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0003 ELMWOOD CIRCLE
C) TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Ma Parcel p�Z/,,.�� ®� / Application #. Health Division � Date Issued Conservation Division a T9 '��/ ���Application Fee Planning Dept. �✓(� . �. Permit Fee �. �4 Date Definitive Plan Approved by Planning Board Historic -,OKH _ Preservation/ Hyannis' Project Street Address 3 P1 m wood C:% rcle Village cm Owner �c�,� i �, r1 V i e_r[' Address Telephone 1 PPeer�rt Request eo t l Me o Is-s- (x Square feet: 1 st floor: existing proposed j 95 2nd floor: existin"a-proposed l otal new_T Zoning District Flood Plain Wo Groundwater Overlay �l Project Valuation _ o — Construction Type& r,&-wt Lot Size ,;X, :2 4 2 'FT Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type:(Single Family Two Family ❑ Multi-Family # units) Age of Existing Structure Historic House: ❑Yes � On I Kin ' Highway:. g g o Old g s ❑Yes ®'No Basement Type: ull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) io Basement Unfinished Area (sq.ft) (p 7 02 Number of Baths: Full: existing_ new Half: existing new Rt�N/cJ-� Number of Bedrooms: exi /lamsting hew Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: Oa'Gas ❑ Oil ❑ Electric ❑ Ot r Central Air: ❑Yes Lit No Fireplaces: Existing New Existing wood/coal stove: ❑Yes [8'No Detached garage: ❑ KxAlng ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: ❑ Aht-ng ❑ new size _Shed: sting ❑ new si 416 Other: Zoning Board of AppealZo orization ❑ Appeal # Recorded ❑ Commercial ❑Yes If yes, site plan review# Current Use ? `c Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 60,c l --,Md UM Telephone Number Address 26 4,41,J in 14 P License #-CS Q E3 y 5, O _leer ��� G y G Home Improvement Contractor# 7 1 I Email jp-a e0,/nr_Ci hl-P44- Worker's Compensation # t4,� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE(: DATE / 10 s FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE i OWNER DATE OF INSPECTION: FOUNDATION C&� tiwra -It FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING a DATE CLOSED OUT ASSOCIATION PLAN NO. 2015 IECC Energy - s Efficiency Certificate Above-Grade Wall 20.00 Below-Grade Wail 0.00 Floor• .30.00 Ceiling! Roof 49.00 Ductwork (unconditioned spaces): Window 0.28 0.50 Door 0.28 0.50 Forced Hot Air 83 AFUE Cooling System• Water Heater• Name• Date: s Comments, REScheck Software Version 4.6.2 Compliance Certificate Project E J Brown Energy Code:, 2015IIECC Location: Cotuit, Massachusetts Construction Type: Single-family y Project Type: New Construction Orientation: Bldg. faces 0 deg. from North Conditioned Floor Area: 1,340 ft2 Glazing Area 10% Climate Zone: 5 (6137 HDD) Permit Date: Permit Number: Construction Site: Owner/Agent: Designer/Contractor: 3 Elmwood Circle E J Brown Colony Insulation, Inc Cotuit, MA 76 Holly Lane 28 Jonathan Bourne Drive Centerville, MA 02632 Pocasset, MA 02559 o Compliance: 3.1%Better Than Code Envelope Assemblies A§sernbly Cavity* Cont. Perimeter Ceiling 1: Flat Ceiling or Scissor Truss 670 49.0 0.0 0.026 17 Ceiling 2: Cathedral Ceiling 200 49.0 0.0 0.022 - 4 Wall 1:Wood Frame, 16"o.c. 448 20.0 0.0 0.059 23 Orientation: Front Window 1:Wood Frame:Double Pane with Low-E 44 0.280 12 SHGC:0.50 Orientation: Front Door 1: Solid 20 0.280 6 Orientation: Front Wall 2:Wood Frame, 16"o.c. 448 20.6 0.0 0.059 24 Orientation: Back Window 2:Wood Frame:Double Pane with Low-E 44 0.280 12 SHGC: 0.50 Orientation: Back Wall 3:Wood Frame, 16"o.c. 384 20.0 0.0 0.059 21 Orientation: Right side Window 3:Wood Frame:Double Pane with Low-E 34 0.280 10 . SHGC: 0.50 ' Orientation: Right side Wall 4:Wood Frame, 16"o.c. 384 20.0 0.0 0.059 20 Orientation: Left side Window 4:Wood Frame:Double Pane with Low-E 8 0.280 2 SHGC: 0.50 Orientation:Left side Project Title: E J Brown Report date: 07/07/17 Data filename: \\COLONY11Server Documents\COLONY\REScheck\BrownEJ=6-20-17-ElrnwdCir-COT.rck Page l of 9 q Gross Area Cavity- Cont. Assembly ��U-Factori�_-U& ue Perimeter Door 2: Glass 30 0.280 8 SHGC: 0.50 Orientation: Left side Floor 1:All-Wood JoistlTruss:Over Unconditioned Space 870 30.0 0.0 0.033 29 Mechanical Equipment s - . .- Efficiency Forced.Hot Air Gas 83 AFUE Compliance.Statement. The proposed building design described here is consistent with the building plans,specifications,and'other calculations submitted with the permit application.The proposed building has been designed to meet the 2015 IECC requirements in REScheck Version 4.6.2 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. Name-Title Signature Date Project Title:E J Brown Report date: 07/07/17 Data filename: \\COLONYl\Server Documents\COLONY\REScheck\BrownEJ-6-20-17-ElmwdCir-COT.rck Paget of 9 REScheck Software Version 4.6.2 Inspection Checklist 3 Energy Code: 2015 IECC Requirements: 0.0% were addressed directly in the REScheck software Text in the "Comments/Assumptions" column is provided by the user in the REScheck Requirements screen. For each requirement, the user certifies that a code requirement will be met and how that is documented, or that an exception is'being claimed. Where compliance-is itemized in a separate table,a reference to that table is provided. Section, Plans Verified_ Field Verified # Pre-Inspection/Plan Review+' Value Value Complies? Comments/Assumptions & Req.ID ... . r f ,. � .., : _ . a, A :: 103.1, ;Construction drawings and OComplies 103.2 ;documentation demonstrate ; ❑DoesNot [PR1]l ;energy code compliance for the z .R building envelope.Thermal p ❑Not Observable , ,� I 9 p >. !envelope represented on = ONot Applicable 'construction documents. <. 103.1, Construction drawings and - Ocomplies 103.2, documentation demonstrate ODoes Not 403.7 'energy code compliance for r ' [PR3]1 ;lighting and mechanical systems. _ []Not Observable ( l !Systems serving multiple ❑Not Applicable dwelling units must demonstrate compliance with the IECC ; ;Commercial Provisions. . .- 302.1, Heating and cooling equipment is Heating: ; Heating: ;OComplies., 403.7 sized per ACCA Manual S based ' Btu/hr ; Btu/hr :ODoes Not ' [PR2.]z l on loads calculated per ACCA .h, NOt Applicable Manual or other methods Cooling:, Cooling: ;❑Not Observable ; Btu/hr Btu/hr ' approved by the code official. 'Q Additional Comments/Assumptions: 1 High Impact(Tier 1) -2.. Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: E J Brown Report date: 07/07/17 Data filename:\\COLONY1\Server Documents\COLONY\REScheck\BrownEJ-6-20-17-ElmwdCir-COT.rck a Page 3 of 9 Section # Foundation Inspection Complies?'. e_ _. Comments/Assumptions &Req.!® . 303.2.1 JA protective covering is installed to ;❑Complies ; [FO11]2 ,. protect exposed exterior insulation ;❑Does Not J and extends a minimum of 6 in. below ;grade. ;❑Not Observable: ❑Not Applicable 403.9 'Snow-and ice-melting system controls;❑Complies [FO12]2 linstalled. :❑Does Not U :[--]Not Observable ❑Not Applicable Additional Comments/Assumptions: 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 'Low Impact(Tier 3) Project Title: E J Brown Report date: 07/07/17 Data filename:\\COLONY1\5erver Documents\COLONY\REScheck\BrownEJ-6-20-17-ElmwdCir-COT.rck Page 4 of 9 Section Plans Verified Field Verified # Framing/Rough-In Inspection Complies?g Comments/Assumptions &Req.ID Value Value 402.1.1, ;Door U-factor. U- U- ❑Complies :Seethe Envelope Assemblies 402.3.4 ! :❑Does Not ;table for values. [FR1]1 ; ❑Not Observable ❑Not Applicable 402.1.1, ;Glazing U-factor(area-weighted U- ; U- ;❑Complies ;see the Envelope Assemblies 402.3.1, 'average). P ' table for values. •;❑Does Not 402.3.3. ! I ; 402.3.6, ❑Not Observable 402.5 ; ; !❑Not Applicable [FR211 303.1.3 1 U-factors of fenestration products I❑Complies [FR4]1 ;are determined inaccordance ❑Does Not !with the NFRC test procedure or !taken from the default table. f l�" r � ❑Not Observable ; ] ❑Not Applicable 402.4.1.1 ;Air barrier and thermal barrier ❑Complies [FR23]1 :installed per manufacturer's ❑Does Not instructions. ; ❑Not Observable , 'y , < ❑Not Applicable ! 402.4.3 ;Fenestration that is not site built ❑Complies [FR20]1 :is listed and labeled as meeting g ❑Does Not lAAMA/WDMA/CSA 101/1.S.2/A440 or has infiltration rates per NFRC ❑Not Observable 1400 that do not exceed code ` `" ' '❑Not Applicable i limits. p i 402.4.5' IC-rated recessed lighting fixtures , []Complies [FR16]2 sealed at housing/interior finish ❑Does`Not sand labeled to indicate <_2.0 cfm r ❑Not Observable leakage at 75 Pa. ❑Not Applicable 405.2 All ducts in unconditioned spaces ; R-- R- ;❑Complies ; [FR2511 ;or outside the building envelope ! !❑Does Not ! !are insulated to>_R-6. ! ❑Not Observable j :ONot Applicable 403.3.3.5 Building cavities are not used as ❑Complies [FR15]3:. Iducts or plenums. x Does Not { []NotObservable i ONot Applicable 403.4 I HVAC piping conveying fluids R- R- ;0Complies ; [FR17]2'j above 105°F or chilled.fluids ! ! :❑Does Not below 55°F are insulated to>_R- e' 3 ; ;❑Not Observable ; ❑Not Applicable 403.4.1 ;,Protection of insulation on HVAC ❑Complies ; [FR24]1 'piping. ❑Does Not ! ! . „. ❑Not Observable ! h`} ❑Not Applicable 403.6 ,, ,Automatic or gravity dampers are '' '; f'�. " '' '`� °'' °" ❑Complies [FR19]2. j installed on all outdoor air ❑Does Not ! I intakes and exhausts. ! 3 ❑Not Observable ; ❑Not�; �� � � .'w'� Applicable *".,.. Additional Comments/Assumptions: 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) M3 Low Impact(Tier 3) Project Title: E J Brown Report date: 07/07/17 Data filename: \\COLONY'\Server Documents\COLONY\REScheck\BrownEJ-6-20-17-ElmwdCir-COT.rck Page 5 of 9 Section Plans Verified .Field Verified Insulation Inspection Value Value Complies? Comments/Assumptions &Req.ID 303.1 All installed insulation is labeled ❑Complies ; [IN13]zorthe installed R-values � " ag� , tX .g,;❑Does � Not provided. + v ❑Not Observable ; ❑Not Applicable 402.1.1, `Floor insulation R-value. ; 'R-' R. ❑Complies ;See the Envelope Assemblies 402.2.6 ❑ Wood El Wood- f❑Does Not ;table for values. [IN1]1 F ❑ Steel ❑ Steel ;❑Not Observable ❑Not Applicable i 303.2, Floor insulation installed per s; ❑Complies 402.2.7 !manufacturer's instructions and ❑Does Not [IN2]1 in substantial contact with the 2 - # ;underside of the subfloor,or floor ❑Not Observable Warning cavity insulation is in y. pqw ,: .-'$ ❑Not Applicable contact with the top side of sheathing,or continuous insulation is installed on the underside of floor framing and jextends from the bottom to the ;top of all perimeter floor framing tmembers. ,; 402.1.1, Wall insulation R-value. If this is a: R- R- ;❑Complies ,See the Envelope Assemblies 402.2.5, ;mass wall with at least 1/2 of the ❑ ;table for values. Wood Wood ,❑Does Not 402.2.6 !wall insulation on the wall [IN311 exterior,the exterior insulation :❑ Mass ❑ Mass ❑Not Observable requirement applies(FR10). ;❑ Steel - ;❑ Steel :❑Not Applicable 303.2 all insulation is installed per : ❑Complies ;W [IN4]1 manufacturer's instructions. []Does Not ❑Not Observable ❑Not Applicable Additional Comments/Assumptions: 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 . Low Impact(Tier.3) Project Title: E J Brown Report date: 07/07/17 Data filename: \\COLONYMerver Documents\COLONY\REScheck\BrownEJ-6-20-17-ElmwdCir-COT.rck Page 6 of 9 Section Plans Verified Field Verified # Final'Inspection Provisions. Value Value Complies? Comments/Assumptions & Req. D 402.1.1, ;Ceiling insulation R-value. R- • R- :[]Complies ;see the Envelope Assemblies 402.2.1, ; ❑ Wood ❑ Wood ❑Does Not •;table for,values. 402.2.2, I ❑ Steel `❑ Steep. ` 402.2.E :[]Not Observable ; [Fill' ; ;❑Not Applicable 303.1.1.1, Ceiling insulation installed per n ,' r r ❑Complies 303.2 manufacturer's instructions. ❑Does Not [f12]1 Blown insulation marked every „ .i 300 ft2. ❑Not Observable ❑Not Applicable 4012.1 lVented attics'with air permeable ❑Complies [F122]2 insulation include baffle adjacent - ❑Does Not to soffit and eave vents that extends over insulation. x ❑Not Observable ❑Not Applicable r _ . 402.4.1.2 Blower door test @ 50 Pa. <=5 ACH.50 ACH 50"= ❑Complies ; [FI17]1 ach in Climate Zones 1-2,and j ;❑Does Not <=3 ach in Climate Zones 3-8.' Qtdot Observable l ❑Not Applicable 403.2.3 Duct tightness test result of<=4 ; cfm/100 cfm/100. .;❑Complies [F1411 i cfm/100 ft2 across the system or ft2 ft2 ❑Does Not i<=3 cfm/100 ft2 without air handler @ 25 Pa. For rough-in ❑Not Observable tests,.verification may need to ; ❑Not Applicable loccur during Framing Inspection. t ; 403.3.2 Ducts are pressure tested to cfm/100 ; cfm/100 ❑Complies [FI27]1 (determine air leakage with ftz ft2 ❑Does Not .;either: Rough-in test:Total �QNot Observable leakage measured with a pressure differential of 0.1 inch ; ❑Not Applicable Iw°g. across the system including ; ;the manufacturer's air handier ; ;enclosure if installed at time of ; itest. Postconstruction test:Total ileakage measured with a ,pressure differential of 0.1 inch w.g.across the entire system I including the manufacturer's air handler enclosure. 403.3.2.1 ;Air handler leakage designated ❑Complies [F[24]1 by manufacturer at<=2%of ` ❑Does Not !design airflow. I k; Vll _. F it []Not Observable ❑Not Applicable 403:1.1 Programmable thermostats t ❑Complies ; [FIV installed for control of primary w ❑Does Not �b p heating and cooling systems and w ° []Not Observable initially set by manufacturer to 1 w``" ' j "' I code specifications. .x ❑Not Applicable j 403.1.2 . jHeat pump thermostat installed r„ ❑Complies [FI10]2on heat pumps. ❑Does Not. ❑Not Observable ❑Not Applicable 403 521 Circulating service hot water y ❑Complies ; [Flilj systems have automatic or ❑Does Not f'Y �j accessible manual controls. r Y ❑Not Observable ; IONot Applicable 403.6.11• ;Ali mechanical ventilation system OComplies [FI25]2 ,fans not part of tested and listed ❑Does Not .t HVAC equipment meet efficacy and air flow Limits. ❑Not Observable ; ..,::;. ❑Not Applicable 1 High Impact(Tier 1) 2 Medium Impact(Tier2) 73' Low Impact(Tier 3) Project Title: E) Brown Report date: 07/07/17 Data filename: \\COLONMServer Documents\COLONY\REScheck\BrownE)-6-20-17-ElmwdCir-COT.rck Page 7 of 9 Section Plans Verified field Verified # Final Inspection Provisions Value" Value Complies? Comments/Assumptions & Req.ID 403.2 S Hot water boilers supplying heat a ❑Complies ' 2 �ft�¢ �� hr r e fit' 4 [FI2fi] through one-or two-pipe heating ,t°,�+sh <.1j�k�l ❑Does Not systems have outdoor setback rtt � �A�raa�� l a u Not Observable ,control to lower boiler water qu.1 � [:]Not temperature based on outdoor ❑Not Applicable temperature. 403.5.1,1''Heated water circulation systems 4< ❑Complies ; [F128]� have a circulation pump.The, 7' _ ❑Does Not system return pipe is a dedicated 4P }return pipe or a cold water supply ,, ae []Not Observable ' 3 pipe.Gravity and thermos- ❑Not Applicable jsyphon circulation systems are I not present. Controls for 4 j circulating hot water system ' pumps start the pump with signal Ifor hot water demand within the joccupancy. Controls automatically turn off the pump when water is in circulation loop i ri is at set-point temperature and ." a ; OV no demand for hot water exists. > ; 403.5,1.2.[Electric heat trace systems Complies [F129]2 Icomply with IEEE 515.1 or UL ❑Does Not 1515. Controls automatically []Not Observable ' adjust the energy input to the c" g, heat tracing to maintain the ❑Not Applicable desired water temperature in the ' piping 403.5.2 Water distribution systems that ❑Complies [F130]2 _ ;have recirculation pumps thatDoes Not ' pump water from a heated water ; . � :^ . 41 supply pipe back to the heated ❑Not Observable water source through a cold ❑Not Applicable water supply pipe have a demand recirculation water - system. Pumps have controls,, . that manage operation of the pump and limit the temperature S of the water entering the cold water piping to 1049F. 403.5:4 $Drain water heat recovery units -° ° ` `'= ° ❑Complies [FI31]2 tested in accordance with CSA ODoes Not +B55.1. Potable water-side ❑Not Observable ' I pressure loss of drain water heat recovery units< 3 psi for �' ,,. . w, ; ❑Not Applicable individual units connected to one or two showers. Potable water- side pressure loss of drain water a heat recovery units< 2 psi for . 7 M l� 7 :S R,,v 'N ��'•' 1 individual units connected to ;three or more showers. 404.1 75%of lamps in permanent µ ❑Complies [FI6]1 fixtures or 75%of permanent w « w- k °''❑Does Not fixtures have high efficacy lamps Does not apply to low-voltage []Not Observable , !lighting. ," '` ❑Not Applicable ; L404':1 1 ;Fuel gas lighting systems have ❑Complies ; [F123,R, °I no continuous pilot light. []Does Not - []Not Observable v ❑Not Applicable 401:3�`" r Compliance certificate posted. ., J❑Complies [FI7]2 1:160es Not ❑Not Observable ;. 1[1Not Applicable 1 High Impact(Tier 1) 2$ Medium_Impact,(Tier 2) 3;Low Impact(Tier 3) Project Title: E J Brown Report date:,, 07/07/17 Data filename: \\COLONY1\Server Documents\COLONY\REScheck\BrownEJ-6-20-17-ElmwdCir-COT.tck Page 8 of 9 Section Plans Verified Field Verified # Final Inspection Provisions Value Value -Complies? Comments/Assumptions & Req.ID 303.3 (Manufacturer manuals for F ❑Complies [FI18]3 ;mechanical and water heating a�d'� s � h" ❑Does,Not �.,• ,systems have been provided. ¢�, �' � �r,y �� ala ° e � ONot Observable F ' ❑Not Applicable Additional Comments/Assumptions: 1 High lmpact:(Tier 1) 2 Medium impact(Tier 2) 13,1 Low Impact(Tier 3) Project Title: E J Brown Report date: 07/07/17 Data filename:\\COLONYI\Server Docume6ts\COLONY\REScheck\BrownEJ-6-20-17-ElmwdCir-COT.rck Page 9 of 9 wnecseaul�of�fcuaaa(zuQ a 011iee of Coasumes Affairs&Busunes3 Regulation Registration valid for jndividual use pnly before the R HOME IMPROVEMENT CONTRACTOR eagiration date. if found return to:` Regisfratlon i:xpiratio__ 311 i Type: OffiCe of Consumer Affairs and Business Regulation Individual., 10 Park Plaza-Suite.5170', EARL BROWN HZI .,Boston,MA 02116, EAR} 't. . L BROWN `76 HOLLY LANE CENTERVILLE.MA 026 dersecretary Not valid without signature s " Massachusetts Department of Public Safety y . Board of Building Regulations and Standaeds License: CS-004650. Construction Supervisor EARL E BROWN 76 HOLLY LN :,z �4 CENTERVILLE MA t Exp0ation: Cohimissioner 0411312018!2 18 i �114E,� Town of Barnstable Regulatory Services 9TABLZMAS& ' ` Richard V.Scali,Director , Eo;MrI. Building Division Paul Roma,Building Commissioner ` 200 Main Street,Hyannis,MA 02601. www.town.barnstable.ma.us Office: 508-862-4038 r Fax: 508-790-6230 Property.Owner Must.' Complete and Sign This Section , ' If Using A Builder r, Log-1 as Owner of the subject property hereby authorizek_.� , to act on my behalf, . in all matters relative to work authorized by this building permit application for: (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. ature of Own E` ' ._.Signature of Applicant r '. � ' � pp , Print Name Print Name T Date ° ', - s . . • . . ;. a . ` r Q:FORM&OWNERPERMISSIONPOOLS Town of Barnstable J Regulatory Services , drrt rRichard V.Scali, Director Building Division BAMAIRE ST . r Paul Roma,Building Commissioner � 1s�. 200 Main Street, Hyannis,MA 02601 prFD MPS www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER': name home 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 minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required tocomply 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 world,that such Homeowner shall act J 1 R as supervisor." -r ` 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 bires'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 to amend and adopt such a form/certification for use in your community. Tlxe CowmoTnPealtlt a,jf Vassac1rusetts . Depmrarrerrt afrruizrytiial Acciderds Offrr°e ofrmystigations 6t70 FEas iugtorz r freer , Britoil!4 02-UI -rurkers' Campensation Insurauce Affidavit:Bmlder-jCuntracfurrsJEIecfricians/Plumbers , Applicant Informatian Please Print Legibly Name(Sudaeesstaganinfimadkidad SA r Dahn f.-)'►/\ Address (nov h Cit.yJStatn(Zip � t 1►t Phoneme y Are you an employer?Checkthe approprildebom ' T . of r ect require I am a general contractor and I Te a ( I.❑ I arn:a empla�r with ❑ ` 6, ew coon: o .ees full anNor part-time), liave l tired tTte sub-caatrat�Eors Y ( P � 2. I am a sole proprietor orpartn listed on.the attached sheet , . odeling slug and have no employees • , These mb-contractors have g.,❑Demolitioa woda for 7 e in any capacity. employees andhave Woriccrs, y 9. El S.uilding arldfi6n O w &ffe cO n insu are comp_insuranm etinired_] 5. ❑ We.are a corporation and its 10:❑Electrical repairs or additions 3.❑ F am.ahomeowner doing allwork Gfficenhave,exercisedtheir 1L❑Plumbiagrepairsor additions . myself[No kars'camp- right of exemption per MGL 13_❑Roofrepaim inmir nce required,]Y c.1,52,§1{4h and we have no employees.[NO workers' 13.❑'Other comp_insurance required.) •Aay RnHcmtthst cbedesbos f1 Tnzlirt also filloutthe secdonb9owshasing&jrvwo&ee eompenm oupoRcyk5rmadon_ I llammea=ers who subMit tHis affidand M&itng they—daiag RU WU J-d d—MM autside contactars nMSt submit a new affi&Vlt indicating SOCIL rG3nt=torsth2t checktlris box must attached=amitional sheet showing thename of the mb-coatcsctDm and state vrhether ornot["tense entitieshave employees.Ifthesuh-Loatzrturshave.empioyee%they nmst pm-Me their worken,-WMp.policy number. I apt[an entpIoyvr float;is prm-iding markers'coagwLsadort ifn7trancefor my eacp&yees 'Seloev is thR poficy iMd job site frtftarmrctfan, , Insurance COM.Panyifam: - Pohcy yr pelf-ius.I ic_ FkpifatioaDate: Job Site AddressV ci 15tatd Attach a copy of the workere compensatiGnpolicy-declaration page(shoving the policy number and expiration date). Failure to secure coverage as regaired under Section 25A of MGL c 152'can lead to'the imposition of criminal penalties of a fide up to$UOO OG andFGr me-year inVdsoumcut,as vae11 as civil penalties in the farm of a STOP WORK ORDER and a fine of up to 0-00 a day against the Violator. Be adtdsed that a copy of this statement-maybe forwarded to the Office of Itrvestigations ofthe DIA.for insurance coverage ii erfrcatioll- I da hergb radar th arts aridpeaah!ks ofge.g'ury flrattlte uc;{orraatiamrprm rigid aboi g.fs trars and carrect si •• e_ Date: Phone T �p T Official use rainy. Da not ivrite is this area,to be carnpleW by cfty artoirn a fficiat City or Ttinn: P'ernntUcense# Issuing.infhear€ty(cirdeL one): 1.Board of$ealtk 2.Building Department 3.Cit3-lTuvm Clerk 4.Electrical Inspector S.Phimbmg Inspector 6.Othei r Contact Person: Y Phone#: ---- -- - -- - 6 -Information and lastructiolis Massachusetts General Laws chapter 152 reggaes all empIoyers to provide workers'compensation for their employees. p o this fie,an rszrplaprr is defined as."_.every person M.the servi ce of another under any contract of hit e, express or implied,oral or written." An Moyer is defined as"an mc$vidnal,pazinersh�p,association,corporation or outer legal entdy,or any two or more . of the foregoiing engaged a Joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other Iegal entity,eurploymg employees. However the owner of a dwelling house having not more ffim tb=apartments and who resides therein,or the.occupant of the- dweIImg house of mofher wh.o employs persons to do mafift,a1,ce,consfrac4ion or repair work on sneh dwelling house or on the grounds or bugdm' g appurtenant thereto shall not because of such employment be deemed to be as employer." MGL chapter 152,§25C(t7 also stiles that"every state or local licensing agency shall �ithhaId the issuance nr renewal of a T3cense or permit to operate a business or to contract btuldings zn the commorreQealth for any applicant who has not produced acceptable evidence of compliance with the huan ce-coverage reqused" AdditionaIly,MGL chaptrr 152,§25CO, states"Neither the commaawealthnor a'ny of its political subdivisions shall enter into any contract for the performance ofpublic work untl acceptable eyidmc;r,of compliance with tare insurance.. requu-emeaifs of this chapter have been presented tD the contracting authorzty_" AppIira7f�C Please f0l.oin the workers'MmPemation affidavit completely,by checking,fie boxes$at apply to your sit o ation and,if necessary,supply sub-contractors)name(s), addresses)and phone numbers)along withiheir certificates)of ;mince. Liinitf--d Liability Companies(LLC)or LimitedLiabiility-Paz-taerships(LIP)withno employees other than the members or partners,are not requn ed to cagy workers'compensation msmmlcn— If an L LC or LLP does have employees,apolicyisrecj�red. Be advised•thatiiisaffxdaYit may besubm:��dtoth5Deparfrn�ntoflndusftial Accidents for confirmation of ii=asce coverage• Alsa be sure to sign and date the affidavit The affidavit should b e-retumed to the city or town that the application for the permit or license is being requested,not the D ep a tiamf of Ln2L,stad A_ccidm—ts. Should you have any questions regarding tTie law or if you.are required to obtain a workers' compensation policy,please caIl the Department at tha amber listDd below Se1f-film a copanies should enter their se1f-fisura ce license number on the appropriate line. City or Town OfEEda-Is f . Please be sane that the affidavit is complete and prmied.legffily. The Department has provided a space at the bottom of the affidavit for you fill out in the event the Office oflnves igations has to contactyouregardingthe applicant P leas e b e sure to fill i a the p=nitlliceme mrnber which vM be used as a reference number. In addition,an applicant that must submit multiple pemlibUcense.applications in.any given year,need only submit one affidavit indimfin ca -ent policy inf6rna don(if necessary)and under"Job Site Address"the applicant should write"all locations n (may or town)-"A copy of the-affidavit that has been officiaIly stomped or marked by the city or tDwn maybe provided to the - appHcant as proof tlrat a valid affidavit is ou file for fatal 'peLmi[s or licenses_ A new affidavitmust be fffied out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial-Ventura (Le.a dog license orp en:mit to bum Ieave;eb,.)said person is NOT req=ti to complete Ibis affidavit. The Office of Invmfjg�would hke to thank you m advance for your cooperation and should you have any questions, please do not hesitate to give us a call The Dep ar=13f s address,telephone and fax nmDber. Thj CaMManWealth of I sachus-ft-as , Degarfmmt of l idrstdak Aocirlen • f��of�,�e�iig�fio� ��4 Stan S�ti�t ' n� o�11I Tel.4 617 -4 Qxt 4€06 or 1-977-MACSAFR Fax#617-727-7M WW Kevised 4 24-D7 as�.ga-Tf dia AWC Guide to Wood Construction in High Wind Areas: 110 inph Wind Zone Massachusetts Checklist for Com fiance (7s0 CMR 5301.2.1.1 ` P ) Check Compliance 1.1 SCOPE WindSpeed(3-sec.gust) ................................................................ ........:............:........... ...........110 mph WindExposure Category.................................................................. .............................................................B 1.2.APPLICABILITY Number of Stories(a roof which exceeds 8 in 12 slope shall be considered a story)�_stories 5 2 stories RoofPitch ...:.......................................................................(Fig 2) ........................................... s 12.12 - -- MeanRoof Height ..............................................................(Fig 2).................................................. ft s 33' BuildingWidth,W...............................................................(Fig 3)................................................/ ft 5 80' UP— BuildingLength, L (Fig 3 <-80, 9 ............................... ( 9 )........................,................... Building Aspect Ratio(L/W) ...............................................(Fig 4)........................................./.�o� 5 3:1 Nominal Height of Tallest Opening2 ...................................(Fig 4). ........................................... s 6'8" 1.3_ FRAMING CONNECTIONS General compliance with framing connections.....:.:............(Table 2)...................... 2.1 FOUNDATION ' Foundation Walls meeting requirements of 780 CMR 5404.1 Concrete.......................................................................................................................... ConcreteMasonry........................................:.......................... .................................:..........:...... / .... ✓ 2.2 ANCHORAGE TO FOUNDATION''3 5/8"Anchor Bolts imbedded or 5/8"Proprietary Mechanical Anchors as an alternative in concrete only ✓ Bolt Spacing-general ... ............... Fable 4)............................................... �in. ............. ................. ........ Bolt Spacing from endfJoint of plate ............. (Fig )............... ��in.<_6" 12 (Fig ).................................... Bolt Embedment-concrete........................................ Fi 5 ..................................5_in.z 7" 7 Bolt Embedment-masonry..................................... ..(Fig 5). ........................................ in.?:15" PlateWasher...............................................................(Fig 5). .............................................k 3"x 3 x VV 3.1 FLOORS p n 1 Floor framing member spans checked ...............................(per 780 CMR Chapter 55)..........a..... v.. . ✓ Maximum Floor Opening Dimension....:..............................(Fig 6)........:.......,.(.Y. . .............. ft 512' Full Height Wall Studs at Floor Openings less than 2'from Exterior Wall(Fig 6)..................g�.............. Maximum Floor Joist Setbacks - Supporting Loadbearing Walls or Shearwall.:..............(Fig 7).....,................. ft 5 d Maximum Cantilevered Floor Joists Supporting Loadbearing Walls or Shearwall................(Fig 8). ......... ......h!1?. ..(' P,f l�ft <_d Floor Bracing at Endwalls...................................................(Fig 9). ........... Floor Sheathing Type .... (per 780 CMR Chapter......................................... 55)...,� . Floor Sheathing Thickness .......(per 780 CM Chapter 55),.... ,/�1... .`. in. Floor Sheathing Fastening..................................:...............(Table 2)... d nails at•�in edge/ain field 4.1 WALLS Wall Height /t Loadbearing walls.......................'............................... (Fig 10 and Table 5).......................... Ftt 510, ✓ Non-Loadbearing walls................................................ (Fig 10 and Table 5)...................... 5 20' Wall Stud Spacing . ......................... ...............................(Fig 10 and Table 5)................/Z I in.5 24"o.c. . Wall Story Offsets ........................................................(Figs 7&8)........................................... _aft 5 d 4.2 EXTERIOR WALLS' Wood Studs Loadbearing walls............... .... . ............(Table 5). .......... .......2x ft in. _f . Non-Loadbearing walls................................................(Table 5).............41P4........2x ft it%� Gable End Wall Bracing' Full Height Endwall Studs........::..................................(Fig 10)........::.............. :. .......: ......... - WSPAttic Floor Length...............................................(Fig 11)................... ... .. ft zW/3 Gypsum Ceiling Length(if WSP not used)..................(Fig 11)...................... ft>0.9W and 2x 4 Continuous Lateral Brace @ 6 ft.o.c..:(Fig 11).............................. ............................... or 1 x 3 ceiling furring strips @ 16"spacing min.with 2 x 4 blocking @ 4 ft.spacing in end joist or truss bays/ Double Top Plate �`J / Splice Length ........................................................(Fig13 and Table 6 601. `� Splice Connection(no.of 16d common nails).............(Table 6).............,...................................... .....� AWC Guide to Wood Construction in High Wind Areas:110 mph Wind Zone Massachusetts Checklist for Compliance(780 CMR 5301.2.1.1)1 Loadbearing Wall Connections Lateral(no.of 16d common nails)...............................(Tables 7)...................................................... Non-Loadbearing Wall Connections / Lateral(no.of 16d common nails)...............................(Table 8)........................................................ Load Bearing Wall Openings(record largest opening but check all openings for compliance o Table 9) / Header Spans ......................................... .............(Table 9). ......... ................. ft Chin.511' SillPlate Spans ........................................................(Table 9).................................. ft_in.511 . Full Height Studs no.of studs .................................:. able 9 Non-Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) Header Spans.............................................................(Table 9). ...............................:�ft in.s 12' Sill Plate Spans. .(Table 9). .............................. ft=in.s 12" Full Height Studs(no.of studs). ..................................(Table 9)......................................................... Exterior Wall Sheathing to Resist Uplift and Shear Simultaneously4 Minimum Building Dimension,W Nominal Height of Tallest Opening2 ................................................... ...............6..M . s 6'8" V/ Sheathing Type.............................................(note 4)............................ ,`.��P © �G able 10 or note 4 if less ................''l.......3 -in. . Edge Nail Spacing. . _ R ) ........................................... Field Nail Spacing.........................................(Table 10)................................................. in. Shear Connection(no.of 16d common nails)(Table 10).................................................... ✓ Percent Full-Height Sheathing.......................(Table 10)........,.................................... . .. . /� 5%Additional Sheathing for Wall with Opening>6'8"(Design Concepts).0,1*.........7 Maximum Building Dimension,L . Nominal Height of Tallest Opening2 ............................... ... .: 5 6'8" Sheathing Type.............................................(note 4)............................. I�►.7/ �... Edge Nail Spacing...................................:.....(Table 11 or note 4 if less)....................... �3 in. Field Nail Spacing.........................................(Table 11)................................................. n. Shear Connection(no.of 16d common nails)(Table 11).................................................. ..... Percent Full-Height Sheathing.......................(Table 11)............................................ ... o f/ 5%Additional Sheathing for Wall with Opening>6'8"(Design Concepts).. ......... Wall Cladding / Ratedfor Wind Speed?............................................................. ................................................................ 5.1 ROOFS Y`;t Roof framing member spans checked?..........Y..........(For Rafters use AWC Span Tool,see BBRS Website) Roof Overhang ...................................................(Figure 19)............._0_ft s smaller of 2'or U3 Truss or Rafter Connections at Loadbearing Walls Proprietary Connectors Uplift................................................(Table 12)............................................U- plf Lateral.............................................(Table 12).....................................,.......L= pif Shear..............................................(Table 12)..............................................S=Mplf Ridge Strap Connections,if collar ties not used per page 21... (Table 13)....... .......................T=2c�4(5ff Gable Rake Outlooker.........................................(Figure 20)............. ft s smaller of 2'or L/2 Truss or Rafter Connections at Non-Loadbearing Walls Proprietary Connectors Uplift................................................(Table 14)................ ..........................U= Ib. Lateral(no.of 6d cpp on nails) (Table 14).......................................L= Ib. Roof Sheathing Type... ........ Y► �lo�� ...(per 780 CMR Chapters 58 and 59) ............ in. 7�,6"WS� Roof Sheathing Thickness......................... ................ ..................>? �.. ... Roof Sheathing Fastening .................................:........(Table 2). ...............$. ...... ..n ./ Notes: 1. This checklist shall be met in its entirety,excluding the specific exception noted in 2,to comply with the requirements of 780 CMR 5301.2.1.1 Item 1. If the checklist is met in its entirety then the following metal straps and hold downs are not required per the WFCM 110 mph Guide: a. Steel Straps per Figure 5 b. 20 Gage Straps per Figure 11 c. Uplift Straps per Figure 14 d. All Straps per Figure 17 e: Corner Stud Hold Downs per Figure 18a and Figure 18b, 2. Exception:Opening heights of up to 8 ft.shall be permitted when 5%is added to the percent full-height sheathing requirements shown in Tables 10 and 11. 3. The bottom sill plate in exterior walls shall be a minimum 2 in.nominal thickness pressure treated#2-grade. I� v AWC Guide to Wood Construction in High Wind Areas:110 fnph Wind Zone Massachusetts Checklist for Compliance(780 CMR 5301.2.1.1)1 4. a. From Tables 10 and 11 and location of wall sheathing and Building Aspect Ratio,determine Percent Full-Height Sheathing and Nail Spacing requirements b. Wood Structural Panels shall be minimum thickness of 7/16"and be installed as follows: i. Panels shall be installed with strength axis parallel to studs. ii. All horizontal joints shall occur over and be nailed to framing. iii. On single story construction,panels shall be attached to bottom plates and top member of the double top plate. iv. On two story construction,upper panels shall be attached to the top member of the upper double top plate and to band joist at bottom of panel.Upper attachment of lower panel shall be made to band joist and lower attachment made to lowest plate at first floor framing. v. Horizontal nail spacing at double top plates,band joists, and girders shall be a double row of 8d staggered at 3 inches on center per figures below:Vertical and Horizontal Nailing for Panel Attachment -MEN THIS EDGE RESM ON RRAAIING LW8d NAILS ATBbx ,. 11 11 • 11 11 11 1 !I 11 11 1 Ed 11 11 II 11 11 1 11 11 11 1 1 II 1 G 1 11 I l N - II C � rI•F j m 4 I i D 1 11 11 11 ' II W it 11 g 1 I I Q 1/ 1 LL1 1 r ii ii 3 i 14 11 J I r 1 11 11 - DOUSL MILSPACING PAfVEE_ d � r v See Detail on Next Page Vertical and Horizontal Nailing for Panel Attachment ' r AWC Guide to Wood Construction in Sigh Wind Areas:110 mph Wind Zone Massachusetts Checklist for Compliance(7so cmn 5301.2.1.1)` 6 a 66 za ; r r r 1" z I w ,. i, ' 1 a �a t 1 I FRAMING MEMBERS i EDGE Ra-ERMEDIATE I r r i yg� z I r r STAGGERED 3•MMtl TIASL PATTERN PANEL PAN L EDGE DOUBLE NAIL EDGE SPACING DETAL Detail Vertical and Horizontal Nailing for Panel Attachment AWC Guide to Wood Construction in High Wind Areas: 110 mph Wind Zone �.1 g p o e Massachusetts Checklist for Compliance(780 CMR s3oi.2.1.1)1 FAQ*: WFCM Checklist Question: I understand if a new home is built in a town in a iio mph wind zone then the American Forest and Paper Association (AF&PA) Wood Frame Construction Manual can be used to prescriptively design it. I also understand that in some cases the home can be framed per the WFCM1oo mph Guide, if it meets certain requirements including but not limited to aspect ratio, roof height, number of stories, and exposure category (B). I have heard that.Massachusetts has a "modified" checklist that can be used instead of the checklist at the end of the Guide. Is this true and what can you tell me about this "modified" checklist? Answer: You are correct on the items that you have noted. MA has modified the checklist in several important ways. The MA version allows a roof with a pitch up to and including 8 in 12 to not be "counted" as a story. Further it does not require steel hold downs and straps in many locations if full height sheathing is used as defined in the MA checklist. Further, if the building will have furring strips installed in the ceiling abutting the gable wall then 2 x 4s installed on top of the ceiling joists are not required. There are other changes as well that were not noted here. The MA version of the checklist was formulated in recognition of the highly regarded framing methods used in MA for many years and wood framing that has been used in North Carolina over the past io to 15 years which has performed well in severe hurricane weather in that state. *Answers to FAQs are opinions of the BBRS Staff and do not reflect official positions or code interpretations of the BBRS. /s r3 le �qc Q y " P2/V. CZ!�2'ln/ooD C/.dc:GLE I certify that this, property. is- located ,CERTI F1 ED- PLOT PLAN . in flood hazard Zone C (outside the'...500. ' year .flood) as identified by the Depart- (jq, ,��q �CoTc.i7" ment of Housing and Urban Ddvelopdnt, (HUD). L.QCATIQ. . ........... _ -SCALE . . ... .. ,DATE . � ... Date y/ PLAN, RE'FJERENCE 4K4nvC 47�'3�.(/ Reg. Land Surveyo . . „ I certify to its title 'insurange company . that there are no visible ever,o,achments I C.ER.TIFY THAT.THE' �i�?^!�.• U! EZG/�vG or easements` except as shown and that_ this SHOWN ON THIS PLAN IS LOCATED.Ok TH'E GROUND plan was prepared under my- immediate AS, SHOWN HEREON AND THAT IT CONFORMS TO THE` SETBACK REQUIREMENTS OF THE TOWN OF supervision. l3F+j�tn.3TA$G�'•„ , . WHEN CONSTRUCTED oArE �!.?y � - �1•qu,�C REGISTERED LAND SURV QR Town of Barnstable Pr Buildin e,:::. ;;:' °�. .x` v aY.; .F, .:€ .,_fir,�. ,�w.'. ,,??> � .. •' :'"�� ,. s:::BARNWAR g t ost, Card Tha �s�Vis�ble rom the°Street A 'roved Plans'Must be;Ret�ained gn•:Job ndthis� rdgMust.be Ke t 3 :. �PostedUntil+nFinal Inspection Has�'BeenMade. �, �����' �, ` � � �-�°� � : , Permit ' � _; WfieireaC�ertificate:3of�0 A ccupancy,�s Required,such Building shall�Notbe�Occup�ed_untiha;F�nat lnspection3ha,M been�made�� ' Permit NO. B-17-2143 Applicant Name: EARL E BROWN Approvals Date Issued: 07/11/2017 Current Use: Structure A f Permit Type: Building-Addition/Alteration-Residential Expiration Date: 01/11/2018 Foundation:g-A r ( Q Location: 3 ELMWOOD CIRCLE,COTUIT Map/Lot 010 031 Zoning District: RF Sheathing: Owner on Record: LARIVIERE,JULIE K Lontractor�Name: EARL BROWN Framing: 1 >q Address: 3 ELMWOOD CIRCLE S �ontrac#or License� ill 2 . COTU IT,MA 02635 E Est Project Cost: $185,000.00 Chimney: Description: REPAIR TO FIRE DAMAGE,NEW UPGRADE SMOKE INSULATING •3 P � Permit Fee:. $993.50 SHEETROGK,INTERIOR TRIM. ADD 15'X13' KITCHEN ADDITION, NEW Insulation: 15X12 WOOD DECK n FeePaitl $993.50 X Date 7/11/2017 final: Project Review Req: REPAIR TO FIRE DAMAGE, NEW UPGRADE SN/IOKES, INSULATING SHEETROCK, INTERIOR TR€M� ADD I.S'X,1�3� �f' �Iwv� Plumbing/Gas KITCHEN ADDITION,NEW 15X12 WOO®DECK Rough Plumbing: .._ �. �..,Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work autoh lkei bythis permit is commenced within sric i»onths aft ssuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction.document is permit has been granted. All construction,alterations and changes of use of any building and structuresshall be in compliance with the local zoning Maws and codes. Final Gas: A �. „ This permit shall be displayed in a location clearly visible from access street or-;road nd shall be maintained open for pu'I in'l ion for the entire duration of the M work until the completion of the same. Electrical N s The Certificate of Occupancy will not be issued until all applicable signatures bythe I3uildmg�and Fire Officals are provided on this permit. � Service: Minimum of Five Call Inspections Required for All Construction Work: ." 1.Foundation or footing Rough: 2.Sheathing Inspection =� _... 1-_ - � 3.All fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 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: "Persons contracting 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 Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT _10 T' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION, Map Parcel Application # 1 Health Division Date Issued BUILDING DEPT. [` Conservation Division Application F2 Planning Dept. AUG 02 2016 Permit Fee Date Definitive Plan Approved by Planning Board Tn gF 67ABLE Historic - OKH _ Preservation / Hyannis Project Street Address 3 �L-M u/ eod C.` K Village C,G T LA. t 'r Owner ?"L i e I y R L 2 e- Address 3 E-LH wood cd R Telephone 5�198 4949 9 19 o Permit Request RCA.-% o 1 nsrelc o,0n- S A itt,7- X0e�le- o476dj /=LC.*c JLe!vJ, T( rC.y y g �i o wr n tA- //o on c D u Q, 7 o or�.ee 17,4 /4.4,?& IV-0 Srn u c'T u R-e Arch o VA1_ Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation q►O 0 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes 0 No On Old King's Highway: ❑Yes ❑ No 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: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached 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 APPLICANT INFORMATION (BUILDER OR HOMEOWNER) _ Name l Cp A zC 'A-Lt 2 t Telephone Number `7?1 R 6 S6 7 7 Address [ L awl brz— License# C_-S FA - CAS-1 `7 B R.odefLA-,m4 MA 0 X3 .70 Home Improvement Contractor# � � ��a 7 Email L u 1 17 /YS PJ>C'0�7 Worker's Compensation # K � W C 7 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE Y ;L ��6 FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL 1 PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. � rr d - MULTI-STATE RESTORATION, INC. FIRE* FLOOD*WIND* SMOKE*HURRICANE*VANDALISM Fed ID#050515889 CONTRACTORS REGISTRATION#140427 AUTHORIZATION TO PERFORM SERVICES AND DIRECTION OF PAYMENT y i i L G ✓ v.I ,e herein referred to as "Customer",authorizes MULTI-STATE RESTORATION,INC.,herein referred to as"MULTI-STATE",to perform any and all necess cleaning and construction services on Customers' property at: c3 C(('f rC t I Ui t • Ad ZI GEL 35_7 Telephone: e C�� � ``l2,c -b and with respect to items that need to be cleaned at a remote location,to remove and. clean such items as necessary. Customer authorizes f T FC�A_T_ je�"' Insurance Company,herein referred to as "Insurance Company",to directly and solely pay MULTI-STATE. If for any reason the check should come to be or be made payable to the Customer, Customer then agrees to pay MULTI-STATE immediately upon receipt of the check from the insurance company. In order,to expedite payment to MULTI-STATE, Customer hereby appoints MULTI-STATE as attorney-in-fact,authorizing MULTI- STATE,to endorse Customers'name,and to deposit Insurance Company checks or drafts for MULTI-STATE services. Customer agrees to pay Customers'deductible in the amount of$ that applies to this claim. If the loss is not covered by insurance,Custol grees to p y the total amou�to MULTI-STATE upon receipt of the invoice. i ature of er It is my understanding that the services to be performed by MULTI-STATE will be limited to those,which are authorized by my Insurance Company. Insurance Company Name. Policy Number Customer agrees that MULTI-STATE is working for the Customer and not the Insurance Company or agent/adjuster, Additional remarks: 41 I have read this doc ent and completely understand and agree to same: Sign a i Date Printed Name P.O. BOX 2210•MASHPEE, MA 02649.866-921-9111 •FAX 774-238-4422 25e Cormwomveah*of Massadrttsd& Deparlirrent of ludr sfYid Acddmft Office of Im. adores. 600 Washuzoon Street Barston CIA 02111 kvrvla�mass:�v�a�ia . W'erlmrs' Camipensaf uuInsurmce Affidavit Btildeim/Caniractm-sMecfririanslPhiinbers AppUcaut Inf[irmatiou Please Print F.eel"bIy u.L,-n — S �eS�vr n Adam t CAA�� 10411 City/Statc(zilr } #$A Pee- 61.,6 4f Phone- 3b$ 47-7- 3333 Are YOU an employer?Check the appropriate box: Type of project(re", I.R'I ant a employer vdih. � 4- ❑I am a general cantmctor and I 6. ❑Nets consizuC1iCn employees(fall andfor part-time)-* I=e hired Me subs contactors 2.❑ I am a sale prppsigto r orpartner- listed outhe arched sheet 7. ❑Remodeling These sib-aonnfractam have ship and have no employees 1£ &�Demolitioa ' wadzing for mein a employe an es dbaire wodmrs' any��`- $ 9_ ❑Building addition,[No WudMM'� V-insu ce Comp.insuratw' 1. . reclnued] I ❑ We are a corporatim and its 10❑Eleel�ical repairs or a l ions officers have exercised flower 3.❑ I anon homeowner doing all warlc � . 1L❑Plumbsogregaiss or addatiams . o •oomp iig of eseaip6on per M(M . ;�+ nee r .���e mired j F c- , ¢l(4�andwe have as L_❑Roof �� employees.(No Workers' 11[1 Other •�.ecy apg�abat�edcshox�mast aLsa fiIlouEth�secHoaheTowshauiug ffie¢ivadcexs'cvmp�•�fi�,,•poT�eyi�ffv�o� . Hzmeawamwbo submt dris zffidavif inaut ag fley axedming Ruwa l saddLembke outsid c0nt.,nr==ust snb=tanewafr3daeit i"f icufm Sn�h fCosnactoasf=che 1,11 sboutnmstz.=rIedassddid— sheet shoaingt4ienaamofthe xssmd state whether or nut theseeafitaeshsve employies.Iftheauircoatmt+m have emplayee-%dieynnstgmvidethev warkers'tamp.policy M—her. I am ann s1liplayw tJirrtis prauitiiing workers'couTensaf inn inmiraum for ury cnrpl`o wm Bel`osv is dneptrlicy and job site inforrrnabWL In cecomganyName: . Policy,4 c r Self--ins-I ic-4k 1 oti (&I C 16 IJ /7 rob Site d C-t%L. CitglStafel;r;F: 02 07-LA-i-r- 0 oZ 3J- Attacb a copy of the workers'compensationpolicy dedaration page(showing the policy mrmber and expiration date). Fail=to secam coverage as requirednnder-Sw ien 25A o€MCH.c� 152 can lead to the imposition of caintinal penalties of a fine up to$L50a 0Q andlor one-yearimprism=aeut,$s well as eiV2 penalties n the fora of a STOP WORK ORDERand a fine of rep to$250-00 a day against the violator. Be adirised drat a copy of this statemRmt maybe forwarded to the Office of Invesdgatioas of the DIA for;nusura ce coverage tiedffbafi+m I do heraby ceWj3i anrder the pains andpetuffi s ofgediuy that the utfornun ouprimirL d abmre is bare mid correct hate: Phone]k 'r7 2 G Y- 5-L-r7'7 t7irwird use only. Do neat tvrke in ifds area,br be cvmpleted by city artooann ofO'iciaL City-or Tows: Perm bff ieense k Issaig Auflwrity[circle floe]: L Board of Health r.Buff€Iing Department 3.Qiy fown Ouk 4.Electrical hupector rr.Plb¢nbing Inspector (.Other Contact Person: Phow#- 6 laformation and Instructions , General Laws chVtm 152 recjm=all=glapr tD F Vide WDE compensa on fIQfhDir employees. ; p {o this stag,an employee is defined as.¢.Vmy porsanin$ie service of a o&m under any contract ofbi express or iiaplied,oral or Wrn:]:-" An Foyer is defined as"an individual,per,associatiaa,corporation or other legal enfitY,or MY tWo Cr mars of tho foregoing engaged in a Joint mctz rlse,and including the Iegal n 2=CU(atives of a deceased employer,or the receiver or trustee of an individual,partumsbip,assamalaon or other legal entity,employing employees. However tie owner of a.dweIliag Douse having not more than tbree apartments and who resides therein,or the occ¢pant of the - dweffing house of anger who employs persons to do mace,mnstruct on or repair work.on such dwelling house or c n the grounds or bonding appTtrt=z:otthemb shall not becanse of such=ployment be deemed to be an empployea" MGL chapter I52,§25C(6)also stqtPS that every saafe or Ioca.I licensing ag-nCy droll Withhold thie issaance ar renewal of a HcoUse or permit to operate a mar to consfruct butidings iu the commonwealth for any applicant-Who has not produced acceptable evidence of compliance with ti m insurance.-ovexage required" Additionally.MGL chapter 152,§25C(7)states fiTeither the c6mm.cnwealth nor gny ofits political subdivisions shall enter into any contract for the performance ofpubhc Wmkumbl acceptable evidence of compliancewith the,iosorance. regtm�m=ts of this chapter have been presadt d tD tie -moo authoiity." Applicants ' Please Ell out the workers'compensation affidavit complet-ly,by checkig'de boxes aat apply to your situation and,if necessary,supply sub-�ntrasior(s)name(s), ad&mss(es)and Phone numbers) along Wirth their cmtlf cate(s)of ms r-Emce. LmitedLiabilityCompames(LLC)or Limited LiabilhyPatac.shTs.(LTP)withno =:Eployees other than the mertbers or partners,are not required to cry workers' coropensafam ingarance. If an LLC or LLP does have employees,apoIicy is regvired. Be adviseth datthis a$daYitmaybe submitted to the Department of Industrial Accidents for confirmation of insurance covmaage. Also be sure to sign and data the affidavit The affidavit should be ret>zoaed to-Le city or town that the application for the putt or license is being requested,not the Department of IsdastrIsl A cc ens Shouldyou have mrf gnestiams regarding the law or ifyon ale regaired to obtain a Workers' compensa ti rn,policy,please call t3ho Departure t at the number listnd Wow. S61f-iasurodcaropauies should enter their self-n+saran ce license number on the appropriate Eno. City or Town Officials f _ Please be sore the the affidavit is complete and printed IegRIy. The Department has provided a space at the bottom. of t$e affidavit for you to fill out in the event the Office oflnvestigations has to coact you regardng the applicant Please be sure to MI..in.the pen�itllicense umber which Will be used as a refe=ce number. In addition,an applicant that must submit multiple permit/Iicease applications m m3y given year,need only sohnut one affidavit indicating can-eat policy fit:Eb ation iLf necessary)and under`job Site,4_ddress"fie applicant should Write"aII locations II-(city or town)-"A copy of the affidavit that has ben officially stamped or marred by the city or town may be provided to the applicant as proof that a valid affidavit is on file for ftd'nre peIMits or licenses. A new affidavit must be Mod out earl year.Where a home owner or citizen is obtaining a license or permit not related fo any businrss or commercial V&Mt e Cl-e. a dog license or permit to bum leaves a .)said person is NOT required to coripIete this affidavit The Office ofInvestigEdons wouldh-b--to.thankyou.in.advance for your cooperation and shorrldyou-have any gaesiicns, please do not hesitate to give us a call. tel a and fax rmmbec The.Deparime�s address, ephon _ .. . Dega�m�c}f dal Acxidenl� �t=ofXnVe5tTgkii= BQsto�lA Oil11 Ted 4 617-' -49W ad 4€6 or I-97716-�� Fax 617`27 7M Revised 4-24-07 W W =ase gavwa CERTIFICATE OFILIABILITY INSURANCE VATli I 07QW20115) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO FUG14TS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMAMVELY 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), AJUTHORaE0 REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT- If the certificate holder is an ADOMNAL INSURED,the policy(ies)must be endorsed, If SUBROGATtON IS WAIVED,subject to the forms and conditions of the polity,carlaiil POlkies MArY requ"an ondomeme-rit. A statement on this certificate dots mot confor rights to the c0flificale holder in lieu of such ondorsemeniii(s)., ................. ............... STARKWEATHER& SHEPLEY INSURANCE BROKERAGE INC. (4 01 4 3,5-36 0 0 tk'CZN -, �....................... ........ 60 CATAMORE BLVD, ............. twc* ............. EAS'11 PROVIDENCE Rl 02914-1226 AMGUAROt.NSURANCE00 42390................... .......... ............ ........................... I NSLRER El: MULTI STATE RESTORATION CAPE COD DIVISION INC .................................................. ................... ........................................................ . ................ ....................... ........ .1 yolk .......... ................... ................... . . PO BOX 2210 MA 02649 COVERAGES CERTIFICATE NUMBER: 73188 REVISION NUMBER: tHIS IS, TO CLRRy II(AI IIIL;�101_0LS OF 04SJRA14G- LIST:-;:)ULLO�ArtIAW_t3*L'1,V Z&J_*J IO 111=1 114SURO VO i fliiE J(XICY N0IWfl1dSIA%JJN(J,A14Y 4LQJfRJJ;_1r_ %W OR COSIL)III04 Ok' AW CONIqACI 01ti alflt;R;)OQJWNI Will Ll�i;OLCI ro Vail0i I)PIS C.1.RTIFI(;AE_, MAY BiL aR MAY rli-_` NSJRANIC�- AI`WRU_:3 UY 0(XICIiLS 2ILR' IS 10 ALL TflC LX CLUS ICAS AV W V011 i IONS 0$SLr,,Ii POL ICI--S,LIM fT S S I 40WI N MAY HAVL U. *4 RE HY PA30 CLAIMS ......... .......... ----------- ...................w_..._1................................... ........................... ............I ................................................................................................................. 7 1 YPE 04�ftsuoANIM LUIS 1 COMM*KLAI,GENERAL Ii"rVrY CIAMIS&V1.01 (XQJR ............ ......................... ........................................................... ........................................... NiA ........ Mrsb k.t.. ......................................... ........... ............. AuTom"ieumpury )XT ............. ................. VX,tu:14AMY rpor pm"..f ................................ ............ ........... curs $ ........... VWNIA.' .................. ................................................ ...................- U"Rt�LIA LIAO LA01 QCCXWP..WAE i;XCE5S UAr* WA ............... .................... ....... t ViN .... _Ira.'' ............................................................................ A VA 4--A R2WC712G.'M 0711612017..................... F I. r' ARE CA EMR.—M.F�S 500;CfA ................ .................. ........... .......... V!!4ASf_F`tXlcy Lim I $ NIA O"C'4p 1 toN OF OftftA I iONS)LOCA flOAS *041C"S(ACORD 10,Ad"W"34KiimlY.e Sutwaign,Moir t"01100.00 a ftoi*"'m*16 eawitw) VV6rkfift CdW4)W)Aa1lon beirieft will be paid to Massadvaetfs enVlay"�t only.Pursuant to Er idarsepwrit%VC 20 O 06 8,no aLithorizaton is given to pay oaims for bereliLs to amplayeas In states o#*r than M333adlusftli 4 V*9)"ed twos,LY has Nriad ftse enlaoyfts outside of ILA assach;,Zefts. Thil aj(t;r4raI6 of oo;jcy W1 fo"(in V*date That Wii-6 cetiiktatos was Issutd(4,m.lieom tI)4 exprafir.irt data on the abovo voticy pn%iodep Ihr; issue daki Of this carfificalo orijlliuranca). TbA status or this coverage can be n1o6wred daily by awassmg the Pnxif or C4v6r.Va-Coverages Verificmbw 110101 1111w RIE, 3 Elmwood Circle Omit AAA G2635 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THIREOP. NOTICE WILL. ea WILIVEAED IN Town of Barnstable, ACCORDANCE WITH THE POLICY PFfOVIStONS, 267 Main Stram AiJ TttORIZE0 REPRESENTATIVE MA 02601 I K Croy+,CPCU.Vvre Piresiderit Residual MaAel WCRISMA 0 1198 14 ACORD CORPORATION. All rights reserved. ACORD 25(201WOI) The ACORD name and logo are registered marks afACORD ACC)o® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 7/29/2016 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). PRODUCER CONTACT Beth Deschene NAME: Cross Insurance, Inc.- RI a/c NNo Ext: (4,01)431-9200 A/C No:(401)931-9201 376 Newport Avenue AIL ADDRESS:bdeschene@crossagency.com P. 0. BOX 4830 INSURERS AFFORDING COVERAGE NAIC# East Providence RI 02916 INSURERA:Selective Insurance Co. of SC 19259 INSURED INSURER B: MULTI-STATE RESTORATION CAPE COD DIV, INC. INSURERC: 68 NICOLLETTES WAY INSURER D: INSURER E: MASHPEE MA 02649 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1651772535 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 ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVQ POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY - .EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE ❑X OCCUR DAMAGE TO RENTED 100,000 PREMISES Ea occurrence $ S 2139645 1/2/2016 1/2/2017 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 X POLICY❑PRO OTHER: JECT ❑LOC COMP/OPAGG $ 3,000,000 $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Per accident) $ - HIRED AUTOS NON-OWNED - PROPERTY DAMAGE $ AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DIED RETENTION$ $ WORKERS COMPENSATION PERT OTH- AND EMPLOYERS'LIABILITY Y/N STUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE - E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: 3 Elmwood Circle, Cotuit, MA 02635 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 Main St ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE Beth Deschene/BDX ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD NS025(201401) (`� t TTP ch G 4 PO 1L (NL. 3 EL M w o v Sr r-L � 2 i Ix l d " WI 3L w0vj 2- _ d Massachusetts -Department of Public Safety Board of Building Regulations and Standards - dorl Super Visor I o .-- - �,fnii��uuwu JUUGI YI1V1 � lX.1. rauui'v License: CSFA-051784 RICHARD D LAiTIA 1 UAH DR Rockland MA 02370 Expiration Commissioner 0410112017; � CJGL(1BCCGL/L ryL�/UGCGJJCLCiLCUJB Re of Consumer Affairs&Business Regulation .. E IMPROVEMENT CONTRACTOR License or registration valid for individul use only before the expiration t L1 istration4 date. If found return 042� _;, Office of Consumer Affairs and Business Regulation I Expiratio Type „q I07�5l2017,;i 10 Park Plaza-Suite 5170 MULTI-STATE RESTOPAT ON I<1C C;gpE COD Supple C.:`o Su a Boston,MA 02116 RICHARD LAURIA i" 21 PEQUOT RD. MASPHEI=,-MA 02649 i Undersecretary µ f No alid t ut signature Town of Barnstable *Perm �FTHE Tp� . ILIATres 6 mont from issue date "� Regulatory Services *Perm BAMSTAByi�►ss rEg Richard V.Scali,Director �p 1639. ♦� rEo +& Building Division Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601, www.town.barnstable.ma us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel NumberC5.11 0 Property Address .. o d A O esidential Value of Work$ 0 Minimum fee of$35.00 for work under$6000.00. Owner's Name&Address ; —A i(' - [- 10, -\V r CJ Contractor's Name IF�c.C` 1 t 0 (ice Telephone Number '27' 9 Z-7 yY 6. T` Home Improvement Contractor License#(if applicable) Email: e— � o y h .Construction Supervisor's License#(if applicable)- CISs 0, tP ❑Workman's Compensation Insurance' AN 2 8 2617 8e�' �Q�� oleproprietor � ��®g El am the Homeowner TABLE ❑ I have Worker's.Compensation Insurance- Insurance Company Name Workman's Comp:Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request heck box) e-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to 'IZN .vk ❑R of(hurricane nailed)(not stripping. Going over existing layers of root). Re- de' :Sjeplacement Windows/doors/sliders.U-Value 030 (maximum.32)#of windows /S #of doors: *where required: Issuance of this permit does not exempt compliance with other town department regulations,Le,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 ed. SIGNATURE: Q:IWHILESTORMSUilding permit formsTYPRESS.doC 01/25/17 9 r the C'rmzraoinveaht ofMassackusetts Dqwtmeat of lndrrsb id Acdderds ffFwe of�ms 600 Washfivion Scheer BasiWn,MA 02111 tv on masmgm1dia Warimrs' �oh�e>asa 7nsur2nazceAffidavit:B.htilde; ContractursMectrici hunbers A13PUcan#lufa mafran Please Printv . •.Dame� �G.,'�� ���� w�. - _ • eitgf�t�tel � Phcha�� - Y7 c t � - . �, . Are you an employer?:.Cheekthe appropriate bo= Type of project(requEed}= I.❑ I gaa etnployerwitb. 4 ❑I am a gener-d contractar and I 6. ❑Rein eonst ru ction Svgew(fan andfor pa�fiime)* have hiredthe snb-con&actors 2. I am a sale prcpF etfbr arpastuer- Iisted flatile attached sheet ?- ❑Remodeling These sub-contractam hate sS>fp and have nfs employees $. ❑Demolition wai-ng forme iu any sty_ esaglayees aadha>Ve warkgrs' s 9..El Building addition [No 'comp_insuzance comp.;�„�•��•,' ' . ' . . 1� Electrical repairs�additions required-] 5. ❑ W_e are a corpasatifla a>sd its ❑ 3.❑ I am a homwwner doing all wcuk ofFce3s have a=cised their 11_❑Pluaibingrepaim or additions myseIf[No workers'CQMp_ Cot of exemption per]kM- _ c.f52, �I(4k aadwehaveno 1 ❑Roofrepairs �47C7Ra�,�e required-]1 - employees.[Nownx�b=' 13_❑other comp_ice rzigdnEd_I' '�uyappffcr��atc�ie�hos�ltaosia]snSllo�thesectaaheTozvshatsiag�e¢wakes'compeasatiaape]"iegi�ormaaan_ _ ffamemmemuhasah=itddssT3dzvtin . SpeyRmdam.OvralLuld=me Gutddkcentsctars7stsuItmit anew affidavit mdi-9" mcb ICaattacfn6YHz[check this boat nicest attarhe�ffi additi�al sit shooting s of the s¢b caamscross�d state whether ar nottha5e emitted e employees,ifthes•`-•-4=-+.--base employes,dW=5tpmy-de&ek sradceis'tome.ga19U aMhcr_ I am rfra elripIayar t7iat is praviziirtg zvarkers'con rrsrdiatt ursfirarfcs fnr MY CMFI IWes $etvry is tlrspaUCY fund job site - injormatinfs - Insurance Compan*.ame= Policy�or Self-iu&Lic_ r pisatiaa Date: Job.Sit�Addrees: Citpl5tate/rp_ Attach;aropy aftlie workers'fxmapensatioapoIicy declaration page(showing the policy number and respiration dots). FaRrm to seem-e coverage as required under Section 25A of M-GL m 152 can lead to the impos ifu n of criminal penalties of a fine cep to$uoo oD indror oao-yearimp-,=mezd as well as cif penalties in the farm of a STOP WORK ORDEIRand a rMe of up#s 0-00 a rday abet the violator. $e aL&ised'i3zt a copy-of this statmentswaybe fxvmded iu the Office of I4rsrestegatians oftie DJA fox iusmnce coverage s .om_ I tkiher ndpna sa yhaJe info fr mza apm-W abmv is true and correct Si - Date- Phone 07- "-7 7 t7fi%�iaf rasa.anfy; Dv z[at wrke in Ms men,tic be-carrtp&tetd by tip artutrn to f j`C&I City or Tom - Permiff.,ieense:ff , Issuing kufhVrity(ca-cie One): L.Board of Hc9th I BW- mg Depart I City1roven C3rzk 4.Electrical Inspector S.Phzmbmg Inspector 6.Other Com#act Person: Phone#: " Inf orm�ation and Tns ct�ons r� � w. MaSc CbMeft Gem Laws ffiVter M rMF3=all cmgloyess-n gr<s &WMTX 'DOmPeasatM for their employees- ParsIMM3ttO this sfat3te,an ernploym is defined ash.may pmsoain the service of another order nay coact ofbne, or imPHOd,oral or wr>ffr -7 An.�&Tm-is defined as"an.iadiyidoa`L per,assocrahon;corpordion or other legal e deceLy,ased or any rr.o or more of the;foregoing=gaged is aJo� ,�inclndmg the�FePr==±d �s of a deceased employer,or the receiver or trustee of an indtvidna�p =p,association or other legal entity,=T107.mg emPloYees- However the owner of a,&MUimg horse havmgnot more�threes aPartme±s andwho resisles thearein,or the occrgrMt of the- dw nbg house of ano&M who employs p=M=fn do ma w,rrmeU o_rf;on or repair work on such dwelling hoIIse or on.the gro=:Lds or bmMmg app ``hereto sba notbcmnse of sash emrplaymea:Lt be deemed to be an employer." MM chapter 1:52,§25C{6)also stars that¢every state or local licensing agencg shall withhold$ze issaance ar renewal of a license or permit to operate a business or to consftact bmfldiugs iii tiie commonwealth for any, applirautw•ho has notpraduce .acceptable evidence of cnmphancewith the hzur-ance.coverage required," Additionally.M(H_cbaptE r I52,§25C(7)sins aldeithm the co= ur PeaM nor amy of its Political subr£tvisIms shall eTi�-r into any coairart for the penance;ofpnbli o Work mmZ able evidence of camplim=Viiih Iho fiMa e.. regnzements of this cbaPterhavebempreseotedto the e0tnfradinga3fh0i1ty.,, AgpIicaats Please fal ont the woii='compensation affidavit compl�Y,by g bodes that apply to yoir siinaiion noel,if s)name(s), addresses)and phionenumber(s)along�vI&ffieir=tIf s)of necessary,supply or I mmitedLiabHi Par�hzPs(LI:P) no eir�Ioyees oilier than the msur�ce_ Limited.Liabi7iEY Compawes(LLC} members or pmizaez-s,are not required to cagy woike&eompmsafiou insorance. If m IL C or LLP does have employees,apolicyisrequned. Beadyised-(ha:tthisaffi&-VkmaybesabmiftedtittheDepmfinentof Indnsfiial Accidents for conE mafiM of insm`,m=coverage- Also be sure to sign and date the affidavit Tbt affidavit should be returned to the city or town that the application for the pert or license is being r not the D epar(meaf of ; Ill Aca en:b, �uldyou have any gaestions regarding the law or ifyou are regaaedio obtain a wogs' comP.e nsation pofiey,please caU fm Departoneot at the number listed beInw: Self-inmn-ed wniPa�es should ear their self-insurance license umnber on the appropdate line. City or Town.Officials Please be sore that the affidavit is complete and printedlegifIy. The Departmcnthas provided a space at the bottom of the affidavit for you to fM out i a the event the Office of Iuvrstig os has to conbe YoaregZrcUIog the applicant_ cant Please:beine stofllmihepen llr-ensemm�berwhichwfbctsedasarefereucemm�ber. 7ii-addiiion, agpJ' that must submit n llYT10 p ie aPPlitafions in aay given year,need only submit one affidavit h1ficl3ting t policy information.(if nt cess�)and under°job Sim Address"tie z: h should wrle"all lotions i a (�Y or town)_'A copy of-the-affidavitthat has been officially stamped or maimed by the city or tnvtn may be provided in ffie applicant as-proo-fthat a valid a:ffida&is on file far fine peanits or Hmnsm Anew afEidavkmzmt be fMcd oirt ech a year.glhea e a home owner or citizen is obtaining a license or pmmknot related to any business or commercial ve�e (Le_ clog licxase or permit t o bum leaves etc-)said person is NOT regni aA t o com1plete this affidavit a d Tbr,OfE=ofJuvestigationswouldlicntoffiamkyoumadvaacefuryourcocpM_ajionandsfigoldyouhaveanyquestions, please do not hesitate to to give ns a call. The D ep7tmenfs address,telephone and fax rsmbea: Depart nm t Qf l-&�l.AAGcident� f,�-face of�e�Cigktio� . Bps y&(dill Fax#617` 27 7749 Ravisc .4-24-007 g I f Town of Barnstable Regulatory ' gu atory Services KAM Richard V.Scali,Director _ 63¢ Building Division Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 " www.f own.barnstable.ma.us n . Office: 509-862-4038 Fax: 508-790-6230y ' Property Owner Must Complete and Sign This Section_' If Using A Builder as Owner of the subject property • hereby authorize E0..t —7:�&o uj Y\ to act on my behalf . in all matters relative to work authorized by this building permit application for: (Address of Job) **PO ol fences and alaxms.aie the responsibility,of the applicant Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. s J�t4ue-of er — — - ^awn -Soat4e of Applicant Print Name`, .Print Name- Date/ Q:FOR?v S:OWNERPERWSSIONPOOIS a. Town of Barnstable Regulatory Services drt �br,_ Richard V.Scali,Director Building Division s�srtsrwsr.�. Paul Roma,Building Commissioner MAB& i639• 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: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occgRied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner 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 this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc 06/20/16 C��ie`�amirna�rusea.�t,�a�'C/'eil,�aaQcrT6,uael.�a Office of Consumer Affairs&Business Regulation Registration valid.for individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: Registration:, ,73111 Type: Office of Consumer Affairs and Business Regulation Expiratioit13 Individual 10 Park Plaza-Suite 5170 Boston,MA 02116, EARL BROWN !a! EARL BROWN 76 HOLLY LANE CENTERVILLE,MA 0261 dersecretary Not valid without signature 4 Massachusetts Department of Public Safety I f Board of Building Regulations and Standards . { r j License:CS-004650 Construction Supervisor EARL E BR614N 1 76 HOLLY LN CENTERVILLE MA 02632 ..�n Expiration: Commissioner 04/13/2018 Samuel F. McCormack Co., Inc. Insurance Adjusters and Appraisers Samuel F.RUDmlack Co.,Inc. ADJUSTERS AND APPRAISERS June 15, 2016 Barnstable Town Hall -- Building Inspector ' 367 Main Street ' Hyannis, MA 02601 I.) � RE ASSURED: Julie K. Lariviere LOSS-LOCATION: 3 Elmwood Circle, Cotuit, MA 02635 ray _ POLICY NO: 0996357 TYPE OF LOSS: Fire DATE OF LOSS: 06/14/2016 OUR FILE NO: 16-02216 To Whom it May Concern: Claim has been made involving loss, damage or destruction of the above-captioned property, which may either exceed $1,000.00 or cause Massachusetts General Laws, Chapter 143, Section 6 to be applicable. If any notice under Massachusetts General Laws, Chapter 139, Section 3B is appropriate, please direct it to the attention of this writer and include a reference to the above- captioned insured, location, policy number, date of loss and claim or file number. Thank you for your anticipated cooperation. Very truly yours, Robert W. McCormack Adjuster rwm@mccormackadjuster.com cc: Board of Health 42 Holbrook Avenue,Braintree,MA 021841-800-972-5399(781)843-1222 Fax(781)849-8191 One Jonathan Bourne Drive,Suite 7,Pocasset,MA 02559(508)403-2600 Fax(508)403-2602 www.mccormackadjuster.com Town of Barnstable ARPlSTABLE r TOWN OF °F�"E rti Regulatory Services ' °�` Thomas F. Geiler,Director 2019 AUK 8� 26 anaxsrABLE, Building Division v�pl i634� Tom,Perry, Building,Commissioner - , 200 Main Street, Hyannis,MA 02601.,. ° ®IVI rn Nvww.town.ba .. .. :. stable.rna.us', Office: 508-80-4035 Fax: 508-790-6230 PERMIVC� + ..FEE�. e � S�L�C/ Cif z� 1 � t SHED REGISTRATION 120 square feet or less [: 60 l A� � _ �y 3i IM 1 e" e Location,of shed(address) Village Propertyowner's name`. Telephone number ,. Size of Shed Map/Parcel# ` S ature Date Hyannis Main Street Waterfront Historic District?. Old King's Highway Historic District Commission jurisdiction?` Conservation Commission(signature is required) l�-> Sign off hours for Conservation$.00-9i30'&3 30-4:30 g PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY'OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEETHE APPROPRIATE COMMISSION FOR DETAILS. THIS. FORM MUST BE ACCOMPANIED BY PLOT PLAN Q_forms-shedreg REV042506' f� CCYL CG r�V c Frei locct6om of-property: 0 tLt 6 .o { de elk ?Z0 Story dw e h - 3 ap*dx 10ca con v Sh etVo 0 10 .0, AA JV0 0 ., Y refI f694 044 :25000 f o02f D' . c ja Gf flood pan¢ , hood gone. ss her�fy cerri that ttus mor age itlsp"tlon. was rvparect�or PAU X T. �7 / o rt ce& erS P C'. � OmpaSSZank�rsaV6n s No o 311 . H She 4%xUing=m her eon, esno&�f U. im a speaca 9'EmA f tood 1, ° [War& at�d..wi an,e Ctive daze of 72-' ,2" ate Iocahonl of, the dW(-,1 ,Oes.. cortfmn rto the local ,rl 6y-laws veffi�t' wtthe�trnwFcoristYuaion wift res echo horizontal dtmmsiona� 50 Scale: I" _ setback racLu l renu is or is exem pr from, violatwn alf o-ream enz Hate cZtLom under Mass. &neratlaws Outptlrr40A-_Secttonv 7. File ::Nor PLEASE NOTE: The structures as shown 'on this plot plan. are .approximate only. An actual 'survey 'is'necessary for a precise determination of the building location and encroachments if any exist, either way across property lines.. This plan must not he used for recording purposes or for .use in preparing 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 acclomplished by an accurate instrument survey which may reflect different-information,than what. is shown hereon. Please note that 'this is "NOT A BOUNDARY SURVEY" and is :'FOR MORTGAGE PURPOSES ONLY". COLONIAL LAND SURVEYING COMPANY, INC. 269 Hanover Street - Hanover; Mass. 02339 Phone: 781-826-7186 Fax: 781-826-4823 t TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION � y y a 7 Map 6 9 Parcel Permit# 7` 0 7 Health`division 'iF / 553 4Date Issued d ConsVrvation Division ; �. ��`��� Application Fee , Tax Collector Qo r K L— © FC r f �O Permit Fe� 7f Treasurer J Planning Dept. � � ` ,-Date Definitive Plan Approved by Planning Board Z Historic-OKH Preservation/Hyannis l; ? o > Project Street Addressco C i� 2 Village COT Owner i a/i^ �� L 0.�J Vl� P_ Address phi, WOO 1�> Li 2c- /e Telephone L670 k — Y,L 0 `3 U LL Permit Request I 4 ��.��.'�� `�1"l/iMu[./�.v .._ Li � � — /�i•D.a �L�� 0 Q(/`iT' Square feet: 1st floor: existing_ proposed 2nd floor: existing 'ADO proposed ~_9 Total,newer Zoning District Flood Plain OL Groundwater Overlay } Project Valuation �3 Z CVV Construction Type IA)Ooh - 211-m 6 _ Lot Size C', 'f. Grandfathered: ❑Yes ❑No If yes, attach supporting d, cumentaion. co Dwelling Type: Single Family , Two Family ❑ Multi-Family(#units) m Age of Existing Structure a Historic House: ❑Yes 9No On Old King's Highway: ❑Yes ANo Basement Type: Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) �, Basement Unfinished Area(sq.ft) 9dNumber of Baths: Full: existing new Half:existing % new Number of Bedrooms: existing new Total Room Count(not including baths): existing r7 new /�J ff First Floor Room Count Heat Type and Fuel: ❑Gas Oil ❑Electric ❑Other Central Air: ❑Yes 1*o Fireplaces: Existing s4-S New Existing wood/coal stove: ❑Yes )�No Detached 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 7qy' 1 R y' or3F Name �Reti/cl- Telephone Number ��d — 7 7/— Address Y y piieep- 4&lvc-- License# Home Improvement Contractor# �/ LJ 3 a Worker's Compensation# 61 U6 21:/,Oa_ ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO S' SIGNATURE '`� DATE OC FOR OFFICIAL USE ONLY r»` y 40- - PERMIT NO. .2 r DATE ISSUED �AP/PARCEL NO. ADDRESS - i ^ VILUAGE- � OWNER• ,�I�f" - f '.T •J ;� � � ;�:` _ �, DATE OF INSPECTION: FOUNDATION FRAME INSULATION - K T-13 -U3 FIREPLACE w�. ELECTRICAL: ROUGH FINALS - - PLUMBING: ROUGH FINAL ' f } H GAS: ROUGH FINAL'~ _ FINAL BUILDING t; r , DAT,CLOSED,OU -ASS OCIATION_P,LAN NO. _ I i . to U RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE �ro, 4 d New Buildings,Additions $50.00 �7 Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$96/sq.foot= x.0031= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE Jr �fiD�' a� ✓ square feet x$64/sq.foot= x .0031= ZI 7, plus from below(if applicable) ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >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 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fee N 7 o projcost ,���0�2�'C�r��•C� 1n� �C�10�. �J r� ticanx: arc vc erc locatiom of-property: C o to 6 5 I 0 de ed, no.- .� sor� i�. � n� approx• I oca c can she a ^ )11/00 ref ��694 044 , 2�000100,2�� C �a of w od�ane�. flood zone: +�, kin . hCt�El�jCQ ''(}IQtU.S1ilOr Q9e 1tIS�¢C1�10YL Wi�S CQCGtN,'{r u GROVER kPr1Ce&V=1S.-PC. & vm assZankrsavcn s No 3IJ11 ghe dwelling , hereon, esno>�'�fa.L1 in.a spedca FEAA flood, o hmar& at12d.wi axv eRctive date of 7 2-9,2and. qhe locatt'on-1 OP the dwelling does wn#onn rro the local wm -taws uti of W, Scale. at-the tune&Fconstmaion with, respectto horh5wft 1. dimerlsiona� 1� � 50 / - thaclz requirements or i�s ex+em.pr-Frm, vtola.twn ai oreemerit' Date: 6 dct bm under Xtass. &ne rat.Zaws Ou"P'"w 4oA-gecttom 7. File No. PLEASE NOTE: The structures as shown on this plot plan. are approximate only. An actual survey is necessary for a precise determination of the building location and encroachments, if any exist, either way across property lines.. This plan must not be used for recording purposes or for use in preparing deed descriptions and must not be used for variance or building plan purposes. This plan must not be used to locate property lines. Verification of building locations, property line dimensions, fences or lot configuration can only be accomplished by an accurate instrument survey which may reflect different information than what is shown hereon. Please note that this is "NOT A BOUNDARY SURVEY" and is "FOR MORTGAGE PURPOSES ONLY". COLONIAL LAND SURVEYING COMPANY, INC. 269 Hanover Street - Hanover, Mass. 02339 - 'Phone: 781-826-7186 - Fax: 781-826-4823 I • 1 ✓k 1°amxmaizuseea i a��ac<uiaelta BOARD OPBUILDING REGULATIONS License: COk4STRUCTION SUPERVPSOR Numbg7-;;g$ 012430 Bill tel3.ale.1�q 0 j ,`I .X,F 42 04 Tr.no: 25823 R�stired10 n FRANK G CAPRA l 40 COPPER LN - CENTERVILLE, MA d2$ Administrator Results Page 1 of 1 Home Improvement Contractor Look Up Enter Search terms separated by spaces. Search terms can be Town/City,Name, or License number Select Search type: r; AND c`: OR Search Search Results _ Reg. No. F Applicant 11 Street IF City State Zip-1 Name lExpirationi 110321 CAPRA HOME 40 COPPER CENTERVILLE MA 02632 C`PRA' OWNER 10/20/2002 IMPROVEMENTS LANE FRANK Total of 1 Records matched. Back to Home Page J BBRS Privacy Statement http://db.state.ma.us/bbrs/hic.pl 10/8/02 . The Corrimonwealth of Massachusetts Department of Industrial Accidents Office offffestfoat M. 600 Washington Street Boston,Mass, 02111 Workers' Cam ensation Insurance Affidavit location - ' hone# ' aO •I am a homeowner performing all work myself. ❑ I am a sole L rietar and have no one workin In ca achy %/%/%/%// % �N/6�n, GG/ Om ensationforLay �' i'�;'-^:�:is3•T;�;,:???t:;e::;>7;•.,t;:.};.axrS.�^^:`}; ;:Y{,• rkers C .:rr.:4v{:.}}x•Y:+}•a?:;r,:•}L•..s}:F$;:;?;+3::?{3.:'t•:•'. 'S;:#?r.::..•y?.:::: + 2.:':$, .:}gY: am an erO vT r,��'din w0 P }•• i 3;3• ..;T.. >�},`•. ..•••;%: .:;#?q$ 3:%i•,y `•$;{�L vl_ Lll�l v.}:•^C^:T:h}n{'i:'.:3%3}`•• ';:•#}: +r.Y•{• :? •:.i+•:?::3}:Y `:;:\^:;.. .!r~� {{O" ..}. 3:+:;+• ...t rrYf^.^3'�.. ?.,;{;%}}:d}}. :::'S•i•::,, %:}{YS>:N•`.`s}., .. ... ...... ...r.. .i%. .... .... .... r. `.: .3:t;•}S:'w'$::}i:%i'v^''C'4 i;\r h-�^',vk ::Y.w r..rr. .Y........... 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Faffnre to seNre coverage as nquirea 'der Section n 15A'of MGL 152 ca ]ead to the imposition of criminalpenaltles of a fine up to 51,50a.a0 and/or one pears, p�dsontnentasweIias d�ffpena devffithofInvestiga T01'oltheDIAfur overage zmcation00 a dap againstme. I�ders(andthat a' copy of this statemeatmay be forwarded to the I . erju _ dpenaldes-of-pry d that the-rnformatian P rov3cTedabnve�sltualvi�corred2 -L Date Signtura . - l �Go 1 -2 2-1:Phone# Priat name offlclalUse only do not write in this area to be completed by city or town offldal - - perntit/license# OBufldingDepartment city or town: ❑Licensing Board ❑Sele:tmen's Me contact person: r ' I Information and Instructions for their Massachusetts General Laws chapter�152 section 25 requires el0yers to provide a son m the serviceeof another underany pqp tract employees. As quoted from the `law , an employee is r3'P , .of hire,-express or implied, oral or written. artners , association, corporation or other legal entity, or any two or more of An employer is defined as an individual, p mP _ the foregoing engaged in a ion enterprise, and including the legal representatives of a deceased employer, or the receiver or ship, association or other legal entity, employing employees. However the owner.of a , trustee of an individual,partner .. dwelling house ham 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 urtenant thereto'shall not because of such employment be deemed to be an employer. building app I GL chapter section 25 also states that every state or local licensing agency shall withhold for h is uanc i 6 who has M y pp ' of a license or permit to operate a business or to construct buildings m the commonweal not produced acceptable evidence'of compliance with the insurance coverage required. Additionally,neitherthe' commonwealth'nor any of its political subdivisions shall uienterments ofy'confract for the p this chapt r have een presentedBce of public work uatil to the contracting acceptable evidence of complia�oce with the insurance requirements authority- _Y. .' .... .. . . .;.: , Applicants Please fill in the workers' compensation affidavit completely,by checking the of insurance as lies to affidavits maybe supplying company names, address and phone numbers along with a certificate _ _ _. submitted to the Department-Of Industnal Accidents for confirmation of insurance coverage. Also be sure to sign and rI date the affidavit. Tlie•affidavit shouldIe returned to the city or town that the application for tlia permit or license is artrnent of Industrial Accidents. Should you have any questions regarding the'law",;a 9if yQu being requested, not the Dep berlii tEd below.: aie required to obtain a workers' cAmpensatioiz policy,please cal�'the Depa#t a at the num City or Towns ottom or Please be sue that the affidavit is complete and printed legibly. The Department has preondede ace at the li antb Please affidavit for you to fill out in the event the Office of Investigations has to contact y regarding PP r tcense iiu abei wliic}i wilLbe used is a refeience n.1m�'or TTie affidavits maybe be sure to fill in tliape been made: the D ep eat b tmail or FAX unless other arrangements Have - „• . esti ations would like to thank you in advance for you cooperation and should you have a eoii*. . The 0$ice of Inv g, ,.,... .: �I... .please do not hesitate to give us a callON The Departarent's address,telephone and fax number: ,�.,... .. .: ..7. T..•.• - The'Commonwealth Of Massachusetts Department of Industrial Accidents Dike of InvestIPUD is 600 Washington Street , Boston,Ma. 02111 fax 9. (617) 727-7749 W7) 727-4900 ext. 406, 409 or 375 �OFZHE Tp Town of Barnstable Regulatory Services *` enxxszns , ' Thomas F.Geiler,Director v ass 039. p m Building Division lED MA'S Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date—, AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction, alterations,renovation,repair,modernization, conversion, improvement,removal,demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. L Estimate Cost 7Gi Type of Work: A Address of Work: P Owner's Name:-5di / Date of Application: l I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent e /old k1d Date Contractor Name Registration No. OR Date O�rner s Lvarre v Assessor.' and lot number .. a..l..L....��.,?...: ..: 1 I� w r SEPTIC SYSTEM MUST BE- INSTALLED IN COMPLIANCE Sewage, Permit number .................................................... WITH ARTICLE it STATE .q nas ,fit.. i._ -3 .TH E Tp�Io _ TOWN O F B A R N�S T u' � m D WN v i STOLE, - BUtL�DIHG INSPECTOR p i6;q �0 ;a APPLICATION FOR PERMIT-aTO ........ ................. ... ��' .. ......................................................................... y TYPE OF CONSTRUCTION ......f'.........'`..........................................�� ........................................... . .................. r �:..... �yr...........19.� TO THE INSPECTOR OF BUILDINGS: ()Q The undersigned hereby applies for a permit according to the following information: Location ... .. ..O..f..............�13...........�..�/.!.7�.,Gt1..Q.<�.�?...... /..�j........�/.��.. Proposed Use .../... Zoning District ....... ...............................................Fire District ...C.®—ev ............................................ Name of Owner . ..........�......fss Vic...... %Y�....Address .........�. Ur/� ............................................... Name of Builder ..... � m�J..........................:Address ............. ................. .... Nameof Architect ....../! � � -?.........................Address .................................................................................... r . Number of Rooms ..................................................................Foundation .............'1-95 ..... /D o�.....��........... .. ............ Exierior Kge,�..�...... ...............................Roofing ......(>.p . ...... .........��.✓�t� 1 T� Floors .�'...... ........ ��� '�....:. Interior ...�.... /.. '>` r ................................. Heating Fr. �. .. .`,, ..� �. �::x�. .:Plumbing ...1.P./.��� �^.....�.. ... ................:....... Fireplace ..�!:SPo.........��/�.......o �1. ....................Approximate Cost .�Q Oua.......................... .. Definitive Plan Approved by Planning Board �____-•�/f-________19 2-t� Area ......................................... Diagram of Lot and Building with Dimensions Fee of ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH e Cis. I hereby agree to conform to all the Rules and Regulations of the Town. of Barnstable regarding the above ' construction. .r. '.� Name ...... ................. . . . . . . ' . . ~ �� ~ � T. F. Associates, Inc. 1%172 1 1/2 story single family �welling ilm'wood Circle ` , . - '9 �mt'm1t 2 .----------.---------------. . T F Associates Owner -----.�__�_________.'_..�__ ' ~. . frame ' / Type of Construction ' on .. ----- _____,_____________ ' �—.....---- _ . #3 �pkot -----�.. ........ Lot -------- —.. . — �� ,Parmk Qronoa6 —. _lV �Date f Inspection n.. `.�!]` � .. ]gDate Como�t� ` \ ' ` ' ' - PERMIT-REFUSED ----''~----''—^---------'' ]g ' ..................................... '--------^'r--r . ' . —_----..'.—..-------..—.--- / ..—...---. ................................................... ' .- ............................................................. ' . � ^ Approved l9 ' _------------.�—.. ^ ' -------.------.-----------.— / ^ , � ^ -----------.------... —.�—.. ^r -- ^ ~ � ^ . � Assessor' nd lot. number f.N..! '..... k f .... �. 41 P � _ Q ,.. `Sevkbge:Permit number .......................................................... TOWN OF BARNSTABLE 0STHEt� 0 t � [t I ]BARI BLE, i - 16 A BUILDING . INSPECTOR s 4.1 r APPLICATIONFOR PERMIT PTO ...... c. ......................................................................... 'f TYPE OF CONSTRUCTION .......f Q . ...... .................................................................................... .... ...... �:.....a�. 19. E TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: l� Location ''�.. ..... ... .......... � �Axi�/ /�a is �' ...... // , ,/.,.%. r{. ...�.. if . ProposedUse .71 ... `................................................ ...................................I.............. ....... Zoning Distric�...�Y....�"—................................................Fire District ...................................................... Nameof Owner /- .... �s�� ��� n �....:.........................Address ....................... ............................................... Name of Builder ..... �� %! •- ��... .......................... / ..Address ................. ........................................... ,- �•.._---- ��ir/ice/ Jr Nameof Architect ...... /���r��. -'.........................Address .................................................................................... ` Number of Rooms ............ .........................................,......Foundation d... �� -..r o...........f.. '..l............. T//� ...............Roofin �� 5 � '�J � Exterior :........ ... `............................................. g ..................:.....................................`......................... Floors �� .......:............Interior -� ...�.... /� yr f.�2�sc.'G..:....................... Heatin ar .........Plumbing �P�/� err ........................... g ...... Fireplace ........ ....... ...........................Approximate Cost �`%fl O�v ............... .................................;................ Definitive Plan Approved by Planning Boar/d ______�-_�X�_____19-�`� Area �.. ................... W / 0 Diagram of Lot and Building with Dimensions Fee ` SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ..........................1/ ..�...` ' -'.:�.........:.. t+ , T. F. Associates, Inc. A=10-31 19172 1 1/2 story single family dwelling ^ � cationElmwood Circle ---------------------. ~n ! Cmtuit ' .-------------------------- T. ^ ' � Owner ----..�-F. �aaoc�atam» I�o_-_-__-------..-- ` frame � Type of Construction -------..................... . � . | ----'-'-_------------------'' 1 � � | �p� #3 /Plot ---------. Lot ----..~-----. � May ] 77 Permit Granted ----...--------.lA � - Date ofInspection ------------lA Dote Completed ----------'--]q ^ ' ' ' ' PERMIT REFUSED ' . . °~ �g . ----''--'`--^--''-------' ' ' .--.--.----.----------.---.--. . . . . . �- I -.-----.-.------.--.. . -. ---- - ,- U �m '----- 2...................... ' Approved ........................ ........................ 19 . � � ^ . � -------------..~.--------..- � ^^ r � � -----------------..-.—.....-..~ . � � 1-1'0'-1 - ® - ._ _ T BxnBn2 loleonu�br' - r3O flDer.Bbasl ]"on' NDer pleas 1-1"on Y110 t n t a . 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Ca�� � tt4 a �} GENERAL NOTES: r 1:PRIOR TO COMMENCING THE WORK THE CONTRACTOR SHALL EXAMINE ALL CONTRACT DOCUMENTS,FIE CONDITiONB,DIMENSIONS,ETC.FOR ACCURACY AND TO CONFIRM_ THAT THE WORK IS BUILDABLE AS SHOWN.THE CONTRACTOR SHALL PROMPTLY INFORM THE ARCHITECT,IN WRITING,OF ANY DISCREPANCIES AND SHALL OBTAIN CLARIFICATION FROM THE ARCHITECT PRIOR TO PROCEEDING 1WITH THE WORK IN QUESTION OR WIrH ANY RELATED WORK. 2,THE CONTRACTOR SHALL VERIFY AND COORDINATE WALLS AND FRAMING THAT REQUIRE A NONTYPICAL THICKNESS DUE TO STRUCTURAL,ELECTRICAL,MECHANICAL, EQUIPMENT,OR OTHER REQUIREMENTS. 3.ALL STUD WALLS AND PARTITION FRAMING SHALL MEET STRUCTURAL REQUIREMENTS OF -- — - _ - THE LATEST EDITION OF THE IBC AND CURRENT STATE OF CONNECTICUT AMENDMENTS: - 4.VERIFY MOUNTING HEIGHTS OF BACKING PLATES AND SPECIAL STRUCTURAL SUPPORT REQUIREMENTS kWITH EQUIPMENT MANUFACTURERS BEFORE INSTALLING BACKING PLATES AND SUPPORT. 6.ALL THROUGH-PENETRATION FIRE STOPS SHALL COMPLY WITH IBC SECTION 714. Elmwood- Circle Ce.WHEN INSTALLING DRILLED-IN ANCHORS AND/OR POWDER•DRIVEN PINS IN.NONPRESTRESSED tkj 't A 02.635 REINFORCED CONCRETE,USE CARE AND CAUTION TO AVOID CUTTING OR DAMAGING THE EXISTING REINFORCING BARS.3 . - 7.ALL DOORS AND PENETRATIONS IN WALLS AND PARTITIONS SHALL MAINTAIN THE REQUIRED FIRE PROTECTION RATING OF THAT WALL OR PARTITION.WHERE A CONFLICT BETWEEN PARTITION RATING AND DOORIFRAME RATING OCCURS NOTIFY ARCHITECT PRIOR TO PROCEEDING. S.ALL INTERIOR FINISHES IN ONE-HOUR RATED AREAS SHALL BE CONSTRUCTED WITH CLASS 2 MATERIALS.ALL OTHER MATERIALS SHALL BE CLASS 3 FIRE-RESISTANT MATERIALS,PER THE LATEST CODES AND STATUTES, PROJECT CT S TAT U S■ PROJECT DATA. ETA■ 8.TYPICAL DOOR LEG IS4"MINIMUM OFF WALL ADJACENT PERPENDICULAR WALL OR PARTITION, e. 10.ALL DOOR HARDWARE SHALL COMPLY WITH THE CURRENT REQUIREMENTS AND, ` F THE C D _GUIDELINES OR ACCESS BY PHYSICALLY DISABLE (TITLE-24); ■ 11.PROVIDE WEATHER STRIPPING FOR DOORS SEPARATING CONDITIONED AND 9 UNCONDITIONED SPACES PER TITLE 24. 12.ALL EXIT DOORS SHALL'BE OPERABLE FROM THE INSIDE WITHOUT THE USE OF A ` rS1 Q e C U�S S O E DETE�T�IS REVIEWED M V K SPECIAL KEY OR ANY SPECIAL KNOWLEDGE OR EFFORT,EXCEPTION PER USC PPROVIDE READILY VISIBLE DURABLE SIGN ON OR ADJACENT TO THE DOOR,STATING THIS RING BUSINESS d e DOOR TO REMAIN UNLOCKED DU HOURS LETTERS SHALL BE 1 HIGHON A CONTRASTING BACKGROUND , BARNSTABLE BUILDING DEFT. DATE 13 PROVIDE EXIT SIGNS PER IBC AND CURRENT STATE OFCONNECTICUTAMENDMENTS e i 14.A FLOOR PLAN PROVIDING EMERGENCY PROCEDURAL INFORMATION SHALL BE T TO THE S N NOT POSTED AT EVERY STAIRWAY AND ELEVATOR LANDING,AND IMMEDIATELY INSIDE ALL PUBLIC ENTRANCES BUILDING INFORMATION HALL INCLUDE BUT LIMITS TO HE FOLLOWING\ -` - - - - A.LOCATION OF EXITS AND FIRE ALARM INITIATING STATIONS. B. OF FIRE ALARM RN AND STROBE. ... . --- ------ C:DESCRIPTION RED EPART ENT EMERGENCYOTELEPHONE NUMBER S-1-1: FIRE DEPARTMENT DATE BOTH-SIGNATURES ARE REQUIRED FOR PERMITTING BYAMBULATOR,.EMERGENCY. OR AND O.THE PROHIBITION OF THE USE OF ELEVATORS DURING EMEhGENCIES.- C R E.INSTRUCTIONS TO BE FOLLOWED 'SCOPE O F W O \ • PHYSICALLY DISABLED PERSONS IN THE EVENT OF A E GENCY. ` . a : :. _ 15,SIGNS SHALL BE PRINTED WITH A MIN.OF 3/1B"HIGH NON-DECORATIVE LETTERING • - PROVIDING A SHARP CONTRAST TO THE BACKGROUND,THE INFORMATION SHALL �S�G JAW 1 OREBTHAN BEA S80VE THE FLOOR PER ICC7AN61 A 17 1. INCLUDE THE FLOOR LEVEL A EDGE OF = SIGNAGE S LOCATED NOT M 1,Interior non•badbearing partitions,finishes,fixtures end:equfpmeM;as indicated,am to be removed. I.Offices,Toilet Roams,Store ge Rooms and Classrooms" :; - - „- - - 18.FIRE EXTINGUISHERS ARE O BE LOCATED A5 REQUIRED BY THE GOVERNING . 2.Electricw Systems - .. ... -. ` REGULATORY AGENCIES. . Fire Suppressions System. ' 4.Mechanical Systems :. 17.FIRE SPRINKLERS SHALL COMPLY WITH IBC CHAPTER 9 AND IBC STD S-1.FIRE SPRINKLER PLANS SHALL BE SUBMITTED FOR REVIEW TO THE PROPER:REVIEWINO ` AGENCY PRIOR TO CONSTRUCTION.CONCEALED SPACES SHOULD BE SPRINKLERED. ' 18.A COMPLEMENT OF FIRE EXTINGUISHERS WITH A MIN.CLASSIFICATION OF 2A10BC SHALL BE MOUNTED SO THAT THE MAX.TRAVEL DISTANCE TO AN EXTINGUISHER,ON A FLOOR,BY ° EXTINGUISHERS BASIERS 76 FEET.IN ACCORDANCE WITH THE IFC STANDARD,THE TOP OF THE FIRE R T T rr A J C ■_ • `• •�• VICINITY MAP■ EXTINGUISHERS WHICH ARE NOT READILY VISIBLE FROM ALL DIRECTIONS SHALL BE z HIGHER THAN 5'4r FROM E FLOOR: _ PROVIDED WITH SIGNAGE TO INDICATE THEIR LOCATION PER IFC 1002. " ' 19.APPROVED STAIRWAY IDENTIFICATION SIGNS SHALL BE LOCATED AT EACH FLOOR LEVEL " LL ENCLOSED:STAIRWELLS,THE SIGN SHALL IDENTIFY THE STAIRWAY,INDICATE .OWNER ER T WHETHER THERE IS ROOF ACCESS,THE FLOOR LEVEL,AND THE LOUVER AND UPPER TERMINUS f ARCH ITEC 1 T� OF THE STAIRWAY,THE'SIGN SHALL BE PLACED APPROXIMATELY 6'•0"ABOVE THE FLOOR Owner , LANDING IN A POSITION WHICH IS READILY VISIBLE WHEN THE DOOR IS IN THE OPEN OR CLOSED Wiles ArchitectS,, LLC t POSITION,SEE APPENDIX COF THE INTERNATIONAL FIRE CODE IFC SECTION 1210.4 ' 155 Brooklawn Avenue 20.CONTRACTOR TO MAINTAIN CODE COMPLYING EXITING AND SPRINKLERS DURING - ort, C6 06604._ B'„'�Jan - CONSTRUCTION b ph.I 920K3-366- 003 CIVIL ENGINEER.' . STRUCTURAL ENGINEER: Cb LANDSCAPE ARCHITECT M.E.P. ENGINEER � + . _ Wlhefe draw Underno cl vmemnae ehcMtA dMwInp bo wlad forWO%amaa . U. .. dhunoea or Pot any other wv0ome to debmane quaff New N dimmakne ere h 9lteetlon dre aontreom peaoMlbleroreblalnhyalerdlawn4I. (n - - - AreMbdld le not taepor�de 4u lneondehnobaln - - - coePapb dde b pdt�Hnp,p1oWn0 and/wdl0ttd a • I tAevArKagpeypooXlaatlona nM ad w dowmome, . MAtanh am bo u o8 Moe for WIft eabry . - I yAh reaped b dde Proleot 7hb hdudoe dmotrer� . - - In MkIrdo .dao NdNt.a erid dmb . Cottaukeide ehe06o deemed Bm ealhereend bvmara . Mainall eomae hlnoownarao of OeMoa and elmll Wton'and otherm amd n0hh,Indud4g eopyd0me.The Inebumeme o19eMae enW trot be used byd+a Oemerw°e M°mdmamr for Nerve 4ddlbotm,e0eretbtrmto tlda Prajed arts • . - odrerprojode,xMhouttM pd rwM ra d—at of - .. Mo�ees7n Prbfeaelorte6 My arau0=rtzed uee of the . . - Croa tmfO. Bee.wisadbnat to WMDUt erear - - - Germrel°ontreobrebob tblc and wdhoutlledTdy to - Vdlee AroNtede andkrawlroonwd0oma - N Ii a 3 Elmwood circle, r T T.r , ; !. Cotuit; MA.02635 a M7 A u J P.I."Ianw Beal: T _ W. Wies+architects,uc 155 BrooMewn Avenue Ph:203.368.6003 - .. 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In elecuarta form VWas and dMr \ - Conoutbrdo W40 ba deemed as syenm and saaera . ` - oldralrMapsaWalnsNtinerdadfieMaO and and ratan ed OnUnan IeW,-WU"and other rammed s. • doht h lockdrg eopydghk,The lnonumsob or SOMue - ` and not Db wod by du Omura®anoonbaaw _ P� other,eoa,WaautQ pdavMdenegeemantW _ tlw.Wldfe PmfasWormLAnytotautholizedu Mae • - - • - MusA hbft ors gale r, Maoutdab9dyb - Wlea ArahMmte and/or tlAeir wnwRems _ _ _ Roof IF3 Elmwood Circle, " I Cotuit, MA 02635 y-Floor a. _ Q ,[� rr, ��cgndFfoqr a-,V � a _77- FirBt Fioor Foundati m — — -- — — — — — — — — Foundation vWBgd es t'Arch Itects,LLC -1''3, — - — —'— &ooWawn Avenue— _ I-I 11-1.1 . ` : ( III—I I _—— _ Bridgeport Ct 06soa . I - III I-I=1 I-III: 203.366.6003 203.364.1761 I III=1 I • I I hI I i=1TI I I� 11=1 11_I 11=1 I I_I i';. - - w.v esar�t,,orn - I C=III—III-1 11=1 -1 11=111- 11=1 11- : -' l i l III =III— I ,eM; II1=11l=III=1 I I ;. 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