Loading...
HomeMy WebLinkAbout0049 PUTNAM AVENUE �� �%� � j J I I N i j 7 6d APPROVED6/-6,z �i TOWN OF BARNSTABLE f n GAS C�'WIRING PLUMBING ❑ BUILDING tyz �f„ BV I LSD I��_. 7E I d, PARCEL ID 040 600 194 �� GEOB:ASE ,ID ADDRESS 59 PUTNAM -AVENUE PHONE COTCIIT < ZIP' I LOT C ... B14OCK � €9T SIZE DBA ' DEVELOPMENT DISTRICT PERMIT e) 4786.17 DESCRIPTION NEB ..;4 BDI.M. SIN FAM/REMOVE KITCHtV\ �`�IST Ajj PERMIT TYPI Y $UILD TITLE . NEW RE IDENTIAIo 'jepaitk enteof'Healt4; Safety CONTRACTORS ROBERT J COOK and Environmental Services:. ARCHITECTS: ._ w. IME u TOTAL FEES: .'m l ,978".8 roi CyNtiJC-UC- -T_ E =CO7ry ? ,>;>-_.. 4,;$2 8, ra ,.0. 0 -T. A. .B , A+: 101 ��I LE FAM HOME D . CkIEI� 1 PRIVATE l��t,m �IT r�' ,.r BUILDIN IS10kr1ollBY i. r ! 4 1 `"LE I S S U 08/0ti3r23vnv EXPesRAI%ON DATE > 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 FROMTHE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OFTHIS. PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. . MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND 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- (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ELECTRICAL,PLUMBING AND MECH- 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE: `ANICAL:,INSTALLATIONS. 4.FINAL INSPECTION BEFORE OCCUPANCY. VISIBLEPOST THIS CARD SO IT IS BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS = I '"'rV 3 1 CHE NSPECTIOWAPPROVALS ENGINEERING DEPARTMENT p 0;s o� 2,,LL BOARD OF HEALTH �I ox,4 OTHER: SITE PLAN REVIEW,APPROVAL WORK SHALUNOT 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. BUILDIN G PERMIT �', Assessor's map and lot number ........ X.. . _I,.,.�:,.. Sewage Permit number�h-0.���� "�`� 16�1�Ti4LL���gg0+�CM MUS'�` ;,�v,. o� .ry 9� ` - ARISTAD 1 ����Ie���'r .:H LE i House number .......:......_.........:.......::. ' ... .................' E 1 WITH TITLE 5 'ob Mb3v NMENTAL CODE R ' TOWN OF 'BARNS�TARtETlO°=' - BUILDI INSPECTOR APPLICATION FOR PERMIT TO ... . ..... ��..,, .....A. �!. u TYPEOF CONSTRUCTION ....:k .. . .. c'............................:..:................................:.........................:..... F .. . ...............19 7 � -TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies f r a permit according toLthe following information: Location ...?\.. .i�/��4.Vt.&.. �..1.�:L.,.... 1`,1�:,1.�.�.:�: .:.............:.......................... ProposedUse . ...................................................................................................................................... Zoning District ...................................... Fire District ...... �.9.::J: ........................................ Name of Owner :.1 .,. ... � ,. x.......Address �s. t� � Gv�,. .......... Name of Builder" ... . = .�. ..... .��, ...Address ........ ........ �,G��: . ., N�.`�`✓.... .r 11z�inn Name of Architect ............ 1.4..............................:.Address ..................... ............... .......... Number of RPM Foundation ,. '' •i��' - ; `d ....CG-ek-o_--r-le-A �Exterior .l.. .... .pC-�: ...........:...............................................Roofing ....�.'�.. ... � ':�................................................... FloorsInterior ............:.....................................:..............:........................................................:. Heating ..._.. .... Plumbing "Y 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 T-1 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the own of �n ab regarding`the 'ove construction. o Name ...... .. .,...F.. .... . ... .... ......... ROPES, EDWARD 24249 . REPAIR GARAGE No .................. Permit for .................................... Accessory; to Dwelling Locar, Pdtnam Avenue Cotuit I. ......................................................................I.......... Owner ...............................Edward Ropes............................ Frame -4N Type of Cons'tru' ction .........................:................. 1.0............ ..................................................... t. Plot ............................. Lot .................................. Permit Granted ....q:91Y... 2 Date of Inspection ........................... Date Completed .......... ..19' d eo� r T /9 Ufa Assessor's map and lot number �?..... . v.. a ......... FteeT o 0 Sewage Permit number•r�l-�:s3.?�s..•.--�..,....,1.�. .:...... Z 133 3TABLE. i House number ........................................................... ...:....... rasa 039. �90 TOWN OF BARNSTABLE BUIL D" un INSPECTOR APPLICATION FOR PERMIT TO ...... ... .. L} TYPE OF CONSTRUCTION .....�-,0• C.S... .................... ......... ..::................ . ...... . ......... ......... .. ...........�lf.. µ,. '................19 . TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies f r a permit according to the following information: Locationf.'.�..L` 'F,.�IL. ..... . .. � ,. .. Iti. .!..? . .... ..... .. .............. .. ... .............. ProposedUse .......(��� . �t, .�jy, [e .f . ......... ................ .. .............:. ... .... ........ ..... ............................... Zoning District ..... .... ........................Fire District ......b.�. .4.k a _ 'fir - Name of Owner Cr a.R�..;rx ::.l� 5!-°.! `?. .``r....:..Address ► : :.�,�. ..� k. �: ............: Name of Builder' �-,L. a Address Name of Architect .............fi\1../.... .................... .......,Address :...... ......... ......... ..:............................................. Number of R•oms ttt Foundation ` . . C� Exterior .3 A. r. . r�. .............:...........................:......:..........Roofing ... .� 1 ................................................... . cE� Floors { • • •tea :.. .`Y.............................................. ..Interior ........ ..... .:...... ... . .. ................................ la Heating .........0.I ........................................................Plumbing .................................................................................. Fireplace f"SSi _ .................................... ....................Approximate Cost ... :.�r ...�3 ,........ ..�.. ...... ..........:. j G Definitive Plan Approved by Planning Board ---------------- ----------------19_______. Area> .... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH t � ! 1 •4 � l —f OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS' - I hereby agree to conform to all the Rules and Regulations of the Town of Bdrnsfable regarding the dbove construction. Name .. S:� ............ / ROPES, EDWARD 24249 Repair Garage No ................. Permit for .................................... Accessory to Dwelling ............................................................................... Location Q Putnam Avenue Cotuit ............................................................................... Owner Edward Ropes ................................................................. Type of Construction Frame ................................................................................ Plot ............................ Lot ................................ _ X� July 29, 82 Permit Granted ........................................19 Date of Inspection ....................................19 Date Completed ......................................19 0 �- • ' � � ( M•Ri6f 1'Nto'.Wfi1.t`.-a-+—•r - -' _ — 1. �1 - 1 rfa�....._...: . _.Blear EnMTtON - --AYf0.ttLv/KrLN � - � >srr-.ar•v�[¢�N.....:... :._ .,._.—�� r . t j I ..1-na.tmrs�we♦.p. - - ' [[[ 'E Dcsyc]Da��r- �.soal ."-�fll N♦64D ] •e 191ar.en..: mWe in Omit ns i �• ' '� m�.faa�'r'r. f'I P' b amr.rT - ZAP""w" mw tic5ort tour. . . ..... ' ....Fc1UliMTIDN PUI:1" GC<kISR�07:I f�f+_+_uY♦yYb� . 1 •.r N:♦n:n.ry ei.nr ene r.forrrr er'DC D.1re rot rn onry.Arry O]Mr are M lrry PrOMbr `s I. � 1— .___-- .uu:• _ ....ovm.r: Ai /afa i A M MALE - NEW PAIN ­NX _ � r EKyr Er•�/ LaWI I '_— JC.1 .. -•—. / 1 — �[ - I�1 '�../ Jl \k��'lt lip jr fn(%l r\C .' - u TD t I /-AFrt,e�a axrvj'X3 l,rnilcn/ iX•y, �... ,'� h A' t - - w M -1-7"I- - Dk.a,a-, r NE D _ - J C -... ... w G ' —E? ,r.,,,b -> .,,,.t��-c�.i� _ r r •,cr .^.. F l� _ wi T r ItIn. 11 n� - a gag Pr,nv _ rl(AMt lie' '"/V•SCnC' �i r .. - PT. (141�iVl s.'zc. rl r.('.. yrryfl)/G Nb N MA,CN n C ;. r L IA-7_LiLIL w r Avg' n B Pr Lt o6th- LAv a c,_ c ZA 13 eA,./J�netg .V .... -uw_1 � TIIII �•� � � vx; � � �---,I LIL y W II - LnJL^1HJ cX ow I Un4F I Far u�au o n0. NFLJ - - sr"oat I Au rro `\ - d At ?�z �•.' 6a3s L --- ��,� Y7GpP7 W5 .3 F• - 'F- !- "r. IS- "J_ 5:�..�_ Y'N/bN r _ _.—._.8�� _-'-"-" -- 4 35�.9'V�- � ,'!(4.P- "f TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map YO Parcel O 00 1 ,- Permit# SEPTIC Sy STEM a Healthbivision ;NSTALLED IN COIPWPL i'"' Conservation Division EI�� VVYITH TITLE q Fee �� IRONri�jFINTA� h$v 3 y o 'f/zzl4 s Tax Collector Y f, Treasurer a. Z k - Planning Dept., Date Definitive la, tpved by Planning Board Historic-OKH Preservation/Hyannis - Project Street Address Village0-m-u I (foC&rev, v s'. ra H N I K�«e- Owner Address Telephone O q Y Permit Request k6mobi5t 'r -5 Q S 0 6wjALL 2 5° rV LC-C' ' W i( o mile '.,v iA m4 6 TR i'"zz�q IU �� ; - Square feet: 1 st floor:existing prol.�posed 2nd flo r: existing proposed is Total new-- —�k6l(/ �'Jd I stimated Project Cost C) Qrb Zoning District Flood Plain Groundwater Overlay .. Construction Type vu J o Lot Size j , 5 -� A" 4 Grandfathered: ❑Yes Wo If yes,attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure I J66 Historic House: Ves ❑No On Old King's Highway: ❑Yes XNo Basement Type: ❑Full Pkrawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) - Basement Unfinished Area(sq.ft) Number of Baths: Full: existing 3 new / Half:existing new Number of Bedrooms: existing new 0 Total Room Count(not including baths):existing 10 new 6 First Floor Room Count Heat Type and Fuel: Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes Ad"No Fireplaces: Existing _ New Existing wood/coal stove: ❑Yes XNo Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:)Q 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 ���IP F d!� A-CivZA-16 Proposed Use l BUILDER INFORMATION Name�O�'VI�� ��5cel Telephone Number 05_ Address Il^ /466 t b 1c License# 9 S& 3 Home Improvement Contractor# /0 Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO �R� ,fA-6 � + SIGNATURE 04S DATE ? ' o FOR OFFICIAL USE ONLY -. .. PERMIT NO. ' DATE ISSUED MAP/PARCEL NO. ADDRESS R VILLAGE. y OWNER DATE OF INSPECTIO;III: FOUNDATION FRAME INSULATION °� � U fI ' , r FIREPLACE' -' ELECTRICAL: ROUGH FINAL, PLUMBING: ROUGH FINAL GAS: ROUGH FINAL - �{ -'FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. ` TOWN OF BARNSTABLE BUILDING'PERMIT.APPLICATION' Map <3 Parcel (26/</R. 00/ F1� r Permit# z Health Division - Z Z I ..5� � Date Issued � +. � .�✓` .Conservation Division CA L Fee 71 , 8 0 U Tax Collector % T SEPTIC SYSTEM MUST BE reasurer - " <, INSTALLED IN COMPLIANCE . Planning Dept. ,• , S • }` ENVIRONMENTAL Date Definitive Plan Approved by Planning Board . CODE AND : TOWN REGULATIONS Historic-'OKH Preservation/Hyannis i Project Street Address lv. Villagee�'i'V F { Owner J f ;j t� ,V OU lt5� #' Address Y 094L u i f °v:crb. ✓ 01 o N ,Telephone ° Permit Request C A0 oojv �v:�� a�- ^� X� � q Square feet: 1 st floor: existing • " proposed 2nd floor:existing proposed Total new Estimated Project Cost 23 � Zoning District Flood Plain Groundwater Overlay " 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:yYes ❑ 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 ,4 new rt ' Total'Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil O Electric ❑Other - Central Air: ❑Yes .❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No 'Detached garage:❑existing ❑new size Poo isting U new size g.X 3 Barn:❑existing ❑new size. ''Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Reco'rded❑ Commercial ❑Yes ❑No If yes,site plan review* Current Use Proposed Use BUILDER INFORMATION Name_ � /'/Om/f.S Telephone Number Address �:3 L K l�D1 C/ 6A License# Home Improvement Contractor# � Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTI%FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE Grp `� DATE _ '�"2-!� -- t= FOR OFFICIAL USE ONLY PERMIT,NO. waT,l - 4. DATE ISSUED MAP/PARCEL NO. ADDRESS :` — VILLAGE OWNER W � • r,' ...} .' ? � • ` r ". :Y • _ 1 ,r, '' + • '. > DATE OF INSPECTION: FOUNDATION ��--e. " .� -L�• i 7 r`f _ ; i f { -FRAME INSULATION r FIREPLACE ELECTRICAL: ROUGH FINAL { PLUMBING: ROUGH FINAL h��y f GAS: ROUGH- FINAL ` i � yip � r -+ -, r• J '- l , • 4 �. S A . - . FINAL BUILDING co DATE CLOSED OUT - s 10 ASSOCIATION PLAN NO. _ im n TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �C, Parcel Permit# Llq(v Health Division r Date Issued, Conservation Division m < jTc;�710� Feef3,� Tax Collector =4 ;•F: - 3",1 TreasurerT_ - INSTALLED IN C0-jPL1AiNX: WITH TITLE 5 Planning Dept. ENVIRONMENTAL CODE AND Date Definitive Plan Approved by Planning Board TOWN REGULATIONS Historic-OKH Preservation/Hyannis a ' Project Street Address Village Owner aftv►riC5 Address y 0* 09 C C7, O�j(Vl C I Lam, y Telephone p Permit RequestNS�g l C- y J C�uC���e �oy►v0,47i0�. EPC,��� C�1rrs, R I Z c��A+g� �A-c-r fopF tN b i� ti z ,�cev q E S'/DING Square feet: 1st floor: existing 00 proposed 2nd floor: existing 3o0 proposed Total new Valuation UZ:� Zoning District Flood Plain Groundwater Overlay Construction Type W©Db fRAn 6- Lot Size 1 . 13 ACRE Grandfatliered: ❑Yes ❑ No If yes, attach supporting documentation. I Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Agb of Existing Structure 1700 ? Historic House: .Yes ❑No On Old King's Highway: ❑Yes VNo Basement Type: ❑Full ACrawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) ` ® Basement Unfinished Area(sq.ft) 34 f Number of Baths: Full: existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new (5 First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric Xother 110A) Central Air: ❑Yes *0 Fireplaces: Existing _� New Existing wood/coal stove: ❑Yes XNo Detached garage:❑existing ❑new size Pool:Xexisting ❑new size Barnp(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 L_ v ACs BUILDER INFORMATION ' / t— Name / Ode Telephone Number `7 — 1� c� Address 3 R L�*8, o(e r License# L 7 Home Improvement Contractor# Worker's Compensation ALL CONSTRUCTION D I RESULTING FROM THIS PROJECT WILL BETAKEN TO / d bUMP5� SIGNATURE DATE r FOR OFFICIAL USE ONLY PERMIT NO. t " y DATE ISSUED - r MAP/PARCEL NO. . t r � ADDRESS VILLAGE OWNER' DATE OF INSPECTION , FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL • s PLUMBING: ROUGH FINAL GAS: ROUGH--z FINAL. - FINAL BUILDING 7 � m DATE CLOSED OUT i ASSOCIATION PLAN NO. y t f 1+ N �i RM q .. ..... ................_....__....._....__.___ - + 508.428.619' rgns in om •.0 ao9r '• In i p V r..u....•r o.•w....e u�o... ..C.........ine u a.wi.<.no...r.Dray,wq•o.n...0.....raq y.a. '� �I �C i T e 4 I .pa II EIEVnT10N C - ...._._.._............. h Afir - 4 7ren �.. j ::i {. t I � 1 Ill V r! - -- t I i nnu.!n•.y 91anr. Iay9Y.•9y oc.o..r•wr.n•Y..a IK ony.wny orn«Y.e 1•..rl•.ly yraY m. Lo F �.� x y Pow r k t.' Town of Barnstable = *Permit# �1. Ecpires 6 ni ntlis onr issue ate Regulatory Services gee • r + HARNSTAHLE, MASS. Thomas F. Geiler,Director y� i639 1�$ �lfD MP't A Building Division Tom Perry, CBO,.Building Commissioner ,200 Main Street,Hyannis,MA 02601 www,town.b ams table.ma.us Office: 508-.862-4038 Fax:508=790-6230 EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY 2 Not Valid without Red X-Press Imprint Map/parcel Number Property Address �.-C Residential Value of Work /0169,1`4 0 Minimum fee-of$25.00 for work under$6000.00. Owner's Name&Address —5t V-4 Det N"i C V S e✓ O A s ' e4 .' - 1 eo rl S i r u c- t 01%—}. Telephone Number �U�,�lav'--O`f,S-dam Contractor's Name - f' - Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if-applicable) 18 01 a .,. ' , RAM [ Workman's Compensation Insurance' . Check one: .1� I am a sole proprietor ❑ I am the Homeowner TOWOF BARNSTABL I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# t0 r Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) Re-roof(stripping old shingles) All construction debris will be toS ' ❑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: roperty-Owner must sign Property Owner Letter of Permission. A copy of the home Improvement Contractors License& Construction Supervisors License is required SIGNATURE: Q:\WPFILES\FORMS\building permit formS\EXPRESS.doc The Commonwealth of Massachusetts Department oflndustrialAccidents Office of Investigations 1500 Washington Street �� Boston, MA 02111 2�=s� wmv:niass.gov/din Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant.Information Please Print Legibly, Name (Business/Organization/Individual): d�Q�S `✓ '0tUSit Address: Ci-7 CM of d r t City/State/Zip: LA• BMA IlS t a Phone #:sd(T Yd(f _6 Are you an employer? Check the appropriate box: Type of project(required): 1. with employer I am a[� 4. 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.. 7, ❑ Remodeling ship and have no employees These sub-contractors have g• Demolition workingfor me in an capacity. employees and have workers' Y P Y• 9. ❑ Building addition [No workers' comp. insurance comp.insurance.$ required.] 5. We are a corporation and its 10.❑ Electrical repairs or additions 3•❑ I am a homeowner doing all work officers have exercised their 11.E]Plumbing repairs or additions myself o workers' com right of exemption per MGL y [N p. 12.E:] Roof repairs insurance required.] t C. 152, §1(4),and we have no - employees. [No workers' 13:0 Other comp.insurance required.] "Any applicant that checks box NJ 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. tContraclors 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: ' f4.N , P I q Policy# or Self-ins.Lic.#: (D NU�. � Expiration Date t Q 0 0 . ,lob Site Address: LM PV lrj 4" -�-e 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 MOL 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 le DIA for insurance coverage verification. I do hereby c fy under he ins and penalties of perjury that the information provided laove i trite and correct. Si natur /� Date: ® 7 10 Phone#• ��09 6'-IS(? 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 S. Plumbing Inspector 6. Other 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 g engaged g ) P of the foregoing a ed in a joint enterprise, and including the legal representatives of a deceased employer, or the o 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-contractors)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 pen-nit 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 insuredcompanies 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-MASS.AFE Fax # 617427-7749 Revised 4-24-07 www.inass.gov/dia i �IHE r � Town of Barnstable °^ Regulatory Services STABLE, ' Thomas R Geiler,Director 039. u,� 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 7, rA.9 pvpy �,4 use , as Owner of the subject property hereby authorize V-4e4 � &Os(r Ve' lu YV to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) ? l U jSnature of Cwnv atdf Print Name if Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Town of Barnstable Of I"F royti o Regulatory Services Thomas F. Geiler,Director BMxrtsT,MLE, 9�P ; 96 - Building Division _ lACD Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print- DATE: JOB LOCATION: ' number street village "HOMEOWNER": name home phone# work phone fl CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be,a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner, Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements., Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required 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 d4 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.. n•\wPF1LESTORMS\homeexempt.DOC From:Erica Barrett FaxID:OLDE CAPE COD INSURA Page 2 of 2 Date:6/14/2010 10:04 AM Pag � y IS CERTIFICATE lS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED Y THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN i HE ISSUING INSURERS AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER. MPORTANT: If the Certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION S WAIVED, subject to the terns and conditions of the policy,certain policies may require and endorsement A statement n this certificate does not confer rights to the certificate holder in lieu of such endorsement. PRODUCER Old Cape Cad Insurance Agency Inc 296 Winter Street Hyannis,MA 2609 COMPANIES AFFORDING INSURANCE COMPANY A GRANITE STATE INSURANCE COMPANY INSURED Michael Meagher 97 Emerald Street e Mamtons Mills,MA 02W-0000 THIS IS TO CERTIFY THAT-THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOT WITHSTANDING 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 THE POLICIES DESCRIBED HEREIN IS SUBJECT TO.ALLTHE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, LTR rme OP 91 RANCE PC OLICYIFFICIM DATE POLICY EXPIRATION DATE A WORKERSCOMPENSATION D EMPLOYERS'L IABIL nY LIMITS E PROPR IETOR/ PARTNERSIEXECUTIVE e OFFICERS ARE: INCLoEXCL❑ '6619858 11/09/2009 1 11/09/2010 ATUTORY LIM ITS OTHER CQvwago Applies to MA Opamton a Onty CH ACCIDENT $ 100100 CEASE POLICY LIMIT $ W0,00 iSEASE-EACH EMPLOYEE 100 00 DESCRIPTION OF OPERATIONS/VEHICLEB/SPECIAL ITEMS RE:THE WORKERS COMPENSATION POLICY DOES NOT PROVIDE COVERAGE FOR MICHAEL MEAGHER CERTIFICATE HOLDER CANCELLATION TOWN OF BARNSTABLE : SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETME BLDG DEPT EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE 200 MAIN ST WIHTE THE POLICY PRO+nSONS. HYANNIS, MA0260t AUTHORIZED REPRESENTATIVE Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 162938 Trig 283438 i Expiratron: 4'/27/2011 `y TYPe DBA MEAGHER BROTHERS CONSTRUCTION MICHAEL MEAGHER JR. i" 97 EMERALD LN .r MARSTONSMILL,MA 02648 Admioistratar `' } �lussuchusctts - D clr►rtrncnt of Puhlic Suft t� 9 Board of Buildnm" Regulations and Standards Construction Supervisor License _ License: CS. 102260 "--777 Restricted to: 00 JL MICHAEL MEAGHER JR 97 EMERALD LANE MARSTONS MILLS, MA 02648 Expiration: 1115/2012 f T r#: 102260 t nnuuiasiwcr , License or registration valid for individul use only before the expiration dale. If found return to: Board of Building R lations an tandards One Ashburton Pl `e Rm 130 Boston,Ma.0� 9 8 wy r — N valid withoa si t � � ponce b'1 o N qugowl �} �! som 7 —mm"Wot ,ate ,u�Y R CADDY G/o�JQART m Vt i T• tv Qj slool f } t C,C, g / i7fD SET FM f o g d.etkme nn a n�d � " lliffY g n FM as naa M r SAIZA TAME REGISTRY 0� DEED�v BARNS _ ". gi - - �f- a - �. .. /fOt7/1!3 ;a Meadow u. �- /1017/N4 �. o 3 N 1 TO BE 4. •�' � REuolfn � m ft Y / FR,yE U11FI11/G Pry"'d 1"t �ll r LPL ��/�! F m �_ s 19VI.20,w 58Iiv5'37•'� a te-= /1017AC - 263�..91_ S.lL --iv �' pots S aide ::-- MIX . . SHAPE FACTOR 16.1fL 587 � Ir l A cotwt fu ' 0 1 ll .3 °11EIlA1C o¢ ? I I M/6 ' N n I N o m. cABOT ,W to 34• 00 SDO-tz' Cg 10_ZY FNO. o / 79.526 9.;tfL uplord / T \ - .HARRIET R CABOT. o 4.747 aaR.reHmd / o •'4 C.B.\ .%FIDUCIARY CA E ¢ . ao _ 1.93.oces totol . SET N a, CAr $ 0 0� :'V �• Fjy2�i o � ' a R/0. ,�' . . SET - CIL - - im- .O r flagged f - �S� gib 1t F �etland� � _gyp`.. � � � � � iS7? •"� $ C.B.. po F71D.A �� IL } S15-zi,05^w AL WrA CEL - AL&AL co =�o� ci Q�J C�• O . �A 2p!� xa t "G 11�?k(� SAL__---- . 6'2d"G� BARNSTABLE REGISTRY OF DEEDS sr� JA a> to 0.�)-nw�- - � yl . auuvsi'ns� - The Town of Barnstable '�" . �' Regulatory Services e E1 Thomas F. Geller,Director Building Division Elbert UIshoeffer, Building Commissioner 367 Main Street.Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion. improvement.removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence of building be done by registered contractors.with certain exceptions,along with other requirements. O Type of Work: Estimated Cost i Address of Work: UI T - Owner's Name: C Date of Application: c�3 I hereby certify tiiat: Registration is not required for the following reason(s): []Work excluded by law []Job Under$1,000 []Building not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby appI a ermit as the age f the owner. 3 Date Contractor Name Registration No. 31z3 OR Date Owner's Name q:forms:Affidav Jio CLM App.ma 1 TabL.LZ2.2b(aoaaa� Prarripdre PszkaM for 06 and Twe-Fsmidy R=Wgmdd Ecildla Jff,,d with Focal Faso 8'I&wduM I 11fmmuM ai= 8 tllaaag Ceilia8 waII 11loar g Slab Ke�ayt:miia3 Arm'(K) U-vim R v:lrr� &-"d el Rrvatue� wau Plana= &vi' 3"1 to 690 Hndnw Deem D&W Q 12% I 0.40 I 3E 13 19 10 I 6 I Normai R 12% OM I 30 19 19 10 I 6 I N S I=. I 0s0 3E 13 19 10 I 6 I IU AF UE T 13% 036 3E 13 21 WA ( WA ( Norms! U 12T p 46 3E 19 19 10 I 6 I Norma! v Iri. 0.44 3a 13 1 21 WA I WA CAME w 13% 1 dM 30 19 19 1 10 I 6 u AFUE X IE%. I 032 3E 13 25 1 WA WA I Norma! Y IE•/. i 0A2 3E 19 25 1 MIA 1 WA I Normsl Z 18% 1 0.42 31 13 19 10 I 6 I 90 AFUE AA IE7. 1 d5a ( 30 19 19 10 I 6 I 90 AFETE 1. ADDRE. S OF PROPERTY: PLJ (� 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL G —A=G: 4. %GLAZING AREA(#3 DIVIDED BY#2): S. SELECT PACKAGE(Q AA-see char above): U jj NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK.US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: for=4990303u 780 CMR Appendix J Footnotes to Table J5.2.Ib: Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skvlights, and basement windows if located in walls that enclose conditioned space, but excluding opaque doors) to the gross wall area, expressed as a percentage. Up to 1%of the total glazing area may be excluded from the U-value requirement. For example,3 ill of decorative glass may be excluded from a building design with 300 R=of glazing area. 'After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for whole units: center-of-glass U-values cannot be used ' The ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness over the exterior walls without compression, R 30 insulation may be substituted for R-38 insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing(if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the root 'Wall R-values represent the sum of the wall cavity instilatian plus insulating sheathing (if used). Do not include exterior siding, structural sheathing,and interior drywall.For example,an R-19 requirement could be met EITHER by R-19 cavity insulation OR R 13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-frame or mass(concrete,mas to wall constructions,but do not apply to metal-name const ruction. 'The floor requirements apply to floors over umconditioned spaces(such as unconditioned crawlspaces, basements, or garages).Floors over outside air must meet the ceiling requirements. `The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned basements must be included with the outer glaring. Basement doors must meet the door U-value requirement described in Note b. 'The R-value requirements are for unheated slabs.Add an additional R 2 for heated slabs. ' If the building utilizes electric resistance heating use compliance approach 3, 4, or S. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package. 'For Heating Degree Day requirements of the closest city or town see Table J5.2.I a NOTES: a) Glazing areas and U-values arc maximum acceptable levels. Insulation R values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b) Opaque doors in the building envelope must have a U-value no greater than 035. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c) If a ceiling, wall, floor,basement wall,slab-edge, or crawl space wall component includes two or more areas with different insulation levels, the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing or door`components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(035 for doors). ESTIMATED PROJECT COST WORKSHEET LIVING SPACE Value (high end construction) square feet X$115/sq. foot= (above average construction) square feet X$96/sq. foot= (average construction) square feet X$57/sq. foot= GARAGE (UNFINISHED) square feet VS25/sq. foot= PORCH square feet X$20/sq. foot DECK square feet X$15/sq. foot= OTHER square feet X$??/sq. foot= Total Estimated Project Value e66 f � 0 U-7—&I l T 7` 3.o a� � s os , t ne LOmmonweaWl of Massachusetts y' Department o�'Indttstrial Accidents - - 600 Washington Street Boston,Mass. 02111 Workers' Compensation Insurance davit nam 5 4!� location: M/25 testy ❑ I am a homcaw=p �g all wc&�� hone# I am a sole wom etor and have no one is an9 caaacitr ❑ I am an empiover dmg easatioafor ..�. � on this 'ob. ..:......:•;::K{},.};a>•i::'•::.:::.::...:iC•.v... vv.:. ...vv V:t�?:K:Yr?OS•}v+?:?:::, .v... � �i{;C6{}}}:.v::•^•;.}hnti•{.}.::r::.tis.t...y.}ti::'C.i'•:•}7: v:::v.:: '.:':..::,;..:.. tOTIID8DY'flIIlaC:'.' ,..,,.c»1.:,•,.:•.i;..." p`:4�rny:}• r r �a� :<h32�?�`r� } s < +�<o>i .. . ..........: ............. ............ ... ...:.:::n:•:::.::::.... :.. ti;•:::ti}n}}}}:{v:t-.^'iv:��+:�\.':.?:i{{a". .v.:{'i:":;{rCdth�:i;•.,v.:v..:::::r ..........,;. ....^.::v:{rtix:: •}}:::.:.......:. ..:.•. :.,,:•.::.......?.�?:.'!.}v.;Lt:t}nn,3:J:::....w.{:•)iMl+xiNk .. •.?.+.3....?..?...... ......{i:••:.:'.:.:;?:...;.. .. ...... ...:................x:v;......,;.;.:..,..r.::.:.. .ti,., .a, ...;... :v.v;:.... .:.•., :v:.:;}.}},v,:?w.-:/:M.}:p}h\: .: .....::.v:•:.v:n:v....... ';.}?v.?.:{..,............ :.,••.+ h..r ....:.v..:...::::.Yi}v::v :,i:.vi�i}:i::' .wv:....::••?:.: :•i::4:::{i4:.:.4:?}+y:+}}\:+i:;.}:•:i•:J,.::n.,.;.... .........,..... {. ,\a TK•}?•a:•.[ :,: .auvin,i{.. :.......:.}::}};:?.K{w:':`i:j:?:•.::v.:::v:.�..:::.:i4::::•::::.: tiNAMU.CKb ): { {::.v::.:v:::,-.:,,•.i{•:.iy,},:•:¢ri:x-.s:;:•:::,.:, . ,.....�:-:•.:..;.:... .a:"."-;)^.yv., ,;:..:..;;n}:.}}•:.i::•.�:-.�:.'�•.-�-.•.':r:{:k?�ck. .{yixn}{•.v.•;x.%.;yhe%:,;:..: �t :.�::.:....:...?�4.,av:::.;.• ......::•iv•v .+ ...,•a+':'^i!:iW".: ...nr'• :{h '....ySy4•': {ti{{iIXOy.Kr.M!.'%dFA�}.0,,;.,._.'•:;:a<'•i'.:,�n-.•v'nw?};+''}:vC: i<i'+i.','%2ivi%ii? ::::: ••.{i. ?K?M:.i:.�..:i�•�,'F..::`:i::iw �ti:{aS... .:.::.v.+:•}>::}:.\r�iij:?is4i'C;,Y::}ti.{;•}r::;:})+`:tiK.;:{..n:;..n ��+� .. '' .. :• ;av: nMK�.v\.'�`�y\Ati1.. ...%h7:•�`,�; :•:• ... . ram '::::::J::?:'�''.?:::.................... K*., .: ..,.nX�P: •.:::r•.X4¢;'::,y'{•{;•::x;.;:.•.}U{ti;• -..........:........:.;.... .,..... .,,,-:r:�,...... . { < .. , K :-.r}: .:x+�!�+::::rk+xM1rrh::,ir:.}•.,:.w�:•A,�„�.-.�.,,:i+'.<,a:•,:::.-.n,::.,.. :?•:::;;.;.;.Y:::...,::::..:,:•.Y a:: ;::.: y:: .::.`:a:aNas<::::?:}}•:ua?oq?c: KG00 bY : •S?oA:�... ky;.; .:,::,•:i<o}:a::,-.: ?a:;.:::;.,;;-;.;;.: rti...Y. :..,.+C•.ti�R. *•.-•.<. •w.ti�.�ox< � ,t•:2s:s%wj� _ rxu }:ytt2C'2�..'....::...t .•::.::� !}':•-{:•+�':::. •...:.:.,+P}+ : •ax+'vi'iN,"•,"}:tii:.{;.,+yn jQltt!'�ttR''t:Q� •..:.... ,:::ff..: .:....v.<{}• oa: [:?'-:•}:?va}:y.T+,•+:?Mtiifiii, ❑ I am a sole esor,gene:-aI cpati-actor,oar hommwnes.(mrde one)and hm hired the cm===as".b� have the following wo�cers' cam;easazina polices,. ........,Y,,. .:.:::�.:.,:•::.::•::::::::•.,..ti.... .......... :+.;;,..,..:?0+:ra .;'.;:..,-.:..fi.. ,'`.'.•}�n: .�-?ti::::.:.vr7�F.};. .i4: „-.aw:.:: . . ..... ... .............:::r+}.^:.;':w.a:;:;:..1........,. .Sv.:h:v:: +,'K' .: ��^.,:•.u.;.au•:;{{:KY iC' .. ... vm:!?v:4+::..::,Zk'•�(.�.:aY-,..:: +.:....,:•:,d. }.:; ,.,.. .....fi .. ..}}J:,Y.P{:;�?.'•:.};r{r;::�{w D ..:.:k.......:,�,••,.•.,::a,..:.:.,,.;.;�.,w,:.?'`t'•w{.•}Taxrh?io-';' a�S'°°° :psy' ,oyox{{;'�,.?,cft':'n. t.h. :::•,;�k;::;:;�::a:�}'••�i;;:£:::":':::'•=::_: ....... v::•:.:v::•. .h.. ... .,'M:�Q?:;:v::`:tih .OM?l!0?QQ??:.?., •KM?:'^S.it{{:+.KVii«' :...w h.....h.,Y:.r,.:..:...........zw��.•:. +ra ........ .....au. xx;':••s>•.Y}}•{::�otit!ea,�.• .:.:.,: •::.,,�:.Y:::::,hy✓r::::}.:Y... :. :. ............... . .... .:2?`.�.`'2�dcet44 :i ,iR3 . ...: :::r:iy::;::;?`• :,M1:c;::"""}}..r:`: :.::;-. .:................., .:............•:::::::•::.,.j;{«::r}r.},;s..y.;.};a•..`�}}}»�•x•:{,.:?};r ..• .,.:.........r.:R-. .+.v..kw�.`± .'• }} ;.,`w��,n3•..,a••:r;:.;ir':�.:;;;•}.+:;.. adds >:{{ :..{::«?.}•:;..}:;{« }:Y:« ' . t �"^��{.: iN r ._v,}: '•_;: n >:::?::::.... .:.....-..:-::::.. "<'03K�3'�obcoaKa}„ Y:Y» �• Ica^^^`^ .::;.s:::-:-: :;•;:•::}:;•:?;:?:..n:,,,a..x•?;.>..++�+.KyPi>:t;:;i}•••.kcs„ .a+ . ::rt :..::..... . . ..- ,^^.:+�mwa•' •;.,}:•::.}:.};.; vmv::::::.::..?;.xv.Y{: n.n;}.'i.}ri�,<w:<GJL{•?:�:::v:{v;n,, .....::,,:::•:{.,}::tiry:.:.•.:.:,::{:t�?w+'�,:.?:.,¢,:}i.:•.,:',''�•Mw.�' .avRa�1,J � .. ••+ ,,�r�<u d •.: ".fix,. ::•.. ,�.x. , �....:;-:o:::::,�::::;:::�.:•::•.�}:;s::-.;•......:.;.:rv:•:.::.:,.;::;}::�i•:.s;sip:.. .. .:.. . .:�:.�:.....,............. ..;...}}wc�,a;J�s�a.:..hvw}}:•h •.:Y'.:.�.....: , :+•.J�k2?aFi2:s.3.�:....,::rx;k•:;;:aY::•KiroaY:. ..q+;�.•.?�.'•�tii�a:�;a'.C�w','�':�c S:v::��:�:t;:'_ ............ ....:�. .:.,:•.::........... ,.,;••Y••:hk ... ..F•'ii:�:;:!:w:{•'?'.Qaq:::<'• r y;•• ...h+c<r»tta+}..::-:.;..;.;. .::......................:•:•:•:,Yves.:•:}::.�:•:~::r.Yr` '..,...,,.:.:••:?•.... .; a,x'..,F$4k!?N?QQta:'??Q.:• .. ,�,Jx'R ................... .............i..:::....... tin.•:::;r.:+>:=:�i:2.'f+n.':•.}?;;}a<::•.,Y:,,• ... .,•:-� :, ,.. ;•�:>c4.+;:'?::;ra�+::;:::.: :�:�:'•:.: C[JiffDHTiV118TflC'..:.:�::..:.:a«�e.,,..., ... .ti..,Y...... .........r..;.yvA°•°-�•.:••..$��d :•;T': };�xaYa:t.�Y}:{.;i};{•?:•;�:>::;-::•:;.;.:.;.;:: ..:::.,....,}.:.,;:?�c;:,::<::••:'{:t:•;.>.+,+rrtrrria\v:o�.?YcmR?�:^.? b ��o�O'�Yb '.... '.'..LoJD'. }`v:Yi!xririiRx«}.w.Y}::;:s?riv:`•,;sag:::.: :::::::::;:_ :.... ..,:.:::;.::hY::.•:.:..a.,,,.; ?..;,;.Y: i::: ,.:};{:ti ,:MiMY. ... .>;..,..;;.::;rw.:?x•,•_•+?::,,;,}:;;.Y.;:x. ;...:..: '?ti :2;;:,.•;Ki£�.:,....,;..,:., :`Yiiw.ra-:14�,$C??• •.} _ :RSic?R•. .„i4o}7ii;::vx;:::;>`::%;> ::;:;:;;:;:, .,,•.;.,.. .......... .,.;..;,., ' ...teu;.Y•i}:" '9Y:..cu`''.,i''c�.':c�000n.::{,K,.'<;a::oMaicck:};%aa'o:wfw:::c:'ty".�:.. addzrYr.. .... ..:.; .:. ..... _ :•:•. :<..?�... �}r:;�:a£<�'•`}�"`. 'ZvY ank�:,,.i;,;:>:�<:r�'>:<�:i��'�»:r�::::: ..:}. ..........^.M ,Y:Y3cexoo}}..:•: oyes,, Y:; x•.:,^:::. •,. ::..wxNus}::•: ?.:.:.:;:�:;:.:. :.Y :• "fit:...•..A:h+?h::,•....:..Y::..............:.............> ..:.:,...:.....::..,:.....::.:::......,.. ,,.:... .,.;.- ..,.:r4' :• ��''`.: .. a' :;° s°'""" ?. :'.:;Near??k,'+eh'Uo.:c2:;.Y2:i:::2;::2•:;.i::;:::;:::::;:::::;:;:::: «,.. ;:::- }:x;;,..,; .::.......:\.•:•:..h, h: .,:.}. :gabs OI ..:.::,...;..:::•. .::;.;:::.,::;...,....,r....:: r.,:,.: .:r•.a::::•r•:..•r. .K.:t�Ey; •}} ;•:�}};�' y„L,.x ..:K?.:'-....' ,..t-...•+.•;,M}±??:•:{•s•r.::�:::::;;•:;•:•::::•.; };. <t:.}... ,, ,.#.....?bK' "`•:{•h•::. x.r. Kva�r;'� m000aa.?M:: M ,,.:.¢-}°'4Ks;•x}f;{.t;+ai:is:+ . ........................................:..L......?}Y........ :.r.. .•.::,,x.n nh..... +}}?ti<{:•:«inK•ti.}}%J.::YSO!<:Kir::.-:.�::.:...:: r.....:w.:Y::v::::•.:w.fi5:::•::.v::.a:•ti:iiY.-0KOKi, v+{,w .�`,'+"c.'....y:•::}ni+:n., .............::::v::::............:...................................:::.:::.-:::....�::::::..::r.,w:..v:.,,K-}};.�:::J•}}:a;...{}aY�i.{i.:::.v•.:vv:::n::n:vv:::::.............K. ..........,..:.:.:.... :.... .. .. .::•:::........:.h:.......... ...... .ha { �';S';K: ,:.:,.-.;m•� ......:r.;::xii;:�:::;:::i>»w'z:�i-;ii:>:;:;:>:-:�:,.. .. .... ...... u..{...:W::M,y,,:?rtiv:?.:.:.4 k^.':•+:;{,;{:x ... yam.., y: .:. '.. ..: h4a,.,.,.�,. k'.'a??C}}:{:{?^:i{{:+x i{<{<•}:<::Jii!?•i}: }i iii:4::::is+w QIIIT'�tf['C•L"o.. ..';.Y:.Y:.Y.�-:.v:.Y:::.�:.,::.::::.................?\,.,...,.:'�`�P`^M2.a•,v...b OB...Ii}'({}�,..,. ... w.. �•:.;$C,Yp:Y;,��00�00PCtL?CY.Y,A,Ni4iiv�!:S:}:ii::w'viJiJi�vi?:::: Pails a co.eca a covemp m regmvd—.i Sado =ofMM,M=Imd to tbt �m��gmaitiaa of a Bess up to$L��=. oos vein'ImPtdmsum m TmA as dell pmattlse in the form of a ffM WG=DEMB"a fta otSIOQ 00 a day artimt zm I=dzrrtaad cop?ofthbrtatemeatnmybeforwardedto the Ommoflar ofUwM&toroowaazevaimztioo. I do it rrchy ccrri r Pubu and allies of erjrrry[het the iutjormatio�e provided abovie is nerd co Signs Date Pr...t name A ( -- Phcne# - o in ri-I use oniT do not write in this area to be compieted by t>citycr fawn omdat dtT or to", OBuildlat DepatQaE1 J check if Immediate response is required c3gdseaam a OiIIu OHraJth DcPwvacnt contsct person: phone — (2 w 1 1 II 1 1 • 11 1 11 / • • • • • •11 • 1 �/Iol• • w1 (SADA9111104 - • • • ol• • • •1• • • • • • • Otto • 1 J / • •1 •• • is 4 of • • •J: • • 1/ •111 w•1 • .11 • 1• • U • I •r. • «11 Y.•• ..� • • • .••ol• • • • • old so - so • I• .•MN • •..1 OII 1• • • /1 N1/«• .11 • •••11 • • •1• •11 U • 1 / ••1•. •1/ • • • I •• • •• • •11 • J • •/• • • •• •. of • •• I I 1 • •�••:II •1 Mt «•/1• • ' 11-•11 • •_«•/_• 1• • .1• «•II• •-41 M 1 1 1 / 1 1 .•' 1 • ' • 1 • •1 I / • • Y11 r 1 1 / 1 • 1 M I 1 I 1 �. 1/ 1 , 1• I, • , / / • 1 : 1 • 1 r' 1 , 11 • 1 too 11 1 1 r" 1 • • •• 1••1•- I • 1••./ • / 1 / •• .•• • IA .• 1• •r 1 ••/ ' Y •1. V, I w•II�/ 1111• .11 •••1.1■ - 1.1 • •�1 ••1•. • • • • • •. Io/• • • • • •1•r•• .•, ' UI •• 1, Ift..1 _• •1/ �•,•.w1 U. •1 1 MI .•• Iy • • • • N • • • •Ht• •/• go OPOSIG . • A • • • - / •.• U1 w•1 •1 I •11 Y••% •.« •w,1� I.1 .••IIIJ••H✓.1. •I/ •1 1• /••:•, « •.• ..�: .� 1 • 11 •1 :// 1 • ' • 11 .1 •, .,• • v.,• •11 1.1 •••11 • �..• •• 1 • .11 ' , 1 w • •1• •1.1 • • 1 " • _ 1• •••IIIY •� . • 1 111 •1••1• •y • ,1 MI I •r 1 � A 6�_fojomq old • • •t. • •• •' ' IA •• • •••••�• • •• ••• .•• •1• .1•• •• .• ••����////��������"�������������������////LG�/weLLLG�%//��,��cU//.� �L(LLG�GGLGLG�G�GGGjiG%/ 1 1 /0 11 1 1 1 1 1 all 1 1 1 1 • I A 1 1 1 I 1 1 1 1 . 11 �., 44 A" Awm jr ( , ! �,."—►s .T I NO 9lWt FACTbt ►6.t -- -- - � o ! l 4T' ,� I N aa., 4C. 1111c w > ` t N pe571licl a N 4 �9� m] g 79.526 9%R. wb+i ��\ NARfMET+t C,ABOT 4,747 %fL wNsW ` O 41 CB\ c/o rvt1G7AR7 TRUST Ca a g 1.93 oerac tvtd� SET Std/4iT C.£. CA FM, !� s a N 4 �► -_-- 9p77)Uz1'1Y - �'.Ti v �` = ♦ e 1b. AL A AL 7C b. $ GS AL &AL—. . � l 315Z�'Off1i N' moo, COOT no. /O { er A; d G Cr,n� -- - �P MlV�:1� � 6lbi. �•��1�It� tl 1�l�y __._...... —_ _.- ' _. .— _17/. HONE INPROVENENT CONTRACTOR Registration: 104246 Expiration: 7113102 Type: OBA THONGS R. NORSE REMODELING Thomas Norse aoMINIS7RAT0 � 393 Lakeshore Or i Sandwich NA 02563 GTE BOARD OF BUILDING REGULATIONS' ; License:'CONSTRUCTION SUPERVISOR r Number. CS 009474 Birthdate 0&Wl957 _ Expires 6il2 001 Tr.no: 4905 _ ;Restricted To: 00 THOMAS R MORSE _ 393 LAKESHORE DR` SANDWICH; MA 02563 r % AdfniniZt or The Commonwealth of Massachusetts —••� Department of Industrial Accidents " �° ' � �= _= OfBceoflo�esdgadoos 600 Washington Street r -_ Boston,Mass. 02111 - workers' Com ensation Insurance Affidavit name: � �( location- hone city ❑ I am a homeowner performing all work mvsel£ Allow"J, am a sole Proprietor and have no one ing in anv capacity /%%///%/// //%l0 � y'" %/ // %/G/vll/,%G ''/ //// /// Gi, ir�"%�//////////O//////M����� %//OT//�///////%////O/%�i, workers ensation for my employees woriang}on this job. as 1 prcmding CO P....::::.:::.:.,_:::: .:::::::::.::::::.:.::::::::::::::::.:::::::::::::::::::::::::;::;:?.> ?;< I am emP.o9ef.....:.::.:::.::.:::::::::::::::.:::::....:.:::::.::::.::,.. .:..:::: ::::.::::::::..:::.:::.:::.:::....::::.:::::::::::.:.. :.:..,:::.:::.::::. :::::::::::::.:....::::::::::.::: ::.:..::.::.:.::::::.... ....... anv Hero `s`:: ..........:::.....,:::;:.; .::.;.:::.::.:.::::... .............::..::..:.:::::::::...................::::::::::.... .......:. . ;:. erne .. ......:......:,.....:.:::..::::::::......:...::::.-. # . am a sole proprietor, tmerai contractor, o homeowner(circle one)and have hired in the contractors listed below who have olices: workers ..,::.:.....:::::::, :.::::.::::::.}?.:;.:>:->:.;.;..}:.:?.;:.}?.}:.::.:;:...:.:.....:???-::: :.....«<: >:::;;:::?:;<:>}:;;«.;:.:?.;;:.;: folio comp...................p.::::.:::::::::::.::::.. . .::.::::.:... . ::. the :::?.:}:<?.:.:::.::.::::..}:}:::?.}};;:.;:::}}}}:.::.::::?:.::.::.::::.;:.}:.}:}}:;.}:.}}:.:.:?;?.::::.:::.}:<.::.:} .......::.::.:.::.:..... ................::.:.... ;. x ......... ......... ........ . . .... ... . . ....... ter. ..:.:r...:: .::.:,:::::.}':::.}':::::.�.�:::.::::::::::::::::..?.:}..}}.. ............::.. tttttlre .......?..:.... .... ..'fin.. .. .... .. r:x.... ... hi.:::::..,..•... w::.,:,}.•}' .........r ......... ....... v-v,x,• r. .. rxwxr ...... .:.......... v::::. :..:::•. �.;.;:}: :.. .............. ............ ....... rib. ...... .r..... �x .........nn......•r:•:... .... ... :.... •• 'i.:}}..... _ .::.._:.....-: .:.......:.:.. ...:......:::........:•::.�:::.... .....::::::::::•>�•?:••:::>:•::i>::i•:i iSiir:::ii:::i:::?:;:�}:�:;:ii::•>:?:iii:•i ii:•xr••�:,•' :.:::�-:iii-•}:�::t�:.�:., .............,..:....:,......... ... .... ... ..... ................ ..:•::::.....h...;v•.v::• w::::::.,...:::0+:????•::..............:•.v::.•::!?•}%?•}::a:. :nH......;?}ik.::i::v::}:nw::::?... ..... ... ... , ..... .......:::::::nw:::•• ... x...... ...... ..... ...r .. ......:....v..n..r Y...r.. ..x:?v:.v:{•}::yi:?i?¢::¢:v.}:?•i:..:n..y:::.:vit:wv-.}vw:,:.,-...::.�::::: ........ ......... ....n::• ...............\..........::v.:.............r::v:.}::::nw::rn.. ..Y.-1v:t:.:4:vx{::::•.- ..:v...:..:............... ??q,}}r.:::.}`:?•:�:•}:::v.v :::.....,.:.;0.....vn-L•}}}YY}}:bi:-i}}:-}}:::v:.v::::::a:•{•�?•$}:?•.v::•:v??•}Y:.},'•:?:�:•}:rw{??:4::��::•.:????:^:.:::....::.. o,��• .. ` $:: Y ::+S5: :::::::::i:%:+.ii::r:t: ::::: 5: :::2:::r:: ::::::::::: %;::<:;:r:::'•::::::::'•:%:ii '%:iifiii: >::;::;;. ;rater ..... X. ........... .. .. "n .:............... 0 ........................................ ................ ................................. lieu 0 under Section 25A of MQ.152 can lead to the imposition of criminal penaltie+of a fiat;np to S1,S00.00 and/or Fanare to secros coverage required one yam,imprisonment as wen as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I m derstand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify lhepains and penalties ofp9d7W that the information provided above is trtr�and eorrcd `� Date q Sigaatnre Print name Phone# ,�1����l9 i r ly do notwrite in this area to be completed by city ortown oiScialpermitNcwe# - QBuiiding Deparbnent ❑See e t mg$oani response b tared ❑Sdectrnen'a Office ❑dheckif immediate respo req . ❑Health Department contact person: phone#; ❑Other (terued 9/95 P1N 1 - 1 :11 - 1 . q • •1/ • �11111 • a . . . . - , • . Ilt•:11 .1• •11 • 1- a/1 . . . . �. . •111 11 - 1 L / . .�•1/�. � •�1 •11 1/ 1 :/ . 1. 1:1 11 .a 1 - •1.1• 1 - w••• . 11/1• - . • w(MP41111 • r r • - . 1�• 1 1 / • • •1 A • • •M • •II • •• .0 • 1 • .11 It.• • • /1• 1 - • • • 11 • �11 • - • 1 • 11 �111 - • JI• 11 • / • 1 •Y. • .� �1/1✓•1• • •:• �•: �/ itlu• • • 11 �/ . • 1 / • •1 • •1�1 1 1• •M • •11 • • 1�1 �•Y. a11.1 • �•111• • t/ ' �•111• • • • �/ 11 � • ' 1 ti • / • 1 • 1• 1 11 • 1 • /1 • 1 1 1 .1• •11�111•. 1 • 1 • �Y • r 1 •I 4111 • 11• .111 • 11 1 ` I 11 ' 1 • • 1 • 1�/ 1• :1111• • •�•1 •11 • • • 11 111 :11 1 Y- •II • 1 • •II •1 • ••11, •11 1 / 1 • I II • 1 •lb k(wilefiffell /1 •J • 11•• • fill[. • • • ofa4fjffm,1f11•)($ill II N11 / • • 1 �••1/1• • 1 • :i • •11 • Y.1/:� 11 .1 1 I I V I :11 I � 1 1 1 1 1 1 I Y" 1 1 - 1 1 • 1 1 • 1 : 1 1 1 1 1 II 1 1 1 I 1 1 1 1 :./ 1 :.1 / 1 1• •11 I 1 �111\-1 1/ •11 11 •II • �'% 1 1 • 1 • (/. •• 1• Y✓. 1 1 r •11 / M111�1 111 • 1 Y•111\ 1• 11 •:/ • •11 .11 • • 1 1 ••• .. 1.1■ • Y. • •:.11 •1 Y•1111• 1 111 11 11 11 1 V" i• 111 �1/ �1111. • 111 MI / /:•1 1 /��•1 • �111�• • 11 Y•111• •11 1 7Iy 11 11 • .. :1 V•Iltl•�/ Y:1• •11 . .\ • . I Y•11/1• :+I' 1 • 1 � .•11 • /1 • •/' 11 .1 .11 / • 11 YI\1 .1• •11 .11 • • • 11 • •I111• .11 1 .111 1 1 .11 1 1 1 •II \11111 •�1 •II • 11/ Y:q •►• W.11 • II 1 .11 I •/ / 1K 11 • 11 1• • • 1 1 - • •11.+11 •) 1 111 •. M •=•11♦ •1 Y•I11.1.11 .1• •II •I 11 11 .11 Y' Y• •:1 •� 1 1 I 1 V :JI 0 U 1 1 1 I .. 1 I 1 • 1 1 1 :1./111 �• 1• 11 MI �I •1 • '• 1 II .1 /I - .11 1 W.1• •II •I 11 •-1.1111 •1 V�.1 • - 11 • �• �• I 1 11 1 - • .1It .. .•11 • 1 111 •. - « •ti111. 11 • I • • • I I 1 - .11 • 1 1 ^ • •11 .••Y• uu • // .• L• • • Bill to ' U•.•ti V•I111•�•/ Y:1\ •11 • • 1 1 11 1 �1 .1 111 �•11 .t /1 111111 \ .•1 -ILI 1 • • 1 1 1 1 1 �: • 1 II •1 /1 •/ • 1 Y11111• �./- .11 1 1111111�/ ..•I 1 1 1 1 \11:•/1 1 / • 1 �1 / v .1 /1 • • 1 •I11 • . ...• •y • • .•y I Ire)11 11 11 :»11 11 , .1 Y- • 1 =. • 1 .12 •II 1 all •%111 r 1 1 • .1 11 it - •�1•II11 .•1 111111 • :1 • 1 1 I / �1 :+1�/ ..1 1111/1 1�1 1 ■. • 11. 11 1 - •11.1�• 11 1 • /11 N11 • • 11 •I 111 • 11:.1 • .11 • �111 �•11►. 1 •�-,1 11✓. 1 al 1 i. • 1 • •Y.0 •11 • 1 • 11 1 • 1 • .tl Y • • 1 •• 1�1 .1• •II 1 • 1 • 1 • / .11 1 1 • •1 �����j��/�jj��j/���j�j�jj 1 1 • •11�111 • • w, r • / •11 .11 / GY it 111 1�1 1 1 111 1 1 1 1 1 1 1 1 1 1 1 1 1 I I I 1 1 11 1 pF THE Tpy,. The Town of Barnstable MxivsenBU& MAS& �0 Department of Health Safety and Environmental Services 1659. �Eo +A Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 t Building Commissioner Permit no.— Date— AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the`reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. a V Type of Work: 1 �1. Estimated Cost o� �"'�C�a`���'Vy� T �1 Address of Work: R 9'�� 1/1�YY�- �/`� l C�"tv►"P" Owner's Name: l./ ►V Aj RAJ S l-P, Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded bylaw . . MJob Under$1,000 []Building not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent a owner: (ed. Date Contractor Name Registration No. OR Date Owner's Name q:forras:Affidav 16 'aO 1!,:-:14 AFIEI=I c_:AH Pi IOLS TEL 50 6-O 7 92 P. 1 AMERICAN GON11 E POOLS, RI REG NO.217 A DIVISION OF AMERICAN SWIMMING POOLS, CORP. CT REG NO.HICOOSEA299 e • 540 ARCAnr AVENUE (CORNER TAUNTON AVENUE) MA REG NO. 100284 SEEKONK, MASSACHUSETTS 02771 •-••-•'••"•' TEL.(508) 336.7577 FAX (508) 336-8792 ESTIMATE FOR SWIMMING POOL NAME 7twL wJPI't� IrJ�11 /L rL"�.1 L'/ DATiw -f� MAIL ADDRESS CITY _ __. ._..,._._. n _ PHONE�'-tl JOB ADDRESS t� /'�/`I>�6►3 l /1�� COJU _ ✓a- _ POOL SIZE X YO Ott DEPTH S 6`r TO VY _,SHAPE= <"I f19�1G,Ul� CONSTRUCTION SPECIFICATIONS: 1. Contractor's engineered structural plans and specifications for pool. . . . . . . . . . . . . . . . . . . . . . . . . . . Included 2. Contractor's plans showing layout of pool . . , . . . . . , . . . . . . . . . . . . . . . . . , . . . . , . . . . . , Included 3. Contractor to lay out pool before excavation (approved by owner) . . . . . . . . . . . . . . . . . . . . . . . . . . . . Included 4. Excavation of pool and removal of soil , • . , • • • . . . . . . . . . . • • • • • • • • • . , . . Included 5. Contractor to hand form and shape pool. . . . . . . . . . . . . . . . . . . . • . ..• . . . . . . . • • . • • • • • • • • . • . • . Included 6. Engineered steel reinforcing throughout pool structure : . . . . . . . . . . . . . . . . . . . . . . . Included 7. Engineered concrete,gunite structure to meet or exceed city or county codes, Owner to water cure concrete-gunite shell and fill pool after plaster. . . . . . . . . . . . . . . . . : . . , . .. . . Included -"-- a. One f'band-waterline tile; .- American Custom Tile 7- Other Tile n Size & Color. �y /34- c610$07y. . . . . . . . Included 9. Deluxe safety grip coping . 14OMf. . rl Cantilevel Deck Apron . /10)-!0 . . I-1 , . . . . . . . . , . . . 10. One set of shallow end steps . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . , . . . . . . . . . . . . . . . . . Included 11. Interior finish to be waterproof Marblelte plaster . . . . . .k/ft lK. . . . . . . . . . . . . . . . . . • . • . . . . , , . Included 12, Three to six man pIr eter crew (had troweled) . . . . . . . :: . . . . . . . . . . . . . . . . . . . . . . . . . . . . Included 13. Clean up after each phase of construction , . . , . . . . . . . . . . . . . . . • • • • • . • • • • • • . • • . . Included 14, Supervision of construction . . , . . . . , . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Included FILTER EQUIPMENT SPECIFICATIONS: 15. Approved Deluxe American Filter ►'1'j-331D . . - - • • • • • , . . . . • • • . . • . . . . Included 16.Weatherproof pump and motor with hair and lint strainer � `��}_ �j P . . . . • . . . . . Included 17. Complete hook-up of all water lines from filter to pool. . . . . . . . . . . . . . . . . . . . . . . . . . . Included PL.UM61NO SPECIFICATIONS: 18. Plumbing,non-corrosive type, including face piping. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Included 19. Skimmer with self adjusting weir a�, . . . . . . . . . . . . . . . • . . . , . . . . . . . • . Included 20. Pressure return lines -:n; included 21. Concrete pad for pool equipment . , . . - ' -- , , . . , . . • . . . . . . . . . Included 22. Main drain receptacle with grate�-- t� ` • . . . . . . Included 23. Lest basket In skimmer chamber . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . Included 24. Waste Water Disposal r!ipFitting on Filter, rl Irrigation, r1 Drywall, O Sewer, I7 By Others MISCELLANEOUS SPECIFICATIONS: 25. American diving board Size 26• American Ladder No. _____,_Model No. Swimout f>t✓ 27. Approved Marine Cite, 500 watt,heavy duty construction . . . . , . . . . . . . . . . . . . . . . . . .. . . . . . . . . Included 28. Approved deck box . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., , . . , , . . , . . . . . . . . . included 29. Deluxe Cleaning Tools, includes 18"Nylon Brush, Hand Skimmer, 16' Pole . . . . . . . . . . . :. . . . . . . . . Included 30. Instruction on pool equipment and maintenance procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . Included 31. Initial chemical dosage and water treatment Instruction . . . . . . . . . . . . . . . . . . . . Included 32. Public liability And workmen's compensation insurance . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . IncIU4ad 33. Pro e y damage negligence Insurance to pool during construction . . . . . . . . . . . . . . . . . . . . . . . . . . . Included 3V nl _ . =- esic - ,7 -B Pnai PF16 f7t7wt'rd!_, OPTIONS: 1. Heater type IC Model No. 4f� �.� STU rating 017d PDX. , . . . , . .a�,O,Q fV O 2. Waterlines connected to heater by Contractor . . . . . . : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Included 3, Heater and gas permit jgtn Gas Llne 0Uip41?A L.F., venting of heater , 4. Pool Valet In Floor Cleaning System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 Polaris Vac Sweep. . . . . . . . . . . . . . I :QO Kreepy Krauly . . . . . , . 5. Chlorinator . . . . . . . . . . . . . . . . . . . . . . . . • • . • . - 6. American Pool Sias- Model No. 7. Winter Swimming Pool Cover . . . . .L-CU F . . . .�. . .C�fTp.r"-t . ,!' 7.FS.�t. . . . . . . . J S. SPA- Size r iotdt7 MP O o v DO 9. Handrail 71k-0v� due, 1MION 161r^rOp V omvinoxuiea� ��.aaa�rc/u�ae� BOARD OF BUILDING REGULATIONS' License:CONSTRUCTION SUPERVISOR Number: CS -- 009474 _ B�rthdate•,08f22/f957 _ .. Tr.no: 4905 y Rristed'To: o0 THOMAS R.MORSE 3` 393 I.AKESHORE DR - SANDWICH, MA 02563 Administrator; OME'IMP OVE ENT TAC OR r. - r L. S'an ch��Q256 z ���Je e: l I' p (Cis --Nis C) 7� _ ;-o t/-N Duj. yl_� I t /u� v�A` TOWN OF BARNSTABLE BUILDING PERMIT I PARCEL ID 036 044 001 GEOBASE ID 42946 ADDRESS 49 PUTNAM AVENUE PHONE ZIP - LOT BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT CT PERMIT 41202 DESCRIPTION SIDE/DECK/REMODEL/PART DEMO/REBLD SEWPT#8243� PERMIT TYPE BREMOD TITLE RESIDENTIAL ALT/CONY CONTRACTORS: MORSE, THOMAS Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: $124.00 DIME BOND $.00 CONSTRUCTION COSTS $40,000.00 434 RESID ADD/ALT/CONY 1 PRIVATE P t STABLE, +' MASS. �► 1639. �0 Ep�l 6 BUILDING DIV BY DATE ISSUED 09/21/1999 EXPIRATION DATE I e . TOWN OF BARNSTA�LE BUILDING PERMIT PARCEL ID 036 044 001 GEOBASE ID 42946 ADDRESS 49 PUTNAM AVENUE PHONE ZIP - LOT BLOCK 4 �, LOT SIZE DBA DEVELOPMENT. DISTRICT CT PERMIT 41202 DESCRIPTION SIDE/DECK/REMODEL/PART DEMO/REBLD SEWPT08243, PERMIT TYPE BREMOD TITLE RESIDENTIAL ALT/CONY CONTRACTORS: MORSE, THOMAS Department of Health, Safety ARCHITECTS: r` and Environmental Services TOTAL FEES: $124.00/ SINE 1q�, BOND $.00, � Qi► I CONSTRUCTION COSTS $40,000.00 434 RESID ADD/ALT/CONV 1 PRIVATE P STABLE, 1639. ED Mp/A -_ BUILDING DIVI M& BY DATE. ISSUED 09/21/1999 EXPIRATI TE 4 r J TOWN OP' rn.A.RI STABLE BUILDING PERMIT PARCEL ID 036 044 001 GEOBASE ID 42946 j ADDRESS 49 PUT.NAM AVENUE PHONE711E k. LOT inwC K LOT SIZE DLA DEVELOPMENT.1 `` DI.STRIO`T PERMIT 41202 DESCRIPTION SIDE/DFdK/RFMaDEL/PART ENO/R BLD S0,PTa1524& PERMIT• TYPE BREMOD TITLE RESIDENTIAL AL`C/CON T CONTRACTORS: MORSE, TH7MA8 Department of.Health, Safety AR.CH.ITCTS: and Environmental Services TOTTYAyyL FEES: .124.00 p1r� lli�l:i.J .$'.(}I CONSTRUCTION COSTS $40Y000.00 * a 434 REBID ADD/ALT/CONV PRIVATE R srABi.E; MASS. ` BUILDING DIV LION BY DATE ISSUED 09/21/1999 EXP:IRA`PIPN A ATE .000 I r 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.;Obbt,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAYBE OBTAINED�FFiOMTHE 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 FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND 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). t 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 APPROVA S PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS V'`e4 f 0ck+ 2 2 2 Q1. :ts. 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 BOARD OF HEALTH OTHER: SITE PLAN REVIEW APPROVAL. 6 WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVEDTHE 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. . BUILDING PERMIT i5:1\ .._ The Commonwealth of Massachusetts F _= -- Department of Industrial Accidents Office ofl�esdooffoos . t 600 Washington Sheet � ; Boston,Mass. 02111 . Workers' Compensation Insurance Affidavit name: location: 14J--e-1 . U�/V �CC, — ci 1 .r �` hone# I' V . ❑ I a homeowner performing all work myself. . I am a sole rietor and have no one worli>s in env achy ❑ I am an employer providing workers' compensation for my employees working on this job. COIDp8nY n .. »<>»> - `Sig ii'`i i:i i%i i ii_ ::'ii i:i : ....: F•:??::;;.; •. .;:.:::•:::::::r.:...•;::::•::•::;;;: address.:: .. :..::.:... . .......... „...... .; ;:::>r:.;;;::;::.:.:.::.,::: .:; is <'::'f:;it%%:<i::::::<:miiO"le i 7:-":'i:i::%::::::;;:;:> i;i;:;i c;;?::;;r;:: i::i%?.i:i ';:::::.:::'r...=: tits . :.....: :....:. ::::.;:: . > < i .,:..::..:. :.::.:;:.;;:.;:.;:.::.;:::.;:: al Cv �M 4� insurance ."....:;: :.:::,::;.;.:::: ....... . ::... :::::;>::;;:::;::;;;:.>:<::, :::>::>:::.::. ::..;.;>;;:;;;:....;;:>:;;;:::: I am a sole proprietor, eral contractor,or homeowner(circle one)and have hired the contractors listed below who the following workers' co ensation policesr n cumoanvgm- ; :y:S«`'z> <z [': ' j : ' i t ti `�- - : :::a i>::2>:: i<::::>� :%'?i?=±i= 'i 2i ;<<����� 2'i ':: .....i< '`:i'` i r i<i±i5addres _............._........ ......_... ..... . . _ . __................:.::......:::::::............::::.:::.....::::.................................... :............................................................................... ::::.......................::::::::::.::::.:::::::::.::::::::::::::::::::::::::.":.::::.::::::::::::.::.:::.::::;::::::::::.::.;;::...................................... ...........:::.�:•..............:•::.:::::•.:::.................:.....:..:.:..:•::::::.:. ..................... .....................................................�.�::•:::::.'�:.:�r•::.}. ... :::::::::::.........:......................... .......... ............................................................:::::::::::::::::::.... :.....................:.....:..:...........:....:..;.,.......::::;::::::::::::..;..:•::::•:..:.::.. ......:.....:..........:............b one y.,. ....:::.:::::.:: ........::::.::%; .............................. � .. .. ... ........ .........: .................. ............ ,r;...:� :•:::.::::::::::::::::::::::.�:::::::::...................... .................. .......................................:...................:...........:..............................................................................................:....... ......., .....,....... campsny>name:..:<:::::<....:..... ;:- «. ...... :......<.-::. .:.. ::.:.. :::.,"'. :::.:::.: ::.:::.::•::. address: :d:::.: ::.:::.:::.:.::........::.:::.:.::..::::::...:::.... ...::.::..:...:.:.:.:..:::..............:.::.::.:::.::::.:::.::................. City' .. :;Fy:;;'::::: ::<FFi:`::::1. ::F::i:%:: :;F::FF:;%•::>:�::•r:::::•::•>::;?;:FF:;>;:::Fr'R;:::F:,::,:::::::F;F:;::;:;::;:::�:•::;::::•:�::•::•::-r::;::. ::::i:F: '' �/ gaflnre to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verincation I do hereby c fy tainy and penalties of perjury that he information provided above is&W.and co ed ki PDate �� �qY - Signature l ! — Print name d �S A ® Phone# 7i�—� �_ offidal use only do not write in this area to be completed by city or town offidal City or town: permiWcense# ❑Building Department ❑Licensing Board ❑check if Lnmedlats response i,required ❑Sehxhnen's Office ❑Health Department contact person: phone#; ❑Other Devised 9195 PIA) - . II Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual, partnership, association, corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. ' MGL chapter 152 section 25 also states that every state or 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 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. r, Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits 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. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided'a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the piii i llicense mimber which will be used as a reference number. The affidavits may be retaziR io 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. . The Department's address,telephone and fax number The Commonwealth Of Massachusetts Department of Industrial Accidents Office of luesugadons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 eat. 406, 409 or 375 �VEr The Town of Barnstable LMWffABM �m� Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 f ` ' Office: 508-8624038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. ! Type of Work: Estimated Cost c GZ Address of Work:__ � pcJ A.1 oQry 1 q� Owner's Name: a! b/9/l�j�J 04k)W. Date of Application: q. 0 \ I hereby certify that: Registration is not required for the following.reason(s): Work excluded by law Job Under$1,000 Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply permit as the age of the owner: 'Y1�1 l o y Date Contractor Name Registration No, OR Date Owner's Name q:fortns:Affidav Y ",V^�nsiea.-.' 'a�Tw.�-c.+.w.T^.�.rw+'fw,.t• �-r� �� �,�(aaoadEuaella y IMzr PROVEMENT CONTRACTOR Registrat>.on 104296t r TyPe = OBA ry'} j EzPiration 07/13a 00 �; THOMAS R MORSE REMODELING X's Thon. as R ..Morse Lakeshore Or j c gpM1N1DR Sandwich MA`02563 F ;Jfte L/pp�ryNNNZIOCQU/L ���[ZC/tU4P,�b BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number..,CS 009474 Birthdate: 08/22/1957 Ekpires:08i=001 Tr.no: 4905 RwWctedTo: 00 � THOMAS R MORSE" 393 LAKESHORE DR G.��•a► SANDWICH, MA 02563 Administrator r` � HOME IMPROVEMENT CONTRACTORS REGISTRATION Board of Building Regulations and Standards One Ashburton Place - Room 1301 Boston, Massachusetts 02108 | IMPROVEMENT CONTRACTOR strat ion 100740 Expiration 0b/23/94 - PRIVATE CORPORATION] HOME IMPROVEMENT CONTRACTOR Registration 100740 Capi zz i Home Improvement , Inc . ' Type - PRIVATE CORPORATION Thomas Capi zz i , Sr . Expiration 86/23/94 1645 Newton Rd. Cotuit MA 02635 50uu Homo {mpmvemeA/ loc Thomas Capbu/ S/. — 1645 Newton Rd. '----- ("m/t »^ N/ux5 ' � � � � . | ' | � . ' � ' ` . / Assessor's office(1st Floor): Assessor's map and lot number /V ® f<l. _ , � wP�at:TNIt>o`. Conservation Board of Health(3rd floor): Sewage Permit number lira»� ru& Engineering Department Ord floor): �o o639. \�a° House number tIto NO 6' Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2-00 P.M.only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO �^� TYPE OF CONSTRUCTION �-- G 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location Proposed Use Zoning District Fire District Name of Owner LE- Address /U i iI/�i9 ot7/�� OZl,4�j Name of Builder AddressZ6 IS—ALVAa),61 �,— Name of Architect Address Number of Rooms Foundation Exterior Roofin— Floors Interior Heating Plumbing Fireplace Approximate Cost 5 C C Area Diagram of Lot and Building with Dimensions Fee ®, OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the ve construction. Name 442e6wrA Construction Supervisor's License OS�Z1 Z- HINK.LE, SALLY No 35258 Permit For Re-ROOF '7� r Sirigle Family dwelling _Location 49 Putnam Avenue , Cotuit Owner I Sally Hinkle Type of Construction Frame ? u. r Plot Lot I I I r J Permit Granted August 6•, ' 19 92 Date of Inspection 19 Date Completed 17 19 • 4 : . � � � it � -