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HomeMy WebLinkAbout0726 PUTNAM AVENUE 72(o S�v a,� •��� . t i °I L2,1/y --1 pUtHETp� Town of Barnstable *Permit# Expires 6 months from issue date &UMSTABLE, : Regulatory Services Fee O v Mnsa i639. ♦� Thomas F.Geiler,Director �A � 'F01A0'`A Building Division Peter F.DiMatteo, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Q / Not Valid without Red X-Press Imprint Map/parcel Number ©✓� ©�/ Property Address 76 IOUIWAM kO-. (;T ,(?—. f7_(ov,5 Residential Value of Work Owner's Name&Address lTJRAJ� XO-A-0 VJ lLL-1A#4,S Contractor's Name VJILdAk&-L k�. EVeFP_cK r Telephone Number.5h _&6q_7"Z, Home Improvement Contractor License#(if applicable) j7 Q94 7Z_ Construction Supervisor's License#(if applicable) [gWorkman's Compensation Insurance Check one: ❑ I am a sole proprietor OCT 2 1' 2014 I am the Homeowner I have Worker's Compensation Insurance 'T iTh"�i OF BARNS LE Insurance Company Name Workman's Comp.Policy# �lll�Of�C,•3�� Permit Request(check box) ❑ Re-roof(stripping old shingles) ❑Re-roof(not stripping. Going over existing layers of roof) Re-side Replacement Windows. U-Value 0.30 (maximum.44) ❑ Other(specify) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. Signature Q:Forms:expmtrg Revised121901 The Commonwealth of Massachusetts ( Print Form • Department of Industrial Accidents UV Office of Investigations 1 Congress$&eet;:Suite 100 Boston, MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly r �p Name(Business/Organization/Individual)' X11,4,t4re-f 7 , G jeI t'%'T Address: City/State/Zip: l��/Il� ©Z6 -5 'Phone 9:.�� Z2f�—ZQO9 . Q�3G�7OZ . Are you an employer?Check the appropriate box: Type of I)r®tact(Y'egnil'ed): 4. L am a general contractor and I 1. I am a emploN er with l ❑ - 6.:❑New construction employees(full and/or part-time):* have hired the sub-contractors 2:0 I.am a sole proprietor or partner- These on the attached,sheet. 7. 0 Remodeling Th - n r h `,. ese sub co tracto s a e shipand no employees 8. ❑Demolition P _ , working for me in.any capacity. employees and have wort ers 9: 0 Building addition [No workers'comp.insurance comp. insurance.+: required. ? ❑ We are a corporation and its' . ME]Electrical repairs or additions 0 q officers have exercised their 11. Plumbing repairs or additions �. I am a homeowner doing all work ❑ myself. o workers' comp. right of exemption per MGL P 12.0 Roof repairs insurance required.]t c. 152, §1(4), and_we.hai-eno Wcuao employees. [No workers' lip® Other comp. insurance required:] An applicant that checks box#1 must also fill out the section below showing their workers''com compensation policy information. Y PP g P im Y 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 a 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 nF employees. Below is the policy and job site information. Insurance Company Name:. Policy#or Self-ins.Lic. #: QI I«oZ-D,3[y Expiration Date 3 —.3' Job Site Address: ZA& ' PL�7X'/,*`l` �'• City/State/Zip: ` l 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 criininal penalties of a fine up to$1,500.00 and/or one-year imprisonment,:as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that-a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi ,under the airs and penalties o e 'ug that the information provided above is true and correct. - - - Si!nature: Phone#: " 11-28-7$PC9 Official use only. Do not write in this:area,to be completed by city or town official City or Town: Permit/License# Issuing Authority°(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical.Inspector.5.Plumbing Inspector G.Other: - Contact Person: Phone o: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'.compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership, association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterpnse,.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." M 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 constiuct buildings in the,commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor,any,of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,.are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required.'Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly.' Tlie.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. ln'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 calla The Department's address,telephone:amd fax number: The Commonwealth of Massachusetts � . . Department of Industrial Accidents i... Office of Investigations 1 Congress Street, Suite 100 Boston,MA 02 l 14-2017: Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Revised 7-2010 Fax 4 617=727-7.749 www.mass.gov7dia t ACORD CERTIFICATE OF LIABILITY INSURANCE 1 DATE (M D/�) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Arllt r D.Calfbe Iroffance Agency,Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR wvmcalfeeinsi-ance com ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 336 Gifford StnBet FalmDlgh MA 02540 INSURERS AFFORDING COVERAGE NAIC# INSURED WllliainT.Everitt INSURER A Arbella Protec don Insurance CO P.O.BOX 1340 INSURER B: INSURER C: Cohat MA02635-1340 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRADD` POLICY EFFECTIVE POLICY EXPIRATION POLICY NUMBER LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,OKOK A - NCOM MERCIAL GENERAL LIABILITY 850OM14 0301=14 03/31/2015 DAMAGE TO RENTED $100,000: CLAIMS MADE a OCCUR MED EXP An one person) $5,000. PERSONAL&ADV INJURY $1,10MA . GENERAL AGGREGATE $2A00,0w GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ZOMO . X POLICY AFrT PRO- LOC AUTOMOBILE LIABILITY A COMBINED ANY AUTO 102000M 03 09►3Q►2014 09►30/2015 (Ea acc ident)SINGLE LIMIT $ ALL OW NED AUTOS BODILY INJURY $2%0K X SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $5�, NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $2,O. (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION AND W C STATU X OTH- A EMPLOYERS'LIABILITY 9111620314 0313'Ii2014 03131/20'15 q 50M ANY PROPRIETOR/PARTNER/EXECUTNE E.L.EACH ACCIDENT $ %om OFFICER/MEMBER EXCLUDED? Yes E.L.DISEASE-EA EMPLOYE $500,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $5001000 OTHER k DESCRIPTION OF OPERATIONS/LOCATIONS[VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS QFMIhy-Genera Contractor Will Bm tt IS excluded Under converage far W xkers C Tpensahork CERTIFICATE HOLDER CANCELLATION eff�,,,� SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Jam Jo and`1 Wiliam DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN 7Z PUtwm Ave NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR C01"t+MAOM5 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE O ACORD 25(2001/08) IIWCOM CORPORATION 1988 U Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-012955 WILLIAM T EVENT 4._ PO BOX 1340 3 ; COTIJIT MA 02635 Expiration Commissioner 03/17/2016 (021e l 1.11J7lOWe'ealfll a�C/flri��ac�n�e/L3 Office of Consumer Affairs&Business Regulation License or registration valid for individul use only its #OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: registration• t7g992 _ Type: Office of Consumer Affairs and Business Regulation Expiration: .,.9/29/2016 Individual 10 Park Plaza-Suite 5170 Boston,MA 02116 WILLIAM T.EVERITT WILLIAM EVERITT 155 RIVER RIDGE DR: MARSTONS MILLS,MA 02648 Undersecretary Not valid without signature oFTHE Ipw Town of Barnstable �T Regulatory Services WXNnABLE, t y MASS. �► Thomas F.Geiler,Director 1639. �plED MA'S A,� Building.Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, JVAK3 w I1_1' lA M 5 , as Owner of the subject property hereby authorize- ]I LLt kA —C'. >�V�K l to act on my behalf, in all rnattets relative to work authorized by this building permit. (Address of Job) Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. i Si e of Owner Signature of Applicant ./ ilAlli JOAA) Pont Name Print Name Date QTORM&OWNERPERMISSIONPOOLS 6/2012 Town of Barnstable *Permit# Expires 6montlisfrom issue date Regulatory.Services Fee Thomas T.Geiler,Director Building.Division . -7R ESS PERMIT Tom Perry,CBO, Building Commissioner AUG _ 5 2010 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us TOWN OF BARNST,A6LE Office: 508-862-4038 Fax: 508-790-6230 ENS TRESS PERMIT APPLICATION - RESIDENT7A.L ONLY ' Not Valid without Red X-Press Imprint Map/parcel Number Q al Property Address d I k ► m -AV & 4� 1 W : �esidenttial Value of Work ) C "Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address r-Te c `d TOM tot I �`IAMB Contractor's Name V �IVL7C-� CW �. Telephone Number Q '4eq Home Improvement Contractor License#(if applicable) I � . Construction Supervisor's License#(if applicable) q. F(J ❑Workman's Compensation Insurance Chec one: Ef�i am a sole proprietor ❑ I am the Homeowner 1 have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) Ef Re-ro.of(stripping old shingles) All construction debris will be taken to ❑`Re-roof(not stripping. Going over existing layers of rooi7 ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximurn.44) s 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc: ***Note: Prop Own r t si Property Owner Letter of Permission. c py of th o e Imp vement Contractors License is required. SIGNATURE; Q:Forms:expmtrg Revise061306 of1HET ti Town of Barnstable, h . .� Regulatory Services . - + 33X NSTAWZ. y MAC $ Thomas F. Geiler,Director 1639 Building Division Tom Perry, Building Commissioner ' 200 Main street Hyannis,NIA 02601 "'w.town.b arnstabl e.ma.us Office: 508-862AO3 8 Fax: 508--790-6230 Property Owner Must CoMplete and Sign This Section If Using .A.Builder . �, C'�r�.rd..c,�► I l l cans - . &Fu-� as.der of the subject propertyherebyauthorize Q Q_S to act on my behalf, in all matters relative to.work authorized by this building permit.application for: ricma m Ave, (Address of Job) ignature of Owner Date • Cif �i��Gt.�YI S _ . : Print Name Q:FOR.MS:OWNERPERMIS SION f - ' The Commonweatth ofMassachusetts ' ,Department oflndustriarAccidents Office of.l"nvesti'gations 600 Washington Street a Boston,.f 02111 ` www.rn ass gov/dim Workers' Compensation Insurance,Affidavit: guilders/Contractors/Electdcians/Plumbers Applicant Information Please Print Le 'bI Name(Business/Orgaaization/hdividual):• J�j�(1� •Address: •�• X �� City/State/Z p, �n�!S fl O�OQ #: Phone Are you an employer.' Check the appropriate box: 1.❑ I am a employer with 4. ❑ I am a general contractor and I Type of project(required): Ployees (full and/orpart,time).* have hired the sub-contractors 6, 0 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, 0 Demolition working for me in any capacity, employees and have workers' [No workers' comp.insurance comp.insurance,$ 9• [l Building addition required.] 5. [] We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 1 L El Plumbing repairs or additions anyselL [No workers' comp. right bf exemption per MGL insurance required.]t c. 152, §1(4),and we have no: 12, oof repairs employees, [No workers' . •13.❑ Other comp,insurance required] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additionalshect sbowing the name of the sub-contractors and state whether or not tbose en tics have employees. If the sub-contractors lave employees,they must providt:their workers'comp,policy nurnbcr.lam an employer that is providing Workers'compensation insurance information. ..for my employees 'Below isyhe policy and job site. Insurance Company Name: Policy#or Self-ins.Lic,#: Expiration Date: lob 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 tip 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$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the CIA fo insurance covers e verification, I do hereby c r the painsrflenaties ofperjurythattheinformationprovidedabov is ue and carrecSignature; • �a Date: Phone'#: Official use only..Do not write 1n•th aarea,'fo le completed by city or town offciaz City or Town: Permit/License# Issuing Authority(circle one): X.Board of Health 2,$uildingDepartment 3. Ciiy/Town CIerk 4.Electrical Inspector S.Plumbin:Ins:pector. 0. Other Contact Person: Phone#: u B Iat < , aa��ol�l�'�P ic3 ng`�fe ]o� License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 124310 Board of Building Regulations and Standards --- Expiration: 6/1/2011 Tr# 284683 One Ashburton Place Rm 1301 Boston,Ma.02108 Type: Individual James Curley James Curley 287 Fuller Rd. Centerville,MA 02632 Administrator "���1ot valid without signature .. . - Department o'Public Safety •�•• Nlussuchutiettti 1 1 Board of Buildin Regrulations and Standards: .� M Construction Supervisor Specialty License License: CS SL 99138 Restricted-to: RF,1NS AMES CURLEY I 287 FULLER ROAD CENTERVILLE, MA 02632 Expiration: 1/28/2012 (limmissiuner' Tr#: 99138 Board.of Building Regulations and Standards License or registration valid for individuI use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:. Registcati6n-1.24310 Board of Building Regulations and Standards Expiration 6"j1/2009 Tr# 130873 One Ashburton Place Rm 1301 T :e�=ln;dividual Boston,Ma.02108 Yp James Curley James Curley 287 Fuller Rd. o Centerville,MA 02632 Administrator Not valid without 'b ure r • TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �� Parcel 8/ Application,# 6 6 ``(q 00 Health Division Date Issued Conservation Division ,Application Fee �0 Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board 0`G Historic - OKH Preservation / Hyannis Project Street Address Village Owner �f'��Lr CSC//��/� Address ��7'�i')�i��✓� - ' v�7� Telephone D �P— - 2//E Permit Request `)1 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay �. Project Valuation Construction Type Lot Size / Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family. .C�' Two Family ❑ Multi-Family (# units) ' 'v Age of Existing Structure Historic House: ❑Yes 3014o On Old King's Highway; ❑Yes ZNo ) t r 4a Basement Type: d Full ❑ Crawl ❑Walkout ❑Other -=A Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) ` �.a �3 Number of Baths: Full: existing new ® Half: existing d new m- Number of Bedrooms: existing G new p Total Room Count (not including baths): existing L) new First Floor Room Count cl Heat Type and Fuel: 2 Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes G o Fireplaces: Existing New Existing wood/coal stove: ❑Yes 61"No Detached garage: ❑ existing 0 new size—Pool: ❑existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: �9'eAsting ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes a4o If yes, site plan review# 1 Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number Address :Z' 6 License # (_ a -w% f 0 - Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE f DATE Lc2Y1110 L l l ` FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP./PARCEL NO. f r ADDRESS VILLAGE OWNER ' . r DATE OF INSPECTION: ` s FOUNDATION FRAME oK ! o R 7 INSULATION s FIREPLACE ELECTRICAL: ROUGH FINAL a' PLUMBING: ROUGH FINAL GAS: j^=i - ROUGH ;r} FINAL A:IFJNAL BUILD.ING:. -- - —_ f _ DATE CLOSED OUT �C ASSOCIATION PLAN NO. } c The Commonwealth oflMMassachitsetts r _ Department of Industrial Accidents 0 ce oflnvestigations 600 Washington Street e MIN g ;jo Boston, MA 02111 www.mass.gov/dia -Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers A : licant Information PIease Print .Le ibl 1Jarie (Business/Organization/Individual); ,C Kc) A-dlress: 1 C1.y 9 Ale-1 C i tl/State/Zip: Phone #: Ar-e tou an employer?Check the appropriate box: Type of project(required): 1.❑ 1 am a employer with 4. 0 I am a general contractor and I tmployees (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.1 7• l W�emodeling ship and have no employees These sub-contractors have 8. D Demolition Working'for in any capacity. workers.' comp, insurance. 9.,0 Building addition No workers' comp.insurance 5. ,❑ We are a corporation and its �/nquired.] officers have exercised their 10.0 Electrical repairs or additions 3. -1� Iam a homeowner doing all work right of exemptiomper MGL 11.0 Plumbing repairs or additions myself. [No workers'cramp.. c. 152, §1(4), and we have no 12.0 Roof repairs insurance required.] t employees. [No workers' comp. insurance required.] 13.❑Other "Any appIivant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowters who submit this affidavit indicating they are doing all work and then hire outside contractors-must submit a new affidavit indicating such. $Contractor that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees: Below is.the policy and job site information. Insurance Company Name: Policy #or Self--ins. Ltc. #: r Expiration Date: Job Site Address: 'y �' z0abx?, Al � � 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 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 ofthe DIA for insurance coverage verification. 'I do hereby certi! ender 1h a s enalties of perjury that the information provided abo e is true and correct. Si f nature:'. Date: Phone#: FC1 e only. Do not write,in this area,to be completed by city or town offccial.. n: Permit/L,icense# hority(circle one): Health 2. Building Department 3. City/Town Clerk. 4. Electrical Inspector 5, Plumbing Inspector son: Phone#: a Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. lursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, txpress or implied, oral or written." ,In 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 nceiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the aNner of 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 h g or on the grounds pp e ds 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 ofa license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7)states "Neither the commonwealth nor any of its political subdivisions shall enter into-any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have.been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s) name(s),address(es)and phone number(s) along with their certificate(s) of insurance, Limited Liability Companies (LLC)or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured,companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the penmitllicense 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-MAS.SAFE Fax # 617-727-7749 Revised 5-26-05 www.mass.gov/dia Town of Barnstable Regulatory Services t KAM 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 HOMEOWNER LICENSE EXEMPTION Please Print DATE: �L JOB LOCATI N: /ry !� GZ v e— 7161 number strget village Q ``HOMEOWNER': ��f"GZ��4 (/'� Ll/d�—S �D O " name home phone# work phone# U CURRENT MAILING ADDRESS: city/town state zip code i 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 rsigned"homeowner" rtifies that he/she understands the Town of Barnstable Building Department minimum inspection pr es r u d that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." . Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the pemut 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. z C:\Users\decollik\AppData\Local\Mrcrosoft\Windows\Temporary Internet Files\Content.Outlook\D_ DV87AAZ\E)KPRESS.doc Revised 072110 ' 016' P" ve tea, s _ -----�---- Ex;s4t 3 O Cil 146 13 . � l 3 � 0 - r CARBON MONOXIDE ALARMS S MUST BE INSTALLED PER MASSACHUSETTS BUILDING CODE a .......... ��i ��� � . _ . ��� - ,, �! . . �, c� ��' �° �' cry` .. �.. . � ���. --� '� Assessor's office(1st Floor): p SEPTIC SYMM MUST SE YME Assessor's map and lot number INSTALLM No Board Health(3rd floor): _.�/�i/6 •� Z p�/ VM�5 Sewagea Permit number l 0 I 1V6RCW AL CODE p BASd9foDLL. Engineering Department(3rd floor): rasa House number T,OWN REGULAMO S ;° i639- e� Definitive Plan Approved by Planning Board 19 o war d. 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 ol, Q-, TYPE OF CONSTRUCTION (0- 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to a following information- Location �- Proposed Use Zoning District s Fire District e Name of Owner Address Z 9r �, Name of Builder u Address 3�1 f i t W)' W Name of Architect Address Number of Rooms _ Foundation Exterior �'- Roofing Floors Interior Heating � Plumbing t Fireplace q*� Approximate Cost �b, a Area 1,0 V Diagram of Lot and Building with Dimensions Fee �' Q OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ' NaMeZ Construction S pervisor's License r WILLIAMS, GERALD No 33063 Permit For ADDITION Single Family dwelling r' Location- Lot 32, Ptii-nam Avenue Cotuit Owner Gerald Williams Type of Construction Frame Plot Lot Permit Granted July 13 , 19 89 ' Date of Inspection 19 Date Completed �/ 19 iM1' (rtit !oil � r M , jig s) f.i +` , i TOWN OF BARNSTABLE Permit No. ------ --399_---- Building Inspector sansrun Cash X OCCUPANCY PERMIT Bond No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to V. D. Whynott & L. P. McGratlAddress Box 238, South Yarmouth, 14A lot #2A 726 Putnam Avonue,. Cotuit Wiring Inspector Inspection date,���,� Plumbing Inspectort/ a Inspection date Gras Inspector / A i'j Inspection date eEngineering Department �/ f� , ,�,.� / � Inspection date,,��Q THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. 13 ............. 19....�i . �� ....................... .: !.. ..�....... _. _..... 1 � Building Inspector Al /loon it 48 �,rvimu ��.3 SPA; 3 S Altn - 75 V ,: 4 3 47• ,� F� S3 ' 8 F. �oT Z a o03lo wf THGMAS E.k;ELLEY CO.ENGINEERS-SURVEYORS Gz-� 346 LONG POND DRIVE ��ad /� �-"�/ 7 SOUTH 1'AR?vfouTlI, MASS. Co�� Ole4T.02664 CERTIFIED PLOT PLAN J zK orP��N ss LOCATION 14J!7,,. .4,./1�S . :. . . ... t� Q THOMAS e e '"� °. rya SCALE . �. .=..30. . . DATE . . .� q 4 KEU PLAN REFERENCE . Z4!L,.STES 0 SURV�� � 9o�F GJST6 6�,IF. / . . . . . . . . . . . .o ,. . . . . . . . . SHOWN ON THIS PLAN IS LOCATED ON T E OUND AS SHOWN HEREON AND THAT IT COFORMS TO THE [�,ra•�/p,� - E ,f �a SETB U T TOWN OF HEN CONSTRUCT DATE . . x PETITIONER: `! +� TOP OF FOUNDATION CONCRETE COVER CONCRETE COVERS 0 4' CAST IRON 12,MAX. - 12"MAX. PIPE (OR 4ORANGEBURG(OR EQUIV.) EQUIV.)— IN. PIPE- MIN. LEAPH PITCH 1/4"PER. PITCH 1/4 PER.FT PIT PRECAST o' NVERZ, a LEACHING ` e EL.. lob INVERT INVERT n . Q t` PIT OR SEPTIC TANK z3 DI ST. • w EQUIV. INVERT EL F. . . . BOX EL. 9 - Q .. GAL. INV T a v' :-v. 3/41'TO 11/2 /�D� ELQO� INVERT w o �. o EL �o �: WASHED w o ° STONE • � " WDIA • . , �p� IA. IV6 PROFI LE OF GROUND WATER TABLE SEWAGE DISPOSAL SYSTEM /G 4c' NO SCALE ,,��// SOIL LOG WITNESSED BY . DATE/.7//U,Zl:f//f g TIME.14 'Kf7 BOARD OF HEALTH TEST. HOLE I TEST HOLE 2 ENGINEER ELEV. �..5SS-m,7 -> LEV. — . . . . . "}OpDCb '" DESIGN DATA NUMBER OF BEDROOMS! see So1L _ . . . . . . TOTAL ESTIMATED FLOW . J� � . . . GALLONS/DAY BOTTOM LEACHING AREA SQ.FT. /PIT SIDE LEACHING AREA SQ.FT./ PIT ¢g•' C�oi�/i7- 1�11�D GARBAGE DISPOSAL (50% AREA INCREASE) 11/.71lub ; TOTAL LEACHING AREA .�2�?l.•.Q� SQ.FT / PERCOLATION RATE . . . . l K/ . . . . .. MIN/INCH / LEACHING AREA PER PERCOLATION RATED/ P. SQ.FT. /(/.D. .WATER ENCOUNTERED NUMBER OF LEACHING P TS APPROVED . . . . . . _ . . BOARD OF HEALTH DATE . : . . . . . . AGENT OR INSPECTOR THOMAS E.KELLEY CO. ENGINEERS-SURVEYORS 346 LONG POND DRIVE SOUTH YARMOUTH,MASS. �X, M�S'S f� ��TC'KEIL � �- y Ko.24246 /S7E PETITIONER �� �� �/r S�0NAlt n +�z F T F TOWN OF BARNSTABLE OH Tab OFFICE OF i BAHD9TSBL MnaR : BOARD OF HEALTH y pj i639 a`�0 397 MAIN STREET '0'Fa Nor • HYANNIS, MASS. 02601 To : Building Inspector From: Health Department Subject: Test hole and Percolation Test A examination of the soil at Lot) :Address) ( Village) was made on found to be ; (date) suitable for sub-surface sewaget at site of test hole. Building Permit will not be approved or sewage permit issued until Health Department receives two copies of plan showing building, sewage systems and all other details listed in Board of Health instructions to sewage applicants. This approval does not constitute a final decision concerning the installation of a sewage system. All State and local Health regulations. apply to final approval. -stit - (Signature) _ 6 6/20/75 s'f 14 Lyl L c �- A 1 (00. 00 - 3 I w J 4 2.5 > J N Z O 47- 22, 003 5. F. - 151.43 + ' Z L_ OT � l 0t THOMAS yG I or THOMAS s 9 S E. I j ;lo KELL � No.2 i . ,f CERTIFIED PLOT PLAN 0 90 G/s �P ,�``� �F�IST oe Cc r V. FSS�ONAI s aJ� LOCATIONI , _ SCALE . !. . 3.Q . . . DATE ! PLAN REFERENCE .`?NC?CJt) (�� .L�QT THOMAS E. KELLEY CO. LAND SURVEYORS 346 LONG POND DRIVE i SOUTH YARMOUTH, MASS. 02664 . . I ! I CERTIFY THAT THE 1-0Vl'Q .\q�o^! S-iOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON AND THAT IT CONFORMS TO I THE ZONING LAWS OF THE TOWN OF W �•-D REALTY TRUST laN9-u -aiA,l-L HEN sT /UCTE . 5`70 M AIO S TREGT , 29, 1�16 i DATE . �c.�l . . . , PETITIONER : H ' nA �'1 1 S • MA;S • RE . LA SURv 12R THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) m A , I / �C(�'-J L DATA • q. L•"� !� Yt h 1 ♦. �l 1.� r .� ��t � r` � I ` - } ' ' I 1 �J ti:'� �;� � iijr,^-� ilrl: I ) k JIf ! 7 L J r• l� �. ... J< <,J `it �J\..��L� �..1 J J `/ L.J U i `. `� .. .. .. _1_. •� L �J ... _..� 1\1 4� L A}sesso�'s map and lot nu e�............................:.............. ' BE F7NEt o Sewage Permit number ...7......... . .............+........................ INS T ALLED li"J COMPLIANCE � /�_ WITH ARTICLE II STATE 4 2 BJBHSTABLE. House number ....................,.......... .... Y�........................... SANITA i CODE ANC TOWN 9°o Mb 9.�`0� 01GU ONS. -_ - O Mix TOWN OF BARNSTABLE BUILDING -I1SPE�CT® R APPLICATION FOR PERMIT TO .?: rF > �. ! � TYPE OF CONSTRUCTION ....... .......... r..2 . .................................................I9. X TO THE INSPECTOR OF BUILDINGS: The undersigned, hereby applies fora permit according to the following formation: Location .... ... c..4 :....�t.�._.'V A�1�!1 ..�.............I .......�.t...........:.. . Proposed Use ..........!; -��1. r N �..�.. '� — - - ......... . ....... .............................................................................................I......................... ZoningDistrict ........................................................................Fire District ......... . ..i ........................:................... Name of Owner .. .: P,. ��! '.............................Address ..... -3' .. ....... .:..1•A'�l ./fit� u -- Nameof Builder .........�.A-(`'A.�........................................Address .................................................................................... Nameof Architect .............2....................................................... Address .................................................................................... l Number of Rooms ..................................................................Foundation ....... ..... ..... W10 .a1+t r.)�"�.............................Roofing t� ' �'�Exterior ...................:............................. ...........�................................................................ Floors ...... ...................................... .`....�`? ... M,;r .C.?L�...e�-.........Interior .51 T(Lcs�' Heating - g... .......... t--.....................................Plumbin I)V C ................................ Fireplace ................ . . .............................................................Approximate Cost ... ,�~.1,O®�............................ Definitive Plan Approved by Planning Board _________19 L. Area l.. ..................... Diagram of Lot and Building with Dimensions .....Fee /........................................ SUBJECT TO APPROVAL OF BOARD OF HEALTH DONd - I hereby agree to conform to all the Rules and Regulations of the Town of Barnsta le regarding the above construction. L �+ Name .. ............::::::::::..... ...............�.... .. .. .. �. ` ^ � ' _ � ` .�2O590—. permit --.���. ' . . single family dwelling —.—.—^—.—.`--',..—.—~---. , v Locoti n '......���q��..������..! . � ---.----..C..����..—.------.------. � ' Ovvne, ..........V:..D,.. ..&..L�..P... � Type ofConstruction -----..f)VA0Q.............. � -----.--.------.-----------. � ^ - Plot ............................ Lod ............ ................ ` . � ' e��er l9 Permit Granted �" ..lg 78 ^ � Dote of Inspection J / ....................lg - Dote Completed —. ---lg � ' � PERMIT REFUSED / . _____^__,_,~.,--.`----.,.. lA . . `-- � ----... . � . "" -----.. ^..' .... ........ `—_--- ~ ' . --�v�~�..^=n==°=,..~---.—.. Approved ' � ................................................ l9 � ` . ` . -------.—.----.....--.---~~—.— . . � ^ ----...-----~—.-----..--...~~—. . � | | ' . . e _ 046 Assessor's map''and lot numbe 3 .......... .... THE • F r o� •Sewage Permit number 7 nC/� s- B ARNSTAXE, i House nurriber ........._..... .-. .f .: rb s A S 9 s 39- 0 '£0 MAY a� TOWN ' OFF .BARNSTABLE ' 4 BUILD3,I1MG .. NSPECTOR APPLICATION FOR PERMIT TO ;....Zac/G . �i� �e���� /..�................. ......... . ............................... ..................................... TYPE OF CONSTRUCTION .... �.Q�- r M.............................................................................................. ./clr.....CY ....:19..P... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ......... .......... �......................................................................................... ProposedUse ........,0��,5q/dfn?_ ......>............................:.._..................... .............................................................. a Zoning District ...................................................................:.:..Fire District .............0 fv a Name of Owner 61&-a/" A✓Oa!?.. .a.bll/.Ol Address ...`...Q....'? .... ............... ... ...... .............. Name of Builder ..... P�f.s�.Q'/ r1.FF�.f .................Address !1.1..✓....^�...... .. � ;...f..l..rl lho e -...... Name of Architect SUm /� Address Satin ................................................... .................................................................................... Number of Rooms ....... ... l .. .. :n .� .......... 3 � ?'u. ?Yt : ...1.... � !'7 ........Foundation � j!;�' . � II `J Exiei or f,!/Ll C'PfJF3n— S Roofing 4 ............ .................. ................ Floors ...: ......... ........J ��...Cp....�...............Interior .......S e: d-��?L ......... �3�-��► � �,/� Heating ��'>U.... .... Q:? tS tAl. t�.......... Plumbin ..._} g ........ Fireplace .... ................................:.............. ..... ...................Approximate Cost ...............41549 Definitive Plan Approved by Planning Board ______________________________19________ . ' Area CJ " " W- (fW6' ................... . Diagram of Lot and Building with -Dimensions -fee l.............. . . ....................... SUBJECT TO APPROVAL OF BOARD OF'HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the wn of Barnsta b1p r garding the above construction. Name . ��... ... . . ............................................... Construction Supervisor's License .............................;...... r WILLIAMS, GERARD P. & JOAN .K. 25799 Build Dormer No .................. Permit for .................................... Single Family Dwell ' .................... ..................................... ........... Location ...Putnam Avenue ................................................... Cotuit ............ ............................................... .................. Gerard-P. & Joan K--..Williams Owner/................................................................... T 'pe76f Construction ....�A�a.m.e......................... Y -41 ................................................................................. Plot ,K........................ Lot .................. tv) Perm it'AGra nted ... ......19 83 Date of Inspection ...07:1� ...:6 9 Date Completed .......... ... .. ....................19 01 'o" ry 4, r 1-6 < 1 I. HEREBY CERTIFY THA T THE EXISTING BUILDING IS L OCA TE ON THE GROUND AS SHOWN. C.B. 7&7.8 319 FND. LOT 34 D RT E. N . ROEERT s9yN B ATE . ROBE E HANNIGA HANNIGAN C.B. No.28645 cn L. FND.im 125. 04 ' — `ss�oNaL LOT 2 22 2004 S.F. EXISTING? _ 29.66' DECK ^. - _ LOT 3 i 49.23' 0 3f.65. N PROP. REM LOT 11 o `v OWNER- GERARD P. 6 MOAN K. WILLIAMS ----4e_oB--------- 726 PUTNAM AVENUE. ti rr, COTUIT MARNSTABLEJ MA o ' o 24' , r ZONING CLASSIFICATION' i G RESIDENCE F w ; It PLOT PLAN FRONT YARD SETBACK 30' 726 PUTNAM A MENUE, COTUI T SIDE YARD 15 0 ; ti REAR YARD 15 BARNSTABL E COUNTY MASS. C.B. ; ; I UUL Y 8, 1988 FND. 1,i0. 00 ' S 19°-47'-35" w ROBERT E. HANNIGAN PUTNAM VENUE E ,4SSOCIA TES I/L 1 INCH'.= 30: FEET PIMIC VARIABLE Ii� MI 406 WILLARD STREET 30 0 30 60 OUINCY MASS 02169 ® s o nv 472-8332 �1 - _ I I L Jt�d � (`�•'�'j� Ar f __�f. � J, 'It�r�f� •i�— i'•1�, �jl i� 'il lts `,� ��•�.. •/. I. _ __-I 4�I1.�1. Aj pT, �n AC-) �••__. ---- fit.=�. '� �" ,. - �� . \� � ' � � ' �, � . \\` \'\`\,,\ � I( � I ``'•4� �\ \\`\ %n/1 l-l- '7+=��:�.�.&,raer/•. . � i —}F X I,� . 1,411 -' 1+" 4� •��'_-�u cry, / � �I:.� ..�cc. ,I �� � .�: �' � �� ��. `r\ "'-' 4 qI ry kx JA ry ' �GdL+.- _����r:.L°J7^.G �1�`L- (}, ..' 7� -•-rq= •'1, '. '. \ `\` •\\ ® �r ��,j[, �I i j � ,I ��'� •!..� 1D U) +• I - '1 ✓ � � ,`� \ `\ \ •\ � !�I jai., •-�' ' I � , C G3.\Q' .'C31•%•lfirs-� 1 ;Ti (�i �' � � \ : � �\�\r \ E..L�L. `_'i�t'�u tt� I � _. . � " � '. _ L.-4 �NG�L•�'.�za�\,V M ,•�I r r" `�y ,fit, I P2?j +Y _�; '•r`j Gj � .�,A�i Wt"�^.'"TT'• 4'�-.`.`. \r�l.o�.r �c1NOL � (� 1 .. 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