0 3,4,10 �YS Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE y-2 Z—O FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED e I MAP/PARCEL NO. ADDRESS VILLAGE 1 P OWNER ' DATE OF INSPECTION: FOUNDATION Dnou�� c �� S-3U U3T FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL' PLUMBING: ROUGH-�. FINAL" GAS: ROUGH' E': : FINAL FINAL BUILDING f51 I ! O Y F ?s`•" � R 4� � t DATE CLOSED OUT r = a s ASSOCIATION PLAN NO.' t RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings;Additions $50.00 �� n Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSAEET NEW LIVING SPACE square feet x$96/sq.foot= _ '� x.0031= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0031= plus from below(if applicable) GARAGES(attached&detached) square feet x$32/sq.ft. r ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 r >1000 sf-1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) . Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 i Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) 'L� 3 Permit Fee FZHE ley, Town of Barnstable ti Regulatory Services + BA LE,A$& � KA$S = Thomas F.Geiler,Director 9 $ . 16.39. n;9. 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 I, 309we$ /�/e L'.S`T��/l� , as Owner of the subject property hereby authorize,, Mg act on my behalf, in all matters relative to work authorized bythis building permit application for(address of job) Signature of Oij9her Date i �5-RA 0 P.Q�sT,CW' Print Name 13oal it ul Bililrliu�I:cgulalions;uu l tita uilurds ='t HOME IMPROVEMENT CONTRACTOR `I r i Registl*Mion: '101014 Expiration: 6/24/04 Type: Private Coiporation CAPE COD HOME IMPROVEMENT (;obali NlacLaughlin 25 lyanough Road Hyannis, PIA 02601 ti r ' BOARD OF BUILDING REGULATIONS _ - �4 License: CONSTRUCTION SUPERVISOR Number: CS 010350 Birthdate: 07/23/1941 i' Expires: 07/23/2003 Tr. no:. 11905 rtCau iclad TO: 00 - ROBERT A MACLAUGHLIN _/ 25 HARVARD ST «» S YARMOUTH, MA 02664 Administrator ! A - The Commonwealth of Massachusetts —= Department of Industrial Accidents Office 9110 OSt/,paffonS 600 Washington Street Boston,Mass. 02111 waiiiiiimi Compensation Insurance Affidavit name: c S T.%�1 location 7riy.�A NG°�iD•G•e.� �/9N� ci �z«a-e phone# 77/`S/9fI ❑ I am a homeowner performing all work myself. ❑ I am a sole proprietor and have no one worldn in a capacity am an era 1 er rovidin workers' compensation for my employees working on this job.::::::::::::::::::::::::::<.;:%>. Sim ... vra >a tldre d :::.......................... ........... ........ ............. ..... :.....:::::,;:.;::.::;.:.. .... iron .. insurenreca;::»:.� � � ��:<.<. ;. ..•? :.;::.;:.;;;>.:..::...: �.::.: slice.#... ...i��. ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have n workers' Compensation polices: the folio mP ................................:.::::.::::::..................:::.::::::.:::::.:::: ;;.;:.:;.;;:.:;:t.;;;;;:.;:.:::::.:::::::::::.;..�:.:;;::.;;;:;.:::;.:: :::.;�;:,:.;:.:;.:;.:;.;;:.;::.t. :.::::::::................:..:::::::::::....................::..::::::::::..:...................:..::::.:.::............:: :..............:...:.:: :::::::::::::::::..::.....................::::::.::..............:>.:::..,........:..:.::. '•`am:cam an n .:.....::.:............:.. :....�..::.. »> di�te .. ....................:.....................::...:.......................:..........................................:... .. ....:.::::..................::.::::.................:....::: hors ........,.:,,..... ,,..:.. ......... ......:. .................................... ..t........... .... ... ,.�::::::.....,::.:::::. ,...... ..:...' .,,t::�.{...•:•:•::.:::::::::i:;^:w::.h.::::^:.`.%::.+.•:;;i•iii:.�:::.�::^.�::.::.ii::.{�i}:}:::•::::.�:.::<:ry}:••iiviiY.i^ii}:•::v:::::•:•:::::.::::::::w::. O�1rY M`..................................... .... . .................._... _ .. .. VINNOWNWOM .t >'<': . bII rQ72':i: ��tiuiaran // FafimY to aecose coverage as required raider Section ISA of MGL 151 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or one yam,imprisonment as weIl yu ctvfi penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I mtderstand that a wpy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains and en allies of perjury that the information provided above is true and correct Signature Date Priest name �dL7 /�G ��• t Phone# official use only do not write in this area to be completed by city or town oimc ial city or town: peradt/iicense i$ ❑Building Department ❑Licensing Board ❑checkif immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; Other Oasud 9/95 PJA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", 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 section 25 also states that every state or'loc'al licensing agency shall-withhold the issuance or renewal construct buildings in the commonwealth for any applicant who has permit too operate a business or to co g.. of a license or p p , the not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither commonwealth.nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of`compliance with the insurance requirements of this chapter have been.presented to the contracting authority.. Applicants t` Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company1 ' names, address and phone numbers along with a certificate of insurance as all affidavits maybe submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and Gw: date the affidavit. The affidavit should be retumed 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. City or Towns 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. The affidavits may be retmmed to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. O%/r%%%%%M The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Invesugauuns 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 Town of Barnstable Regulatory Services • BARNSTABLE, f e' er Director F.G rl 9 MASS. Thomas F , 163q. Building Division Tom Perry,Building Commissioner :200 Main Street, Hyannis,MA 02601 Fax: 508-790-6230 Office: 508-862-4038 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization, conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. Type of Work:,� .ft�ilQ.sO /Q® Estimated Cost Address of Work: 46.0- /�/� Owner's Name: �IQ/h�.J �/Q� f Jr.0 / Date of Application: I hereby certify that: Registration is not required for the following reason(s): ry []Work excluded by law ❑Job Under$1,000 OBuilding not owner-occupied El Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: AM Date Contractor N me Registra ion No. OR Date Owner's Name Q:forms:homeaffidav L From:Joe Madera 508-862-6007 To: Date:4/21/2003 Time: 7:25:26 AM Page 2 of 2 DOW= EC CALL® 2002 DESIGN REPORT US Monday..April 21.200307:23 File Single 1 314" x 11 718" VERSA-LAM® 3100 SP Name CC Home Preston.BCC: RB01 Job Name Mr.&Mrs.James Preston Description STRUCTURAL RIDGE Address -.65 Thread Needle Lane Specifier - City.State,Zip - Centerville. MA Designer Joe Madera Customer Cape Cod Home Improvement Company -: SHEPLEY WOOD PRODUCTS Code reports ICBO 5512,BOCA 98-52.SBCCI 9852 Misc - _ I Standard Load-30 PSF 115 PSF _Tributary 06-06-00 ; BO Bi 1170lbs LL 1170 Ibs LL 620 Ibs DL 620 Ibs DL Total Horizontal Length-12-00-00 General Data Load Summary Version: US Imperial ID Description Lo; Ref. Start End Live Dead Trib. Dur. S Standard Utnt.Aied Ljad Left 00-00-00 12-00-00 30 PSF 15 PSF 06-06-00 115 Member Type: - Roof Beam Number of Spans - 1 Controls Summary Left Cantilever - No Control Type Value %Allowable Duration Loadcase Span Location Right Cantilever - No Moment 5370 ft-Ibs 43.9% @ 115% 2 1 -Internal End Shear 1495 lbs 32.4% @ 115% 2 1 -Left Slope 0/12 Total Deflection L/505(0.285") "6% 2 1 Tributary 06-06-00 Live Deflection L/773(0.186") A 2 1 Repetitive n/a Max.Defl. 0.285"(Limit: 1") 28.5% 2 1 Construction Type n/a Span/Depth 12.1 1 Live Load 30 PSF ; Dead Load 15 PSF NOTES: Part Load 0 PSF Design meets Code minimum(L/180)Total load deflection criteria. Duration 115 Design meets Code minimum(L/2'- load deflection criteria. Design meets arbitrary(1")Maxir,i w a deflection criteria. Disclosure Minimum bearing length for BO is 1-1/2 The completeness and accuracy of Minimum bearing length for B1 is 1-1/2". the input must be verified by anyone Entered/Displayed Horizontal Span Length(s)=Clear Span+1/2 min.end bearing+1/2 intermediate bearing who would rely on the output as Member Slope=0,consider drainage. evidence of suitability for a particular application. The output above is based upon building code-accepted design properties and analysis ' methods. Installation of BOISE engineered wood products must be in accordance with the current Installation Guide and the applicable building codes. To obtain an Installation Guide or if you have any questions,please call (800j232-0788 before beginning . product installation. BC CALC@, BC FRAMER®, BCI@. BC RIM BOARDTIJ,BC OSB RIM. BOARDT'" BOISE GLULAMT"' VERSA-LAMS,VERSA-R1M8. •VERSA-RIM PLUS®, VERSA-STRANDT'", VERSA-STUD@,ALLJOIST@ and AJST"are registered trademarks of Boise Cascade Corporation. LLV LIVLJ l; Ex/sting Cesspools. ; (pump & F111 w/sand) 99 PROPOSED CONTOUR Ex/stin Cesspools E (pump & p f/ll wsond � ) • 99 PROPOSED SPOT GRADE 40 EXISTING CONTOUR o` \ r Fa t PO'I I tw 1g1 crn-oc n aee,rF30.23 EXISTING SPOT GRADE N 35. PU, �K. TEST PIT ° ry �' a . e•az W— EXISTING WATER SERVICE a tiU ° one _ I �_ Jam/ / / Sq•86, Greeat Marsh Rd e•s EXISTING TREE LOCI�JS- I \ w\n 45 Pr Route 28 \ / �' poi/ 1 Sep Ic TankOgL- / `\ LOCUS MAP N.T.S. 46 `5 wires ove 1\\ \ v� h / i aPc AQ \ \\ � / P GENERAL NOTES. ! i Pr9 \`•� /Q� l D/p x a �(� /VE'4Ya t 1. ALL CHANGES TO THIS PLAN MUS'jT BE APPROVED BY THE LOCAL 1..:...: / U O b - ♦ y BOARD OF HEALTH AND THE DESI,IGN ENGINEER. TP 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS D � EL/4 -3 oO� Q: OF THE STATE ENVIRONMENTAL CCPDE, TITLE V, AND ANY APPLICABLE LOCAL RULES AND REGULATIONS. �O 3. THE SEWAGE DISPOSAL SYSTEM SI-HALL NOT BE BACKFILLED PRIOR u n) i I I TO INSPECTION AND APPROVAL B`r6 THE BOARD OF HEALTH AND THE LOT 9 Uy - DESIGN ENGINEER. P MAP G'lO j I 4. ANY CONDITIONS ENCOUNTERED DpURING CONSTRUCTION O0 THE DIFFERING DESIGN � _. FROM THOSE SHOWN HEREON SHeALL �\ PARCEL 78 ENGINEER BEFORE CONSTRUCTION CONTINUES. I 5. ALL ELEVATIONS BASED ON ASSUIWIED DATUM. a 11 20,8001S.F. I I I \ 6: THE DESIGN ENGINEER IS NOT REj-SPONSIBLE FOR THE FAILURE OF RNpp j I ; THE CONTRACTOR OR OWNER TO INOTIFY THE LOCAL BOARD OF 5l I HEALTH FOR PROPER INSPECTIONP.S DURING CONSTRUCTION. a'' p � I 7. WATER SUPPLY PROVIDEq BY TOWN WATER MAIN. BENCHMARK I B. THERE ARE NO PRIVATE 'HELLS LCOCATED WITHIN 150' OF THE S.A.S. TOP OF CONCRETE- alI �� 1 �� RT. BULKHEAD CORNER I I 9. AREAS DISTURBED DURIN' CONSTkRUCTION SHALL BE RESTORED TO A EL, 47.77 (assumed) CONDITION ACCEPTABLE TO THE OJWNER. 10.'IT SHALL BE THE RESPONSIBILITY' OF THE CONTRACTOR TO VERIFY THE THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING Siy 99' I CONSTRUCTION. 11. WHERE REQUIRED, CONTRACTOR S3HALL REMOVE ALL UNSUITABLE SOILS \ IN THE AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF THE S.A.S. \ I AND RLPLACE WITH CLEAN FILL A.kS SPECIFIED IN 310 CMR 255(3). �• \\ 1 j eC 12. PROPERTY LINES SHOWN HAVE BIEEN COMPILED FROM EXISTNG PLANS I `1 AND DEEDS OF RECORD AND ARE-- APPROXIMATE ONLY. THEY DO NOT REPRESENT AN ACTUAL ON THE IGROUND PROPERTY LINE SURVEY. If PROPOSED SEPTIC -SSYSTEM UPGRADE I I o PETER ET. �� OUSE garage i ; o McENTL — 65 THREAD NEEDLE LAN,, VLIV L\`V II ILLL� IVIln� I CIVIL I No. 35109 Prepared for: James Preston, 65 Th read Needle. Lane, Centerville, M/ A, RTC/SSE�w♦a`F Engineering by: - SCALE DRAWN JOB. NO. AYOUT / N ES/0 Engineering Works 1"=20' P.T.M. 52-02 23 Deer Hollow Rand ForestdoIe, MA 026444 DATE CHECKED SHEET NO, 2i Q Z (508) 477-5313 04/23/02 P.T.M. I of 2 ._3,. I I I I I I I - - - - - 77fff 1 = _ Existing outside \ shower ( I WP \ Edge of existing deck��� CE (V Three Seasons Room � I ( I ( I I I cUtend-deck+ Zto'meet'the. -addition — — Floor Plan 1/4" = 11611 Home Improvement Specialists Mr. & Mrs. James Preston Page 1 25 lyanough Rd. 65 Thread Needle Lane Hyannis, MA. 02601 Centerville, Ma. 4/18/2003 End Elevation 1/4" = 1'0" Home Improvement Specialists Mr. & Mrs. James Preston Page 2 25 lyanough Rd. 65 Thread Needle Lane Hyannis, MA. 02601 Centerville, Ma. 4/18/2003 Deck Side Elevation 1/4" = 1'0" Home Improvement Specialists Mr. & Mrs. James Preston Page 3 25 lyanough Rd. 65 Thread Needle Lane Hyannis, MA. 02601 Centerville, Ma. 4/18/2003 Right Side Elevation 1/4" = 1'0" Home Improvement Specialists Mr. & Mrs. James Preston Page 4 25 lyanough Rd. 65 Thread Needle Lane Hyannis, MA. 02601 Centerville, Ma. 4/18/2003 '71 3/4!' 11.1/4"LVLridge rf 2x8 rafters @ 16"o.c.w/3M'-I beadboard plywood(face down), 12 3/4"CDX ply sheathing,ice&water —I 3 shield&asphalt roof shingles fav- 2x4 KD studs w/1 O OSB sheathing&white cedar shingles 2x8 PT joists @ W o.c.w/ /fiberglass screen wire&1x4 / mahogany decking � r 2-2x8 PT girt Grade 17'dii concrete 'SO na-tube piers to �48"below grade_) Cross Section 1/4" = 1'0" Home Improvement Specialists Mr. & Mrs. James Preston Page 5 P P 25 lyanough Rd. 65 Thread Needle Lane Hyannis, MA. 02601 Centerville, Ma. 4/18/2003 I � I L - - - - - - - - - -- - - - - - - - 2x8 PT joists @ W o.c. m tp 2-2x8 PT gi, 6 6_� 6'-0" 6" Pier Plan & Joist layout 1/4" = 1'0" Home Improvement Specialists Mr. & Mrs. James Preston Page'6 25 lyanough Rd. 65 Thread Needle Lane Hyannis, MA. 02601 Centerville, Ma. 4/18/2003