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Y0 G 3 Q�y V, 36,S� f Town of Barnstable Building Department Brian Florence, CB 0 Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.bamstable.ma as Pre-application for Business Certificate C) Parcel Data Map de— Applicant Information e0bleWants NameR Z-C Applicants Address. Email Address Telephone Nmnber ,� D " 61'S 1 /C'9� Listed❑ Unlisted ❑ Business Information New Business? ---------------------------------------- Yes No Business is a registered corporation? ----------------------- Yes No If yes Name of Corporation Does business operate under the registered corporate name? Yes No is the business a sole pr-oprietors]4or home occupaiion? --------GO No If yes then a Home Occupation Registration is regga red—See Building Division Staff Name of Business C c CC o I , ,q, C `� G -e.eS Business Address t ( © ( �-zz `'n w ► V t ja,6A C'(!�1 EY-Uf i ve f ImA Type of Business n6 !Sf �L - ding COMMissionff Office Use Only Co onsAT, AAA QA 0 IN VIA CM Building Commissioner 4K &t Date In h Clerk Office Use Only L Town of Barnstable Building Department �oFVE rAcyy Brian Florence,CBO Building Commissioner LIRNSPABLE. : 200 Main Street,Hyannis,MA 02601 ntAss. - v i639 1�� www.town.barnstable.ma.us - Office: 508-862-403 8 Fax: 508-790-6230 Approved: Fee: CP Permit#: HOME OCCUPATION RAGISTRATION Date: Name: (�� 6e/ Phone#AA : � Address: D Village: L �(J� (Ac?_G Name of Business: ` q Type of Business: T W �' y / - C)� — YP Map/Lot:. oo INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. d C C . Such use occupies no more than 400 square feet of space. rn � . There are no external alterations to the dwelling which are not customary in residential buildings,and there cn 0 is no outside evidence of such use. No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular �p M matter,odors,electrical disturbance,heat,glare,humidity or other objectionable effects. � C � • There is no storage or use of toxic'or hazardous materials,or flammable or explosive materials,in excess C -=1 of normal household quantities. . Any need for parking generated by such use shall be met on the same lot containing the Customary Home Z Z p Occupation,and not within the required front yard. M Cn 9 . There is no exterior storage or display of materials or equipment. Z ' m . There are no commercial vehicles related to the Customary Home Occupation,other than one van or one W D 0 pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to C C exceed 4 tires,parked on the same lot containing the Customary Home Occupation. r -0 C . No sign shall be displayed indicating the Customary Home Occupation. I i• If the Customary Home Occupation is listed or advertised as a business,the street address shall not be 05 included. Z. No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigne ave read d agree th e above restrictions for my home occupation I am registering. ql Applicant: Date: m Homeoe.doc Rev.10/17 y ..ffeu.f.�..t._..1L'.:'SfLL:tf.tLY.4tA:a.LYIvi.Y:pW1,.¢'/atLE'�,1lroaL-n:Trir+l.rl�fiallcWY..a._a> Li.Difn.aK.,ut.r,>•..Sin.iln•..v+GWI.4LM1'YYUIru.[:aYun[rvsi+.YN.UfJNtaY[NCSryWtivnYi.WaalfuaAusWal..J:vLLa4.uuRva.e.aw:uYtl.a...w.tt,.unla+:ns.iL•Y•s'u.nf•.mYv.•A.a.amlwo.u.u.a.nvfuMw-.••��.•••�•.•am.uu.i.rvuau...vw..nv.�_ 1 YOU W1514 TO OPEN A BUSINESS? For Your Information: Business certificates(cost$40.00 For 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do.byM.G.L.-itdo.e.'s.noCgiveyou.permissionto operate.] You must firstob.tain the•neces�ary signatures on this form at200 Main St., Hyannis. Take the Completed.form to.the Town Clerk's Office, 1st FI., 367 Main St., Hyannis, M-A 026.01 (Town Hall) and get the Business Certificate that is required by law. 11 DATE'S;-i(---S r6 ( ill i pi se. Lip?�.�3iT;"•,., 'I ' APPLICANT'S YOUR NAME/ + ' +t'k'+y%'�' 1' 0 BUSINESS YOUR HOME•ADDRESS: � ;'JI+`' ICU 31 2�1 Yk e 1 JJego j U!'JEW."111�1' TELEPHONE •#' Home Telephone Nu m or E—MAIL — ��� •' �� NAME OF CORPORATION; NAME OF NEW BUSINES e 1". + TYPE OF BUSINESS IS THIS A HOME OCCUPATION? ES NO i (AI-7 ' ADDRESS OF BUSINESS_ C' �'� MAP/PARCEL NUMBER I A sassing] When starting a new business these are several things'you must do In order to be In cgmpllance with the rules and regul'atlons of the Towh of d'o Barnstable. This form is.intend to assist you In obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the eppropriato permits and licenses required to legally operate your business in this town, 'I. BUILDING COM 1551D 1=R'5 OFFI % 'US I C�rN�'r'LY Wl i n HOME �`:vvi-.Ay 1�yi`a This individu I o i d f n o r uire Brits that pertain tothistype of business. RULES AND REGULATIONS., EAII._URE T1`0 COMPLY MAY RESULT IN FINES. orized g tdre C MENTS ��. 2.' BOARD OF WEAL This individual has been informed of the permit requirements that peftaln to this.type of business. Authorized Signature* COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This Individual has been informed of the licensing requirements that pertaln to this type of business. Authorized Signature** COMMENTS: - 1 uwn ul !Barnstaple Building Department Services FiNe r Brian Florence,CBO o* Building Commissioner RARNS'ABLE. ' 200 Main Street,Hyannis,MA 02601 Mass. g 163q. `�� www.town.barnstable.ma.us 7,ejf Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: Permit#: HOME OCCUPATION REGISTRATION Date: I 1 Name: G P �� Phone#: � ✓ �� Address: Llz 1 `VN 1 \ Village: V6 l� Name of Businesse Type of Business: V— y t le Map/Lot: �U W INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,*subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the.dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be.permitted as of right subject to the following conditions: • The activity is carved on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • " Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter,odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • .There are no commercial vehicles related to the:Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing-the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall bg employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned,have read and agree with the above restrictions for my home occupation I am re ' terin ./ Applicant: Date: Homeoc.doc Rev.06/20/16 50`� 3is - a� � `fa r Ier System 'es ❑ No 'es ❑ No . ent Use only A NA P M ox 12 7 7 (=wLvt O20a 2 MIMI 6-4 4. GeorgeJessopArehitects@_Verizo .net a November 28, 2016 77 Mr. Paul Roma, Building Commissioner Town of Barnstable 200 Main Street Hyannis, MA 02601 Re: Fraternal Lodge Fire Escape Inspection Dear Mr. Roma; In accordance with 780 CMR1001.3.2, I have inspected the secondary means of egress from an elevated first floor Assembly A=3 occupancy at the Fraternal Lodge, 1989 Falmouth Road, (Rt. 28), also referred to as a fire escape, and find it to be of rot and insect resistant materials, adequately designed and well constructed, and in compliance with the 81h edition of the Code. Further, I find after thorough inspection that the condition of this structure is sound and fully functional showing no signs of deterioration other than change of color to weathered grey. Sincerely yours, George A. Jes o Jr. AIA 9 p� Registered Architect, Mass. Lic. No. 6597, exp.AutU. 31,2017. - cc. Martin MacNeely, Inspection Services RED 'F C-O-MM Fire Departments�o�* 1875 Falmouth Road-Rt. 28 b Centerville, MA 02632 ° No,65 a • BARI�ISTABLE, v ` Mass. A,Member of American Institute of Architects,Boston Saicty of Aaliicects,,Preservation/'lassachusects,The Qauonal TnAt for HBO,x Preservation ° t MICHELE CUDILO, P.E. Consulting Structural Engineer Centerville, Massachusetts 02632-1979 • (508)771-7601 • Fax(508)771-7163 mcudilo@comcast.net May 31,2013 Town of Barnstable Building Department 200 Main St. l Hyannis, MA 02601 Attention: Mr.Thomas Perry, Building Commissioner RE: MASONIC LODGE: Egress Modifications to Apartment Centerville,MA Dear Mr. Perry, At the prior request of the Building Dept. representative,Jeffrey Lauzon,the Contractor,Centerville Building Corp.,and I reviewed the above captioned project for the purpose of addressing the structural requirements of the ledger,attachment, namely adding sufficient bolts into the upper deck ledger to attach to the existing building brick wall. The existing upper wood deck structure is now attached with a total of(14)5/8"diameter expansion anchors,a minimum of 3"into the brick for a required shear value for each bolt of less than 200 pounds each. The value appears within the capability of the masonry material. To the best of my knowledge and belief,the construction is adequate and in conformance with the requirements of the 8`h edition Massachusetts State Building Code requirements for loads and construction. Si cerely, 1�dt f-f�— Phele Cudilo, P.E. /2011-209 { cc: W. Desouza �P�tNOF44Ss 4' MICHELE yG� CUDILO • a STRUCTOH.AL �, No 3477,,4 e 10 9��FGlsTEP FSSIONAI� TOWN OF BARNSTABLE BUILDIN9 PERMIT APPLICATION Map Parcel Application # Health Division ��(�9- Date Issued Conservation DivisionlL t�c�G Application Fee 00 Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board CO D�17d//2-d1Z Historic - OKH _Preservation / Hyannis Project Street Address 9ieq -F-k-1 �® rJ4- P.o Village coM-W- '(.fk� Owner CR6 eVi116 WONA CO- 4VG Address Ilan FAL44OUT Telephone 506 77.5 245.' Permit Request ,16 INGk- A-- 56COOD WyEAU, OF E65 A t U I Lot 1i Cg Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District t� Flood Plain Groundwater Overlay Project Valuation# 3 O0ye6a Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Mom Count, Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Ca Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood%coal stove; ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existinggnewsize_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ! Telephone Number Address �ERO� License# C.S (o75D Home Improvement Contractor# 41;2117Y Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE . DATE Ih{yJ� 'I 1 FOR OFFICIAL USE ONLY Z, . APPLICATION# ` DATE ISSUED a: MAP/PARCEL NO. r ADDRESS VILLAGE x OWNER 1 DATE OF INSPECTION: . � r FOUNDATION . } FFRAME 31510 INSULATION t FIREPLACE r 8 € ELECTRICAL:' ROUGH FINAL PLUMBING: ROUGH FINAL _ ` GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT r ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 wM •�• www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Orgmization/Individual): : ;Zsoffloua If, Address: 'lag K .V De. p2(o`f 6 City/State/Zip: M/9620,5MI-51MA Phone.#: 0 Ufa o - n Are you an employer?Check.the appropriate boa: Type of project(required): 4. I am a general contractor and I 1.❑ I am a employer with ❑ 6. ❑New construction rr employees (full and/or part-time).* have hired the sub-contractors . 2:Ir 1 I am a sole proprietor or partner- listed on the attached sheet. 7. Yllemodeling ship and have no employees These sub-contractors have g, ❑ Demolition workingfor me in an capacity. employees and have workers' Y P ty. 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.Lic.#: Expiration Date: Job Site Address: City/State/Zip: - Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure,to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,560.00 and/or one-year imprisonment,as well as civil penalties'in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under t pains and penalties of perjury that the information provided above is true and correct. Signafore:` Date: Phonek 5,99- #140 '/6�D�p Official use only. Do not write in this area,to be completed by city or town`official City or.Town: Permit/License# f 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 fm the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the,number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials, Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a'reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in _(city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person,is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone-and fax number: The CouunonwWth of Massachusetts Departnaem of Industrial McidentS Office of Investigations 600 Washington Street Boston:,MA 02111 Tel. ##617-727-49-00 ext 406 or 1-977-MASSAFE Revised 11-22-06 Fax##617-727-774 www.mass..gov/dia ��e' Pan .u,eaaartuaeiYa "OffiT. ce a COnsumer`Affairs&Busme+ts lteemat i �t _- HOME IMPROVEMENT CONTRACTOR1. xRegistrafion i.n87a E nradi> i' Q9/2012- 7r s 7ad+a1 44- { i ' i t of + I , St a►cf t�f t4jltj#ig-1Zcgul.ifions and Starrlards Co s tuc#a0n>Supervisor Licenses License CS 67505 mg BRIAN DAB�AKER - 4.2 KERRY DR V1ARSTONS MIII'L 02648 Expiration: 8/12/2013 {'caia�ii�3i �e Trp: 21059 SHE T° Town of Barnstable Regulatory Services + BMMSTasLE, + 9 Maas, g Thomas F. Geiler,Director . �p •i639 �� _ Tiro 39 Building Division Tom Perry,Building Commissioner . 200 Main Street;Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize �!/�'� �• �'�� to act on my behalf, in all matters relative to work authorized by this building permit �8 1-c (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. Signature of Owner Signature of App cant Print Name Print Name - Date Q:FORM&OWNERPERNOSIONPOOLS 62012 i Town of Barnstable THE T� Regulatory Services aArrsrABIZ, : Thomas F.Geiler,Director MAss. 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: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is,or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section'109.1.P) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with.said procedures and requirements. Signature of Homeowner c ' Approval of Building Official 4 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 permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:fonns:homeexempt eY Town of Barnstable ' Regulatory Services MAW Thomas F.Geiler,-Director .. Building Divisions Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 May 18, 2011 Fraternal Lodge Building Corporation PO BOX 595,. Centerville; Ma. 02632 - RE: 1989 Falmouth Rd., Centerville, Ma. Map: 189 Parcel: 002001 To Whom It May Concern: Recently this office did a site inspection at the above referenced address and several safety concerns were observed.The following items need to be corrected and this office notified upon compliance: 1) An apartment on the second floor of the building has only one means of egress. A minimum of two means of egress are necessary. A building permit is required to resolve this issue by either adding an egress or removing the apartment. 2) Two skylights are leaking; one of which is over an electric appliance. The leaks' must be resolved. 3) A dryer is exhausted into a wall cavity and does not terminate outside. The dryer exhaust must terminate at the outside of the building. Thank you for your immediate attention in resolving these issues. Please do not hesitate to contact this office with any questions. By Order, We Lauzon Local Inspector (508) 862-4034 .�y a 1 r _ a ' TVL i.� Cij5 fA rro �. P I � UZ , o .. r ( �. I I � •, 4' ,,. � i, ' ^r . ' Y ;a ' _ j SN OF ASS u o2� MICHELE G z CUDILO oNo 34774 U ST86CTURAL C 0 D C CornPt,mj--Nn- io ABC LI K 1 fC N G1�! E p(zoo t:t LIB/' C tJ U 1Z OD trj 0 ►W 1N G ` eqlhR51 4°x ... 4 C; G Lc7 GC.0 l l At l 4 i�c.' x f i s• C-Lpc FSAT�.. — ---� is ' � CGUN QLVUt?� PLAN MICHELE CUDIL4, P.E. Consulting Structural En ineer . 123 Cottonwood late. CeMemift. Mlossochusa is 02032 f# I OJT rown By: MC Date: 2 I brawlng ale. AS NOTED , Rev. 0 S K- -le Nirtse: `Project No.: ALUM.PICKET '-N�i417ROOM I I I I 3 1/2"DIAM-6&Y. -B& ALUM.COLUMN 4"MAX. I I 3/8"WALL PICKET `ry I I WX 3/8"ROUND FLANGE 5PACIN6 \ MAX.RI5E I I WELDEDTO COLUMN W/ (4)5/8 A5.W/ 6". I i 'EMBEDMENT FIN.PAVING I i 7 i X X WGONC.FTG. CF � k4sSA MICHELE ctiG �ox(o 1NZ.iq cUV2�q 44 7CC 1" CUDILO p No.34774 c U _ STRUCTURAL ,�c��aEo`� �LEV./SECTION `SIONAL�� b 5,_0" i PLANYIEW MICHELE CUDILD, P.E. ' Consulting Structural Engineer 123 Cottonwood Lane. Cent Is. Moseoohusetta 02632 _f/►L M OL)Pf r—D, Drown By: MC vote: I 2 , , 11 Drawing ale. AS NOTED Rev. 0 c jj ►J Iles No'mei K-Project No.. �q i u u F1 X► T' K�o Tr_ sus tr OF WCHE�E U Cu0jL0 v 'Vo.34774 �uC7Jr S7 AL 9FrarF,� Sod�t I, tisTNt A-3,; K-UsT- 40i6 rov N•'f. Z►k'._ : ems cop�po - _. MICHELE CUDILO, P.E. Consulting Structural Engineer __.._._..-_......__.. ..-_... 123 Cottonwood lane. Centerville. Massachusetts 02632 Dawn By: MC Date: Drawing Scale' AS NOTED Rev. 0�. S K - -- File Nom e;_._ .,. Project No.: �4A The Commonwealth of Massachusetts William Francis Galvin ... Page 1 of 3 The Commonwealth of Massachusetts William Francis Galvin Secretary of the Commonwealth, Corporations tS, Division One Ashburton Place, 17th floor Boston, MA 02108-1512 Telephone: (617) 727-9640 Q CENTERVILLE BUILDING CORP. Summary Screen Help with this form `'� Request a�Certificate ��,, The.exact name of the Nonprofit Corporation: CENTERVILLE BUILDING CORP. The name was changed from: FRATERNAL LODGE BUILDING CORP. on 6/27/1994 Entity Type: Nonprofit Corporation Identification Number: 043237971 Old Federal Employer Identification Number (Old FEIN): 000356351 Date of Organization in Massachusetts: 03/01/1991 Current Fiscal Month 1 Day: / Previous Fiscal Month / Day: 08 / 31 The.location of its principal office in Massachusetts:. No. and Street: 1989 FALMOUTH RD. City or Town: CENTERVILLE State: MA Zip: 02632 Country: USA If the business entity is organized wholly to do business outside Massachusetts, the location of that office: No. and Street: City or Town: State: Zip: Country: The name and address of the Resident Agent: Name: No. and Street: City or Town: State: Zip: Country: The officers and all of the directors of the corporation: http://corp.sec.state.ma.us/corp/corpsearch/CorpSearchSummary.... 9/14/2012 The Commonwealth of Massachusetts William Francis Galvin =..: Page 2 of 3 Title Individual Address (no PO Box) Expiration Name Address, City or Town, State, Zip Code of Term First, Middle, Last, Suffix PRESIDENT DAVID 15 LIMERICK CT. KONIGSBURG CENTERVILLE, MA 02632 USA TREASURER WILLIAM ELKINS 84 ROLLING HITCH RD. CENTERVILLE, MA 02632 USA CLERK JAMES A. LUKER 67 RASBERRY LN. MARSTONS MILLS, MA 02648 USA DIRECTOR ERIC FUHRMAN 205 QUAKER MEETING HOUSE RD. SANDWICH, MA 02563 USA DIRECTOR RICHARD 199 SHOOT FLYING HILL RD: THOMPSON CENTERVILLE, MA 02632 USA DIRECTOR WILLIAM ARTHUR 3420 MAIN ST., RTE 6A BARNSTABLE, MA 02630 USA Consent Manufacturer = Confidential Does Not Require Data Annual Report _ Resident Partnership Agent For.Profit . Merger Allowed � Select a type of filing from below to view this business entity filings: ALL FILINGS Annual Report Application For Revival 43� Articles of Amendment - Articles of Consolidation Foreign and Domestic View:Filings° Z �yNew Search '-,;' http://corp.sec.state.ma.us/corp/corpsearch/CorpSearchSummary.... 9/14/2012 The Commonwealth of Massachusetts William Francis Galvin .-... Page 3 of 3 Comments ©2001 - 2012 Commonwealth of Massachusetts All Rights Reserved Help http://corp.sec.state.ma.us/corp/corpsearch/CorpSearchSummary.... 9/14/2012 Message Page 1 of 1 Anderson, Robin From: Jim Luker D.luker@gseenv.com] Sent: Wednesday, September 26,2012 2:03 PM To: Anderson, Robin , Subject: RE: Frat Lodge Robin I discussed the complaint with CBC and they agreed to immediately require a police detail on evening functions. We can prepare a formal response next week if you would like Thank you for bringing this to our attention. James A. Luker Jr. LSP CPG VICE PRESIDENT OF ENVIRONMENTAL SERVICES 114 State Road, Suite B1 Sagamore Beach, MA 02562 , (508)888-6034 Fax (508)888-1506 Cell (508) 284-3017 www.gseenv.com Small Business Certifications: •SBA 8(m) Women-Owned Small Business(WOSB)/Economically Disadvantaged Women-Owned Small Business(EDWOSB) •Minority Business Enterprise(MBE) • Women Business Enterprise(WBE) •Disadvantaged Business Enterprise(DBE) From: Anderson, Robin [ma ilto:Robin.Anderson@town.barnstable.ma.us] Sent:Tuesday, September 25, 2012 2:09 PM To: Jim Luker Subject: (SCL: 0) FW: Frat Lodge Robin C. Anderson Zoning Enforcement Officer l'own of Barnstable 200 wlain Street Hyannis, M.A 026oi 5o8-862-4027 -----Original Message----- From: Anderson, Robin Sent: Tuesday, September 25, 2012 1:47 PM To: 'j.lucca@gseenv.com' Subject: Frat Lodge Please find the complaint we discussed. Robin C. .Anderson Zoning Enforcement Officer. lawn of Barnsta6l 200 Main Street Hyannis, NA 026oi 5o8-862-4027 9/26/2012 Lo 9(�3een coyy) �a Acbw I i i i i i � I'I i s e � Message Page 1 of 1 Anderson, Robin From: Anderson, Robin Sent: Tuesday, September 25, 2012 1:47 PM To: 'j.lucca@gseenv.com' Subject: Frat Lodge Please find the complaint we discussed. Robin C. -Anderson Zoning Enforcement Officer Town of Barnstable 200 Main Street Hyannis, MA 026oi 5o8-862-4027 i -J ft ,t 9/25/2012 a _ _ • K ��ti�f'. - •r i� ., I - i r . . - -�,, - � � ,,� 41 ��' .. y it�� ..' � - ,i r. f i it t t?Y9�6� . ' ,��, , ,�/�r CAA .. 1 /�` Ali_ ✓ � ' -'/I r-'`�. ./ \ 7 z' 1. To: Robin C. Anderson Town of Barnstable Zoning Enforcement Officer To Whom this May Concern: The neighbors and abutting residents of Centerville,residing in and around The Fraternal Lodge AF & AM located at th�Read} a 'i1 wish to register a formal complaint regarding noise violation and pollution. It has become a most unwelcome and dis-tasteful neighbor on most weekends. The noise from"functions" and the inappropriate language that can be distinctly heard at all of our properties is in direct violation of the Town of Barnstable Noise Ordinance.Article XXI Section 1. clearly states that it is unlawful for any person or persons occupying or having charge of a building to allow loud or boisterous noises to be plainly audible at a distance of one hundred fifty-feet from any building or dwelling. Not only can the"music"from"functions" be heard at all of our properties,but those of us abutting this property can clearly hear& understand` foul language coming from this property but also have to endure the late night"noise"from bands/DJ's etc...much past an appropriate hour in the evening. Furthermore,it is our understanding that this establishment is a"non-profit" organization and wonder how this building can be'used for such functions,without profit? As residents and neighbors of this Lodge,we are asking the Town of Barnstable to address this situation ASAP so that we may all be able to sit and enjoy our yards and our visitors during the all too short summer months. Thank you for your time and effort with this matter. �',apy Ville•+ .i:.l,nsoa . . t� 1�i dO nt a Akdes Ll2 wild S i vov IDYL P een+erV1 lle Al � ®Zs Z, ✓ i" lam( C�Z�jZ_ 1 C t� TOWN OF BARNSTABLE 30155 permit No. ................ ° BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash a X Yh HYANNIS,MASS.02601 Bond ..... CERTIFICATE OF USE AND OCCUPANCY Issued to FRATERNAL LODGE AF & AM Address 1989 Route 28, Centerville USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. December 14 87 ��v �4� ............................ 19................. r.:�'�; ...,......,........... Building Inspecfor�'�,_,,,, TOWN O FF F BARNSTABLE Permit No. ......r' 3015. 5 ... .. i_ BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash HYANNIS,MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued to FRATERNAL LODGE AF & AN Address 1989 Route 28, Eenterville USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. December 14 19...8�.......... ............................ ............fit!;.:.... ,:... Building Inspector OF BARNSTABLE, MASSACHUSETTS BUILDING PERMIT r'•9-0UG� -- �� DATE ."cOV'EYtI{il�r'I: � )I) n _. c 19 PERMIT NOil'�_��1 CANT_ Fa[1 f PYIiA] ] O ] p ADDRESS_ ]3n:; b54• Hyannis, ifia 4' ! )' (STR EE T) ICONTR'S LICENSE) -•MIT TO Kiti 1 r1 FYatnr (1�:.1 F. x, � .NUMBER OF (TYPE OF IMPROVEMENT) f N0 I STORY :i,l='n'•i r• '�pIR -I p DWELLING UNITS (PROPOSED USE) - AT.(LOCATION) 19?iA RC1171 f )� ('pn} " T r"11 ZONING (NO.) (STREET) DISTRICT_1\:17111..i7-y BETWEEN ' (CROSS STREET) AND (CROSS STREET] —_-'--------- SUBDIVISION LOT LOT BLOCK SIZE ` BUILDING IS TO BE FT, WIDE By - - - FT. LUNG BY_ FT, IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE / USE GROUP BASEMENT WALLS OR FOUNDATION 1 1 TYPE) REMARKS: Sew a';,-, #S36-734 iijJ�)c3 J.i. 7fl�tJ�,'•111�% �.[..z Lf' n`i'i:ii AREA'OR Loa VOLUME. 4076 SQ ft. ESTIMATED COST 300,000,00 FEE 4( .-. (CUBIC/SQUARE FEET) 1 ADDRESS —B_ �'y_hSQy BUILDING DEPT• ,i,'� BY ---�- . -. .. THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARIf_Y OR .. .. _ . . _ ® PERMANENTLY, ENCROACHMENTS. ON PUBLIC PROPERTY NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP- PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL gppROVED PLANS MUST BE RETAINED.ON JOB AND THIS. WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL ELECTRICAL, PLUMBING AND MEMBERS(READY TO LATH)- QUIRED,SUCH 6UILDING SHALL NOT BE OCCUPIED UNTIL 3. FINAL INSPECTION BEFORE FINAL INSPECTION HAS BEEN MADE, OCCUPANCY. P��T THIS CARD S0. IT iS,U VISIBLE FROM STREET _ BILDING INSPECTION APPROVAL S PLUMBING INSPECTION APPROVALS I ELECTRICAL INSPECTION APPROVALS ' x0ov'Ir ox p a. 2 _ 2 3 >e-.— HEATING IN PECTING APPROVALS REFRIGERATION INSPECTION APPROVALS . 1 1 ._ � G OTHER 2 V�TRXf�fJ -- ,"__ Z `r D RD OF HEALTH WORK SHALL NOT --- --- ---- ---- — =--_� `' 4 ' PROCEED UNTIL THE PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION iNSPECTI0N5 INDICAT �NSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. WORK 15 NOT STARTED WITHIN SIX MONTHS OF DATE THE Fp ON THIS CARD PERMIT IS ISSUED AS NOTED ABOVE. CAN BE ARRANGED FOR BY TELEPHONE OR WRITTEN NOTIFICATION. ZN �:� -"'.�.• - = f� off• � � � � - � . Assessor's offioe7,(lst floor).' ' Assessbr's map,,and lot" number. %../1 ' �'I�°, c�c o To t � o� Board'of Health..(3rd floor): ° / —7 L ` NSTALLED IN COMPLIAN ' Sew/ ge Permit. number ................4� (.. ..,.. . �' WITH TITLE 5 t B9flII9Y4DLL 'Engineering Department (3rd floor): f� ��S \ "- ENVIRONMENTAL CODE A��°v,,�'111 3o 0� House number ................`�.... ``, o�orA? ,. L . . APPLICATIONS PROCESSED 8:30 '9:30 A.M. and 1:00•,2:00 P.M. only TOWN. � 'OF BARNSTABLE t B:UILDIHG INSPECTOR ° = ' APPLICATION.'.FOR.PERMIT TO .y! ......- ... .• 'X.� TYPE OF,CONSTRUCTION—. .....•.O.. 7!,:,� rF } .. - • / TO THE INSPECTOR OF BUILDINGS: a` The undersigned hereby applies for-a,permit-according to the following information: Location ......:.....�.�.v ...... 4. R.If�441........................ Proposed Use .................(..: ! .orf!f ........ �.—..7 ............................. Zoning District ........Rc..::...e.T.I...... ' ...C IJ� n —Q ..................... .............Fire District ��,-. �. Name of Owner Address l .�X..`PS.7':i....l , A5............ Name•'of BuilPd er f1wi Snr/,.#.i,i V,7.` ........................Address .........................• .....•...... ...... •.........................• Name of Architect �Rf. .;/,.... .s S.Oc•...............Address rr- .!¢.^� j .. y. �s...... ` Number of Rooms ....... f.......... ...Z✓<.fBOT. �r Foundation ........... /N Exterior ....W.Lt.:.. Hl�/G-L. ..: :........... .....&..........."'...Roofing ......... Floors ......0.N -..... .:....... .•:.�'....=.......... nterior. ..........V.T! ....(.4<5�.��1 ................................... Heating O... V" �y ��.Z- ..............Plumbing aa /1-T/ ( TC�} ! .. A,..... ... .. ....!✓. .... ............ ...................... Fireplace ....... Cost .......... .U�� d�..� .............. Definitive'Plan Approved by Planning Board ________________________________19-_---_-_ . Area .....s./...®../... Diagram of Lot'and Building with Dimensions , Fee .� 60 ... ....... SUBJECT TO APPROVAL OF. BOARD;OF HEALTH R •OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS ' d hereby agree to conform `to all the Rules and Regulations of the Town of Barnstable regarding the above construction. < d Name ... ........ .... :. ....`... .. ............ Y' Construction Supervisor's License ..................................... FRATERNAL LODGE AF + AN. v- 30}:55 r -' FRATr.kiV'AL LUNGE r Permit for ...- � Nod... 1 .. Masonic Temple .... ..... .......................................... Location ... r .1989 Route..28.....•...... .-s t �' µ Centerville -Owner Fraternal Lode..AF . AM......... z 'Type of Construction ......Frame.. .....:............ cr ... ...... ............................. V•• _rAr .% '� {. �+" - '.a - �. - {� Plot ..'.......................... Lot .............. ........ ;' � November 7;`�- �19 86 h ,{�• (f f, � -. � i - ',.- rr _. -, k Permit Gran,ed ... ... .... r Date'of. Inspection ....... ......19 Date Completed .............. 19 i ...... ` � 4.� �: �. .. -,•, fir,. .." _ ,{ �� .... n, 41 4. �,• 'r •�•..-�,._• � ` � ,ft.� (,, •{' �« '• mil' _f � - •• � � k - r No. 7-21858 n tanuivraIf l of ifi�Boar*wrm DEPARTMENT OF PUBLyC WORKS PERMIT BARNSTAPLE Subject to all of the.terms, conditions and restrictions; printed or written below, and on the reverse side hereof, permission is hereby granted to . HUGH FINDLAY, P. 0. Box 1690, Hyannis.; MA, to enter up6 State highway in the Town of Barnstable locally known as Falmouth Road, Route 281for the purpose of construct- ing a drive to his property between Stations 380+82 an 381+06 at the Southerly line of the State highway location, flaring to Stations 380 52 and 381+36 at the edge of the hardened surface as shown on the attached .sketch. Light grading may be done between Stations 380+25 and 381+65. Within State .highway layout, the :drive must have a six. inch foundation of. compac-ted gravel and be paved with three. inches.of bituminous concrete mix, 11 inches binder and 11 inches top to be laid in two courses. It .must butt into and not overlap the edge of the highway surface. . .:_ The. Grantee must not _apply the bituminous concrete mix to the Proposed drive before the gravel base is inspected 5y the Section Foreman.. The Grantee must call Carroll Fonseca. at 563-5088, .to arrange for this inspection. All disturbed areas within the State h-ighway layout must be loamed and seeded.. The drive must be graded in such a manner that no ponding of water occurs within this highway layout. If such ponding results, the Grantee shall be responsible for its correction. All present and future structures located on the property of the Grantee shall be at least twelve feet from the Southerly line of the State highway. That part of the drive located within the State highway location shall be maintained .by the Grantee at his expense to the satisfaction of the Engineer. The drive must be constructed on a minus grade from the edge of the hardened surface of the State highway. The Grantee is responsible for the disposal of all surface . water to enter the State highway layout. If the Grantee should paint any curbing or curb returns within the State highway layout, the paint must be white and must be applied at the time the drive is installed. The Grantee shall indemnify and save harmless the Commonwealth and its Department of Public Works against all suits, claims or liability of every name and nature arising at the time out of or in consequence of the acts of the Grantee in the performance of the work covered by this permit and/or failure to comply with the terms and conditions of this permit whether by themselves or their employees or subcontractors. Please contact Richard Lindgren at 563-5088 when the work required under this permit has been completed in order that an inspection may be made. (continued) H.UGH FINDLAY (Cont.) BARNSTABLE 7-21858 I All required signs and traffic warning devices shall be furnished by the applicant. - All signs and devices shall be in accordance with the Massachusetts Manual on Uniform Traffic Control Devices. The number and location of all signs and devices shall be as deemed necessary by the Engineer fo�, the safe and efficient performance of the work and the safety of the travelling puElic. All warning devices shall be subject to removal replacement and/or repositioning by the. applicant as often as deemed necessary by the Engineer. Cones or non-reflectorized warning devices shall not . be left in operating position on the highway when the daytime operations have ceased. ' If. it becomes necessary for the department to remove any construction warning devices or their appurtenances from the project due to negligence by the appli ant, all costs for this work will be charged to the applicant. All vehicles, excepting passengers cars, which are assigned to the permitted project and which operating on the site: at speeds of 25MPH or less; s-hall have an official : SLOW MOVING VEHICLE emblem A isp?layed. All personnel who are working o`n the -travelled way or breakdown lanes and who are not protected by traffi.c. cones or similar pro.tecti.ve devices shal`1 wear safety vests. ALL OF; SAID WORK.SHALL BE DONE AS .DIRECTED BY AND TO THE SATISFACTION OF THE 4 ENGINEER. Acopy of this permit must be on -the job site at all times for inspection. Failure , to have this permit available at such site will result in suspension of the rights granted by the permit. (SEE OTHER SIDE FOR ADDITIONAL CONDITIONS) No work shall be done under this permit until the Grantee shall have communi- cated with and received instructions from the District Highway Engineer of the Depart- ment of Public Works, at Taunton, 'MA 8244633 This permit shall be void unless the work herein contemplated shall have been completed before September 30, .1987 Dated at Taunton this 8th day of September 1986 FM:cap Department of Public Works, cc:J.McCarthy ✓ By �. ,�4- HMD-604 R. A. Smith, P.E. District Highway Engineer COMMONWEALTH OF MASSACHUSETTS ` DEPARTMENT OF PUBLIC WORKS TRAFFIC DIVISION PLAN COVERING PERMIT REQUESTED BY NUGH FI ND L AY FOR DRIVEWAY APPROACH IN i P N S TA I� L E DATE 9_8 l 9 86 SCALE 1 . = 40 STA,383-FI'r- 24' F.A, L "�-1 " JTH RC'AD PO i E 2 S U R FA C,E 38o tsz 38/toy ,�8z — ;---C L.B.C./. APPROVED TRAFFIC ENGINEER f , r P � i At.r L_e f • �, .w 3 7S oa / .. ro 7g Leta \ d 4 Lit Z 8 FGoo D Zo.v�'; G '13`��� 2 5. ZlJNL : IeD'"I Z4�2 U FOVNDATLON CERTIFICATION TO W N BARIVSTABLE PLAN REF. • 410/ .23 DATE 10/27 SCALE 1" 150 ' ELEVATION I HEREBY CERTIFY THAT THE ABOVE FOUNDATION IS LOCATED ON `N O.i , yetmi4E'E 5GLRVE is i THE GROUND AS SH.OwN, AND COYLSLCLTdYtTt ITS P05I1"ION DOES PAUL• CONFORM TO THE ZONING MA' LAW SETBACK REQUIREMENT ►��se N 70 RASPBERmq, OF S A R r1 S T A QLE �'�•s�fc►stE� 1�t AR T o N 5 tA )L L,S� MA PAUL A. ME.RITHELU R•P.L.S. G ' I HATE CONTINUATION OF ROAD BOND BUILDING PERMIT # O SS i j The undersigned owner/contractor hereby agree to maintain their road bond in force until the following work items. are completed to the satisfaction of: the Engineering Section ,of the Department of Public Works. / (/ loam and seedshoulders as soon as weather permits. other (explain) LOCATION : Z 96 2 CIFE 26 !//z — T2.a Z�11✓,ems C�j� NED Owner/Contractor a GINEE G AU HORI IONS 8i G e Assessor's offioe (1st floor)_: / ` / As esso:'s map and lot number / .....,............................. iTNETo�` Board of Health (3rd floor): Sewage Permit number DAUST '............................. . Engineering Department (3rd floor): , ��o "639. 0� House number ....................................................................... '�cYara� " APPLICATIONS 'PROCESSED 8:30-9:30 A.M, and 1:00-2:00 P.M. only TOWN OF BARNSTABLE BUILDING INSPECTOR I APPLICATION FOR PERMIT TO .........1....C!-. .� :.. - lJ" ...... w ............................ TYPE OF CONSTRUCTION W.,00.: .......12,A�rc ........................ .... ........................................................ ................ U - . ......19. � TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .............p6iu7TE..... .o.......... :x/SfT 2.�1�� . ......................................................................................... ProposedUse . ................................................................................................. p Zoning District ........!.1.�........f�.iV)........................................Fire District .... T�1�;�/L� �ST [ At rf,12/Y t n n&AM BA. � Name of Owner .I,� �.L.,LO G ....? ...Address . X. . ' )...../,Y1411V`!V�.......................... l �... Name..of Builder /Z ' FIL./✓/) ..................Address .................................................................................... .......A.xf �.....A.s.sac .............. / f Name of Architect Cr Address sl............./ ,f'7f}/y/�// Number of Rooms /J ......... .....Foundation .V. ?.E7C...�1�(.C`�L1�,7�i�.,.1.✓�FaaT/�✓G Exterior ....U�!.�1t.... fV/ ff-nL . C /1 ...Roofing AS-Plm ..................... .......... .. ........................................................... Floors 4/..1/✓ /.. c...... .. �.r?./' �- Interior ..........(��E/� r PLIJ�'_ 1......... ................................... Heating /....rj�J0/2 . .....Plumbing ..13....�A77/�� ............. „ F .. Fireplace .................(Yb A ost ..... ..................................................................................................... pproxmae Definitive Plan Approved by Planning Board"________________________________19-------- . Area .......................................... r t" Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name �.�.2.1a�✓ t - l /�✓��� l�t. Construction Supervisor's License .................................... - / � r! �`! -'--T . 30l�5FR�* LODGE ..........---'r-- Location --'l989 _________ ^CentervAle --------------------------' . ' ,Type ofConstruction --�����--------' --------------------------' ' Plot ............................ Lot ----------' November 7, 86 Permit Granted -------------]P ' Date of Inspection ------------l9 ^ Dote Completed ------------'lg ~ .�~ \ ' / ~ r Town of Barnstable Regulatory Services BA STABLE. i MAM Thomas F..Geiler,Director. 1639. 10� Building Division s Tom Perry,Building Commissioner 200 Main Street;.Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 May 18, 2011 Fraternal Lodge Building Corporation PO BOX 595 Centerville, Ma. 02632 RE: 1989 Falmouth�Rd., Centerville,Ma. Map: 189 Parcel: 002001 ._ To Whom It May Concern: Recently this office did a site inspection at the above referenced address and several safety concerns were observed. The following items need to be corrected and this office notified upon compliance: 1) An apartment on the second floor of the building has only one means of egress. A minimum of two means of egress are necessary. A.building permit is required to resolve this issue by either adding an egress or removing the apartment. 2) Two skylights are leaking; one.of which is over an electric appliance. The leaks a must be resolved. 3) A dryer is exhausted into a wall'cavity and does not terminate outside. The dryer exhaust must•terminate'at the outside of the building. Thank you for your immediate attention in resolving these issues. Please do not hesitate to contact this office with any questions. By Order, La zon Local Inspector (508) 862-4034 OQ:zoning5 CENTERVILLS-OSTERVILLE-MARSTONS MILLS FIRE DISTRICT „i S'W '' r�f W '— lie f DEPARTMENT OF FIRE-REBCUE'&EMERGENCY SERVICES 192 1875 Route 28?C t rville, MA 0293J-3117 6 508-790-237 x FLAX John M.Farrington,Chief Martin O'L. MacNeely, Fire Prevention Officer Craig E.Whiteley,Deputy Chief - -�• M.. :- Francis M. Pulsifer, Fire Prevention Officer U1j V'1S10N August 17; 2007 Mr. Thomas Perry-Building Conunissioner Town of Barnstable 200 Main Street Hyannis, MA 02601 Dear Commissioner Perry: Pursuant to MGL'Chapter 148 Section28A, I am malting you aware and'r'equest your interpretation of a bedroom without adequate secondary egress and an apartment without secondary means of egress at: _ , 1989 Falmouth Road Centerville, MA While on a fire alarm inspection at this address, I observed an apartment on the second floor of this commercial structure, The apartment has a single bedroom with undersized egress windows and no secondary egress from the apartment. Please contact me with any questions you have relative to this situation at 508- 790-2376 Ext.l. Thank you for your attention to this issue. Sincerely, . .. Francis M. Pulsifer Fire Prevention Officer e Cc: Robin Giagregorio' "Commitment to Our Community" JSm (Y) c'A ) e«v . � c41 - a67 - �� i4 lkleil JmcRlec�r � C�'ast Renovator Refresher English 10/06/2014 course . T Initial i English 10/06/2014 course Renovator Initial English 08/11/2013 course f Refresher . English, 08/11/2013 course Renovator Initial English 09/08/2013 course Renovator Initial English 06/09/2014 course Renovator Initial English -09/30/2013 course Refresher English 09/30/2013 course Renovator Initial English 08/31/2013 course ype=TRAINING&static=true&glat=4... 3/31/2011 `pF THE► Town of Barnstable BAR AS,' E. ' Regulatory Services MASS. 1679. �0 Building Division pfFD MAC a, 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection E�.1A L li''H M 6 Location 1)e77 i' F A L OI,)uT1~I iel) Permit Number Owner Builder One notice to remain on job site, one notice on file in Building Department. The following items need correcting: (71� r' kY- 2TSEP- NE-_I'GP-r GP- rAT-,Ee INA4 7s�carc, ✓o s f ACSJG ei car= W !gAc.c uS2S Lr DGCis rvoT- 10 QPEr2L-Y s&1,Ppo2?' Eb Xr etATLL-1z"✓Q r9 A\�kJ0kAX:L /Jo i GPJrsti°C L4�7�uGVJ OF STATie- -)A-Y l� �A� s l� A_LL.- 3 5 NoT G k'A S PA g LIE I)v E TU L DcgT/o rJ Pr,T�,d(�s T-✓ R r56✓e S GPEATETc —7-*A-J )q Z-L0 W6L') �j'NLy 6ro1C SNSTA I.LEb .09 �Pct�O K�uLS� perr 2 Ua3y Please call: 508-862-403.8 for re-inspection. Inspected by �Q Date 5/Z 3/110U TOWN OF BARNSTABLE BUILD G PE IT APPLICATION Map/9! Parcel 662ad _ r Application # ®I Health Division ( Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Ally CO Historic - OKH _ Preservation/ Hyannis Project Street Address IV`�"�f�r � Village Owner Ag cA,4,5�za tei Address Telephone ` Permit Request 4p�6e_ ,��y, ,�.o � v,� a4, S'�:c Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay -, Project Valuation ©0, 0'4 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes &No On Old King!s�Highway:.)❑Yews .❑ No © Basement Type: mull ❑ Crawl ❑Walkout ❑ Other UBasement Finished Area(sq.ft.) Basement Unfinished Area Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Courft - Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ���^,� f�o 5 . �,� ?/in Telephone Number Address .� _ �.� License # S" eW:C� � Home Improvement Contractor# ( y� Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE tt ' t t FOR OFFICIAL USE ONLY .APPLICATION# DATE ISSUED t MAP/PARCEL N0. ADDRESS VILLAGE i OWNER 1 , DATE OF INSPECTION: i FOUNDATION Z)5000 A'oh, FRAME. INSULATION ' FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL•i GAS: ROUGH FINAL FINAL BUILDING -5��-3�11 �L.. -7)4h r DATE CLOSED OUT ASSOCIATION PLAN NO. r r The Commonwealth of Massachusetts . t I Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le,-ibly Name (Business/OrganizatiorAndividual): _.%//[i �GC� #�1�1�iO 2zC. Address: 'City/State/Zip: g(,, pPhone #: ��� • 3fc'�� � Ar you an employer?Check the appropriate box: Type of project(required): ]. I am a employer with 4. ❑ I am a general:contractor and I 6. ❑.New construction employees(full and/or part-time):* have hired the sub-contractors 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. workers' comp. insurance 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL I I.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.0 Roof repairs insurance required.] t 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. fi 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 their workers'comp.policy information. 1 am an employer that is providing workers'compensation insurance for my employees. Below is thepolicy andjob site Information Insurance Company Name: Policy#or Self-ins. Lic. #: Expiration Date: Job Site Address: City/State/Zip: ' Attach a copy of the workers' compensation policy declaration page(showing the policy number-and expiration date).- Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the.imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties-in the form of a STOP WORK ORDER and a fine of up to$256.00 a day against the violator. Be advised that a copytof this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verifica 'on. I do hereby certify under- e_pain and en ties o ury.that the information provided above is true and correct Si afore: Date: Phone#: � - Official use only. Do not write in this area, to be completed by city or town 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..Pltmbing Inspector 6. Other , 4� _ - . { S v i TETowti Town of Barnstable r r Regulatory Services r BARNSMU3 .r Maas. g Thomas F. Geiler;Director Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.b arnstab.le.ma.us ; Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must mplete and Sign This Section If Using A Builder I, / �4%✓ �//� �� as Owrier,of the subject.property herebyauthorize tw ..to act on my behalf, in all rimatters relative to work authorized by this bdding permit application for; If Cs ,:/ - (Address of Job) . . Signature of er Date m +l '� Print ae If Property Owner is`applying for permit=please complete the Homeowners License Exemption Form on the reverse side. . t . ; O:FORMS:OVJNERPERMLSSION y{{' . Town of Barnstable �afYrtl<ray Reeulatory Services STAB Thomas F.Geiler,Director BARNLE059 , Building Division �rfD k Tom Perry,Building Commissioner 200 Main-Street, Hyannis,MA..02601 Rrwv.to wn.b arnstab l e.ma.us Office: 508-862-4038 __ . Fax: 508-790-6230 HOA-F-OWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street ^ village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWWER 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 canstrycts more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall subn:A16 the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed tinder the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner'certifies that.he/she understands the Town of Barnstable Building Department isection l3roced ' ements and that he/she will comply with h saidpr ocedures and v� • ., re menu. �y ` Signer .ro of Homeowner Approval of Building Official _ Note: Three-family dwellings containing 35-,000 cubic feet or larger will be required to couipIy 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 pmnit is requited shall be cxerrrpt from the provisions of this section.(Section 1D9.1.1 -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 arc assuring 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 r=sponsibilities,many communities require,as part of the permit application, that the homeowner ecrtify that helshe 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 fonn/certification for use in your community. Q:forms:homccxempt 4/7 /2011 8 : 53 : 17 AM 8740 0 02/02 CERTIFICATE OF LIABILITY INSURANCE DATE04/O7/2011 ' THIS CERTIFICATE IS ISSUED AS A [TATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT - Passaro Leverone & Buckley e„Ne F,G Insurance Agency Inc "/C• No. EHL" "/` "°'` E-HAIL P O Box 160 ADDRESS` PRODUCER Dennisport, MA 02639 CUSTOMER IDO. INSUREDS) AFFORDIHO COVERADE HAIL N INSURED INSURER A: A.I.M. Mutual Insurance Cc The SCC Group LLC INSURER B: 17 American Way INSURER C: /Unit INSURER D: South Dennis, MA 02660 INSURER E: INSHRER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED_ NOTWI'LWSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WrTH 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. LnITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. - I"ar POLICY NUMBER POLICY EFF POLICY EXP LIMITS - Lcr TYPE OF INSURANCE )WS/DD/Y'TYT) - (nvaNDA'rrr) GENERAL LIABILITY EACH DCCURANCE $ ❑C--RCIAL GENERAL LIABILITY_ DANAGE TO RENTED § ❑❑CLAIMS MADE ❑OCCUR PRE"ISE S(E a.o o—ence) ❑ _ NED EXP (Any one person) § _ - PERSONAL 6 AD V INJURY § ❑ § GE[i'L AGGREGATE LIMIT APPLIES BR: GENERAL AGGREGATE PRODUCTS AGG § POLICY �PRQTECT �LOC — CO § AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT FIARY AUTO - (ea a ciaenq § BODILY INJURY (per person) _ § ALL OWNED AUTOS _ ❑SCHEDULBD AUTOS - BODILY INJURY,(p r mident) §'••„T ❑HIRED AUTOS PROPERTY DAHAGE� _ (per cident){.ti., ❑NON-OWNED AUTOS f( §^ ❑UMBRELLA LIAR ❑ OCCUR - - EACH OCCURRENCE'« ❑FACE 33 LIAR ❑ CLAIMS MADE - AGGREGATE '1 § ✓""" F]DEDOCTIBLE ❑-TENTIOU WORKERS COMPENSATION AND EMPLOYEES LIABILITY ER THE PROPRIETOR/PARTNERS/ - § ,..ZOO,OOO EXECUTIVE OFFICERS ARE - E.L. EACH ACCIDENT A ® incl ❑ excl . 6013260012010 12/08/2010 12/08/2011 E.L. DISEASE -POLICY LIMIT § 500,000 E.L. DISEASE -.EA EMPLOYEE § 100,000 COMUENTS / DESCRIPTION OF OPERATIONS OR LOCATIONS: - - TIMOTHY P ST PIERRE IS COVERED BY THE WORKERS' COMPENSATION POLICY CERTIFICATE HOLDER CANCELLATION TOWN .OF BARNSTABLE ' ATTN: BUILDING DEFT SHOULD ANY OF THE ASOUE DESCRIBED POLICIES HE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE ' - - POLICY PROVISIONS. - 367 MAIN STREET HYANNIS, MA 02061 AUTHORIZED REPRESENTATIVE \ _ 7916 I , The SCC Group, LLC 17 American Way S. Dennis, MA 02660 TEL: 508-394-0094 Fax: 508-394-0097 To Whom It May Concern: The Town Of Barnstable Re: Pulling Permits in Town of Barnstable Kevin St.Pierre is a full time employee for The SCC Group,LLC. He is insured threw our company. He has full permission from the administrator/owner to pull permits for this company. If you have any questions or concerns please feel free to give us a call at 508-394-0094. Thank You!! Sincer Sara Speight Office Manager • Ti i r dministrator/Owner +�.. Massachusetts- Depal-01e11 of Puhlic SafetN Board ofi Buil�lii��'F Re!aulatio ns and Stand.0 ds Construction Supervisor License License: CS 44251 Restricted to: 00 KEVIN M STPIERRE .47 RITA AVE ��`,.� , . S YARMOUTH, MA 02664. Expiration: 8/5/2011 Tr#: 22628 Y'immisiuner _. e r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION /�� y oy�y Map 0 V (J Parcel 0� � Application # -.-s>o� Health Division Date Issuedco(u C Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address Village C42, y\ I I p Owner eddress � S L ( (C i Telephone M c s Permit Request h Akq, Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation onstruction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: D existing 0",new:�size_ . -.... ,.tea Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: r ' Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ -- t Commercial ❑Yes ❑ No If yes, site plan review # >; Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name �,1� 3� J��L Telephone Number 11 �� Address I/A vl,, ,� License # Home Improvement Contractor# Worker's Compensation # b 5 V-)0 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT W LL BE TAKEN TO AJ 2)'d ( 0 SIGNAT R DATE � � y7 i FOR OFFICIAL USE ONLY ' • APPLICATION# DATE ISSUED MAP/PARCEL NO. { M ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE 'S ;i GI ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING k c a 4 DATE CLOSED OUT ASSOCIATION PLAN NO. s ' The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 , www.mass.gov/dia Workers' Compensation Insurance Affidavit:-Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/OrganizatioIndividual): e � Address: P0 6 � 03-b,2_ 4711 City/State/Zip: a(3 Phone#: 3U Are you an employer?Check the appropriate box: Type of project(required): 1.[94`am a employer with .4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ .I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g• ❑Demolition workingfor me in an capacity. employees and have workers' Y P h'• 9. ❑Building addition [No workers' comp. insurance comp. msurance.t 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 1.1.❑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 41 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $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:_71�he,,V\a G — Policy#or Self-ins.Lic.#: `).12Q y (7).S l �3 ✓V xp•la on Date: A ej Job Site Address: ��- 1 A City/State/Zip:_c Q y wcw c Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well,as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Sianature• Date: Phone# Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License Issuing Authority(circle one): . 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: oFTMe * BARNSTABLE. • Town of Barnstable �FDMArA ` Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 wwwao wn.ba rn sta ble.m a.u s Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, /AJ 9IL-,LAAA L. 22✓ as Owner of the subject property hereby authorize U 1t 11 a to,act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) A5714 0/ ignature of Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Intemet Files\Content.Outlook\DDV87AAZ\EXPRESS.doc Revised 072110 r . I t i t M11si�x:tchuxetts- Dcliitrtmcnt of Puhlic Salcth ' Board of Building Regulation.and Stundarcl�c j Ctpotruction Suporvicor Specialty Liaonoc Lieease: CS SL WOW " Restrictod-to:.RF.WS I MARK LEMON . PO BOX 423 WEST MYANNISPORT, MA 0287 q=.e . ..ey i :` Expiration: 414I2012 ('..am�isi.,rner Trst: 100207 109Lo dW 81NNd1•H r dM Sa3N011d 0ev f �apoA _ ti�aaa ,• 4 3I Now AW" NO dW i as 1 & WS � :uo1WJ1d%3 z�oz+s�re ��Bleoa `µova ler.PtMPo► 081dW1 SWON 911ZO vw 600 d 0[ :e4 11,N001,N3WSAO o aaWO a;hs-w ald a010 sgal3d»mnauo OLts o oaWO - cn Pug sale}{ ►as a µof; asopa4 go sip a dss oq1 uollel Vow papol11'.�aQ ootaatalSaa typo asn 1µP1MPu1 Rio)P11gh°p1� .4C `ORO DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY 5/17/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.'A statement on this certificate does not confer rights-to the certificate holder in lieu of such endorsements). PRODUCER CONTACT Kathleen Mr-Curdy NAME: y T. Edmund Garrity & Co. , Inc. PHONE No.EM: (617)354-464Q IAIC.FAX No:(617)354-5828 (AI545 Concord Ave. ADDRESS:kathy@garrity-insurance.com PRODUc CUSTOMaIDu90005330 Cambridge MA 02138 INSURER(S)AFFORDING COVERAGE NAIG# INSURED INSURERA:Scottsdale Insurance' INSURERB:Citation Insurance 40274 Mark Lemon, DBA: ML and Son Construction wsuRER c:The Hartford ' 490 Pitchers Way INSURERD: PO BOIL 423 INSURERE: West Hyannisport MA 02672 iNSURERF: COVERAGES CERTIFICATE.NUMBERk?ASTER 2011 REVISION NUMBER_ THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE.INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MMIDDIYYYY MMID GENERAL LIABILITY EACH OCCURRENCE $ 1,000,OOO X COMMERCIAL GENERAL LIABILITY. DAMAGE TO PREMISES EaEoccurrence $ 50,000 A CLAIMS-MADE OCCUR CPS1172739 /7/2011 /7/2012 MED EXP(Any one person) $ 5,000 PERSONAL 8 ADV INJURY $ 1,000,060 GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY PE LOC $ AUTOMOBILE LIABILITY (E MBINED SINGLE LIMIT $ 1 OOO,OOO ANY AUTO BODILY INJURY(Per person) $ B ALL OWNED AUTOS BSTLT 6/14/2011 6/14/2012 BODILY INJURY(Per accident) $ X SCHEDULED AUTOS PROPERTY DAMAGE $ X HIRED AUTOS (Per accident) X NON-OWNED AUTOS $ 4, $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE " AGGREGATE --- $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION WCSTATU- OTH- C AND EMPLOYERS'LIABILITY X T ER ANY PROPRIETORIPARTNERIEXECUTIVE Y/N E.L.EACH ACCIDENT $ 100,000 OFFICERIMEMBER EXCLUDED? ❑ NIA - (Mandatory in NH) 0515N280+1 /18/2011 /18/2012 E.L.DISEASE-EA EMPLOYE $' 100,000 If yes,describe under ._., r DESCRIPTION OF OPERATIONS belay E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 1o1,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION (5'08)862-4784 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town Of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street' Hyannis, MA 02 601 AUTHORIZED REPRESENTATIVE Garrity/KATHYl ACORD 25(2009/09) ©1988-2009 ACORD CORPORATION. All rights reserved. 5 r I Th ACORD name and too re istered marks of ACORD �cF65 ed with pdfFactory Pro triad version www`�bc�IfarceM corn tell ?41i`�� ®_ S Page 12 of 25 Renovator Initial English . 12/22/2014 course Refresher English 12/22/2014 course Renovator Initial• English 10/14/2013,. course Refresher English 10/14/2013 course y Renovator Initial English 04/12/2014 course .�j. Renovator. Initial's ` English 10/06/2014' ' courser Renovator Initial English 08/10/2013 course Initial t Spanish 12/29/2014 r course ' Refresher English 10/01/2013 Y course. N" Renovator Refresher English 12/28/2013 course Initial English 12 28 2 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map I Parcel R / Application # 1 6: Health Division "`Date Issued Conservation Division Application Fee ( V y Planning`:Dept. Permit FeeQ Date Definitive Plan Approved by Planning Board D� S 11 D 1► V Historic - OKH _Preservation/ Hyannis Project Street AddressIf�l Village C Owner C (i/! — Address Telephone Permit Request 1-Z I S,lt,&. I 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 -❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑Crawl 0 Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: 0 Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size — Other: `t Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ $ 6_ _ w4 "u.. Commercial ❑Yes ❑ No If yes, site plan review# < . Current Use Proposed Use APPLICANT INFORMATION y 62 _ A 5 _ (BUILDER OR HOMEOWNER) Name O ,U 1 �4 - ,bat1jj1S, Telephone Number 0 Address I to �L&.J®R(,,_K a License # _3�_/ `A) Hu4 , ✓UA Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE Itv DATE ' �/ t FOR OFFICIAL USE ONLY v APELICATION# DATE ISSUED Y .MAP/PARCEL NO._. ADDRESS y VILLAGE OWNER DATE OF INSPECTION: r , FOUNDATION% FRAME INSULATION! f FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL e GAS G; ' _ROUGH Q 4 FINAL _ =',FINAL BUILDIN:GXA ,## '.li DATE CLOSED OUT >ti ASSOCIATION PLAN NO. F . f4 C I A t - The Commonwealth of Massachusetts 1 Department of Industrial Accidents Office of Investigations •I< <� 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): 5T 0—o rF CA ©L. •�C'c Address: t/b a( - City/State/Zip: UJA kQ D Phone #: 5 L) Are you an employer?Check the appropriate box: Type of project(required): 1.5?Tam 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 # I ❑ Remodeling ship and have no employees These sub-contractors have 8.. ❑ Demolition working for.me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its officers have exercised their 10.❑ Electrical repairs or additions required.] 3.❑ I am a homeowner doing all work right of exemption per MGL 1 1.0 Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.)t employees. [No workers' 13.eOther comp. insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. 'Contractors 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 thepolicy and job site information. Insurance Company Name: c/U Policy#or Self-ins. Lic. #: � (_ _ (.� —7 Expiration Date:�� Job Site Address: r q TI&UWA' , 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$1,560.00 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 certify under the pains an nalties of perj tl at the information provided above is true and correct. Si ature: Date: Phone#: -0� f Official use only. Do not write in this area, to be completed by city or town official City or Town: PermiULicense# Issuing Authority(circle one): 1. Board of Health 2: Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector I6. Other I ' CORRq CERTIFICATE OF LIABILITY INSURANCE DgTE(P.1 fA/DD/VYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.OTHIS011 61 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 BE TWEEN REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. THE ISSUING INSURER(S),AUTHORIZED IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Mason & Mason Insurance Agency, Inc. PHONE 781.447.5531 A/c,No,Extt: FqX 781.447.7230 458 South Ave. E-MAIL ac+NOS Whitman, MA 02382 ADDRESS: PRODUCER CUSTOMER ID#• INSURED - INSURER(S)AFFORDIN G COVERAGE NAICN INSURER A: Seneca Insurance Company East Coast Fire & Ventilation, Inc. 00324 16 Kendrick Rd. INsuRERe: Travelers Indemnity Of Conn 25182 Wareham, MA 02571 INSURERC: Associated International Ins. INSURER D: Hartford Ins Co of the Midwest 20605 INSURER E COVERAGES INSURER F CERTIFICATE NUMBER: 10/11 he bui It 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, INS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Ri--- 405E SUER LTR TYPE OF INSURANCE INSR WVD i POLICY NUMBER POLICY EFF POLICY EXP I GENERAL LIABILITY MM/DD MM/DD/YYY LIMITS SGL300096 07/01/2010 07/01/2011 EACH OCCURRENCE $ 1,000,000 ! X COMMERCIAL GENERAL LIABILITY - DAMAGE TO RENTED � PREMISES Ea occurrence $ 50,000 CLAIMS-MADE I -- I OCCUR I ,. A MED EXP(Any one person) S 1,000 ! PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: n POLICY p, PRO- JECT LOC I PRODUCTS-COMP/OP AGG $ 2,000,000 $ AUTOMOBILE u4BluTv BA3182MS4610SE 07/01/2010 07/01/2011 COMBINED SINGLE LIMIT X ANY AUTO (Ea accident) 1,000,000 ALL OWNED AUTOS - BODILY INJURY(Per person) S B SCHEDULED AUTOS - BODILY INJURY(Per accident) $ HIRED AUTOS PROPERTY DAMAGE S I 'NON-OWNED (Per accident) I D AUTOS 'S �I S UMBRELLA LIAB OCCUR CUBW312331 07/01/2010 07/01/2011 EACH OCCURRENCE $ 1,000,000 C EXCESS LIAB I I CLAIMS-MADE --- li AGGREGATE $ 1,000,00 DEDUCTIBLE _ S X RETENTION $ 10,000 AND EMPLUhNtHbOYERS' COMPENSATION 08WECL1616 01/08/2011 01/08/2012 WC STATU- OTH- $ AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER D ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICERry in NH) EXCLUDED? N/A (Mandatory in NH) If ves,describe under E.L.DISEASE-EA EMPLOYE $ 1 000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 1,000,000 DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. East Coast Fire & Ventilation, Inc. Attn: Beth Toth AUTHORIZED REPRESENTATIVE 16 Kendrick Rd Wareham, MA 02571 David H. Mason ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and.logo are registered marks of ACORD � 1 • _ _��.f�m.+ar.'.F� � tt��M4W� .a6ra4irYF-.. .!fi�'°#3hK �Fi N�1IVEALTMfOFMASSASIETTO '`"_ '� S �EMMETAt`zlwORKER d�S RA STER lJ1�lFtESTRiG_ f_ � 15SUES ti$E� ,1f�°L�INSE 1O rN r r IC "36�1- TT z ggERY tz g t } • >s • - e �. The Commonwealth of Massachusetts William Francis Galvin Page 1 of 3 - The Commonwealth. of Massachusetts William Francis Galvin s Secretary of the Commonwealth, Corporations Division One Ashburton Place, 17th floor Boston, MA 02108-1512 Telephoner (617) 727-9640 EAST COAST FIRE & VENTILATION, INC. Summary C?1 Screen Help with this form Request a,Certificate The exact name of the Domestic Profit Corporation: EAST COAST FIRE & VENTILATION, INC. Entity Type: Domestic Profit Corporation Identification Number: 200442512 Old Federal Employer Identification Number`(Old FEIN): 000855560 t Date of Organization in Massachusetts: 12/08/2.003 Current Fiscal Month / Day: 12 / 31 The location of its principal office: No. and Street: 16 KENDRICK RD., UNIT 4 City or Town: WAREHAM State: MA Zip: 02635, Country: USA If the business entity is organized wholly to do business outside Massachusetts, the location of that office: No. and Street: City or Town: State: Zip:_-- , Country: Name and address of the Registered Agent: Name: DONALD A. 'DENNIS - e No. and Street: 16 KENDRICK RD., UNIT #4 City or Town: WAREHAM State: MA Zip: 02571 Country:-USA The officers and all of the directors of the corporation:' Title Individual Name Address(no Po Box) Expiration First, Middle, Last, Address, City or Town, State, Zip of Term http://corp.sec.state.ma.us/corp/corpsearch/coipSparchSummary.... 4/27/2011 The Commonwealth of Massachusetts William Francis Galvin'-... Page 2 of 3 Suffix Code PRESIDENT DONALD A. DENNIS 361 COTUIT BAY DR. NONE' COTUIT, MA 02635 USA TREASURER DONALD A. DENNIS NONE. r 361 COTUIT BAY DR. COTUIT, MA 02635 USA SECRETARY DONALD A. DENNIS NONE 361 COTUIT BAY DR. COTUIT, MA 02635 USA, DIRECTOR DONALD A. DENNIS 361 COTUIT BAY DR. NONE COTUIT, MA'02635 USA business entity stock is publicly traded: The total number of shares and par value, if any, of each class of stock which the business entity is authorized to issue Par Value Per Total Authorized by Articles Total Issued' Class of Stock Share of Organization or and Outstanding Enter 0 if no Par Amendments Num of Shares Num of Shares Total Par Value CNP $0.00000 200,000 $0.00 0 Consent Manufacturer — Confidential Does Not Require Data Annual;Report _ Resident Partnership Agent For Profit Merger Allowed , — — Select a type of filing from below to view this business entity filings: ALL FILINGS Administrative Dissolution , Annual Report €1 � Application For Revival I Articles of Amendment VieW ilings New Search� `, ­_" `71 http://corp.sec.stqte.ma.us/corp/corpsearch/CorpSearchSummaly.... 4/27/2011 . T The Commonwealth of Massachusetts William Francis Galvin -... Page 3 :of 3 ©2001 - 2011 Commonwealth of Massachusetts All Rights Reserved Help h,ttp://corp.sec.state.ma.us/corp/corpsearch/CorpSearchSummary.... 4/27/2011 ✓ L FIRE EQUIPMENT CERTIFICATE OF COMP_ E�Y Issued To David R Sergi. Z P:untan Avenue. 126stwareham,MA 02538° Issue Dj.jd 313l2b4 i , - [xpiratian E 16 '3124/ZD13 - CertiFcate Number :C�a'566 Restricted to: 41,46.48 -• - a .. X �oID W Nev) Hoot a -Il \A arc -��K-s ZN p Ft_-o a tZ. L EkStSTr�� �1CHAuSf � N-°°� �ucr CatJGf�6TC � WIPI--L Ott S't'AtrlLjeSS WkLI, PA p. g a ck� Q � w cr— O ' M Laec,.e, ov, ANSUL R 1.02 FTR-11 SURPRESSION SYS I r-z r- 4-"vO f =Whell'a fire occur'; ill a protected �Jr�a, it is quickly Sensed by detectors located ill 11ile'lClUch-vork or exhaust hood. 'ROO 366 em - EXHAUST HOOD MANUAL PULL. STATION 48 The detectors tigg -1 ,er the LL- F Ansul Aujitonlan refeasilla Illechall.isill which act0L.Ites the systen]...I'll-c-'surizf n— MECHINICAL GAS LVE the a-entstorac"e tallk.. i directly oil Ill ll Ansulex is applied dii e fil-k�ADSL11eX liClUid SL]j1pYeSSal1t 110\VS (11170U(111 the SI)eCifIC 11 UIC distribution pipini to discharge nozzles. fire in secolids. Job Name. �- Z. SLI111111if(Cd TO: a Trti Towns of Barnstable ' Regulatory Services • =.ixxsusr.E. v was Thomas F. Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnqtable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder 5 I, lwk�51C>nfr of the subject.property hereby authorize r l S ( Co 5 ' \ to act on my behalf, in all matters relative to work authorized by this building permit application for . qg' (Address of job) . ,f Signature of C Date Print Name If Pro edy Owner is applying for permit please complete.the Homeowners License Exemption Form on the reverse side. 4 TOWN OF-BARNSTABLE BUILDING PERMIT.APPLICATION Map Parcel , :Application Health Division Date lssuQd Conservation Divi8io"n APO Fee!cati6b PlanningiDepte! o '.Per mit Fee Date Definitive:Plan Approved by Planning Board P ' Historic OKH Preservation Hyannis Project Street Address . Village ca Al T-6 k urzi L:� OwnerO- Address Y v Jt;V�rIVIUC "614�6ELDL06 Telephone Permit Request lt-movc- Llraa- RW Ou r-iZ146A1& Sarp. I �__-36wm_ or OEVAR' !Rl 6LIES k�b ZOLAC, w TN trw_ 26-sX_cVAtJT ftr1<0 L l 14i0bW&akn 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: U Yes Ll No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family LJ Multi-Family (# units) Age of Existing Structure ZYX'S< Historic House: Ll Yes ;dNo On Old King's Highway: LJ Yes XNo Basement Type: Q Full L3 Crawl LJ Walkout L3 Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: LJ Gas Ll Oil LJ Electric LJ Other Central Air: L3 Yes LJ No Fireplaces: Existing New Existing wood/coal stove: Ll Yes LJ No Detached garage: Q existing L3 new size—Pool: L3 existing LJ new size Barn: L3 existing LJ new size— Attached garage: Ll existing L1 new size Shed: LJ existing Ll new size Other: Zoning Board of Appeals Authorization L3 Appeal # Recorded LJ 77 Commercial LJ Yes Ll No If yes, site plan review# Cirrent Use Proposed Use APPLICANT INFORMATION rn (BUILDER OR HOMEOWNER) Name Telephone Number Qq-237-q02(:) Address A-atq,; License # Taro % ,ql MP 0_tJr.t EjV1_LLF CA3Z Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO M0 SIGNATURE DATE_Z6/(�? V FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER- DATE OF INSPECTION: �i FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL 1 FINAL BUILDING i DATE CLOSED OUT ASSOCIATION PLAN NO. f - The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, M.4 02111 www.m-ass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors Electricians/P.lumbers A " licant Information Please Print Legibly � &.�L z )i- Nainr, (Business/OrganizalionllDdividual): ) mcDa )_/ Address: boy 5W City/Statc/Zip: ��iuTE� f1T'��t A 026�2 Phone.#: Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ 1 am a general contractor and I 6. ❑New construction part-time).* bavc hized the slit-contractors employees(full and/or 2. I am a sole proprietor or partner- listed on the attached&hart 7. ❑Remodeling ship and have no employees Thesc sub-contractors bavc 8. Demolition employees and have workers' working for me in any capacity. 9.r . ❑Bu it ding addition [No workers' epn7p.•incnrancc �mP insurance.$ 5. 10_❑Electrical repass or additions rPz rirCd] ❑ We area corporation and itsofficers have exercised their 11.0 Plumbing repairs or additions 3.❑ I am a hommwnr_r doing all work myself [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required...]t P. 152, §1(4), and we havt no -13.r.-A Other &C employees. [No workers' comp.insurance required-] "Any applicant dial chmkc box#1 must also M out the scetion below&bowing their workcca'coon potiey iafarrrratiM-L t Flamcovrocrs who submit this affidavit indicating tbcy am doing all work and thin hin:outside mntrn-t rs must cukvit a new affidavit indicating such. $Ccmbractors that ebeek this box must attacbcd an additional&bcct tbowing the name of thc sub-contatturs and aialn whether err not those attitics bavc employers. 1f the sub-contractors bavc c riploy z,they must provi dtr their workers'comp.policy nrunbcr. I am an employer that is providing workers'compensation Insurance for my employees. Below is the policy and job site inform-adon Jnsurancc Company Name: Policy#or Sclf--ins. Lic. #: Expiration Dattr.. Job Site Address: City/State/Zip:l L (�11 6- Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required tmdcz Section 25A of MGL c..152 can lead to the imposition of rrinihial penalties of a 5na uip to $1,500.00 and/or one-year imprisonment, as woll 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 statc=rrit may be forwarded to the Office of Invcsti &tuns of the DIA for insurancc covers c verification. I do her cc Jy under the airs-and penalties cf perjury that the information provided above is true and correct Si atuue: Date: C/ Phone OffzcW 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 Inspecfor 6. Other Contact Person: Phone#: Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees: pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or writtcn_" An employer is defined as"an ipdividual,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 dcceasui 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 Rork on such dwelling house :)r on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." v1GL chapter 152, §25C(6) also states that"every state or IDC21 licensing agency sha11 withhold the issuance or -eneival of a license or permit to operate a business or to consiruc.t buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required." additionally,MGL ohapter 152, §25C(7) states "Neither the commonwealth nor any of its poligzal subdivisions shall Inter into any contract.for the performance of public work until acceptable evidence of compliance with.the inmurance equircmcnts of this cbaptrr have been presented to the contracting authority_" applicants lease fill out the workers' compensation affidavit completely, by cbccking the boxes that apply to.your situation and, i.f cccssary,supply vo)— ontractor(s)name(s), addmss(cs) and phone numbcr(s) along with their certifieats(s)of Inane. Limited Liability Companies(LLC) or Limited Liability Partnerships(LLP)with no employees other than the, ,embers or parfncis, arc not required to carry workers' compensation insurance. If an LLC or TJ P does have nployecs, a policy is required. $c advised that this affidavit may be submitted to the Department of Industrial ccid.ents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should returned to the city or town that the application for the permit or license is being requested, not the Department of tdustrial Aecidcnts. Should you have any questions regarding the law or if you are required to obtain a workers' impensation policy,please call the Department at the number listed below. Self-insured companies should emcr their :lf-in m-,mro license mmabet on the appropriate line. ity or TowA Officials case be sure that the affidavit is complete and printed legibly. The,D eparmment has provided a space at the bottom 'the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding tho applicant case be sure to fill in the permitfhcc6nso number which will be used as a reference number. In.addition, an applicant it must submit multiple permitllicense applications in any given year, need only submit onp affidavit indicating current lacy information(ifnec=;uy)and under"Job Site Address" the applicant should write"all locations in {city or xn)."A ebpy of the a$davit that has been officially stamped or marked by the city or town may be provided to the plicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit.must be filled out each ur.Where a bDme owner or citizen is obtaining a license or permif not related to any business or commercial venture aves etc.) said persosi is NOT required to coraplcto this affidavit a dog license or pemmit to burn le e Office of Investigations would H -to thank you in advance for your cooperation and should you have any questions, ase do not hcsitatc to give us a ca1L Department's address, tcicphone•and fax number. Tha Commonwegth of Massachusetts Degi3.rtment of Industrial Accidt<nts Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-490.0 ext 4.06 or 1-877-MASSAFB Fax# 617-727-774�9 : 11-22-()6 ywww.ma.s2.gov/dia QFTHEraf• Town of Barnstable ~' Regulatory Services �RAxr ,►MASS. Thomas F. Geiler,Director �Fo �a Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office:' 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I. p6kyrd= 'rt4DMI-, a , as Owner of the subject property hereby authorize. � VIgQ� I.11l"eM36 1 6 to act on my behalf, in all,matters relative to work authorized by this building permit application for: NTL'�rCl.� A (Address of Job) • i �ature f Owner Date hym- Mnla)ZE Print Name E dt CE��e2�Zt� �6 If Property Owner is applying for permit please complete the Homeoccmers License Exemption Form on the reverse side. . } r� , f Town of Barnstable �oF tr+E r,� Regulatory Services • . Thomas T.Geiler,Director sARNSTAst e, t<t�ss. Building Division PIED I��a Tom Perry,Building Commissioner . 200 Main Street, Hyannis,MA 02601 R'ww.town.barnsiable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER': name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as - supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on'which he/she resides or intends to reside, on which there is,or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be.required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section io9.1 r 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 permit application, that the homeowner certify that he/she understands the iesponsrbilitics of a Supervisor. On the last page of this issue is a form currently used by You may care t amend and adopt such a form/certifrcation for use in your community. several towns. y i t4k I!Sd-TA/LZ-<Z) ��-V?6b -CFF 4,b UMCci> Un-r//' A rrpLe-- SX7S-rMT�M41rRM6 . --ZWx-6j, ZE usj7j16 4- '?PoDucr s- A ram- .&ST5,4Nr- - -� .� - -*' . ' y. -- -----^- --- - -- - ----�---�.-w-+t-r..•-w+. -.. �.----'^--*-e.ti..-.�;�•-• ,.�`�-Rl---^.e'er...,...r..s..r-...w_.�-�... �..�_�..��. �_ c � � - +- . .�.._-.�-._._... �.r...r ..+r.-t.�-�...._......+..�-�-+ram-..-+..H.....�.�-,-+�..�,.-^r++-- �-.r ._.- _,.-�-.-.�..-.�-...-.M.-r_....-a�.a�r..-__ ..--.�+.w r►.-�. _�.. ' { �� t . $ �_ . _- - � � � - ._ .'_-_�. yam- ,..-.r�__ _� � _ -�-r__ r�. _� __- �..._-�.-�..�___.�.. �--.�. �__..,. ...�--_�._. - f•r_ sra a '•.•�.'�.rv'�:ti'.�. :.�,s. ffo=/p i�z.�ar. a\/m,e,•a R. > ;: 4�r.% ..� t= �r—=z.... +''•. N,:I'%°� Pi O ' t:+i ai%''a't 0°'% i�;°�'4iy+r•e' 9oi r%> +i'p.•, -+o°+,!.,'•t;i� ,.'�t ••i°�'�i4 °%'a f'ii 'iw:ri i - -.•o. `':✓.3'r. ::4*�: ,.� ,> .1 v + ♦ r" ♦ ♦• • ♦ ♦ i ♦ 'Z v• ♦ • ♦'Y�%•. y00'+smOt.,%..p •i�♦tO'f .0e :s �'+ + ♦ o t s �' 0.9�• ♦*� 'r• � ,�o�� c W ott � off•o• r'g � ss>r"� }��s4�'+ t �0 0 Q t p, °� � �+t o�• , �r,t� 9 e, }�`��'�. e:HIM t!f y�� ,�. }►+ ;.p.��+ f ,• � .. ,• 1ff`:�; �d�l, Iji'Oi T16, aJames Hardie® Building Products 10901 Elm Avenue Fontana,CA 92337 �::; Hardiplank®Lap Siding Ha rdi panel' vetticai Siding _e A 50-Year Express Limited Transferable Product Warranty s� ,tin 1 LIMITED WARRANTY COVERAGE:James Hardie Building, (d)misuse;(e)repair or alteration;(f)settlement or structural movement 1i,•:SaQ Products,Inc.("Hardie")warrants(for installation within the U.S:and and/or movement of materials to which the Product is attached;(g) Puerto Rico)to the purchaser and all transferees prior to and including damage from incorrect design of the structure;(h)exceeding the .e�•f. _ e 4 pP�z the first owner of the structure to which the Product is applied,and the maximum designed wind loads;(i)acts of God including,but not limited first transferee of such structure(each a"covered person")that when to,hurricanes,tornados,floods,earthquakes,severe weather or other manufactured,the Hardie Fiber-Cement Plank or Panel Product natural phenomena,(including,but not limited to,unusual climate +v HARDIPLANK®or HARDIPANEL®,(the"Product")complies with conditions);0)efflorescence or performance of any paints and/or �. V,,�•►+®' ASTM Cl 186,and is free from defects in material and manufacture. coatings which are not Hardie and/or Hardie affiliated applied;(k)growth r;;p When used for its intended purpose,properly installed and maintained of mold,mildew,fungi,bacteria,or any organism on any surface of the according to Hardie's published installation instructions,the Product for a siding(whether on the exposed or unexposed surfaces)and in this respect, period of 50 years from the date of purchase will(a)remain non- ANY CLAIMS OF DAMAGE CAUSED BY MOLD OR MILDEW ARE �i re, combustible,(b)resist damage caused by hail or termite attacks,and(c) EXPRESSLY EXCLUDED;(1)lack of proper maintenance;(m)any cause will not crack,rot or delaminate.If during the Warranty period,any other than manufacturing defects attributable to Hardie. :•A} Zi✓' Product proves to be defective,Hardie,in its sole discretion,shall replace the defective Product before it is installed,or,during the first year, 4.DISCLAIMER: : reimburse the covered person for resulting losses up to twice the retail The statements in this Warranty constitute the only warranty extended by :i�} ;:':' •� cost of the defective portion of the Product. During the 2nd through the Hardie for the Product. HARDIE DISCLAIMS ALL OTHER 44. r•p 50th year,the warranty payment shall be reduced by 2%each year such WARRANTIES,EXPRESS OR IMPLIED,INCLUDING ANY that after the 50th year no warranty shall be applicable. If the original IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS yin retail cost cannot be established by the covered person,the cost shall be FOR A PARTICULAR PURPOSE,EXCEPT WHERE PRODUCT .. } 1�+.• y= determined by Hardie in its sole and reasonable discretion.Hardie's PURCHASE IS SUBJECT TO CONSUMER PRODUCT WARRANTY iA replacement of the defective Product or granting of a refund pursuant to LAW,OR BY USAGE OF TRADE OR COURSE OF DEALING IN d,•,lv�•� f Section i of this Warranty SHALL BE THE SOLE EXCLUSIVE WHICH INSTANCES THE DURATION OF ANY APPLICABLE <�:°•,0} f +p REMEDY available to the covered person with respect to any defect. IMPLIED WARRANTIES ARE LIMITED TO THE FIRST ELAPSE OF �I Hardie will not refund or pay any costs in connection with labor or THE WARRANTY PERIOD PROVIDED ABOVE,OR SUCH % accessorymaterials. SHORTER PERIOD AS APPLICABLE LAW PERMITS OR REQUIRES.Some states do not allow limitations on how long an implied 3�;:;�•,N1+ �•3. 2.CONDITIONS OF WARRANTY:Hardie's liability hereunder to the warranty lasts,so the above limitation may not apply to you. 'i1t•S covered person shall be subject to the following terms and conditions: :;'! A. The claimant must provide proof that he/she is a covered person. NO OTHER WARRANTY WILL BE MADE BY OR ON BEHALF OFe�10 B. The Product must be stored according to the manufacturer's THE MANUFACTURER OR THE SELLER OR BY OPERATION OF (+ s instructions at all times between purchase and installation. LAW OR BY USAGE OF TRADE OR COURSE OF DEALING WITH C. The Product must be installed according to Hardie's printed RESPECT TO THE PRODUCT OR ITS INSTALLATION,STORAGE, $; �pP installation instructions and all building codes adopted by federal, HANDLING,MAINTENANCE,USE,REPLACEMENT OR REPAIR. state or local governments or government agencies and applicable to This Warranty gives you specific legal rights and you may also have other {q'°S the installation. Failure to install and finish the product per the rights which vary from state to state. x �• ; manufacturer's published instructions may effect Product :1•'± ., performance and voids the Warranty. 5 EXCLUSION OF INCIDENTAL AND CONSEQUENTIAL )irdp. D. The covered person must provide written notice to James Hardie DAMAGES:IN NO EVENT WILL HARDIE BE LIABLE FOR ANY ��if••+�Y�T__ Building Products,Inc.within 30 days after discovery of any claimed INCIDENTAL,SPECIAL,INDIRECT,OR CONSEQUENTIAL defect or failure covered by this Warranty and before beginning any DAMAGES,WHETHER RESULTING FROM NONDELIVERY OR '+:ay)\ �!•y;�— �t permanent repair. The notice must describe the location and details FROM THE USE,MISUSE,OR INABILITY TO USE THE PRODUCT of the defect and such information as is necessary for Hardie to OR FROM DEFECTS IN THE PRODUCT.Some states do not allow the e.� investigate the claim. Photos of the product,showing the defect or exclusion or limitation of incidental or consequential damages,so the failure are not only helpful,but also must accompany the notice, above limitation may not apply to you. {i�•� when appropriate. `��`.• } E. Upon discovery of a possible defect or failure,the covered person 6 MODIFICATIONS AND ALTERATIONS OF PRODUCT:Hardie 4„ ef�y must immediately,and at the covered person's own expense,provide shall have no responsibility hereunder for defective Product subjected to .—'`,:� ?, for protection of all property that could be affected until the defect or further processing or alteration after shipment. d`• failure is remedied. Before any permanent repair to the Product,the . +1 V'y+� covered person must allow Hardie or Hardie's agent to enter the 7.SETTLEMENT OF CLAIM:Any refund or material replacement by }`f property and structure where the Product is installed,and examine, Hardie pursuant to Section I hereof shall constitute a full settlement and photograph and take samples of the Product. release of all claims of any covered person hereunder for damages or other relief,and shall be a complete bar to any litigation filed �1•+ � 3.EXCLUSIONS:This Warranty does not cover damage or defects subsequently to the covered person's acceptance of such an agreement. resulting from or in any way attributable to:(a)the improper storage, �:�♦�'•,�n shipping,handling or installation of the Product(including,without 8.MODIFICATION OR DISCONTINUATION OF PRODUCTS: limitation,failure of the Product to be installed in strict compliance with Hardie reserves the right to modify or discontinue any of its products �� the terms and conditions set forth in Section (c)of this warranty)and/or without notice and shall not be liable as, result of such modification or ar:< per.® improper installation of studs or other accessories;(b)neglect;(c)abuse; discontinuation. ,fi,;} �I James Hardie ' A `� 1-800-9-HARDIE ,o } s b 0• ,°.tf tA: ,°�.tt♦.,0ei� ° e♦+,`d+;4'�r °••°+.+t.*tF✓;.��..s;.,°6 se'i:°++i,.�r,.ee 9, +°•�°i. ♦.•y°.S+:�i o°6t r.4e e�,° �.e:9:°e,+t+t.,♦s,°A°Wte°✓iV°,�A�.e•:•�,t.+�:O�dA�4 �;,✓?�� et�.jJ'j a ✓�s/,�_�52+TMss,.�st�.+y3�.aK, sa,a jl.+_ s�.;• a �_:.<:e:S�..?-..er'°.✓�he:�y.✓ e4'• ,t�:af'r, z'..•.e L. •r.•s _�I!� et �,�i'i ert.4.y*1 _. i . I : �r 3 a ', _ c i f ,, SPECIFICATIONS I s - � - VI` .� a, i, �3s ���', CadarmilF � ' i k�N Y ;b, Thickness: ' 5/16 � c* �' v V�� 3 Weight 2 3 1bs/sq ft i 'dA , Sizes 4'width x`8'height . ",3� , 14 width z 9'height � � s, 4 width x 10'height Cedarmill° f .. ) _ .. .. :.:. 8 s -- - - for vertical applicat,on s,Hardipanel®vertical siding,delivers beau ty and lasting performance. " ' ■,Structurally sound as a shear panel,Also combine with Harditrim®planks'for an attractive board anti batten took ■ Manufactured with exclusive PnmePlus®sealer"and primer which provides uniform sealer and , p_nmer coverage and an excellent paint surface " , i ■ 50 year limited t'r'ansferable product only warranty " S �W Y� N fI t "n ! I� Sierra 8 1.,;!.:.1Ili.:�I,­IL.,1,.:::.­:,,II1II1.,::;...­�...I.!1';­.-,1,1�1I;i,�:..:,.'.,:�u:1�—1"_,_:.1:.I::.I..l:�I::.,x I.'II.,�.=4:LI,:..:,.�.'I­..­�::�.11_-­:,�I1::::;�..l.-.1:.:.,fi.1.­;;.�_i_..I,I,I­­.­l—'_1,,:,i�`­.:i.,.iI..eI,-�";'�1­::_."l...,,M.i:,.I..'.::::1"!I:—.:..I?.­...'.:;..�i:,:.�;�,.­::I�:I—";.­'!'.,i....',,:Z..I�..;i_.i:�::.!—::.I-::-.:1:.x_.'"i:qiIE—,�`�,l­.1­.!:I-­...�...I1:,�1::.,::_':;1,;:i,�,-�.I;,�:,1...:1:1..1:..,:M.l�:i_­1 I1:1�,;I.L"1.!."1:1I­..0.1::-.i'.!i�.:�1ii�.i.�:/xs­,,:1.:�_1-1-.i1I.—Z,I:.l.I­�:,.:L1��:�1z1�:.�I.:1.;.....".iI::."i:i�;::iz�-�.::::I.—i:1.�.,1:::",,._,�,,:i",qig;�"K;`1.!1.,._..:;'...:,I,;��If�1I;:i1.::::�.:_,.,�­,_i::'I��]�;.­ii.�::1.1.i;:,e,,,.I.:,,l:i;.I­,,".1�"�1 Iq,ii:.,:�:.._1f,l�,��I,"J:iI..:L,,l_;'�I..".....`,,�­',.';,,,I,1,,,,,;.;:,:"­�:,z.:,'.i,l::i­._.!�� { � s a ' 19 11 ' �' YY :. . ca3 � , Thickness: 5l16 fiyP , il' t � M r , 1t , Wei lit: 2.31bs/s ft ts � �iYbf 'e Iw j�' � , 9 q fqa �t, � Sizes:" 4'width x 8 hei lit' ', '� a�i ^ ¢ r ` ' �i �'r ,� 4'width x 9 height € �,, 4'.width"x"10 height ..:gym.arm, ..P i'. Sierra 8 ',: r $tUCCO and "s x Smooth'Panels(not shown) '` Ttiickness:V 5l16 y , Weight: 23 lbs./sq.ft. Sizes. 4'width x 8 height s 4 width x'9'height 4 width x 10 height T ' '_� Stucco I. ,. a I 1.1 a Sealer and; Primer t Pei mePlus sealer ,and pnmer'affords complete primer coverage and a uniform surface for fieltl applied lir t finishes.The primer is compatible with most commercially available acrylic,"latex and oil based topcoats, and;James Hartlie0 can provide a list"of manufactures recommended topcoats that work particularly well with the-pruner,: l _...._. .. ._.--.__-___. .._, _.... _..__ . J 3 } .4_ ' 6 - a :' . . t. �' f � . 'Board of Bu Ids g Regulattods and Standards r Construction Supervisor License 'a License .CS '99060 I Expiration 9/28/2011 .. Tr# 99060 :. Res io 00-a I� KYLE MCDEVITT� {Ipp 13OX 1 4 I} G`ENTERVILLE,MA OZti3 Commissioner: s i l , License or registration valid for mdividul use only before'the expiration date If foun d return to.` i aid of Building Regulations and Standards I One Ashburton Place Rm 1311E Poston,lVla.02108.. . . ; Not valid without signature fie zoouuealt�i Board ofBuiIdin g Regulahons'fianchrds HOME ndSt IMPROVEMENT CONTRACj OR Ij Regist%t o 159932 . r �trat� � 112010 Tr# 2694Pfi ` `' •P � �Ype DB 1 K.J.MCDEVIV TT UILDIN i'i KYLE MCDEVITT, �'�� ELING -r j 288 HUCKINS NECI( CENTERVILLE, ,.q'i , .r' Ad mimskitor _ '' —� — µ f -- N; �4. ti f a I' k r 4 �r � y N` ySi+ •s � w `, -' �' g - � � '�. �. '.. .. � � �, '9 '! f •e .. � .. A � .. �s �o s n' a s s w I TOWN OF BARNSTABLE j SIGN PERMIT I PARCEL ID 189 002 001 GEOBASE ID 36005 ADDRESS 1989 FALMOUTH ROAD (ROUTE PHONE i CENTERVILLE ZIP - 1 LOT 1 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT CO PERMIT 42121 DESCRIPTION FRATERNAL LODGE - 8 SQ. FT. PERMIT TYPE BSIGN TITLE SIGN PERMIT CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services TOTABOND FEES: $25.00 CONSTRUCTION COSTS $.00 d Qi► j 753 MISC. NOT CODED ELSEWHERE 1 PRIVATE PI .E * BARNSTABM • MASS. 039. A� BILDI,N DIVI ,QN��r DATE ISSUED 11/01/1999 EXPIRATION DATE ' - The Town of Barnstable ,,►msff„BI,E ; Department of Health';SaAty and Environmental Services' m KAM Building Division 039' rFn Mpt�' 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralp F. h Crossen Fax: 508-790-6230 Building Commissioner, { u �c �� ��� Tax Coll or a.: • ,,` ;,` ' Treas Application,foT_Sign Permit _ F . Applicant: T�-�1� 14L '�—�1�� Assessors No. Doing Business As: 'Telephone No, Sign Location Street/Road: t-'lq.-L—O 16.( /r-1 Yz o j'u Zoning District: K C- Old Kings Highway?' `Yes/V Hyannis Historic District? YeS49. 1 J, Property Owner Name: t"2t�}I l..C)176t✓ 17c��" C�YZ-�r Telephone: `7-7$ "'(5. . Address: It? TO �9 L M (�lli't-1 W' 'Villager C1--_-1TEYL l/I L.-05 Sign Contractor a' , Name: CLA f351 C ,�C 16 5 Tel '7 r - t Address: `-�I 1+/114`tT Village: ' Ct`C 69&V Description - - Please draw a diagram of lot showing location of buildings'and existing signs with dimensions, location and size of the new sign. This should-be drawn on the reverse side of this application. " Is the sign to be electrified? Ye f o (Note.'Ifyes,,a wiringpermitisrequired) I hereby certify that I am the owner or that I have the authority of the owner to make this application, that the information is correct and that the. use and construction shall conform to�the provisions of Section 4-3 of the Town of Barnstable Zoning Ordinance. Signature of Owner/Authorized Agent: /'_//�f/ �rX Date: + / „ Z`J Permit Fees size: ✓ v C� . `� k ,F ` _. .. + •. j :. Sign Permit was approved: Disapproved: d Signature of Building Offici Date: / Y Signl.doC rev.8/31/98 •t t -� 0 UT i r i` i i 1 i i l V c i 2 A.F. & A.M. 21 MONDAY TOWN OF BARNSTABLE Y - SIGN PERMIT PARCEL ID 189 002 001 GEOBASE ID 36005 IADDRESS 1989 FALMOUM ROAD (ROUTE PHONE CENTERV-I LLE ZIP -- LOT 1 BLOCK LOT. SIZE DBA DEVELOPMENT DISTRICT CO PERMIT. 34682 DESCRIPTION FRATERNAL LODGE A.F. & A.M. (8 SQ_FT. ) PERMIT TYPE BSIGN TITLE SIGN PERMIT CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services i TOTAL FEES: DIME i BOND $.00 , CONSTRUCTION CASTS $.00 i 753 MISC. NOT CODED ELSEWHERE t * BARNSTABLE, + MA83. i639. A� FD MIS B ILDING DIVISIO Bf r DATE ISSUED 11/12/1998 EXPIRATION DATE "EA The Town of Barnstable - ti Department of Health, Safety and Environmental Services 9e� MA �0�' Building Division ArED MA'S A 367 Main Street,Hyannis MA 02601 s Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230- •-- . Building Commissioner Tax Collector Treasurer n �/ Application for Sign Permit Applicant:�6 i�4 4 A In c)Wtc _k�1��.��. - Assessors No._1 �, 00 001 Doing Business As::EJ2 Rnd kcdp AE Ahl- Telephone Sign Location Street/Road:_/q �-I yy\ounN �j�• Ct-�Tie.�U�l��� �- Zoning District: I - Old Kings Highway? Ye No Hyannis Historic District? Yes/0 Property Owner Name: -'rf2/ E C SAL UP&-c ��dk, r)_(n Telephone:--17 iz_ a Yam__ Address:- ( 0( � IQJ. Village: r� e ro" Sign Contractor Name: Telephone:_ Address: Village: Description Please draw a diagram of lot showing location of buildings and existing signs with dimensions, location and size of the new sign. This should be drawn on the reverse side of this application. Is the sign to be electrified? Ye(/No (Note.Ifyes, a wiringpermitisrequired) I hereby certify that I am the owner or that I have the authority of the owner to make this application, that the information is correct and that the use and construction shall conform to the provisions of Section 4-3 of the Town of B stable Zoning Ordinance. Signature of Owner/Authorized Agent: J '4Date:_j a W, L9 9 T Size: Permit Fee:_ ✓2 % Sign Permit was approved: Disapproved: , t Signature of Building Oflic Date:__Z `_�� Signl.doc rev.8131/98 77) A7 SAS d :1^S ., 2ND iI I Q � 7 � 1���� 1 art= 17 ,1 , d M f R _' !N I . l sii cO.5-1 7 O SD. p' 2 -- S l oep ;nJ 00 0 •S 16-fj . . t�� SCf1l.C. t Sign TOWN, OF BARNSTABLE Permit * BARNSTABLE, MASS 9� 16 ArFp A� Permit Number: Application Ref: 201000740 20070419 Issue Date: 02/22/10 Applicant: FRATERNAL LODGE BLDG CORP Proposed Use: Permit Type: SIGN PERMIT Permit Fee $ 50.00 Location 1989 FALMOUTH ROAD/RTE 28 Map Parcel 189002001 Town CENTERVILLE Zoning District SPLT Contractor PROPERTY OWNER + Remarks 8 SQ FREESTAND FRATERNAL LODGE y Owner: FRATERNAL LODGE BLDG CORP Address: PO BOX 595 CENTERVILLE, MA 02632 Issued By: p POST THIS CA".......... THAT IS VISIBLE FROM THE STREET Town of Barnstable Regu atory Services 9BA R'''„ 'E� Thomas F. Geiler,Director i639 ♦0 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 Permit# Building Official approving----------_ Application for Sign Permit �'I oo�Oofqq Applicant: � � _ _ . Assessors No. 0 -____ Doing Business As: Telephone___________________Telephone Not�'_v �7 .z5 Sign Location pp � Street/Road: -'` � �U� - 1--- --- Y � --------=------- Zoning District: - ------ Old Kings Highway? Yes/ T& Hyannis Historic District? Yes/ to Property Owner Name:C1 -_G_0Q-V-�WC------------------------Telephone:-608 D5 2455 Address:_A"VC1_� ------------------Village:_ce,� - ---, - t a C- „ er Sign Contractor � _.. ct� r�A-cva a, c- Name:-----�---=`-------- - �=------------Telephone:-�' __- o- -- -� Mailing Address: 40:1_EWE 0- 1�rc Qb --------- - ___ r-} _�•� - - ---------.•Description --------- ---- Please follow the cover directions.You must have an accurate rendition of sign with dimensions and location. c 3 Is the sign.to be electrified? Yes Nc (Note:If yes, a wiring permit is required) Width of building face_-5 0---ft.k 10=_ bcg_x .10 Check one Reface existing sign_---or New_i/ _Total Sq. Ft. of proposed sign (s) 4!Z EM If you Piave additional signs please attach a shcetlisting eacli one witli dimensions If refacing an existing sign please provide a picture of the existing sign with dimensions. I hereby certify that I am the owner or that I have the authority of the owner to make this application, that the information is correct and that the use and construction shall conform to the provisions of §240-59 through §240-89 of the Town of Barnstable Zoning Ordinance. Signature of Owner/Authorized Age :- ------ Date_ v 110 SIGNS/SIGNREQU revised103009 I� A LODp - , AoO AoMo i Instituted 1801 C MEETS CENTERVILLE9 MA. 2ml MONDAY DAM CLIENT: CONTACT: PHONE RLENAME: APPROVED BY 103 ENTERPRISE RD, HYANNIS, MA 02W 508-280-6511 - • O� O O O O 01II 2 �1Ya it y F — ,.,;.�;. - � ovzek Q oo MAI o � � r y,. r; .. i..w .+_w' .c ,..'�+r�"",r �.,�i :R .x+ >+.; '"��„�.Gt4''�.k"a'i,�.:ti�'!$h��+• �.�r� y-'' •r r y � � .fi«r` ♦, eYt:'Y P r *S4�, F �� !: '`ey� a L, * . 3 z�_ r L+• at y :,:+,; �„ �`.. x.- .,a. '' �.'-. ;.: - � G 1':.3' .•1�� r.t: p+,,. Y:'` +. 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Y 4"'�Yr���hf�' .Yvf"^„W �y`a'�Fv�' �'ry � 9 • ..'��.� �'. <• :'� .�'�.7.!_"'?:-ra.;^•."! <• �''' � _ ;A�.\ �.. <s�4.._a�,F, �:r� >r•..>v7'5 .,Yf!� `F�*�k:�n "•'�:l?.'�1t�:' �S'- Y'."^� v� n�.� R '� ,�-s'�t C� ®� "d'' °;`' i�=-+. .,,,.a,r ...,. t.1 rr .Sr.r�°I ..ie `€, .�.. +•,�;-,`1,: i vt't a. c. �'.� 4'�'c. �"�`'•� :at -.T"�w$, !.fir .�:'#",�•il -�r .��'?S't:..• ♦"'jC`ti.- r `Q-C7 VolCY � t ° wf 7x/ ^v✓N �J �'r $ST. CENTERVILLE-OSTERVILLE-MARSTONS MILLS FIRE DISTRICT DEPARTMENT OF FIRE-RESCUE&EMERGENCY SERVICES r 1875 Route 28'-Centerville, MA 02632-3117 1926 508-790-2375 x1 - FAX: 508-790-2385 John M.Farrington,Chief Martin O'L. MacNeely,Fire Prevention Officer Craig E.Whiteley,Deputy Chief Francis M. Pulsifer, Fire Prevention Officer August 17, 2007 Mr. Thomas Perry- Building Commissioner 'Town of Barnstable 2.00 Main Street - Iiyiliii-is, i�`�iA-02601 Dear Commissioner Perry: Pursuant to MGL Chapter 148 Section 28A, I am making you aware.and request your interpretation of a bedroom without adequate secondary egress and an apartment without secondary means of egress at: 1989 Falmouth Road Centerville, MA While on a fire alarm inspection at this address, I observed an apartment on the second door of this commercial structure: The apartment has a single bedroom with uniersized egress windows and no secondary egress from the apartment. Please contact me with any questions you have relative to this situation at 508 P4�� - 790 237� Ext.l. Thank you for your attention to this issue. ; Sincerely -'4 " t O vn� TM. Francis N4. Pulsifer Fire Prevention Officer Cc: Robin Giagregorio "Commitment to Our Community" j�5 00z oo1 r /jlYF.vvi3/ /lam 177<..sue 667 I _... —. ; r .s 711. .�.�Y .1 i. rY1 .:.�r_a nn:4•,:�.,...e..-1 z 4 r< --- EL-2q.00 . '. S OO T)4 ELEYAT, o N �7 775 SCE 7 15 J /t;��,•R�_ Gov J Zhu�:cr�f �1 t � _ � 1 1 t Assessor's office(1st Floor): O0�•00l Assessor's map and lot number ' v o�THE>o Conservation(4th Floor): Board of Health(3rd floor): ' Sewage Permit number _ i "trace ' °o 039, Engineering Department(3rd floor):.:.: House number Definitive Plan APProved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN ' OF BARNSTABLE t !BUILDING ' INSPECTOR APPLICATION FOR,PERMIT TO .. .TYPE OF;CONSTRUCTION 9 ( 19 q TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: r 1 Location t qqq F1q Cal) I �T ��, C 1�T V ��-1.�� m A, Proposed Use Zoning District 'C' Fire District C o Name of Owner F C'C_iCf im1 A Address S A M'F- - Name of Builder Address �7 OLD FAA^ 14 Q`4_ 42+�t..ILI yd P Name of Architect 1.Q E LSD \?,2 P 116. Address �W1 C E Z N, O ( , Number of Rooms Foundation C O0C2E—if . Exterior woo , S���Q Roofing Floors CC�1-��-��` S L- Interior Heating Plumbing Fireplace Approximate Cost Area b25� 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 constructi n. Name Construction Si ipervisor's License 0 4 0 I FRATERNAL LODGE 713 No Permit For BUILD PROTECTIVE ENTRY Lodge Location 1989 Falmouth Road - Centerville Owner Fraternal Lodge Type of Construction Frame . Plot Lot Permit Granted March 3 , -1-9 94 i Date of Inspection: ' 4 Frame 19 IL Insulation 19 Fireplace - 19 a Date Completed =` 19 } i 4'-9LI 4 i 4'0" 5,-7" D -u D V N - T IM m N 0 O O Ip 0 O V Z Z O _ ZZZZ Z � 0 --_0iT Cl) ym coNAND_ Z1 D_ m ND. Oxo '� X v D -Om0 �@ 0 W 0 � rnZ � - 0 ; � 0 0 Z cn --i -1 0 z 0 c z i 03 A NEW STAIR FOR: Dm CT rrrr���mcr Brewster, Main Street Rte 6A z Fraternal Lodge AF&AM 1 w j 1 I, Brewster•MA phone 1 1989 Falmouth Rd. Residential Commercial 508.896.0051 phone ? 508.896.6199 fax Centerville MA 02636 o Sustainable Design www.capecoddesigner.com NU'f1C'k'UF WYI'RI(;I R: THIS DRA11TV/;IS THE PRUPFRTT OF THE.A.IDT.(.T HAS RFFV PRFPARFD SPFk.1RMIN'FOR THE.011NFR FOR THIS PROJECT AT THIS SRT.AND IS NUT TO&USFll N'ITI IOHR N oll N CONSW OF PLL ARCT IRFCT 0 A.F.AR/NITF(T IN(_ill