Loading...
HomeMy WebLinkAbout1446 MAIN STREET (COTUIT) �� ;I 1 ��'. i o �J R oF11HEP y 'own of Barnstable *Permit# ' v J y� a, T rpires 6 months from issue date 1��r LE, Richardeg>1 Regulatory Services vices Fee s ASS. 0 1639. 1i��® chard V.Scali,Director Building Division Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Map/parcel Number D 1-7 /0 2—! Not Valid without Red X-Press Impriw Property Address 1 y �_t/`� S%,� `L�T C L 'Presidential Value of Work$ ( J�U�'� Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address :/M /.,/6,N Zl 10 t0 pC.f—TV IV sT-YL�i- L i �A-/L1 13et 0 &-9: MA OZ.i 3� Contractor's Name .P A 1)L—,: —. CA A U 1-7 —i-- Sc "--E Telephone Number Home Improvement Contractor License#(if applicable) 02 f Email: (D V 1 P 0 C_4-2_OC Lt f. Construction Supervisor's License#(if applicable) l O 8 ( 5 4-- ❑Workman's Compensation Insurance . Check one: ❑ I am a sole proprietor ❑ I am the Homeowner _[J-T-6—ave Worker's Compensation Insurance Insurance Company Name L--I 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 L`�Q Apt 2 v1313 C—>Z. rZoo ❑Re-roof(hurricane nailed)(not shipping. Going over existing layers of roof) ❑ Re-side Y ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. AI *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: C:\Users\Decollik\AppDatalLocal\Microsoft\Windows\Temporary Internet Files\Content.Outlook\2PIOlDHR\EXPRESS.doc Revised 040215 The Commonwealth of Massachusetts -- - Department of Industrial Accidents Office of Investigations - } 600 Washington Street Boston, MA 02111 ` www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: / v/ A-t A/n/ 5.1 City/State/Zip: 0S_11'a V)LL L_ AYA- Phone #: Sb`d V 2_9- 117� Are you an employer? Check the appropriate box: Type of project(required): 1. I am a employer with 4. ❑ I am a general contractor and I employees (full and/orpart-time).* have hired the sub-contractors 6. ❑ New construction 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g. ❑ Demolition workingfor me in an capacity. employees and have workers' yf 9. ❑ Building addition [No workers' comp. insurance comp. insurance. required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.❑-6"fller /�L —I&jOE comp. insurance required.] *Any applicant that checks box 41 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. lContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lie. #: PVC,5 j I S 5 86 70 0 26 Expiration Date: Job Site Address: 'N City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi under the pains and penalties of perjury that the information provided above is true and correct. Sign re: C Date: 02 Phone#: Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): . 1.Board of Health 2. Building.Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Property Owner Must Complete & Sign This Form If Using a Roofer / Builder. C.(print) as Owner Agent of the subject property hereby authorizes Paul J. Cazeault & Sons Roofing Inc. to act on my behalf, in all matters relative to work authorized by this building permit application for. Address of Job l q� C a /ut A Signature of Owner_ Mailing Address of Owner /0 A- FPL-,L-4N Telephone # 5b a 22 -Z Date �?�1 /a o t III Please return this form to Paul J. Cazeault Roofing along with your signed contract. It is needed for us to obtain the building permit required by your town to complete your roofing project fax#508-420-4555 office@cazeault.com r/ ACC CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD,YYYY) 08/11/2016 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 - - NAME; Linda Sullivan DOWLING & O'NEIL INSURANCE AGENCY PHONN E (508)775 1620 ac No): E-MAIL ADDRESS: Isullivan@doins.com 973IYANNOUGH RD. INSURERS AFFORDING COVERAGE NAIC# HYANNIS MA 02601 INSURERA: LM INS CORP 33600 INSURED INSURER B: PAUL J CAZEAULT&SONS INC INSURERC: INSURER D: 1031 MAIN ST INSURER E: OSTERVILLE MA 02655 INSURER F COVERAGES CERTIFICATE NUMBER: 76558 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 SUBR -POLICY EFF POLICY EXP - LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ _ DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES Ea occurrence $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: - GENERAL AGGREGATE $ PRO- POLICY JECT LOC PRODUCTS-COMP/OPAGG $ OTHER: - - $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS N/A BODILY INJURY(Per accident) $ HIRED AUTOs NON-OWNED PROPERTY DAMAGE $ - AUTOS_ - Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE N/A AGGREGATE $- - DED I I RETENTION$ $ - WORKERS COMPENSATION X- PER OTH- AND EMPLOYERS'LIABILITY Y/N - _STATUTE ER ,.. ANYPROPRIETOR/PARTNER/EXECUTIVE E.L EACH ACCIDENT $ 1,000,000 A OFFICER/MEMBEREXCLUDED? N/A N/A N/A WC531S386670026 08/10/2016 08/10/2017 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under - DESCRIPTION OF OPERATIONS below - E.L.DISEASE-POLICY LIMIT $ 1,000,000 [N/A DESCRIPTION OF OPERATIONS I LOCATIONS.I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) - Workers'Compensation benefits will be paid to Massachusetts employees only. Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay, claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force'on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at wwW.mass.gov/lwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Paul CaZeault ACCORDANCE WITH THE POLICY PROVISIONS. 1031 Main Street AUTHORIZED REPRESENTATIVE Osterville MA 02655 DanielM.Cro ey,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD �r i- w` ;3•:7:? ':;_t/ .e-r r t' /Jr �" �' r' ��iaj/!� 1:!/ r• �?.7t F�,r y ,<.r,L'[%a�t�''i��'✓' :�.i,���.Y�.. Y);>: Office of Consumer .Affairs �hicfBusiness regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02.11..6 Home Improvement Contractor registration Registration: 103714 Type: Supplement Card _ PAUL J. CAZEAULT & SONS, INC. Expiration: 7/9/2018 RUSSELL CAZEAULT 1031 MAIN ST OSTERVILLE, MA 02658 Update Address and return card.Mark reason for change. SCA1 0 20Vi-05/11 Address Renewal Employment Lost Card c✓�P !f r::i/ilr r:vli:(Yr�Y/I C!,I(�Y'LC7.i.;ll!'�lij rf/1 ' License or registration valid for individual use only ffice of Consumer Affairs&Business Regulation `` before the expiration date. If found return to: �s_kFOME IMPROVEMENT CONTRACTOR P Office of Consumer Affairs and business Regulation - . ;'Registration:. 103714. Type: — 10 Park Plaza-Suite 5170 5_1,1 Expiration- :7jgj2048- Supplement Card Boston,MA 02116 PAUL J.CAZEAULT&S:ONS, INC. RUSSELL CAZEAULT 1031 MAIN ST / OSTERVILLE, MA 02658 Undersecretary Not valid without i'dnature t Massachusetts -Department of Puuiic Safety �1 Board of Sudding Regulations and Standards Construction Sullcrl'isur i i tense: CS-108157 RUSSELL CAZEAULT::.: 2071 MAIN STREET Brewster MA 02631 = _ NO " Co nrnlsslorer 111231201E .` TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 011", BARNSTABLE o Ma i t Parcel / A lication #_Z01 l G Health Division x3 w 3-3 -"pd �" 12 f Date Issued Conservation Division Application Fee r� ""'°" � Fee Planning Dept. ,;, Permit Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address Mq( f,ft Si Village CffNjjA Owner .� �rn Address TelephoneCftlon&w.Mn 2 3 Permit Request T i�oom • No Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Famil Y Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) �Vv Number of Baths: Full: existiing- _7?::� new e Half: existing new Number of Bedrooms: CD existing 'new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: )CGas ❑ 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 Telephone Number %2a Address P � �7 11 License # l S- C)9 4 J O y, Q SY►y� � . M Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTI N DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ' 0/ 011/i 0— :� 3 SIGNATURE DATE �J L FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS 'VILLAGE OWNER i s DATE OF INSPECTION: ' xFOUNDATION ,95w„,Ttj�. FRAME ;INSULATION,.,._, �. FIREPLACE w ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL s GAS: ROUGH FINAL • FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. AC�® DATE(MMIDDIYYYY) �� CERTIFICATE OF LIABILITY INSURANCE 06/24/2015 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 GerNAME: 908 a in Street Agency PHONE 508 428-9194 A/c No: 508 428-3068 908 Main Street Osterville,MA 02655 ADD E-MAIL S:certs@Qermaniinsurance.com INSURERS AFFORDING COVERAGE NAIC N INSURERA:SAFETY INS CO INSURED INSURER B Scott Peacock Building&Remodeling,Inc. INSURER C P.O.Box 171 Osterville,MA 02655 INSURER D:Commerce&Industry Ins.Co. INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE JUM WVD POLICY NUMBER MMIDD MMIDD/ LIMITS A X COMMERCIAL GENERAL LIABILITY BMAD022118 7/5/2015 7/5/2016 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE DAMAGES( RENTED OCCUR PREMISES Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY❑ PRO JECT ❑ LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ D WORKERS COMPENSATION WC 005-81-5464 6/22/2015 6/22/2016 PER oTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ S00,000 OFFICER/MEMBER EXCLUDED a N/A (Mandatory in NH) 1 E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under ---- DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500.000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) f . CERTIFICATE HOLDER 'CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Scott Peacock Building&Remodeling,Inc. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Box 171 ACCORDANCE WITH THE POLICY PROVISIONS. Osterville MA 02655 AUTHORIZE TATIVE © -2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are regis ed marks of ACORD f The Commonwealth of Massachusetts ir - Departmew of Industrial Accidents i Dice o,f Invesligad ens � 400� Washington.Sfreet f J Boston,M D211.1 tVMV.Mass:gtn}/dia "Workers' Covapensation Insurance Afffida-vzt:.Builders/Contractors/ lecttic ans/Piuimbel-s Applicant Infor:rnation Please Print Le 'bl Irp f y Nance(Business OrgmizatioaU&vidml): `) Address Phone#Are am an employer?Check the appropriate.box: Type of project(required): 1.0,I a a employer with 4• Q i am a general contractor and I 6. Q Near construction employees(full andlor part-time).* have hired the sub-contractors 2..❑ I am a sole proprietor or partner- listed on the attached sheet. 17. ❑:Remodeliug ship and have uo employees These sub-contractors have I Q Demolition working for me in any capacity. employees and have workers' 9. Q Building addition [Nu workers'comp.insurance comp.insurance.: required.] 5. We are a cospotatiou and its 1 Q Q Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11_Q Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.Q Roof repairs insurance required.]t c. 152,§1(4),and we have no employees.[No workers' 131]t7ther comp.insurance required_]', *Any applicant that checks box#1 ax W also fill out the section below showing their wtorken'compensation policy information- 1 Flotneowners who submit rtri3 af5detd[indicating they are doing all work and then hire outside contractors must submit n new affidavit indicating such- -Contractors that check this box must attached an additional sheet showing the statue of the sub-contractors and state whether OF not tbose entities have ewplo}mes. 1f the sub-cautrecton:have employees,the),must provide their workers'comp.policy number. I aut an erltpli yver iliac i:s providtjtg iiwrkers'colnipens'aIIon insurance for ltty'eniptoyees Below is file poli'eg and job site inforniallOM 1d Policy#or Self-ins. j Li/c. ': ig(� � ��}�h C7) �QL Expiration Date: Job Site Address -1"l,"` ��1`�lN►c c� cilpstate'Zip: fi W/I 0 2,0 Attach a cop),of the workers'compensation policy declaration page(showing the policy number and expiration date). Failuree to secure coverage as required under Section 25A of NIGL c. 152 can lead to the imposition of criminal penalties of a fine up to y 1,,500.00 snd'or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a.fine of up to$250.0,0 a day against the violator. Be advised that:a copy of this statement may be forwarded to the Office of Investigations of the DILL for insurance coverage verification. I do hereby, reify,under the pain ?". d penalties of perjttrl that the ii�arxeattan provirlerl abflr�z is btr;e and correct, S tare: --~ AID /,+ Date: Of cial use ort(y. Do Jlot it-rite in this area,la be coruplered by do,or town of ciat City or`Fovrn: PermidLiceuse# Issuing Authority(circle one).. I.Board.of Health 2.Building Department 3.City-frourt Clerk 4,Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: 6 r/ rr JJrCc iil �OII1"C°i Affairs.4c Business Regulation License or registration valid for individul use only (;MOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: flfegistration: 151853 Type: Office of Consumer Affairs and Business Regulation Expiration: V /2016 Corporation..: Private Cor 10 Nark Plaza-Suite 5170 SCOTT PEACOCK Boston,MA 02116 BUILDING&.RE_MODELING INC JAMES PEACOCK 1046 MAIN STREET SUITE 7 OSTERVILLE,MA 02655 —-- —Undersecretary _ Nut valid without signature IWI Massachusetts - Department of Public Safety �V Board of Building Regulations and Standards C,nJsfru.tiiui SuperciSM- License: CS-094500 JAMES S PEACOCK PO BOX 171 Osterville MA 02655 t' Expiration Gurnn is uJ✓ 07/22/2016 THE r � Tow.n OfB4.•rI1StabIe 'Regulatory Services "RNsrA.BLE, .. y ' MAaa Thomas F. Getler,Director Bu IdingDiwision ' Tom Perry,Building`Commissioner " 200 Main Street; Hyannis, MA 02601 x ww.town.barnstabie.ma.vs Office: 508-862-403 8 Fax: 508-790-6230 Property Corner Must Complete and Sign This Section If Using A Builder as Owner of the subject.property hereby autho ' r to act on mp behalf, in all matters relative,to work authorized by this buildi ng pernut apphcation'for. AN-0 Stwt (Address :of rob) Sig e o Owner Date Pant Name If Property Owner is applyrng°for permit TA-easecornplete the Homeowners License Exemption Form oaffie reverse side` Q:FORMS:0 WNERPERMISSIDN i 16 15 04: 12p SCOTT PERC 508 428 7625 p. 1 Scott Peacock Building & Remodcling, Inc.. Post Office Box 171 • 1046 Main Street, Suite 3 Ostexville, MA 02655 phone 508-428-7600 • 508-428-7625 fax scott peacock(a)verizon.uet FACSIMILE TRANSMITTAL SHEET 'f,e. 2CAFrom: pore Com an A N Of 0 Date: 691 `7 Fax No.: 30 # of pages Including cover page V URGENrr II FOR REVIEW FI PLEASE REPLY AFOR YOUR USE Notes/c mamnts: Tw- U1R. y Yov 16 15 04:. 12p SCOTT PERC . 508 428 7625 p. 2 r Town of. Rarnstalble UAUN.4TAUI.K Regulatory Services f0 Mnr�y Thnalas F.C.ciler,Director Building Division Thomas ferry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.towu.Luriestablc.rml.us Uflico: ios-862. 1038 Pax: 509-'190-6230 Property Owns rMust Con-1plete and Sign This Sectioii If Using ABuilde>t e • ,._ . K OA 2 s 1,..__.� _..•—_ ,�. Owner of die subject propuny hcr�lj�rautl�c>,:i�.0 G(�.. to act on my behalf in all matCis relative; co work authunized byelu; building;pc:-ruitt applicatiolu fon (Addrr:ss of Job �' i Si�;na"' — 0.: c5w,,�;Y - — YaLe F'riul'N:ff11c2 2 �1:\}YI'III.IijllUls•15Uiiiildntl�,licrrnil1'irrns�l'iKl''f�l:iti�.dx: Rev kt-020101 1 �pp,XE►p��p� Town of Barnstable BAE. Regulatory Services. MASS. i639.M Building Division prFD AC a. 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 - Inspection Correction Notice Type of Inspection Location —WqG MA,-5-P) Sri' Permit Number Owner Builder One notice to remain on job site, one notice on file in Building Department. The following items need correcting: i Z o\je�L 7-AS Please call:. 508-862-4038 for re-inspection. Inspected by Date 9 i 'oWn ®f Barnstable p L E - �, Regulatory Services Thomas F.Geiler,Directorr+n - a. ' H►rMASS. Building Division OpF®eta Torn Perry,Building Commissioner., 200 Main Street,Hyannis,MA 02601 - —'� www.town.barnstable.rna.us Office: S08-862-4038 Fax: 508-790-6230 PE #I �., FEE: - � �U SIZED REGISTRATIOIeT ; RESIDENTIAL ONLY 200 square feet or less Location of shed(address) ," Village Property owner's name Telephone number , ID1 01-7/0 Size of Shed Map/Parcel Si ature Date ? . Hyannis Main Street Waterfront Historic District? NO ' Old King's Highway Historic District Commission jurisdiction? - If over 120 square feet,you must f➢le.with Old King's Highway / Conservation Commission(signature is required) Sign off hours for Conservation 8:00-9:30&3:30-4:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY F .4 Ali O THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS: " THIS FORM MUST BE ACCOMPANIE Y A PLOT PLAN Q-forms-shedreg REV:052813 oFTMEr Town of Barnstable' • � t9 Department of Health Safety, and Environmental Services H ,.pARNSTAN { P MAE&059. Conservation Division 200 Main.Street,Hyannis MA 02601 Office: 508-862-4093 Robert.W.Gatewodd FAX:. 508-778-2412 Conservation Administrator MINOR ACTIVITY REGISTRATION -00 r perty Owner Telephone number e9 6c-k H E Vim. f T. Mailing address 4/0 Project location. Map/Parcel# Project description The following minor activities will be reviewed,under Art. 27,by Conservation staff instead of the Conservation Commission,,as,long as.they are constructed at least 60' from a wetland resource area or top , of a coastal bank * Pathways 4' in width * Fencing that does not create a.barrier to wildlife movement, 6" above grade * Conversion of lawns to decks,.sheds, or patios that are accessory to single family homes, as long as:. house existed prior to.August 7,1996 -alteration within the buffer zone.is less then 250 sq. feet. -sedimentation and erosion controls are used during construction * SfYnwdoes not' de'stonewalls for retaining wall purposes, grading and/or fill) SigKapae Date G, Review y Date/' GIS Plan Attached(fee charged for plan) Q/WPFiles/Form/MinorAct ASSESSORS REF.: a / Q Yap IJ.Parttl 11 �� � LCD4B.• F OVERLAY DISTRICT AP-Aqulhr Pmlxllm DYWct U •ReNaed re.ndmla.Prvfectbn:�' • \ \»A rs OwbY Diefncla-ApN.198J N CJt�P'P't i, FLOOD ZONE: ( 7 o - d, ®' �� R �� Zvn.S 1 d V!J(ew Pr ) / •,_ �e l Q St'ok� } CammunitY Panx Na py1 � . Jmr /1J11 z W ma2D d ;'' `\ 2 d LOCATION MAP: L / ot 73 5$•Y, SS.S iL ry \` b _ ScaN 1'_20 ' .. � � a B�NDEE .. .•.,E��� � _8- ',� BONE: Io VII ---------------- ' F�vnlvge l br)ISD" N s.rooa,: .� .. (/ _ __fir a_n✓M. - C .O '` / ��. ._ __ __`�•`,��./ 4: ®" ♦ �--,i--' '-�=/i man.im.�� _ -__ -' ko.. � _ +SpO• ,� - /� _e Tap v/(/dM1 Eleua19.95'(NCN)29) _ _— —_--- C AL i Fglvv Rauh SBIft - v t wQ.CabR: TmG,a lert mfe Pubmn Ar,w R£N9DM' Add 10 ed OJ 21 I s—I Nau b en4N lem(/I/8mte Ilm, ' Add 1 b Addllbn 042:O8 9 rJ / RII1E Site Plan PREPARm Bn MR ARm FOR: HOTE4 / Proposed Addition Sullivan En�re,.h�,.Ina Ca�eS Rand ,fie prtgry ra.r b naem mom.a. At Po B�dSp Porte d Jim P. MOnzi pIM Ran awlaWe.ae d b mma<bn. 7446 Main Street at..w.,wA ueJs oelm cr.w4 Mm .tamwa++« ,fib tmD.»-e..,Dau.ao-am a z)me Ivpo9rapnly xb�norra,.m meanw Barnstable,(-bro Mass. n.Reen ze/srn bz JD seP/oz bran: AM FNId: wNRrYON J)1M1e datum.uad b.NOw 38,a Rred mem °A DN April 29, 2073 sutE.' Y r: 40' " as Dom.: w "^I1YO'daM1ini OraebO/ CI)JZDI.dp - II , r � f f FN� , �- I I i f I I I f f I tv i f l I � E- � � C ► � f I I I + I i f � i ► I � + I i I �� � � f � I 1 I I I f ► ► � . ` i I � i � I � I i I ( I I i i I ; I : � I ► j I � n I ► I i LI OL � ! 41-1 Is n i I i � ' I ! ► I � ( I .. ! �; � ► I i 1 � I I I -�-- � l i ! I I I ► -. I � I ' ' ;-11 j ► I � ' � � I I I I I I 1 � I !! 1 I - I I � ! ► � I i I � � I � i � ► I I � � j ► ► I I , a 1 � E J � � � I ► I I � 1 I ► ' I I ' I � � I I fir ( 1 I i I I I I i I . ! TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map I Parcel 6zl Application c9v/ Health Division Date Issued 1 Conservation Division //' Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis Project Street Address 1 Y_(0 sI 1p-e.-c-1E Village Owner J �r Address !o -I 1 �It�1 Cal 1 sr Telephone 2 � Permit Request "hm ;Square feet: 1 st floor: existing 1300 proposed 2nd floor: existing 3eo proposed Total new Zoning District 1 Flood Plain Groundwater Overlay 3� ,Project Valuation a-5v;lmo Construction Type� � Lot Size 54 Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.' Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure 9f Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: UITu-1I ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) �� Number of Baths: Full: existin new Half: existing new Number of Bedrooms: ? existingnew — � Total Room Count (not including baths): existing �7/ new First Floor Room Count Heat Type and Fuel: ❑ Gas )60il ❑ Electric ❑ Other Central Air: ❑Yes No Fireplaces: Existing New Existing wove coal sto;§: des ❑ No Detached garage: existing ❑ new size Pool: ❑ existing ❑ new size _ Barnr.21 existing 7 net size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ OtherW 9 Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ cap Commercial Yes No If yes, site plan review # Current Use r Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) _ a e Telephone Number Address 1 I License # a3- Oq q bW Home Improvement Contractor# 151853 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESUL IN FROM THIS PROJECT WILL BE TAKEN TO UV(,. SIGNATURE DATE t ' :FOR OFFICIAL USE ONLY > APPLICATION.# k. DATE ISSUED MAP/PARCEL NO. ;a. ADDRESS VILLAGE 6 - OWNER DATE OF INSPECTION: f. . t) FOUNDATJ.ONyL)A?s ,,iron ^a.uA.i:�. FRAME ;INSULATION.l CIS611 2A . a3:,/ -„k FIREPLACE ELECTRICAL:_ ROUGH FINAL PLUMBING: ROUGH FINAL y GAS: ROUGH FINAL FINAL BUILDING' Ily DATE CLOSED OUT a ASSOCIATION PLAN NO. a c 3 I S03' ASSESSORS REF.: Map 17, Parcel .21 { \V I C, O I certify that the new w� \3 0 foundation shown hereon \ �, ZONE: ID Q conforms to the setback RF (RPOD) \ �+ requirements of the Zoning ' Area (min.) 87,120 SF Bylaws of the town of ,�1 Frontage (min) 150' \ Barnstable. 55°000 Setbacks: 5� Front 30' \ Side 15' Rear 15' � 1 RICHARD R. L HEUREUX 11 o NO. 34312 FLOOD ZONE: \ 1 9 1 ate I \ Zone C & VI Community Panel No. \ #250001 0022D \ �� +h� ^ \\ July 2, 1992 m �� Lot 13 Q \\ \ L.U. \\ I \ \ \ New Concrete �•Ar Foundation A'4 \ �\ 2 1 Sty W/F I Shed 1.1 ^, 55.3" #1446 2 Sty W/F \ Dwelling 1 1 � 1 CB/LP moo. 1 Fnd \ 1 a 1 co I i \ \ 1 1 CB/DH O \ Fnd J O G to "E 0'4 t SZ f•0 M°�5" tNs PLOT PLAN_ °<<1558y �j5° At 1446 Main Street M BARNSTABLE NOTES: (cotuit) MASS. 1.) The new foundation shown was located on the DATE:231SEP11 3 SCALE:1'=40' ground by conventional survey methods on 0 "10 20 30 40 60 80 FEET 23/SEP/13. 2.) The property line information shown hereon was PREPARED FOR: compiled from available record information. The Glenda Manzi Cotuit Trust Jim P. Manzi, Tr. 3.) This plan is not for recording and is not to be used for construction layout or deed description PREPARED BY: CapeSury purposes. 7 Parker Road Osterville MA 02655 DWG #.C429_1 G1 cpp 1 FIELD BY. RRL/WHK/JVB (508) 420-3994 / 420-3995fax PROJECT NAME: ADDRESS: C.. r--e t- _ PERMIT# ::;� PERMIT DATE: M/P: �� I LARGE ROLLED PLANS ARE IN: BOX I SLOT `( Data entered in MAPS program on: BY: q/wpfiles/forms/archive I The Commonwealth of Massachusetts Department of Industrial Accidents ' ilOffice of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information j� Please Print Legibly t' Name(Business/Organization/Individual):. r Address ,W ( >b MPMO TT1 Sut z City/State/Zip:0,..A 111t AR Cua Phone#: g28`-7tObo Are you an employer?Check the appropriate box: Type of project(required): 1(t I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition workingfor me in an capacity. employees and have workers' Y P h'• 9.`wilding addition [No workers"comp. insurance comp. insurance.$ required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions officers have exercised their 11. Plumbing repairs or additions 3.❑ I am a homeowner doing all work ❑ g P myself. [No workers'comp. right of exemption per MGL 12.❑ Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. �1 Insurance Company Name: r , ' m" Policy#or Self-ins.Lic.#: S W Expiration Date: 1p 02J I Job Site Address: I�N to �. ST City/State/Zip:&114 t-.MA QZ 5)--- Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,50.0.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do her ce under th pains and penalties of perjury that the information provideddj above is true and correct Si ate. Date: 0 � " 3 Phone#: Official use only. Do not write in this area,to be completed by city or town official City or.Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance.coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations,has to contact you regarding the applicant. Please be sure�to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax# 617-727-7749 www.mass.gov/dia A1CO/ CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD"YYY) V 07/03/2013 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 Germani Insurance Agency NAME: 908 Main Street PHCNN Ext: 508 428-9194 FAX No: 508 428-3068 Osterville,MA 02655 E-MAIL ADDRESS:certs ermaniinsurance.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:SAFETY INS CO INSURED INSURER B: Scott Peacock Building&Remodeling,Inc. P.O.BOX 171 INSURER C: Osterville,MA 02655 INSURER D: Commerce&Industry Ins.Co. INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.' INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCEJhM& POLICY NUMBER MM/DD/YYYYI (MM/DDIYYYYi LIMITS A GENERAL LIABILITY CP00001152 7/5/2012 7/5/2014 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence) $ CLAIMS-MADE OCCUR MED EXP(Any one person) $ . PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PRO-JFCT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED CHEDULEDJU entAUTOS AUTOS ( )er acc BODILY INRY Pid $ NON-OWNED PROPERTY DAMAGEHIRED AUTOSPS AUTOS Per accident) $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ D WORKERS COMPENSATION WC 005-81-5464 6/22/2013 6/22/2014 we sTATU- OTH- ANDEMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEq$ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Is required) y CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Scott Peacock Building&Remodeling,Inc. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE - 1- ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD It Massachusetts —Department of Public.Safety Board of Building Regulations and Standards Construction Supervisor License:'CS-094500 JAMES S PEACOIC PO BOX 171 ; OSTEVILLE MA-02632 �t f Expiration Commissioner 07/22/2014 Office of Consumer Affairs&Bus,(,ess RegulationL((f License or registration valid for individul use only OVIE IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: 151853 Type: Office of Consumer Affairs and Business Regulation j xpiration: ..%1'. 14 Private Corporation 10 Park Plaza-Suite 5170 g on SCOTT'PEACOCK BUILDING& REMODELING INC Boston,MA 02116 JAMES PEACOCK 1046 MAIN STREET SUITE 7 OSTERVILLE,MA 02655 -- Undersecretary. -' -- -Not valid without signature Rug 26 13 11 : 58a SCOTT PEAC 508 428 7625 p. 2 ��► , . Town of Barnstable ..� Regulatory Services . MAS& g Thomas F.Geiler,Director rya " Building Division _ Tom Ferry,Building Commissioner 200 Main Strcet,Hyannis,MA 02601 - www.towa.barnstable.ma.us Office: 508-862-403 8 'Fax: 508-790-6230 Property Owner Must Complete and Sign This.Section If Using A Builder as Owner of the subject property sY,, ¢, hereby authorize ���I �(/1C..__ to act on my behA in all matters relative to work authotizcd by this building permit. Au fKw 0�1 tulct (Address of job) **Pool fences and alarms are.the responsibility of the applicant. Pools are not to be FAled or utilized before fence is installed and all final inspections are performed and accepted. y•�gtTaturc of O n Siguaturc of tlpplicamt Print Name Print Name Date ;. QYORM&OWNERPERMISSIONFOOLS 612012 Tr!. fir` .-..(. a -- r _ a I tt rn u�ro I - 1 j I I _ L C� 64 I _-- ------ -'---j (....,... I!I ..• I :;enrN. 00 ' I �• His I - 9 j ^i .,� I( o':,r"»a:nc:'s:',�r I _. ____._ri.�-,.,z.r e,..-f I 'I .. � K.,.....—. .=-+/� �/� �„ f - -- c,�- � � • t lam, I'" JLl MSTR BEDROOM � � :BASEMENT I "'TGN=u -R BATH. 'I .- jj tz I I � ' +��� �� •<....,c..,.. I I Q _ i OI } �„ — slrnNe I I ----� �- Ic k.'�'� v �i s.{���: I 5 i":e`cYv L - i I 1 � �y I I. I i I L. I E N '^ o. m, I �--_•_•__- I II _ :o I arrw� .,x �x•� SMOKE DETECTORS REVIEWED q USETrS lob lm 7. J-*TT, -E BUILI ING DEPT. DATE ml. 0 �o Cmm FIRE DEPARTMENT DATE N f `"= A 1, � - I �:.. � � _ F'L �80TH SIGNATURES ARE REQUIREG FGR PERMITTING G� 1 ec+.[. rs:.. _J -.... _. � FQPaDA-:7NDr:-a_ ,'I ac..e .. •_ _._._. O�yOJ (RS�O A 1 PROF / ♦ 1 ISSUEDFMCONSTICIVN .m I of T s ...✓-s,. ". A_ I_ eerw roar.0 nrw 1 ��.+ I .. 9 L I � �� °r•c i,..rw ,o $f w n �u a 2t<fa �5 _. � �I s _ .14 MEW fM z I7 I Yt sin F R:JN L E ✓A ION -L EFT ELE /A ION " 4 1 I:ito � a mutt A ab X y l 11 r— `—F f �I \ ¢ A�V1 -- V y �l — r I: f sa S roer�1 i 1 w cum II. I�..)��S:.J�trt' II�-� �ITf��I� 'R F A R E`/ 4 T G N "ROFE55\� - / • 2 g�FpR(ONSf@ICTION em 2 of � 1 1 — I 1I 8-1 i rt REM :,n i,c.rua wm v ��'I 1 I •_� . � . =.•,.:, � ,zs i,.rvm-- � _—'•"we�rouwn ___` I � -..... . _ I ' o " ' �FJCISTN6 BASEMENT I �•••n�.oe.a � roh..n •••, Cp a w a y —a + Y t . In c N O y.b m DETAIL AT EXISTING BALGON'f •�li w t' .;.�'I I i "` 't°, :. �. a eC'7" 2 I IL PO s mm 'I I I ensEMErin I I p Q Pa, mo REG� -. ._..._- u:in°..,.. PROFESS\°�kP A—3 - awFOFaecolmwxrlox .nl g or � (,F.\ERA_ - FOUNCAT�ONS - MASONK 3.CONNECTORS S4UNN ARE AS - 0' A_L PL`nOC n4_ 'PA - __ MANUFACTURED SMPSO. Fr lMA\C A D \\- J\C¢ __ - STRONG-T,F CO !M1 SOB MLIT ON5 TO H f C r'v\ :N,:M' RF '< \' . $. - I 1;Li - I.THE 4_LOWAE P-51 E MASONRY G N RY T CN SHALL MUST BE AP RO' -J N MIT NG ry ,N.kF. BL AR NG GAPE Y NORM TO H+ REM BY THE EWINEI R IN5'AL_.ATGN A 'G F L OR rlG_\FG_',R O S Or,;:AN N,iS NW CH S TO E VCQ' 7 \ '. _':.G FEGIF CAI \. ^R MASONRY OF ALL GGNNEG TuRo-HALL BE _;A"SF1N KA 1\ '�6 EPFGR_CG\STR,CT ON. J�TURES IA POI/.AIE E dd!. IN STRICT ACCORCANCE KITH THE RCNGTH OF MASONRY FM-500 P51. THE MANUi'ACLRERS NSTRUC T,^vN5 \LL 5AF- I. "-G.I AI ON?: _ /MUST EMPLOY ALI.RF:OJiRED 5PA\M1A.nG E' i f :AF BF F t r!Y 'C LONE' TN Ck _5,A - ARR FASTENER5. ., vl ; f CO!TR K,•OX TO LOWER_E/A \'IA.\ D WN• 2 V k-!GAL REINFGRC.NG^F MASONRY - - G RC'^^✓F A,..NG E\GS::RC 5I-¢,�'f AI .\EF A_S GA THE DRAM\ 5 F EOUI C TO - nA SHALL=E AS INDICATED ON SFAN R_\T:Y'6' `'L UiN'RAt.FOR_kE57-G\_.cIL�TY. REACH ROPER BLAB NG„A C'fY. THE DRAWINGSV ALL CORES OF 4,.ALL CONNECTORS SHALL BE Za � MASONRY'J'NITS SHALL BE FILLED HOT DIP GAL'✓ANI_EG. NITH GROVT. ¢EINFORC!N'G BAR C a:MA.'. F"'IC' 5 RU-4-UNEI6LE 3.KA LS AG`NG AS RETAN,WA:._5 LAPS SHALL BE 2-6'MIN. = ER: 8 i'OR V: .NAT,O.GI AI_ SHALL NOT EE 5AC':E LLCG A-^OJT - 5.INSTALL ALL CONNECTOR FASTENERS - - DC GNR A = - - ----------- R'/I IGN�s R:C i BRACING UNT L ALL S1.FFORTING 50;L BEFORE LCADIMv THE JOINT. '(HI' 1 SLABS ARE IN,c_iGE-a 4T 3.HORIZONTAL JOINT REINFORCING 1.APPLICABLE ol:!,i,'45 GODE FOR MASONRY SL+ALL E=FOUAL MASSACH';,'SF.?TS dTH.ED:T;ON - ADEOVA'E STRENGTH TO D'UR-O-W.A.L TRL=-S MAMlr AGTEREU E.SPLIT WOOD IS NOI AGC,EFTA51_F. -Jul c oGNAF[CARE'A5 6ECN WITH WIRE LON`URM,II.G TO A5TM A d2 - FOR ANY CONNECTION. a N IN'HE F;:LPARA'inH OF 4.COMPACTA_L r!L„NDCR FCC-ING5 1 COATED FOR GORRO',ON PROTECTION OE-.5\W ND SFLCL' !O MFH N - d,\:..DRAWI\C>S AND SFCGIf IC.\IiGNS. 1 5LA65 i0 THE SPEC F:ED TENS Ty 14 AGGORDA4LE WITH A5TM.A 153. V-,W H. NL.✓LR THF. \{W DOv hCT /ERIFY, GLASS B-2 ALL'N'RE SHALL BE '.ALL EXPOSED FRAMING`EFIBERS -- - W.E•+ r\FAN. :A,:A\ i UM.AN ERROR °GAGE M NiMJM. PROVIDE MINIMUM SHALL BE TREATED PER ArYA R.L LRAL D-5 \GR T Fln 1 I R TH\ R_A ON tl b IM.ERATIVE LAP GF b"a USE FRCFADR:ATED T5 G?M GLA O_'5 7 MEMBERS IN _._._ _.. _.._ ._ E+. fii-t TNL CJ�I.RACroR SH.AL.L CirfELK OR CORNER SECTIONS 4.ALL CONTACT WITH SOIL SHALL BE A IF.N SONS d DETAILS d h4.'S- --" WALL INTERSECTIONS TREATED PER ANPA G23/C24 II -FIR5T F:.0OK tic BSc F�l - ✓TkI ___ STRUCTURAL STEEL _ V.- JN r0N5 'MZN50N5, - CCA OW.JOB SITE FABRIGATION5 Ii 15-oF DL by O L Jar N5 A'IHO e0[ AIL 6U75 d BORE5 SHALL BE TREATED IN I+� nR LN I i\,- HE.F.ROUGH- I.DESIGN FABRICATION 1 EREG-ION COCNRETE MASONRY UNITS SHALL _ ACCORDANCE WITH.AWPA SM.M4. .- �. SECOND-..GOP 3O P" L! C f tC A' ENT ION L. t,6-ChSINCE¢ SHALL EC '+AGCO¢DANGE NTr• CONFORM TO ASiM C 90.THE AI-,:,5P_C'F CA-1^✓N FOR AT T,C._c - 20 F I 5TR„L'L1RAL STEEL.OR 5011 M4G=, - 8 ALL MANUFACTLRED LVL WOOD FRAH 4G 10 p CONY,RETE BRICK SHALL CONFORM SHALL L'ENIT LATEST EDMON r -TO ASTM G55. PHYSICAL PROPERTIES AS A MIN�^N: it -RGG` r, 30 0. F -d-OH O R\W N( OR - - - ALI CGNr:RLT,.kv NI 7K ING ALL EXT.NA S'GR 15 P R, Ti A TH 2:STRJ.,TLRA;, A L5 5•A__GONFCRM E='9\IObP I F -2d00.FV=240 It ®a 'A;LJL Ar. ti7 e SH P FRAW:NGS TO THE FOLLGWIN 'E.GROUT SHALL'ON.-ORM TO THE _ it FOF A MAN ACTURIRLL UMBER REGVIREMLN-5 OF ASTM G�46 d , N WA.' '0rc SC FLF FK Ar_151 1 Ik GNN'.L ORS A HIDE ANC_ EMBER5 AST^". SHALL HAVE A COMPRESS•/E_ 9 ALL FLOOR IG STS SHALL BE AS I - r S RENGTH OF 3000 F5I MANUPAC?URCREU BY HOISE CASCADE _ tGR K./:W F OR J FABRICATON. A992 CRAG.SC. GEGKS;T'O¢GnES ^E_,= jl -- d AS SIZED ON ME DRAWINGS. ALL 1 !U P - 6 HANNC_5 1 A!vG_2S A5. Alf FA5TENING-,BEARING.BRACING a L_ __._:. _._. .. _. ✓ERTIr AL 1 BOND BEAM -' _" C. Z'JND 1 RECTA\G;tAK USES REINFORCEMENT St�AL CONFORM INITHFTHE MANUFAG1EUER R5f REQUIREMENTS. -' p_ v 70 A5TM.A 500.SR AGE E F -,E K5I. TO i HE REGUIREM.ENT5 OF.A5TM A615. Ous _ i .\ !h lr�F WORs.AND HAI ERIAL- 5!IAi GMP_(NI 1 -HL 5"rC F!CATIONS 3.ALL GALJ.AN�NG SHALLCONFORM d MORTAR SHALL CONFORM TO THE �„ � REMIREMENT5 OF A5TM G 210 - ---- -'- "- C'K kI,(If¢A G NC,RF-f FOR Et1iLD NGS TO ANTI?A 12_ - --- 7. .. - AND SHALL BE TYPE M OR 5, t.z....•a,n� �_ _ _ _ � ;y��pQ• ''G_ 4.BOLTED CONM1EG"IONS SHALL EE N TH _ _y _ --- �tQ' z_ G\C R_TC IIA HA✓C A 28 DAY HIP'STR\&TH BO_lZ.N Ar CO¢_l N E 9•IkAECTIOALITY N HANCE KITH PERFORMED I-m - _ - -+ --, p 4 G M k _A- .R NuT+Or 300E PS WITH THE SPEG`ICATION FOR ...:.r"M:b - ,�'• 5�- In - ry H MAXIWFI. NGH A>GREGATE 0 5TRUC LR.AL JYJIN'5 U51\5.A5TM A 325 S - e.n+a_,, - 7 14AX y:•M E AIR EXTRA NMENT FOR OR A 490 BU_75. Ri'J'JIREMENT_OF.API 5'.A.IiASGE b/dd. (�.' ___- - -- -}- PROF SS\ C\rLR„k GGNCRE'L EXFOSEC TO 5.ANCHOR 5GLl$_ _L BE A,3(M A 3G1. FRAMING LUMECR a CONNECTORS .un....s.�..,w n 3.A..RC N'OKG'4G STfk SHALL BE - ._- - •iE O`BROC - .{I ` DFr OR.-` EARS Or NFW BILLET STEEL b.WELD5 SHALL BE MADE FY OPERATORS _ h -- GC7h'ORFI NG r0 A5TM A EIS GRACE 60. CERTIFIED BY THE 5TA\DARv I ALL FRAMING LUMEER 5HAEL BE I .o"LL L,..a n+v - - I - - 5 N am ' OUALIFICAT.ON FROGEDJRE OF THE K LN PRIED 19N.MAXIMUM MOISTUREMEE R 5-HALLC y p AMERICAN WELDING SCOIETY. AS CONTENNIMUM T. BE OLLOW!NGT �I '+___-_-- _ - 1 �t 2m 4.".G\Ck /LR G REM-ORG!NG EARS � - SH FI'AS C-Ono DE55N VALUC5 FOR 5PRri,E-PINE-FIR: II ; �. l 1.MELDING SHALL BE!N ACCORDANCE < 1 ~L° N C H \ \ GGh k F N.AGLU DIRCC TLY W TH THE AW5 Di I GOD`_FGR%hELC.NG F1-5 STUDS 6O,FCz UG71UN GRADE A:A'N�I LARI' i FB=80c FV-6S FG_i50 I � -- - __ I mod' N BUILDING COM1STRL'GT ON. .�.. ;� _ E 2 ,\ A!..0,.".¢..^'A-i iriNS. B_ OI5TS•RAFT'R5 NO.I GRADE 1 -._.. -..__ ._. ....I m „�, -N: E it �..T 7-5 d.CONNECTIONS\-Or AIL D FA-L, FB''S0,FV�lO 1 I - - &".Co GNED 0¢71 E LOAp-, 'OWN I .. .. _-I I $ r•0 S,M H R ,iN C N RUC CN YJ'N"5 ON THE DRAW N5 's¢ OR OA.o G POST NO 1 GRADE FB>bC70. r- -.. i LJ Lj A "C:l U\ PC C.IF CA:LY GI/EN IN THE STANDARD LOAD. FJ 65 FG=6'S ME it .. - I 5H rvN ON rHE CRANNG-5 C7¢nL..CNED TABLES 0P A S-, GR HE SPAN IN nF TINE BY nL.N,i NCER. SECTION:STREN,.T.I SRC`!ED .-•e ... x:. 2.ALL FASTE\IN5 OF FRAMiNG, _. PLATES 5ILL5 5HEATHIW>1 - __ _ ___-- 4 ELF`/A'!O\'S NOTED AS'T.^iP GE c-c>L- OTHER WOOD MFNC'NS SHALL REFER TO THE-OF FLANG O-RG LEG = N'\C DA\ LW TH THE GGR E . SCGTIUNS ✓ A,SSrGnh .IN•MUM I ,noe 1 eom R OU REME\T50. -HE ..a MA SA HUSET SATE Bll!DI4G '_ - 11 CODE DTH ED 710N, I. C-1 S 1 65fIfD FUA CUNSfPo1EIlON r. 4 Of 1 !t ,--- r 1 L�--- ^J Li - ...._ -- ---------- _ _ I i• x L �J JI r-- _ -------------- --- 1� I _ -- -'- ' F1-R51 CR. ...KA MI NG PLAN T. G E I L I N 6 R.A M 1 N G +P I..A Nef, q by z t .. ..-. ... ,. n. . I REO P ; AL ENGNCD Mm N�� ol volx�Fos.-pcvi\l - ) C �Ya = I I m _NOOC PO_UP wD DONN y z _ p ig •$ - - . ` ' -. t p '_.;� x N_ PGa _r,p : _---- -- oLA R L '_CW y� ul Li < - - BRAi_- 'AR AA-t PRGJIDC f� C 1 ID .. i •__ _. . . I 1�. : :: :o a. � -- �e - S.if•Y:,,VG ON a;tr 5�7U •a.N . .. N i''•' - - I_ ffiBA®Y6RY R\ 1 AR nAL'.E:N[ARr\S fi C ______ _____ - Ir . ....>a- .• .... ' :.o...z,e - -OLD _O_, O\t AG -IG A-_ ^O LL roe. .o I � � . .., jb �: _ 1 _ 1 by RUO FLAN - _ \.iG/� A `."i s_ '\65 dre •I -'— Yr/ _ P_ •'N-c55.\OT.D- o: 5a: R✓ RA 6C\FRA '40-L= ` AND".F LA' D A L5 OR C rLR h 'p. RLGL'RL-Y N 5. S_2 �, _._. .. ._.. __ ___.___—_.—._—_.—, AglEO FON(Q45iPoICIION .m � Of •r I7 .. RGGRSPAN ' LGNNECTGR OETAh i I 1�. ;t aAFTER HANGER ' r - \ p,.y'TEps 2xIMLY12 LEOGER �i _ WTO SEnMBERLGNSCRfle lGP38GT. a- CURE Mel FRMIING li 17� ; 1 I PEa CORNER sPALT:DQ18'o4 . u Ji- '�L�� 4 mRNEa snws OGARAGE FIOLDOWN DETAIL®EXT.HALL »O HOEDOWN DETAIL®'TYPICAL EXT.WALL OORNER/WALL O COILED STRAP DETAIL IO LEDGER DETAIL - fAS12 I .. RAflFRS ,. t sPP50N W d + 1 _f FRA1�dVE 21It . h7s 1115 �. T _ sIMp AR) H161 2LEOGER I Wl3fBOTO GOEm _ NORIZONTAL Zt BLOCIfING FOR ',P} I S II / 1 Rk4Wr BLOW O -NARJNGTHEPLYw00DEDGES LE'DGFR. - I T d SNODLOBEPRO.VNEOYATWH 1B'6 WTBIOECGRNERS - G .. ` M.._ N r. m 37 ISTAB...1. C_4 N o II PLYWOOD BLOCKING DETAIL 12 RAFTER CONNECTION DETAILS 13 FRAME-OVER LEDGER DETAIL . y e:nf A ' RlM aasr JOISTHANGER DECK mTB 1 ,.P ACHUS`cTTs CI_� N se-1 Ht CLIP P.T.MAM :•� 3 •,: ` 0 'C C N N .... .., ea•.s..;. (1 PER ,O. .d . SIMPSON BCS POST CAP w O po N•• P.T.POST11-3 sumsDHAWPOST BA,sE - of REG�o�v' 66 LDS . ANdDR BOLT �,.: - PROFES`'� N C V to IVOa1SWASONON ON BE OG^V a•DIA e1GPam Paonrttl �� � .nle 'NiFSCRPTVE RESOBrtLLL Fu ., . �accoxsmucnoH•. �: ' ! 14 TYPICAL RI06E STRAP DETAIL OPTIONS IS PORCH/DECK DETAIL ro S-4 SWEDFURCONSIPoIQNM! w n of n J TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel v Application #�, 0,5q(o Health Division ' Date Issued a 24 DS Conservation Division �_ Application Feelop Planning Dept, Permit Fee 'av Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/Hyannis d� Project Street Address Village l A JI± Owner) Q,I'�1.�S m GU'17�J Address �f.(/I YYIGYII � . Telephone- - -—929- 1 _3 Nu� �' I 11 . {i A �-z ao-� 7'tt Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new _ l Zoning District -Flood Plain Groundwater Overlay Project Valuation �;Q00 Construction Type wd T" 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: 0 Yes ❑ 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: I '3 . Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes �No If yes, site plan review# Current Use ��Gi� Proposed Use c --APPLICANT INFORMATION'._- (B IUIILDER OR HOMEOWNER) S,dame � � �2 S I��n` �0C. Telephone Number �Y` Q 2 ��� a p Address 9 r` -� mA�t.YI ST <��- 3 License # S 0qq 0 rX 1 Home Improvement Contractor# �S V S � 'fe A aO� Worker's Compensation # W0 ��q& (0 Z ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO `�7ILt�Y1 SIGNATURE DATE 10 l� N � FOR OFFICIAL USE ONLY �PPLICATION# DATE ISSUED MAP/PARCEL NO. ' ADDRESS VILLAGE OWNER ' DATE OF INSPECTION: } >5 FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH ;FINAL PLUMBING: ROUGH ;FINAL r GAS: ROUGH FINAL FINAL BUILDING i DATE CLOSED OUT ASSOCIATION PLAN NO. ' The Commonwealth of Massachusetts 1Departtnent of Irtdustr'ia1 Accidents Office of Investigations 600 Washington Street Boston, AM 02111 www,mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information t .y� Please Print Le 'bl Name (Business/Organization/lndividual): Address: City/State/Zip�`�/YV1 A0 SV Phone.#: e you an employer? Check the appropriate boy: Type of project(required): 1.X I am a employer with 4• ❑ I am a general contractor and T * have hired the stab-contractors b. ❑New construction . employees (full and/or part-time). Remodeling 2.❑ I am a'sole proprietor or partner- listed on the attached sheet 7• ❑ g ship and have no employees These sub-contractors have S. ❑Demolition working for me in any capacity. employees and have workers' 9 ❑Building addition comp. insurance.$ [No workers' comp.insurance 5. ❑ We are a corporation and its 10.[I Electrical repairs or additions u required.] • 3.El a homeowner doing all work officers have exercised their 11.[�Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.P Roof rep ' s insurance required] t c. 152, §1(4), and we have no d employees. [No workers' 13.� Othery comp.insurance required_] "Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy.information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit an ew affidavit indicating such. x_ont actors that check this box must attaehcd an additional sheet showing thc name of the sub-contractors and state whether or not thoso entities have employees. If the sub-contractors have cmployecs,they must provide their workers'comp.policy number. fain an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information Insurance Company Name: Policy#or Self-ins. Lic. #: W01 L01114 7&-4.2- Expiration Date: �! �%Z Job Site Address: `1"Irt -" City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to'the imposition of rrimirial penalties of a fine rip to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine ed that a copy of this statement may forwarded to the Office of of up to$250.00 a day against the violator..Be advis Investigations of the bIA for insurance coverage verification. — Ido hereby ce fy under the pains penalties of perjury that the information provided above`is true and correct Signature: Date: p'_ O . Phone#: ✓'1 2b"� to Official use only. Do not write in this area, to be completed by city or town officiaL City or Town: Pern inicense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Toy m Clerk 4.Electrical Inspector S. Plumbing Inspector 6. Other Contact Person: Phone#:. Information and Ins' t °uctions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees: Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer,'or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7) states `Neither the commonwealth nor any of its political subdivisions shall enter into any contract for,the performance of public work until acceptable evidence of compliance with the inzurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, iIf necessary, supply sub-contractor(s)namc(s), addresses) and phone number(s) along with their certificatc(s)of insurance. Limited Liability Companies.(LLC) or Limited Liability Partnerships (LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LL.P does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for.the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the nurgbcr listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Towfi Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in:the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/hcensc number which will be used as a reference number. In addition, an applicant that must submit multiple permit/licensc applications in any given year, need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address" the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (Le. a dog license or permit to bum leaves etc.) said person is NOT required to complete this affidavit. The Office.of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call The Department's address, telephone-and fax number' Tll(-,C()mmonw,-alt1 of Masgarhus tts Department of llC)la.St it l AQ-Cidc�nts Office of�UVCStIE.(TIkS 600 WasEngton Street Boston, MA 02111 TQ1. # 617-727-49,0.4 ext 406 or 1-877-Iv1ASSAk'E Fax# 617-727-774 Revised 11-22-06 . www.mass.go�/dia o¢YHEr Town of Barnstable ~` Regulatory Services w + vBARN S& Thomas F. GeHer, Director �p t63q. �� .. reto) Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstahle.ma.us Office: 508-862-4038 Fax: S08-790-6230 Property Owen Must Complete and Sign This Section ff Using A Builder 1, y S �Vla;n7�1 ' ,as Owner of the subject property hereby authorize` �J �,C%���fi� I Yf✓ to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) V- . 'gnature of Owner Date almZs 2-1 Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Town of Barnstable �ppIHE Regulatory Services r Thomas F. Geiler, Director +- BARNSTABLE, P MASS. �P 039. Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis, NfA 02601 wwiy.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 Official on.a form acceptable to the Building Official, that he/she shall be. all submit to the Building Offi p . g "homeowner shall g 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 sh work,that such Homeowner all 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 homeowneris fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. ' -' -- -- - - -- --� •—� ��� _—,.,.,.,.� vus.uuu,� aa•vv��au•vu .�I VV1 �li • .•,'.?: 4. ;i` ul :cr,I,' !.16•'!. '1: I!I,r.4,ti�:' �,:;.: DATE IMHIIDDIYYI �j I � 7; ;U+ �. :� .;!-' i `�;'r.•c,ur,ryr"'tI,�Ar!'li''�'�.: lit. J /a C®� �,;i E a,.' I ��,y;•r:'"^'r,' 11�J r l:;l,ti.,.I:,.,..,.[ a II: — ,M ii,1 ppai �LE�.;�p :[ "' I ''f �'I, y �?I!I:,.• y w a' 8/25/2008 1 h d., _�._k... 7` ,,r,. y.:ru:.:��.�....�-r..a.•..�--:.1:.,...:::u.r.:r-it,.-.IFI:.:......I..•.__"' ,.,f k;�.er�.:La14:'i�.�..1!1 .. .;..�._, _ - ..:a.���.a ._;...J. _9.1.-_i•.-__-_ .,.:.. q:.•:P�-f�'4..r.,� �...-h•1,....II_I A,..::4�,n7..F. :s!e-r:1�iE"L!iiLl.: Pt�DDUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE GERMANI INSURANCE AGENCY HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 908 MAIN STREET ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. OSTERVILLE, MA 02655 _COMPANIES AFFORDING COVERAGE COMPANY A SAFETY INSURANCE INSURED COMPANY SCOTT PEACOCK BUILDING&REMODELING a AIG AMERICAN HOME ASSURANCE CO. PO BOX 171 ' OSTERVILLE, MA 02655 COMPANY C COMPANY D 4..'.........:.. .1 1.�.._., ..ill ... ....,; .:._,. r.•� w�.- '_,r' :'1•r•- ,..r:l. •:.n...,i,,� rrvM r. •��1, ';i.••::•: 1, 1 •r:,._.r n ,.I•?.i:1'.�5il:. •:Y�::1r r �:�: 1_.., ri: ,-,.. 22 1�:�'•i ..f. a__.fur '-b:, _.1.•� .�u.,F, r.l�''.�:• , (( .-,••...�.. . �1'. .�._...�_ �"I:�a_�'?F!MfRi_ 41�.1•n rl liFc '.:n»!usa.,4,i,• ,.Au.aa:�.md,!Mbv.e,,,.al..r.,.., 1 - 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 B Y 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, CO TYPE OF INSURANCE POLICY NUMBER I POLICY EFFECTIVE POLICY EXPIRATION' LIMITS LTR DATE(MMIDUN) DATE(MMIDD/YY) GENERAL LIABILITY GENERAL AGGREGATE 6 2,000,000 A X COMMERCIAL GENERAL LIABILITY I CP00001152 07/05/08 07/05/09 I —'"—' r PRODUCTS-COMPIOP AGO S CLAIMS MADE LI OCCUR PERSONAL B ADV INJURY 18 OWNER'S 8 CONTRACTOR'S PROT EACH OCCURRENCE 16 1,000,000 __._--•--•-- '' FIRE DAMAGE (AAy one fire) IS MED EXP (Anyone PerBun) 16 AUTOMOBILE LIABILITY I COMBINED SINGLE LIMIT 15 ANY AUTO ALL OWNED AUTOS i -•••- -••••_..._.._ BODILY INJURY I s SCHEDULEOAUTOS (Perpereon) 1 HIRED AUTOS I BODILY INJURY I y 7!— NON-OWNED AUTOS (Pereuldenl) . ........----- PROPERTY DAMAGE ;y GARAGE LIABILITY AUTO ONLY-EA ACCIDENT 6 ANY AUTO I' OTHER THAN AUTO ONLY: EACH ACCIDENT 5 --- i AGGREGATE 3 i EXCESS UARILITY I EACH OCCURRENCE - is — — UMBRELLA FORM ! AGGREGATE I6 OTHER THAN UMBRELLA FORM 16. wC BTArU- OTM B 1 WORKER'SCOMPENSATIONAND iWC 696_76-82 06/22/08 O6/??/0 9 TOR III Ep EMPLOYERS'LIABILITY EL EACH ACCIDENT 6 100 000 I THE PROPRETOR/ I INCL EL DISEASE-POLICY LIMIT :6 500,000 PARTNFRSrEXECUnVE ........ _...._... .. 'OFFICERBARE i EXCL' EL DISEASE-EA EMPLOYEE 16 100,000 i OTHER DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESISPECIAL ITEMS ' COVER PROPERTIES AT:MARCEL R.POYANT 269.274,282 BARNSTABLE RD.HYANNIS,MA 02601;1620-72 FALMOUTH RD.CENTERVILLE,MA 02 ; PLAZ TWENTY-EIGHT NOMINEE TRUST, 181-195 FALMOUTH RD.HYANNIS,MA 02601,CENTERVILLE SHOPPING CENTER I NOMINEE TRUST, 1676-1698 FALMOUTH RD.CENTERVILLE, MA 02632:20-30 OPECHEE RD.CENTERVILLE,MA 02632 .':I •M1'':1`•if'.. •...1_Ir,. I,1. �.}j:p .y a ry 'r•!' ' '''•.:' r:•,. :r.i:::r ,- r �}�{{T .}IC1LflF,Rsrd�...r:_•-1i{cLip'i!.1_, 4.„'T,.!a..h_L'i 4. .M.:4 i s.••t.. '�:,�:_���}C?' .I•'('i('tti'i' `::6�.9-L'��''ia c.l.;'. :•9::�_ a'a,..11�:e•.:LT�{'' r�yl:...".5:�.r1�.4rr�M L:'S•r` :i" .ti_.. �. ;t{,��,yy.EPiS;��oaN,.i_.L�,�:L�h.:•a:�.f., ��.I•�• •1�..`._.?'�••, � _'4�'_s.,r ._ SHOULD ANYOF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE p� o �/ EXPIRATION DATA THEREOF, THE 133UING COMPANY WILL'ENDEAVOR TO MAIL ATTN•. SALLY 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE MOLDER NAMED TO TILE LEFT, TOWN OF BARNSTABLE FTANFAILURE KIND UPON THEN OMPANCE AL i IMPOSEENTS OBLIGATION REPRESENTTATATWA. FAX#-, 508-790-6230 AUTHOpp#EppREPRESENTATIV.5 JeN� .iFLl�ftdi. !r ' '- S 01 h ,!,1,.��.�... �:,{ 1; .,a �il, .,,,�;,rp,� :aa rr 'vv' "a,• ;,::1;.-,...Y erb,^:'Ir^rR, •tm rr,:- - -q�•,.;�;:: - -,,.. d�P �. .. r��1!IE �; ,:..•1 6r,,.Ik � !r..:-r:''!I:B r,..+:a,.:q l:l y1nf15'4„a!15""a��;:i;rr .,;III• `'I�'•'�jiqq. ,l 1 nt:a'„G�li Atl' �AVQfii!! .. �. nu.,,:.n� 1'::;.d.m,:�ni�..L�� I�� <1.,It.),:,�rl.::¢,r,.;,�.a..,... �.__. ,k il,: -Sii•i:i:'.L,• �'4�_ ,I;II!`lr�}` 1� :,,i_:J,I,QjI i�-,..:. t yIIKI I:..,-=F'�w i. :. . . .1 .I;;. =11yi'.•} . �, � .. ,,oL;:L,-f�•A�i�iOR�C:`OI��Ip�i, .� f ,- �/Ze -�o�m�rrzar� �`�'a°ac�iuvelza Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration'.,,151853 Expiration 717/20lug 10 Tr# 271501 t Type$ Pfiyate Corporation SCOTT PEACOCK BljILDING-41 REMODELING INC JAMES PEACOCK _ r•d 1046 MAIN STREETSI�I�TE 7 1 Administrator OSTERVILLE,MA 02655 T' j s ✓Lie6 wµ , r � `License: CONSTRUCTION SUPERVISOR �4 Number; CS 094500 Birthdatei"07/22/1962 Expires: 07/2212010 Tr.no: 94500 06 Restricted: 00 JAMES S PEACOCK OSTEVI 171 LE, OSl"EVILLE, MA 02632. Commissioner e r t tO .-;:�7e6t-O *c OVtflq /z — r AWE Tow_ n of Barnstable �ermitP L to (,ss--3 ~� Expires 6 Whs from issue Regulatory.Services Fee 7 Y • BARNSTABLE. • / MASS.9. Thomas F.Geiler,Director s6;q. ��Eb MA't s Building Division .4 $'ET RMI Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 N 0 V, 2011 www.town.bamstable.ma.us Office: 508-862-4038 C} � ?,. X �q i9 fax. 5�8t=7 �623�'�� EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY Not Valid without Red X-Press Imprint 1 Map/parcel Number 1 V Property Address XResidential Value of Work�� Minimum fee of$35.00 for work under$6000.00,. Owner's Name&Address j im 1 I 7—l Jb jVI-01vrh , , c I Contractor's Name S 6lephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) 1. S °U1 S"t (.J Workman's Compensation Jnsurance Check one: ❑ I am a sole proprietor ' I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name /` (M WI �;�I� .Workman's Comp,Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to r ❑Re-roof(not stripping. Going over existing layers:of roof) a ❑ Re-side #of doors F {, Replacement Windows/doors/sliders.U-Value 5 (tnaximum.44)#of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner most sign Property Owner Letter of Permission.., R A copy of the Home Imp ovement Contractors License&Construction Supervisors License is r wired: f.� SIGNATURE C:1UsersldecolliklAppl a& Local\MicrosoftlWindowslTemporaryInternetFileslContent.OutlooklQKIH7J6E1EXPRESS.doc Revised 070110 K, • The Commonwealth of Massachusetts t Department of Industrial Accidents Office of Investigations 600 Washington Street Y x, Boston, MA 02111 www.mass.gov/dia Workers' Compensation Tnsarance Affidavit: Builders/Contractors/Electricians/Plumbers' Apl2ficant information Please Print Legibly Name (Business/Organi-cation/Individual) Address: 1S (F. City/State/Zip ,MA Phone #: ' ID®' Are y an employer? Check t e appropriate box: Type of project(required): . 1. 1 am a employer with 4. 0 1 am a general contractor and I : employees (full and/or part-time).* have hired the sub-contractors 6. Q New construction ?.ElI am a sole proprietor or partner listed on the attached sheet. . 7. Remodeling p ship and have no employees, 'These'sub-contractors have •g••,Q,Demolition working for me in any capacity, employees and have workers' _ 9. 0 Building addition [No workers' comp..insurance comp.,insurance.+ ' S. We are a corporation and its, 10.❑ Electrical repairs or additions required.]' ❑ p , 3.0 1 am a homeo��mer doing all work officers have exercised their 1 I.Q.Plum,bing repairs or additions myself. [No workers':comp: - , right of exemption per MGL 12:Q Roof repairs insurance required.]:' c. 152,`§1(4),and we have no rep employees. [No workers' 13. Other comp. insurance'requtred.] 'Any applicant that checks box 91 must also fill out the section below showing their workers',compensation pol icy,ini'onnation. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new ahf,i avit indicating such. *Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state-Whether or n6t those entities have employees. ll'the sub-contractors have employees.,they must provide their workers'comp.policy number: I am an emplcwer that is providing workers'compensation insurance for my.emphvees. Below is tit policv and job site information. UA1011 �pInsurance Company Name Tf , (A �e Policy#or Sell-ins. l.,ic. #: � 5�f Expiration Date: f `- ,�,.}, ; h / Job Site Address: �"I LP ����;(/� City/State/Zip: (XJIuL Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage'as required Under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 acid/or one-year imprisonment, as well as civil penalties in the form of.a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of th DiA for-insurance coverage verification. . I do hereby certif ter th a* d penaltte, perjury that the information provided above is true and correct. i 1 Si nature: u / Date: Phone Offrc•ial use onto. Do not write in this area,to,be.completed by city or town official. City or Town: Permit/License#' Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector. 6. Other Contact Person: Phone#: 1 Massachusetts- Department of Public Safety _ Board of Building Regulations and Standards Construction Supervisor License License: CS 94500 JAMES S PEACOCK PO BOX 171 t OSTEVILLE, MA 02632 Expiration: 7/22/20,12 ( I'll till issiuncr Tr#: 29233 ✓l� U�O�/Y27Y/,(YI2LI.e6CLLG%L (1�'✓l��.L7.JJCGCf2CId�4 •. , . Otfice of Consumer Affairs&Business Regulation License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: -��- Registration: 151853 Type: Office of Consumer Affairs and Business Regulation Expiration: 7/7/2012 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 SCOTT PEACOCK BUILDING&REMODELING INC ' JAMES PEACOCK 1046 MAIN STREE11SUITE7. OSTERVILLE,MA 02655 — Undersecretary of valid without signature a .464ZP CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) ��. 07/06/2011 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 - - NAME: German)Insurance Agency •_ PHONE - - - FAX c908 Main Street AIc No): 508 428-3068 E-MAIL - _ - ADDRESS: - Osterville,MA 02655 PRODUCER e- CUSTOMER ID#:. - INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: SAFETY INS CO`- Scott Peacock Building&Remodelling, Inc. f INSURERB: ~ P.O.Box 171 Osterville,MA 02655 INSURER C INSURER D: National Union Fire Ins.Comp. INSURER E: INSURER F: fi COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR.THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT,TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. - INSR TYPE OF INSURANCE ADDL SUBR _ - POLICY EFF - POLICY EXP LTR POLICY NUMBER MMIDDIYYYY MM/DD/YYYY r LIMITS- A GENERAL LIABILITY CP00001152 7/5/2011 715/2012 EACH OCCURRENCE $ 1,000,000 COMMERCIAL GENERAL LIABILITY - DAMAGE TO RENTED- PREMISES Ea occurrence $_ " CLAIMS-MADE.F OCCUR - - 'MED EXP(Anyone person) $ a PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ POLICY PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $. - (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS _ (Per accident) NON-OWNED AUTOS $ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ _ - - $ D WORKERS COMPENSATION WC 5815464 6/22/2011 6/22/2012 WC STATU- OTH- - AND EMPLOYERS'LIABILITY YIN L T R ANY PROPRIETOR/PARTNER/EXECUTIVE t OFFICER/MEMBER EXCLUDED? NIA - - E.L.EACH ACCIDENT $ l OO,000 IMandatory In NH) E.L.DISEASE-EA EMPLOYEE $T' 100,000 It yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,B more space is required) ... CERTIFICATE HOLDER CANCELLATION-. Scott Peacock Building&Remodeling,Inca SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Fax#"508-428-7625 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD F OF THE Tp� r r Town of Barnstable MUMSTAIBM %639. ��� Regulatory Services . aTEO�'y s Thomas F.Geller,Director Building Division Thomas Perry,CBO - Building Commissioner , 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder as Owner of the subject property. n I hereby authorize " o I" L�( 4 °i1 j�f to act on my behalf, in all matters relative to work authorized by this building permit application for. i Ll�a SI Outuf- (Address of Job) 1 Sig o Owner Date �1il� Z Print Name Q:\WHILESTORMS\building permit forim\EXPRESS.doc Revise020108 _ ��� �SHEr Town of Barnstable e'rmit# Sys l �o • y�P ti� Erprres 6 axonthsfronr 'slue date Regulatory Services Fee * BARNSFABLE, " v MASS. g Tpnm,s F. Geiler, Director TFb MPS Building Division Tom Perry, CBO, 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 Number Property Address �L �" ❑'� � i1J y l�7t��� -- — Residential Value of Work f_L �� Minimum fee of$25.00 for work wider$6000.00 Owner's Name & Address J� Z/ An fil 0 6 ukol Contractor's Name <1' (�t��� C�(�(�/�-� Telephone Number. I Lome Improvement Contractor License#(if applicable)____15I J _ Construction Supervisor's License # (if applicable) �jWorkman's Compensation Insurance 1 Check one: d t s ❑ I am a Sole proprietor X- ta'�.��, ��.S PERMI ❑ I am the Homeowner O C T 2 3 Z008 •h I have Worker's Compensation Insurance Insurance Company Name -� TOWN OF BARNSTABLE Workman's Comp. Policy# _� Lo— / b `lU Copy of Insurance Compliance.Certificate must be on file: Permit Request (check box) r� ❑ Re-roof(stripping old shingles) All construction debris will be taken to Gre'i t. ❑ Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ` s, Replacement Windows/doors/sliders. U-Value (maximum .44) 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e. Historic,Co servation etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A co of the Home Improvement Contractors License is required. SIGNATURE: r Q: W11FILESTORMS`. ilding permit forms\EXPRESS.doc Revised 100608 ,y The Commonwealth of-Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 ,y www.mass.gov/dia Workers' Compensation insurance davit: Builders/Contractors/Electricians/Plumbers Applicant Information ? Please Print Legibly Name (Business/Organization/Individual): �nL Adclress i&LA C ,3 � � 6a i City/State/Zip: i , C� Phone.#: Are you an employer? Check the appropriate box: :Type of project(required):. 1.� I am a employer with _ 4. ❑ I am a general contractor and I 6. ❑New construction . employees(full and/or part-time).* • have hired the sub-contractors listed on the attached sheet. 7. ❑Remodeling 2:❑ I am a'sole propzietor or partner- These sub-contractors have ship and have no employees 8. ❑Demolition working for me in any capacity employees and have workers' 9 ❑Building addition comp. insurance.$ [No workers .comp.insurance to.❑Electricalrepairs or additions required] 5. ❑ We are a corporation and its 3.El I am a homeowner doing all work officers have exercised their 11.El Plumbing repairs or additions myself.[No workers' comp. right of exemption per.MGL. 12.❑Roof repairs insurance,required.]t c. 152, §1(4), and we have no 13.❑ Other employees. [No workers' comp,insurance required] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners•who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. I arrc an employer that is providing workers'compensation insurance for my employees. Below is.the policy and job site' . information. Insurance Company Name: -" Policy#or Self-ins.Lic,#: 1�C /� Expiration Date: ll�l��� oq lob Site Address: I `���I' o City/State/Zip: CiC> -�1 J-620? Attach a copy of the workers' compensation policy declaration page'(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK;OR.DER and a fine or. Be advised that a copy-of this statement maybe forwarded to the Office of of up to$250:00 a day against the violat Invest' atio of the DIA for insurance coverage verification. X do hereby ert' nder th p ins and penalties of perjury that the information provided above is true and correct. Si ature: I, Date: Phone Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): J.Board of Health 2.Building Department 3. CitylTown Clerk 4.Electrical Inspector 5,Plumbing Inspector 6.. Other Contact Person: Phone#: Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of Hie, express or implied, oral or written." An employer is defined as "an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee-of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to'operate a business or to construct buildings in the commonwealth for any applicant who has not produced;acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter.152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for,the performance of public work until acceptable evidence of compliance with fire insurance requirenoents of this chapter have been presented�to the contracting authority." Applicants Please fill out the-workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), address(es) and phone number(s) along with their certificates)of insurance. Limited Liability Companies(LLC) or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance, If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit.or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate-line.. City or Town Officials Please be sure that the affidavit is complete'and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number, In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information-(if necessary)and under"Job Site Address" the applicant should write"all-locations in _ (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year,Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves-etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number:. e ColumQnweaM of Musaclusetts Dt-,paitu-,at of lmd�ai A.caid is Office of luwsdgay.o s 600 Washington Street Boston,.MA 02111 TO--. 6,17-727-000 ext 406 or 1-9-.77-MASSAFE Fax#G17-727-7749 Revised 11-22-06 � • . www.mass.�c�v�dia . I i SHeTOwti Town of Barnstable r y Regulatory Services =A.RNSPABLY y MAa9 $ Thomas F. Geiler,Director 1639 Eo �a Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office' S0.8-862-4038 Fax: S08-790-6230 Property Owner Must Complete and Sign This, Section If Using A Builder as Owner of the subject property hereby authorize ,� Q� � s r �hC to act on my behalf, m all matters relative to work authorized.by this building permit application for (Address of Job) nature of Owner Date Print Name If Property Owner is applying for pen-nit please complete the Homeowners License--Exemption Form on the reverse side. n•FnRr„rcn�unrz•Rnr«uaerccrnrr i Town of Barnstable Regulatory Services i 4 a BARNSTAsr_e Thomas F. Geiler,Director MASS. 039. ,0� Building Division AIFD {n Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 vc'ww.town.barnstable.ma.us Office: 508-862-4038 Fax: 509-790-6230 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 be/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/hcr responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a forra>/certification.for use in your community. Q:forms:homeexempt _ t ✓/ze6�'14f�`�S"C��"�11�CAD l I�`f�E��/���I��� �r w License: CONSTRUCTION SUPERVISOR Number: CS 094500 �Y Birthdate:07/22/1962, i° Expirim 07/22/2010 Tr. no: 94500 Restricted: 00 JAMES S PEACOCK OSTEVI 171 LE, ' OSTEVILLE, MA 02632" Commissioner f T ✓fie Vr anvmoaeuseac� °�✓v�ac�iude�b Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration:,.151853 Expiration 7/7/2010 Tr# 271501 ti Type Pnvate Corporation SCOTT PEACOCK BUILDING&REMODELING INC JAMES PEACOCK ,I 1046 MAIN STREEYQSUITE 7"> OSTERVILLE,MA 02655"" Administrator i • r . _. __. _ _ _ _ .. _„ _._._ ..,,,. _-,,,.,,,,,. vua.uuu a a.•vv��u•."u �,VV1 1 1,6fii:' :'1. ::1,; ''1, L ;,I :j. :1:,:'4'. !,r{ni,.i d71 Ili ,Z:7i;' .1•' 'r• r;.�.r{ ,rn' f � II�j��'I"'.1 �I I t �' 1 �I.1Irr'� ,:•;:;�.,.i.. DATE IMNuoD �./7 , �' ? 1. :L;;-• .+� f,. .fr' j1� I ` �w,a�. „r•.gf` ia ytilc4!:,.::i. w d,_n' �_ �0� �., _ .__... Y19 •,I�w l:.. Ir':•5�w W, 8/Z6/2008 dlru:,-.,r:.,r.,�..,-,,....•..:._-::_:.-.,_,�-.:r,.,:::.cu}JFr.:..,::�r ...,�..,rk:m-..�iilc.••:.J.:I'�i^:'�n�1.R-:4!::J.-=a.!�__ - 1..Lr�_R"1.:i.- -f:.L: •p_ Ar- ;v9'�'r,L __lii_:r] PRODUCER THIS CERTIFICATE'13 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE GERMANI INSURANCE AGENCY HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 908 MAIN STREET ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. OSTERVILLE,MA 02665 _ _COMPANIES AFFORDING COVERAGE coAANr SAFETY INSURANCE INSURED COMPANY SCOTT PEACOCK BUILDING&REMODELING g AG AMERICAN HOME ASSURANCE CO. PO BOX 171 • OSTERVILLE, MA 02665 COMPANY COMPANY D rfi) L fl .•,�. her.-• dh. "rf�l! •?,' }'v"i'd' :h' .ra.. r!L y' �p�.� g ",c::IL !a(_u .I u r• j•ii :, j,�'.''Ei' i -L� .'�r:-}, �. � .:7: �..,._ U .r, ,(�� .L ':r__dMr '1�:,' .1!• =1rs._�•,au!p;u. ..�"!�' 1• II- , t 4I�_I•r •,I ii�,:.. .,-f- v.�l�:k'u ..4.'4,=N. _�:.I.�L: ih. el,,:il.:u.,v4,+••r•T•i••u,J- - 7�.••...•_-..IL....L!,:�lia:lei..u...•nr.4'...�-,. •...- 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 B Y 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. co TYPE OF INSURANCE POLICY NUMBER I POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE(MNIDDIYY) DATEIMMIDDIVY) GENERAL LIABILITY GENERAL AGGREGATE S 2,000,000 �( COMMERCIAL GENERAL LIABILITY I CP00001152 07/05/08 07/05/09 —"—' ' '- ' ' PRODUCTS-COMPIOP A( S CLAIMS MADE L IOCCUR PERSONAL BADVINJURY 18 _ OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE Is 1,000,000 I FIRE DAMAGE (Any one fire)i S MED EXP (Any one Perawl) I t _AUTOMOBILE LIABILITY I COMBINED SINGLE LWIR I f ANY AUTO ,.. ALL OWNED AUTOS BODILY INJURY �s SCHEDULED AUTOS (Per pmon) HIRED AUTOS I BODILY INJURY I S NON-OWNED AUTOS (Pereuldenl) _•_._._..._ ---- PROPERTY DAMAGE :y GARAGE LIABIUTY I AUTO ONLY-EA ACCIDENTANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT I i AGGREGATE S i EXCESS LIABILITY I EACH OCCURRENCE - '6 F UMBRELLA FORM ! AGGREGATE I — OTHER THAN UMBRELLA FORM i WC BTATu- OTM B WORKER'S COMPENSATION AND i WC 696.78-62 08/22/08 OB/22/09 _roar UNIT- ••••• •T, EMPLOYERS'LIABILITY d EL EACH ACCIDENT 'S1 00000 THE PROPRIETOW INCL EL DISEASE_POLICY LIMIT S 500,000 PAnTNEREIE%EWTIVE ..... 1OFFICERBARE EXCL- - EL DISEASE-EA EMPLOYEE I t 100,000 OTHER DESCRIPTION OF OPERATIONSILOCATIONMEHICLES/SPECIAL ITEMS COVER PROPERTIES AT:MARCEL R.POYANT 269.274,282 BARNSTABLE RD.HYANNIS,MA 02601; 1020-72 FALMOUTH RD.CENTERVILLE,MA 028 ; PLAZ TWENTY-EIGHT NOMINEE TRUST, 181-196 FALMOUTH RD.HYANNIS,MA 02601;CENTERVILLE SHOPPING CENTER I NOMINEE TRUST, 1676-1698 FALMOUTH RD.CENTERVILLE,MA 02632:20-30 OPECHEE RD.CENTERVILLE,MA 02632 ,. ... ,-•� �•• - �r{r rr:, ..r�L!,;.,'• .,;•,:r,;: �.t41r'!1? ,il •'i;•:L., ,21r, :•f6::v.�:;�:::•r.;:q r=,1�..rl.__,.II..,! F •h ,,,..r_ ,•-4", Cr'',Y�ti� `r_C: ':I�i �y. :::;'�;,:•�..� r � T .NG1L.fl r:6l�=u:,r- ti: ,'t�5!:• E r: 1. '4 ':�r;,:_ '• •.;�L;'il'1 ''y,'�i�'"I`'`'.i':,-• ..;.i �9_._G,,;d3,..n.. - vd' ,.. .:...`_.L:a __a:..a:�,..!triJi.c.9,iiF'��e'S•,.,a.._:_ -... _:� � ,. �.......a,.�... ........?!r.._..,..•�..�a..,.._...._1<:•':Er?'E_-.._�._�l�r'_sy ......... p� o SHOULD ANYOF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE �"►TTItl.. SALLY EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL /� ^_ DAYS WRrMN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION ORLIABILNY TOWN OF BAfZNSTABiLE OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIM, FAX#: 508-790-6230 AUTHoaPIR EPf�W rAT1v§� y,�r� -'?," } k'Nilii�i; - '24{!Gn" °,a,:i �n^.:a�ici:.,p'li'�'nl'�'Iz,r'".i'"�tiJ,��!:.�':n.4;.-'.'.•.Yf:,, I:'•e m!-r,:-• elr�' =A'4,_.1. - ..ylP .L 11. ,l , ,r."•r r li'a;�n.:,,.:, ti F.i L;j•.�! ri.._1:5 .yr..,.., L•�..__. P .�;i;,r':.t,• :•T•'` '''U-�a 'f 1„r.,�:'L;fli•U!�,. r,,.r 1(�(r�1 ;'L.-a'��_:�„_F-�,'Ik•G��'' �..I ,ii; ;.i,5;ir: �,,.., 1 :YL.;,I r �R�. O1�71.rJ�,,. �. 'I'own of Barnstable *Pcrtuif il�;- U�c��t' Lapires G arartths froin issue date nAmMAMirrnnt� Regulatory Services I;eC Thomas F. Geiler, Director Building Division Tom Perry,CBO, Builditig Coriunissioner 200 Main Strect, I-lyanttis, MA 02601 www.town.barnstablc.ma.us Office:•508-862-4038 Fay: 508-790-6230 EXPRI✓SS PRRMIT APPLICATION - RRINDENTIAI., ONI.,Y Not Valid without Red X-Press Irnprinl. Map/parcel Number,.G) 24��z Property Address Cr ffResidential Value of Work -WV, Minimum'fee of$25.00 for work under$6000.00 Owner's Name&Address 4/- i Contractor's Name Oz.- 7'� � / �. Telephone Number 2 Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one; ❑ -I am a sole proprietor ❑ Ism the Homeowner '"E PERMIT I� I have Worker's Compensation Insurance Insurance Company.Name S E P 1 0 2P08 Workman's Comp.Policy i 9 9-�Z - _I SIABL Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) Re-roof(stripping old shingles) All,construction debris will be taken to / ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Rc-side ❑ Replacement Windows. U-Value — (maximum .44) 'Where required: Issuance of this permit does not exempt compliance'with other town department regulations,i.e.Historic Conscry aAon,etc. ***Note: Property Owner must sign Properly Owner Letter of Ho zc Improvement Contractors License is required. SIGNATURE: ��,ii t� Q:Potms;cxpmlrg .01 LTV 01 .{]S oeZ Rcvisc071405 `} ri The Commonwealth of Massachusetts Page 10 of 10 u ,= Department of Industrial Accidents t Office of Investigations si 600 Washington Street tiu - t 4Su it Boston,MA 02111 r www.rnass.gov/dia Workers' Compensation Insurance Affidavit: ]Builders/Contractors/Electricians/Plumbers Applicant Information �— Please Print Legibly Name (Business/Organization/individual): PA U L_ J • C2 Z e QU l+ e n S 1 1 OC)4"N 6_--7 )L Address: 10 3 City/State/Zip: (7)5 t V j M18r02(o SS Phone#: So y 2-8 - 11 ^1-7 Are you an employer?Check the appropriate box: Type of project(required): 1Z I am a employer with [2. 4. 0 I am a general contractor.and I 6. New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet x �• ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp.insurance. 9. El Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its I officers have exercised their 10:0 Electrical repairs or additions required.] - 3.❑ 1 am a homeowner doing all work right of exemption per MGL I I.Q Plumbing repairs or additions myself.[No workers' comp. •c. 152, §1(4),and we have no 12.IR Roof repairs insurance required.]t employees.[No"workers' 13.❑Other comp. insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. iContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site- information. Insurance Company Name: Policy#or Self-ins.Lie.#: ��� Expiration Date: 4 Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. -Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DID►for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature: Date: Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 2.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Boar o uz in g#egulso., One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement�:Contractor Registration Registration: 103714 -- = Type: Private Corporation Expiration: 7/9/2010 Tr# 269847 PAUL.J. CAZEAULT & SONS, INC' - v Paul Cazeault ------ -- 1031 MAIN ST - :.' — ------- -- — ----- OSTERVILLE, MA 02658 - i77 Update Address and return card.Mark reason for change. S-CA7 ci SOM-07/07-PC8490 Address. Renewal Employment ❑ Lost Card ' Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 103714 Board of Building Regulations and Standards Expiration:;..779/2010 Tr# 269847 One Ashburton Place Rm 1301 ._Type:=Private Corporation Boston,Ma. 02108 PAUL J.CAZEAULT;_&;SONS,;INC. Pain I Cazeault Boar o �dmgatoons an �taniards�� One Ashburton Place - Room 1301 _ Boston. Massachusetts 02108 Construction Supervisor License };- - License CS: 26325 J�_ a Restriction: 00 . r _ Birthdale: 10/20/1959 Expiration: 10/20/2009 PAUL J CAZEAULTQt 1031 MAIN ST — __— OSTERVILLE, MA 02655 Update Address and return card.Mark reason for change. DPS-CA1 v 50M-07/07-PC8490 -- —.._ (� Address Renewal .Lost Card 1� .Board of Building Regulation$and Standards _r Construction Supervisor License. License- CS 26325 Birthdate 10l20/1959 ' z Ex natio n • P 1.`Q%2012009 Tr# 6311 PAUL'J CAZEAULT AIco� CERTIFICATE OF LIABILITY INSURANGE CSR•:RF DATEIMRIDDNYYY) CAZEA-5 O8 -11/OB PRMUPER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE MacIntyre Fay. & Thayer Ins Agy. HOLDER-THIS CERTIFICATE DOES NOT AMEND,EXTEND,OR " 77 Accord Park Drive Unit B-1 ALTER THE COVERAGE AFFOkbED BY THE POLICIES BELOW. Norwell MA 02061 Phone: 781-261-2000 Fax:781-261-2099 i INSURERS AFFORDING COVERAGE NAIC# INSURED (INSURER A: American International Co. INSURER 8: . � Paul J Cazeault & INSURERC: Sons Roofing.. Inc- lOr3R1 Main Street 'INSURER D: Osterville MA 02655 .INSURER.E: j. COVERAGES THE POLICIES OF INSURANCE LISTED ED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. .. �.. POLICY NUMBER ;P Y EFF E ! TION LIMITS LTR MRO TYPE OF INSURANCE + DATE MMfOp PATE MMlD I GENERAL LIABILITY EACH OCCURRENCE S .COMMERCIAL GENERAL LIABILITY I pREMlSE$".(Ee_ocourence) S j CLAIMS MADE n OCCUR MEO EXP(Any one Person) $ i ! PERSONAL$ADV INJURY 1$ GENERAL AGGREGATE ;S j GEML AGGREGATE LIMIT APPLIES PER: I PRODUCTS-COMPIOP AGG j$ � �POLICY( 1 jgCOT- LOC i 'AU70001BIL,E11A81LtTY j ! i COMBINED.SINGLE LIMIT 1 (Ea accident) ANY AUTO $ 1 ALL OWNED AUTOS i BODILY INJURY ; Lj—{-SCHEDULED.AUTOS ; I (Per person) '$ i r-1 i HIRED AUTGS j 1 BODILY INJURY $ 1 NON-OWNED AUTOS ( (Per accider l) I I. PROPERTYOAMAGE I S Ir'j i i {Per accident) - 1 I, 1 IG—A�RAGE LIABILITY t ?AUTO ONLY_EA ACCIDENT is - I I ANYAUTb OTHER THAN EA:ACC, S; I I AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY ( EACH OCCURRENCE S I ; OCCUR CLAIMS MADE AGGREGATE"j i ti S DEDUCTIBLE I i Is j � I I RETENTION I WORKERS COMPENSATION AND I I X TORY LIMITS ' ER _..._..- ............. EMPLOYERS'LIABILITY A I 6978565 08/10/08 08/10/09 E.L.EACHACCIOENT is100000 ANY PROPRIETORIPARTNERIEXECU7NE OFFICERIMEMBER€XCLUDED! I EL DISEASE-1EA1EMPLOYEEj 3 10OO.00 If yes,describe under F "SPECIAL PROVISIONS.befow L DISEASE-POLICY LINtlT I S SOOOOO I OTHER i ) i I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION FOR REC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR_TO.MAIL"0�30 .QAYs;WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO 00 SO SHALL For "Information -Purposes IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AU TATiYfa� ACORD 25(2001108) /`� ©ACORD CORPORATION 1988 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dowling&O'Neil Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Agency HOLDER.THIS CERTIFICATE DOES NOT AMEND EXTEND OR 973 lyanough Rd., PO Box 1990 AL`FER THE tOVERAGE AFFORDED 13Y THE POLICIES'BELOW' . � Hyannis,MA 02601 INSURERS AFFORDING COVERAGE NAIC# IN'5URED INSURERA: Western World Paul J.Cazeault&Sons,Inc. 103 1 Main St reet INSURER B: Osterville,MA 02655 INSURER C: INSURER D: INSURER E: COVERAGES 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 CONTRACTOR 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.AGGREGATE LIMITS SHOWN MAY.HAVE BEEN-REDUCED BY PAID CLAIMS. TYPE OF INSURANCE POL-IGY_NU.MBER POLICY EFFECTIVE POLICY EXPIRATION NS ..DAB M D . _.DAT Q MMlOD LIMITS A -GENERAL LIABILITY NPP1145484 04/30/08 04/30/09 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY . .DAMAPREMGE TO TENTED CLAIMS MADE a.OCCUR .MED EXP(Any one person). .$5 OOQ X BI/PD Ded:1,000 PERSONAL&ADV INJURY $1 00O 000 GENERAL AGGREGATE $2'000 600 GEML AGGREGATE LIMIT.APPLIES:PER PRODUC�T.S-COMP/OP AGG $1 00%000 POLICY j LOC - AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS - BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (PAr accident)- GARAGE LIABILITY AUTO ONLY-EA ACgDENT $ _ ANY AUTO - — -EA ACC $ OTHER THAN AUTO ONLY: AGO $ EXCESSlUMBRELLA LIABILITY EACH OCCURRENCE .$ OCCUR CLAIMS MADE - AGGREGATE $ DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION AND WC STATU- OTH- EMPLOYERS'LIABILITY - I SI ER ANY PROPRIETORIPARTNEPJEXECUTIVE E.L.EACH ACCIDENT -$ OFFICER/MEMBER EXCLUDED? If yes,describe under E-L DISEASE-EA EMPLOYEd$ SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS 1 LOCATIONS l VEHICLES I EXCLUSIONS ADDED-BY ENDORSEMENT.I•SPECIAL.PROVISIONS - Operations performed by the named insured subject to policy conditions and exclusions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Paul J.Cazeault&Sons DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL --,In DAYS WRITTEN Roofing,Inc. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 1031 Main Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR OstBrvi.11e,.MA 02655 ..REPRESENTATIVES. AUTHOR17M RESENTATIVE �_ ACORD 25(2001108)1 of 2 #52027 �[! LS1 ©ACORD CORPORATION 1988 r Property Owner Must Complete &Sign This Form If Using a Roofer / Builder. .a 1 (print) L j2 as Owner / Agent of the subject property hereby authorizes Paul J. Cazeault & Sons Roofing Inc. to act on my behalf, in all matters relative to work authorized by this building permit application for: Address of Job Signature of Owner IV Mailing Address of wner /&V Telephone# J-' ' 2 Date (Please return this form to Cazeault roofing along with your signed contract; It is needed for us to obtain the building permit required by your town, to complete your roofing project, thank you) fax#508-420-4555 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application# � Health Division 2—ooS 71 5�� Conservation Division Permit# Tax Collector Date Issued /V rp Treasurer Application Fe A��* �� Planning Dept. Permit Feed► i Date Definitive Plan Approved by Planning Board ( 0 ® Historic-OKH Preservation/Hyannis uh Project Street Address y44('n op ki �"('. �c�C' ��• . Village e_c>T u CT- Owner `r A(k-EJC7 ` �t 1 I4IZI Address Telephone !0l'h— �abq.— Permit Request --�7LCC> a/y�iLtJ Sr�(G_ CB GC-17"��f� Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay -'�:w Project Valuatio Construction Type Lot Size Grandfathered: O Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure l5C> Historic House: ❑Yes ?<No On Old King's Highway: ❑Yes P:Ro Basement Type: KFull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) k5c>0 a' Basement Unfinished Area(sq.ft) — Number of Baths: Full:existing new Half:existing new Number of Bedrooms: existing ST new Total Room Count(not including baths):existing new First Floor Room Count .3; Heat Type and Fuel: X Gas ❑Oil ❑ Electric ❑Other Central Air: _4Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes �No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:4existin _ ❑nevy�size Attached garage: existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes "SNo If yes, site plan review# X Current Use lacama0c,7 Proposed Use BUILDER INFORMATION r r-- Name- �'—L��� �© - �� Telephone Numbed. �.� LfG1 - 10-? l Address LAq QM License# << Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATU DATE �`�� i r FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE L i � OWNER 1 k r DATE OF INSPECTION: 3 FOUNDAT 4bL FRAM INSULATION FIREPLACE i ELECTRICAL: ROUGH FINAL 5 PLUMBING: ROUGH FINAL ± t GAS: ROUGH FINAL FINAL BUILDING f DATE CLOSED OUT ASSOCIATION PLAN NO. •yam L f Oct 26 2006 10: 15AM Stonegate Capital 6.177392238 p. 2 OCT-26-2006 10:17 P.02 Reg➢gitory Mess g a 5 Thomm$."or,Director s Building Division .` :' `fo�.�aYrry,�aa1ldiag Co4rasaissiones 200 Mda St,ve% Hymis,IAA 02601 . ww►.texu.berc�able.wa.ae ' itce: SDS-862-4038 Fax:. 50R 790-6�3D ?Cmdt 90. a Date - AFFW AVIT 310MM jbM0VEb0=CONTRACTOR LAW �SwjF1 W.V,w7 TO P f A IPLICATION Mfj L e, 142A re �&jt 1'he ox"anstrmettm,ait mean,rcaaov®tiooaz, gang,godaanizatiau.convenioN %WW4,&=Jilion,at roWVUoti=®f=WSlat'a+an to spy gro-e?&ftg 1DW=,000%dad W ceauia at liad m-,but not mrs t w four dweUi g its.a<14 atrncea"wbdcb'wt k4JUM to '�a oaaoe of U ' be d=by ash d e ct n,w ace n MOP`+oaa,AIMS art2i®they Type of 1(� (�I,� 0 ted Cul Address of Wm]c�� "C(D 1�-C�t t[-� aL C - 6Lc0�-� Y bacby c *f*mt Ugiemflm is hot raqwnd fat*a faaBowing remson(s) Wade eaciuded by law ]a Under SIX0 g not owner-a�piea z N94te is berft given thRig oVmRS?1JI.LWG TMZM OWN PUBUT OR DEALING MM VrWGIST3=D Ct3N mom R AFMCABIS SOMM MROVENW7 WORD.DO NOT HATE A SS TO T=ABS71RA77ON PROS OR GVARAMTy=SIR MCL r.14M SIB U=Mt FWALT MS OF PM=Y Y 1weby Imly fm a p t aSUS Of*e 0'%mw- do Dato contaaator State Regjstraaca No. t ' Date F9wa�'6 si Rw. DM TOTAL P.02 Town of Barnstable tNE o� Regulatory Services • Thomas F.Geiler,Director BAWW"tom MAM Building Division �'°TFo n+a�c► Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 i Office: 508-862-4038 Fax: 508-790-6230 HOIVIEOwNER LICENSE EXEMPTION ��ii�� Please Print DATE: w JOB LOCATION:,, I"L"► ���� C� number street village P-J "FiOMl;.OwNER". work phone#home phone# name . CURRENT MAII ING ADDRESS:Z�6,,. . city/town state zip 6ode 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 saper3• DEFiN1TI0N OF HOMEOWNER Persons)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under'the building permit. (Section 109.1.1) - '.'assumes responsibility for compliance with the State Building Code-and other The undersigned"homeowner . applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies he/she understands requirements and that he/shemwill come Town ofply wl'thtable said procedures and r minimum inspection procedures and requ ents .. . Signature of Homeown 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 ladk 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, ilities of a Supervisor. On the last page of this issue is a form currently used by. that the homeowner certify that he/she understands the responsib several towns. You may care t amend and adopt such a fomi/certification for use in your community. Q:forms:homeexempt Oct 26 2006 10: 15RM Stonegate Capital 6177392.238 p. l OCT-26-2006 10:17 P.01 zwe commonwealth�,fmassarhruset" t Deparftent of bilusltriasd AcrldemO Office of Invesfigafiens 4 600 waasdainvoaa S&Vef Boston,MA 02111 Workers' Compensation Insurance dwit: ARRMS tnt Please Print Leably A NaMe(Busi®ess/Orgenizationllndividuel): t 14`2 Address: t5® 1g:WCtT"4k- U City/slatclzip° ' 1' Phone V. ,%n You ou employer*Cbeck the wpproprieU box, `type of project(requlrad): 1.® I am a employer with 4. [] I=a gt t oral contactor and 1 6. ❑New constrtaetion empluYees(full and/or puat-dme)-'* b-ave bired1he sub-comacton 2.® I etas a solo proviewt or pater- lasted oa the attachsd sheet.$ 7. [J Remodaline ahaF Md Isa`tt:no etaeployoes These sub-cont=tors have 3. D mtoiitioe worldas for ate in my eapaeity. workers'caul;. ffisutma. 9. ® addition [No wMims, comp.insucance 5. ® tie Re a carpora don and its rewired.) oflacers have exercised their 10.E]Electrical repairs or ndditiotzr 3 1 am ahomeswaer daiag all work right offexenWticm Por MOL l l.®Plumbing repairs or additions myself.[NO worms' comp. e, 152,g1(4),and we have no 12.11 Roof repaim insurance required-] employees.[No workers' 13.0 Olhet comp.insfuance requhd.] 4'Aay sWiram da checks boa A m ial dsm fill sus tht wt t9an below showing thou policy iedoematioo. t Knintowma wbo stilimit this affidavit indicating t*are doing oft work and 1hon biro outside conpttsors tenet nitwit a new affidavit indiatiag such, tConearmm fat cheek thn box must atlaebed en addMo®al sheer showing the 4M9 of St sub-ten0setots 00 thou workers°cmlp gnliW intuffiadae. s I tam an V*10yer A C4/s RNW61g workers'conpesasation b1suraeree jar my emlayeAr..Below is fibs peUcy sled Job sire informadwt. lfistarataea Compauy Name: Policy 0 or Self-in.Lie.it; i cpiration Date. fob Sirs Address: City/state/zlir Attach a copy of the workers'compensation poNey declaration page(Agwins the policy number and expiration date). /tenure to secure coverage as reVired tenter Section ZSA of MOL c.152 cw lead to the iota of citminal geWties of a fine up to$1,500.00 and/or one-Yaws itiPisoMR90t;as well ea civil POW682 in the fry of STOP WC1K ORD19k sad a fhw of up to$250.00 a say against The violator, Be advised that a copy of Ws stateintmt maybe fbTwwded in the Office of Iavesaigations of he®IiA for irtst mce,coveragc v u- d Wafptnefirles gfFesjvg`dhms she halbrmarig a proWed ebm is orate aced sonvot i c p�t✓Q of illlTistad UN out+. Pto nag write in ahk UW,w be compdetea by city oertown efflicUL City or Tows. Parnsii/Licenst# Lwviag AiAorhy(t leele one): 1.Beard of Health 2.Building Department 3.City/Town snarls 4.lltwuical Auspettor S.Plumbing rnspector 6.tsar Contact Person: noise#� RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings $100.00 Residential Addition $50.00 Alterations/Renovations $ 50.00 Building Permit Amendment $ 25.00 FEE VALUE W ORKSHEET NEW LIVING SPACE square feet x$96/sq.foot= x.0041= plus from below(if applicable) ALA TIONS/RENOVATIONS OF EXISTING SPACE (C CQ square feet x$64/sq.foot= GL(co _x.0041— �.p1us from below i:f applicable) GARAGES(attached&detached) square feet x$32/sq,ft.= x .0041= 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.0041= 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) Projeost Permit Fee Rev:063004 +R TW t Town of Barnstable BARMABM XA . Regulatory Services Thomas F.Geiler,Director Building Division Tom Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, (ale L.* 141/14AI Z/ , as Owner of the subject property hereby authorize u Cam'9Et' IiqYl to act on my behalf, in all matters relative to work authorized by this building permit application for: r ry LUAlk, oL! 6t l �( (Address of Job) t Signature of Owner Date (2L9&AV—A- Print Name a Q:Forms:expmtrg Revise071405 I5 „9b IS a �.. 0 n !D .,sc „ y i s - LL t'V M N „09 ® „Lt I I S. Y 1 1 , - s Y $a 44,11 ... ,. ,.�na3. ,:'•` �.s,.,� .��%' :g� � '^�` "� a ;*..o-�`. �• .:.�� .:i� * �' ,�..yy_ .xC;r sr ,��� "'"'� - +N� Ali` , i w• , ,.•,io:,.8�'` a, -..w».,. . [ ,'�..:.m+. ,. o. , k to ':g ,,;,:. +• r .�_ , #; s� •,, sa cx i< _ ��_. y �, '-". .� . r 5L W5, :a 4.. r{'�,>,. '„IR, , ijt.et,u, ,� , o- -` r .x, N• .s>�#, , F z_:....' t. w r.,.t. _ ,.....:. - +. -':, ,..,,.::, t` d&' •:' +a as, b 74 a :, • z , � x �m t qqf A`* q � ' I-A 71 3 t. ft ar �• .,..... i ' ,- w¢: � _ ,ra. ..r< ,�•�sTn'1�T�„T`.:�s`^."`�xt"�wo-:�.' � gY4e lb i;�E Fill 4 i a 1V r u 1446 Main Street, Cotuit 10/26/06 zH . ' i{r M 42 N-i` v, qwl ,",;Pi� , A 5£ f - a' 'A'4 ., ,., *,., _. .v .- '%." a."k :'•"'�,'r.'� ^d.ems r: a ,� g� t g - s t d��.:, K°e;�'"`�, ice' � ., ".:"� _ ''•-"• � a �� s-cu ,a r r - # g.¢�`:�,=-ems'S v- i� �, *� ,',y�� � K ,�r" ��` ��5 � ,am she w M ti~`•a�.��,.;.a. °.�.' §`� < w "} �w"�- ,c a p °r� 'r ,� y N � ,� -<. .. N ram^ � nr._.�. 4 ++max .�• '^••�ti� ..� a- �.. +: '.s� ,;a.� "'$` " � µ , RkW y.fig � 4y t�. ��,"' .�. y `T � •� " ..mx;, a�,* 3;,�. .a<,,.:.+ �. :.s°""`"' fin„ � - a n • 'ero y 4,. i3 � ry cek ��.. � ,., .�" �� <� to �: - `".�� ,�.«.,:, , � •, .,�15.:. � � � { s k: a a 1446 Main Street. Cotuit 10/26/06 The Town of Barnstable BARNSTABLE. • Department. of Health Safety and Environmental Services - Y MASS. i639. �0 prfp MP' � Building Division 200 Main Street,Hyannis,MA 0260t Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection Location 111616 V *CA 0-7 Permit Number 01V E Owner Builder 4 One notice to remain on job site,one notice on file in Building Department. The following items need correcting: R#r# T&Ar ©(LZ- 4J R ( GC) IVOI-'-lC W e/O 5cZ— � l� PP-7"f)—rng % IS�( � cS 6d(i Please call: - 508-862-4038 for re-inspectio . Inspected by Date Town of Barnstable do Regulatory Services + sAMSrABLE, • yQ MAss. Thomas F.Geiler,Director Up s6gq.rED 64 Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 August 31, 2005 Glenda Manzi 150 Yarmouth Rd Chestnut Hill, MA 02167 RE: 1446 Main St Map : 017 Parcel : 021 Dear Ms. Manzi: This letter is to inquire as to the status of the project at the above referenced address. As you may recall, a permit was issued by this office on September 30, 2003 to demolish an existing structure and construct a carriage house at the above referenced address. To date, no inspections have been recorded and this office has no copy of a certified plot plan showing the location of the structure. Please contact this office at (508) 862-4034 with an update on the status of the project. Thank you for you attention in this matter. Sincerely, Jeffrey Lauzon Local Inspector Q:zoning5 j�2vho $� rltQ2Z TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION b C'J Z :� , r ,, ermit# ��l Map 0� 7 Parcel L $ 'L I Health Division Date Issued 3 G l03 Conservation Division C1 ail r' � �I 'Application Fee Tax Collector Permit Fee Treasurer SEPTIC SYSTEM�i�%IT��c ®e w 3s�©a Planning Dept. i%;sTALLEID IN Date Definitive Plan Approved b Panning Board VATH TITLE 5 OIL-�� t IC . ENVIRONMENTAL C®CE AN' Historic Preservation/Hyannis TOOL.REGUIVrIGNS Project Street Address l q% /lqi n :S+r-e ' Village CAUik - iso Ykrmou oA Owner cirri fi Glenda Y114►i-ci Address Nest A gig , MA OZIG-7 Telephone Q-7 — 9050 Permit Request EAAs r cdwqce Square feet: 1st floor: existing proposed 12nd floor: existing IZ1 Z_ proposed 85�_ Total new t sc= Zoning District KT-_ Flood Plain C Groundwater Overlay -Project Valuation Dmb.boo Construction Type - Lot Size to Sy WOES Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 21"" Two Family O Multi-Family(#units) Age of Existing Structure-RW-hD Historic House: 0 Yes Or<o On Old King's Highway: ❑Yes EMo (art"e., 5 s} Basement Type: a'Full ❑Crawl �Walkout ❑Other 1►N IQ W Nz,(= is Fcx-L-, cogsr sLa3 Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 1100- Ft Number of Baths: Full: existing Lf new Half:existing Z new_C) Number of Bedrooms: existing_ new 0 Total Room Count(not including baths):existing ! new Q First Floor Room Count 1 Heat Type and Fuel: Comas 0 Oil 0 Electric ❑Other t r1bo20,1CP' Central Air: 2 Yes 0 No Fireplaces: Existing `z-- New 0 Existing wood/coalstove: 0 Yes Elo Detached garage:0 existing mew size Pool: 0 existing Cl new size Barn:O existing 0 new size Attached garage:0 existing 0 new size Shed:21 existing 0 new size 'ZZ0 Other: ' Zoning Board of Appeals Authorization 0 Appeal# Recorded 0 Commercial ❑Yes 0 No If yes, site plan review# _Current Use . BUILDER INFORMATION 2 AWaName_ �e��� I'1��n7 — Now 0wv6-k-, Telephone Number Address License# Home Improvement Contractor# - Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE Ec DATE - 7, b 200,3 i { FOR OFFICIAL USE ONLY 1 PERMIT NO. DATE ISSUED MAP/PARCEL NO. s ADDRESS VILLAGE ti OWNER 1 - > DATE OF INSPECTION: t FOUNDATION FRAME T INSULATION_ FIREPLACE ELECTRICAL: ROUGH FINAL r t PLUMBING: ROUGH FINAL ' GAS: ROUGH . _ ' _ : . ' FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. r w ma E- r e� r � r 0 r r --------- -F ----� --�----- ------------------1 1 mswm V/ d..,w 4 1 ;---------- , 1 Q. L . , i �� , , a r•«v I 1 � R 6AaA62 I b I I owc'rors ' 1 __-- p 1 I. \\1 I I Z t 1 �p HAu sioM6E A +.wrotaerlsq. I I . 8 - 1 1. nv+•m I 1 or'.c,m v�ve � n + F ------_--- Q Q L. • I I h 1 I I rvu I I ' ' 6 - .. [�pC�91HW�pplllllll'II''V�IIIII llli'I r r i r r r r 1 I r r r r 1 I r r r r .pw.Iiw on� 1 I r r r r ,. I I a�n� r r r r •r F O U N D A T 10 N P L A NY F I R S T F L O 0 R P L A NP9 SMOKE DETECTORS O.K. 13A]UNVULLE BUILDING DEPT. ' QItu ~ « ON l{ 2 111 olHlran_Ivlw p r�tl .� wWwQ , a r + r r ♦ Q zI Is gsi ScE`C 0 N D o L 0 0 R P L A N A-1 ID LIJ r ® •$ ,..a 2 I L o . .e�. g �M i = = = -= 1 - 6 0?w_•'!'.---f..__. �fl.__ —_._._.—_—._— —_. 1—wwe� �wwiecvmr i_-- ___—.__ l�—?w---� • FRONT ELEVATION — NORTH R16HT ELEVATION — WE5T .aE�sEs� LU ED ------------- _ ---------' tu M a Q v0 —Mrs U w Ame— m. i 1 i i 1 i LR ELA R•ELEVATION — SOUTH LEFTELEVATIONO N — EAST — ^n --- ------------ ,.p LU 0 � SI r -- -•- -- MQ - + � TT � yy2 0 CO, 5 E C O N D F L O O R F R A M I N G F L A N R O O F F R A M I N G F L A N - s. a<�.t� I -O - 6C�I.E� li♦ -O - ��gggpYenp;¢ t .o.w t .or OV m Lu -•da 4 _ ��anm F to N Q v0 5•E C TIRO I N_o - S E CT T 1 O N _ _o . � M A-3 The Commonwealth of Massachusetts - Department of Industrial Accidents -- = exce CURYe5ti9avnfts 600 Washington Street ` Boston,Mass- 02111 Workers' Com ensation Insurance Affidavit OMM: location: y \ hone#C. ' C] I am a homeowner performing all work myself. [] I am a sole netor and have no one worlan in ca a�tp job. ///%//%%%/%%/%//i. ///////%///%/////O/%%/%% %///%%///% %/eS%/ g�/nL/5]%//%%%//%//%////%%/G///%/%%�/�%%%O/l/////////� //// %%/%% %/� , nsation for em a3' {{, ,4:J .w,;.,�! >{ ,; �ca ^.,... / co a nT9.,.. .. r ,:•�'' 4.:• eI$ :S•y,,t! #v"iiy<:a:Y'.f.�d uY,'`•"is µ ;'::3:;i'%:{`% :::'.'. q G'bLY":'��?'Ri2" } kY' 'din work „•i.;:::4:•.:...<.::..3,. >,<:s{,{v{v:.4r;•!....•::.:.4u:•:: {<:{ :,.. IOVI x r::: ::}...: :'.'•'2•'';+`' v. .. .:•n.., fi:}{;{.4..,.,y S}S,W:'< : ':'Y9; v:3'+" S;L$ Eti e;{..... em 1 eI g ,;{tL{ <ti,3;.>.;,v:,:...{;#Yi..7}.., ,�.}kx{•;C••,hv}. '!::isrM��.a22:.p.,q.-J,r:....:7,,•..}}.;;•:: an oy ;>.>:?!tk.. ;•:)...?rf;:<:3:.:.)>:.:;;?:,. ya{3}:{..: w?.•• ✓`.: .., tf.•. n rwr. : r.y,. 1 am .�.r .wv}Y4;•}:•!Q•{{;x4}{':•;..,:.... '•xi{v. ..:$:... 4.:}:4 : ..::Y., . ..r+:•...4 4+.y}: :••::4.4•C•w:i .t { 5+...+7r ., hb '+3. %:::%;ij.`•:}:j\v."t::•rr. •{i+:`v::'f{?,'y;}..{'.^.....<{..f'i• w...,xmw. 4,;Y;.. ,y •'{ A\•.,{::.: :i.. :•::>. {:.{S.};}:.;•.;.;4{•.,;•.iY3-:.?{$ k>3i^ta•;:::3{;:., .'3,i:S3'•,:e•:4<Y:{� .},4:., ..}.h�,.: ...:4:.•:v :xYt).Y..,,4c`,�l<}.2,fi ;.,;:..:....?xk•r.,'x•;% :..3:}•.rr... :-:4•.,..... :: .::.5:.....••t•5.+,.:...b,'r::::....:. }5}x{.;{:<.r: rt•4'v.'•Yr.. ,.}•?tn..•::}e+,S,.::o••}.,....t,!:ta^.1t4:F i..,:;,.,b•..;�: ,.r.:.�ar.:•c`•}4.:k:.,,..::.!•}Y r,••:}.::ti•or:C....:{r..:,:.:.,,{....,:.;'k.:,;3.;:•:{'}..,r:.,:r:....•..r.r,:r:{S!6!�:t •.rY.k•!•:. ,},•t: A ,4.{ rf•.,, \ ;.4.:..:.:....:......n +:}'{•., n}:3S';';ki:#:!;3$:: :!? .:rY.v.r.:.::.5? }:• ....:r}. n,•r vF .n ..r...... r..un n..:..r t+v•n,Ft•. .... ...x•.nn4}:`::::........::... 4 ., :.3•:. :Jf'.,:r.!..:.3r:.4.n•:,}`:..:....,h,r:::. S{:•+,:..4'/i•.v r..n,••,k'$.:}r.:. ..:.:r::•:::Y?::r.,.. ., .; v...•::;}, .. � .:Yn':• i,./-",ik...... .: ....,•,........•...r ......f.#' .}.... k...,:. :}v..4A.:.:n..v}..YF{,•S}::•+.:4:;Nr•:{..� ... ... ...,. ::.4•. .. ..:,. ....,...•.:..:::.::r:,•::.;}r J::i:i?L!rxr,.!r'•':,iY;Rf�!�,:�$�.?,•r.+/,..y.Yti•.'••.::x{.•,•:;�:c8'`'r•�2't;,:;;.yrr}):�.�.. t �{t•,:i::_;iY•. kk'r.: � ..Y,..: :•4.:::.4' ^•.,+.h,. .:::a v.i.: :^4"fir.+nf,.4:{"•r. ,. '�\), y. .' ,r%''K,iY•,:, j' y r:?A:F::,: kS•ki'•Y,::trl 'R...4 ny, .. v:;^.•'�;�:Yti'S'. .�v.+•4 i,••>: a vr,•,c•;j;•rrr,:;.;iyiJ::•:'ii'{.?�;:+ :.\•::.:{::ti ..$ .,Y v ..,4 r {:... :;:}:•2:::•:•.t ,.f.. f. :{ .nR`.v > •.'t'".. .V• f,{i!+'i::�•r....\::;'t�:Y;;.} .}{:• ,.i{�+:.}.:vYr:;.......A:t4.Ur.}•:.5.�i:hr y•, vn;••,•:::;., :.v) ' 'n,}:. n:..v:... :.{.}; r,!r.::'•tiSL':::'::::{ .. .. ...::::.:.::• ::::•::... ..{.. :ti,:,•.,r.. :.3Y•• .;{:::fs:.+.•{7;..Yr.•:::r.•;r•}:••:r:.i•i4?b:`•Y;};..:..r4:, ,t r:�y'.:f3oi;•i,Yfr.i/•4• .{•x,..,,5{.;. :,. :,r.:;...:0:}:.7..:3: :::..::{..rrY•. k,{• L3}Fh» ..x:::x,.,: }), .S•;.;c F:,. t::•r:....,,..x:......�:. n,:^:•..vY:•+r?''2. v,•Y.••4;.4..{,!! '.��"•{' F!,.%a•:xw•.'::5:.4••r!:;u3:;br,.r�ii':••'>,{..}•d:!r_ ...3..,. •JrF:::L..; .,.:Fk,:F'-., ..+..{;i?#7•?$.{•{„ •:.•a:.r:.v:,:+.•.!L.3:J:. r•xd•:+S•::.,•}.} :5:: ..f;i:•.•r.,r.• x..}i{•.•:7r:.#+.•.,a.•:,W{..4'r?r,; .. :•..';x;•r,•.:.,:;•rfiri,::r:.. r w, .• .t!::>.•:......,Y• ,{;v r.. r..}Y W::: .•'•;\},: ^'.,'^'4i:•:• {.., .n.,}}Y:S}L.G:.. ; f'. ...w::.:}.:.;{.>::•::}...n.r:..t'}f S}..:rrf} YL.}:.,,r...:n..rY2:.{: k .if•r�.,..• ..nr..J..:. .,. ... ,... •'$....:. ..:.r. ....:.Sv::!,,t^,,..3;v::•.:;4x•..:�n:;}i•:v:;:+•r.:•i'•.; •:•:;:i3>r. .•#.>g..u•..r ...�Y,r...:,::.:.,:.{:...:. :w.. ...:.;a.:•.:., ,x,. .: .\rx" ,...:.:..:.. ..,. .}Yf{yir•' µc^k�:}}•:5,+.: v•vr.;:•,4}:.,.+:.>vr:+.....,�:...}.4}v: .!.!..r..•:., .,\^i+:n»`Y4.�x4r..,f4.,:xv•..rT..T .:....... .... k"`r',"� 4.:n.; ::::::.,..,::.•rr.:,}::t^,�4\i+k..,••f 4�#:C„< :,o,S,r,..\?t..,. . w::r:.'{S:r•^:f y•:•i W, �{,�k;;. .fi•}„�.n... :r... .,+fJ.. ..r..:..S.......r.k.,•: r.,....4r.•..: -,x.. }:SY..>.L{:'S?.•.!�r#C'r'@.•7:S}4�':, , r,•o°'3:{ •Y ,:}k'.?:,�.<;)^;;.;: .f. ..J:•}::.:..:}:••:.,;,....,.... :,,..•.:{;}';3 ::t.'!.::?•:'::fS::#«z2:3:::..: ,r:.:. •:}Y .h•rr;S>„:,, �,}Y::�::!}{t� '�,.: 4*:,'.•:t.•.?}: v:•;..;..n:7.. .... .... •r,:v•:•.YF.;r.Y;{! :,'•Y,.`,:.. %3'•, M.:. :•.:K w:;v:•:•:v:v.v•:n '}i:;;:. ..L:, ,L. r33:{t � �•,v#,. { k`,•k'; , .:\„ :;4. I.}:+..,4,.+:...t' :::::{..2,.3.•r;t:•:4•.:::•:....., :::�F.v .•:4�.3..SY;yt•\p;.S3'p;r•nS;:. vSS4,::.Y2.`:;•r,{r:}.3t•4r,;.,•.•Yq,}: lhi%<rG ii :Yr.Y 5,..:r}Y.4!S;•{:•:2-r`•.. 4.•Yxk• t;•:•.»••::, , ....{4::•:K.};,• 4Y!!,.;:4:•.:!r}4.••!,.r:•.. v;•;•+.v"k•'y};;v} r r {t•. '°'• •'>a'•i3::..::.L;. .....:...:....:•::r:}-•: M.75 .:.:,•vr..,.•..;:d... 0 .:,,:.; .•';•i...•:.4 t.:.,:t{:,i:4:•:ki•;Y{';;! .:... I• } •h ;'+;'t;}4;Y.;,+i3,' ...:•ra::.. .3.k!.•.,:. r...'.;q,.•+•}• •.S•??:4 :.tY.::::>r •-3}::::..x••:::.:{{{:,.. ::,F.. :Fi.L•3f•}:ki,•:3`rX^t kk:: ..e}::k,%?:2}.:;'.:k.:G{C.r:. o.$..})fi7,tY ,.,✓.: u,• .<•:•.••+ :'�:!Fx ..rbitYif4.. ...S:S•'SLtr. .r:•r;;}•:.;., }i••+..:,w• -4 . .'Vaxf:;k.k. :F'tax,.. ....:a:•'•3:}}.:•;•Srl.:• u:•'R'},. 2.;•r."•.'3':::;.r,.}+r,:,. r.w..,.t,:• .!^:3,.;:... .r, y,� �]. ...'x•SY:v.:!, ,;: >.'•;}Y ...', ..Sy,::. ...{.,••:,:,•.:••4}:•{:SL.}• •:•.;r..'{:}•: r. .F•:.,. ,.). {"< },•'{?.,'S' i{x:i,:;:::'S ti:3: p}0'i1H:{F« ..}.,1.r.:?�;}:•: „Y}:x4:{k•:..i;,n,.?:k.Y,.3 :+ Fryi i •}r•:} :: :;y a:•:k.. vx.>:is : }53:.:..3 •::. . 2.,......:..F....{4r...{:•:::,,..::},t .....r:.....:{XXS. f..:.•,.....:.:•:.,v. .f: •......c. .... :::.;.;.,.,i:•..:{r.:;r..;{{•.{{:. ,. •.;;}J.;F, k n'; •s '1 Hi` +r.,.,•r:•.4..:5{..{.::...:•+:•......:•`.• ., .;{,.,, .. .;.;. r,.;}..t,......:...• }:v.:; }.K;.•;.. L•,r} r?•.,4353{S'/, .},;:7;: :}^"Yka ..,.�.,. :•:x ..{w.r.•..••r.4•,.r.;fi k}{,,.,.Y6:K: :iv........... .,, :4:v::':.:ti4:{)fy:r.,v..b}4,{ A,.;.; .hi!,, '•{. h MEN. }.:1...,n,:r,.:.+.{•::......J.,::...:.. .a. :•:Tx,..J..�?., ••+::;CYF•!3:•}.::{•.:.;;••....,':..:r,:: .v%$n{},:.. :4 :!• T^•.}Y{• h '} '`r'•-"L'r.,�+t%$ t,• i•r`•....}:•.:•r.v.,.:::rb.4.,,:t..r 4•a.:^•}••L?...E. .t{.; ,ir,•,••..#or•..t4. ..'r},:?"',.,+;: 3}:''•??r•::.ac:{^;.r).,S<.}+'�"-{c:++t�•':fti',tr&,.4,..,; ':t:i;:r 4:.5::+...,..,..... :.r:. •nv:•i'S'4 Y;J i+Yi7}{:L4Y:?•}}^,. .':':�i•3;t?::}j:''{.....v.{{v, ,...v.•N: !Q ..,{'..:•}:r..:.S:.: ,v.}., .}.•::;.Y!•+Yk>.;; ;:.,}''fi>"• r{..i,...:;}��•.`'+:;3 r; ,F;,Sf`•.•;f., r. '...}i;•,y:Ja:`2'' •:4f4•:'3}+`r3::,•::: ;aY.v{rrr,• is{'ar:; ;+::},: .:..{;.r}...:t.,.r{.,.53:•::•:.r, rti..:{,;:}{. nxy r'• o :.r.. •}, ::f :S•.f•}:, :.na ..Y.,{.:•:•.,. .St .t•.:,...;t.}... ..>:•{S:. ::4.f.,:S;.}+{#:;ki kt:;,••:•x�;y`# } .tN.yq .S•:+.,:: '?€ rbx••....5.. ,4 a:}:vr::,:aaAw:,WY.£'•'vk.$.. .;r.;;F:a:c<S:`•'':•iF•::.,.3,,. )..x..,h:3,,r:::•.,,•..•r..a}."•' :oYx••.t,:;:?.:.:n:;t•.., r..�G.. �r r.:k•S,•+�:2+,r+.'•:•:t•:skn. , t,v4;••::/`; r:^�;.5,:::•'•...rif.Y!i;a. ::Y....; •.•{:::!:•i#:+5:3:::.+•:.... :•k?k�SS:•';;+3?:4:;%<?S'ki!; �• �f,;4;•i:t:�•73':v.4,.rr.4.ttN3h+. k':!•:::�.•Y'S):{i.:?<;;;;::rk:7:S.y;!••.;F:d!.,"•'�^a3ik;:}i,.S:v:kyS;2:s7}x::�•r ;:{:ro •.'•:+�vtiF�x•:; •.v;i4r:`;•:.!:;�SXr'C;t;:;::.}{•. }. :•::R,•:: :#x:r<'•l:•�.'rryr{.;}y'.,f•,'.yr•t;.;:.<�3;}�y.4tk:+;r•;d:r;;!+.'s4ry ::{.,Uy:.';R::,.,'+�.fi;;;yf•.:{.$:., '4c:?eC "•'..i. .r.:C;,:•:ry#t••..t, 1ri2StICt`tft ;..;::•r,'3:r%.::L:.:!•.L.; .yF%:•!�.y:,?•: ::r.,::::<y::} . 7:.,.. 'etas eneral contractor, or omeowne circle One) and have hired the contractors listed b1711711, elow who am a sole propn ,g gr ha9e + ation OlLCCS: t•};no-::{r;yr{7r}?^' ?Fy.ry'tLni£•': ;x<r'<<Sf{ •,",'���f;w,� a,}3 MINIM�;� �vi� �c Ca GI1S {arr,.w:<a3r': :5:>;:>.;<••.'.'•i),,.v o ?' ', ,.� 7: INIM .r�:'yNE" workers mPF.r..:;}v:L{<3;:y> ;Sa}%:; \:4.Y..F o-L• £ r} :.; �ffi' llawIll :,}. ...Y..; .................... t:.?i;. is'k•}.�^i f4:t{ 23•'x ` f;' #• r;�ib,:#'f✓r' �R x :{�}y,., the fa .:.w•} '+%i<::SS^%•k#.. .,.t::,.J.:::{...ck•;.;4• : ,« :n.:r.v}'. '•a.:.; xnx a ?.•:: /:: ...•••�;`• %t!:;:•ro.. ; 4 . $,..FG+.• •'{x4�SSr � , :�.'%�`k�.}}•Y.{• Y{•x •? •:,+,..:..: }.,t. •tY. .:as,r '+a ,.W'�»v�4{•::siY-fin.). + 0...Jr.. r..:t•}:}S:•:::{}':i•.v .%..rh, .. {.. ::.+::4. .. {:Y t'''r:>rr. .;r,•:ii.:f,.Y.}v:. ;;ir:•}rr,.. :h Y,..'i n•x; •+{v v....•::::,/. t. ..� v,n., ,..:+y,..•3..r. {. ,, v:+::'•+:4'!:'i:::.v,• nX?.. .4)r. .::9F• r :..J•3. 3 4:S:r:•'.,:5#t4:!i.'•`Y�#:£:`:S.•'c4'�!•r';'.v::',,c,�R+•:kn'�..:.,•.vF,,:fcwr. :3c%r.. :Y.�:•7!{:}F:x4::vx,•!i�'4::'•:ii;3•Y}.4.;.;F., •:, ,,.; •' its•.: .Y:•.v {i.; •., •{• r•. }:•:,v....n\•.. •:tY::::.•ff:••:: '{•$ ::•%'k'.,': .r.: „•r-.•:! vJ�Sk}•��'}j�{+,;+,:#;. .,4.5:::#:S:',•^.3%{:.. ::k ,.. t .,�} .Y.�•;r..;;;;xn'rr•;'r :"3i�fGi{SW$ri°S' '•,`,-4":y�y:. .k5{2:,c• .'' ;x<;!3#:}:....... �{.:Y .\:•. ,4`:•:,d. •} xk?`;?3n,•'{;:cY'. i�!•. .•i'r%^•;,�•: x ¢f :a% ';f � A ��'} 5•,X Y.k.:.:rwr... e;;: h:•;4. .,r{:{:.: •.:SS•;):4:;{'i;f!S:,•:�.'•5: ?•• •S;•{:•?rr^+ ;;a}•r ',•kl ••! :,:^(r,}. !K,. 8Il :IlSIri :i>xaf.'•S.?+,..r..}t #''.5...::•N::y., { .4^v >%.' fi S s.. •ar .f: LSOIl! ::r'FFS,>S>:d4z:S 4•.h k:•.:. k:{>.£:siVi:•likfs•i :{J:+i4!S. . [ 4, v;Sr! C Q:i:;.v.• '+{:r^,.{ rr.vr r3'?n,v :y y^;r4WJ/r.r ...A.}<:%;:y;.{:fr,:{{ti}}'..::::}.. :.} v43:;t: ... ''4`+,fiM.`;,Y.. �:.',•�•4}:. •T.. .f• .,+�??�'v,^\'�.'3!f}.{'. ;v..... .. r.:. '' :..i}.... . - '^'x{tvi'::'O•:v;:..,} y.. Y• x':v. },'Y4}{•}^'.:; r.!t{4. ....v ..x...•. ..,.0!;;:,;, .'f t.. 4:::•i$i;:SS};};•,•tS'!+',; -'F;. :X''{.r.4::c r..,`•.:a.+.\•:,•. f:;•,}}..,,.;S;v.:#<ti:ka;'q;'0.��•�;.r �3h:x•.k:•...t:. ;F....i+•, ..q,..r.•Y •a.r:':::.•.:}7� X. ..5.+.:.:,, .; tf ,+•.:,•:. .::•• C,.•• .:a!r:r:tr,':%:':Y^•.ir{:x};;r:.::{}L•;L•5}}•.;.,!{;bx•:k••:.yY �.kt.Y!•�i^<Y.a• ,:�„i ..�:•':i;3i{{r?:i. "C1„!iV :#.{ 4r .•.: .. :. ,;Ly.v.,• .:.i"i� •:..e,rK'�✓: •':�:v •a,x•' ,;;r iiY.;''%$4Y.Y.•5;:!r nL•;%'•:«• r,.,,St rsy r„ a'Sk•3r'. , 7• •5:,,;:; '•:':• :•:Yri.^.irv3r':; S 'r�'+ky„ :.4 .:;;:L;:.i'•::5;:`•3ii:••}i'^i'•'''i.'•.•N'. •{S{•'i.:Cf�}; }i M•' �p }+F• 4,1.:�. F• • ::{.;n,;{,:;.::SYk::•:ir,.y'r;:{.'::}7:?':YkY••',''•5'"-0S:}::^•.4} :..3.!i�f:�•:);r.4:}rY :S .}a '4+�,{''' 4•.�L! :iE�1�:L15r:;oY' :+.{:?{{k}w{ ..:Y•'r;}v{rx'drr>,;wT<;`,4�!.} F{,r.;a•:: SB:kK,s ^ram. '•:::: :'.:+{Y'7': F•rY4.%::Y+:'{:. .�:•:.J•'v. » q ,^C'{r :}#h•}'�'{:�':,v't:)':•'::kry�: } :.��.i!• {•• �' q� i,'^'''3i:$;:{� :;Sw}•..•'<•y•�;#yx##`f{ .k.•Y'%9J`••{i •.4n..3•y r:..?d�},.•3:32.Y•.{#::{S>Y::;.}:.:,:. r.S:{... :.ii{c..• „�`., Sr!":� ..4:,:;>;ir. {t•:;4Y:%;�r.:,;;Y 3.}ia.. •:�{k••v,;+�,:• i. ,!4:!{..,;v; 52",{•;{f••�+:iti4:?<i.!n,}:•}�:•Yr+ 4,•:v.J•x•�:::.}•.:i:v:i3•i,,; �y✓.•;},;:, ..4 .,N � .•.�•• •%J}.<I!f �••..y!5:::!> y{:;Y s, is:fit. rY } .42•.. w:,itn..•,}r•:;fJ fi{.{n}.... a c}..xF;4^:4 r,..3,0,:::;••.:SS}. �Oi1Ci�..r xv'.. ..f Xa4:•:4}: ^,.u.',.+.!;.}.} >}''%' .:• {r. .:r,J,. v,:^FS^ {;:y�!;./•r`3. {S.:}�gi,';:• ..Y:r".. '`£}•:.:•k•:r.. :r •. .,•::•...?!J:�r .�{$ `�\'.•ri'S••'••rr......:s.'kL•:i:•:;>.,.:y.•:.:... ,;:r�x�;.. ; :, :��°r,•.,}:'�v,�i�'K•.r '3e i, ¢•k: •i>•Y•: .r.•r .;:!..:t,:,•st:,ar':.`,3r.).c•:.,,{, r.�•,,:}%^;,y Y:,,''•.3,Y,'J':�S• x•J••:a..+.::},::: }4;:•s.4:;r.:##G:k: . •#';'• i .Ff.. :::�3^•::'Sr'cr''•.�{-''s"+•5 ":,,% 'aYc' � !3!','.r• tp .dYy.`;'r•,•«•: • }:..,, :.k:}•:;}+:r:SN:;:..r{;::## •`f;V:i:':: Y•. ',z: �•'C� is ."�+•. 'xi°�.'�''�!�¢,\,'r ••.:�;C}.. };7:•,•:;W,;; :4tYr,rc:!r•+,k++«r�i%±•'.'•'•f:•x:+ 7,, % y. ..rr...:rrY :$: 2r}. wvg6".''•'s:;#St{S,:;v:},.. : .r'}t•,;+.>,>:;i;a}:•v:.<:{:r•;.r�•:3�.d�,?.,Y,.3,'r{.<}3,:r::i4. „i/.a}.e}.�rs;. 1 ^',t•. •L}��a��, .1� 7>:: r:,•}ik:}?:;4r:k':;#:;!S{;• +c!y 4}.iS,..;;4.,4<:•+.,,•:^.. ..;} r,}re}'.:.�•:ri•.,+,. 'y. ''r:anrFf.><..:}R.:exti.fi,:'.rr:i• ;:' ,;+fi'4:}}•.YFi:}r::%$};'r'.• 'rr .Y4 Fj v:S,v {r�;,.p'• ::v.••:}' ; fi:•!-,N.f,r,T''i'f{r}{{� j Yr$),.Li;.'r•:Y}i:; ;� {.;••. a S}Ay:;x?#:;'•k.,y;,. ..!9.,.:.S.:SI?:•:n) ,,ti: A$•7: •i:.;:'#k`•:i'r: S''••?:}'h:'::ti:i:'t+iSS}SS:;:3t4;;.;. ..':�:i'•?:. // ,^C'�r!/ i'.}:{:;";:i}{v{'f.••.$+iia.,Y '{:J.'2r 4 v"+ !.',}^i•: {{S}:i...: v,!E?Y>�:?±,Y:'ryt:v3h,G}se �-0•{Ys ?g�y�<.:f:'; Jt?i3�L .J• 4 �{4?:?,}::•Y w)ri: '•{;r:• ; ^::#,`;:::Syv,.;?Lf::i•;,.,}•4ph,:.;/.,cy ., k 4 n,:, !r ;•:C•.•x:+ •:f•S k?n..•i.. ,.,,i. L!•S•',••: yC Y.Y•!•Y;•✓i: E{ :; .� e :... r:r{:r•,kY S}};!!r ; :;3�Y.,vrvrrr:4''•{'}:!'{•-4:1':... :}:b}r/';•• •:{i•. I .i Yiy. !: , .�4i� r x{ .,^i.• >`v:r�.�:Xr$ti±:•' :{ x:Ww•hr!!,j+.{'Y' }{i{:{'.y;.;.r{}..:i,{L:":.},4.v;{r.•!^:x'••v:} x,}'/r v.;.. .{:v,'}r,�.. $..}Nk .i-,y;•Y}P:;• , ,}::•.^^Y ^i9?`r'.{r3•.:C}:•::.•:�,{},:;:$ ..}k:;ir.+:•' ,}.:. ,{t:... ..::,!{4.rY„\,. •}.::'xr:{.:r..::{}r.}..,.?3^:::,•••.' ;::v}!;}}'t:;3Sto?a:r.,,�4,::.;,rrG{c,'.{, :r..:rr/�,±...... .. ;}:s+, { k'{!,'^'n .%.,f..r •:.{•Yr.:x•r};:3:%{':3:::>qk;Y. :r t 7tSrx'Y%},•,•:i% {...�:::;. r.:,.:,vtu•r...;.:.,., .{.5,.;•.,, 4:7c•.nr.}..:,•..2 Y.d•.r .•i'Y . �4.'.i:: ..o. ',.tq,;.•{,f,S.r.�r:�..{,.r.Y �a.Y:4,•{a.•;{t;:S••.,.:•.:..5:::. .:;•{,.;trS}}'•:Y•:}-rk.}:. •.v2;::} Jr:a.,,:{� ..,{4Y:... r:.•r`::%::';::tom::•':..:. .a}:: :S.y�•.:•W'?;Y'y:^k.�af�•}{.4Ys,:,�,•.rF...i: :•:•;oi�2 t!✓,..•rY'•3'!{;',,"•::::•.h.,r:r{rr.;,.,.;.Cr S;k)::`•'•.s.Sx:..•::+Jat:;.:i}{�•:� :....:.,.••r>'•: ;rS,..a,+; ..,:.:•..:•-: •:::..;...:. n:};,:.. }..,,4 :..r:r•....:f.:.S;.rx.k,Lr. :.,:. ...:::•:4.:J.w., ..,.::r::.:. ; - :.j4!,.:•},.{k,4.:.,.,+..:4... k" a,•... •:} • ^;••:£. :.•.;i;f.9:SR;,..f:'{..:k :S\' %�"�c,3y-fi•>.!ru'{h.`r+••:: b yrrF+ :4;'xt.FY S.S.. L^•:: }.}:\Y;J.r.:..}.r.,x3:k;:SS: S rrt %.:4:::!•:333SS:•'S:•S:•;:::•, ..w:f:.. J,.t r.,;'{:S{.^,:S••Y'S{S:%ik:'tc?;S:{ix'S..k..n.{,>:.:. . .\yt:.!, Y•r.'•fi3..3 fF;>. • {:.x.,.}n::n........ y. .:{:..;:.};:,...... 5Y. .,.;„ ,•r:>k•..4.... .:•:r::r•:::....,;4{4S•{v:;y:•;%:Sa,vS{r•F.};t,jk{,,. .�r.,.t .,;.,;.fiv.!•:,{,:oS+S::,..:5;'•S`v•:v�:s .!).!.•r;r .{.... .. •F....'• 'r: .:••:,•:: ••::.:+};>,-::.{.,.:::.•,:fi}:.: •: :F(�. •.'•.fK,..a?},�;.SY•!' �............ , f Y....v o{;,y.n F'•is+4•xy;;xY:'fi i34•k,;F}:�$#irr •\' ••fi'S,ry;% :11HiII :.:Y{v:{i{•;:: L::Y:. ..•r.•.... ?,.t ; F' ;+^•,: N:# !",fi'}}�:, i :� H'Il.� •:•):r:F:,k}:S3i:.r:}Y+.•,:vr ..t#:. ..F..:#k••:{,. ..arr;,.3YS;SSiS•'•.,''•: ; >:}SS}•S!„ +:L•q•+:••}L:..}:.. .;f, 5':t,.r.Y;.'+.: :•.;. : ,,i...,�.:.ttx�''r:}7:,3.•::::. 'w•i•{'iY^:;'<:. ..,•3:!'•:F•:•4:'^.•.Y t•.fi:•:•:.•.,• ::r!•3'Yrrat•Y.»4i.,.�•Y,.:::•:;S'2 :;: •! .'b,,..'w.}•k .:.t•.>n:4�::• ,• l..tr.LS�,,L .tf%4:.,a4Y•r3x•F:.?a,.,S:': •:.i ,... ..r•::::••;••+:•....f.. F,:.`.. •rr;•r::.>.{. :•7,•:•:•:.,t•.;:•.,r,•.;.t•3^..:;.r,.}::•::•a:t+..4'�•:v:.r:r.•:..•:•:.,�{:.; ,..•.,/.{{,•}:tRt%3;:,;c...;y:.{:����,,��yy��,"22 lwrr>...ti,rSkk.., 4..w{..::#•..:::Y...� r .,•{.r.•;.•4:.:,•,•};h;'•`. •};•}:•':+•:.A•:r:!:+••h..::+v....{,:3v.+i•r..>.:.,2v::.; r.;'{,'Y.iYYx>»::�{?4xft4lt••4Y+:Sn':ii;. ••k>'Yf':' ..:r,..JF: ,'r6c :.4{+r.G,•.. r.>..:•w 5: •i•; .:.i... ,.,.•:Sx.:.: S:'+,:Sxf.,;.Ss., ,,,,k,.... •: ,#;.;•5;.,,�; ;.:}Ft;k;f"•:':i:{:4'•47:.•:•:Sr.,4'F•w 9yij,..•.!,.:.•.,•r.•..,r:,.g ?SS" ..J •:;,aw: :'u r r , .,..1.:•,..!.,:::•.. rrt^:. f'}f:':: .;.\..v..i :n f(.7a}:.4:•{•y,..•$^}'!'':ti%rY•i::rw'2Y.•}:v: ti tJ •.•:L:.;:•i4 v'.lr. :a:!:t 3•^.:. r k:9!xd:<y3;.;'.5;. ..{.,$R37,.,4> ..r„W.,.>:+r.::,:::.... :•>:.•J•::...., •.w::f.{!.•••{{ r?#':•,,r: .,r! ...;4'+:.>: , t:3:4^::•}a,•r}}:••. .,•RL.::v:F::.:n,::>.•.v:.v;:.•:v:,v:•>.:•..}.{fi v;:n••r{:.'•::::x +.., ..„ {.vv:•• ..} ,.:R•... ;:y:•::;o:•::::';{h'•Q':.;�7;.•{:•.S'y)tr'y;'k,.kSS?.{S;•vY.•• `fit,{: ,+."'!`Sr\�: '•s'•,.,r.y'•�i.• rS'';vf ::.3•+r ;,rr;.,r.. :.,t:r.,:+:•.,:.�4.S. .'k::S:ir:. ,•^.h rYr:r;.,; }?xk :.i:}:•.;yk}:{r:,..:�.:Y a;:�.vki::S'::•:SS^:59.; ..S.F'}...r.x. •., +i:}•. }r. :••'rt,... w:tt'.!:'::...:. ':,.+.+r:^:.•:{:i^k}.•.}.vr.:#•{r.'.;::..:'�;,;.Y.rr,.,.:;::;•,, { qi {'Y , .$:3?,•y+S',r•:x.., 'eSSN• :}}Y,{;•::::;:. } .^4.vr.. rf 4.v»�/ 7., .�++ :,iE7. :k. ' .i{•'•3•:+.:.:...:3•r•:.+•;;x:r:}3:SS:;.,., ,>s:,� :;;;;r •.i'•Y .4^.a.•)r. .2 .':2::•::•Y:c'k•ri':�kek:::;rr::.:..>.} ... .. ....:......r,•:i:4r:ryi:•:rr., ..,.nx,..,,• •.v..:,.•:n•::,.'{r:•..v i•, ,}.:•.i.v• v..;v...v.}:{vl .y..... J, .:,•n{.x, ......... ......:•..n.....•:. Y.::• .. .:v),.3:.,.F'lrk.}}••...�......•4...r.....v....r ...:;:F?{{:::t:vrfi••:r:U Y•.:3 :n,...•., lr. ...• Yr.{.;}�•#}};r, ,4}':.iiv^Y.•fi:+F .{w:.Y... a.w::;...•;:...., S J:.{v^.'}{{:..;x:vv.,..;;r.7., � {.J:::.v•„+:'+::.•...r v.4:•+:t'v .:4{Y:•.;r.v:r.•e:::.r..... .: {{F.,•.v..iv............i. w+ W :.W :F.: .... .:{+:;+:+•}n:F••.•;•:.r.,..,..}:vr•:•.,:{v}:„•}!:r{.,::•'r'•}i..•: .v?v. air^�3:4:33:i^?:vLr,,{:•::.......?:. i y,L:�✓.:�:ti::::.... •::}.,t:.r r,•:..::. :..t,;. ~<::.5:4}}?4>3: ...c. 1!,lUli ,•x%yfY{k}r? 7cHy?.:g},a,;!<; 4;.tr••::::r:}7.;:•.....:./.::•. •.,.F.r.,;r•:4C4 ,•:..•:'•.,,.,..L.....r.}.a...:;;;.,,,•, E.,,}.. ...2,:4):i.:.. ...x. .....r....:....:.....Y:...•: n .. �}v.:.r , v.. .:.....n.:}:•Rtx..,. }ra'�'. ....::::rr...... vx ;..:..;t:i:v:•r Lw.,Y,. R}iN':7{.J y;n :.r.. ,.,... ....).. r.. ,• . ...o,• ..... .,.. .•::••:•. ..�::{. }:::.:..;..::::',:y.....:.,.,.}R•..t:':..::•. , :Yiit'i+{{.;{: .k:St3'Jc.•:5+3`{?%•jl`.r.3###°k:f:``.:l'v£�utF::. -:}?;4%:^,f:^ •. .�:•...:•.:.::+::..:r:::.,;.:4:{... i3:+,{{ ..y::7,..,;;.L:}::k.};.}.}.:.y:r,.;::'.......... .,........•:::::r::-:{tr..y:+:tvY,{.,::.•:f:t!". FrYr.S,. F :. ..,.,.;, 1'.,,u.;:v.w.+•v,v:•,,;.;:.`. •,:.:„N:,,..::�:�4:.,,•L:......L.. .... ....:w;,.r:,.:w.r.v::: {..:.;;:, :,a.{::.,4r .. n,4,f,.,>4J{;{ ••fir.•.L•'rY'+5;�'7eii.{'•::;f,.:..';':�,^.,* S<,i;>:?+•.�'{•ii,:� �:...... 4:4•..,...... ..;...,•.}: ..r. ....: :r:.,J:4.{.�fi•.•Y{. F',,.;4:) ♦,;.<:;:�:.J• 'S.{! ........r.{,.,!......,......2...... ..,•:,:••:}:.;:.x.}�:?:•:•.. Sa»+• ..»•J!;}�!;.,ri::..t,}:'+.''' F,t:'Sr?':2!o2r•:,.L.. S•}....<y r:Y,,::. ,j �#-.:;,:••:•+:••3•+''}Sf: .. :•.»:..t:a..:?,:..f.... .....:v:, .,•}:'• r::!:{:t....: :.;..}..;.fS::�:%^..::vt;4F..w:::.}:y:••r;:Fv.,.4,;, r�:�.4v,Q•} �,{,. .;.•�f' +: .�3 ,ni•}'{�' . ....... ..... .:.w, r:•ax:•.;.., :•.t.fyry,}:. �....:!::!;c•r...!;;{:,r...:�}.:.,• .::.,w:..v.:..:.;>)>:>::}•?>...:i:, ...4.}�,�}F{,>•,:.{4:^r.;.,., Jf �S�t,.,• �t ..t;'{}s,� x}:+?rye:� iS}{s�:;X'kr••}; • .........v;..;.r�,,;r...^}.<::.!: .: ••:,y.•:t�•::••:•:};{; }..,,•J.::hr.,•:s••::F.4.;r.i.•:•,<:•r}t•.,:•,},.:.•::::::•w:.•::• .v::}�•:{.'S;:})�. •,. .. :•:,FY .:{ ;r„�F.^.�"d:i,^.•'•T,:,•:�>,>,•a; SY}�a.•R•r}.4.# •. .r. ..::r::;!t•:}:,•.-4^•::;vr.;,:...F.s,:;•}x..?k�"••"•rk%p;.•,•:�4::f.L;F:;:2,Ny:J.,,-::•r:i,+••,>}:4.}•...,,:,:,. •:;.::+r•xx{aq..:..;:F+;:{.;F.:•. r.S:•}.}?,•r,a�rh:S'::4;.�.i+c:,r,..,;.,{•>S,i•}.v:{..:. . •l'i.`•;:{;^:v.)x4.::•:'Yn^:•;7...:!'{.yr{4q•r+?•J,•,•::.t^.+§}$}.x.,};;rh,;4r}:'{{•.}i},^.tp,.:•:V:;r• :!}FL::.,i•:r+,.•}}.`5,4.>f:;v:,i,.`'L;»}:w.s, #({{ .,;... v.Jr'!1.,.,n. q,.3•:•i:rF}•4:r,•::{{Sx.....t4,;.i.;•3�^,`.t•:,;:.:...f•x\i•.;Jf'..:.}y:'•:•'.}iS'r':::•n+:•.•.,p}..:{t:,•:{{4y.,u;}?:.:,.':..r...r ..fin Q�'�;�,;' •:F+..;ar.y..:}. :+.,,+vr::v:rw.,:{,YY`x�:+•:�i•:S;N,Yf.{.��:w.n....:.:...:v.»:.V. r ,... i''•':.:'r,•}}.y;•:;•3:�i::.;•.•'.#':': •:0.w•:::.:v'+!.•,+n,;.,rsk•,rkfl;'rJnY+,':�;;'{''r:.��;':ty.,t•:i.:,:v.v..,•.nv.,t::{.,,,r,.}::n4: rSYX•r::•:}:•r:•:•.Y:'.},.\.,.•.. ....... idiisace:cn ::;ti?,^> ,. . 00 and/or osiiion of crhaizulpenalties of a$aettp to S1,500. Failure to aecm a coverage as required sutder Section ZSA of MGL 152 can lead to the P a ftae of$100.00 a day against me. I�detataad that a one years' prt coveest as s en as d-4 penalties in the form of a STOP WORK ORDER and copy ea this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. do hereby certi under thepains and penalties of perjury that the information provided above is iru!and correct I Y Date / 0• t � Si�ature J Phone# �pl Z3Z -`�OAS O Print name Q Ck oMcisluse only do not write in this area to be completed by city or town oMaill ❑ g Depatnent pernii0cen_se# OI,icensing Board d or town: ea's Office city ❑Selec�n• ❑ chtckif in neaijife response is required ❑Health Department �other,-, phone#; contact person: OrAsed 9195 PJA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is de$md as an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceasbd employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or'renewal of a license,or permit to operate a business or to construct,buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any'contr•act for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants e wo rkers' compensation affidavit completely,by checking the box that applies to your situation and Please fill m the mP ers along with a certificate insurance as all affidavits maybe supplying company names, address and phone numb submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain;a workers' compensation.policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to coatact you regarding the applicant. Please be sure to fill is the petmitllicens0 number which will be used as a reference number. The affidavits may be retari Rl no the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions please do not hesitate to,give us a call. , �Dep�ent's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of fnvestigatlans 600'PYashington Street Boston,Ma. 02111 fax#: (617) 727-7749 nh_one#: (617) 727-4900 ext. 406, 409 or 375 °p1HE rod Town of Barnstable Regulatory Services • sextasTi+y Thomas F.Geiler,Director - bs�ss. 9� 1639• ��� Building Division prfpM A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 • Fax: 508-790-6230 Permit no. AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal, demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which,are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements- Type.of Work: �DQrrlo�i�h CDnS-T&y�-� Estimated Cost Address of W ork: l y`t� 1111411J SM e_E k Owner's Name: fo( ZMIV � MAN 1 Date of Application: 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 20wner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME RyUROVEMENT'WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM,OR GUARANTY FUND UNDER MGL c, 142A. SIGNED UNDER PENALTIES OF PERJURY t as the agent of the owner: 1 I hereby app y for a permi g Date• Contractor Name RegistrationNo, n,+, Owner's Name BUILDING IT , +ES gESIDENTIAL PERM . APPLICATION PEE �� $50.00 `-0 New Buildings,Additions $25.00 Alterations/Renovations Building Permit Amendment 525.0Q PEE YALUE WORKSHEET NEW Lr;]NG'SPACE D7 �x.0031= ►7 I n2 square feet x$96/sq.foot= 3 plus from below(if applicable) �TEgATIONSlRENOVATIONS OF EXISTING SPACE x.0031—_ square feet x S64/sq.foot= p1—"'b w(if applicable) ACCESSORY STRUCTURE>120 sq. >120 sf-500 if $35.00 >500 sf-750 sf 50.00 >750 sf-1000 sf .00 >1000 sf-1500 sf 100.00 >1500 sf-Same as new bulding.pez'Mit x.0031- square feet x S96/sq foot= da�. a� (v 7 2 1114 e, *32)5$. �ao3 I -G 5 STAND ALONE PERMITS x$30.00= Open Porch (number) . 1 x S30.00= Deck (number) _xS25.00= ------------- FireplacelChimney (number) Digrouad Swimming Pool S60.00 kbave Grouad Swimming Poai S25.00 SI50.00 gelocationfMoving rai Fee (P ��• t a us above if applicable) per 1 i Town of Barnstable CF THE T Regulatory Services * Thomas F.Geiler,Director - sAMSTABL& « MAss. 9� i639. �. Building Division ArED 1��s Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION q Please Print DATE: JOB LOCATION: 144('P (l1 ki lki S7&FAT C��17 number street village "HOMEOWNER': C�IrLEnJ 1'�"Akr .1 �017-Z3Z- Yos© name home phone# work phone# CURRENT MAILING ADDRESS: I s Y Ak(y)0 uT Cme-svw T' +1 ILL COZI G:7 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 suuervisor. 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 buildWg-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." I Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing.Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by J several towns. You may care t amend and adopt such a form/certification for use.in your community. Q:forms:homeexempt Multi-Loaded Beam(99 BOCA National Building Code(97 NDS)1 Ver: 5.07 By:Archi-Tech Assoc. Inc. , Archi-Tech Assoc. Inc. on: 09-10-2003: 08:56:31 AM Pro:west:-MANZ-I�Eocationt6kHDR:..P_I.C-.KI:NG-U P-ENDjSTL—_BEAMS Summary: (*3%)z*75--If�•x=1='�8W7.5--IN=k�6=0=FTA"E3MicrollamY Trus=Joist=MacM#Iarr+ Section Adequate By: 37.8% Controlling Factor: Section Modulus/Depth Required 10.11 In *Laminations are to be fully connected to provide uniform transfer of loads to all members Center Span Deflections: Dead Load: DLD-Center= 0.02 IN Live Load: LLD-Center= 0.05 IN=U1452 Total Load: TLD-Center= 0.07 IN=U988 Center Span Left End Reactions(Support A): Live Load: LL-Rxn-A= 5412 LB Dead Load: DL-Rxn-A= 2603 LB Total Load: TL-Rxn-A= 8015 LB Bearing Length Required(Beam only, Support capacity not checked): BL-A= 2.04 IN Center Span Right End Reactions(Support B): Live Load: LL-Rxn-B= 3912 LB Dead Load: DL-Rxn-B= 1953 LB Total Load: TL-Rxn-B= 5865 LB Bearing Length Required(Beam only, Support capacity not checked): BL-B= 1.49 IN Beam Data: Center Span Length: L2= 6.0 FT Center Span Unbraced Length-Top of Beam: Lu2-Top= 0.0 FT Center Span Unbraced Length-Bottom of Beam: Lu2-Bottom= 6.0 FT Live Load Duration Factor: Cd= 1.00 Live Load Deflect. Criteria: U 360 Total Load Deflect. Criteria: U 300 Center Span Loading: Uniform Load: Live Load: wL-2= 54 PLF Dead Load: wD-2= 90 PLF Beam Self Weight: BSW= 19 PLF Total Load: wT-2= 163 PLF Point Load 1 Live Load: PL1-2= 9000 LB Dead Load: PD1-2= 3900 LB Location(From left end of span): X1-2= 2.5 FT Properties For: 1.9E Microllam-Trus Joist-MacMillan Bending Stress: Fb= 2600 PSI Shear Stress: Fv= 285 PSI Modulus of Elasticity: E= 1900000 PSI Stress Perpendicular to Grain: Fc_perp= 750 PSI Adjusted Properties Fb'(Tension): Fb'= 2604 PSI Adjustment Factors: Cd=1.00 Cf=1.00 Fv': Fv'= 285 PSI Adiustment Factors: Cd=1.00 Design Requirements: Controlling Moment: M= 19422 FT-LB 2.52 Ft from left support of span 2(Center Span) Critical moment created by combining all dead loads and live loads on span(s)2 Controlling Shear: V= 8015 LB At left support of span 2(Center Span) Critical shear created by combining all dead loads and live loads on span(s)2 Comparisons With Required Sections: Section Modulus(Moment): Sreq= 89.51 IN3 S= 123.39 IN3 Area(Shear): Areq= 42.19 IN2 A= 62.34 IN2 Moment of Inertia(Deflection): Ireq= 222.38 IN4 1= 732.62 IN4 f Multi-Loaded Beamf AISC 9th Ed ASD 1 Ver: 5.07 By: Archi-Tech Assoc. Inc. , Archi-Tech Assoc. Inc. on: 09-10-2003: 08:56:30 AM d_roi<eet=MA_t4Z-: 6=ation:I23.5xS ABM,-xW/P_T L-OAD Summary: cA36 VV-'-2�c4DW� 23F52 Section Adequate By: 22.4% Controlling Factor: Moment of Inertia Center Span Deflections: Dead Load: DLD-Center- 0.25 IN Live Load: LLD-Center= 0.52 IN=U540 Total Load: TLD-Center= 0.77 IN=U367 Center Span Left End Reactions(Support A): Live Load: LL-Rxn-A= 8950 LB Dead Load: DL-Rxn-A= 3884 LB Total Load: TL-Rxn-A= 12834 LB Bearinq Lenqth Required(Beam only, Support capacity not checked): BL-A= 1.25 IN Center Span Riqht End Reactions(Support B): Live Load: LL-Rxn-B= 7335 LB Dead Load: DL-Rxn-B= 3323 LB Total Load: TL-Rxn-B= 10658 LB Bearing Length Required(Beam only, Support capacity not checked): BL-B= 1.25 IN Beam Data: Center Span Lenqth: L2= 23.5 FT Center Span Unbraced Lenqth-Top of Beam: Lu2-Top= 0.0 FT Center Span Unbraced Length-Bottom of Beam: Lu2-Bottom= 23.5 FT Live Load Deflect. Criteria: U 360 Total Load Deflect. Criteria: U 300 Center Span Loading: Uniform Load: Live Load: wL-2= 560 PLF Dead Load: wD-2= 190 PLF Beam Self Weight: BSW= 40 PLF Total Load: wT-2= 790 PLF Point Load 1 Live Load: PL1-2= 825 LB Dead Load: PD1-2= 1002 LB Location(From left end of span): X1-2= 11.75 FT Point Load 2 Live Load: PL2-2= 2300 LB Dead Load: PD2-2= 800 LB Location(From left end of span): X2-2= 3.5 FT Properties for:W12x40/A36 Yield Stress: Fy= 36 KSI Modulus of Elasticity: E= 29000 KSI Depth: d= 11.94 IN Web Thickness: tw= 0.29 IN Flanqe Width: bf= 8.01 IN Flanqe Thickness: tf= 0.51 IN Distance to Web Toe of Fillet: k= 1.25 IN Moment of Inertia About X-X Axis: Ix-- 310.00 IN4 Section Modulus About X-X Axis: Sx= 51.90 IN3 Radius of Gyration of Compression Flanqe+ 1/3 of Web: rt= 2.17 IN Design Properties per AISC Steel Construction Manual: Flange Bucklinq Ratio: FBR= 7.77 Allowable Flanqe Buckling Ratio: AFBR= 10.83 Web Bucklinq Ratio: WBR= 40.47 Allowable Web Buckling Ratio: AWBR= 106.67 Controllinq Unbraced Lenqth: Lb= 0.0 FT Limitinq Unbraced Lenqth for Fb=.66`Fy: Lc= 8.45 FT Allowable Bendinq Stress: Fb= 23.76 KSI Web Height to Thickness Ratio: h/tw= 36.98 Limitinq Web Heiqht to Thickness Ratio for Fv=.4*Fy: h/tw-Limit= 63.33 Allowable Shear Stress: Fv= 14.4 KSI Design Requirements Comparison: Controllinq Moment: M= 70693 FT-LB 11.75 Ft from left support of span 2(Center Span) Critical moment created by combining all dead loads and live loads on span(s)2 Nominal Moment Strength: Mr= 102762 FT-LB Controllinq Shear: V= 12834 LB At left support of span 2(Center Span) Critical shear created by combining all dead loads and live loads on span(s)2 Nominal Shear Strenqth: Vr= 50721 LB Moment of Inertia(Deflection): Ireq= 253.20 IN4 1= 310.00 IN4 Multi-Loaded Beamf 99 BOCA National Buildinq Code(97 NDS)1 Ver: 5.07 By: Archi-Tech Assoc. Inc. ,Archi-Tech Assoc. Inc. on: 09-10-2003: 08:56:30 AM ' �Foje�ta�.�Eacatiou�s'IiS�BEAM:BEf�� WAEL�@�B�Ba1=&�2�, Summary: �ai��5al�x �4ishx 1;5a0-�/21�9E�MicFollam�T�us;Joist=Mecitllilaa�. Section Adequate By: 54.1% "Controlling Factor: Moment of Inertia/Depth Required 8.22 In *Laminations are to be fully connected to provide uniform transfer of loads to all members Center Span Deflections: Dead Load: DLD-Center- 0.21 IN Live Load: LLD-Center- 0.18 IN =U1024 Total Load: TLD-Center= 0.39 IN =U462 Center Span Left End Reactions(Support A)-. Live Load: LL-Rxn-A= 825 LB Dead Load: DL-Rxn-A= 1002 LB Total Load: TL-Rxn-A= 1827 LB Bearinq Lenqth Required(Beam only, Support capacity not checked): BL-A= 0.46 IN Center Span Riqht End Reactions(Support B): Live Load: LL-Rxn-B= 825 LB Dead Load: DL-Rxn-B= 1002 LB Total Load: TL-Rxn-B= 1827 LB Bearing Length Required(Beam only, Support capacity not checked).- BL-B= 0.46 IN Beam Data: Center Span Length: L2= 15.0 FT Center Span Unbraced Lenqth-Top of Beam: Lu2-Top= 0.0 FT Center Span Unbraced Length-Bottom of Beam: Lu2-Bottom= 15.0 FT Live Load Duration Factor: Cd= 1.00 Live Load Deflect. Criteria: U 360 Total Load Deflect. Criteria: U 300 Center Span Loading: Uniform Load: Live Load: wL-2= 110 PLF Dead Load: wD-2= 118 PLF Beam Self Weight: BSW= 16 PLF Total Load: wT-2= 244 PLF Properties For: 1.9E Microllam-Trus Joist-MacMillan Bendinq Stress: Fb= 2600 PSI Shear Stress: Fv= 285 PSI Modulus of Elasticity: E= 1900000 PSI Stress Perpendicular to Grain: Fc_perp= 750 PSI Adjusted Properties Fb'(Tension): Fb'= 2684 PSI Adjustment Factors: Cd=1.00 Cf=1.03 Fv': Fv'= 285 PSI Adjustment Factors: Cd=1.00 Design Requirements: Controllinq Moment: M= 6851 FT-LB 7.5 Ft from left support of span 2(Center Span) Critical moment created by combining all dead loads and live loads on span(s)2 Controllinq Shear: V= 1827 LB At riqht support of span 2(Center Span) Critical shear created by combining all dead loads and live loads on span(s)2 Comparisons With Required Sections: Section Modulus(Moment): Sreq= 30.63 IN3 S= 78.97 IN3 Area(Shear): Areq= 9.62 IN2 A= 49.88 IN2 Moment of Inertia(Deflection): Ireq 243.35 IN4 1= 375.10 IN4 Multi-Loaded Beam[99 BOCA National Building Code(97 NDS)1 Ver: 5.07 By:Archi-Tech Assoc. Inc. , Archi-Tech Assoc. Inc. on: 09-10-2003: 08:56:29 AM 4Ege6LMANZ-L--L-ocation-.-4.3-ROOF BEAM Summary: 2= l ft)W--1r875=1G*xA.3,&FTw/%tU9E-iMicrolla Tros�JoiistuMacMiilaw Section Adequate By: 34.8% Controlling Factor: Moment of Inertia/Depth Required 10.75 In *Laminations are to be fully connected to provide uniform transfer of loads to all members Center Span Deflections: Dead Load: DLD-Center= 0.15 IN Live Load: LLD-Center— 0.24 IN=U663 Total Load: TLD-Center— 0.39 IN=U404 Center Span Left End Reactions(Support A): Live Load: LL-Rxn-A= 2335 LB Dead Load: DL-Rxn-A= 1666 LB Total Load: TL-Rxn-A= 4001 LB Bearing Length Required(Beam only, Support capacity not checked): BL-A= 1.52 IN Center Span Right End Reactions(Support B): Live Load: LL-Rxn-B= 2065 LB Dead Load: DL-Rxn-B= 1128 LB Total Load: TL-Rxn-B= 3193 LB Bearing Length Required(Beam only, Support capacity not checked): BL-B= 1.22 IN Beam Data: Center Span Length: L2= 13.0 FT Center Span Unbraced Length-Top of Beam: Lu2-Top= 0.0 FT Center Span Unbraced Length-Bottom of Beam: Lu2-Bottom= 13.0 FT Live Load Duration Factor: Cd= 1.00 Live Load Deflect. Criteria: U 360 Total Load Deflect. Criteria: U 300 Center Span Loading: Uniform Load: Live Load: wL-2= 300 PLF Dead Load: wD-2= 125 PLF Beam Self Weight: BSW= 13 PLF Total Load: wT-2= 438 PLF Point Load 1 Live Load: PL1-2= 500 LB Dead Load: PD1-2= 1000 LB Location(From left end of span): X1-2= 3.0 FT Properties For: 1.9E Microllam-Trus Joist-MacMillan Bending Stress: Fb= 2600 PSI Shear Stress: Fv= 285 PSI Modulus of Elasticity: E= 1900000 PSI Stress Perpendicular to Grain: Fc perp= 750 PSI Adjusted Properties Fb'(Tension): Fb'= 2604 PSI Adjustment Factors: Cd=1.00 Cf=1.00 FV: Fv'= 285 PSI Adiustment Factors: Cd=1.00 Design Requirements: Controlling Moment: M= 11639 FT-LB 5.72 Ft from left support of span 2(Center Span) Critical moment created by combining all dead loads and live loads on span(s)2 Controlling Shear: V= 4001 LB At left support of span 2(Center Span) Critical shear created by combining all dead loads and live loads on span(s)2 Comparisons With Required Sections: Section Modulus(Moment): Sreq= 53.64 IN3 S= 82.26 IN3 Area(Shear): Areq= 21.06 IN2 A= 41.56 IN2 Moment of Inertia(Deflection): Ireq= 362.32 IN4 1= 488.41 IN4 Multi-Loaded Beam(99 BOCA National Building Code(97 NDS)1 Ver: 5.07 By:Archi-Tech Assoc. Inc. ,Archi-Tech Assoc. Inc. on: 09-10-2003: 08:56:28 AM P_fo MAL4Zl,6ncatm.126Ss�R=R�LTR--@--&ROOF=GREASE Summary: (c2*)u1a54Nzm9a-5atN$x�2°F0--F--Tz--k#2-T=-iSlpruc-e=Eirre=Eir�DrwUse). Section Adequate By: 38.0% Controlling Factor: Section Modulus/Depth Required 7.87 In *Laminations are to be fully connected to provide uniform transfer of loads to all members Center Span Deflections: Dead Load: DLD-Center= 0.06 IN Live Load: LLD-Center= 0.15 IN=U936 Total Load: TLD-Center= 0.21 IN=U680 Center Span Left End Reactions(Support A): Live Load: LL-Rxn-A= 540 LB Dead Load: DL-Rxn-A= 204 LB Total Load: TL-Rxn-A= 744 LB Bearing Length Required(Beam only, Support capacity not checked): BL-A= 0.58 IN Center Span Right End Reactions(Support B): Live Load: LL-Rxn-B= 390 LB Dead Load: DL-Rxn-B= 164 LB Total Load: TL-Rxn-B= 554 LB Bearing Length Required(Beam only, Support capacity not checked): BL-B= 0.43 IN Beam Data: Center Span Length: L2= 12.0 FT Center Span Unbraced Lenqth-Top of Beam: Lu2-Top= 0.0 FT Center Span Unbraced Length-Bottom of Beam: Lu2-Bottom= 12.0 FT Live Load Duration Factor: Cd= 1.00 Live Load Deflect. Criteria: U 300 Total Load Deflect. Criteria: U 240 Center Span Loading: Uniform Load: Live Load: wL-2= 40 PLF Dead Load: wD-2= 14 PLF Beam Self Weight: BSW= 7 PLF Total Load: wT-2= 61 PLF Point Load 1 Live Load: PL1-2= 450 LB Dead Load: PD1-2= 120 LB Location(From left end of span): X1-2= 4.0 FT Properties For:#2-Spruce-Pine-Fir Bending Stress: Fb= 875 PSI Shear Stress: Fv= 70 PSI Modulus of Elasticity: E= 1400000 PSI Stress Perpendicular to Grain: Fc perp= 425 PSI Adjusted Properties Fb'(Tension): Fb'= 963 PSI Adjustment Factors: Cd=1.00 Cf=1.10 Fv': FV= 70 PSI Adjustment Factors: Cd=1.00 Design Requirements: Controlling Moment: M= 2486 FT-LB 4.08 Ft from left support of span 2(Center Span) Critical moment created by combining all dead loads and live loads on span(s)2 Controllinq Shear: V= 744 LB At left support of span 2(Center Span) Critical shear created by combining all dead loads and live loads on span(s)2 Comparisons With Required Sections: Section Modulus(Moment): Sreq= 31.00 IN3 S= 42.78 IN3 Area(Shear): Areq= 15.95 IN2 A= 27.75 IN2 Moment of Inertia(Deflection): Ireq= 69.87 IN4 1= 197.86 IN4 Multi-Loaded Beamf 99 BOCA National Building Code(97 NDS))Ver: 5.07 By: Archi-Tech Assoc. Inc.. ,Archi-Tech Assoc. Inca on: 09-10-2003 : 08:56:28 AM motect 4NZ-6--6eeat+.oa ml-2'--STR:%RAE-T-ERft Summary: (s43)4c54 x 6s4N--x-*t.2402FTw/g#2 Spruce=Pine= ir=,,DPWse, Section Adequate By: 25.0% Controlling Factor: Section Modulus/Depth Required 8.27 In "Laminations are to be fully connected to provide uniform transfer of loads to all members Center Span Deflections: Dead Load: DLD-Center— 0.08 IN Live Load: LLD-Center— 0.17 IN=U869 Total Load: TLD-Center= 0.25 IN= U584 Center Span Left End Reactions(Support A): Live Load: LL-Rxn-A= 1302 LB Dead Load: DL-Rxn-A= 630 LB Total Load: TL-Rxn-A= 1932 LB Bearing Length Required(Beam only, Support capacity not checked): BL-A= 0.76 IN Center Span Right End Reactions(Support B): Live Load: LL-Rxn-B= 677 LB Dead Load: DL-Rxn-B= 356 LB Total Load: TL-Rxn-B= 1034 LB Bearing Length Required(Beam only, Support capacity not checked): BL-B= 0.41 IN Beam Data: Center Span Length: L2= 12.0 FT Center Span Unbraced Lenqth-Top of Beam: Lu2-Top= 0.0 FT Center Span Unbraced Length-Bottom of Beam: Lu2-Bottom= 12.0 FT Live Load Duration Factor: Cd= 1.00 Live Load Deflect. Criteria: U 300 Total Load Deflect. Criteria: L/ 240 Center Span Loading: Uniform Load: Live Load: wL-2= 40 PLF Dead Load: wD-2= 14 PLF Beam Self Weight: BSW= 13 PLF Total Load: wT-2= 67 PLF Point Load 1 Live Load: PL1-2= 1500 LB Dead Load: PD1-2= 656 LB Location(From left end of span): X1-2= 3.5 FT Properties For: #2-Spruce-Pine-Fir Bending Stress: Fb= 875 PSI Shear Stress: Fv= 70 PSI Modulus of Elasticity: E= 1400000 PSI Stress Perpendicular to Grain: Fc perp= 425 PSI Adjusted Properties Fb'(Tension): Fb'= 1107 PSI Adjustment Factors: Cd=1.00 Cf=1.10 Cr-1.15 Fv': Fv'= 70 PSI Adjustment Factors: Cd=1.00 Design Requirements: Controlling Moment: M= 6315 FT-LB 3.48 Ft from left support of span 2(Center Span) Critical moment created by combining all dead loads and live loads on span(s)2 Controlling Shear: V= 1932 LB At left support of span 2(Center Span) Critical shear created by combining all dead loads and live loads on span(s)2 Comparisons With Required Sections: Section Modulus(Moment): Sreq= 68.46 IN3 S= 85.56 IN3 Area(Shear): Areq= 41.40 IN2 A= 55.50 IN2 Moment of Inertia(Deflection): Ireq= 162.58 IN4 1= 395.73 IN4 I Uniformly Loaded Floor Beam[99 BOCA National Building Code(97 NDS)1 Ver: 5.07 By:Archi-Tech Assoc. Inc. ,Archi-Tech Assoc. Inc. on: 09-10-2003: 08:56:26 AM ' d�ni�t�lVFA�IZ-1�ncatiur�=�L+6t�r�R�RoaQ�i�S Summary: t�s3a)s1.Z-5.miL 7_r25rINrxZ:.OaE-T/1-9E_Mier.ollani Trus.J.oist-MacMillan Section Adequate By: 137.3% Controlling Factor: Moment of Inertia/Depth Required 5.44 In *Laminations are to be fully connected to provide uniform transfer of loads to all members Deflections: Dead Load: DLD= 0.03 IN Live Load: LLD= 0.09 IN=U985 Total Load: TLD= 0.12 IN= U712 Reactions(Each End): Live Load: LL-Rxn= 1750 LB Dead Load: DL-Rxn= 672 LB Total Load: TL-Rxn= 2422 LB Bearing Length Required(Beam only, Support capacity not checked): BL= 0.62 IN Beam Data: Span: L= 7.0 FT Unbraced Length-Top of Beam: Lu= 0.0 FT Live Load Deflect. Criteria: U 360 Total Load Deflect. Criteria: U 300 Floor Loading: Floor Live Load-Side One: LL1= 60.0 PSF Floor Dead Load-Side One: DL1= 10.0 PSF Tributary Width-Side One: TW1= 4.0 FT Floor Live Load-Side Two: LL2= 40.0 PSF Floor Dead Load-Side Two: DL2= 10.0 PSF Tributary Width-Side Two: TW2= 6.5 FT Live Load Duration Factor: Cd= 11.00 Wall Load: WALL= 75 PLF Beam Loading: Beam Total Live Load: wL= 500 PLF Beam Self Weight: BSW= 12 PLF Beam Total Dead Load: wD= 192 PLF Total Maximum Load: wT= 692 PLF Properties For: 1.9E Microllam-Trus Joist-MacMillan Bending Stress: Fb= 2600 PSI Shear Stress: Fv= 285 PSI Modulus of Elasticity: E= 1900000 PSI Stress Perpendicular to Grain: Fc_perp= 750 PSI Adjusted Properties Fb'(Tension): Fb'= 2785 PSI Adjustment Factors: Cd=1.00 Cf=1.07 Fv': Fv'= 285 PSI Adiustment Factors: Cd=1.00 Design Requirements: Controlling Moment: M= 4238 FT-LB 3.5 ft from left support Critical moment created by combining all dead and live loads. Controlling Shear: V= 2422 LB At support. Critical shear created by combining all dead and live loads. Comparisons With Required Sections: Section Modulus(Moment): Sreq= 18.26 IN3 S= 45.99 IN3 Area(Shear): Areq= 12.75 IN2 A= 38.06 IN2 Moment of Inertia(Deflection): Ireq= 70.25 IN4 1= 166.72 IN4 Roof Beam[99 BOCA National Buildinq Code(97 NDS)1 Ver: 5.07 By:Archi=Tech Assoc. Inc. , Archi-Tech Assoc. Inc. on: 09-10-2003 : 08:56:27 AM Oct-MA&+ZI.Locatmrt.9:BM.&RGGF. C—R-EAS6 Summary: 4m35sK*x,uW,25zU.qwxs'rLQ70=FTw/aU9E=Microllam%ff2Trus-_daisttlMacM'il Ian Section Adequate By: 72.2% Controlling Factor: Section Modulus/Depth Required 8.88 In Deflections: Dead Load: DLD= 0.07 IN Live Load: LLD= 0.17 IN=U701 Total Load: TLD= 0.25 IN=U488 Reactions(Each End): Live Load: LL-Rxn= 1500 LB Dead Load: DL-Rxn= 656 LB Total Load: TL-Rxn= 2156 LB Bearing Length Required(Beam only, Support capacity not checked): BL= 1.64 IN Beam Data: Span: L= 10.0 FT Maximum Unbraced Span: Lu= 0.0 FT Pitch Of Roof: RP= 9 : 12 Live Load Deflect. Criteria: U 300 Total Load Deflect. Criteria: U 240 Roof Loadinq: Roof Live Load-Side One: LL1= 30.0 PSF Roof Dead Load-Side One: DL1= 10.0 PSF Tributary Width-Side One: TW1= 8.0 FT Roof Live Load-Side Two: LL2= 30.0 PSF Roof Dead Load-Side Two: DL2= 10.0 PSF Tributary Width-Side Two: TW2= 2.0 FT Roof Duration Factor: Cd= 1.15 Beam Self Weiqht: BSW= 6 PLF Slope/Pitch Adjusted Lenqths and Loads: Adjusted Beam Lenqth: Ladi= 10.0 FT Beam Uniform Live Load: wL= 300 PLF Beam Uniform Dead Load: wD adi= 131 PLF Total Uniform Load: wT= 431 PLF Properties For: 1.9E Microllam-Trus Joist-MacMillan Bendinq Stress: Fb= 2600 PSI Shear Stress: Fv= 285 PSI Modulus of Elasticity: E= 1900000 PSI Stress Perpendicular to Grain: Fc perp= 750 PSI Adjusted Properties Fb'(Tension): Fb'= 3016 PSI Adjustment Factors: Cd=1.15 Cf=1.01 Fv': FV= 328 PSI Adjustment Factors: Cd=1.15 Design Requirements: Controllinq Moment: M= 5389 FT-LB 5.0 ft from left support Critical moment created by combining all dead and live loads. Controllinq Shear: V= 2156 LB At support. Critical shear created by combining all dead and live loads. Comparisons With Required Sections: Section Modulus(Moment): Sreq= 21.44 IN3 S= 36.91 IN3 Area(Shear): Areq= 9.87 IN2 A= 19.69 IN2 Moment of Inertia(Deflection): Ireq= 102.10 IN4 1= 207.64 IN4 Combination Roof and Floor Beam[99 BOCA National Building Code(97 NDS)1 Ver: 5.07 By:Archi-Tech Assoc. Inc. , Archi-Tech Assoc. Inc. on: 09-10-2003: 08:56:27 AM ascoti.oaalsUBM-,@:ROOF-t.GREASEv Summary: ,0w75rtI*xz1--1T25TFNvxw1*0tFTw/g1*9E-tMicrollarntexTrus-^Joist_MeeMi I lane Section Adequate By: 76.6% Controlling Factor: Section Modulus/Depth Required 9.09 In Deflections: Dead Load: DLD= 0.13 IN Live Load: LLD= 0.16 IN= U811 Total Load: TLD= 0.29 IN=U455 Reactions(Each End): Live Load: LL-Rxn= 1073 LB Dead Load: DL-Rxn= 838 LB Total Load: TL-Rxn= 1911 LB Bearing Length Required(Beam only, Support capacity not checked): BL= 1.46 IN Beam Data: Span: L= 11.0 FT Maximum Unbraced Span: Lu= 0.0 FT Live Load Deflect. Criteria: U 300 Total Load Deflect. Criteria: U 240 Roof Loading: Roof Live Load-Side One: RLL1= 30.0 PSF Roof Dead Load-Side One: RDL1= 10.0 PSF Roof Tributary Width-Side One: RTW1= 5.0 FT Roof Live Load-Side Two: RLL2= 30.0 PSF Roof Dead Load-Side Two: RDL2= 10.0 PSF Roof Tributary Width-Side Two: RTW2= 1.5 FT Roof Duration Factor: Cd-roof= 1.15 Floor Loading: Floor Live Load-Side One: FLL1= 0.0 PSF Floor Dead Load-Side One: FDL1= 10.0 PSF Floor Tributary Width-Side One: FTW1= 6.5 FT Floor Live Load-Side Two: FLL2= 0.0 PSF Floor Dead Load-Side Two: FDL2= 0.0 PSF Floor Tributary Width-Side Two: FTW2= 0.0 FT Floor Duration Factor: Cd-floor= 1.00 Wall Load: WALL= 0 PLF Beam Loads: Roof Uniform Live Load: wL-roof= 195 PLF Roof Uniform Dead Load(Adjusted for roof pitch): wD-roof= 81 PLF Floor Uniform Live Load: wL-floor= 0 PLF Floor Uniform Dead Load: wD-floor= 65 PLF Beam Self Weight: BSW= 6 PLF Combined Uniform Live Load: wL= 195 PLF Combined Uniform Dead Load: wD= 146 PLF Combined Uniform Total Load: wT= 347 PLF Controlling Total Design Load: wT-cont= 347 PLF Properties For: 1.9E Microllam-Trus Joist-MacMillan Bending Stress: Fb= 2600 PSI Shear Stress: Fv= 285 PSI Modulus of Elasticity: E= 1900000 PSI Stress Perpendicular to Grain: Fc_perp= 750 PSI Adjusted Properties Fb'(Tension): Fb'= 3016 PSI Adjustment Factors: Cd=1.15 Cf=1.01 Fv': Fv'= 328 PSI Adiustment Factors: Cd=1.15 Design Requirements: Controlling Moment: M= 5254 FT-LB 5.5 ft from left support Critical moment created by combining all dead and live loads. Controlling Shear: V= 1911 LB At support. Critical shear created by combining all dead and live loads. Comparisons With Required Sections: Section Modulus(Moment): Sreq= 20.90 IN3 S= 36.91 IN3 Area(Shear): Areq= 8.74 IN2 A= 19.69 IN2 Moment of Inertia(Deflection): Ireq= 109.50 IN4 1= 207.64 IN4 II The Town of Barnstable Department of Health Safety and Environmental.Services Buildin Division 367 Main Street,Hyannis,MA 02601 , 18462-4038 ' 18.790.6230 PLAN RE`�IEw )wner: i ' ah't_ Map/Parcel: 0 l 7 4'L roject Address: r lC" S� Builder: O L3 y�� Che following items were noted on reviewing: r 3 �'tF- 9-c�irt3 Via:UHF P.01 James &i.610da Manzi 150 Y0-rnWuth:;R.Aad C hest `"ht31 ;:,,'oft 4 6 7 Phone: (617) 232-9050 FAX TRANSMISSION: 508-790-6230 DATE: Sept 29, 2003 TO: Jeff Lauzon Barnstable Building Department FROM: Mr & Mrs. James Manzi 1446 swain St., Cotuit. RE: Release Please be advised that all utilities have been shut off and disconnected to the cottage located at 1446 Main St. These shut-offs include electric and water, as well as telephone. There is no gas going to the building. DIG Safe has been notified. Having accomplished the above, the cottage is ready for demolition. Copies of proof that these disconnects have . occurred are attached. if there is anything further we can do, please" let us know;- . Page 1 of 4 =EP-29-2003 09:06 P.02 Stephen Stnith 340 Old Stage Rd. Centerville, MA 02632, (508) 775•3148 Mr. Guile 'Wood 49 Blue Heron Dr. Osterville, MA 02655 Septembcr 26, 2003 Mr, Wood: This is to certify that the electricity at 1446 Main St., Cotuit has been removed horn the cottage. The new service was hooked up to the main house on 09-18-2003 by NSfii AR. The service to the cottage was j disconnected at that time. Please note that the telephone service from the main house has also been terminated. Electrical Permit#71173 Sincerely, Step he mitla . w F i w jCO r Inc. 4� 912g124N33 Wildwood Enterprises 49 Blue Hwon Nve Osterville.Ma. 02655 Mr. Wood, As requested we have prepared the'MArzi Guest house at 1446 Main Sty Cotuit for demolition. Richard N"e disconnected the waxer line in the basement of the main boase and in the quest house. There is no gas service to the Gum house_ There is a copy of the bill enclosed.' Barbara M. whitelcy wrico, Ine, It 12 Main Street unit 10 Gsterville, M& .02655 SEP-29 2033. 09:O7 9/15/2003 29794 Wildwood Emtcgwi 6,lat. coik woad 49 Blae Ham Drive Osterrille,MA,, 02635 1462 Maia Sant Cotuft Nef 30 asks IWI yM3 1 Lab"P 9,14l2003_ 75.00 75.00 1 LABOR AP 91alZ003 53.00 55.00 TAKE OUT TOILET AND SINK AND STME IN MAIN HMSE. CUT OFF WATUt SUPPLY TO MAIN HOUSE. aerials 5,00% 0.40 TOTAL P.04 N MAScheck COMPLIANCE REPORT I I Massachusetts Energy Code I Permit # MAScheck Software Version 2.01 Release 3 I I i I � Checked by/Date I CITY: Barnstable STATE: Massachusetts HDD: 6137 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 9-10-2003 DATE OF PLANS: 8-10-03 PROJECT INFORMATION: Manzi Carriage Residence 1446 Main Street Cotuit, MA 02635 COMPANY INFORMATION: Archi-Tech Associates, Inc., 6 School Street Cotuit, MA 02635 COMPLIANCE: Passes Maximum UA = 242 Your Home = 238 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 245 30.0 0.0 9 CEILINGS: Raised Truss 699 38.0 0.0 17 WALLS: Wood Frame, 16" O.C. 1176 13.0 0.0 96 GLAZING: Windows or Doors 220 0.320 70 GLAZING: Skylights 0 0.300 0 DOORS 21 0.290 6 FLOORS: Over Unconditioned Space 848 19.0 0.0 40 ------------------------------------------------------------------------------- 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 requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate, has been determined us' g the applicable Standard Design Conditions found in the Code. The HVAC quipment selected to heat or cool the building shall be no greater tha 125% f th design load as specified in Sections 780CMR 1310 an J 4. Builder/Designer Date 4 'ob I i TOWN OF` BARNSTABLL 1ST EXTENSION GRANTED - EXPIRES 9/30/04 . PARCEL ID 017 021. GEOBASE ID 484 -ADDRESS 1446 MAIN STREET PHONE COTUIT ZIP - LOT 13 & A BLOCK LOT SIZE D 1 DEVELOPMENT DISTRICT CT PERMIT 71918 DESCRIPTION' 24'X. 28'rCARRIAGIE HOUSSE W/2BDRM &1 ,BATH A 'ERMIT TYPE AADDI TITLE BUILDING PERMIT ADDITION _ r_ CA TRACTORS PROPERTY OWNU Department of ARCHITECTS: PERMIT EXTENSION GRANTED �t egulatory Services . TOTALFEES . $478:40. - - ND: $.00 CONSTRUCTION COSTS $119,808.00 ` 329 STRUCTURE OTHER THAN BLDG 1 PRIVATE • MASS. BU ILD SIO BY DATE ISSUED. 09/30/2003 EXPIRATION DATE `t o THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED APPROVED PLANS MUST BE RETAINED ON JOB AND FOR ALL CONSTRUCTION WORK: WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2.PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL,PLUMBING AND MECH- (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4.FINAL INSPECTION BEFORE OCCUPANCY. VISIBLEPOST THIS CARD SO IT IS BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 2 2 2 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 BOARD OF HEALTH OTHER: SITE PLAN REVIEW APPROVAL WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. Sullivan Engineering Inc. 7 Parker Road, Box 659,Osterville MA 02655 508428-3344 e-mail:psullpena,aol.com fax 508428-3115 March 1,2004 Building Department Town of Barnstable 200 Main Street Hyannis,MA 02601 RE: Permit#71918 /Manzi/ 1446 Main Street, Cotuit Dear Inspector of Buildings, Due to this winters inclement weather we are requesting an extension for the foundation permit on behalf of the homeowner. We have attached the $25.00 fee associated with this request. Please note that the existing cottage was demolished in accordance with Permit #71920. I trust this meets your present needs. If you have any questions, please feel free to. call. . f Very truly yours, b z C7 John O'Dea,EIT Sullivan Engineering Inc. �,, C c,f L T� Cc: Jim& Glenda Manzi rZ 77 //;Z Members of The American Society of Civil Engineers and The Boston Society of Civil Engineers Assesso map and lot number ......M..rl.... �SEPTt,.�..V` .�.... . ,� �•, cG INSTALLED' SYSTEM MUST' g Sewage _Permit number ........�iG�. ...��. . � ALL E WITH:AIR? IN COMPLIq R E . .t �Qyo*THE T0�O3 TOWN O F- BARN, .: .�e ,� ND,roW BAS j HSTLBLE, i 'n. C - r "ABIL •A'\ B1.111DING ' INSPECTOR i6.39 9� r h; C eNpY I; oO « 41 f� > � ................. .. ..qf .APPLICATION FORPERMIT TO .... .�1........ ....... 1 u, TYPE OF CONSTRUCTION ..............k).Q.Cci9........... . . . ....fX�a..• l. .........19. . G. TO'THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .........fJ�........�:1.4.a m......... �x:e.T �o...[..✓...�...�......................................................................... Proposed Use ....... r...sje................�q.."N 1ptt ................ .. . .. ..... Yl.. . :.... . ................... ZoningDistrict .........................................................................Fire District .............................................................................. Name of Owner . .. . 5.. ...I.:I....y� . �C"(. '. .. �f^.r l...... '+°;S.SGy......... 1!4 .4v.....Address 5t.<..h...... T........ ...P.. l T It ... y '// Name of Builder �t>.. ......... . .......... ..a.. ...f.. . ..�........Address {, o.. ......�a.v ........�oirt..P......Q.JT.I-v r c Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ..............02.................................................Foundation ......C . C."!4--c m...f..............W.L.4.C...�C.:...... Exlerior ......w.4..R.r„/.............................................................Roofing ...........W.aP.d.................................................... Floors ...... .................................................Interior .......... / Heating ............................................................................:.....Plumbing ...................... .........................................:................ r 1 Fireplace ....FJ-NK...l ............ .....................Approximate Cost .......... .Q�� Definitive Plan Approved by Planning Board ________________________________19________. Area .....� .7:... l. ...'......... Diagram of Lot and Building with Dimensions Fee (.s SUBJECT TO APPROVAL OF BOARD OF HEALTH 2 s� I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. , Name .............. ............. Craw, Mary Wesson Na18655 add to Guest o ..................Permit for .................................... .....cotta& (Appeal #1976-53) ................................................................... Location 1446 Main Street ................................................................ Cotuit . .............................................................................I Owner ...........��ry Wesson Craw ............................:....... ............. fi Type df'Construction ...........rame...................... A, ............................................................................. Plot ...... Lot ................................. September',1'3 76 X Permit Granted .........................................19 --Date of Inspection .0.... . ... ......19 Date Com pleted JxTn ...... .14..............19 PERMIT'REFUSED ....................................................... ........ 19 .........................e....................................................... • J, ............I............................................... ................... . ............................................................................... • ............. ....................I.............................................. "'AApproved ......... ...................................... 19 ter .................................................................................. ............... ........................................................... Assessomap and lot number ' ... :..'.. ..!. ' Sewage Permit number .......�4..... °`T"ET°�� TOWN OF BARNSTABLE • roe' ��` �. -� BAHHSTADLE, i 1NAM 9 `� BUILDING INSPECTOR �. c war°'• � 77 APPLICATION FOR PERMIT TO t :!� ...................................................�.... .. •? ................................ TYPEOF CONSTRUCTION ............. ./J.," ............. ................................................................................ ......`...r,vl/..............�. .........19 .. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: . Location ......... ..h��l r........ ^....r:.......:�.:? . :• ?"1....:......� :� ,l�i.?.f.. ......................................................................... ProposedUse ........................................ ....... ................ d'.. ..,.. ZoningDistrict ........................................................................Fire District ....,............................................................................. Name of Owner i l�1Jo,n �� ........ .. .�R.m. Address ... .... a .^ M C�T � / d a ..:.. r � ... .."... .. Jl I 7• 1 ! ..... :r. ! ... / 4,4 • R .............................. • �r r Name of Builder .Address .. ...:.. .:...... ............................._.. U , fF Nameof Architect ..................................................................Address ..............................................e:.................................... Number of Rooms r� . .. ... .....C � .......... ............. Exterior .......!(� .......................................................... �?oofg ........... .................................................... Floors u• .............................................Interior .......... !. ! ..�t?. !..+...1........................................... ....�..................': .... Heating ............................................................... ....Plumbing............... ................... ................... .................................. Xz/ Fireplace t-•.G ., �� t ' Approximate Cost l c W. '................... 'n .... ........................... ........... . Definitive Plan Approved by Planning Board __,_______________________ t ... ........' . -----1 9--------. Area ........... Diagram of Lot and Building•with Dimensions Fee �'"`°.. f: .�............................ SUBJECT TO APPROVAL OF BOARD OF HEALTH ,w (V) J t7ous C- r� I hereby agree a to conform to all the Rules and Regulations of the Town of Barnstable regarding the above g construction. . 1 Name 1,.`. .. .. .zCi ,!4-s............... ' Craw, Mary Wmmoou_ A=17~211, j� . ^N add to Gom� � — .. ............................. -- - ._� �53)___.. . . . . Location .........�446..Main..8 .�______. . ' ________Cotolt________._____, ' . , / '\ Owner Mary ge���� �ra� _-----.^.�—' ----------.. . ' Type of Construction ----ft4,P9................... ' . . . ' ................................................. ' ' . . Plot Lot ---------. ` ' � ' - FP re,xx/ cnwxco / ateInspection ^ . .—... Date Completed � . - . . PERMIT REFUSEC ' . V . - ' . . . ............. .�----.. \ --'�f^ —''f'//��-' ----~'' . ! / / ' ,,____________`_,'' _~___'_'' �J ------------..-----.---.---- . �. / Approved ................................................. lg � -------.------------------... . ---------------------.----.. . . . ^ � . ` 3Assessor's offioe (1st floor): ® THE J/7 o 0 Assessor'' map and lot number ......................:.....l..l....... oasd/of,Health .(3rd floor): ewage Permit number :.....�.` !.... ........:............ 2 133 STAB Engineering Department (3rd floor): •o ras House number ................................................:..........:............ � 630 a`e� D MAY APPLICATIONS PROCESSED 8:30.9:30 A.M. and 1:00-2:00 P.M. only! , TOWN OF • BARNSTABLE BUILD.ING ., INSPECTOR APPLICATION FOR PERMIT TO ...............+✓...U ..:.....:..:- ', ..................................................... II . 11 TYPE OF CONSTRUCTION S� W 1 ....._...7.................19. TO THE INSPECTOR OF BUILDINGS: The undersigned' hereby applies for a permit according to the following information: Location ............1. .. ..:..... ':.` :. `.1/...........5.-r..............Co.-f yt.......... ........................................................ ' Proposed Use o o . � ,I Zoning District 1. .......Fire District Name of Owner 'v C x� ....... .'\.'�" ...........Address ...... ...... U Name of Builder �U 'i....Y/. �?�? /..r�� ...Address ..../ ......:........................ /4r>r�K Nameof Architect ..................................................................Address .............................................:...................................... Number of Rooms ........................./......................................:Foundation ...........LJ. ................................................ 6L -�.......... . .���...�/C 5 C_ ................... Exterior ...... (�w.....c....�...5 .....................Roofng ...........:.C Floors , ..............................................Interior ..............d°.l../..y.... ........................................................ Heating .......Plumbing .......:....................... Fireplace ..............................................:...................................Approximate Cost ........././.. .................. .j.................. ' r Definitive Plan Approved by 'Planning Board ________________________________19________ . Area ...... QQ......................... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .......................... Construction Supervisor's License Dzg5.(..r.... CRAW, NICHOLAS No ... 908. Permit for ... Shed ` „t�cee�sory••to Dwelling,•,.,•...•..••..••.. ' Location :.... .14.4.6:Main Street .....................Gotuit.......................................... Owner ..Nicholas C•raw................I................... Type of Construction ........ rame ; ............................................... ......................... Plot ......: ... ..... ....... o . .................................... Permit Granted .......Se,pte�nher ll.......19 86 Date of Inspection ....................................19 l .r Date Completed ......19 y ^ f r , _. 1 Ly Assessor's offioe (1st floor): Assessor's.map and lot number ....... !.... d.l?1'....... BoarA df-.Hdalth (3rd floor): o Sewage Permit number ......ice' ' • . ' i 339HII9T11DLE Engineering Department (3rd floor): , 'oo MAXL House- number e APPLICATIONS PROCESSED 8:30-9:30 A.M, and 1:00-2:00 P.M. only. TOWN OF BARNSTABLE BUILDING INSPECTOR 1 () ? APPLICAT,ION,FOR PERMIT TO' ... ' .. V. � .. .....�` :� ..................................................... .... TYPE OF CONSTRUCTION ......................... ........................................ -,, f .- .^...�.�J.vU� ........................... ( fL A� _ N f.... . ...... .............J.{: 19b TO THE INSPECT OR-OF,BU`ILDINGS:--�- --__ The undersigned hereby applies for a permit according o-the—following information: Location ........... ....4.. .1. ......... �...........5f............... tl �.. ....:.......... Proposed Use �o v L SZ�.�i /...................................... ........ c�Zoning ,District ................ ....Fire District ....... Name of Owner ................. ....... .. .... .. .W .........Address l / Name�of Buil°der, ......................... 5....Address ........... r�l f �r Name of Architect ..................................................................Address'. ...................../........................: . ..................................... Number of Rooms: ........................r/........................................Foundation ...........:.1. ................................................ Exterior ` ��/Yvc 51�1-�J6 .� .��.�' C�L �y . ................. ........... ............................... .....................Roofing ............... Floors .............`....!. /-! tJCr�. .....-:......;..............:: .:.. ' ...interior ; .... �l,`. ...... _.......................................... nr Heating ..................................................................................Plumbing .................................................................................. Fireplace ..................................................................................Approximate Cost. ......../����....... ' Definitive Plan Approved by Planning Board ________________________________19________ . Area ...` .4 ............... .......... Diagram of Lot and Building with,Dimensions Fee 0�......................... SUBJECT TO APPROVAL OF BOARD OF_HEALTH F 1. OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above f construction. Name ..................... .................... Construction Supervisor's License Dzq5 . CRAW, NICHOLAS A=017-021 No .2.,79H..... Permit for ..BuIld...Slaed............ AV...AC.C.P-5.5.Q.r.y...t.o..Dwelling.................. Location .1446-Main...S.tree.t........................... ..........................ao.tuit....................:.......... ......... Owner ...39.ir-h.Q.IaS...Cx.aw.................................. Type of Construction ......Frame.................................... ............................................................................... f Plot ............................ Lot ................................ Permit Granted ............September...12,.19 86 ............. ..... Date of Inspection ....................................19 Date Completed ......................................19 Assessor's' m%`and lot number f. ...�?.��.k ..:..... • F THE , Sewage Permit number ..... .........-..- . SZ— •IDS SYSTEM MUST �Ei SUNSTADLE. House .number ` f............... . 'INSTALLED IN CONTLIc NCE Mb 9 \0� WITH TITLE 'f TOWN ,OF 'BAR 1 C VOISSIM03 BUILDING :INSPECTOR`'' �°N3SNcV01133sns CK ;C , V-= APPLICATION FOR PERMIT TO .........A iDA"'i—k, .....................................................................I. . TYPEOF. CONSTRUCTION ........W 12.....A..........�. .:...................................................................... ......4Z.fi ... .4.......................19.4�.3 TO THE INSPECTOR OF BUILDINGS: The'undersigned hereby applies for a permit ((��according to the following `information: Location ...........(!.. � ....... . �J. .3.........S..P................ .1.!!.s... ....................................... ................................... ProposedUse .............?yt�`� .�tC............IG........� ................................................................................I......................... f Zoning District ........................................................................Fire District ........... .. Name of Owner . .!r48.. 4t...........Cr.cLW..................Address 1.ej (�... . K�.`'?..... .....6 .,8..:'..l..r'........ Name of Builder .....rq. ....I....... ....... ?.0.71153......Address ....... .................... ....................... Nameof Architect ............................................:.:...................Address .................................................................................... �s. • Number of Rooms . .................................. J "'°'9.Foundation ...... C.. . Exterior ......... ......... .� ��.........................Roofing .....:.0®o ........................................................... Floors .......................................................Interior ....... .. '' ..��............................................... Heating ...........F... �C.�......................................................Plumbing ..........:................�....` �^-- � .. Fireplace ..:...............................................................................Approximate Cost .......... JS,V. - .................Definitive Plan Approved by Planning Board ________________________________19________. .Area , g ��..'S ..:10L—T Diagram of Lot and Building with Dimensions Fee f................'A.............. SUBJECT TO APPROVAL OF BOARD OF HEALTH 6 ® I hereby agree to conform to al the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ....a .... ......�..� ............... 60'5�l ` CRAW, 0ICBOLAS ' . ^ � No --24-7-7..O-.. Permit for .—ADD—ZTI—ON----.—. -- — ~ . . . , ' Single I7anziIl' Dwelling ..�'.�---.--.—.---------...—..---.Lourio 1446 Maio Street / --'—'—'---------------'- ' Cotuit ---.�..--------..:—.------..---.. - ' Nicholas Craw Owner .................... F-rame '. Type of Construction ---------- ---- --------------.^..�----------. . . ' plot ......................... Lot ................................ . ' . . . ^ J l 83 Permit Granted —�!���!����--�--..^l� , ' -- - . Date of Inspection —_--_lg - Date Completed ................. ---]9 ` . ' ^ PERMIT REFUSED . —. l� --'' '' ���......, ----.---.----.---`----~----- , ^----..~..�—..—..—.----,_—~.—.—.... ' .............................. .............................................. ----^--'-~—^^^~—'—^'^---''r'---~''- Approved ' -------.�-------- lg ' . . ' - ^ .................... .----------.--.~~..—.—,. ` ----�-----~~------^^--'—^—'—r ' ' | ~ Assessor's mar and lot number ......./... ./� f �5'............. ........ j � �pF THE Sewage Permit number ...............��......................................... Z BARNSTABLE, i Housenumber ........................................................................ 9�O Mb 9 e�0 'FO MPY a` TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ................................... ....................................... TYPE OF CONSTRUCTION (A�n�............................................ c ..1...... �Z....:,............. .................. 19. .. t TO THE INSPECTOR OF BUILDINGS: ' The undersigried hereby applies fora permit according to the following information: Location .....J..... . Ll................................................' ti • r ..� !........ff �l . Proposed Use ........................ .................f.... r ............................ W .......................................................... ......................................... Zoning District Y a .1L�pf :1 aI ............Fire District ....................... f i Name of Owner J ........ ► Ys,. ,► !f�1 ., 4 c .... t . ►......... .................Address .....,,...... ................................ Name of Builder .........................................................c1 t Address ...............,� c;r.0........! ............... ...................... . ....... ..... Nameof Architect f �` r ! f . r _..............................:..................................Address ......................................................................:............. �� I ��. : , Number of Rooms .!X.....e'..!... 'o�r.........�. '......���� fh..""?.Foundation ................:..�c s� c , c� ................................�f.. ... ,r 1 � Exlerior r�a r^r .. ....r. t r' ...Roofing .......�:4xat � ............................................ P .................................................................Interior ........ ! - fa.°j ..!. .......... ��`Floors .r ..................... Heatingr { k { g.................................................................................Plumbin .................................................................................. Fireplace ................... .....r.....................................................Approximate Cost ..........�� ..'? ................................. Definitive Plan Approved by Planning Board ---------------_-----_---------19________. Area .....: .1�.......:�Y ........ Zt��' . .. t% u Diagram of Lot and Building with Dimensions Fee .- ' .. _.d_. SUBJECT TO APPROVAL OF BOARD OF HEALTH r C I hereby agree to conform to all' the Rules and Regulations of the Town of Barnstable regarding the above construction.' Name .. ' ........................................................ CRAW, NICHOLAS A=17-21 No ,24770... Permit for ...ADDITION........... Single Family Dwelling ..................................................................... Loci ...1446„Main Street,,,,,,,,,,,,,,,,,,, .................... r Nicholas Craw Owner .................................................................. Frame Type of Construction ................................................................................ Plot ............................ Lot ................................. Permit Granted .... 1 ebruarX , 19 83 Date of Inspection ....................................19 Date Completed ......................................19 PERMIT REFUSED ... J ....................�....... 19 ................................................................................ ............................................................................... ............................................................................... Approved ................................................ 19 ............................................................................... ............................................................................... Assessor's office,(1st floor): v �` oFI Eto A4sesjoXr s map and lot number ......... Board ,of Health (3rd floor): ` Sewage Permit number .................... •• . I•y••( �nnaen� i B9BBSTODLE, Engineering Department (3rd floor ©v `� �P��de '°0 MM 9 House number ......................................../W....`t�.Y.. ............. 0 MAI a' APPLICATIONS PROCESSED 8:30:9:30 A.M. and' 1:00 2G00°•P.M. only C�SEPTIC SYSTEAA MUST ISE_ HASTALLED IN COMPLIAN EV TOWN OF " BARNSTAB� WITH TITLE5 . SIPE- RONMENTAL CODE AN To BUILDIK." 'I'NCTOR TOWNREG-WATIONO 7 APPLICATION FOR PERMIT TO ..... ADD..:..... ................................................. TYPE OF CONSTRUCTION ........Vob.P...... ............................................. ....................... .�`�...[--t.L........ZS.......19. TO THE INSPECTOR OF BUILDINGS: ' The undersigned hereby hereby�applies �for a permit according to the following,information: Location 1...�` G.......`:I, C�.l�.l.....`.�..1..:.�...c�. .�..\..0�.� ..f.:.l�-} ....... ... 3 ................................. Proposed Use .....Q7 (�� �.\. L ........ �T .N.....a1 ...u ?1�r.��+�.................. �v..� ZoningDistrict ..... r. ...�.. ,..................Fire District .............................................................................. Name of Owner' ".�C1S.. .. ?P1(SS..CV-P1WAddress ..... ..... cl.N....s�:.:..p ......... �..�... Name of Builder .... ...... -� .i�l1L.........W�.l.S.............Address ............ 1�r�::- .....���� ....::��C. C'............ Name of Architect � � lz •7•..... - ��`�............Address � 1h� . .. .... �. .:............. Number of Rooms ..........�........... ...�O.M...........................Foundation ..... 1 0! .......................................... Exterior S� . hSL��........................................Roofing ...... .11 .L j. .• ............ ........... .............................................................................................. . Floors Interior ........7..Cz�!\...... �, . ............... . -- --........................................ Heating ...........L? A. .....................................Plumbing ....... .............).A! .�—............................................. IS r� Fireplace ..................................................................................Approximate Cost ....... :.....I.............................. Definitive Plan Approved by Planning Board _______________19________ . Area ........................................... Diagram of Lot and Building with Dimensions Fee .............. ... .......................... SUBJECT TO APPROVAL OF BOARD OF HEALTH f— Mac l N OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ............ . ........... ..,... `,. .......................... Construction Supervisor's License .. CRAW, NICHOI_AS & PAGE A=017-021 : f G No 9410.... Permit forAdditioil-to.............. le� ..........g.......family..dW.P-l.li.ng........................... _ 1446'Mai n Location .......... n... ....St............ .... ..... tp Cotuit .. - ..... ..................'............................ ............... • - ' �, i ,Y .. - .. Nichol.. t Owner �.n: ..P.age..GrAw.............. ' Type of Construction frame - Plot Lot IVA Permit a ran.e .....:............. ay.. .......1986 - Date of Irispection4?:!�w?:: ...................19 24 Date Completed / . ..... ..19 IT ilk- L ry • Assessor's office�(lst floor): /7 // Awssssor$ map and lot number ......... .............. P Board of Health (aid floor): Sewage Permit number ................... .. .. 'a J. .. �' � n� On 1 EaEasTantE, t Engineering Department (3rd floor): over cow vPSro�e 900 1e 9 House number ................................:........! .........y.!............ �oypr�� f rdG APPLICATIONS PROCESSED 8:30-9.30 A.M. and 1:00-2:00 P.M. only y F BAR TOWN O NSTABLE BUILDING - INSPECTOR .....f... ....) o ... v ,�-- ry cs........................................... APPLICATION FOR PERMIT TO ' 1�..�....................... TYPE OF CONSTRUCTION ........ v...:..:�..�� ......................................................................... r^ ................................. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: ' Location .... -:. .1 ..,...M �-' �` .:.... 2 � x> 1� , Proposed Use L..........- tT � N L2 C5 N1 IJ ................... Zoning District ...... .................Fire District lc7(—).C.T...................................................... ........ . .... l( Name of Ownert�kCAb �, �a l�T��....................................S� ���vlT FRS ;. ►�i!vAddress .................... ...t......................... -4 Name of Builder �.N.M-�- w <��r?.............Address M .......... Name of Architect '°��� r4 •�/.....EJ\A .��..............Address � 1 `C- Number of Rooms ' ��C-M ........................................................Foundation ........I...... .............................................. Exierior I'I•,CS�.�. S� 1.t�C�t,,.�:- ..............................................................Roofing ......... ................................................ Floorst...•1LS�...Y 1C...0 `.......................................Interior ........ ......... ...-----:....................................... Heating ........... .....................................Plumbing ........`......... 1.�.................................................. C�CDG7 • ©o Fireplace .................... .........................................................Approximate Cost ........... .............................................. Definitive Plan Approved by Planning Board --------------------------------19--------. Area .77! �............ .....:................. Diagram of Lot and Building with Dimensions Fee ��' � .............. ..... ........................ SUBJECT TO APPROVAL OF BOARD OF HEALTH i 1 I f �fl OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ...(" - .(�..... C3. ........................ Construction Supervisor's License ......... CRAW, NICHOLAS & PAGE A=017-021 No ...... Permit fWdi.t.:LQT1...U..single.. family.. .......................................... Location .....144.6-24ain-St................................. ...........cotuft........................................................ Owner ....Yftch.Q.14-5...&...P.a g.e..Craw................. Type of Construction ..............fraw................. ................................................................................. Plot ............................ Lot ................................ Permit Granted .....................May..28......1%6 Date of Inspection ....................................19 Date Completed ......................................19 7 4 Y a 4 ASSESSORS REF: ''�� b / ltxus, _ Mop 17, Parcel 11 V t-y7 -' OVERLAY DISTRICT: n I 1 AP- Aquifer Protection District - ' As Shawn an Plan Entitled \ JO _j_ "Revised Groundwater Protection � I nA» q - Overlay Districts' April, 1893 i; N eet \ \ \. , FLOOD ZONE: ; . a fit ;11 a b�ea H Zone C, V11 & V77(see Plon) '•..Meed l'4•" i I / o Community Panel No. m df `f�tdel ®' �'/� r 1250007 0022 D July 2, 7992 ,n d P,,'j a �' ; ::....\ - LOCATION MAP: O} 55,�r�%- 55.3' Ay �^ Scale 1' '2000' 13 d� B6b��/ L ` ZONE: RF P P0�¶� O J1p00 GP�SNGn50 \ s\ - - _ - - - Setbacks., \ ) 750 ;........_....... -.ter ':: �. A: MS NO 2 ``100 Buller Zane 0' Frontage m Front JO' Side 15' In Rear 15' oar ron .,.�•• /0` '- a smr FE,- _-----�6---- •% •� zone C .--� suss -25 — ��-}- 50,Buller Zone D . ;';; - , � AUG 19 3 ; . �,`� / /', � ''I''' � �--' '�--�-------' / i i,,•,r���ylr=Z1�E�i110N� BARN STABL= - -��-m Ind -�, / f0-�� _ --__- 6 - Benchmark: Top of CB/dh (fnd) Elee=19.95' (NGVD 29) e Dune Zon/Zane PR / - Directions: From Hyannis - Follow Route 28 _ / towards Catult; Take a left onto Putnam Avenue and follow to the end; Take a left onto Main Street; House is on the left. /I—. R N N., Add 2 to Addition DAZE- 08109/1-31 l 717LE.. - PREPARED BY: PREPARED FOR., NOTES, - Site Plan y / Proposed Addition Sullivan En eerie Inc. CapeSury 1.) fie property line Information shown was m Bt Jim P. Manzi aom Bee o-om callable record Information: '1l PO Box 659 7 Parker Road P At Ostervllle, MA 02655 Ostervlile MA 02655 sae 28-aas4(5ae)ue-any/a. (sos)sm-m9s(5oe)420-anal A. 2) The topographic reformation performed obtained d /rom an on the ground wrvey Performed an 1446 Main Street ( >< Psaa.Seaxaoe aavea.waavemdeee or between 26/SEP/02 and J0/sEP/02. p Barnstable (Cate) Mass. f J.) The datum used is NGVD '29, a-fixed mean Orolt: JOD Field: WHK/MDH 40 20 0 4a . "V DA 7E SCALE: 0 40� Redew: PS ComP•: MOH sea level datum., _ April 29, 2013 1" Pro)ect#: 22050 Drawing j C47J_2GI.dwg fwww •. ; 20 a are ASSESSORS REF.: • Map 17, Parcel 21 ore ° OVERLAY DISTRICT:, � Wrt °re AP - Aquifer Protection District w► ir' 0: As Shown on Plan Entitled +� �, p 0 � "Revised Groundwater Protection Overlay Districts" - April, 1993 y r oreeek \, 16'+ FLOOD ZONE: q or Proposed catch , Proposed 600 �0 4'ir o Driveway Basin Gallon Drywell T des Zone C, Vol1 & Vol7 (see plan) 00 w/ 1' Of Stone C'e�° o °e°� Community Panel No. M a-. 3 at, �J Cr28 or Roof Runoff ,, �y6 00 d / - /�o � • S #250001 0022 D 0. • of Lot t 2� Proposed , '' July 2, 1992 Edge Carriage House LOCATION MAP: J ore 1� 219 (2 Bedrooms) ,?�'�\ S Scale 1" = 2000' 12 O FF = 29.7' (msl) TH-1 6Z`S�3• Note: Existing Septic System To Be +q0 Removed Or Abandoned one / .�7 eea�9 �F'\ sr F / N6� O Walk Lawn ZONE: �Tpa.': ac oe 2a Feace 12 e 9 i \A Proposed s or < ' Pas\ & \K Septic System \ Rf' ° Yi° (see Sheet 3 of 3) 29\ \ / Area (min.) 43,560 SF f \ / / ° _ .-- - ' hoover '��.� OGl'Buffer Zone , � -- Frontage (min) 150' ,,. Setbacks: .... \ .. -.• �n © �>; . . Fron t 30 Lawn 4 O .. /' /\ Side 15 d ' — — ,1e�e = / Rear 15' O co 14 / _ — 2vt7 ' \ P ,.. t / Guy Pole \ edr I Min I / ' 651e5 a Sil _ — — / FF=30.06' (msl) d Ha Ba - - - -27- - - .� mN o °noble Lawn \. / 2 Story orR —26— — — — — — — —�r S 1 ` / Light Wood Dwelling `N / \ lS RQ� Zone ('--- Post ( ) / �� \ _ / /�S �- Zan V11 (EI.=16) II 5 Bedrooms / �— -t e \'�•......• 1 1 11446 _25 Dec 000 \ Catch \ — _ / / / ..►'t'�`:�' r-! = =_ N�3'Q5 _ ®Basin \ / / — ,., ► '— \ I I '` 0 0 \ $60L ,- --' ' fF A 50' Buffer Zone Z i oae R��/ 20% 13 a \ - n 27 \ 'Lawn / / _25— pU ne_24— / `•. c \ _ Edye of•Lawn i....• '''" / / // / / / / CB/dh - -D ' - Benchmark: Top of CB/dh (fnd) Elev.=19.95 (NGVD 29) - - - / . le lone V \ \ \ \ \ \ \ \ �FEMA' G �/ ngineefin9 sull ivon By -fide Line Oxirnate High / PPPr Directions: From Hyannis - Follow Route 28 towards Cotuit; Take a left onto Putnam Avenue and follow to the end; Take a left onto Main Street; House is on the left, 111446. Title: Site Plan PREPARED BY. PREPARED FOR: Notes/Revision: Proposed Improvements Sullivan Engineering, Inc. CapeSury Jim P. &� Glenda B. Manzi 1.) The property line information shown was compiled from available record information. C 7 Parker Road At PO Box 659 150 Yorm ou th Road 1446 Main Street Osterville, MA 02655 Osterville MA 02655 Chestnut Hill M (508)428-3344 (508)428-3115 fax (508) 420-3994 (508) 420-3995 fax , a. 0216 7 2.) The topographic information was obtained PSuIIPE�ool.com copesurvC�capecod.net from an on the ground survey performed on NJ or between 261SEP102 and 30/SEP/02. o Barnstable, ( ) Massa Cotuit Draft: JOD Field: WHK/MDH 20 0 10 20 40 80 3.) The datum used is NGVD '29, a fixed mean Date: Review: PS Comp.: MDH sea level datum. (,.I Moy 27, 2003 Project 22050 J #' Drawing # C473_2G1.dwg ors I � 10 a p N \ a °ol ASSESSORS REF.: .,. . Map 17, Parcel 21 ® _ +�� ° �N o ?o OVO OVERLAY DISTRICT: AP - Aquifer Protection District °ne As Shown on Plan Entitled 0, C ,. / 0 t� Revised Groundwater Protection 6,&b, \ "� " Overlay Districts" - April, 1993 .e one , + �eek FLOOD ZONE: 4. a w any' catch ,� o\ ✓v ti / �'. • o Basin �, \ To�iPs Zone C, V11 & V17 (see plan) M ad 0, OL* Community Panel No. ° ' '. sled #250001 0022 D q, `�3 P°Jeme�t I �J �'• 01�" ka,e 52? July 2, 1992 °, Q,5 LOCATION MAP. °nv� it �d9e �9 /�, Wjtn BCi/o�9•S� %:'.�C \ S „ - , a \22 o r�D \ 6,• Scale 1 2000 Light li FF=29.69' (msl)� C 9 oP \ 32 n r. n / Post ��' Post ,�' �S A \ \ F 6 O 'Po 6 C foc ZONE. v� / R°, 7lichway c� ° RF Qoy` �a\K ,., ��9 Area (min.) 43,560 SF - 10 Frontage (min) 150' Y - / o - -- - Gl'Buffer Zone :'_ hower Setbacks: 0, .... r`> `��. / Side Fron t 15' f Lawn Rear 15' Co —28- / Guy Pole \ 6/ FF=30.06' (msl) / — / / — _-- — -27— , ° Lawn �U. \\y/ o� / 28\ Light Wood / /tory /'' / / - — -26- — — — — —' \ — / �� �0\ —_Zone C (El. \� I Post (5 Bedrooms) / / / —_ / / "t; 0 Zone 25 ��: "— — ✓ -.-- =i ;�j�"E catch I \\ �� , — / / / 24�_" ' '. +—`.�•=f� '/ _ = == 3 05 " ' \ ®Basin 45 Q 50' Buffer Zone o , 01 / '•• .............. , •.! ice' � / / / / . _ Pko \\O � \ /.ice — / / / // 10/ \cb of 0 ...................... ...r' p v� —26 / Lawn / / — — — — — — — — I Yr \ Ed .of of lawn i... / / / / / / / -24- - ... // / / \ )Nollpop — i —7 / n t'/ r ' CB/dh - ; Ben chm ark: Top of CB/dh (fnd) _ _ / \ Elev.=19.95' (NGVD 29) \ / / / _ \ — --6' �2•00 \ \ \ \ \ \ \ Directions: From Hyannis - Follow Route 28 towards Cotuit; Take a left onto Putnam Avenue and follow to the end; Take a left onto Main Street; House is on the left, #1446. Title: PREPARED BY. PREPARED FOR: Notes/Revision: Site Plan ExistingConditions CapeSury 1.) The property line information shown was Sulllvan Engineering, Inc. Jim P. &� Glenda B. Manzi compiled from available record information. At PO Box 659 7 Parker Road 5O Yarmouth Road Osterville, MA 02655 Osterville MA 02655 1446 Main Street Chestnut to u t Hill Ma. 02167 2.) The topographic information was obtained (508)428-3344 (508)428-3115 fox (508) 420-3994 (508) 420-3995 fox from on on the ground survey performed on v PSuIIPE000I.com copesurv@copecod.net or between 261SEP102 and 30/SEP/02. o Barnstable (Cotuit) Mass. ' Draft: JOD Field: WHK/MDH 20 0 10 20 40 80 3.) The datum used is NGVD 29, a fixed mean sea level datum. Date: Ma 27 2003 Review: PS Comp.: MDH y A n7art il: 22050 Drawing # C473-2G1.dwg