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0316 ELLIOTT ROAD
�� ��� � , , _ . _ ��1C�. "� I�I � �: M �� r ;. 0 O �. C a t�E ® Application number . ..... .1... .. l. ........ qa JUN 0 S 2019 Fee.................. �.:. o aWN U1 pp 8ARN5�,i�iDLE, Building Inspectors Initials. ................:.............. Date issued......�iP.1 1h.1............................................ Co Map/Parcel........ v" T TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: 7_� a C NUMBER STREET VILLAGE Owner's Name: AA M, hone Number Email Address: Cell Phone Number' ` t Project cost$ Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 7.80 CMR Owner Signature: Date: TYPE OF WORK © biding EZWindows (no header change)# '�j� E-1 Insulation/Weatherization Doors(no header change)# Commercial Doors require an inspector's review. Roof(not applying more than'1 layer of shingles) Construction Debris will be going to CONTRACTOR'S INFORMATION Contractor's name Home Improvement Contractors Registration(if applicable)# . (attach copy) �� Construction Supervisor's License# (� t9 7 4(� (attach copy) Email of Contractor �t f FCne number '7��—�`�©� ALL PROPERTIES THAT HAVE STRU URES OVER 7S YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER ............... .......................:.......... . .. *For Tents Only* Date Tent(s) will be erected Removed on number of tents total Does the tent have sides? Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plazwith the location(s) of each tent Fuel source being used LP tank 20 lbs. or>Yes No____, if yes, a gas permit is required. Natural Gas Yes No ,if yes, a gas permit is required. If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand'MY responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date 411 4PPLICANT'S SIGNATURE Signature Date All permit appX(afilis are subject to a building official's approval prior to issuance. i The Commonwealth of Massachusetts Department of Industrial Accidents - Office of Investigations a 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information . Please Print Legibly Name(Business/Organization/Individual): Address: City/State/Zip: ` Zd Phone#: 2 la �✓2 cy ' Are you an employer?Check the appropriate box: Type of project(required): 1.El:am a employer with 4. ❑ I am a'general contractor and I 6. New construction employees(full and/or part-time).* have hired the sub-contractors ❑ 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 t3'• # 9. ❑Building addition [No workers' comp.insurance comp.insurance. required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers'.comp: right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no ' employees. [No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lie.#: Expiration Date: r 7, 0 Job Site Address: l C4 f �Gl City/State/Zip: st2�v J� 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 a 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the D for insurance coverage verification. I do hereby certi u Vrth ains and penalties of perjury that the information provided abov is true and.correct Si mature: / G Date: o%11 Phone#: Official use only. Do not write in this area,to.be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone numbers)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that.a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Tndustial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 4-24-07 www.mass.govfdia 77,777 xe 7&$ E63T{FICA 'OPU �+cas�� tie" �-►rd�as�a ar�sra��xa es�s�+� � s caryOF 1 COLD rorre�rr a3ca €€�'a ads Mtn 4R Rap 4 Ow Ems till t:ECVY638tR�C t d# �YCY't► - gum • 9 " p YCt+i�,"�Sttf �k�tv"p n � > e � "gmgw , r y3 t ya f' q l 1 � e . ,f a �E C / Y .�fq`,.bra ✓�.qE f, � .n Commonwealth of Massachusetts `® Division of Professional Licensure Board of Building Regulations and Standards' Constrtrrl%$t),e►visor ` CS-074660iz �c,pires 02/12/2021 JOSHUA X K611R1 PO Box 2110 % _' > ," CENTERVILLE NA-0;2. �VOISS`i:10 Commissioner I° office of consumer sj Bush( HOME IMPROV eas Regulation EMENT CONTRACTOR TYPE:,��ration CAPE&ISLAND Cp a ' 410 NCO INC. _ •:fir'.:' JOSHUA KOURI 55 ELM AVE. HYANNIS,MA 02601 C` Undersecretary _ r. ►R �1't�µ,.�lFff!fiR �p88 as1R,NAt(da5&Bna Y1 c�act� �7`�i9FG1"if1 C a4PY S§�iG �� " a - �„ ,,� _r a .vim 31sr�� `��' �:•; b' ti. t�. e I Town of Barnstable Building t. Post=This Card So That it is Visible.From the Street ,A w 'roved Plans,Must bI"i etained on Job and this;Card Must be:Keptr i = 6.:, :' '",T`.#';x 3°..ppy , .'y, `µ" ._ � _'"" Posted Until.Final Inspection Has;Been Made. "° i634•`1 .: ^ '4.:;: .d< '. -`4`'ffi ,`«,.:. "' as e "^ .�: : .... 'w+«., ...Mr ' A tj' :��5. ` +Tk."b4 war e (c,.-.:'#w�!r.,��..�- -` ',''� a r it suet Where a Certificate of Occupancy°is Req d,psuchBuldmg shall Not be Occupied.unti.aFinal;lnspect�on has been.made. . Permit No. B-17-1256 Applicant Name: Ralph Bertozzi Approvals Date Issued: 05/15/2017 Current Use: Structure Permit Type: Building-Deck Expiration Date: 11/15/2017 Foundation: Location: 316 ELLIOTT ROAD,CENTERVILLE Map/Lot 227-086 Zoning District: RC Sheathing: .� , Owner on Record: MACQUEEN,DOUGLAS W&PANAGIOTA RIG , s Contractor,,Name: framing: 1 xw, Address: 316 ELLIOTT ROAD .` Contractor license 2 CENTERVILLE, MA 02632 _� ,Est Project Cost: $13,800.00 - Chimney: ' Permit Fee: 110.00 Description: New 32 x 14 pressure treated ��� �`; � �� ° �( $� Insulation: $ 110.00 Project Review Req: New 32 x 14 pressure treated t i If',0 � Fti Date 5/15/2017 Final: � r Plumbing/Gas §q g our r m x� s Rough Plumbing: g' ,v Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within'!' ithin six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents.for which this permit has been granted. All construction,alterations and changes of use of any building and st ucturesshall be in compliance with the local zoning by laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. � Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officals are provided on thispermit. Service: Minimum of Five Call Inspections Required for All Construction Work: , , ' x, . 1.Foundation or Footing �� Rough: 2.Sheathing Inspection `3k 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund"(as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT 0L Wn �g6 47 Town of Barnstable R' CrPT 200 Main Street, Hyannis MA 02601 508-862-4038 i63�.�• Application for Building Permit pP g Application No: TB-17-1256 Date Recieved: 4/27/2017 Job Location: 316 ELLIOTT ROAD,CENTERVILLE Permit For: Building-Deck Contractor's Name: State Lic. No: Address: Applicant Phone: (774) 392-1117 (Home)Owner's Name: MACQUEEN,DOUGLAS W& Phone; (774)487-7031 PANAGIOTA RIGAS (Home)Owner's Address: 316 ELLIOTT ROAD, CENTERVILLE,MA 02632 t Work Description: New 32'x 14' pressure treated • t� Total Value Of Work To Be Performed: $13,800.00 Structure Size: 0.00 0.00 0.00 Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this-application. I understand that when.a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: Ralph Bertozzi 4/27/2017 (774)392-1117 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $13,800.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $110.00 4/27/2017 $110.00 Paypal Paypal ............... ....... .............................................................. Total Permit Fee Paid: $110.00 R5/ s • Y2" THREADED ti HOLE r TOP VIEW n we- a&, PRECAST V5. CONVE1+lTIAL = CONVENTIONAL. 12' DIAMETER SONOTUBE, Lo ALLOWABLE LOAD BEARING CAPACITY = ALLOWABLE BEARING CAPACITY * AREA = r 2000PSF * (0.5*0.56.142) = 1571 lbs. MAX LOAD BEARING 15 1,571 tbs. Lr i PRECAST SONOTUBE: a ALLOWABLE LOAD BEARING AT'TOP= CONCRETEP51 # AREA / FACTOR OF SAFETY 5000PSI * (8*8) / 2.22 = w,w lbs. ALLOWABLE LOAD BEARING AT SOIL = Y ALLOWABLE BEARING CAPACITY * AREA = 2000PSF * (2*2) - 8,000 tbs. THEREFORE MAX ALLOWABLE LOAD APPLIED IS LIMITED BY THE SOILS CAPACITY OF i� 80�lbs. WHICH 15 GREATER THAN THE MAX LOAD OF 1,571 lbs. 'FOIE THE 12' SONOTUBE it i . • SIDE VIEW I GENERAL NOTES= . I. CONCRETE 5 P51 IN 28 DAYS. ITEM WEIC,NT 000 .2. CALCULATIONS BASED ON SOIL PRESSURE OF 2000 PSF. SONOS 1725 W, GGW MEA IM PRECAST CO.,WC.' 79 Barlows Landing Road Pocasset,MA 02559 508-56"776 07 Town of Barnstable low S tti'Y'A�1t+M, ;r 200 Main Street, Hyannis MA 02601 508-862-4038 k, Application for Building Permit Application No: TB-17-1256 Date Recieved: 4/27/2017 Job Location: 316 ELLIOTT ROAD,CENTERVILLE Permit For: Building-Deck Contractor's Name: State Lic. No: Address: Applicant Phone: (774) 392-1117 (Home)Owner's Name: MACQUEEN,DOUGLAS W& Phone: (774)487-7031 PANAGIOTA RIGAS (Home)Owner's Address: 316 ELLIOTT ROAD, CENTERVILLE,MA 02632 Work Description: New 32'x 14' pressure treated Total Value Of Work To Be Performed: $13,800.00 r� co Structure Size: 0.00 0.00 cr. Width Depth Total Area J I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: Ralph Bertozzi 4/27/2017 (774)392-1117 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $13,800.00 ; Date Paid Amount Paid Check#or CC# If Pay Type Total Permit Fee: $110.00 4/27/2017 $110.00 Paypal Paypal ................... .,,,, ......... ....................... ............. ..................... .................. Total Permit Fee Paid: $110.00 Town of Barnstable *Permit#B-q �fires E 6 mo s r n ' a date Regulatory Services Fee « saaxs°re M Mass. Richard V.Scali,Director Building Division Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION -' RESIDENTIAL ONLY n�4 _OQ Not Valid without Red X-Press Imprint Map/parcel Number Property Address �l 5c 1•`�:fi �`t?�r (�v;�. V Le- ❑Residential Value of Work$ (9 VQ Minimum fee of$35.00 for work under°$6000.00 Owner's Name&Address rkf"e) Contractor's Name G — G G - l?C Telephone Number 77(� Home Improvement Contractor License#(if applicable)—) �� Email: glla/n)a1,5 Construction Supervisor's License#(if applicable) G 0 ��ju, ���' �✓/`'''L �� G`'``� "oran's Compensation Insurance Check one: ' T • ❑ I am a sole proprietor 43 [ + ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name ,o����'������� / i U" a � Workman's Comp.Policy# �.c,`'— �)5—��? `!C) 19/ Copy of Insurance Compliance Certificate must accompany each permit. ; Permit Request(check box) ' ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re- fide e lace Windows/doors/sliders.U-Value �r�� (maximum .32)#of windows A #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is re fired. SIGNATURE: QAWPFILES\FORMS\bui ding permit forms\EXPRESS.doc 06/20/16 Town of Barnstable Regulatory Services BMWSTST&U = Richard V.Scali,Director '639 M Building Division EDA'�A 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 1.1 DOM I nf MQCQIILOE� ,as Owner of the subject property hereby authorize CC, b a fU to act on my behalf, in all matters relative to work authorized by this building permit application for: +Irvih� (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. Si e of Owner Sign e idAplThcant � I Print ame Prin ame 1,14 Date 1 r Massachusetts -Department of Public Safety Boardof Building Regulations and.Stan,dards Construction Super-visor License: CS-074660 JOSHUA X KOUI2 PO BOX 210 �@ CENTERVH LE IVIA Expiration . Commissioner 02/12/2017 Office of Consumer Affairs&Business Regulation HOME tMPROV MfNT CONTRACTOR ' s Registration 65936'�— Type: „ ` Expiratio W.. I20-1 Private Corporation CAPE&ISLAND Wqb INC. �. JOSHUA--KOURI., y Tye ill 55 ELM AVE. HYANNIS,MA 02601 Undersecretary Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(991M )of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For DPS Licensing information visit: www.Mass.Gov/DPS License or registration valid for individul use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston;M-A 02116 of al' without signature 25-e Cownta nreah*gfMassaclrrrselts Depa tmeut&f rnd-zrsrrial Acddeffts Oirwe 'rrns. 600 waskilwM Street ' Boston CIA 02111 kPrPxs mm&goP1dia Workers' Ctmpensat an.Iusm—mce Affiavat;BcederslClantractgrsMectric:mnslPlumbers AppHcant Informafrag Please Pant Y era= : t� Addresr m5,/Statel7 tV V4("v`l`r-- sae-,u-- _ 77 0 C Are anetaployer?:Check the appropriate box: T project(required): I am'a general conttact=and I �of P 1 ( egmaed): Iamaemploysuith, � ❑ g 6- ❑New oocEioa employees(fall andfor part-ime).* havehired.the sub-contractors '� I Elvp I am a sole prFietor orpartner- listed onthe attached sheet 7- ❑fi g. ship and have no employees Dxese sub-contractors have 8. ❑Demoaoa w long forma in any capacity- employees and have wods' 9..Q Building addition [No w-odmw Comp.fiwm mce comp.msura required-] 5. ❑ We are a corpora ion.and its 1OL❑Electrical repairs or aa� 3.❑ lam a homeowner doing all work " officers have e3rcrsed timer 11-❑Plumbing repair s or na s ions myself[No workers'comp- right of exemption per I1 M 13-❑Roof repairs - insurance rewired.]y c.152, §1(4),andwe have no employees.ENDwodners' 1311 odu!r comp-insurance mquired-] #Anya Hcznt&atcbetIsboaitomit also MoutthesectioabeIawshuwkZthervm&eiecampmxmffimpe5cginffim=d=- ffameewners Who submit dzis afRdaea iafficsting they axe damg all wa r aad ihm him outside untmcim act submit a new affidseit mdicaiiva sacs_ - ICoatxac I *zt checktM bmr must aftr-ly au.additirmal Sheet sheVcing the name of the and state whether ar notihme emities bad employees.Ifthesdb-c=tc o have employe2%fiie}'xLstpmtAde their wodmm'imp.palm aunilser- I am an euipk�w that fspmidfrrg warkers'compensrdion hLairancafor my empLyzes $etow is fite paucy and job Sao �,formafiarr. _ ' c Insurance Company Name: / - Paficy ExpirationDafe: y Job Re Addn-jw Y /�� ��i1 - _ CitylS : Gtl. � J1 r-C- Aftach a-capy of the workers'comp ens atiom:poHey declaration page(showing the policy,mummer andexpiration date). Far7mre to secure coverage as required under Section 25A of MGL m 15 can lead In the imposition of crimiaal penalties of a fine up to$1540OD sadlor one-year isotzmeoot,as wail as rim peualtit:s in the forts of a ST(7P WORK ORDERand a fine of up to$250-00 a dap against the violator_ Be adidsed that a copy of this statement may be forwarded to the Office of i firvesfigations ofthe DIA for insmraince coverage verifrcstiom- I do hereby cargy pains art rtQlties afFeJiuY ihatthe infornuiff*ortpt ovwW a e" true artd carrect 7 Piupae ik `7 to rg t3rwfiaL uss arrTy: Do rtat write in 96 awrti to be cvinpleted by taip artDwn PS WA �1 or'Ta�scu: ��rmitlT&eEtse Issuing A ufl ority(drde one): L Board of Hadth I BwMing Department 3.Ciyltawn Clerk A-Electrical Inspector S.Ph mbmg Inspector *Other . C omfact Person: Phone#- ormation and Ins-�ctions ' . s M ssac�cOft General Laws aVf er 152 r&qa=all=3PIoY=to XUVide WMIO=e cacoPensstion for fhD r employees. era somttD th7s sfatudL-,,an empkyw is defined as=evmy peasaa in the service of another under any comtL c ofhfir, eMIXe=or io3phed,oral or wrhmf An Moyer is defined as"an filTwidnal,parfnership,association,corpmafion or other legal=61y,or aay two or more of&0 foregoing=gaged is a Joint use,and mclndmg the legal rube se m&w of a deceased=3pIo-yer,or the receiver or trastee of an in dxvi lml,per,association or other legal entity,employing=Pmyees- However the owner of a.dwz: iEng house having not more than.tb=apa-tnm s and who resides therein,or the occgxmt of the - dw Mag house of anon who employs pmsans to dD mat tern- m,caas r ac i on or repair wow on such dwelling house. or on.the grounds or bmTdmg apprntunaz¢hereto shall nDt because of sack eunplayment be deemed to be an employ=. MM cbaptrr 152,§25C{6)also states that"every siafr or local Fi=L ag agency shall withhold the issuance or renewal of a Iicease or permit to operate a business or to con-stract buRdings in the commonwealth for any applicantwho has notprodace .acceptable evidence of cdmpU=ce with tIxe ftLmance.coverage regnirect" Additionally.MCrL chapter 152,§25C(7)states Neither the nm= mwcalih nor a'ny ofifs political snbEviskns shall enter into any contract for the prance ofpubhc work until acceptable evidence of complian m with the msarance:._ rufai ements of this chapter have been presented to the confrasting anthDUIy." Applicants please fiat oin the workers'compensation affidavit completely,by cd=Idng the boxes that apply to your situation and,if necessary,amply sub- ontrador(s)name(s)° addresses)and phMDmmbmz s) along wiihthe=ceatificate(s) of insurance. LnnitedLiBbMtyCompanies(LLC;)orLfiartedLiebilhy Parft==hrps(LIP)wrffno employees other thantho members or parbacrs,are not req<m cd to cony workers'canipensation insmanae If an LLC or LLP does have employees,a.policy is rupimd. Be advisedthatthis affidaYitmaybe sabm tied to the Department of Industrial Accidents for confirmation of fimn-mce covmmg� Also be sure to sign and date the affidavit The affidavit should be raged to$e city or town that the application for the permit or license:is being requested,not the Department of ; Industrial Accide+tr, Should you have:any questions regarding the Iaw or ifyou.ate requaedto obtam a W03i s' compensation policy,please call the Department at the nmmber list below. Self-insured companies should eater their self-insurance Hce' sD now on the appropriate line. City or Town Ofbtciais please be sure that the affidavit is comple#a and pri3te;dlegibIy. The Department has provided a space at the bottom of the affidavit for you to fill out in.the event the Office ofInvestigaiioas has to cojbc.-tyam regarding the applicant please:b e sure tD fill in the peumitllicease m nbm which wn-Il be:used as a refmmce number. Im-addition,an applicant that must submit mvh3ple pe=0i mnso applications in any given yew,need only submit one affidavit i adiraiiog comet policy information(if necessary)and under`job Site Addrrss"the applicant should write"all locations in (may or_ town)-"A copy of the-affidavit that has been officially stamped or marked by ilia city or town may be provided to the ' applicant as-proofthat a valid affidavit is on file for future permits or licenses A ne per affidav>t must be filed out each year.Where a home owner ar citizen is obtaining a license or permit not related:to any bnsincss or commercial (i.e_a dog license or pens¢to bum leaves etc.)said person is NOT rego>cnd to complete this affidavit The Of of Tnvcsfigats would litre tD thank you m advance for your cooperation and should you have:may questions, please do not hesitato to give us a call. The Depsrtme of s address,telephone and fax nitmbea. CDZMXMWWM of rho . - �of�.duA�ents - � n=1�A E11� Ta#617' -4 eft 406 car i-977 M �.�� Fax#617'27 7749 Rjevise ¢24-07g 5/11/2016 9:16:14 PM PST (GMT-8) FROM: 100005-TO: 15087756668 Page: 2 of 7 CERTIFICATE OF LIABILITY INSURANCE 75/11/2016 E(MM/DDNwY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER FRANK L HORGAN INSURANCE AGENCY INC NAEACT 44 BARNSTABLE ROAD PHONE FAX PO BOX 250 c o E 1 A/C Not: E-MAIL HYANNIS, MA02601 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: LM Insurance Corporation 33600 INSURED CAPE& ISLANDS CONSTRUCTION COMPANY INC INSURERB: PO BOX 210 INSURER C: CENTERVILLE MA 02632 UISURERD: INSURERE: - - MSURERF: COVERAGES CERTIFICATE NUMBER: 2987874.5 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICYNUMBER MM DDY� MM ODKYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR A GE TO PREMISES a occurrence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑PRO JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SING LIMIT $ Ea accident ANYAUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY AUTOS ONLY AUTOS _ (Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAS OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ 14DED RETENTION $ A WORKERS COMPENSATION WC5-31 S-377540-016 5/7/2016 517/2017 STER ATUTE ERH AND EMPLOYERS'LIABILITY YIN ' O FICER/MEM EANYPROPRIETOREXCLU ARTNEF;VEXED7 ECUTIVE N f A E.L.EACH ACCIDENT $ 100000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,.Addilional Remarks Schedule,maybe attached If more space Is required) WORKERS COMPENSATION INSURANCE COVERAGE APPLIES ONLY TO THE WORKERS COMPENSATION LAWS OF THE STATE OF MA. This certificate cancels and supersedes all previously issued certificates,only as they relate to workers compensation coverage. r CERTIFICATE HOLDER CANCELLATION .TOWN OF BARNSTABLE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 MAIN ST THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN HYANNIS MA 02601 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE LM Insurance Corporation ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD 29878745 1-377540 16-17 WC yogesh.patil@libertymutual.com 5/11/2016 9:13:58 PM (PDT) Page 1 of 1 i 1 e � t EVE T Town.of Barnstable *Permit# QExpires 6 months from issue date Regulatory Services BARNSTAEM ' �d 9 MASS. Richard V.Scali,Director i639' d� QED MA't A Building Division . AU Tom Perry,CBO,Building Commissioner AUG 2 7 2014 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us SOWN, �p Office. 508-862-4038 Fav me EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY p, Not Valid without Red X-Pres Imprint ��1 Map/parcel Number —7 © O Property Address (�{ U l G ►lt.t� CX R m Residential Value of Work$ 1%X Min' u fee of$35 0 for work under$6000.00 Owner's Name&Address '—<—Z _ e— Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) -9�� Email: d Construction Supervisor's License#(if applicable) �'_S � orkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ P&the Homeowner I have Worker's Co ensation Insurance Insurance Company Name Workman's Comp.Policy# (i5 D` — 1 Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re of(hurricane nailed)(not stripping. Going over existing layers of roof) e-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note:' Property Owner must sign Property Owner Letter of Permission. c py of the Home Improvement Contractors License&Construction Supervisors License is r q 'red. SIGNATURE: QAWPFILESTORMS\building permit formsEXPRESS.doc Revised 061313 , Deparhuent of lidust►. al Accidents -- - office of-rmlesd9a iens 600 Waykington Street Bostan,MA 02.H1 wmv.mas&grrfdia W.orkers' Compensaf Dnlnsi=uce Affidavit:$nilders/Centra:ctorsMecfriciaus/Mumbers Applicant Information Please Print Legill IV Name uc c- Address: % L City/Statclzip= e Iron ' employer'Check t appropriate boa: 1_ am a employer with�_ 4_ ❑ ISM a general c tractor n ad 1 6 ❑New Mnstrisction employees{full and/or padXvne}* have hied the sub-contractors. 2_❑ I am a sore proprietor or partner- listed on the attached sheet y- 0 Remodeling ship and have no employees These sub-oontractors have, g- ❑Demolition. w for me in an c ci � employees and.have workers' ot�ng Y � � _ 1 9_ ❑Building addition r �c*anr [No,Workers,comp_inae comp-insurance rec ed-] 15..❑ We are a corporation and its 10_❑Electrical repairs or additions 3.❑ I am a homeowner doing all wow officers have exercised their 11_0 Plumbing repairs or additions myself [No workers'comp- right of eNmcaption per MGL 12_0 Itn f repairs snsarrance required-]1 c_154§1(4),and we have no, employees-[No workers' comp-insurance requir�.J " Y applicant drat checks bax 91 trmst also fill out the section below showing ibeir Svor&eis�compensatioa p�iiry infhrmatiori Hameoarners ado submit this affjdsvA nbffJcxt=•g they ace doing all Stuck and then line outsides contEwtum— sabm3t a net`affidxW ib£catvig such- =Gontisctors that rharY this box must stteched za additional sheet showing the nmne of the sob-conft3cba and state whether ornat dose entities Lave onployees_ If the gob-contractus hwe empjoyees,they mast provide ter workers'comp policy number- am an tzmplr�yer that is prot�i tvorlse 'compertanhmn irrrttrrrr[ce for myempFayt?eu Betaar is the poiic}rucd}ob srle in•f otmagan Insurance CompanyName: Policy r4 or Self ing_11-r—4- 4�lklr--711\6 Expiration Date: 2 06,A� Job Sife Address: Gity/stawzip �; F r ,ID1 Attach at copy of the workers'compensati m3 policy declaration page(showing the policy n-amher and expiration date). Failure to secure cotierage,as retl6reddunder section 25A of MGL c 152 can lead to the imposition of-criminal penalties of a fine up to$1,501 0D andlor one-yWituprisonment,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 brat a copy of this statt mmt maybe farwarded to the Office of bn estigations of'dte DIA for insurance cow Tage,vetffication_ I da hereby certi r its oral penalties ofperjury thatthe informiWan pratzded aboue is friu nd correct S.imatu re: Date: Phan 9: 0JEd,al use only. Da not write in this area;to be completed by city or town of f ieiaL City or Town: PerraitilAcense# Issuing Authority(drde oae): 1.Sward of Health 2.Building Department 3-Citvfrowa Clerk 4.Electrical inspector 5.Pluurhing fiLTmtor 6.Other Contact Person: Phone#_ 6 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto this statute,an ernployee is defined as"__.every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer;or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the . dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or Iocal 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 Pay 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 compli.a-ace 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 cerilficate(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_ 11e 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 ob mil-?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 PIease 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 permitllicease number which will be used as a reference number. In addition,an applicant that must submit multiple pernitllicense applications in any given year,need only submit one af5da.vit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses_ A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number The Commonwealth of Massachusetts Department of hiclustdal Acci&le Office of Tnwestigatio-as 600 Washington Sit Bostons MA 02111 Tel.A 61772-7-49OG W 406 of 1-& MASWE Revised 4-24-07 Fax# 61 7-727-7749 Wes.-mass-gov/dia { Massachusetts - Department of Public Safety Board of Building Regulations and Standards Construction Supen isor License: CS-080591 - RICHARD A PR A. Y. PO BOX 895 Barnstable?VIA 02630L �! `i.•G, - �� `.�riti� Expiration Commissioner 0612812015 s of any use group which Unrestricted-Building . 3 , c ontain less than 35,000 cubic feet(991m )of enclosed space- e nt e ditto n of the Massachusetts current e. _ Failure to possess a c a ' c caus e for revocation of this license. d e.is state Building Co � www.Mass.Go4/DPS c form anon visit: or DPs Liensing m a &lie�parrurnoazcuealC�i a��/l/�«tac�c��e . \ Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: registration 135897 Type Office of Consumer Affairs and Business Regulation' ,Expiration: 5/17/2016 Individual. 10 Park Plaza-Suite 5170 Boston,MA 02116 RICHARD ANDREW FRCHLIK F RICHARD PRCHLIK; - 68 PILOTS WAY Q �� \ W. BARNSTABLE, MA 02668>`' Undersecretary Not valid without signature f Mra1fi71t re et 6ui'Idin9, l.lc p.o. box 895 barnstable massachusetts 02630 p.508.280.6295 f. 508.744.7774 www.mainstreetbuilding.net • - 0 o CO 0 CTI 0 U1 Aug 7'a, 2014 (0 re. 316 Elliott Road, Centerville Thank you for the opportunity to bid your work: It is always exciting to be part of a creative vision, bear witnesses to, and be part of these transformations. Should you decide to move forward with Main Street, you will be able to experience-our craftsmanship, ethics and attitude first hand. As per our discussions and walk through I am pleased to submit a bid totaling Twenty Five Thousand Six Hundred Fifteen Dollars Ten Cents ($25,615.10)for the work on your home in Centerville.To that end, what follows is an explanation of my responsibilities to you and the project, as well as a line item breakout of costs. remove carpeting throughout..•/ zoaa p g throu g z .75 sq.ft. x 1300sgft $975.00 2 1/4" oak hardwood installed/w poly.. v.O ,.,•\$3.00 sqft mat/$1.50 inst./$1.50 finish x 1300sgft *$7800 tile.. a ` $)0 sgft install/grout..$2.00 sgft remove and prep surface.. $4826.00 _ underlayment for tile.. 25 sheets $1250.00 trim master.. slider and window trim removed and reapplied after extension jambs appIied:..baseboard removed and replaced..' $510.00 master doorway.. pocket door eliminated and new hinged door installed.. arched head casing squared and trimmed to match rest of home.. $484.00• screen porch door.. door replaced with wood, 15 lite.. trim to match existing labor and trim.. $450.00.. unit price$586.95.. total $1036.94 exterior french door.. �: 4�1000y. existing 8' slider will be replaced with a 5' french door.. rough opening created.. interior finish matched, exterior shingles woven' -in to new trim.: $1060.00 labor and trim.. unit price $1236.47.. total $2,296.47 vanity demo.. ,$200.00 kitchen demo.. ` $300.00 . expanded,kitchen'demo.:` v half wall and fridge nook removed..$300 add door to bedroom three.. $200.00 unit/$104.00 install and trim hallway bi-fold door tune up.: $80.00 addl. trim where required from wall buildout, door/window'openings and m'isc.. $1860.00 demo master shower.. ' $300.00 new shower framed, pan set, and tiled.. $300.00 pan/$120 framing/$2380.00 the 30 yrd roll off dumpster.. $585.00 exterior shingle.. strip and replace 8 square(800 soft)sidewall shingle.. $2800 labor $1600 material.. $4,400 total 1 garage and porch archways.. square off openings and re-trim with 1 x5 primed pine.. ��-e . overhead and profit.. 15%of above.. $30,307.41 x .15 (4,546.11) _$34,853.11 $34,853.11 I , 5 Were bead-board requested in baths the formula for its cost follmws� 8T� $10/If materials Option price for additional re-shingle in rear of home..1.75 squar 962.50.. i / Work parameters are for the above mentioned only.. andy additional wor or materials(screens etc.) required a additional.. The above price includes all construction labor and material cost to complete the scope of work outlined in our discussions. All construction will be executed to code,.in workmanlike fashion.. Crews will arrive no earlier than 7:00 am on work days and will break down by 4:30. Site will be left broom clean daily with rubbish containers covered.. No sign or awning prices have been included in this contract.There are no prices for Mechanical. All existing heating and cooling equipment is expected to continue to satisfy the space and has not been quoted for alteration. Work can begin within a week to ten days upon acceptance of this proposal and the satisfaction of the first Application for Payment. Should this document be rejected, all terms relating to the interior fit-out will be nullified. Length of Build Out is anticipated to be Fifteen to Twenty Days (15-20). No legal claim can be made, nor financial responsibility levied against, Main Street Building, LLc with.regard to this time estimation. Progress schedules can be provided weekly for review by you,The Client, and any representation you may employ.. An initial application for payment in the amount of one third total.contract price will be submitted for work to begin. Terms put forth in these General Conditions will be accepted and followed accordingly. All applications for payment are expected to be paid in full: Work will not proceed with any outstanding balance. Any alteration or deviation from the proposed specifications involving additional costs will be executed only upon a written change order; and will become an extra charge over and above this estimate, paid for in full at the time of its genesis.This is to include, but not limited to, hidden damages uncovered during the course of the original job outline and/or additional work required by the local building authority.All work performed outside the parameters of this agreement will be executed at a rate of Sixty Seven Dollars ($67.00) per man hour plus materials which will be provided at cost so long as acquisition time is billable.This proposal does not include verifiable material price increases, or previously spoken to additional labor and materials which may required should unforeseen problems arise after the work has commenced.The financial responsibility for any of the aforementioned variables will fall to You,The Client. All agreements contingent upon strikes,accidents, or delays beyond our control. The Owner/Client will be notified of any and all necessary construction-related permits.The obligation shall fall to the contractor to obtain such permits.• You,The Owner/Client,may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction. Cancellation must be completed in writing. There will be no refund or assumption of responsibility for special-order windows, doors or any other non-stocked materials after three days from this approved proposal:All warranties will be null and void if account is not current and paid in full. Owner to carry necessary insurance upon project location.Workman's Compensation and Public Liability Insurance is maintained by Main Street Building,LLC. Main Street Building, LLC will place no lien or security interest on property as a consequence of this contract. Furthermore, Release of Lien paperwork will be collected from any subcontractor who is employed by Main Street Building,LLC, with regard to the above referenced. The language contained in this contract supersedes any other contractual obligation held or implied by either party. The Contractor and The Client hereby mutually agree in advance that in the event The Contractor has a dispute concerning this contract,The Contractor may submit such dispute to a private arbitration service which has been approved by The Secretary of The Executive Office of Consumer Affairs and Business Regulations and The Client shaI be required to submit to such arbitration as'provided by law. 1 , All material is guaranteed to be as specified. All work is to be completed in a professional manner, in accordance with standard practices and the submitted drawings and/or specifications for above outline. Acceptance of proposal The prices, specifications and conditions are satisfactory and are hereby accepted.You are authorized to proceed as specified. Payment will be made as outlined above. Do not sign this contract if there are any blank spaces. (, 7 01 signature date R. Andrew Prchlik, Owner J . signature date Client u p.o. box 895 west barnstable massachusetts 02630 0 508 280 6295 f 508 744 7778 createbuild@me com x . NOTICE U - NOTICE TO TO EMPLOYEES EMPLOYEES . 1 The Commonwealth of Massachusett's DEPARTMENT OF INDUSTRIAL ACCIDENT 600 Washington Street; Boston, Massachusetts 02111 617-727-4900 As required by Massachusetts General Law, Chapter 152, Sections 21, 22 & 30, this will give you notice that I (we) have provided for payment to our injured employees under the above mentioned chapter by insuring with: AmGUARD Insurance Company NAME OF IINSITRANCE COMPANY P.O. Box A-H 16 South River Street Wilkes-Barre; PA 18703-0020 ADDRESS OF I'iVSURAI CE COMPANY MAWC570216 02/06/2014 02/06/2015 POLICY titiliBER EFFECTIVE DATES AUTOMATIC DATA PROCESSING INSURANCE AGENCY,'INC. 1 ADP Boulevard 800-524-7024' Roseland N] 07068 NAME OF LNSURANCE AGENT ADDRESS PHONE Main Street Building LLC 68 Pilots Way West Barnstable, MA 02668 EhfPLOYER ADDRESS 01/22/2014 EMPLOYER'S WORKERS:COMFENSATION OFFICER (IF AYf) DATE MEDICAL; TREATMENT The above named insurer is required in'cases of personal injuries arising out.of and in the course of employment to furnish adequate and reasonable,hospital and medical services in accordance uvith the provisions of the Workers Compensation Act. A copy of the First Report of Injury must be riven to the injured employee. The employee may select his or her own physician, The reasonable cost of the ser- vices provided by the treating physician will be paid by the insurer, if the treatment is necessary and reasonably connected to the work related injury. In cases requiring hospital attention, employees are hereby notified that the insurer has arranged for such attention at the ME OF HOSPITAL ADDRESS TO BE POSTED �3Y EMPLOYES. Assessor's office(1st Floor): n +SYSTEM MUST�� of?ME TD Assessor's map and lot number,f 1 o o�P /� ! "' _ Board of Health(3rd floor): . � °`� �INI COMPLIANCE Sewage'Permit number — - WITH TITLE 5 • IRONMENTAL CODE AND i Dsaa97sDLL EnginE;ering Department(3rd floor): � �J(� � rrua House number i6 J ' TOWN REGULATIONS °�.,F }q.6`�� Definitive Plan Approved by Planning Board 19 ���� APPL*TIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only PPPROVOWN OF BARNSTABLE Barnstable(o;::.ervation Comm? s kDING INSPECTOR S0CATION FOR PERMIT Ta 4 TYPE OF CONSTRUCTION 19 �! TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for permit accordi to the%following information: 9 Y PP � 9 Location LU FYI !� k)J r0 L/ t�/ A s Proposed Use 0 Zoning District S' �e .P1.4 /�* -�� Fire District C! t Name of Owner Te �1 t� ``k -S Address 34 l'�0 /1 (ae il,41-" ,�/!,11R I Name of Builder 27 A//a k Address $ c � Rh P f� , Name of Architect Se- Address Number of Rooms_/ - Foundation 1. e m e w �� C° /\_ Exterior c e � a Roofing 74S D .14200 -Z/ P Floors Pu Interior �Q Q C, C >� � t Heating � � �^ Plumbing � � ti- � � C- Fireplace ,9 G1 '�, Approximate Costf//, qC9d Area00 l 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 above construction. a Name Construction Supervisor's License JENKINS, LORI _ 345,76 BUILD ADDITION NoT emit Fo - .F i c`5 Single Family-Dwelling Location 316 Ell:-iott 'Road, (Lot #15) � t � 1 Centervilsle Owner. .Lori Jenkirns- A, Type of Construction FrameR f w I -{ i1 Plot Lot --' Permit Granted September 18, 19 91 + t Date of Inspection 19 DaWnCorroted �/Z T L 19 IU 0 : 1 � ; a i i 6 '�•tc" `fi`i6'.`,"✓ry{�.t'y.V„ bN 1Tf"-,:r-fL'�/"w"`'.�'"Y'1ryr.'.rlL'(�"'!>•✓$�!`�tI° "qv."' a„Y+^' TN^"T4r+"er ,^a rt -Assessor's office(1st Floor): Assessor's map and'lot number O��. 0 �1„ 0 i TH E T 0 P Board of Health,(3rd floor): eW Sewage,Permit number 27- // Z DAHdS•!i�LL i Engineering Department(3rd floor): J�+ YAB House number J °o obs Definitive Plan Approved by Planning Board 1.9 i APPLICATIONS.PROCESSED 8:30-9:30 A.M.•and 1:00-"2:00 P.N4.only , TOWN 4F BARN STABLE DING INSPECTOR APPLICATION FOR PERMIT TO [� f— `►to t0 M TYPE OF CONSTRUCTIONK. ff ' I 19 _ I TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies fora Dermit accordi g to the,.f Ilowing information: 1—GT I S Location [l/ /+� ` t�/� eil- J4 e5 0% Proposed Use d Zoning District S .� Fire Districts st—A At M ! 5 Address 34 E Name of Owned,',!, l r0�7 f Name of Builder �-G e Q A//a l � Address � li cam' Ti L! P U d f^ e Name of Architect ss e i_'_ Address i '- Number of Rooms Foundation l../� 14 f Exterior C e J d , '� Roofing S D 00 i G! Floors a'.S t ,,. Interior - t .. Heating Q , '^ Plumbing ,, 0 o d Fireplace `1 Approximate Cost Area Diagram of Lot and Building with Dimensions Fee O� a i ,j 0 0 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. j 4. Name Construction Supervisor's LicenseOF i JENK.INS, LORI A=227-086 No 34576 Permit For BUILD ADDITION Single Family Dwelling Location 316 Elliott Road (Lot #15) Centerville Owner Lori Jenkins - Type of Construction Frames Plot Lot Permit Granted September 18, 19 91 Date of Inspection 19 Date Completed 19 � I PERMIT CQMPLE3ED 1!1/.Y I . . �, • � � I I j i j r �/ i i i -� _ ,� � I .� I �:_. f � � I I� v i � I i I 1 , b - ' f �` i •' rl n: i m � x L � c � o � _ I � ; y rT A JI d - m F1A) d U 6 - Ri I ld m A I 1-111ft m r rn �^ m L � v II r r m� -1rp r f ti �Y f� '\ i c , 3 � w Y i - v i C � L A r -i A A m y m mi D i � a tfi Z � oN � PH r K V c I 0 � Jw �� Zoe 0 p ^i• `r u p --- �o r r m .bY. m x yI L c S 2 b Or 4 I P m P v A r P m It 3 I � pp I �TN LL r r D m /it k1 GM LL � x I ttTy I �L I J v c 2 pp I I d L I � j -/FL1 p oe Sr`er ;IS k Ir N T y�C=yy mp my m m f ce r D Ib�• r� "I-MATC14 &XI & : I1. WALL LINE UP D L A/ATCM EkIrJN i wit d 4 F n Q!O' MAMA7.- CEu7E4 ON&De --- ----' . .al-O"..---- A tap _Rym e y At x '! p tn"tl = vi C f n mp -4 m X f �N O 3 u` w I , - -CRESS PERMIT Town of Barnstable *Permit 1 2012 Regulatory Services isw Me hine dam Fee • F.-Geller,Director 01. (�'�KA Thomas RNSTABLE Building Division �Z-7 f�L Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barns.table.ma-us Fax: 508-790-6230 Office: 508-862-4038 - EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X--Press Imprint Map/parcel Number aa�1 C Property Address I 1 O (Residential Value of Work /O Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address to Sprinkle Home Improvement Telephone Number 508 775-1778 Ext. 10 Contractor's Name 103757 Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) CS 6643 )QWorkman's Compensation Insurance Check one: ❑ I am a sole proprietor,: ❑ I am the Homeowner (� I have Worker's Compensation Insurance Insurance Company Name Associated Industries of MA / A.I-M Mutual Insurance Co. AWC 7004943012012 Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany.each Permit- Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripPmg old shingles)'.All construction;debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) . Re-side #of doors` Replacement Windows/doorsYsliders.U-Value maximum.35)#of-windows •Where required: Issum of this pernnt does not exempt compliance with other town department regulations,►.e.Histonc Conservation,etc ***Note: Property t3wner must sign Property Owner Letter of Permission. p ome Improvement Contractors License&Construction Supervisors License is SIGNATURE: DataU ocal\Micxosoft\wind ws\Temporary Internet Files\Content.0utlook\DDV87AAZ\EXPRESS.doc C Vjiers\&olr&Aop Revised b�21 I0', - ;. 4p�, �\ The Commonwealth of Massachusetts _ Department of Industrial Accidents Office of Investigations 1 Congress Street,Suite 100 Boston,MA 02114-2017 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Aaalicant Information Please Print Legibly Name(Business/Organization/Individual): Sprinkle Home Improvement Address: 199 Barnstable Road ( City/State/Zip: Hyannis, MA 02601 Phone#: 508 775-1778 Ext. 10 Are you an employer?Check the appropriate box: Type of project(required): 1. ✓1 I am a employer with 10-12 4. ❑ I am a general contractor.and I employees(full and/or part-time). «. have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner-, listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. .❑ Demolition working for me in any capacity. employees and have workers' [No workers' comp.insurance comp. insurance? 9. ❑ Building addition required.] 5. ❑ We are a corporation and its 10.El Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I I.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152, §1(4),and we have no I Q l employees. [No workers' 13ROther.Sl n� 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. tContractots 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 employee& Below is the policy and job site information. Insurance Company Name: Associated Industries of MA./A.I.M Mutual Insurance Co. Policy#or Self-ins.Lic.#: 7004943012012 Expiration Date: 01/01/2013 Job Site Address: 2)1 e (1 i0 City/State/Zip:C° ,; ,J i(l e, M 60 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereb cent' h ns and penalties ofperjury that'the information provided above is true and correct Date -- -- Phone#: 508 775-1778 Ext. 10 Official use only. Do not write in this area,to be completed by city or.town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: L-71 X Town of Barnstable Regulatory Services ' Thomas F.Geller,Director Building Division Thomas Perry,CBO Building Commissioner , 200 Main Street, Hyannis, MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property Sprinkle Home Improvement hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signa o er' . .Date LoYc, Ie IrOcAS Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\decollik\AppDataU.=I\Microsoft\Windows\Temporary Intemet Files\Content.Outlook\DDV87AAZ\EXPRESS:doc Revised 072110 ,f Unrestricted -.Buildings of any use group which. contain less than 35.000 cubic:feet (991m')of ` Massachusetts -Oepartment of PUDIIC Sater, enclosed space. Boaro of Building Regulations and Standaros ( n:rrurtt, n �ulicn,tfr _Zen se•CS-006643 BRAD K SPRINKLE 190 LOTHROPS LANE Failure to possess a current edition of the'Massachusetts W BARNSTABLE MA.0?6 State Building Code is cause for revocation of this license:, For DPS Licensing information visit:. www.Mass.Gov/DPS rrus s.,;�nr 10/08/2013 Office of.Consumer affairs&Business Rc-olation License or registration valid for individul use only. ,HOME IMPROVEMENT'CONTRACTOR before the expiration date. If.found return to: 40gistration: 103757 Type: Office of Consumer Affairs.and Business Regulation Expiration: 7/9/2014 Private Corporatior• IO.Rark Plaza Suite 51,70 Boston,MA 02116 SPRINKLE HOME IMPROVEMENT,INC.. Brad Sprinkle 199 Barnstable Rd: Hyannis,MA 02601 Undersecretary Not valid witho signature. f - 2/20/2011 9 : 35 : 33 AM 8740 ® 02/09 CERTIFICATE OF LIABILITY INSURANCE TUD ctStiVzrZcil= zu ZWONli A9 A mTTia;.OP E zaresm lan G&W AND.Geser / t0'a"aSa 0Y0i Tm d'>ZiZYif@�Y'Mr NOUN— TiiD C6i1T=fICJ12E cm NOT APlt�zvx='0i.XX0&jZVX=AM=# xx=.Ox N,mm mm cOrDtaOi Arro" Al<1= YOf.cm a=*. TNSO CNN73NTC= OF iaODRA =DOW M COMMSx A-callw.T' I= 200=0 Zxa0mcm 1105'xG=Xm•=VWjnw vm an Oamcn. AM Tab' =mrzcA= IIOLaNat. SDI =Axvi:Zt the."atii3Cata bAl4lor as"an ADDZTZONAL LaOaiD. eha ap1loy(4N) Cara:be ao0at:aOli. Zi 80aa00aTZOa ZB tUliVaD. ruL)rcc "" the te=o aIId'cAmUt eaa of-tA*Nam. Cal'taln gaftSNa Cry Lmq"ia an andammum a. A ata0aaant oD.th3a dltllLGG,4069 not eonfot el ants to the eat tilieate holdim itl.Ilau Qt-.nler aaQesaaMatto). - - B II. a SU=Vaa .=x Ageacy. — � - 88. 2 a2month Road „�e <�aaiS� MA 02601 CUSTOMS F _ ,,,a,m. ...•la. 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""" INSTALLED IN COMPLIA :- �� Z B8HH9T4DLE, House number . l G WITH ARTICLE II STATE SANITARY CODE AND T 1639. .E 0 REGULATIONS. OYP,jA,. TOWN OF ►-BAIRNSTABLE r� BUILDING" IWS,PECTOR ' APPLICATION FOR PERMIT TO ...:....................... :........ ..... ... .. ........... ........................................:......... TYPEOF CONSTRUCTION ..................................................................................................................................... .................. ..................19. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: �e.T..%s:.........�.11.............` ����...... .fir- 1 ...Location ..... ... ... .......................... .:.....:.................................... ProposedUse ............................................................................ .............................................:........................................:...... Zoning District ......................... ...........................................Fire District ........ ..... ... Name of Owneri5.......Address Nameof Builder .......Fh.1.... jYt.n... ..Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ..................................................................Foundation ........;::. ............ .: :.................................. Exterior ............. ..5:t.......`F�n.....--. � ... ...................Roofing Floors .......................................................Interior .....................:.... .......................... .. ............................ . Heating /..........:...................Plumbing............................ ...........�N .... ......I............................................. Fireplace ................ .................................................Approximate Cost ....................................................... ..... Definitive Plan Approved by Planning Board ----------------------_---------19________. Area ... �..:.a�. Diagram of Lot and Building with Dimensions Fee r� SUBJECT TO APPROVAL OF BOARD OF .HEALTH �d CaWA1£C O � I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ...4. . ...... . ......................... Jenkins,. Richard B. 21270 one story ................. Permit for .................................... single family dwelling ............................................................................... 316 Elliot Road Location ................................................................ Centerville ............................................................................... Owner. .............R.i.char.d..B....Jenkins .. . ........ .. .. . ........ Typeof Construction ...................................frame....... ............................................................................... Plot .............................. Lot ..............#15 ................. Permit Granted ..............May. ..7..............19 79 Date of Inspection7'A-.n-., e......19 Date Completed .......1 ............. 9 PERMIT REFUSED ............. .... 19 ...................................... ............... ............ ................................................... ............ ........... .......................... .......................... .. ................. ..... . . ........ .. ...................... ... ......... ... ......................................... ,,-Approved ........................................... 19 ......................... ..................................................... ................................................... I 14 '9 i •tr • - f � r 1 ,a G r C-Mt~i 1'F t a P Lc)-r PIT-. /51. i 4 L4UaTiyr.� ��.t•.!rt'CGztJrt..t_L-S —n-4wr TPr= roUr4b4-rjot,3 -5tAowQ � t2EGIS r*izar-> i_a.u© Tµt5 Cat-AW t° +�tc��' 8�►S uk-� P= 1 r sc[ v+�..+.G c� �tAS��r 1 Q(.)AAi2i.i; �,c.►t~.�c_ �' �,�V' :its. vc=c:y., :T"fi �i•it�a�w APPt_l CA.►•` -r + � I. Eh.l{�.tlr��g +.tLc' r�L ca�t� 1ct Ur=rC°etic<..1L- LOT t A W& � 14�46W TOWN OF BARNSTABLE permit No. _____- Building Inspector Cash ___--- 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 Richard B. Jenkins' Address TrA 01r; '11_6 :711"i nt Rnnfi- rAntPmri 1 le R Wiring Inspector u i t��� Inspection date Plumbing Inspector I_ '�l Inspection date Gas Inspector y _ Inspection date 'Engineering Department .e', Inspection date 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. 19/1 ! _.... ......... « «_ .»..._ . , ..................... .. `Building Inspector Assessor's map and lot number .. .... �?..... ....... 0_. THESewage Permit number ..... f.7 ............................... House number ................... ..�T. B9BBSTADLE, ..��..........................J�..... 90 rae& L p 1639. `00� . MO a' TOWN OF BARNSTABLE a BUILDING INSPECTOR �. APPLICATION FOR }.�PERMIT TO ( ......................................(_A. . • ......... !} .................................... . J t`= rkr 1 v .� r r JF�r.. °f•. ! '•• �, ., ....i a ..` .......... TYPEOF CONSTRUCTION ...................................................................................................................................... .......... `.. '.............19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..tt........ .-. ......... ,A �.�...j ..../!�'.+ ....................... F :1 ?' .r ......:... ProposedUse .................................................................................................................'............................................................ ZoningDistrict ............................................................:............Fire"Dist'rict ....... :......` ......................................................... Nameof Owner .,;I1;•f("....(. l/* '..:.....!,. �'..11 .......Address .................................................................................... Name of Builder� .! .} V`�'�..v�. ....... ),,, r ° 1.f?,";.Address ............................................................... .................. Nameof .Architect ..............................................................f...Address ............... .................................................................... . _,. Number of Rooms ' Foundation ........:..: ::. ". .............................................................. Exterior ............. r. .:....... .................Roofing .............. . ^�.. ,,1 ..'1.. ......................................... Floors ................ . a i..........:........................................Interior ...............................w t......... 7 .. Heating ....... :.. .......... ^ 3i .E;.fA... .................Plumbing ................ ....... ....................................................... Fireplace ............................Approximate Cost Definitive Plan Approved by Planning Board,________________________________19________. Area ... ............ 9 Diagram of Lot and Building with Dimensions Fee .................' SUBJECT TO APPROVAL OF BOARD OF HEALTH I ' r• i I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name . : ? '1r^s ��r,...�. R...�d nrf�..:...................... ^=^ki^~~, ^~ ~- ~�~^^ ~^ - '= 2^, =w A� 21270 ' one No ................. Permit for ---..—���q........... oio�le feuui dnmell^ � ����,��.������''«����'��.�����''' 316 Miot Road Location ---.------------------ ________..Oeo�er��ll�_________.. � � Owner' ___.Richard..D... Type of Construction .........frame....................... ' � ` � Permit. ~....~- '—".. — °"= of Inspection" uo/a Completed ^- � PERM�IT REFUSED � ' ..................]' --------'. ' ^7^ ~ --' / ................. ---' A —''^' .... —' ^----^.�'^^^—''F---^— ' Approved ................................................. l9 / -------.-------..--.-----..—.. � ' -----`-------------~--~^—~'— /