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HomeMy WebLinkAbout0127 GLENEAGLE DRIVE l�7 �� � �r�v.�� �� ;�� d v h _ . _ _. . _ � _ __ .___. Q _�... TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 1 Parcel 14 3 Application # Health Division Date Issued 101 se r Tk4- Conservation Division �4rApplication Fee (DO Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address I2-7 &1--CAJEr?G1- �QIVC Village c6A'77e�z y/4-/-1' Owner �Ic�,9f2� /,ram, ��a2 04'7i'0Q7U,u6' Address &7 6-4 A-jc,Z4t= bKo Gam?Z Telephone t Permit Request (96, FT- M/9S'72F2 f3��,Pvt�/�J ��iT� 0a6le y�� �.��S ilk /�-� T/3�/�� ��/�G� �' �X�ST/•vim Square feet: 1 st floor: existing JL4proposed ZW 2nd floor: existing proposed 3& Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 11114 000 —Construction Type AJc�t� Lot Size 7 4�Qeg Grandfathered: ❑Yes ❑ No If yes, attachsupporting'documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(# units) 8/ Age of Existing Structure (C1,78 Historic House: ❑Yes >(No On Old Kingjs Highway: 0 des No Basement Type: Full ❑ Crawl ❑ Walkout ❑ Other _ ? teal Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing 2 new �_ Half: existing D new U Number of Bedrooms: Z existing t new Total Room Count (not including baths): existing 3_new First Floor Room Count Heat Type and Fuel: XGas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes XNo Fireplaces: Existing 'I New Existing wood/coal stove: ❑Yes Ud 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 YNo If yes, site plan review# Current Use 1Z c'St Oe"T7'9L Proposed Use 2 'oc'i✓77fiL ~- - - - APPLICANT INFORMATION _ (BUILDER OR HOMEOWNER) Name I`� �V�� � S�7�5,/NL Telephone Number �s � S ? z-- Address GJ/L,C v T' License # C.5-Uy -2-7IY N�wlS't�� MW_ O ZS4(::Pf Home Improvement Contractor# /C)0_03 Email Worker's Compensation # U ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO lZv 3 — Gc, I .Sclplii e- -kD SIGNATURE- N DATE 0J a L FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. J S4� 1 t ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME _.. ti 41 sty rim 1`�-llt�1� .5 D 11�`L/l� N / INSULATION D �I l FIREPLACE ` ELECTRICAL: ROUGH FINAL L i PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING .3h7hi DATE CLOSED OUT ASSOCIATION PLAN NO. Q. 1 a ,. w i :1 N : l wy 4 - -i. -lam � y � f t Ffi.40D.�ec 77 CA T1 c , F�M A 46 aCAL �-wig, t�hl ' AN 13C3p.K 6 : E ,ram, :PA't�r£ :'7f tin 4 -HA T Th,E '6xZ57 OWA). ANb FD��`?�f�/TN .,.. . '. : .7NE3urc 7' al QLF 817 l 141-oW ST Ys ,0"O CiT1/PO�T,MA. I 1 Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 - Boston, Massachusetts 02116 - : Home Improvement C�Iit tttor Registration Registration, 109503 Type: Private Corporation n N` x Expiration: 9h612016 Tr# 255703 -.� RW ANDERSON & SONS INC1 _ RICHARD ANDERS:ON 6 WILLOW ST. 'SANDWICH:, MA 02563 �! v YJpdate'Address and return card.Mark reason for.change. Q Address 0 Renewal Q..Employment E] Lost Card SCA 1 i; ,20M-05/1.1 (92. . License or registration.valid for indiv►dul.use only Office of Consumer Affairs&Business Regulation before the expiration date: 1f foun8 return.to: ME IMPROVEMENT CONTRACTOR Office..of Consumer Affairs and Business.Regulation U961gistration -,-, Type' frationf�6� 0�6 Private Corporation 10 Park Plaia.-Suite 5170 . Boston,MA;02116 RW AND.ERSON 8 RICHARD ANDERS1f 6 WILLOW ST ==�. A SANDWICH,MA 02563 t Undersecretary Not valid without signature Massachusetts Department of Public Safety Boaid of B,:rld ng Regt!a#ors a d Standards Construction Supervisor License CS-007714 R1CMHARD W AND RSU` 20 GROVE ST y Sandwich MA`0136,3 , .J11W Expiration Commiss o;ner- 05/26/2016 AC 0 CERTIFICATE 4F LIABILITY INSURANCE F�5/2015 MI°DNYYY) f. - I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT_AFFIRMATIVELYOR 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 poky(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 net confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAMEACT Sarah Thorpe Mark Sylvia Insurance Agency,LLC PHONE 404 Main Street 508 957-2125 A No:508 957-2781 EMAIL Centerville, MA 02632 ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A.Farm Family Casualty Insurance. INSURED INSURER B R.W.Anderson&Sons Inc INSURERC: 6 Willow St - i . Sandwich,MA 0,2563 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED'ABOVE FOR THE POLICY PERIOD INDICATED, :NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE ADD UBR POLICY EFF POLICY EXP LIMITS Amu POLICY NUMBER MMIDO MMIDDNYYY 4_ 701' MERCIAL GENERAL LIABILITY ' EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES Ea occu ence $ MED EXP(Anyone person). $- ` PERSONAL;&ADV INJURY $ GEML AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRO- POLICY a,JECT' E.LOC PRODUCTS;-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ a accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED 4 BODILY INJURY(per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY'DAMAGE $ AUTOS Per acciden $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ ' A WORKERS COMPENSATION 2001 W6446 9/18/2015 '9/18/2016 PraTurE ER AND EMPLOYERS'LIABILITY YJ N ANY PROPRIETORIPARTNER/ExECUTNE [NE.L.EACH ACCIDENT $ 500,000 OFFICERIMEMBER EXCLUDED? N i'A (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 500,000 If yyes,describe under, , DESCRIPTION OF OPERATIONS below. E.L.DISEASE-POLICY LIMIT $ 500,000 i DESCRIPTION OF OPERATIONS/.LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may attached if more space is required) Carpentry t Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER` CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED.BEFORE Town of Barnstable THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200.Main St. ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE ©1968-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD Town of Barnstable Regulatory Services BAR MAIM Richard.V.Scali,Director -BuBding.Division Tom Perry,Buildium Commissioner I 200 Main Street.,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must i Complete and Sign TIns Section 1fU sing . x r.Ider I, k\1AO1V-6 Oxv� 4'eaK�-" M a6oae' O".r of die subject property hereby authorize tJ AV P eQ43 4- to act on my behalf, in all matters relative to work autlorizedbydiis building permit application for. (Address of job) Pool fends and alarms are the re-spowilAity of the applicant. Pools are not to be filled or utlized before fence is installed and all final inspections are performed and acccKted. Signature er sipn�anme i-1'A.Dpl-icarit a;6Mo-vqt a-rjonc W -1U OWC�kxox" Print Name Print.Name Date Q:FO'RMS:OVn\Tr�-R?E-PJv2SsIONPOOLS the Comrnorrivealth of-Massadjusetts Departure nt of Indu- ial Accidents l7,f -ce of lmwsiigadans 600 Was iJIgtorr Street Boston,41A 172111 witit.rnrrssgovfdia,s Workers' Campensation Insurance Affidavit Builders/Contractors/Electricians/Plumbers Applicant Infarmatian n Please Print Legib iv u lX Name aisiuessforgaum on&dal). j •lr, 1�09�.CV AJ YL.Siz; �! , /x)G Address (o Lty/�-LyG•� �T Ci lstatel �/ Phone Are you an employer?Check the appropriate box: ' Type of project(requir-ed): LK I am a em to er with 4. ❑I am a general contractor and I F y * Have hired the sub-cmttacVto�rs b ❑New consfructian employees(full azitlfo€pnrt-time). 2.❑ I am a sole propidetar orpautner IL-ted on the attached sheet 7. 54 Remodeling ship and bane no employees. These sub-conRractors have S.,❑Demolition waiting for in any capacity. employees and have workers' 3. IW Building addition [No workers, Comp.insurance Comp-msuranc5e_i rewired_] 5. ❑ We.are a corporation and its 10❑Electrical repairs or additions 3.❑ I am homeoumer doing all work officers have exercised their 11.❑Plumbingrepairs or additions myself [No workers'cep_ right of exemption per MGL 121-1 Roofrepairs insurance required.]F c.152, §1(41 and we have no employees.[No workers' 13.❑Other camp.msurance required-] *Any appB antd atchedmbos#1 Est also filloutthe sectionbelawshaning th&wodeie com9enm&npo1icyinfbmtff5om_ I l amwwners who submit[his Mda«r nu eating they are doing sill vast and then hire outside contractors nmst submit a new affidavit indicating such_ =coutnctots that che[t.this boor must attached an additional sheet showkag the name of the sub-coatramcs and state whether or nut those eaddes have employees. Iftbesub-caaxractoMhlVeemplaye�_s,they mustpm-W their warken'romp.policyumnber. I am an etnp r float is protatlirtg tnorkers'comrrpensahirtt irrsttranca f or m}*�nipio}�¢s $etoiv is die poFic.,y&Rd job site informadam . Insurance Company Name: /'J ��^--�""*A F " &!Y Policy�or Self-ills.Lic. 2 Lat'�.l GtJ��Sl�� Ekpigaf on Date: 'Aj11!o Job Site Address: 2 Ctty/Stafe/Z.p: �J�"P/i,�t� A054 az�3 L Attach a copy of the workers'compensationpolicy declaration page(showing the policy number and respiration date). Failure to secure coverage as required under,Section 25A of MGL c_157 can lead to the imposition of criminal pemshies of a fine up to$1,500 00 an&or one-bear iniprisortment as well as civil pemalt%es.in the form of a ST)DP WORK ORDER and a fine of up to$250-0!0 a day against the violator. Be adsrised that a copy of this statement maybe forwarded to the Office of Investigations of the DIk for insurance coverage vfication- Ido hereby c l t the turd penaitres afFedury that time hzformati n prot rted abaiv isltrue arrrl correct Si2�ahire: Date: Phone ii Ofja'cial rise only. Do toot wrke in this area,tit be completed by city ortomrn afficiat City or Town: PermitUcense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.[itytFown Clerk 4.Electrical inspector for S.Plumbing Inspector 6.Other Contact Person: Ph-one#: 1xiformation and lastructions Massachusetts Geheral Laws ffiVtir 152 rego:ires all employers to provide workers'compensation far their employees. Prlrsuantto this sue,an Ia3're is defined as`-..every person m.the service of another render any contrast of hire, express or implied,oral or wziien." An enployer is defined as"an mdividA partnership,association,corporation or other legal entify,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 - dq,eIlin 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(S)also sues 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 not 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 nbr any of its political subdivisions shall enter mto any contract for the performance ofpublic work until acceptable evidence of compliance with the insurance, rcq TTETents of this chapter have been presenf-ed to the contracting aothority_" Applicants , Please fill out the.workers' compensation affidavit completely,by cheakiag me boxes that apply to your sitdation and,if necessary,supply sob-mutrantor(s)name(s), addresses)and phone number(s) along with their certificates)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 iastnance. If an LLC or LLP does have employees,apolicy is required. Be advised that this affidavit maybe 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 retzmmed to the city or town that the application for the permit or license is being requested,not the Department of n , Accidents. Should you have any questions regarding the law or if you are reqaired to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self_jnsu ance license number on the appropriate line. City or Town Officials f - Please be sure that the affidavit is complete and primed 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 penmWlicrose 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 of Eidavit mdicatng 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 maybe provided to the applicantP - ' as 'roofthat a valid affidavits on i file for fW=perms or licenses A new affidavitmust be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial ventase (ie. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would h1r,to thank you in.advance for your cooperation and should you have any,questions, please do not hesitate,to give us a call The Dcjp rtmenfs address,telephone and fax numiberr Tl�e�a�c�n eaZt3 of Massachusztts Department cif Ii d€gkial Accidents �itoe off-vestika L a..- 6Q0 wasbi GII Stf-,f--t Raston.,MA G� I I I Tf,-L 4 617 727-4900 CXt 06 or 1­97ML &AFF, Fax 4 617-727 7749. Revised 4-24-07 maass-gavIdia FTHE r Town of Barnstabllev f)� 11S Regulatory Serviges LE � Thomas F.Geiler,Director 4N I./; 24 saRNSrABM M^ 0. $ Building Division prED Mp'�A Tom Perry,Building Commis is oner 601 200 Main Street, Hyannis,MA 02 Office: 508-862-4038 Fax: 508-790-6230 PERMIT# FEE: $ �i SHED REGISTRATION 120 square feet or less Location of shed(address) Village. �/,/,P � 4 &E��G' 6- . 221 71,T1 Property owner's name Telephone number /0 ,i /y3 Size of Shed Map/Parce.# i Signature Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? Conservation Commission(signature required) PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:121901 i L o -r- 13, 3 , i S 90. .777 d _ � LOT j LOt ! , , J�11 G ._ i T.4tc30!/ Z7OA7., L 0,C.4-ri�ry R 10 L T /1 �4 a SHO,l;J'N rr (�! P4�AIV 1300K 9.. 66 Af -IN CG FO[/n.D.4 r/0" 40-AT1 .6 Wn/: NCOA/FOQi--JIY/Tf1 ul, Dinl of r�E r �sinv PA. AFCAL _ 817 rw/GGOw'sr YAa L2"o ra/-,X-o�r,a1A: TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �CtkParced Application # Health Division Date Issued Conservation Division ..Application Fee Planning Dept. >Permit Fee, Date Definitive Plan Approved by Planning Board ?` : _ G►� ,�131 � Historic - OKH _ Preservation/Hyannis 3 Project Street Address (��tP� GA&L€ �yE Village V i(�(�,. �5Z Owner i C kayeb (Z 0 N Address SA K E faS bav c5 Telephone S-O C - 7/3j Permit Request �%I Sy`d`l NE7a1 DE-66A26 ��'�0/Giri�(�a R� U I�YIS /IVl r Square feet: 1 st floor: existing proposed V Ov 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation �100 00 Construction Type Lot Size Q,Z�7 4near 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: ❑ existing 0.new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other::r "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 06 t q4a Address `iVir, Old WTV� GEC License # C-S 76441 cL��E-WSTne- 0 U.3.1 Home Improvement Contractor# J 7 31 0�` Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO -5-r"LR-- SIGNATURE DATE S w '4 FOR OFFICIAL USE ONLY r 'APPLICATION# DATE ISSUED i MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION o&> co k ' FRAME s INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL j PLUMBING: ROUGH FINAL GAS: ROUGH I FINAL FINAL BUILDING ti DATE CLOSED OUT y ASSOCIATION PLAN NO. t Y- . The Commonweal th of Ma ssachusetts usetts Department of Industrial Aecidents Office oflnvestigations. 600,Washingfon'Street .► Bost 2 on1 II MA 0 , 'v www,mass.gov/dia ' t` Y Workers' Compensation Insurance Affidavit: guilders/Contractors[Electricians/PIumbers Applicant Information Please Print Legibly Name (Bus iness/Organization/Individual): G�GIti � Address: ' CitylStatelZip: S r O�i�73 Phone# �� � �•7 �o ��62 Are you an employer? Check the appropriate box: Type of project(required): 1.El I am a employer with 4. ❑ I am a general contractor and I 6.'❑New construction tnployees(full and/or part-time).* have hired the sub=contractors Lam a sole proprietor or partner- listed on the attached sheet $ 7• ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working forme in any capacity. workers' comp. insurance. 9. ❑ Building addition - [No workers' comp.,insurance S. ❑ We area corporation and its 10.❑ Electrical repairs or additions required.] officers have exercised their right:of exemption per MGL 1 1.❑ Plumbing repairs or additions 3.❑ I am a homeowner doing all workp p myself. [No workers comp. re�n c. 152, §1(4), and we have no 12.❑ Roof pairs 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'compensationpolicy 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-contmaors and their workers'comp,policy information. I am an employer that is providing workers'compensation insurance for my employees. Below-is the policy and job site information., Insurance Company Name /" r✓ �f Policy#or Self-ins. Lic.M w C/' 31 S —J "91;4-0 f' 011 Expiration Data: 171 Job Site Address: �Z7 �lt'iYl !!G� QR/�� City/State/Zip:&+eek l/ Attach a copy of the workers' compensation policy declaration page.(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152.can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the fort 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. :1do SiMhereby c der the pains Pena f perjury that the information provided above is true and correct " Data:r. Phone 4 Official use only. Do riot write in this area, to be completed by.city or town official City or Town: Perm itlLicense Issuing Authority(circle one): 1. Board of Health 2.Building Department 3. City/Town Clerk 4. Electrical Inspector S. Plumbing Inspector 6. Other Contact Person:, Phone #: Al Town of Barnstable ` Regulatory Services • f i pp v MARL g Thomas F. Geiler,Director Eo � 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 Complete and Sign This Section If Using A Builder I, l l�� !� M 030"& as Owner of the sub ect ro e J .P P riY hereby authorize �(�'�'L'"(L j r(,L CIL to act on iny behalf, in all matters relative to work authorized by this building permit application for:' , i? &- eri EAqje .. G�IL1I�yLM1 (Addres of Job) J L " ll Jgriature of Owner Date Print.Name If Property Owner is applying for permit please complete the Homeowners License. Exemption Form on the reverse side. . . Q:FORMS:OwNERPERMISSION 1 Town of Barnstable Regulatory Services t BARNSTAB Thomas F. Geiler,Director Building Division Tom Perry, Building Commissioner 200 Main.Street,_Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-962-403 8 Fax: 509-790-6230 HOKEOwNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town stater 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. DEFINrrION of HOMEOWNER Persons)who owns a parcel of land on which he/she resides or intends to reside, on which there"is, or is intended toy be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constrticts more than one home in a two-year period shall not be considered a bomeowner. 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 perfbmipZ under the building permit. (Section 109A.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.be/she understands the Town of Barnstable Building Department rninirnum 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 iequired 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 cxm'-npt from the provisions of this section_(Scction I D9.1.1 -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 homcownas 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 awarcness bftep rrsults 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 Supervisar. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully awarz of his/her rtsponsrbilitics,many communities require,as part of the permit application, that the homcowncr certify that hrlshe 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 fom>/certific-tion for use in your community. Q:forTns:homccxcmpt F i� • Nlassachus tts- Department of Public�S ifetj Board of Building Regulations and standards Construction Supervisor License License: CS 76441 Restricted to: 00 s PETER A KIRCHNER '' b 142 OLDREDTOP RD ' BREWSTER, MA 02631 1 Expiration: 12/6/2011 (,tnuii;a„�aer Tr,: 12580 0/ Office of Consumer Affairs and Business Regulation E�y 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 168809 Type: Individual Expiration: 4/8/2013 Tr# 211107 PETER A. KIRCHNER PETER KIRCHNER 142 OLD REDTOP RD BREWSTER, MA 02631 pdate Address and return card.Mark reason for change. -- ' Address ❑ Renewal F Employment Lost Card DPS-CA1 0 5OM-04/04-G101216 oo�� 2c/i%r°eCia License or registration valid for individul use only office of Consumer Affairs&Business Regulation e$ Y Of @!HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: J' Registration: :A68809 Type: Office of Consumer Affairs and Business Regulation '� 3�Y Expiration 4/8/2013 Individual 10 Park Plaza-Suite 5170 �7X/ Boston,MA 02116 PE FfR A.KIRCHNER- PETER KIRCHNER 142 OLD REDTOP JRD � BREWSTER,MA 02631 _ Undersecretary Not valid without signature 1 5/10/2011 5:56:13 AM PST (GMT-8) FROM: insurancevisions.com-TO: 15092582116 Page: 2 of 2 A4CO i CERTIFICATE OF LIABILITY INSURANCE °ATE110/2011`" 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 certficate holder is an ADDITIONAL INSURED,the policy(lea)must be endorsed. If SUBROGATION 13 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 ROGERS&GRAY INSURANCE AGENCY ING CONTACT PO BOX 1601 PHONE 800 553-1801 FALX IA&No): 508 258-212 SOUTH DENNIS, MA 026601601 EMAIL ADDRESS: INSURE S)AFFORDINGCOVERAGE NAICP 94BUI ERA: Liberty Mutual Group INsuREo PETER KIRCHNER INSURERB: 142 RED TOP ROAD WSURERC: BREWSTER MA 02631- INSURER D WSUREIE: INSURERF: COVERAGES CERTIFICATE NUMBER: 10157867 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. FULJCY POR TYPE OF INSURANCE SUB POLICY NUMBER M MUT EFF P Y EXP LWITS LTRwwD GENBRALLMENJTY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES a Ocaerence $ CLAWS-MADE F OCCUR MED EXP(Any oneperson) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GENL.AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ POLICY PRO. LOC SINM $ AUTOMOBILE LIABILITY a eaNED ittat L IT $ ANY AUTO BODILY INJURY(Per person) $ AUTOS"ED 8 AUTOS BODILY INJURY(Per acddeN) $ NON-OWNED (Pe�acadeM AMAGE $ HIRED AUTOS AUTOS $ $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ $ A wORKERaCOmPENSATIon WC1-31S-381508-011 4/28/2011 4/28J2012 ,/ TRYTLIM ATITS ' AND EMPLOYERS'LJABRJTY YIN ANY PROPRE-rORIPARTNERIEXECUTNE E.L.EACH ACCIDENT $ 100000 OFFICERIMEMBER EXCLUDED? �Y NIA (Mandatory in NN) E.L.DISEASE-EA EMPLOYE $ M yes,desabe under OESCRPTIONOFOPERATIONSb9bN E.L.DISEASE-POLICY LIMIT $ 500000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Allach ACORD 101,Additional Remarks Schedule,Y more space to required) THE WORKERS'COMPENSATION POLICY DOES NOT PROVIDE COVERAGE FOR PETER KIRCHNER Mmakers Coo at I anow Part One of the di applies onlyto the Workers'Com nsation Laws of the State of MA. ATE H LDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TOWN OF BARNSTABLE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ATTN: BUILDING DEPARTMENT ACCORDANCE WITH THE POLICY PROVISIONS. 200 MAIN STREET HYANNIS MA 02601 A° IMUREPRENrATYVE 14dtr. .4Jeff Eldridge 0- 0 1988-20`0 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD CERT NO.: 10157857 CLIENT CODE: 1539742 AnneChandler 5/10/2011 5:52:07 AM Page i of 1 This certificate cancels and supercedes ALL previously issued certificates. Client#:65686 KIRCPET ACORD,. CERTIFICATE OF LIABILITY INSURANCE D511012011 ATE rn 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($),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 NAME: Kimberly Ann Miller Rogers&Gray Ins.-So.Dennis PHONE 508 398-7988 E c.No: 508 258-2116 aC No. o Ext 434 Route 134 E-MAILADDRESS: P.0.Box 1601 CUSTOMER ID>P: South Dennis, MA 02660-1601 INSURER IS)AFFORDING COVERAGE NAIL# INSURED INSURER A:National Grange Insurance Co. Peter Kirchner INSURER B 142 Old Red Top Rd. INSURER C Brewster,MA 02631 INSURER D INSURER E• ` INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I SR I DDL UBR POLICY EFF POLICY EXPLTR LIMITS OF INSURANCEMaL POLICY NUMBER MID M A GENERAL LIABILITY MP18758Z W2712011 04/2MO12 EACH OCCURRENCE $1 000 000 DAM-AUE TO X COMMERCIAL GENERAL LIABILITY PREMISES Ea ocw Dense $500,000 CLAIMS-MADE a OCCUR MED IXP(Arty one person) $1 O,000 PERSONAL&ADV INJURY $1,000000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS COMPIOP AGG $2,000,000 POLICY PRO-JECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT" $ (Ea accident) ANY AUTO BODILY INJURY(Per Person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE HIRED AUTOS (Per accident) $ NON-OWNED AUTOS $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN ANY PROPRIETORIPARTNEWEXECUTIVED WA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ Ifyes desabe unOF der DESCRiPT10N OPERATIONS Hebw E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) Workers'Compensation certificate will be sent directly by the company CERTIFICATE HOLDER CANCELLATION 10 Days for Non-Payment 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. Attn:Building Dept. 200 Main Street AUTHORIZED REPRESENTATIVE Hyannis,MA 02601 0 198 -2009 ACORD CORPORATION,All rights reserved. ACORD 25(2009109) 1 of 1 The ACORD name and logo are registered marks of ACORD #S66751/M66750 KAM 9r ens 3 '� r�� �—le ' SPA SPECIFICATIONS 2 �1) Ta ` r" r � Q� s a�,`i jR z. ® 7'7"x 8'4" 500 1 008' 6,228 120 Ibs Vista 38" 325"* ! gallons lbs. e�s 230 volt, 50 amp (Model SS) 2.31 m square 4,000 P q ' Single phase GFCI foot Seats6 feet 1,893 457 2,825 x 97 cm �� Y protected circuit v Adults . 2.54m liters kg kg. ® . T7"x 8'4" s 500 1,008' 6,403 125 Ibs Grandee 38"< ** x 230 volt, 50 amp IVl�el GG 325 gallons Ibs lbs. er s 2.31 m square `4,`Q00 px Single phase GFCI x feet18932,904 protected circuit Adults 2.54m liters kg kg. ® 7�9 x T5" ', 450 875 _ 5,503 120 Ibs # Envoys 36" 325"* 230 volt, 50 amp Model gallons Ibs lbs. per sq 2 36m � square 4,000 : foot Single phase GFCI >Seats;5 x 2,496 91 cm feet 1,703 397 protected circuit Adults 2.26m liters kg kg. T3"x:T3" = 365 r 789 4,708 Ana® 230 volt, 50 amp . ,. Model AR 36" 325*# gallons Ibs Ibs. 120 Ibs 2:20m Wyk square 4,000 per,sq Single phase GFCI Seats 5 x 91 cm . 1,382 y358 2,136 foot feet protected circuit µAtlults 2.20m 9 9 liters k k Vanguard®- 77 x 7'3" 150 ' 400 789 5,175 135 Ibs 230 volt 50 amp Motlel 36" square .�� gallons Ibs lbs. 220rn per sq Single phase GFCI (. feet 6,000 ' foot Seats`6 x 91 cm 1,514 358 2,347 s protected circuit Adults 2.20m liters kg kg. Sovereign®t' 6'8"x 7'9" 120 _ 355 713 w 4,724 115 Ibs .� F er s 230 volt 50 amp gallons s Ibs P q , Modef II 33 square 6,000 g Ib foot 2.03m Single;phase GFCI Seats 6 x 84 crn feet 1,344 322 .; 2,143 z _ y protected circuit Adults 2.36m liters k kg g. x s 115 volt, 20 amp Prodigy® 67"x T3" 325 613 N 4,199 Dedicated GFCI Model H 33" 90 1,500 gallons Ibs lbs. 12 0 Ibs protected circuit Y ) 1.88m square or per sq or Seats 5 x 84 cm 1,230 278 F< 1,905 oot 230 volt, 50 am feet 6,000 f P adults 2.21 m litres kg. Single phase GFCI s protected circuit 115 volt, 20 amp Jetsetter® 5'5"x 7'0" 29, 225 4,50 2,852 Dedicated GFCI- ModeI,JJ 90 1 500 100 Ibs , protected circuit Ibs lbs 1 65m 74 cm square or gallons " per sq or Seats 3 X r` 852m 204 _ 1,294 feet 6,000 foot 230 volt, 50 amp Adults r 2.13m litres kg kg x Single phase GFCI Y protected circuit ®.CAUTION:Watkins Manufacturing Corporation suggests a structural engineer or contractor be consulted before the spa is placed on an elevated deck. NOTE:The"Filled weight°and"Dead weight"of the spa includes the weight of the.occupants(assuming an average occupant weight of 175 lbs). "Effective filter area is based on 6.5 square feet actual area per filter(5 filters used)with 10 times effectivity rating. LOT 13 TEST HOLES -NAIL IN 'ELFi1• JUNE a3, 1978 /G c� i DOLE zo.o I PAUL MURRA%- 2145 PECTOM i �i'- TEST I EL6Y. a.o.0 aara z„o * HOLES of RESERVE tall PROP WATER 0 0-14"LOAM AND j LINE ; �- I 5US501L i DIST 13OX - 'o - ,{ tj i aZ4''eo�COARSE SEN K ..� 1-• tS /a, ; S,9ND AND GRRY6L LEACH PIT \ a ; 60 144"C.0ARSt i '^ S/aND M� a i { zz sp rvn. Li.l LOT /a _ J 23/ 23 �: lh NO WATE1i ENCOUNTEhED 1 W i I LOT 11 N t TOUM WATER /5 AVAILABLE . i M/N1M!//rA SCALE / =30' j3 u/G.D/NG 5 ETc3AClc •2EQU/�2�ME.�/7� ' ;2 C) F,G?OAI7 P.2o pa SED _� QED.20oM5 � SEPTlG 5y5 TE�l CONS T2 UCT/ON SNA11. COMFO,eM TO MASS• DES/GN FL_0.-J- 33C) GALlCkAY ! En/v/eon/a1ENTAL Coat T/T/-L Y LEAD'/-/ .2ATE L 9- M/A //VG/�Q• P/ZoPaSED eEViSED 7-/-77d QAfrNS;AQLE eEQU/eF� LE,lCNAee,4C33o)�v)_ /3 Q. L/E.QGTH ��GULt3T/OHS TOP of � P2O,oOSE27:LEACN A,2EA Z OF PEa 5`rOt1c a•`2'� - /.r7PE.2V/O[!S GOVE.t + MANHOLE.�CO✓E.2 7b EXTEND TO TO,o2EVE.VT F/.VG." W1Tsl1N /'OF F//J15L1E0 6.2AZD1✓ F20n!/VF/L T2AT/.v"= ►_I 2¢"Co✓ExZS� /0 I7lST. IC I M/•vin7u 4-CASr f aox 6 M,u 4"D1A- rE _ -- MPi'7.CMN 3-vE,N � T 4 D1d. F. t..L,(� /O LEACH M1N OOTcH - = E P/T ��.. 10"KiN "2' 3' 1{ 4"�F(10T /^1 /¢' ✓4��FOOT M!^� p/TCH �- /4-/ Z L'" II �� _Y /OVO MiN �C �4'•�FOOT 2.001� +�3't1A5 HEU y C -r- /,Vrp-eT 8 F O NE /NVE.Q GAL L0n1 /NVE.eT 6'' z_- T CAPAG/TY 0uN '+ SE PTIC TA,V.e - ,r F1EV. /B-O 14 8a7,FCK4 0F. ' 19•� (WATE2T/GNT�. /N✓E.2T c['•1 - 1NVE.ZT 1a..o S/TF_ PL A A/ PROP)5ED S1�AVA &L LOC AT10/V 13 R STAL� E(CENTfRVILLE) MASS: 2EFE�En/GEG LOT ON_ FL AN _Boo K_�6o_PAGE 7/ 1N OF qj,+I SEAT/G TA1v r, D1ST¢/BUT/Onr Box -Ole �i�y OUTLETS' AND LEAGi//,VG P/T �'-�'Q 6E OF QE/nlFO.2CED cONC/2E7% i� r,�..�� IpNG2ETE ST�E_t/G77�/ 3000 Ps/ FRANK NANiFL \ s°_' �� TEeL 20000 13Y !.r'^'t,'F j 7"A.yLO.C--. CC)R7P '��."'�k/;, J H-/O LOAD/NG Ls a 0k-IvE b'VAY NOT TO 6E L Oc-_4 > ya (3n70L., R7-, nfAa5. Ova UA/LEs5 H-00 1S CERTIFY THE 13UILD;N& SN04JN ON THISit DE516N LO/aa/NG /S USED. -- FLAN 15 PROPOSED ON THE &ROUND AS SHOt,,N AND IT DDES CaNFORM W/TN Y-4 TNT L'V l: ILD1Nc SfTBCk f-MOREMENTSOF THE TOWN OF QA:RNSTA&Ly4f�� P �,yo 8T4 y0 OATE NEIILTN QvErvT A PPA--OVA L_ } (Ail qv�6 .. _ Es { I Mio-sPAn► 6uLK & �„ € MLO W' 50AOUbc,� wjibl(,fcc� ly I (A l)l ta. ,..... ... .. { 2x.10 3 i'A",<`1 ,lz" AFP SImPSok.1 AS.0 hsAdSL,-�, SC.RLC. I Jy° — I 3'1 � ` h AH C:4:rgS 1 i��� 60�� SOIiQ �if WI� 1G� 1 ; a Zx1 aIa . S(M PSoO AP 9 MS AS { i ^� Deck 5-9-11 ANTHONY Centerville,MA 11:27am ..,...1,�" 1 of 1 KeyBmm@ 4.507f IonBeamEngine 4.509m Materials Database 1293 Member Data Description: Member Type:Beam Application:Floor Top Lateral Bracing:Continuous Bottom Lateral Bracing:None Standard Load: Moisture Condition jry Building Code:IBC/IRC Dead Load: 12 PLF Deflection Criteria: U 60 live, U240 total Live Load: 60 PLF Deck Connection:Nailed Member Weight: 9.5 PLF Filename:KYB1 Other Loads Type Trib. Dead Other (Description) Side Begin End Width start End Start End Category Additional Uniform(PSF) Top 0' 0.00" T 0.00" 4' 0.00" 0 98 Live Replacement Uniform(PLF) Top 0' 0.00" 7' 0.00" 42 210 Live Span carried:T 0.00"simple span T O 7 0 0 7 0 0 Bearings and Reactions Input Min Gravity Gravity Location Type Material Length Required Reaction Uplift 1 0' 0.000" Wall Steel WA 1.500" 2335# 2 T 1.750" Wall Steel N/A 1.500" 2335# Maximum Load Case Reactions Used for applying point loads(or line loads)to carrying members Dead Live 1 184# 2151# 2 184# 2151# Design spans T 1.750" Product:AFP Trued Beam 31/2 X 91/2 1 ply Component Member Design has Passed Design Checks.— Minimum 1.50"bearing required at Daring#1 Minimum 1.50"bearing required at bearing#2 Design assumes continuous lateral bracing along the top chord. Design assumes no lateral bracing along the bottom chord. Allowable Stress Design Actual Allowable Capacity Location Loading Positive Moment 4171.'# 10341.'# 40% 3.57' Total load D+L Shear 1818.# 65314 27% 6.43' Total load D+L TL Deflection 0.1031" 0.3573" U831 3.57' Total load D+L LL Deflection 0.0949" 0.2382" U903 3.57' Total load L Control: Positive Moment DOLS: Live=100% Snow=115% Roof=125% Wind=160% All product names are trademarks of their respective owners t .it—V'- Copyright(C)1987-2011 by Keymark Enterprises,LLC.ALL RIGHTS RESERVED. c a nmmses, -Passing is defined as when the member,Floor joist,beam or girder,shown on this drawing meets appfipble design criteria for Loads,Loading Conditions,and Spans listed on this sheet The design must be reviewed a ualified deli ner or deli n rofessional as r u"Z for royal.This deli n assumes oduct installation accordn to the manufactures s specifications. L Town of Barnstable *Permit# rzo � Expires;6o'Na date �'P� TRIWIT Regulatory Services Fee Thomas F.Geiler,Director AUG - 8 2006 Building Division TOWN OF BARNSTABLE Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY l Not Valid without Red X-Press Imprint Map/parcel Number' Property Address Residential Value of Work �C �d Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address G eX.4_ C/� 1;144 f Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) �� D Construction Supervisor's License#(if applicable) V�Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# 7 �C &I y l®S— Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) Q Re-roof(stripping old shingles) All construction debris will be taken to SG��lJ" rc ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) "Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. o y of Home ement Contractors License is required. SIGNAT I Q:Forms:expmtrg Revise061306 1 ne c,ommonweacrn uJ lnuzsu.v eus Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plu�abers Applicant Information Please Print Legibly Name (Business/organizationadividual): Address: City/State/Zip: Phone #: F 15 A,rS you.an employer? Checkthe•a propriate boa: Type of project(required): 1t�Y:im 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 $ 71 ❑ Remodeling ship and have no employees These sub-contractors have 8. 0 Demolition working for me in any capacity. workers' comp.insurance. g. ❑ Budding addition [No workers' comp. insurance 5. ❑ We are a corporation and its 10.❑ Electrical r airs or additions required.] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL 11.0 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' comp.insurance required.] 13.❑ Other "Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information: t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tcontractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp,policy information. I am an employer that is providing workers compensation insurance for my employees. Below is the policy and job site information. /) Insurance Company Name: Q/J/ Policy#or Self-ins.Lic. #: / 7 /k 6 Expiration Date: O —� Job Site Address:_ 43 7 �o l��v.. �G�-S� �� 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-f me 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 f Investigations of the DIA for insurance coverage verification. I do hereby certi a pains d pe es o erjury that the information provided abov is true and correct Signature: 11 Date: 1�5, 0 Phone#: a Official use only. Igo 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 11 6. Other Contact Ferson. Phone#�• --- i _p registration valid for individul use only Gf �arrvma�zu� �/ ` License or reg't Re ulaf+ons and Standards lration date. If found return to: Board of Building g befo►i the exp•TRACTOR Re ulations and Standards Beal ti of B 1301uilding g HOME IMF I OVEMENT CONT One.kshburton place Rm . 12536 02108 Regist_rati-.br,__.._� Boston,Ma ONE �"2007 lug t W.p - C�OhLca� FRASER CONST_ N 1� _- DEAN � '�.�i �.•��lu'°�'I — Not valid Without signature FRASER 71 TARRAGON CIR Administrator COTUIT,MA 02635 i a CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/Yrr.) PRODUCER 09/22/2005 (508)588-1260 FAX (508)588-7236 TH1S CEF,'IFICATE IS ISSUED AS A MATTER OF INFORMATION Wise & Quinn Insurance `Agency Inc. ► ONLY ANI''CONFERS NO RIGHTS UPON THE CERTIFICATE 449 Pleasant St. 1 ) HOLDER,'I'kIS CERTIFICATE DOES NOT AMEND?,EXTEND OR Brockton, MA 02301 i ALTER TFI�COVERAGE AFFORDED BY THE POLICIES IBELOW- CISR, Paul Crowley II NsIVRERS I , AFFORDING COVERAGE NAIC# INSURED Dean Fraser ;INSURER A; Hartford Insurance Company DBA: Fraser Construction Co. (INSURERS: 71 Tarragon Circle I INsu`!rR c; Cotuit, MA 02635-2443 IINSURER0. I INSURER E: COVE. AGE _THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE!NSURED NAMED A?OVE FOR THE POLICY PERIOD INDICATED.NOT%vVITHSTANDIN( ANY REQUIREMENT,TERIN OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH R? SPcCT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY TJE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOVVN a SAY HAVE BEEN REDUCED SY PAID CLAIMS, I.TR "DD' TYPE OF INSJRANCE FOLK Y EFFECTIVE POLICY EXPIRATIpN POLICY NUMBER LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE is. DAMAGE TO RENTED CLAIMS MADE OCGJr'�. MED EXP(Any one persan) PERSONAL&ADV INJURY $ GENERAL AGGREGATE 5 GEN'L AGGREGATE LIMIT APPLIES PEP; POLICY PRO_ PRODUCTS-COMP/OP AGG S JECT LOC AUTOMOBILE LIABILITY — ANY AUTO COMBINED SINGLE UMIT $ (Ea accident) I ALL OWNED AUTOS I. SCHEDULED AUTOS BODILY INJURY (Per person) S HIRED ALTOS BODILY INJURY NON-OWNED AUTOS (Per eculdenO S PROPERTY DAMAGE S {Per acddenl} GARAGE LIABILITY AUTO ONLY-EA ACCIDEhIT S ANY AUTO I EA ACC S OTHER THAN AUTO ONLY: AGG S EXCESSIUMBRELLA.UABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE S DEDUCTIBLE S S RETENTION S , S WORKERS COMPENSATION AND 6S600-794X619-1-0S 09/26/Z005 09/20/2006 X I WCSTATU- OTH- EMPLOYERS'LIABILITY TORY LIMITS (� ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ 5O0 00© OFFICERIMEMBER EXCLUDED? If yes,describe under E.L.DISEASE.EA EmPLoyE4 S S00,000 SPECIAL PROVISIONS elow OTHER E.L.DISEASE-PbUCY LIMIT _S S00;000 eSCRIPTION OF OPE.RATICNS 1 LOCATIONS/VEISCLES I l;JfCLUSIONS ADDED BY ENVORSEMENT/SPECIAL PROVISIONS the operations usual to carpentry. _RTIFICATE HOLDER AN L Ti N I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE I EXPIRATION OATS THEREOF,THE ISSUING INSURER YJILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Fraser Construction Co. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABIUTY � 71 Tarragon Circle OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. COtult, NIA 02635 AUTHORIZE-0 VE C� I r ORD 25(2001108) FAX: (508)428-0123 ©ACORD CORPORATIbN 1988 I TOTAL INVESTMENT: LANDMARK AR 30 - $6,710 *4 Star Warranty Upgrade will be applied if proposal is signed and returned within 10 days. (see enclosed brochure). 2.5% discount of paid by cash or check Payable immediately upon completion NO MONEY DOWN - NO Payment at the start or part way thru Payments accepted are: CASH- CHECK- MASTERCARD -VISA-AMERICAN EXPRESS *Any payments not made within 30 days of completion will be charged 1 '/2%for every 30 days the payment is late. Possible Extra -After the shingles are removed from the roof, we will lift one sheet of plywood to make sure that the insulation is not up against the plywood sheathing preventing ventilation from the eaves to the ridge. If it is, ventilation panels will be installed by; removing the plywood sheathing, installing the panels, turning the plywood over and then re-installing the plywood. If needed, this would be charged for as an extra at the rate of$4.00 per panel including Materials 8s Labor. There are 6 Panels per sheet of plywood. Possible Extra -Any rotted or otherwise deteriorated trim boards, plywood sheathing, lead flashing, or other carpentry needing replacement will be done and charged for as an extra at the rate of$45.00 per hour, plus materials, plus 20% overhead mark-up on total extras. FRASER CONSTRUCTION Warranties the labor for 10 years FRASER CONSTRUCTION Warranties the shingles against Blow-Offs for 10 years. CERTAINTEED Warranties the shingles and labor 100% for the first 5 years, and then on a pro rated basis for 30 years total if the shingles become defective. . CERTAINTEED Warranties the shingles to be ALGAE resistant for a full 10 years. Any deviation or alteration from above specification will be executed upon written orders and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays are beyond our control. Owner should carry fire, tornado and other necessary insurance upon the above work. We, if not accepted within thirty days may withdraw this proposal. FRASER CONSTRUCTION: Carries Workman's Compensation and Public Liability Insurance on the above work. DATE OF ACCEPTANCE: SUBMITT Y: Home n Fraser Construction TOWN OF BARNSTABLE Permit No. -_-2043.7 Building Inspector t Cash $400 00 OCCUPANCY PERMIT Bona No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building.shall be occupied until a certificate of occupancy has been issued.by the Building Inspector." Issued to Frank Hanifl Address 36 Center St. , Yarmouth lot #12 127 Gleneagle Drive, Centerville Wiring Inspector j; '� Inspection dates i r r f Plumbing Iuspec�114 r'^"—' � Inspection date Gas Inspector f Inspection date VEngineering Department�.J�9.,.,. ( `r%?_(/. L�--�T'—'`action date ] THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. .................. 1... ._........_..._, � ...... V'Building�Inspector ...... ......__ ^.ti � Assessor's map and lot number ........ 6IK �G�� - 22- 7f-- ..... ......... �;-r, Bpi 7N E .. ��� SYSTEM MUST BEE Sewage Permit number �.-.-.':... ...... ..................... SEPTIC INSTALLED IN COMPLIANC Basrh9eTae nLE House number ... ­�... ........................................ WITH ARTICLE II STATE, 1�ARBODE AND T, N t639- i . 0,* TOWN OF BA�RI fjS� BLE BUILDING INSPECTOR , APPLICATION FOR PERMIT TO ....r...... ........................................ TYPE OF CONSTRUCTION ...............w S�.A, � /.............................................................................................. ........ .l.>vv. 5.........!;L.7.19. TO THE INSPECTOR OF BUILDINGS:' The undersigned hereby applies for a permit according to the following information: Location .. � f ! V }e..........:........:... . 1-.....�.. ............. .k� ... . . ..1.@............ ............ ProposedUse ............ .L.\ .c.`E�.............................................................................................................................. Zoning District ...............as.................. .........Fire District ..���%��v��( � —...4�5�.:.............. Name of Owner .....1.. ka Ak.........�............ ..........Address ......... b .� �� �1 Nameof Builder ..............:.....................................................Address .......... .:�r.. ..0. ..1... ..................................... Name of Architect �1�.{!t. ®.f .......D.P. .9. ®.........Address ...5e..vWde U k'./§......J...4 Number of Rooms ............... ..... .IVY ..............................Foundation ......Z.6...........I...yam- qQ.x.......(;70.aCr.��:...c.. /-/,, D_ n / f / Exterior C:C 10—y�.....S( . ..h .1�es....t Cbp..f�®�L400fing ............. F�:"`�jl ..... Floors . ....... .. .... .. ..rJ ..... .......4nl..!'!4..l�...........Interior ................... Y i¢��........................................... �^ n 1 aV ,/ Heating 0..V.. ..... .........W... (C:'............Plumbing ................... �Tt/��........................................... Fireplace ...............:..)Q.61� ...................................................Approximate Cost .....:!...y e: Definitive Plan Approved by Planning Board -------------------_-----------19_______. Area �, .. .../.�jT(............. Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH Frank..Hamifl I� Joe Vf36 Center St. /1 A- � Yarmouth, Mass. t l . � y a .F 11 hereby agree to conform to-ally the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ..&U.... ... ............................ Hanifil Frank loo ... Permit for 2...atory..dwelling. ............................................................................... Location .......lot. ...1.2...Glen.e.agle...Dr. . .. ........ . ........ .... ..................Centj=vi1,1.e..................................... Owner_.........Fraak.-Haxiifl. .................. .......... Type of Construction ........Wood..Frame............. ...................................................................... Plot r..19.1. ..143. ..... . .... Lot ................................ -'Permit Granted ...Ju!Y...�.j....................:.19 78 Date of Inspection .................19 Date Completed ........ 19 ti 0, a PERMIT REFUSED 7- .................... ...... 19 .J......................................................................... Y f7O t ....... ...... /�- -I./ I...... ..................... ..... .......................... . ................................. Approved ................................................ 19 ............................................................................... ............................................................................... i it L•O T 13 3 v ' r Ljj O t LOT 141, iC� 169 d�- L� y �1L L SZ-6 1/1 -- x 7 .480 . L 77' Pl-.Q . L o CAT CAN 7dEO k►6�B C.E• MATS. 13E/NG- LOT : /a. . A5 SHOLL IV DN P4-AN QDaK Z 6 o PAGE 7/ LowF..ap • .� �'�� � '�� "; • � -/NG F'OUn�L�,t7 7-iCY� L.00��"ipv /S GbP�E `Y/TH WA OF LQ_LE-H-A N) !' L 1 445 � n Ri o - .�,.�.�,�...,�,,,� Assessor's map and lot number ............................................ QyOf THE Sewage Permit number ........................................................ e`` �+► Z EAUSTADLE, i House number / MAO& ................................................. 90O i639. `e00 am A TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .�,.X IIk'w...........................(............ ......................................................................... TYPEOF CONSTRUCTION ...............................:..:.................................................................................................. .......... .- ...........................'.19..:.::. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a�permit according to the following information: Location ......... ..!�...........f. ..............S...T P L7 / ............ 1)t�..1.V. ....................... .......................... Proposed Use .. 4'Q ..F �,.. C;.� ... .... .. .................... .. .... ............................................................. p Zoning District ............... ...e.................. .J A r A �' ........ ,11-r S rc I (..f..�.r j:?..!................... .. .Fire District '" Name of Owner .....FA fit, l�i� ........r J ...........Address ......�`?G........... �� /' fi'�?. �......... .................... A. .. ...... ... ..... I r t f �... r l Name of Builder ...........................................:........................Address (4 ? Ir k U U f/J Name of Architect 71�P 1+1 ri/ t n4U P........ J F;✓ `t'�F' Alle ... 19s I C-Or y 1 F r Address . r Number of Rooms ...............`........!' ��,..............................Foundation ....../.(5 1 tt C r� cv Y A f .... . ..........................................f.... Exterior ( nr r7 v" L� 1 VI�i /P C� '�i� ( /J!!J')��'C/.lRoofing ..............11(; "f.?_-a,/ �.........�?..�a ............. .... ..... l ... Floors4 /..................................... .Interior ...........................:.............:.......................................... Heatingi.......................................................Plumbing .........`....`............. .r,....:`............................................ Fireplace !A.! ......................................................Approximate Cost ... ........... Definitive Plan Approved by Planning Board ________________________________19--------. Area ......................:................... Diagram of Lot and Building with Dimensions Fee { a .... ....................... SUBJECT TO APPROVAL OF BOARD OF HEALTH 4 � ?. FrankMat'alfl 36 Center St. tar oath, Zs. CAI I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .................................................................................. HauifI, Frank No 20437-- Permit for.,2.. . � ----~''—~—'^—~—' -------'---' ` / Location —.l*t''#-1-2'' ''S�^.----'' ' _ ................. ...................................... {}vvnar ........Fnamk..-Hami-f 1----------' ' Type of Construction ....Wo,od..Irxame................ ` ` / ` -------------' � r Plot 301 \ . ` . Perm . � ^ ~~'~ Completed ........A..........................19 PERMIT REFUSED . . , ' / .. — 19 --------'—'' ------ - , _—.—.—.~..~-.—. ------ � F� -...' —����� ------' —]y����� v" v^ L � ............................,............,,..... ,.......,....., � . . Approve � � ................................................ lV , ^ ' ` -------'-----''`--^^^^—'~^--^~~' --------------.—.---.....--.... �