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0309 PINE RIDGE ROAD
. ►ve ' $ Town of Barnstable � � Building. x -P Th�Catd �Tha�t it�S% bie fro�ro the Stre appproved P(a rs iM st be Retained ort Job and fhiSzGartl f4AnSt be Kept Pasted WhereakCertl icafe3of Oceupancy is Requ d,su Buiiding shaiyi Not be Occupied untii a Final Inspection has beptti made Permit Permit No. 116-2627 Applicant Name: PETER FIELD BUILDING&RESTORATION rk Approvals Date Issued: 09/16/2016 Current Use: Structure Permit Type: Building-Addition/Alteration-Residential Expiration Date: 03/16/2017 Foundation: Location� 309 PINE RIDGE ROAD,COTUIT_ Map/Lot 006-033 Zoning District: RF Sheathing: r a Owner on Record: GARGIULO,CHRISTO_PHER&KRISTI �� T� , Contractor Name PETER FIELD BUILDING& Framing: 1 # RESTORATION Address: 309 PINE RIDGE RD 2 COTUIT,MA 02635 t —A" wContrattor Llcense 120362 Chimney: u Description: remodel existing house as designated by ADS Constra'i' i to Est Project Cost: $60,000.00 include removing existing garage to accomodate'remodel of 1st flr. } PermR Fee: $356.00 Insulation: _ to include pantry and mudroom.2nd floor to include laundry,master z � q off- Pee Pald-: -$356.00 Final: ,bedroom and bath apporx 550 sq ft.bedroom counttotremain same 3 bedrooms.Edisting FP to be removed5yr Date ' 9/16/2016 x � n Plumbing/Gas Project Review Re y a a' ` Rough Plumbing: �h _ ,. - _ , Final Plumbin "'8uildingOfficial g- Rough Gas: This permit shall be deemed abandoned and invalid unless the work a ithord by,2his permit is commenced wnhiA4six monthstafter issuance. zs xq a Final Gas: All work authorized by this permit shall conform to the approved applicationandtle approved construction documents for which;this permit has been granted. All construction,alterations and changes of use of any building and stnretures shallibe in compliance with the Iota] 641irg 6y lawws and codes. This permit shall be displayed in a location clearly visible from access streetorroad and shall be maintained op n for pubhe inspection for the entire duration of Electrical w s the work until the completion of the same. „ t � a3 s Service: The Certificate of Occupancy will not be issued until all applicable signatur by tte Butldmg and 1 rre Officialsare prowded on this permit. Rough: Minimum of Five Call Inspections Required for All Construction 1.Foundation or Footing Final: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Low Voltage Rough: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection, S.Prior to Covering Structural Members(Frame Inspection) Low Voltage Final: 6.Insulation 7.Final Inspection before Occupancy Health Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction., Fire Departments/ _ "Persons contracting with unregistered contractors do not have access to the guaranty fund"(as set forth in MGL c.142A). Final: a. Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT a . -; TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Z—M AI I Map ©Olo Parcel 03::!� — Application # Health Division Date Isaue Conservation Division Applicati ee " Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address Nc— IQD6� lP 6LTr,k t7"" Village Lli 7- Owner r uID Address �[�C Telephone Permit Request n?aA0L�F�� iiG, hnKe ctS �oras ,c�-iw, iwc>%u4e2 tom ' Ab MA Square feet: 1 st floor: existing% proposed 2nd floor: existing proposed Total new Zoning District f Flood Plain Groundwater Overlay Project Valuation l9d a Construction Type Lot Size AO Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes No On Old King's Highway: ❑Yes Al No Basement Type: ,81 Full ❑ Crawl ❑Walkout ❑ Other ' Basement Finished Area (sq.ft.) S DU Basement Unfinished Area (sq.ft) T 7 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:"-X Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes t ,No Fireplaces: Existing New Existing wood/coal stove:A Yes No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage:Xexisting ❑ new size _Shed;_qexisting ❑ 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 -� '!G�ed� Telephone Number Address Z/? License# GSA (' Sro38 Home Improvement Contractor# 620 Email r' �� S�f, Worker's Compensation # -qM 7�Z�78� f ALL CO STRU ION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Zo�bf� SIGNATURE DATE •I b FOR OFFICIAL USE ONLY RPPLICATION# t DATE ISSUED MAP/PARCEL NO. i ADDRESS VILLAGE i OWNER DATE OF INSPECTION: FOUNDATION FRAME 0 m Ng QK INSULATION r^ j FIREPLACE s ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL `S FINAL BUILDING . FlIvAd d I DATE CLOSED OUT ASSOCIATION PLAN NO.. = Bowers, Edwin From: Bowers, Edwin Sent: Monday, February 12, 2018 8:27 AM To: Ipeterfield@comcast.net' Subject: Permit/Application: B-16-2627 at 309 PINE RIDGE ROAD, COTUIT for Building - Addition/Alteration - Residential Hello, Peter To confirm inspection on 2-9-18 We will Need the Gas permit G-18-40 Closed The Fire department approval Also make sure the House Number is reposted Please notify me when complete and I will close the permit Edwin Bowers Town of Barnstable Building Inspector 508-862-4025 1 Town of Barnstable Building Post This Card So Thaf rt�s VisibleFrom the Street Approved Plans Must beRetained on lob and fhis Card Must be Kept KAMw� Posted Until Final Irispectlon Has Been Made �` �� � � '�� z ,� `;5 � 9 p rm • s63p s °a'Certificate of Occu Banc :is Re'uiredsuch Buildm' shall Not:be Occu ied'unt�l a Final ins ection.has=been made 1 el jill� t Wv e Permit No. B-18-74 Applicant Name: Kevin C Saunders Approvals Date Issued: 01/08/2018 Current Use: Structure Permit Type: Building-Sheet Metal-Residential Expiration Date: 07/08/2018 Foundation: Location: 309 PINE RIDGE ROAD,COTUIT Map/Lot: 006-033 Zoning District: RF Sheathing: Owner on Record: GARGIULO,CHRISTOPHER&KRISTI 1, Contractor Name: Kevin C Saunders Framing: 1 Address: 309 PINE RIDGE RD Contractor Llcense 3860 2 COTUIT,MA 02635 E Project Cost: $0.00 Chimney: Description: Attic A/C system-duct �Permlt Fee: $85.00 y Insulation: Project Review ee Pald $85.00 Re F j q: n Final: Date 1/8/2018 y �dlkrCrn Plumbing/Gas Rough Plumbing: Builclin Official g Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after Issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the,approved construction documents for which this permit has been granted. R Final Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zohi by laws and codes. } This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for,,public inspection for the entire duration of the work until the completion of the same. r ', Electrical The Certificate of Occupancy will not be issued until all applicable signatures by"the Building ap6Fire Officialsa e provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work : -=a' Rough: 1.Foundation or Footing 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT r -Commonwealth of Massachusetts Qftmb�Q Sheet Metal Permit Map ,Parcel Date: IZ—/7"I7 ® .. 6w Pe t#J3 -1v , 1 (1 Estimated Job Cost; $ JAjq 0 8 2C �`� Permit Fee; $ � Plans Submitted: YES NO I�! g o v ' ' re d: YES N4 nAA al�p Business License# Applicant License# Business Information Property Owner/Job Location information: Name: 6U, 1 ��'� Name: U Street: (� �� ? Street: City/Town: City/Town: Telephone: WF_41�0y 60q3 Telephone: Photo I.D.required/Copy of Photo I.D. attached: YES ✓ NO Staff Initial estricted license I I J-2/M-2-restricted to dwellings 3- Ties or less and commercial up to 10,000 sq. ft./2-stories or less Residential: 1-2 family Multi-family Condo/Townhouses Other i Commercial: Office Retail Industrial Educational- Fire Dept. Approval Institutio e Other Square Footage: under 10,000 sq. ft. over 10,000 sq. ft. Number of Stories: Sheet metal work 'be completed: New Work: Renovation: HVAC Metal Watershed Roofing Kitchen Exhaust System i Metal Chimney/Vents Air Balancing Provide detailed description of work to be done: Ae - 4- { • z OD y •t � f st INSURANCE COVERAGE! I have a current liability insurance policy or Its equivalent which meets the requirements of M.G.L.Ch.112 Yes alo❑ If you have checked XM indicate the a of coverage by checking the appropriate bolt below: i i A liability insurance policy Other type of indemnity ® Bond ❑ i OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the Massachusetts General Laws,and that my signature on this permit application this requirement. { Check One Only i Owner ❑ Agent ❑ i Signature of Owner or Owner's Agent f By checking this boxO,I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and ! accurate to the best of my knowledge and that all sheet metalwork and installations performed under the permit issued for this application will be . in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. I Duct inspection required prior to Insulation installation: YES NO Fro ess Ynspections ' Date Comments i Final� e�tiOn Date Comments I nse:Type of e ! sy — - aster I Rle Master-Restricted , i ,Ityfrown ®Journeyperson Si ure of Licensee Dermft ❑Joumeyperson-Restricted License Number: Check at www.mass.aoxWol j i - i nspeetor Signature of Permit Approval i Town of Barnstable Regulatory Services MABA Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street Hyannis,MA 02601 .www.town.barnstable.ma.us Office: 508-862.4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section- If Using A Builder as Owner of the subject property hereby authorize &ag (�ge& to act on my behalf, , in all matters relative to work authorized by this building permit 3UA- (Address of Job) **Pool fences and alarms.are the responsibility of the applicant. fools are not to be filled before fence is installed and pools are not to be utilized until all final inspections are performed and accepted, Jae of O 'er Sigm plicant f 1 Print Name Print Name - IZ-r�rt� Date Q:F0ItMS:0WNERPERIvIISSI"00LS t 77te Commonwealth of Massachusetts Department oflndustrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 11 UV. www.mass govAUa ' Workers'Compensation Insurance Affidavit;Builders/Contractors/Flectrieians/Plulmbers Applicant bdormation Please Print Legibly Name(BusinesslOrganizalionadividual): Address- city/state/zip: 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 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.4 1_ . 1* Q Remodela ig`_ ship and have no employees These sub-contractors have 8. (]Demolition to ees and have workers �P Y working for me m'any c�aerty. #. g, �Bu�ldang addition [No workels'comp.insurance comp.insurance. 10.❑Eleotcaical repairs or additions required.] 5. ® We are a corporation and its P 3.® I am a homeowner doing all work officers have exercised their . 11.®Phunb0g repairs or additions ' myself. [No workers'caffip. right of exemption per MGL 12.®Roof repairs insurance required.)t c. 152, §1(4),and we have no employees.[No workers' 13•®Offer. comp.insurance required) *Any applicant that chocks box#1=at also RU out the section below showing their work='compensation policy idoroadon. t Homeowners who submit this affidavit indicating toy are doing all work and then hire outside contractors must submit anew affidavit indicating such. tContractors that check this box must attached an additional shoot showing the uante of the sub-wnft=h s and state wbodw or not those entities have employees. If tlu sub-contractois bave employees,they must provide their workers'comp.policy number. ,Cam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: A. Policy#or Self-ins.Lic.#: Expiration Date. Job Site Address: City/State/Zap: Attach a copy of the workers'compensation policy declaration page'(showing the policy number and expiration date). Failure,to secure coverage as-required undcr.Section ZA of MCTL.c.,l.5Zcan lead to,&e in:pasidm,of.criminal penalties of a- ns ri --- - -� fip to S 1,500.00 and/or one-year ilnpxisonmcn# as well as rival penalties in the form of ,STOP*ORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copyof this statemerit may be forwarded to the Office of TxLvestiaations of the DIA•for ansuraaxce coverage verification. I do hereby cer fy under the pains and penalties of perjury dW the information provided above.is true and correct Sitature: Date: Phone#: Official use only. Ao nat write in this area,to be completed by city or town official City or Town: PermitlLicense# .Issuing Authority(circle one): 1.Board of Health 2.BWldin g Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: { i • i . . /) +y DRIVERS,! OW, -RE Nam lLor NONE, t UNDER I 4 k. - ! 3 ELSMSMAND InR x !\!�' [ 'i 11 i. ,�� w• S 6r-�1t 3 . F - . t _ ... �`�E,TVA' !11�R SHEE N A t, ISSUEP- T :E h s � :y .S S � � S �.: TT MAST .. SAUNDERS e 1 , r t ' + 34 80I I. L I — CERTIFICATE OF LIABILITY INSURANCE 02/1412o 7°"'�'�'' 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()es)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 endorsements. PRODUCER CONTACT Paychex Insurance Agency Inc NAMEm PAYCHEX INSURANCE AGENCY,INC. 150 SAWGRASS DRIVE PHONE , 877-266-6850 FAX . 585-389-7426 ROCHESTER,NY 14620 E-MAIL Certs@paychex.com INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A:AmGUARD Insurance Company Seaside Gas Service Inc INSURER B: Travelers Indemnify Co of CT dba Seaside Gas Service INSURER C: 67 Helmsman Dr INSURER D: Yarmouth Port MA 02675-2467 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. INS TYPE OF INSURANCE NDSDRL UB°R POLICY NUMBER FOLIC YYYY POLICY EXP LIMITS LTR� (MMIDDIYYYY GENERAL LIABILITY EACH OCCURRENCE $1,000,000 , X I COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $50 000 CLAIMS-MADE�OCCUR ME $5 ,000 A SEBP809250 02/09/2017 02/09/2018 PERSONAL&ADV INJURY $IN CL UDED ' AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2 OOO OOO POLICY =PROJECT=LOC - PRODUCTS-COMP/OP AGG $2,000,000 z AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED SCHEDULED BODILY INJURY $ AUTOS AUTOS (Per person) HIRED AUTOS �AUT03 ED BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ (Per accident) $ X UMBRELLA LIAR O OCCUR EACH OCCURRENCE $ 000 000 A EXCESS LIAB =CLAIMS-MADE S E U M 809295 02/09/2017 02/09/2018 AGGREGATE $1,000,000 DIED JA RETENTION$10.00 $ WORKERS COMPENSATION AND V I WC STATU- OTH- EMPLOYERS uABILITY E.L.EACH ACCIDENT $ 5OO OOO B ANY PROPRIETORIPARTN CUTIVE UB 7G122299 OFFICERIMEMBER EXCLUDED?DED4 � 01/26/2017 01/26/2018 E.L.DISEASE-EA EMPLOYEE $SOO,OOO (Mandatory In NH) r N/A E.L.DISEASE-POLICY LIMIT $500,000 If yes,describe under nPqr.p'�' OPERATION- DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION PROOF OF COVERAGE DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES., AUTHORIZED REPRESENTATIVE ACORD 25(2010/05) @1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD t' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map_ 6010 Parcel A ic�ation # 02 Health Division Date Issued Z Conservation Division Application Fee Planning Dept. Permit Fee ta) Date Definitive Plan Approved by Planning Board n� 4Ci Historic - OKH _ Preservation / Hyannis 4 Project Street Address d ;? RV Village T�f Owner I Address df Telephone 6 � ��� / Permit Request �-� �` I'��£-tom, �'_ �y - /� } >✓� rt' S t Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Dr Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure � Historic House: ❑Yes & On Old King's Highway: ❑Yes Basement Type: Cj'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: existingf new Total Room Count (not including baths): existing 7 new First Floor Room Count Heat Type and Fuel: &Ii�'as ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes Ch c, Fireplaces: Existing Z New Existing wood/coal stove: ❑Yes &lo Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attacli�'d garage: A existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: w� - a ZE Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use I7`fi�t APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name '� �� C Telephone Number 5-l' Address License # cas7r ` Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE — DATE c� FOR OFFICIAL USE ONLY C APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE E , OWNER • f DATE OF INSPECTION: FOUNDATION FRAME { INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL t PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. _ The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.massgov/din Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organizarion/Individuai .Address: . City/State/Zip: Phone#: Are you an employer?Check the appropriate box: Type of project(required); 1.❑ 1 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 shipand have no employees These sub-contractors have 8. []Demolition working for me in any capacity. employees and have workers' comp. insurance.$ 9. ❑Building addition [No workers' comp.insurance P� ,�, 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.Ul am a homeowner doing all work officers have exercised their 11.❑Plumbing.repairs or additions myself. [No workers'.comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t. c. 152, §1(4), and we have no employees. [No workers' HE Other comp.insurance required.] *Any applicant that checks box 01 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. tContractors 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.Lic.#: Expiration Dater 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 DIA for insurance coverage verification. I do hereby certify d r the pains and penalties of perjury that the information provided above is true and correct Si afore: Date: Phone �� Official use only. Do not write in this area,.to be completed by city or town offzciaL 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 Contgct Person: Phone#: i i IK r Town of Barnstable Regulatory Services Y t B"NS•ABLE, Thomas F.Geiler,Director y MASS. 4� 1.639• ,�� Building Division ArFp MA'I a Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-7.90-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: D JOB LOCATION: number. s eet village "HOMEOWNER": 7�% ��� name home phone# work phone# CURRENT MAILING ADDRESS: _30 — Eity/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units*or.less and to allow homeowners to'engage an individual for hire who does not possess`a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which'there is,or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section,109..1.1) 4 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 requireme ts. ure of Tionneowner s, s Approval of Building Official r ti s _ l w'- 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 , • k �y ,, - 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 j Licensing of construction Supervisors);provided that if the homeowner`engages a person(s)for hire'to do`such work,that such Homeowner shall'act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as.Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by. several towns.You may care t amend and adopt such a form/certification for use in your community. ` • .y Q:forms:homeexempt ppTME Toy, Town of Barnstable Regulatory Services • BARNSTABM yQ MASS, Thomas F. Geiler,Director Op 'i63919 ♦0 Tiro Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must ` Complete and Sign This Section If Using A Builder k 1, ��4 , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work a oxized by this building permit. (Address f Job **Pool fences and alarms are the res o ility of the applicant. Pools are not to be filled or utilized before a is'installed and all final inspections are performed and ac pted. gnature of Owner ignature o Applicant Print Name Print Name Da QTORMS:OWNERPERMISSIONPOOLS 6/2012 77 n Q�4 Tull c� to 12 fc v Barger Masonry, Inc. P.O. Box 219 Cotuit, MA 02635 Cell#.508-776-3556 Fax# 508-428-5685 i. p Kam• ` r n 1 t �� B t - t Barger Masonry, Inc. P.O. Box 219 _ Cotuit, MA 02635 Cell# 508-776-3556•. Fax# 508-428-5685 r _ , } f THE rokz . Town of Barnstable t Regu-iatory Services 9 MASS. �* Richard V-Scali,Director 'i639 prEpIa Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 5.08-862-403 8 Fax: 508-790-623 0 Property Owner Mush 4 Complete"and Sign This Section if Usma,ABuilder r, Y1S Gar '�11� as Owner of the subject property hereby authorize to act on my behalf, in an matters relative to work authorized by this building permit application for- (Address, - - - �q ►n� - � C�r�- mot:. �� of Job) , Pool fences and alarms are the responsibility of the applicant.'Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted: Si ture of Owner gnature of APPhc r � r7 _ �Y61 (Sam WI Print.Name u Print Name Date Q:FORMS:O WNERPERMISSIONPOOIS Town of Barnstable �... Regulatory Sexes ce P�ati cxe roiyk Richard V_ScaIi,Director Building Division sARirsrAsr.E t Tom Perry,Building Commissioner MASS-y� 1639 ��� 200 Main Street Hyannis,NIA 02601 www.town.b arnstab Ie.ma:us Office: 50 8-862-403 8 Fax: 508-790-623 0 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: �G number St=i village name home phoney work phone CURRENTMAII,114GADDRFSS: . �ITV 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 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 constricts more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance Arith the State Building Code and other applicable codes, bylaws,rules and regulations- _ The undersigned"homeowner"certifies that he/she.understands the Town.ofBarnstable Building Department minimum inspection procedures an requirements and that he/she will comply with said procedures and requirements_ Signature o omeowne Approval of Building Official Dote: 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 persons)for hire to do such work,that such Hameownershall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q;RuIes &ReguIations for Licensing Construction Supervisors,Section 2.15) This Iack 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 respo nsible. To ensure that the homeowner is folly 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 Iast page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/ee'rtzfcation for use in your community. Q:\WPFELES\FOPNS\building permit forms\EXPRBSS.doq 1 Revised 061313 _ �. - �trn��a•,��asst�e�tr�r� �a�-�.rs� ��gens�T�Insur�an.� da-git�-�dersfl�cf�r�l .�cfr�cia�slP�rrni�ers Infc�rma Pleas Hat ca ya-a ait employer?CIreckih XpgrpriafB b T a. e . PI; P I am a eaxplO*wjf i ` ' 4 ❑:I stag Din=l ccaltacEor Mcf I 5_ []New employees{feltaWOCpatt4im * frav�IFu s i ❑ I am a sole propaetQr orparfner- listed as the,attacfied sh�E �e sub-mtartars have ' sbilz avd hate a>?eaxplayeEs $_ ❑. nS:final , for me in emglnyees aa$bav�vro �' �„ 1 9- .E A ildmg addHoo waurat�-. s camp_Msul �e COS IO $lert,;r�i of additions i1 5_ ❑ We area corparafit�aud ifs ❑ regsi am a hom es dain4 all worn 'rr;red Their I l4:1 Fiumbiag repair or addiEous WyseLf Fo moo ' aghtCt��ofe ffortper�fQ J�0 Roof repass . mcrn�nrE 1 6c-Il`i §1( }>aadvm hm * xy sayIlx of 33iatchrr barri zmstalso iM uatffiesse�iinnbrTn�chr��F ii�rswozkeaT rflmnFssslioupotic3 a� �Eo-mebotnecsuix,�t�i�siss�d�r,. -+,r-+;=g�y;,�T ' S;�•.--�-==rt��+7*Eb,�h�cox�.acrosmnsts�3�tann�r�dsritm^�sac7L Comas 7nst check this box mutt xttsrhe3 sa zdditinnaI sn 7' the n of Bra sr� d�s m3 stst�tchataer ocnntfnnse b MMPIU�_ rfthe M b emnTTa zes,megEst gmaiaa tin-WurhU-s'comp.paTcy m>mb- I am :rc T-aaca far my enp[ayges. Heicw is tftapq&cy raid jo b site TcP Go' lame AIM / :CyQ��fc6r.t1 l/tSP�Lte f-oficg 9 gar Sk f-ivs-Lic-4k z1op 762:-�-7e4 I ZO/ P4, xati-aD:ats= S i� Af;acb 2t-COPY of the markers'conxpensaiiln CrRLT`declArsiion Page-(-,hv !ng to polio ramher.sriti txp�fion raze). FailmEt Secfscai25A ofMCt c TSB can lead to the -iosifion'ofcrimr`ual pmalfies of a ' fin$up fa L50Q_00 andlor any year*m opt,as eI1 as cif pc alEi�s in fire firm of a STOPWORK OR IR and a f of up tcY S250-Dg a day apia.st.1he violatcc_ Be advised that a c{rpg of fhis stxt=e t maybe f xwarded to f7i; Office of IQr�sEL�tzoas of ire I?Z�fnrrnm-crsmr.�cam-esitge _ _ Ida.fix cer jpzffcatfheucjvrnza r�prax dubr�x*ershuermdcaFract e b PhoRe E tcc rasa rraE I?q rtattprN— �i Ays urectF tr ba completed by cz�P or h7ft;a qfficiaL G or To P�rnt ..cense# F[�i��afh�rit�'{mcI�nne� L astci�f$eah3i ngI artm sf Faxis{ rrlt 4 RIeatiidalEaspett?r'5,PlmIhmgELSPxtor 6'.G her MiassacirmejS Cienr-ml Laws chapter 152 mgair s a>Z employers to provi workers'compensear}n for tioez employe Pm�rJ�rrt-tn t hIS statII an e�Iayee is denned as -_may peisan ai ffie,service of Mother under any contrait ofhire, .. expr>'ss cir impli5d, araI or writhm_" . An= T.ayeF is der Tied as`man iadivi±ml,par' ffship,associan,'Mypm-�im or ner Iegal eufitY> ar any two or mare offfie fnrzgomg engaged m ajoint cnta rpzlse,aacl ip ingtbe Iegal represent fives of a d ease�3 employer,-or flee receiver or trustee of an ia�idual,pa team .associafion or other legal entity,employing employes. However the Dame-of a d ellinghouse haviag not more than furze aparments and who resides fheram, or fine occupant of the 1Fmg house of anafher who employs persans to do maintenance,const=aon,or repair Rork on such d-,vt hig house or an the g<o>mds or building appurtY-naat theta to shall not because of such esployment be deemed to be-an esplo5icr.'> 7�iCiI chapiair l.52,.g25C(6)also stains that¢every state or Iacal�rceusmg`agency shall withhold the issuance or reneivaI of a Iicense.or perrnit to operate a business or ta'coa?sfrrrct buildings in the commonwealth for auy applicant mho has not p roduced acceptable evidence of conlphance with the h2surance.eovtmge required.' . Additionally, MUL chapter 15Z;'§25C(7'sta�s`Neithea the commonvTealth nor any of its political subdivisions shall errteer iato any contract for due perfon ante of pub lic.work until acceptable evidence of campIiance with the iasuat at requirements of this chapter have been presented to the contra cti g araliority.} ApplicarLts ; _ , Please,-Ell orb the woIkers' compeasafiom affidavit completely,bychecl�gthe boxes that apply to yo r siivation and if necessary,supply sub-contractors)aarne(s),addrzss(es)and phone ninaber_(s)along with their c:rficate(s) of i��vr nee: Lhnitr i Liability Companies(LLC)or Limt Liabilt Paraffsz4s(LLP)wtihno employees ofiher_ than the members or partners,are notregtairedto carry workers' compensation in�ce_ if an LLC or LLP does have m z ed-that this affidavitmay be sub mid tb_ the Dep¢rim mt of- lndfral. eplcyees;apo�icy isreqused Be advis _ Accidents r confsmation.ofiDSDrMC-e coverage. Also be Sure to sign and date the affidavit .The affiria5at should be rearmed to the city or tuwn that the application for tbt pc it or license isbeing requested not the Depatzient of Indusizial Accidence: Shou]d you have any questions re ffie lav7 or if.you ire requred to obt3L1 a wrorkers' mom_pensafion policy,please call the Depa tiat t the nrrnber lis`�.edbelow. Self-insured companies should enter their self-i s=acc licemse mml5er on the appropriate Eat. Cityor Town Officials . Please be sure fhatthe affidavit is complete,and printed legzbly. The Department has provided a space at the bottom of the affidavit for you to fill out is the event the Office of InvP ons has to contact you regardm g b e"applicant Please be.Srnz to fIl in.the pennitllieease m nbar v�aichwrdl be used as¢reference number: In addr5on an plicznt that must submit multiple pnauitlIicense applications is any given year;need only.Yabmif one affidavit indicaTl�currznt policy-infomafion(if necessary)and ruder'�JQb Site Adds, ss"the applicant should write all locafions in (city or town)--:A copy of the affidavit that has be officially stamped or marked by thLe city or town maybe provided to the applicant as proof that a valid affidavit is an f lr for futumpeimits or licenses: A new affidavit must be IEd ott each year_Vqhere a home.owner or citizen is obtinmg a license or permit notrelatrd to any business or commercial Yentlu e (Le. a dog license or permitfn bait leaves eta_)said person is NOTreed to complete this affda�nt The OMce of Investigations would hke to thank you is advance foryour cooperation and should you have any questions please do nothesitate to give us a call The Depatfinenfs ad& s telephone and fax number FhMm �of D=pa n((it Qf d s al acid is. ofluvc�g a M&Cal I I Tel.,41 6I 7- 7-4-,905 at4-M Q£ F 416IT-727- 44 F evised 4-24-0 � gat a_ I Act CERTIFICATE OF LIABILITY INSURANCE °ATE`MM,°°,Y~YY' - �� H 09/07/2016 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 German)Insurance Agency y - PHONE FAX 908 Main Street C o Ext 508 428-9194 A/C No 508 428-3068 Osterville,MA 02655 E-MAIL ADDRESS: ' `t INSURERS AFFORDING COVERAGE NAIC# INSURER A: INSURED INSURER B Peter D Field Peter D Field Building 4 Restoration INSURER C PO BOX 16 INSURER D:AIM-Mutual Ins.CO. 33758 Cotuit,MA 02635 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 POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR, DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP(Any one person) $ u PERSONAL&ADV INJURY- $ GENT AGGREGATE.LIMIT APPLIES PER:. GENERAL AGGREGATE $` \ POLICY a PRO- ❑ JECT LOC PRODUCTS-COMP/OPAGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO ; BODILY INJURY(Per person) $ ALL OWNED SCHEDULED t- BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Pe[accident $ UMBRELLA LIAB - OCCUR EACH OCCURRENCE $ 4EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ %. $ D WORKERS COMPENSATION AWC-400-7023784-2016A 5/16/2016 5/16/2017 PER STATUTE ERH AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.'EACH ACCIDENT $ 100,0,00 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional.Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Peter D Field THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Po Box 16 ACCORDANCE WITH THE POLICY PROVISIONS. Cotuit,MA 02635 AUTHORIZED REPRESENTATIVE- i • ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD r i � - l iassachusetts;Lfepartment of ftbtic`Satety` :Board of Building Regulations and Standards License:`CSFA-065638 f CoitsYructi+��ri^Super>tisrsr l & P TER D FIELD t�sDx,1e CGTUIT Mi! 026 , ...� Expitmtiori, Ci�it3rnissio»er o7r�arzu�x` ��e c ,Consumerai.r RI § Re'` 414.t Ta k '.laza = sae 1 0 Bptaaa icfi - to� xPro mer't �Bl r tQr . stray n Regislrat ow 1:203-62 Tyt Ci1A a �, EXitanti �tr3�t2t� r#�' 7260 PETER%FIELD 010I .MING R� �' F ATION � g � PETER: FIE .C} P 0 W b C0Tl1fi 1� 0.2�3� � �� � v f plot ddriess And t rn�caird. a re Qn,f r h tinge. ►dd.ress` 'RtO ewa 1 � :Ernplsrtneit ' ...6 Lsst Gard: .t n se£1r.2" ss#r I an Y lid'fQ.r Mitd3 *.. d' u �';oHI Ue.af ►na �er xNrsusis� attn H ?ME INI �R�iV1:MENT Gt9NTRACTt?R efare the exp�rati n date. If found return to a ;C?f ee of Gansa�nner Affst rs and �uslness 9 lat on .� � isglsttatlo� ���'12Q�62 T?tP "' �xpir ti©n Idl3E l2{l1?' QBA `1tI Park kt is wife 5170 . pE7 > IE, C3$U, 'STC?RATlC N', x pMR— FVLt td�errrret' at.vilid'withat signature;; oFt rqk, Town of Barnstable *Permit# C�o p^ [ � ires 6 month�om issue date q Regulatory Services lee . sAxrtsr�, \I ��' � � Thomas F. Geiler,Director q TEc � ' ' G `�.:• Building Division Tom Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.to wn.b arnstab l e.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 Q Property Address // i( irl✓' /� �sidential Value of Work Cg7dGt, Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Chepe: ole proprietor am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp. Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) Re-roof(stripping old shingles) All construction debris will be taken to ❑ Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders. U-Value (maximum .44)#of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy the Home Improvement Contractors License& Construction Supervisors License is req SIGNATURE: Z:\WTIFILESTO ilding permit forms\EXPRESS.doc Zevised 07011 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly N_ame_(-usin_ess/Organization/Individual); r�- '---Address:-:= C�v?4 ems- City/S Zip: Phone#: Are you an employer? Check the appropriate box: 1. am a employer y with 4. ❑ I am a general contractor and I Type of project(required): ❑.I employees(fall and/or part-time).* have hired the sub-contractors .6• ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g• ❑Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp.insurance.$ 9. ❑Building addition �required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions �-3-L�__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 insurance required.] t c. 152, §1(4),and we have no 12• oofrepairs' employees. [No workers' 13.[1 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 information. is the policy and job site. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: 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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify r the pains and penalties of perjury that the information provided above is true and correct V a��re �" - -- CDate:�o Official use I.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 Inspectors 5.Plum 6. Other bing Inspector Contact Person: Phone#: THE Town of Barnstable Regulato1MrJ Services • BARNSTABLE, # >aw 9.. Thomas F. Geiler,Director, i63 , f a may' Building Division' Tom Perry,Building Commissioner 200 Main Street,Hyan7able.ma.us ,MA 02601 www.town.barn Office: 508-862-4038 Fax: 508-790-6230 Pr erty Owner Must Co mp te and Sign This Section If Using A'Builder r as Owner of the subject propertp hereby authorize t/ Iny behalf, in all'matters relative o work authorized b 's.building permit:----- (Address of Job) *Pool fence and alarms are the responslb* ' of the applicant. Pool t3' e a Pp s are not to be qed before fence is installed and ools are not to be utilized until a final inspections are performed nd accepted. Signature of Owner Signature of Applicant Print Name Print Name Date Q:FORM&O WNERPEROSSIONPOOLS �1HE r' Town of Barnstable Regulatory Services BARNSTABLE, Thomas F.Geiler,Director MASS. 16;9. �� Building Division rfD M�A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-8624038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print JOB-LOCATION: E. numberl streef village HOMEOWNER �.S A � name home phone# work phone# CURRENT-MAILING=ADDRESS: / city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides.or intends to reside, on which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such . "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and ;reuiremen re-of-Horneowne�, s 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 proc6ed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue-is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt 1 ::::\✓•4�7GR7c•'' [iiti:� : �'i1�iMT;FlM1 ::`<{``.'•'. B::::: DING RRV :..::::.::.:..... .....::. ...::............... ........ kW.,I)ING «<:.006 033 :........:::::.::.::. ..:. IBUILDIN ....MEMO :::::...:.. �< AME BARGER ::. PINtiti::��. RID.... GERD.S: J428 8117 :.:.AN 1 .•: L: . ........:...:•::::::•v:is•::::.v U N BUSINESS G ..... ........ > HAS TRUCKS.—WHY LAR E G AR E YO U ALL WI NG O G HI O B MT E IN BUSINESS IN E IN A R. ZO NEa. Psaa . . . . . . . aaaaaa WILL CALL AND SEND OUT INSPECTOR. ,1 k VA r' C ,,r U 6 G �G ,emu a \,-y G ti C _ Assessor's map and lot number .(... ! .. f .�.�'` � OBI ' ��/G�_ ,3 Q ' 7 CF THE TO \ SEPTIC SYSTEM MUST Sewage Permit number ....../1.91.,, F .......:. INSTALLED IN CO WITH ARTICLE 11 STA BAUSTAnLE, House number SANITARY CODE ?— ....... .............................................. MU& AND i639. REGULATIONS. aMAYor* TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..................nf..... ...........1..Y....... ....... I.ti...................................... TYPEOF CONSTRUCTION ..................................................................................................................................... C^ 4.L. .........19 . TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following ggC information: Location ...... ...?I.... .�! /. ... 1N.,fe.... ..................G 1..,(/.... 7............................................................ Proposed Use .................Sl..Q ! ..........��,� Li'4:..f,P`W., ................................. Zoning District .......I . ...................................................Fire District .................. � � ........................... �Q Name of Owner !Q .fiR ...............................Address ...... Q... ....... !.!lrlR.C........4..I.lv.. Name of Builder ......S .H!^..>�. ...................................Address ......................c ...e................................... Name of Architect .... . :.�...........................Address .....................5 '` .. ..................................... Number of Rooms ............./.................................................Foundation ......<.0"I (-./.L../(..................................... Exterior ............ .Q a. ..................................................Roofing ...... -t, ...................................................... Floors ........... ......................................Interior ..... .....14-,010 !: .................................. Heating ......... Y... ............................................Plumbing ..............1,10-1-4-1 &-C........................................ Fireplace ........... ��........................................Approximate Cost ..............3.e—V.......GG................................ Definitive Plan Approved by Planning Board ---------------_____-----------19_______. Area ...... .l..t .... .................. Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH �'2Z Q so aid 4 � I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Na0..xrrr:. .......... ............... Barger, James A=6-33 No2.1.!A6........ Permit for ...Ad�...W..QgrUe.... ............................................................................... Location .......30,Q„Pine R dg@....... otu t...... ............................................................................... Owner ...JaMeA3arZer...................................... Type of Construction ...Woad..Frame................. ............................................................................... Plot ............................ Lot ................................ Permit Granted .......Mp.Lrr ..2�................1979 Date of Inspection ....................................19 Date Completed ..................... 19 PERMIT REFUSED ............................................................ 19 .............................................................................. ............................................................................... ............................................................................... ............................................................................... Approved ................................................ 19 ' ......................................................... .................... ................................... y _ T HE mum ' VA J , TOW������7�T ���� �� � �� �� �� � ��-� �� --- ` N� ��' |�� �� ��� � 0�� �� JKY� p���� ]� �� ��^ ���� | � �� N`N �� �� INSPECTOR ' �� �� �� ' ' . ��0N0N| N0N ���� N ���������� 0 NN �� i ^ APPLICATION FOR PERMIT TO ............................................................. ............................................ � / r TYPE OF ����������������������.��� -__-_ --_ ;���--_..-_----~----.. ' � �=�� l �^7 -...,^.^.~—.,^—.. ..-... ".^_, TO THE INSPECTOR OF BUILDINGS: � ` The undersigned hereby applies for o permit according to the following information: ' Location --- .--��./...r/�.. �.<+/±X.-../i��--..--.-.| ../�.<.��..�.......-.-.---.------------ Use -----. -�/. ..-.-../��.°4.[-.��±-.^.»`v/..�-...-..----.---.--.-.---..- ' . _ ~ Zoning District --.y.L./-..—.-..---------............Fire District --..--..!'-.-..<..��x..:.--.------..- ^ Nome of Owner ~--.- .l. .��(---------.-A66reo ....................................................`.L-- .. L..7- | �. ' x Nome of 8oU6ar ....... .4���..�.�!------------Ad6�mu -.----.--_-.. ............................................. Nome of Architect -' �wlp?rr� -:.---------A66reo -------,. .----------.------- ` Number of Rooms ----. ----------------.Foon6o�ion -- '/.. .!- ..�-----------_. � � . Exiehor ............�'/���!�..-----------------.RooGng --.......................................... � | Floors ---'/^-��^i./~/y �-. -...-�--------_--|ntehur -.. -.�-..L''_..!�,_____________.. � Heating ---��....'/�-------------------'Plum6ng ................. �� �� Fireplace '--'/�'��.��---- ...........................................Approximate Cost ............... ................................................. / � Definitive Plan Approved by Planning 8uond lV---_. Area ...... �- | � ^-�^ � � Diagram � i� and Building w� ����� F� ' � / ---- .............................SUBBZ TO APPROVAL DF BOARD OF HEALTH Yk17 / 5 '' ~�~ --'-- -/ / ` . / | � - ( ^ ' ^` / ' �r | hereby agree to conform to all the Rules and Regulations of the Town of Bornshz6|o regarding the above construction. r | �o m��=��-.' :�� ��f��� ,- ^ '- �--- c�`-'' ''.' ' ----'—'~ Barger, James A:76-33 No .... .Permit for ........ ............................................................................... Location 309 Pine Rid6em cgtgit.......... ............................ ............................................................................... ........ . ...... .... . Owner ........Jame.s...Barger.)............................. Type of Construction .�oso.d/Frame................... .................................... ..... ................................. Plot ........................... t ................................ /Lo Permit Granted .... ..................19 79 Date of Inspection ......................)............19 Date Completed ......................... ..........19 PERMIT REFU /EIDO 7' ......................................... ....f................. 19 ......... .... /Z I/ ............................. ..................... ...................................... . ................................ .......................................... ............................/.............................................. t .............. Approved .................................. 19 ............................................................................... .................. ............................................................ Assessor's, map and lot,number -_ Q%/• Ci.�.�i Sewage Permit number .... ...... v dyrp�pi�io� y�FTNEtp�I Y TORN OF BARNSTABLE 33ARISTA IL C ." M i639. LDfNG INSPECTOR �O 1639• \00 �_ O MPY, r� 0 APPLICATION FOR PERMIT TO .:............................................................................................................................ r' TYPE OF CONSTRUCTION .. ................................. °...19.° TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for permit'according to the fall wing information: ti Location .....:. ........... ..... .... :.... .. .... ....... :.................. ... .. .. ...................... ProposedUse ........................................................................................................................................................................... Zoning District ........Fire District ........ Name of Owners .M....r ,......Address ......... oo ..... ..... Nameof Builder........... .......................Address .............................:...................................................... Nameof Architect ............ !p. .......... ....................Address ...... ,................................................................ Number of Rooms .....Foundation •. g' Exterior ..........Roofing ...... .. ®. .... ................. ` ....... .............. Floors Interior ............. °...... ......................................... ................. ........... ................................................. HeatingPlumbing .:............ ................ ...--- '..-......,,... ............ .. /. ............... Fireplace .................................:Approximate Cost ............6 Q.O..................................... .. .. ............... .,..... ... Definitive Plan Approved by Planning Board ----------------------_----------19________. Area .......l... © '......... Diagram of Lot and Building with Dimensions Fee .—^ SUBJECT TO APPROVAL OF BOARD OF HEALTH �X•',D= I hereby agree to conform to all the Rules and Regulations of the.Town of Barnstable regarding the above construction. Name ....................................... ' Barger, J. C. , ^ , No -����7—' Parmkfnr --. ��—.—��---..�m—. ^ ' �u� ' � �—' —',. '��°°^w^'' *�'�*----'---.- ���e ����e �m�� ' Location --.309� , ` -r------' ''' --------' . cp .�mit ,—.--,---.--..------.—...-----.. J. C. Barget Owner ---.------------______.. ' . Type of �r�m�« -------------_ . . . . . . . - ----..~---....-------.--.-----. . ' ' Plot ............................ Lot ................................ ' - _ ' . . November 22 ' 7� -P�r�'h'T�/dnt�6 ..�-.—.--_----_--]g -'--c;f |p9-0octron ` . .................... � Date Con`o|u�a6 9l,��.��,�------..lA . . ~ / . . ' PERMIT REFUSEb . . . . ^ .--.—.,.--..--..--...-----.. lg . } ' .---------.~..—.---------.--...—. ' . --_-_..--._--.—..—.--.-----.—.---. . - - . . . -_--.--^_--..—..~..,,_.--...-....-..~' ^ --.-----.---..—..-----~--.'.---.. ^ . . . . Approved ........................................... ..... lA ' -------.--------......—.—..—...- . ----------,.-----.—~—..—,,—.... . . , . . ' ' ' | __ | ^;.....-w .w, :.� .. . �.k'-... .� 0.fixc"s:.�'-.w; :r'e••,y.� �'�re3. _ , Assessor's map and lot number ........ ......:............................ ' Sewage Permit number yFTHEt TOWN OF ;BARNSTABLE HJSBSTADLE"6 9 BUILDING - INSPECTOR APPLICATION FOR PERMIT TO ..................... .................................................................................................... LIC TYPE OF CONSTRUCTION .............:..........`......... .................... ..................................................... ............ ....... "..................:....'.. ....19.. . r TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following-information: r ,Location ........ ................................... ProposedUse .......................................................................................................... ................................................................. ZoningDistrict .......................................................................Fire District ........ ........................ ....................................... Name of Owner � ..,...... .......fi ....... .t.r :f...r...............Address .................................^. ........`......... ........................ Nameof Builder .....................................................Address ....................................... .... ....................................... Name of Architect ' �r Address ......:.. Number of Rooms ...............................................Foundation ` Exterior 11 ' ...Roofing S .......... ........................................ ............ . .......:.... . ............................ ........... Floors . � .Interior Heating a.....:..............................................Plumbing ................................................ Fireplace ...............................................Approximate Cost ` L�40 . Definitive Plan Approved by Planning Board ________________________________19________. Area !!.. r : '... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH � � y �r..�..._w.++.M.a�.. w.-...saw.«..w-. .�.�l��V.r._...rr�.. ..+wv.+n.......♦ t 4� t ! 1 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above f g 9 construction. L' Name ..................................................................... Barger, J. C. A=6~33 + ^- l0027xx No —.----. Panni� for --����������---. ' add porch to _ —'----^--'—^---'—'--'--^—^~'—^--` 3O9 Pine Ridge Rmad Location� ---------.----------'�.. � Cmtuit . .--.-----.----..—.----------. . Owner J. C. ��r ' ^ . / ' .,,- _ Construction_ .—. ' . ....................................... j............................ . . Plot ` h ' r . - m Permit Granted~ Date of Inspection ....................................19 . . ' --- Completed_ ...................................... . . ' ` . . PERMIT~ " ~ . . -----' . . . / ' —'-7'— '7^~--`^-' ^—'—'—'--'' .. .—. .�y='. --..+—.—.. � ' \��Y ° � � . —..��—_----.--....—...��--..----.. . . Approved ................................................. 19 ` ^ ----~---'------^^^^~—'------^' ----^------^--------^'^^^^^^'~^` ' , U U ` " HB1 LOFIRCTIOX 1 EASnKS CQUIIdGni?I _ r �.ROE I en.wcGE (O�, a0 C, a' r � r T%awA , rarer�,� J ,wulr 51xNW.[:, /R06T s-m h - O U tiw%•tT sXw� Q 0 u UCiriXb XM'E • I] z IAAXD RId2 1.,W6tiI^l U6 NFAO GISIN6 ; C t V/ Y1G.S`1eGlF5 t : IBA PORnCO ROOF LCnI�- t "' e N OVER E%lETw6 FRorn �� Q e�'O� � � N •.,�p lNTON E#Snf6 � � . - - d �15oe:T'XL5 a Y d --- -------------. .—._ --.— - .—.—.—.—.—._ —.—.—.— ---noon- � J IrUFII 11 U5 OQdHt- ®®�®®©® • 05TOM SiPORf Llill rr`•'' N S 130IJt� � LPI 11 X910/I OOO S EAS as _XE:,� E locwt®w TIE >aSioG —.—.—. —. —. FPtsr FIOOff_—. V 0----------------------------------- - LouT1w — — ---------------------------------------------------------------------- \ - f FRONT ELEVAT I ON {-i SCALE, I/4• . I'-O' - - - e8'o�f T: gg . _ �osnXE co1sTR.cnoX � N31 caXSTwuTnX �`� e" E i g aog fseUK COXf.RmGE E 2�atr�$oo agg 3g�afi_ga�C$o`$ X -� '`�RurlrclwL o$3�e.oS�o��r��o U(�lIFH RA:'E A'AW.T 9Wl5LE5 E8s>�a���3 kYt&$� 12 - ORCHIFLIUtAL s� - AEPIVLT slmwrs W.` XeT oaw8t w EXYnR$ V QQc _ XOIGE STRKII�Sao � L W - t _ EM _Q o e c v o Nc.sXeras .. - HAoaop "c:5MN6LS W 0 � Q IB'1 PORnCO POOi -NtwNH 6VRC�Y � � \ HRH w!liH2S/ O�Ht ERSnfiS FROXi - O W DC.TCfOnS •-�. y- °i _sFram naoX W - .J—-— — — — — — — — — — — — — — — — — — — — — — — � Q W LD i CAII� - We _o t eoAaos c tt ❑❑ ❑❑ 2 Ri I%4 Y+0 LAEwb a 1J6 NEAO CASwb �' a je- ®� - 6 X ansmE� O ~ aF re+NIIiY ((1 —. —. LMIDMS lO RBi4X NN1�YOIm FIRST FiA"R FIRST i;pOft TO�OM P.T.5LLL Job no.: i503 deb - J11£b,?OIS scab AS NOTED 5 6 MEE - SIRLCTJfrE ON SMALLT bev, - CFBtATOR I ' , GOXOIR'fE R+DiiYNLL ' __________________________________________________________________________________ .-____--__-____-__---___-__-_--_--______-_---_--_-__________--_-_-___-----_____-___-____-- - " LEFT ELEVATI ON R E A R E L E V A T I O N _3 SCALE, 1/4• • I-O' SCALE: 1/4 • I'-O' M O a z o (J r LLM � r 'J a V / v N W Q ---------------- -------- c N U : -- — 0 0 0 0 0 0 n m �I P f D l 3H Ill L�•L . 0 0 - CI I xl a ray 4x4 a�4x4 ! I vaos a m•oc.I vao gr-8 d 6 r 6'°b P - POST POST ID O O o. TO o O�E �-•go�SptlnF��. . — — — �j j� oao.ss�.�s r� W WHdJI fRAf111K 3:®5• 'OL. I. / ----------- ------------------ v• O o 1 _________________________+__ F � a O W Q eaa To 1 EWaGKER Q J ro a� OL SECOND FLOOR FRAMING PLAN ROOF F R A M I N G PLAN r w SCALE: 1/— I'-O' i - SCALE: 1/4' = 1-0' (v Z Z l� O- m LL j— I5o2 m.e .'ae Io.gas �m AS ma w men., aPEw.Toa I ALL DIMEN510145 ARE SUB-ECT TO BE AAS.1;]olb ALTERED DUE TO THE FACT THAT V E ARE USING AN EXISTING FOUNDATION. OVERALL EXISTING GARAGE DIMEN51ON5 ARE A55UMED TO BE 24 FEET DEEP AND 24 FEET WIDE.NOTIFY THE DESIGNER a IF THE DIMEN51ON5 VARY 516NIFICANTLY ^4 PRIOR TO GON5TRXTION. _ o m • � a z ° 0 . Q r 12 Tar,• _ r. C < (IMP) Arrc+•rEcnRA� AR/xrEcoLRAa yr w.SNNSlES AYINLT'J1N6lE`i I? PLYoLJ VS CDx x) woos.w•oc. 2A w,o4. 05•w•oc. Q � N �m5.EAa++ O w N- z FA'Llw,RAKE A�LIrRt�ORR EO6E� RM T➢161 + 11 COMi VBlf IR w (fHE) IIX FASC-(TrEJ c n� Q xe FREZE LOKI.VB f R a Ix STRAPPW6 _ I%SCfiTf(fHE) r rtrE/ w . z Ixa IEAD cASIRS ORar•I frrE/ - ew fREm EnSTor, L C mlr� D E T A I L w D E T A I L APPRO%PNTE MATCH+E)Y L tVET ooraae OLTAIL$Ye111 5 C A L E:_1 1/2• = I'-O E%�}IIyS CGT®ITIOG LM 5 G A L E. I I/2' = i'-O ExI5TIR6 Gplq{I(X q+ E%LSTRK HWiE EAST HOLE • ���Voo�o�c ajo� �trmsb��.68gg.3tag'3Q o� obi' 3sb�g'E�am-o ash §= 0&+58oas�� 8 o_yp oir ��a LU _ vQ z � p o i w o � o O � W � o tu _J Q LU Q I J�no.: Ep2 dety y�g p,2015 eceb A5 QED • mean OPERATOR 1 0 4 r y- 1 � • i r 1 N; 0 z a r r T .1 0 U w Q - — 0 ]W. VY J - 31 V1' T-]V1' T-7 VY 3'-1 VS r E 14 ' 0 0 S --------- — - e E � --- \a EVRO Y '--` BATH 5E - - - � %= ns/ ai PLAYROOM - V4 1 9'ri' ry bhp l/4• _________ " ----------------- -- z•ud rocr�T°' ---------------- - ' i s HALL f�(`V''(��^\' t a S V o yb �,• o �1 LOSET �OSET -I L Q `OE�S�b oSbs a,b-o b-10 vs• c-s• 9 d _ °0^9o°$Y8�hSo 0 ----- -- ----------- Aso^eag€ssaztFrs� LA Z W f m Q ------------------- ----- ----------------- ------ ------ ---------- W Qn 7d' Zd' O w o iv O SECOND FLOOR PLAN Lu O V• smoll, . a riNED DaTE OP TO ALL DIMENSIONS ARE 5UB IEGT TO BE ALTERED DUE TO THE FACT THAT VE ARE USING AN EXISTING FOUNDATION. DA 1 E w- OVERALL EXISTING GARAGE DIMENSION5i ARE ASSUMED TO BE 24 FEET DEEP AND - 24 FEET WIDE.NOTIFY THE DE516NER BOTH CfF.I' r j ti - "' R Rf�/]ITTING < IF THE DIMENSIONS VARY 5IGNIFIGANTLY �•— -- �-- - /� PRIOR TO CON5TRUGTION. (H, 0 e 0 r.. to a z 0 (� r x E r SOLD 'A/C DiEpT a ro ?016 z tAi O,,, Y) o B G - zca vs• zao• as tea• as tee• 7-l0• c w DEN E a a h4 Jv J r C PANTRY -----'----- y rave Au EgSTVK clL^IY N9T RaOR . E*5TWRR=115 a1 1.—T YAIm MDRCOl1 ________________ ' - EASTUG 6PRAGE. TO NATL11-rlE MS m E45 lB`I M11_ -E%F TIIG -EITKSI GONL. RDOR fRp'TN/o T FLATS ' .6GMT TO 144TLN TFE EJeeT11G IgFh PLATE �` 1-BxbG NB6M. G &E "r Y' � KITC.FfEN _ yr wm PATLa.EZISTmz OFFICE .. p nea+M adXb-e MUDRoom s•a• RerwE EXST@le DINING otxR orto TtE PN Ml IEN bARAbE EIOSTsb 6ARA6E ND rE6.DYa To INVE �LI45TopAFiE AIS)PATr A5 R a I LwoRr cLosEr. i Aroa.rsTwc � - R s h 5 B o 3t u g` ° 1�V or coolx o¢ PAr Is�' 5 2'� b - t Ft�oR Alm cE�.az `o �y°_b�j-Li ` � I�iFE fxsTws o —I NIM FtLSN eEAfl N b �—a LIVING rAto °§` 3'gSb os3r� H0 PATLN AS A yy �,g� - --- srw OF OF STAN ER PORINM W \Ir (—� rAe 9A To---------- war«r`--l—iU( E�asnns carolna+a+ anosnE sloe aF Rs � MUIDPG N91 RALHiS � Q LLI PK RH1v.'E ElOSTQlS Po'R Z RM. tP ANo rvM TO ST OPOSI''P ,E = 6 OF STAa25. W TAI (� O ]4'O• v• v 'F-N31 LOJHSD E+ O O Q� z Q J p IL Lu lL Z O FIRST FLOOR PLAN -- ° tL Q SCALE. 3A6 I—O IL �+ m j� I5o= _ - C � �� - �-.�•�'�� �lo.gas d.aun OPERATOR t ALL DIMEN51ON5 ARE 5UB,.IEGT TO BE ALTERED DUE TO THE FACT THAT VIE ARE USING AN EXISTING FOUNDATION- OVERALL EXISTING GARAGE DIMENSIONS ARE ASSUMED TO BE 24 FEET DEEP AND 24 FEET WIDE.NOTIFY THE DESIGNER a IF THE DIMENSIONS VARY SIGNIFICANTLY - /� _A PRIOR TO GON5TRUGTION. /H� 1 o m