Loading...
HomeMy WebLinkAbout0160 HILLSIDE DRIVE I o e o a . b 4 e r a o 9 Town of Barnstable Building Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept SAWWA tKASS, 'Posted Until Final Inspection Has Been Made. el e •_ ca _. w..-..cup incy, q_,._�� .m..._.�,,B .ding shall, be Occupied until a'Final Inspection has been made. 1 a mit Where a Certificate of Occu anc is Re wired,such Buildm shall Not Permit NO. B-19-482 Applicant Name: BRADLEY,STEVEN F& BARCZAK,SUSANNE L Approvals Date Issued: 03/19/2019 Current Use: Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 09/19/2019 Foundation: Residential Map/Lot: 193-056 Zoning District: SPLIT Sheathing: Location: 160 HILLSIDE DRIVE,CENTERVILLE Contractor`Name: Framing: 1 Owner on Record: BRADLEY,STEVEN F& BARCZAK,SUSANNE L Contractor License: 2 Address: 23 TIRRELL HILL ROAD µ- p Est. Project Cost: $ 10,000.00 Chimney: 'BEDFORD, NH 03110 j Permit Fee: $ 101.00 Description: FINISH OFF BEDROOM &GAMEROOM OVER GARAGE Fee Paid:." $ 101.00 Insulation: F 7 3o J4 i' Date ,' 3/19/2019 Final: Project Review Req: NEW PERMIT FOR EXPIRED PERMIT B-2009-02506. SMOKE DECTOR UPGRADE REQUIRED. NO DOOR AT BASE OF-STAIRS J ' WITHOUT A THREE FOOT LANDING Plumbing/Gas Rough Plumbing: Building Official This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Final Plumbing: All work authorized by this permit shall conform to the approved application and the:approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be' in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. ' pp signatures by the Building and Fire Officials are provided on this permit. Electricals The Certificate of Occupancywill not be issued until all applicable si natu Minimum of Five Call Inspections Required for All Construction Work: Service: 1.Foundation or Footing 2.Sheathing Inspection Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed' 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 6 Final: ' 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Rough: 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Health "P?rsons contracting with unregistered contractors do not have access to the guaranty fund" (asset forth in MGL c.142A). Final: Fire Department Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: OFF� �V)\ QL Application Number....... .......... . ............. Mnee Permit Fee.......................................Other Fee........................ 16,1 TotalFee Paid.............. ................................................ ...... TOWN OF BARNSTABLE Permit Approval by. ?*'17- ..................On...31/916..... BUILDINGTERNUT /q................ Map............ Pa=l........0.4;7........................... APPLICATION Section 1 - Owner's Information and Project Location Project Addr6s-sr„/6 6 lhllwe 4kl ve- cVillWe Owners NEaCe-) Owners-Le—gal=Addie—sG—A&0 Owners-CeT-#, 'fb CCqAq Section 2-Use of Structure Use Group_ ❑ Commercial Structure over 35,000 cubic feet Commercial Structure under 35,00*0 cubic feet Single/-Two Family Dwelling> Section.3 - Type of Permit ❑ New Construction E] Move/Relocate' EJ Accessory Structure E] Change of use ❑ Demo/(entire structure) El Finish Basement ❑ Family/Amnesty K—&e-At Rebuild El Deck Apartment Sprinkler System ❑ Addition ❑ Retaining wall ❑ Solar 19,Renovation� F-1 Pool .0 Insulation % Other—Specify. Section-4 -Work Description, off 4U6 200, 61he46--4- Last updated. 11/15/2018 I /• 1 T , Application Number.......... Section 5—Detail Cost of Proposed Construction /0, d ya Square Footage of Project-, ` 7( Age of.Structure ( q4t Dig Safe Number # Of Bedrooms Existing Total#Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics 0 Wiring ❑ Oil Tank Storage ® Smoke Detectors 0 Plumbing ❑ Gas ❑ Fire Suppression © Heating System ❑ Masonry Chimney ®Add/relocate bedroom Water Supply Public El Private PP Y - Sewage Disposal ❑ Municipal N On Site Historic District ❑ Hyannis Historic District ' ❑ Old Kings Highway Debris Disposal Facility: I amusing a crane ❑ Yes ® No Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland,coastal bank? Yes ❑ No Section 8—Zoning Information Zoning District R c�R D Proposed Use Lot Area Sq. Ft. Total Frontage Percentage of Lot Coverage # of Dwelling Units(on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed ,Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No Last updated. 11/15/2018 gQk The Commonwealth of Massachusetts ,Department of IndustrialAccidents Office of Investigations 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information - Please Print Legibly Name(Business/Organizadm/Individual): bf(,Vt- \ Address: ' 6D �Iklidt_ �✓Ive C- City/State/Zip:-, �YA 00� Phone#: U/ -3 _ d ICI- 0 a'-7 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with- 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. [1 New construction 2.❑ I am a sole proprietor or partner- wed on the attached sheet. 7. ❑Remodeling ship and have no employees . These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp.insimmCe comp•insurance.: required.] ed. 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions officers have exercised their �] I am a homeowner doing all work � 11.El 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 worker;'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 thepolicy and job site information. Insurance Company Name. Policy#or Self-ins.Lie.#: 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$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 Z I y (Phone#:-1 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: . Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to,this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority" Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone 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 lice to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Aoddents Office of Invest igataons 600 Washington Street Bostfan,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 4-24-07 www.mass.gvvfdia , Assigned Contractors;. ,(3y Assign Name License Type License# License Exp. Insurance Exp. Addres a KOSS,DAVID JHPL 19754 5M12012 Q 1Mb2016 0 36M. " H .p. Address._" City State Zip Phone# o one# x# .,36 WASHINGTON AVE WEST MA 02673 (508)778" x' (508)778-4981 ( . Hint:Double click on any license record above to edd contractor information r" Applicant Doing Vlork a PemovE from Li S•' a, ,� (License Status Inactroe or Revoked) (Selected License) ------------ Application Number........................................... Section 9- Construction Supervisor Name Telephone Number Address City State Zip License Number License Type Expiration Date Contractors Email Cell # I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and i documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your license. Signature Date Section 10-Home Improvement Contractor Name Telephone Number Address City State Zip Registration Number Expiration Da te I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your H.I.C... Signature Date Section,ll H ome-Owners-License P Ezem tion_ y Home Owners Name: I�r/�� Q R4b Lam. ZA - Telephone Number 603 00`t- G 9 9L7 Cell or Work Number G 0 3 SO q '/9a 7 I understand my responsibilities under the rulesmd regulations for Licensed Construction Supervisor in accordance with 780 j CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. !j� LSignature-�-_� Da e APPL=ICANT-SIGNATURE Signature -Date- i� Print-Name Telephone Number &03 90 l 997 r� m�1_permit_to .ETC VGA/�R � ���A �U� ' -Y (2 Y14 1-(�C� Last updated: 11/15/2018 Section 12 —Department Sign-Offs Health Department ❑ Zoning Board(if required) ❑ Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation ❑ For commercial work,please take your plans directly to the fire department for approval Section 13—Owner's Authorization I, , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of job) Signature of Owner date i Print Name Ir Last updated: 11/15/2018 Commonwealth of Massachusetts Sheet Metal Permit Map lq j Parcel _ ermit# ES 01M:. Estimated Job Cost: $ �76F7 r ' 9 2Q1:9Permit Fee: $ v Plans Submitted: YES NO J�I�I\� ",�� �����lsewed: YES NO Business License Applicant License# Business Infomnation: Property Owner,/Job Location Information: Name:9r"I p Cc, /Ud d- Name: S'��i/ 1'J l / P Street: 3 ( N Street:M 0 L41L�zs P City/Town.: �ULit�/ � ��d City/Tovvm: Telephone: — �, `9 � Telephone: 60 Photo I.D.required./Copy of Photo I.D. attached: YES NO Staff Initial J-1 'M-1-untestricted1icense J-2/,M-2-restricted to dwellings 3-stories^or less and commercial up to 10,000 sq. t. /2-stories or less Residential: 1-2 family Multi-family. Condo/Townhouses Other Commercial: -Office' Retail Industrial Educational Fire Dept.Approval Institutional Other Square Footage: under 1.0,000 sq ft. over 10,000 sq.ft. Number of Stories: Sheet metal work to be"completed: New Work: - Renovation: HVAC `TM Metal Watershed Roofing Kitchen Exhaust System - T. Metal Chimney/Vents. ' Air Balancing Provide detailed description of work to be'done: C5's'" P Town of Barnstable Buildin9 �i £ s< 4 ly'. ,+. .:,5": o-<`v' ��: �' J�,� e's3j' .,e,'. S.fdPy... Y 3, ''"&' '�, •,<` �:% -,'�i�.p+ .�^ st This.Card So:That it Is-Uislble'From the Street-A roued,Plans;Must�be�Retamed on Job,and this Gard Mush be:Kept :� - M1tNtT'[`A81. • P .,,, s cam. .:, ,,,f.' `£, ;;.' S(! ,.: '� t .pp ' x; Ne, ;, ' •, , Permit eh Bu11ldmg shall NoOcp e4d<untla F�na�l Ihas beermad"e . Permit NO. B-19-1444 Applicant Name: ADERLIN J MOTA Approvals Date Issued: 04/29/2019 Current Use: Structure Permit Type: Building-Sheet Metal-Residential Expiration Date: 10/29/2019 Foundation: Location: 160 HILLSIDE DRIVE,CENTERVILLE Map/Lot. 193-056 Zoning District. SPLIT Sheathing: Owner on Record: BRADLEY,STEVEN IF&BARCZAK,SUSANNE L ,ontractor�Name ADERLIN J MOTA Framing: 1 Address: 23 TIRRELL HILL ROAD 4 ContractorLicense 7050 2 BEDFORD, NH 03110 Est" Protect Cost: $0.00 Chimney: 3 Description: Finish and Install (2)ton central A/C system Permit Fee: $85.00 Insulation: Fee Paid $85.00 Project Review Req: Required documents per 2015 IECC should be,on site for 4A Final: inspections Date 4/29/2019 r- "F Plumbing/Gas Rough Plumbing: ne Official � .: _ This permit shall be deemed abandoned and invalid unless the work A*ihorized by this permit is commenced within sa months after issuance. Final Plumbing: All work authorized by this permit shall conform to the approved application and�the�approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures s"lNe in compliance with the local zoningby laws and codes. This permit shall be displayed in a location clearly visible from access street.V road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. ' Electrical The Certificate of Occupancy will not be issued until all applicable signatures by.the Building and Fire'Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work( -4 Service: 1.Foundation or Footing 2.Sheathing Inspection > Rough: 3.All Fireplaces must be inspected at the throat level before firest fluelining is insta lI 4.Wiring&Plumbing inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Rough: 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: - TISURANCE COVERAGE: a current 'a i ' insurance policy or its egwvalentwhich meets the requirements of M.G.L. Ch.112 Yes dNo ❑ haveli b lity If you have checked ygj, indicate th type of coverage by checking'the appropriate box below: A liability insurance policy Other type of indemnity ❑ Bond El OWNER'S INSURANCE ER: I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the Massachusetts Gene and that my signature on this permit application Waives this requirement. Check One Only s Owner, ,Agent ❑ Signature of Owner or Owner's Agent ' 9 ` By checking this box[],I hereby certify that all of the details and information 1 have submitted(or entered)regarding this application are true and accurate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be in compliance with all pertinent provision of the Massachusetts Building Code and'Chapter 112 of the General Laws. Duct inspection required prior.to insulation.installation:YES. V NO Progress Inspections Date Comments - Final Inspection Date Comments Type of License:, By ❑Master Title ❑.Master-Restricted' r cityrrown ❑Joumeyperson Signature of Licensee Permit ❑Joumeyperson-Restricted Q� License Number: Fee$ ❑ Check at 4.,,.,,.� mass.gov_/doll Em ail: Inspector signature of Permit Approval r '0 600 wasae ort met — :Bosto74 MA 62M GV leers' CmapensatimIm7m-=cL-AfEidavi-t RwIAerslCmfi°act yr- -eL ins hers #7nfan P�as6 Ftr-md EY JAW Phn i3re Q e>alsloyer?Checkthe apprapriafe b Tppe Of graject trccl-�'d 0 � I mn a genera ntMctnr=d I L I am a empl r v �. .6. 0 New ari��tiaa : ' employees{fa11.a�3far partrfi�.e�* lave 1•rue�fhe sub=camteart�s - _ Tilted flniixe duklied sheet 7. � fide in,c ❑'I am a sole prpp�ietararpadner- ' �ieso ►cantract=have y � Sty]and have no�i{F5T?efi 1. 8-•El De¢10�CfltI. -wmldnIIb Rx.tee os anY G g' exs�gletyees a�TI3L*e�SFU�' 9 �EIIST��d$if1flII _ COMP sn rrcr rrtt r ff jy-p Eig• Cpglp' SLSF3IIC� .. 1�.'.��eC�It'.31 3 of a QII3 5_ D �WeareacmPosaf�aaadYfs " re� �1" crfacsrs hav C=-dsed fhek 1LEI Fhimbmgrep$is ar gd&fia's 3.[❑ I am a Itrma� er doing alI tgor3e esQ. Myl-if[NO WO MIM,gip- °f g L I�oa re}zavrs ifyc�zsarnre= irpal egipa2-L INC) , ❑�taer cml ;T, i�cTuireaj •AnYR ucmtcatrberksb=91mada]samOutjj,--sechoaibgusrs 6!kwOdMe parHcgiMfuMsfi=- #names sIIb jai �—� �ab�6c �ta �a�-fits .�m-r�ecScihs b=x�st XtbEhEdc sddibcrosl sh�=i stiac�gthen�-m�of the su3r c sod shdz�dL��mt Ehnse ea bs�e -=ffc3—Tft}�sa5 zant6 a45 �°ti ide i� sc '>�o.paTi� ssbeL . T uirt an einpio�€r fTjatisprai-N-ir g iv�rkers'zotm�Lsrrti�rn i�rnars fflr m}.smpIa}Tees"$eFo�v is fTiapm�xcy artd ja€a sita r I21�'Qf3I1F��itlIt1T73EIg�3QI0: 1'v/U1 � ' / ' V 'F"� - P fic}� arSeTf-m O P�� r a. Job Sit ch a•Capp of'the tsar rs'camp efioizpaTi decT ratim,ytge(-shmvl the pdEcy= ber=d cmpsrtian•bate). FaR=e fn sec=Covecage as regdu i3 un&r Smfibn 25A elf'MM r-I can Tend to 11M impositian of mmina4 pe�ties of a - fine up to$L540 fla a=Var me-year,mpcsp as�l as ci .p s m�e fartxt s STOP QP�TCIR�{lgI?Et and of too- �.cTa�abaivsE fire viol:d r_ 33e advised the a cnpY this sixteaa s�agbe f ded•fa Office of tea Fi y Ctc � ct psrs s a.fFaz r'tTCaft�iB r atzs urn rr m i/!3 a IS less an rGyre . Phaue Frse ri£ Dv swt mite i"€Tam aria,tDI be cumF& .fir hg t+riatFn , city or Town Per Litertsa i$oard f$e=lf i mg]Ejc e�3 Fo Clete" eafritallusge it 3.P biagIds 6 T�formatiwa and lustr.uetio s 7vf��c is GeterBIl.aWs ebapf�:M requ6im alb cmpIopess'fD pn�Wm3m&=mF=mfion fmfb a eazplupe. Pm�aaxrtto sfatt�, ��y�is dcfined evr�typesonmfbe smvice of=ffi=UZJ=a¢y caatactoflme, express or ipliecl ozal or wriifea - N Aa e�Iay�zs d�med as"an par�ccsSbzp,assouiaticm,cazpor�frun or other legal eoizt9,or any two or mare •� ofthe foregoing is a Joinf andilY--b Dgtbe IegaIrepres=tH&es of a&=z=d Cmploy¢,or the receiv=or t=t-ee of au per,assoc dim or othcrIegal eatify,=gLuirg employees. However f r- . oftbe owner'of a dweIImghouse havmgnotmore tbm finee apmimeofs aad�ho resides Therein,or fb�oc - dWrDh g ho-ase of ano&er who cuTIoys p=om to do,m a tman c c,=shuct io or repair work an such dweldng home' or oa the gm=nds or bMldmg qTM*oant-ffiM-Cb shan=tbecause of such=ploymentbe dcemedto bean employees" MI M chapter 1,2,§25g6)also suers that¢emy, F f or Ioc�l ficrTzsiug agency shall withhold ffie issaaace or rmew'a.I of a Hct-m e.or permit to operas a Tmsiness or to constmct biffidmgs is-the con=nwealth for=T applicantwho has notprodnced accepta.)jIe evidex[r�of cDzaplzance'�1 the IIrs-�azice_wYe�agereY�_" AdEfinma ,MfiI.ebapt!:E-152,§2SC(7)sbLL-S-Ietdzrrthc nur;�qy ofifspoTTical sabdivisions sfiaIl ear m o airy=2tzzt forthcpeCET�ofpoblio Vmk-or[I acceptable ma-eam of c=pE=e, -ith The mom==. re,C.Lt===MtS of this rbapEea•have'be,=pres=±t-dto fine c=bind zzthorty.�' �.ppTxcan-ts - Phase fDI o-c± the Wort s'cm3pmsation affidavit cnmpIet L by cherfg the bo.Ms mad apply to yozzr sit o mcd if necess EY,Supply sub-co�S)name(s),addresses)=dplimenIImbe s)along- ithtll=cextEr-a�s)of L�d Liabz7ify Companies(LLC)Cr ldzzziiz Liabzlzty Paztneahzps(LLP)wrfhno emPZQpe=s other than the members or pmtuei,ze not requ e: fo cmzy wa±=&caznp�msonce. If m LLC or M does hzm cmployees,apolicyisregaitc& Be ailyisrAfadtfiis afEffa-yilmzybe sabmiffmdIntbr.DepadmeotofIndusfaal Accide�mr co=Emafm off coverage A-Lso be sure to sigzz aad des the �;F_The afhdayitshould be fmmedtoffiecty- agp'dcafimf--dmepeusorlic=--isbemgregm.-S d;not-Le Dgarbnm.of T�staal As¢irf�,-� �aldyou bavL airy q�tzons=eg�zTmg the IaFv ar ifyon.are regoirrd tQ obtain a�' ' cpmapenca±impoficp,plmse call thcDep attaa==I=listed bcow. Self-ins -edconipmi sshouIdem'�rtheir self•*rrcm-�„ceTiccnse�Txtor.theappr�ai�Ime ' City or Town Ofadals 1'Iease be sin e thaf the off avif is ca�plcf�andpz -dlegi�Iy_ the Deparlmcntbas pro7i.dcd a space at ffzebotbaa ofthe affidavit for youto fM outintlie event the Office ofI-avestigatioIIs has to yoareg�zngthe applirM Pleasebcsurnto fill lmthepe croscn-frn erwhidzwMbcusedasareferenco�bcz Inddh aion,sr.applicaut tip roust submit m-�ple p erm ha ose appHtE ions iaany aveu year nce3 onlysabmit me a$davh maazat =eat polic�mf„T,,ai;an(¢'nay)and under`fob�Q��"The applic�shouId�"sII Iocati���s zz (cmy er town)--A copy of the-off lavitthat has b=a officia�s mTed or marked bythe city ar f3vm maybe pmvidCat3 he appfic at iris proof that a valid affidavit is on file#nr finuxE'pctm$s orHC=cs-.Anrwaffidm&l t be mcd ozzt Each year Where ahome owner or c_ais obbia7mg ELH=_sc or pe=itnotielafcdta any b„si==or commercial TEPf= (ie.a dog Hcease orpezit to b=leaves etc.)saidpeR'Cf171 h NOTI=4#cd to complete this of cTayit The Office ofTnvcsfipfum wu UUmtckfmokyoumadvaacc foryonr wopezeionand should yonhave anyquesdon% plea e dfl troth tEl givens a Ca The Depaztoze�s address,Telephone and fazxmmbez • • _ - . . . Of lvallllmQh: Depadmmt cif l A=id .fS ' Zt D m." Q2111 Rvisec34-z4-D7S IgR c ` OIVtMONWEALTH OF MASSaCHUSET�S ?I I i BOARD ISSUESTHE FOLLOV1LtNG LFCEIYSE d fklm h� JOURNEYPERSON UNRESTRICTED ii g r h Q. 66 CROSSM/#N ST #'"sltgVl, it,". j ( CENTRAL FALLS RI 02863 f f i �705-0 } 04/28l2020. ` ;4 512144 A ,,w•r,t% Y. l wwyrF Commonwealth of Massachusetts Division of Professional Licensure i Refr n1' ,. N�eC�'bn E'o,�t�ractor - ff. RC-147993 t Etpires: 04/29/2021 ADERLIN JOSS MOTH '. 66 CROSSM/i0tll STR- ^ CENTRAL FALLS Rh 02863 r� ti Commissioner V^ i ` Commonwealth of Massachusetts lug Department of Fire Services BU-148652 Oil Burner Technician Certificate ADERLIN JOSS I Oy f" . 66 CROSSMAN STREET CENTRAL FALLS RI 02863 Expiration Date State Fire Marshal /Y 1 r ACC) CERTIFICATE OF LIABILITY DATE(MMMD"YYY) �i INSURANCE 07/06118 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS . CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed, If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: - ONE Insurance Leader,Inc. AIC,No.E.* 401-781-1810 1 Alc No): 401-781-1816 1237 Elmwood Avenue ADDRESS: Providence,RI 02907 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Main Street America INSURED INSURERS: GUARD INS Prince Noah Heating&Air Conditioning Inc INSURER C: ouard ins 173 Bolton Street INSURER D: Bedford,MA 02740 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. EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/D� MMfDY EFFC LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1.000,000 CLAIMS MADE OCCUR DAMAGE TO RENTEU-- PREMISES Ea occurrence S 100.000 MED EXP(Any oneperson) S 5.000 A MPP5345D 09/09/17 09/09/18 PERSONAL&ADV INJURY S 1.000.000 GEN'L AGGREGATE LIMIT APPLIES',PER: GENERAL AGGREGATE 5 2.000.000 POLICY❑JET LOC PRODUCTS-COMP/OP AGG S 2.000.000 OTHER: S AUTOMOBILE LIABILITY COMBINED SINGLE L IT S a accident ANY AUTO BODILY INJURY(Per person) S OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident S S UMBRELLA LIAB HOCCUR EACH OCCURRENCE S EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTIONS $ WORKERS COMPENSATION _ _ AND EMPLOYERS'LIABILITY Y/N X STATUTE ER ANY PROPRIETORJPARTNERIEXECUTIVE EL.EACH ACCIDENT $ 500,000 B OFFICER/MEMBER EXCLUDED? NIA PRWC936055 07/23/18 07/23/19 (Mandatory In NH) E.L.DISEASE•EA EMPLOYEE S 500.000 If yyes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500.000 DESCRIPTION OF OPERATIONS 1 LOCATIONS/VEHICLES (ACORO 101,Addltlonal.Remarks Schedule,maybe attached 9 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. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION, All rights reserved. ACORD 25(2016/03) The.ACORD name and logo are registered marks of ACORD Prince Noah HVAC Proposal & Marketing - WWW.PRINCENOANNEATINO.COM Plan . .. . ...... ............ ...... ..... WE WILL BE RESPONSIBLE TO INSTALL THE ALL PArCESINCLUDE FOLOGVINGEQUIPMENT. KA TERIALSAND LABOR JOB NAME: 01/04/19 160 HILLSIDE DRIVE, CENTERVILLE M.A STEW CAPE COD 1) FINISH AND INSTALL,LENNOX CENTRAL HEAT AND A/C SYSTEM. 2) INSTALL 2.5 TON 96%45,000 BTU LENNOX,MODEL#EL196UH045 V36B VARIABLE SPEED FURNACE. 3) INSTALL 2.5 TON VARTICAL AC COIL,MODEL#CX35-30. 4) INSTALL 2 TON 16 SEERS LENNOX OUTDOOR CONDENSER UNIT,MODEL# 14CXS024. 5) FINISH AND INSTALL COMFORTSENSE 550 WIFI PROGRMMABLE THERMOSTAT. 6) INSTALL 1400 CFM MERV 11 MEDIA AIR CLEANER. 7) INSTALL PH-TREAT NEUTRALIZER FILTER. 8) INSTALL PAD FOR OUTDOOR UNIT. 9) FINISH AND INSTALL(7) BRANCHS SUPPLY, (5) ON FIRST FLOOR AND (2) ON BASMENT. 10)INSTALL TWOS BRANCHS RETURN IN FIRST FLOOR. 11)FINISH AND INSTALL ALL THE,BOOTS, FLEX AND GRILLS. 12)RUN LINESET BETWEENG AC COIL AND OUTDOOR UNIT. GAS AND ELECTRICAL CONNECTION ARE NOT INCLUED. # AHRI201868856 JOB CAN BE WELL DONE FOR SUBTOTAL: $10,500.00 TOTAL: $10,500.00 Acceptance of Pfoposal: The Above Prices and Specifications Are Satis actory and Are Hereby Accepted. jc Signature / Date Our Jobs Have 1 Year WarrantyServlce +10 Year Compressoi Warranty From Manufacture (AfterReptistration) Phone:508-991-9229 E-mail:Princenhhvac@gmail.com We Glad To HearFrom You GivesA CallAndAskForow,Referral ProgramAnd SaveMo eyNow! OUR PROPOSAL INCLUDES ALL LABOR,TOOLS,AND EQIPMENT 14ECESSARY TO COMPLETE THE FOLLOWING SCOPE OF WORK... Y fk TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # (� Health Division Date Issued Conservation Division Application Fee (� Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address Village tli )Lex y/�/�. Owner &lk4 Address V Telephone 6- -,Y(04r Y&el7 Permit Request �va � � D �CAon n '.22 N ' [ Y Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new .Zoning District Flood Plain Groundwater Overlay. Project Valuation�Zdo 3��3 onstruction Type Lot Size Grandfathered: ❑Yes\ ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family `ate Two Family ❑ Multi-Family (# units) Age of Existing Structure l l&` Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑- all ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) •//yV Basement Unfinished Area (sc� Number of Baths: Full: existing� new Half: existing .-. nevi Number of Bedrooms: existing —new Total Room Count (not inclu 'ng baths): existing new First Floor Roo Count Heat Type and Fuel: Gas ❑ Oil ❑ Electric ❑Other rn 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 (&W (e4qU--­� Telephone Number Address� /O/t 6t1tio"'I'VII of /64icense# 6J 0&�Zm, Home Improvement Contractor# Email k /►')i I'16b`Awtit co, Worker's Compensation M202 60P Go, ALL CONSTRUCTIO RI ESULTI G FROM THIS PROJECT WILL BE TAKEN T0534W �T SIGNATURE \� DATE %//�- FOR OFFICIAL USE ONLY APPLICATION# IL DATE-ISSUED MAP-/PARCEL NO. r r ADDRESS VILLAGE i' OWNER } DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING: DATE-,CLOSED OUT AS,SOCIATION,PLAN NO. ;o Housing ,t Assistance kiwi Corporation _ Cape CW! HOME OWNER WEATHERIZATION WORK PERMIT&FUEL RELEASE: PLEASE FILL OUT AND SIGN THIS FORM .IF YOU ARE . �f THE APPLICANT HOME OWNER. hereby consent to and agree that w atherization :work may be done by the Weatherization Program of Housing Assistance Corporation ( herein after referred as Agency" ) on ,the property located at: ldk The weatherization work done will be based on programmatic priorities and availability of funding and it may include all or some of the following measures- Weather-stripping & caulking of windows and doors, insulation of attics, sidewalls & basements, attic and other ventilation measures and possibly replacement of badly deteriorated windows. in consideration of the weatherization work to be done at my home I agree to the following: I. I give permission to the "'Agency" its agents and employees to travel onto or across said property with such equipment and materials as- may be necessary to perform weatherization work on said property. 2. The Housing Assistance Corporation reserves the right to inspect the fuel or utility bill for the weatherized unit on an ongoing basis for "no more than five (5) years after the weatherization work is completed. I have read the provisions of this agreement as listed .and freely give R my consent. V ome Owner: (Signature) �✓ Date: Agent: (signature) Date: The Col ealth:ofMassacf usetts; Department-of Industrial:Accidents 00ce of Investigations 6U0 Washington Street Boston,MA. 021.11` wwio mass gov/dlo. Workers'Compensation Insurance Affidavit: Builders/Contractors/Etectricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual) Tupper Construction Co LLC Address: 546A Higgins Crowell Rd , City/State/Zip: West Yarmouth, htA 02673: Phone:#: 50.8-778-0:11'1 . Are you an employer?Check the:appropriate box: Type of project(required): 1.0 I am a em to er with. 4.. ❑ 1 am a general contractor and.1 P Y 6. [ New construction employees(full and/or part-time): have.hired the sub-contractors 2.❑ 1.am a sole proprietor;or partner listed the;attached sheet..t 0 Remodeling ship and have no employees Thesesub-contractors have 8.. Demolition working for me in any capacity. workers.' comp.insurance. g. _D Building addition [No workers':comp.'insurance 5. 0 We.are a corporation:and its required.] officers have exercised their,. 10.E Electrical repairs or'additops 1711 am a'homeowner doing all;work. nghtof exemption per MGL, 11.[)Plumbing repairs or:°additions c. 152, 1 4 ;;:and we have no. myself;[No workers'`comp; § O 12:[]Roof:repairs. insurance requiredjt, employees. [No.workers' 13.U,OtherWea#hEriZatIOf1 comp.insurance required..] 'Any applicant that cheeks;box#1 inust 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 mid icating-such. +Contractors that check-this box must attached an additional sheet showing the[lame of the subcontractors and their workers'comp.policy information, - I am an employer that isiproviding workers'compensation:insurance for myemployees. Below is.the poliiy'and job site information.: Insurance Company Name; Policy#or Self-ins.T is # WCC' S 0.0 5 5 9 3 012 012 Expiration.Date: 10015 � � ,/ Job site Ad / 0. H`kr ' e—: r , City/State/Zipt��71ejC V �k y o h ozy% 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$1500.00 and/or'one-year m.0 isoriment.as well as civil penalties im.the form of'a STOP WORK ORDER a fine. of up to$250.00 a day.againstthe::violator. .Be advised that a copy of this statement may be forwarded to the'Offi ce:of investigations of the DIA for irlsurance.coverage verification: I do hereby certify under.,th a and penalttes'.0 perjury that the information provided above is true and:;correci Si attire: t _ Date. Phone#: ,$cial rose only. b0no0write.in, this area,to-bevompleted.by city or town oJfic aZ City or Town: Permit/Lcense# Issuing Authority(circle one):. 1.Board of Health 2.Building Department 3.Cityaown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6..Other. Contact Person:: _ Phone#: ♦fi _. s� # r�.SSct�t L1a� a 'J3 ;Y`�•:' �s _�ti � .;t ' 1tTi H�r4r����.�'''f�.$ 's�" # _r".� _ :3so�..;JT�:.1�.L'F,_73[,_•c t�i.`�,,estr-yr�$a.T?�:'v.r,..".s�:�5 A71a 2.Ny im2o:� .3 s ' .4Ei iF tii Zri��ti 2;«t 1274 877i a GS-4169068 RICHAA D 8 PE F i9 B i4f TECH 13IZ sd:T - ,_,4,. �°:.�2'FiE't'F�`�,�;4e°E-t4�'•"fi� LE`�H$ 'st,3��Eer.{.i!Jr7(rni:w� .•-ed`: '�a41.rC';..' �2f3'i>2£3�4 a. f+ ?f'III I72 'f/ ffl'f=;_i^IYf.i(ff yfllh .a,;; � 1..cense or:r�rorrariun valid fvc insii�idul usr:nr1 £A47ir"emfCQaztsmtrifasrs`�Bns+utssltce4tiass �� G'Pt9E 44~?t#'RQ3lE4e4iE G�i•4�AGF�4Z- D2£asre E(ae sbx�ss ' dsete. Ilfn�ncl re€?s�ss+a: r eg.4ri rocs 173434 = €?fiice o1 sf' r t�2;s atislBusiriess Rua`=ion 1t3: n aza-. uu S17 • _ 1:xW LG . ." 4021 UPPERGONSTs,UCT4C>is!CO - 29C4�Ft�5d) s:JFf�E�c: \� 1t.YARdfC7E! 1i,MA O?6?3; r�itcecreia _ �q a'a.hf�a�e sag��ste�re„ is i 's G13r3i�;7flF 4d .' r F; y - y t p�€sgie$ yi�4���dgfe8saftd��affersar�si�' �;. - a: t?ERt.��1 dA { 4XH41ldC. �ict4�rd�4 upper �� i upper,^ons ru:�cn Suiii!>g Safety professions(:�;L , b— .. 1 t •fr a a a�: , l..v® , CERTIFICATE OF LIABILITY INSURANCE DATE(MMfDD014 L..� l0/29/2ola 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 endorsement(s). PRODUCER CONTACT Lora FitzGerald NAME Southeastern Insurance Agency PHONE (5OH)997-6061 FAX No:(508)940-2T31 439 State Rd. AEbmpAg'LESS:lfitz@southeastex-nins.com P.O. BOX 79398 INSURE S AFFORDING COVERAGE NAIC# North Dartmouth MA 02.747 INSURER AArbella Protection Insurance 41360 INSURED INSURERB:Boston Insurance Brokerage Inc Tupper Construction Co LLC INSURERC: 27 Roberta Drive INSURER D- INSURER E West Yarmouth MA 02673 INSURERF: COVERAGES CERTIFICATE NUMBER2015 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. IL SR TYPE OF INSURANCE POLICY NUMBER M POLICY EFF EXP MMIDDI LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 ncom MERCIAL GENERAL LIABILITY DAMAGE TRENTED PREMISES Ea occurrence S 100,000 A CLAIMS-MADE aOCCUR 500008743 1/1/2014 1/1/2015 MED EXP(Any one person) S 5,000 PERSONAL BADVINJURY S 1,000,000 GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG S 2,000,000 X I POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT a accident S 1,000,000 A ANY AUTO BODILY INJURY(Per person) S ALL OWNED X SCHEDULED 1020009389 2/1/2013 2/1/2014 BODILY INJURY(Per accident) S AUTOS AUTOS NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS Per accident S Uninsured motorist BI split limit S 250,000 X UMBRELLA LIAB HOCCUR EACH OCCURRENCE S A EXCESS LIAB CLAIMS-MADE AGGREGATE S DED I I RETENTIONS 600058368 1/1/2014 1/1/2015 S B WORKERS COMPENSATION X I WC STATU- X OTH AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? N I A (Mandatory In NH) C5005593012014A 0/3/2014 0/3/2015 E.L.DISEASE-EA EMPLOYE S 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1 000 000 DESCRIPTION OF OPERATIONS I LOCATIONS I 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 INFORMATION PURPOSES ONLY ACCORDANCE WITH THE POLICY PROVISIONS. TUPPER CONSTRUCTION CO LLC 546 A HIGGINS CROWELL ROAD AUTHORIZED REPRESENTATIVE WEST YARMOUTH, MA 02673 Lora PitzGerald/LHL ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 ontnmi rH Tha a(Inpi i n2ma one1 Innn 2ro naniatamri m2r4c of Ailnpn n 05 15 12:06p TupperCom : 15087785010 , p.1 C®U1STRUCT10N C®. �Lc 546A Higgins Crowell Rd,WEST YARMOUTH,MA 02673 PHONE 508-778-01 11 FAX: 508-77B-5010. WWW.TUPPERCO.COM : Date 1 j S Town of Barnstable Thomas Perry CB0 ' 200 MainStreet Hyannis; Ma'02601 Pd . (508) 790-6230.fax Re: Insulation Permits Dear Mr. Perry This affidavit is to:certify that al[work completed;for permit application f0 Issued on ( j / r has been inspected by a certified Building :Performance Institute (BPI) inspector. All work performed meets or exceeds Federal and'State requirements: Sincerely; Permit #: 'Add ress. , 0. Richard Tupper, I Cc0 License # CS=69058 .. , ►' .,_ ; TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 1 3 Parcels 6Y Application 0 Health Divisions- - 57 I!°"1�'��1 = �— Date Issued 03 Conservation Division "Application Fee ` Planning Dept: ?Permit Fee' r.(O Date Definitive Plan:Approved by Planning Board rj Historic - OKH Preservation/Hyannis Project Street Address 1430 H ILLS IO E Imi 9/9 ' Village CIE W1e✓ Owner Tfl'o6 S' .0Pg✓tam mal sT Address AS �BdyV Telephone Permit Request FI N1 O FF 4 Square feet: 1 st floor: existinalIIA proposed ----2nd floor: existing proposed Total new -� Zoning District Flood Plain Groundwater,Overlay Project Valuation / WO Construction Type tn.a o Q ' Lot Size 046 q G.4G S. Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(# units) Age of Existing Structure _ ��. Historic House: ❑Yes CLNo On Old King's Highway: ❑Yes PkNo Basement Type: ❑ Full ❑ Crawl LD!I(Walkout ❑ Other i Basement Finished Area (sq.ft.) 400 Basement Unfinished Area (sq.ft) 10410 Number of Baths: Full: existing` f new I Half: existing new Number of Bedrooms: existing l new= y Total Room Count (not including baths): existing 41 new First Floor Room Count Heat Type and Fuel: 9'Go"as ❑ Oil ❑ Electric ❑ Other Central Air: MYes ❑ No Fireplaces: Existing J New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage:Wxisting ❑ new size _Shed: ❑ existing ❑ new size _ Other: r- p Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ENO If p ,es site Ian review# %P Y Current Use 0-es, prb-^ i % Proposed Use l fiAe ,rru , APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ;ART`-#f✓YL PF3�47�U Co Telephone Number 10" '1'0 (20 Address 3 3 1qS ffLLy i9xi va- License # Icy Clmo -7 2SA4LLE . ^u .S S Home Improvement Contractor# l QS 8 S Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO -ra wy" 0 F Q s rAl LZ 43 4 L- SIGNATURE DATE :g 4 K, FOR OFFICIAL USE ONLY `}APPLICATION# DATE ISSUED �}?j[ MAP/PARCEL NO. .j ` .tea /`� l .• ,' .. . - 5 ' ADDRESS ! VILLAGE' - OWNER k DATE OF INSPECTION: FOUNDATION 3 FRAME INSULATION ' .R FIREPLACE E ELECTRICAL: ROUGH FINAL .- PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT - t ASSOCIATION PLAN NO. Cotuit Bay Design 5085399402 p. 1 Ilk P�516N �� CC0�!�' PAY 43 BREWSTER ROAD MASBPEE,MA 02649 PH: (508) 274-1166 FAX: (508) 539-9402 EMAIL: s ;v'e >COtuitbo-ydesi=n-com FAX COVER SHEET DATE: TO: F ZC�tj FAX #: -- FROM: C Q s � ol k Cotuit Bay Design 5085399402 p. 2 0 east cape engineenn& inc. 44 Route 28 P.O. Box 1525 CIVIL ENGINEERING -Orleans, MA 02653 LAND SURVEYING WATER RESOURCES - LAND COURT ENVIRONMENTAL 508-255-7120 PHONE - SITE PLANNING SANITARY CERTIFIED PLANS STRUCTURAL 508-255-3176 FAX - WATERFRONT -- July 27, 2009 Mr. Steve Cook Cotuit Bay Design, LLC 43 Brewster Rd_ Mashpee, MA 02649 RE: Niblet Renovation, 160 Hillside Drive, Centerville .Dear Mr. Cook, East Cape Engineering, Inc has completed review and analysis for the Niblet renovation project located at 160 Hillside Drive in.Centerville. We reviewed the-existing steel beam to determine if the beam remains adequate for the change in loading. The existing beam was determined to be a W 12 x 40 steel beam , based on the dimensional measurements you provided. Using the required floor loading requirements of the building code we determined that the existing W 12 x 40 steel beam. . • , is adequate to carry the design floor loads. If must me noted that the new center wall that is framed beneath the existing ridge beam must be famed so that load is not transferred onto the wall and subsequently onto the steel,beam. The steel beam cannot support both the floor load and the ridge beam load. If there are any questions, feel free to contact me at any time. IN OF h�qs ate- � . J - MARK A. ctiG Sincerely, 1 p i RACK IE �. e � � Cl L CAI 9068 4 M k A. McKenzie ISTS?- Treasurer, East Cape C. d ENERGY CONSERVATION APPLICATION FORM FOR ENERGY EFFICICIENCY FOR ONE-AND TWO-FAMILY DETACHED RESIDENTIAL'CONSTRUCTION (780 CMR 61.00) Applicant Name: it - P,4Gtg�C-y Site Address: t(, y j+j o,,",®,Z &,Vir print Town: Gcc twTr4w Applicant Phone; 5-,) 1 1-fa- O C) Applicant Signature: Date of Application: NEW CONSTRUCTION: eboose ONE of the followin two'o tions 780 CMR TABLE 6107.1 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA FOR NEW ONE-AND TWO-FAMILY BUILDINGS NCkXLVUM MINIMUM Ceiling or Basement Slab Option 1: Fenestration exposed Wall Floor Perimeter U-factor floors R R-Value Value R-Value wall R-Value AFUE HSPF SEER R-Value and Depth National Appliance-Energy .35 R-3 8 R-19 R=19 R-10 R-10, Conservation Act(NAECA)of 4 ft.• 1987 as amended,minimums or catcr as a licable Note: This form is not required if you choose either of the two versions of REScheck as listed below. ❑ Option 2: RES check Version 4.1.2 or later variant software analysis must be completed 780 CMR 6107.3.2 REScheck—Web which can be accessed at http://www.enErgycodes.goy/rrscherk/ ADDZTCOIVS:OR;ALTEI2ATIONS.TO EXISTING BUIZ.DINGS.O VER'5 YEARS OLD* *)3uildings under 5 years old must use option#1 or#2 in New Construction section above. Complete the following formula to determine the % of glazing: (a) Gross Wall & Ceiling Area equals Formula: (100 x b_a) SF 100 x — _ % of glazing (b) Glazing area equals SF b a If lazing is<-406/..4se the chart below. If glati.ng is > 40 % roceed to "SUNROOM" section 780 CMR TABLE 6101.3 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA ADDITIONS TO EXISTING LOW-RISE RESIDENTIAL BUILDINGS MAXIMUM MINIMUM Ceiling and SIab Perimeter ❑ Fenestration -Wall Floor Basement Wall U-factor Exposed floors R-Value R-value R-Value R-Value R-Value and Depth .39 R-3 7 a R-13 • R-19 R-10 R-10, 4 feet a R-30 ceiling insulation may be used in place of R-37 if the insulation achieves the full R-value over the entire ceiling area(i.e.not compressed over exterior walls, and including any access openings). ' SUNROOM—An addition or alteration to an existing building/dwelling unit where the total glazing area of said addition exceeds 40% of the combined gross wall and ceiling area of the addition. Note: Owner to fill out Consumer Information Form found in Appendix 120.P .r . �ZHE Town of Barnstable Regulatory Services BARNHASS.STABLE " Thomas F.Geiler,Director E16yq. & 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, To✓ % Nt 6 L,ET , as Owner of the subject property hereby authorize f}�Ef�/� It4• ;?f) ffec p to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) ignature o r ate �&4 .Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS:OwNERPERMIS SION Town of Barnstable "o Regulatory Services ..� SAMMBLE Thomas F. Geiler,Director 9� 16,39. ��� Building Division ArFD N1A't A 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 109.1.1) 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 .r requirements. ' Signature of Homeowner Approval of Building Official I 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:\WPFILES\FORMS\homeexempt.DOC Board of Building Regulations and Standards License or registration valid for individul use only i HOME IMPROVEMENT CONTRACTOR `' w. before the expiration date. if found return to: Board of=Building Regulations and Standards Registration 105488 _, One Ashburton Place Rm1301 Expiration 7/17/2010':f `.•Tr# 269518 type " r Boston,)Via.02108 -In dMdual ARTHUR M.PACHECO. " Arthur Pacheco A 133 ASHLEY DR .n CENTERVILLE,MA 02632-: Administrator, Not valid with(eit signature f N1ass•ichusctts - Department of Public S feth J ' Board of Building- Re�-tilatio►ts and Standards C.onstruction,Supervisor License ° License: CS 31802 ' Restricted to: 00 k ARTHUR M PACHECO 133 ASHLEY DR CENTERVILLE,MA 02632`,... s g Expiration:'6/15/2010.. C'nnun, .inns°r Trf: 29134 '� � � '<f•. pi a '�d 'h k - - r • r , . . w g'R x # • 01 i , 7 The Commonwealth of Massachusetts Department of Industrial Accidents r Office of Investigations' 600 Washington Street Boston, MA 02111 i� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): &j`q✓4 y Ce Address: ! 3 R5ilie`( 0/.. City/State/Zip:t:tNT "c.Lii�o--' AA. 4,4 SYPhone,M )' P W7 R &eb C? 0 Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a Y emP to er with 4. I am a general contractor and I 6. ❑New construction employees(full and/or part-tim.e).* have hired the sub-contractors .2.J�[-4 am a sole proprietor or partner- listed on the attached sheet. 7.. ❑Remodeling ship and have no employees These sub-contractors have g, '❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp. insurance comp. insurance.t 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 l l.❑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 An/c Sy Ja F comp.insurance required.] �a �t`f;'tr6GTL�C� "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. lContractors 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.M 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 tip to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance covers a verification. I do hereby certify der the pains and a alties o erjury that the information provided above is tru and correct. Si ature: Date: S Phone# U 7 Oi t5 (A G7 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health '2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: . Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their.employees. Pursuant to this statute,an employee is defined as "...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7) states"Neither the commonwealth nor any of its political subdivisions shall . enter into any contract for.the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary, supply sub-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 bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to-thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth-of Massachusetts Department of Industrial Accidents Office of Investigations, 600 Washington Street Boston, MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 11-22-06 www.mass.gav/dia Town of Barnstable Regulatory Services THE Thomas F.Geiler,Director Building Division ELAMSTABUF. : Tom Perry,Building Commissioner � 1' �� 200 Main Street,Hyannis,MA 02601 �ED MA'S A Office: 508-862-4038 Fax: 508-790-6230 February 4, 2014 Arthur Pacheco 133 Ashley Dr. Centerville, MA. 02632 RE: 160 Hillside Dr., Centerville, Map: 193 Parcel: 056 Dear Mr. Pacheco: This letter is to inquire on the status of building permit application number 200902506 issued by this office on or about August 3, 2009. Please contact this office for the required inspections or explain your apparent lack of progress. Thank you for your immediate attention in this matter. Respectfully, r L Lauzon Local Inspector jeffrey.lauzonga town.barnstable.ma.us (508) 862-4034 �UTE. I 1 f 24IIL/ NO P2oCIJZESS SALE 2.(-�pq . $ PolcE wj ow me?— ANn Town..;of.Barnstable.: *Perri #< 2 . y� p� Expires 6 months from,issue date. MASS. Regulatory Services Fee:. 9� , ; g Thomas F.Geiler,Director A'ED1A°`a Building Division XoP PE,,. ,,, .,, Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 OCT 1 4 2003 Office: 508-862-4038 Fax: 508-790-6230 TOWN OF BARNS-1r,_. -._- EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY / 2 Not Valid without Red X-Press Imprint Map/parcel Number Z� o)(� Property Address �A /•� J•�h ) 1)L' �/�2Y 722 2 U) Residential Value of Work Owner's.Name.&.Addressli Contractor's.Name Telephone.Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License.#(if applicable) ❑Workman's.Compensation Insurance Check one: ❑ I am a sole proprietor am the Homeowner ❑. I have Worker's Compensation Insurance. Insurance Company Name Workman's.Comp.Policy# Permit Request(check box) Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side , ❑ Replacement Windows. 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. Home Improvement Contractors License is required. Signature Q:Forms:expmtrg Revised121901 �V �6a� Town of Barnstable *Permit# � UI '4 Expires 6 months from issue date Regulatory Services Fee Thomas F.Geiler,Director �'l Jzel� Building Division '7 Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.t6wn.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTYAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address /& 0 1� d c�,� �- [Residential Value of Work 3 g �oZ ++ Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Contractor's Name F-A&At-c. c6YL:Z .� Telephone Number 50 0 Home Improvement Contractor License#(if applicable) z"j 3 Construction Supervisor's License#(if applicable) 9 0Worknian'ss Compensation Insurance -PRE S PERMIT Chec one: ❑ I am a sole proprietor APR 2 2 2 9 ❑ I am the Homeowner 0,I have Worker's Compensation Insurance TOWN OFARNS--ABL Insurance Company Name ko- 6-Lacli U {� Workman's Comp.Policy# LL f� - 63 Lq 1 M S5 to ^� Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) aRe-roof(stripping old shingles) All construction debris will be taken to G 0--'(4L,__ ❑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. A copy of the Home Improvement Contractors License is required. ' SIGNATURE: Q:Forms:expmtrg Revise061306 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/Organization/Individual): FA a_4_� , L LG Address: g x City/State/Zip: C�jbj ma- bo'�63� Phone #: 569—YO-60 Are you an employer?Check the appropriate box: Type of project(required): I Z-1 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 working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.1 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 1 l.❑ 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' 13.0 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. 11 Insurance Company Name: �N Q alL Policy#or Self-ins. Lic. #: �, — (� 3 { 5�6 — (� Expiration Date: Job Site Address: 1 0 l j lUO L L �( . City/State/Zip: a4zz;�_ 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 certi&iinderihe nd pe lties of perjury that the information provided above is true and correct t e­­ Sijznature: Date: Phone#: �4�' Yoe 012 oC. I 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#: hightFax N3-2 10/1/2008 1 :56: 31 PM PAGE 2/002 Fax Server i : :::::vr ISSUE DATE i THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORD•[ATION ONLY PRODUCER AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND}EKTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. WISE&9 PLEASANT ST INSURANCE AGENCY COMPANIES AFFORDING COVERAGE 44 BROCKTON MA 02301 coMPANY A HARTFORD UNDERWRITERS INSURANCE CO INSURED LETTERcoN>PAxv B FRASER CONSTRUCTION LLC IEITER PO BOX 1845 COMPANY C I MTER COTUIT MA 02635 cow"Y D LETTER COMPANY _ E LETTER THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD MICATED.NOTIVITHSTAMI NO ANY REQUIRERIDNT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIMCATE 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.IDSTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS CO TYPE OF INSURANCE POLICYNUNIBER POLICY POLICY LINQTS LTR EFFECT[VE DATE EXPIRATION DATE D/YY) MM/DD/YY GFIylltsr.LIABIIITY GENERAL AGGREGATE $ ❑COMMERCIAL GENERAL LIABIL]TY PRODUCTS-COMP/OP AGG. $ ❑ CLAIMS MADE ❑ OCCUR. PERSONAL&ADV.INNRY $ ❑OWNER'S&CONTRACTORS PROT. EACHOCCURRENCE $ ❑ FIRE DA WAGE(Any One Elm) $ NIED.EXPENSE(Anvoneperson $ ALTI OA'IOBH.E LIABH II y COMBINED SINGLE LIMIT $ ❑ ANY AUTO ❑ ALL OWNED AUTOS BODILY INJURY $ {PvPerson) ❑ SCI EDULED AUTOS ❑ HIRED AUTOS BODILY INJURY $ (Per Accldcnt) ❑ NON-OWNEDAUTOS ❑ GARAGELIABBSI'Y iiOPERTYDAMAGE $ ❑ EXCESSLIABHdTY ❑ UMBREL AFORM FACHOCCURRENCE $ ❑ OTLIER THAN UMBRELLA FORM AGGREGATE $ ' STATUTORY LIMITS X A WOR�R'S COAHIENSATION a«Ac®ENT $500,000 AND UB- 09/26/08 09/26/09 DISEASE-POIICYI-IIvuT $500,000 0341M556-08 EMPLOYER'S LIABILITY DISEASE-EACH EMPLOYEE $500,000 OTHER THE PROPRIEPDR/PARTNERS/F� OFFICERS ARE INCLUDED. { DESCRIPITON OF OPERATIONS/WCATIOMS/VEHICIdS/SPECLIL TMIS I THE INSURF,D'S NIA WORKERS COME %1SATION POLICY AND ITS LIAM-ED OTEIER STATES INSURANCE IIWRSENIENP AUItIORIZF.S THE PAYAR7I1I'OF BENEFITS FOR CLAEILS II NUDE BY THE INSURED'S ALA E RMOYEES IN SPATES OTHER THAN MLA.NO AUTHOIHZATION IS GIVEN TO PAY CLAIMS FOR BENEFIT'S IN ANY STATE OTHER THAN 51A IF TIBE INSURED LHRES.OR HAS HRIED.PAIPI,OYEES OUTSIDE OF 51A.THIS POLICY DOES NOT PROVIDE COVERAGE FOR ANY SPATE OTHER THAN NIA. THIS REPLACPS ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMB:COVERAGE :::�=:r :f�fld.'h��.L:$�C•A�: �B�}:�:•:i�i:=:{ti�i}:•'r:�}:�r i?:� ?i'r:=: r}:�•}:•:•:�}:-:•}}?::•:•};:{{•:: TOWN OF BARNSTABLE ` - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE PO BOX 40 EXPIRATION DATE THEREOF,THE ISSUING CONIP 1NY WILL ENDEAVOR TO NNB, HYANNIS MA 02601 Io DAYS wRITTEN NOTICE TO THE CERTIFICATE HOLDER NA mD TO THE LEFT. BUT Fan I1RL;TO NU1B,SUCH NOTICESIIALL IND'OSE NO OBLIGATION OR r.iALLn rry OF ANY IOND UPON THE COMPANY.LTS AGENTS OR REPRFS1wrATTVES AVIHOR17Sp REP86�YfA774B - MAMA CAS7?FF1-0,J(ZE¢ r ✓1e i�a�rurreovzcuea�,fz o�✓�¢c�ivaella. - Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration; 112536 Board of Building Regulations and Standards EjpiraEiota 3%23/2011 Tr/% 281021 One Ashburton Place Rm 1301 Type: DBA Boston,Ma.02108 FRASER CONSTRUCTION.C.O. DEAN FRASER 104 TWINN VIEW LANE E FALMOUTH,MA 02536 l Administrator Not re Boar o nil ing egula ons an tanRars One Ashburton Place - Room 1301 Boston, Massachusetts 02108 Home Improvement Contractor Registration Registration: 112536 Type: DBA Expiration: 3/23/2011 Tr# 281021 FRASER CONSTRUCTION CO. DEAN FRASER P.O. BOX 1845 COTUIT, MA 02635 Update Address and return card.Mark reason for change. Address Renewal Employment Lost Card CA1 0 40M-08/08-DBSLIFORMCA108212008 • t� _x {BQand ltlitt onsnd andttds Si perwsorL-.r on canse 6 ' g Bcegr S2 'E�ir�dafe. ; J�T7 ' 1AIP --fZ'%o11• TO 9606 DEAN IFRMSR 1-084T11i.INNNIEW, L EAST FALMOUTH,Ift QZ536 mm5 inni�r r s Fraser Construction, LLC VCONSTRUCTION P.O. Box 1845, Cotuit MA. 02635 Email: fraser_construction@verizon.net www.fraserroofing.com FAX 1-508-428-0123 508-428-2292 HICL#112536 CS#97668 RE-ROOFING PROPOSAL DATE: April 8, 2009 PHONE: 508-362-4647 NAME: Tom Niblet MAIL ADDRESS: same JOB ADDRESS: 160 Hillside Dr. Centerville, MA 02632 EMAIL: motsspotl&aol.com FRASER CONSTRUCTION hereby proposes to perform the following services in a neat and professional like manner and in accordance with the manufacturer's specifications and local building code. -Remove and Haul away all of the old roofing material -Re-nail all plywood sheathing as needed. Fraser Construction will supply the following material. The homeowner will supply the Architectural Style Asphalt Shingle. Fraser Construction will strip (remove) existing shingles & install shingles provided by homeowner on garage only. Supply & Install - CertainTeed Winter - Guard: (ice 8v water shield) Waterproof Underlayment System (3ft. on eves and valleys, 18" on rakes, walls, and skylights) Supply & Install - Roofer's Select Underlayment Paper (as recommended by CertainTeed) Supply & Install - hick's Ventilated Drip Edge or 8" Aluminum Drip Edge Supply & Install-Air Vent Ridge Vent (as recommended by CertainTeed) Clean & Remove - Debris from work area daily. PRICE- $3,892 Initial . . r ' Payable by check 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 1.5%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$6.00 per panel including Materials & 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$55.00 per hour, plus materials, plus 15% overhead mark-up on total extras. FRASER CONSTRUCTION Warranties the labor for 12 years FRASER CONSTRUCTION Warranties the shingles against Blow-Offs for 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, LLC: Carries Workman's Compensation and Public Liability Insurance on the above work, certificate available upon request: DATE OF ACCEPTANCE: GI 14Lt Homeowner Fraser Co c ' , LLC Assessor's offioe (1st floor): /n� /_ SYSTEM MUST BE Assessor's map and lot number ......y .�.`'1. ..-.. (p. - 7 ' � �_ ® ON COMP '1Q.. toy` °3oard of Health (3rd floor): /'� %f TH TITLE 5 Sewage Permit number .......'........ ......C.0 .2.. Kiv _d`�"' a � TAL ®I 9TLEU. Engineering Department (3rd floor): 'TOWN REGULA�� �A°a - p 1039. House number 9� t APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ............f-.6.1. tVQt.C...... ....?. C'...6Y............................................................... TYPEOF CONSTRUCTION ...........................77�.-.rY..Y. -........................................................................ .�9............... ................19.0. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies fro a permit according to the followiiq information: Location ...... ...... / S�\� , r (/ o..... �...................:�..Q.�'........Ce.,.�.............................................................................................. Proposed Use f—c�!` Qf` 41 I' C� .... ............................................ ......... —� Zoning District �j-f ` .../....�................�........f.......................Fire District .../...S....•...........................e..........e..o.v....c.1...... . .Name of Owner ...... ` J . l .........Address / .a 'e. A. �. '. ms ..... . ... ...................... ^� /'...'--Address '!Name of Builder .....:�..L.. .�Q'. ���`1S`�.,p�l..� ... �(. �rP;r/'S..... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms .,— .................................................................Foundation .... .. " ................................................. Exterior .............. .. Floors .. ..... ...................................................Interior ...........1.1...........I........................................................ c.��r ..........................................................Plumbing .................................................................................. Fireplace ..................................................................................Approximate Cost ............... °`rZ5d.e�.........'.... Definitive Plan Approved by Planning Board ________________________________19________ . Area ......... .. ........................ Diagram of Lot and Building with Dimensions Fee b.............................. SUBJECT TO APPROVAL OF BOARD OF HEALTH qy � OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of 4Tof Barnsta e construction. Name . ............................................................... �DDo?� Construction Supervisor's License .................................... NIBLETT, THOMAS No Al2.84.. Permit for Kitchen ..... ..... ............... ....Sinqle Family Dwelling.......... ............................................. Location 160 Hillside Drive .............................. .............. /r 1 ,;��. ....................Centerville ............................................................ Owner ......Thomas Ni-blett - ....................................................e....... Type of Construction .....Frame.................................... . ............................................................................... • t_' Plot ............................ Lot ................................ October 87 -Granted ........ 8 19 Permit ....I.............. Date of Inspection ..........................n........19 Date Completed .......... .........19 Assessor's offioe (1st floor}: _.,i:Y •� ~� � ^ .Y '".' V - � ' Assessor's map and lot number n — •� QyOFTHEto�` { ......Y . :.`� ......... . B'bard of Health (3rd floor): Sewage Permit number ........................... ' B98d9TADLL, � 6gineering Department (3rd floor): o NA°i House number •. o �b39• \0� APPLICATIONS PROCESSED 8:30,-9:30 A.M. and 1:00-2:00.P;M:" only ' TOWN OF B"ARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .......... .)5h..l.q. ..r...... .....!..! t'1(1........................... TYPE OF CONSTRUCTION ........................... ' .�Gt !)'] -........................................................................ ............ n V... -. . '...............19.�1..�j . TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the followin information: 17 Location ! U / i Or , Ce,� Cr v ....................................:.................................................................................................................................................. �et , ProposedUse ��-........................................................................................................... Zoning District ..........................Fire District 16 Nameof Owner ..7.4.. a . . . ..........Address .. �... ...... ........................ ...... ....... ....... ...........................e...........................I............... t dame of ,Builder S �` f.q"'..'e...� l I .....Address .S-!� ��dvSAN o� d4 vt t 1'. (�i^e"I.V �/P' + .......`. .................................... .......... Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms^..................--................................................Foundation ................... . ................;..................................... Exterior ..............I......\0..........................................................Roofing ..............!.... 1 Floors .............. ........... ...................................................Interior ........�� N, \ ....................... .I......................................... I A cP r Heating ..................�...........................................Plumbing ...............................c.................................................. .. ......... ��7 Fireplace .................... .. .................................................Approximate Cost ..............................6 ................�..................... Definitive Plan Approved' by Planning Board ____________________19________ . Area .........!!.`'............................ Diagram of Lot and Building with Dimensions Fee r SUBJECT TO APPROVAL OF BOARD OF HEALTH LN r OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the T wn of Barnstable egarding the wove construction. Name ..... ......................................................................... Construction Supervisor's License .................................... NIBLETT, THOMAS A=193-056 Aq& 31284 Enlarge Kitchen No ................. Permit for .................................... Single Family dwelling .......................................................................... Location .....1.6.0...H.i 1.l.s.i-de....Drive. . ............... .... .. . .. .... .... .. .... Centerville ............................................................................... Owner Thomas Niblett .................................................................. Type of Construction ..Fr........ame............................ .... ............................... ............................................... Plot ............................ Lot ................................ Permit Granted ..... October .8.........19 87 ...................... .. .. Date of Inspecti6n .......... ..........................19 19 Date Completed ...................................:..19 � '�� ilk f ► � ,, ;�! - � � :� � � - �� • , , ', �� �i, .. ,.l �,I �r - ���� -- � - _- - ` , � ,_ �--- �� - - _ �� t10M ts Karen Lilly 774-368-0551 Karen@LillyHomes.com 23 West Bay Road LillyHomes.com Osterville, MA 02655 o Assessor's office Ost fl:oor); y� Assessor's map and lot number /7 /� .... . yoF THE toy .. Vard'of Health (3rd floor): �', �� �� d�Q ♦� Sewage Permit nu mer. .. . 5 �� �Ir`�y rM1�<• vac Z EAHd9TODLE. I! wngineering Department (3rd floor): moo A° - douse number ....;................................1 k . .............. ; n 4,L Cc � '°�o r or, _. ' 63 `- Definitive Plan Approved by Planning Board ------------------------------- REGULATIONS YP ' APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00 2;00 P.M. only TOWN OF ' BARNSTABLE BRILDIN.G. I-NSPECTOR AIA Ige-�, � n, APPLICATION FOR PERMIT TO ................. TYPE OF CONSTRUCTION. ......!-�..O.P—Q...... .......................' ................................................. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby-applies for a permit according to the following information: / 1 • Location ...1.�............. ........ :........ ..................... ........................ ............ Proposed {fbOn Use ....�...�... ..,...�.:......�e.�... ......:. .:.....: ...................... Zoning District .....� . .. .... ... ..... . ......... ..................Fire District .... ...: Name of Owner ............... ..................[. ......... ..... ... >..........�: Name of Builder 34 e-,ec 6 'r- y.,,� L� ! Address ..S.0 � ......74:°., 5,p` C��(� ....nn....K-,..) . .... ... ...... . . ......... ....... ... lam: ... Nameof Architect ....................................................... ............Address ...................................................... Number of Rooms .......� .........Foundation ....1'.Ori c s e. ' <p (� Exterior ... �.�.�.....................:............................. ...Roofing Cy : .y5...a.t..e...e...............�. _ ..........Floors p ............ ...: Interior, ,................................ Heating car ..�.....`f v .................................Plumbing ..aflrt .,iUC,,� h Fireplace ....:.Approximate Cost Areal... .... Diagram of Cot and Building with Dimensions Fee OCCUPANCY PERMITS REQUIRED FOR NEW..DWELLINGS I hereby agree to,conform to all .the Rules and Regulations8of the T Cvn of Barn Ltaleegardi g. the above construction. f Name ........ .....`... .................. ............................... Construction Superv.isor's License .. ©� NIBLET, THOMAS No 32297...• Permit for ...Build Addition Single Family Dwelling..,., k Location ~. 160 H.illside. . • .Dr.i.ve........... , . .... .. .... .. .. .... .. .... Centerville f� ...........•,• _Thomas -Niblet........................ - - r+• y( _ • Owner .... .......... 1.......... .... ................ -� - Type of`Construction" ......F.r.aMe.:....................... .. .i........................................................... T oPlot .. Lt . _ , September 26 , 88 Permit Granted ...........................19 - Date of Inspection r 19 . .... .............. Date Completed ..........:.....� /�� ....19 ; `t 5 4 R r .. 3 - i ,. - r - ,F S • Z O , NEW -n X a z !"o'! • DECK T a m • -, ° ' (VERIFY DECKNG&. w - • EXIST - " e - C-� r EXIST EXIST EXIST. -,r RAILINGS MATF.RIAL6 - •) - • - W1011NER51 � � m m m EXIST. 00 BATH 00 r m (E%ISTINGI (E%IST-1 ` r o '• (Ti 0 n Exlsr - EXIST .Tr m REMODELED - EXIST. I 'TIT, - �7 m BEDROOM#3 BEDROOM#2 I s"�' a �i G) e I e EXIST 1 b« Al • I "� I �. - BATO - DESK - b° S - I BATH EXIST. "' VI 0 I KITCHEN T 7D �s'.c d �- 4 CLOS11 rn 'I 6KY � b 'I6NYUGNT� �26".6S h � _ ''� I � O O _ �.� 11�i . .. . Alb ABOVE - rh, A, i I I I v v _ v, W 1J m I i CLOS. L---� � NEW � EXIST. , � [77 B,:•.6•B' S _ HALL o D " HALL D x SHOW cR FOLDING - I , - - . HALL EXIST.' � EXiST. �`m m m GAMEROOM o1 I L___ �'� ze co ,. it I SK11I HT SKY-HT - - .. DINING .PATIO e 0 b F I SKYLIGHT CLOS.I - 1 SKYLIGHT A '�)( I I © I 1 - UP r eovE L r.ea I ABOVE I L_ L_ C OS. �. t I aIFOLD I. NEW 2 , d EXIST EXIST 1 EXIST. ` BEDROOM#4 _ b„ I BEDROOM#1 • ' 1 SKVLIGM� .I SKILIG 1 _ • p'� Z - • EXIST. w • 3 ABOVE ABOVE LIVING sI I •� I L_ a Y _J _J _ - EXIST .EXIST. s - t ul A Al :::EKI.T .'- .m m - � .Z 0 - EXJs i. EXIST ExlSi EXIST - E%ISi EXIST EXIST:' • - _ x C CD .,:-. _ + y _a,D•t - fra•. T.Q: - fs.a: - "ze•-v:.' • - - a Q. Z ""'� '. • a' r (EXISTING( •:.. ' -• `.` - (E%(STING) '(EXISTING (EIUSTING)' T •• (EXISTING) , : r f • rn in m • FIRST FLOOR PLAN _m0 EA ' NEW CONT.RIDGE VENT • & ._ W CONT RIDGE VENT y••""I (REMODELED AREA=676 S.F.) �NE c 12 w SMOKE DETECTOR '2 ExisF 2.mRAFfER ,^ (EXISTING HOUSE 1400 S.F.) © EXIST ROOFs.RUCNRET L.MY' S m rn EXIST. EXIST 2,10R ERS& ©CARBON MONOXIDE DETECTOR _ _,p m A - •, - . ROOF STRVCi URE TO REMAIN TOP OF PLATE f - .. EXIST,Sv12BEA1., LEGEND:- - 155 __ • m 0 C R1 «. TOP OF%A;E WIPL•'NOODGUSSETS ABOVE TO TIE IN EXIST _ EXISTING.WALLS - N`EWSIMPSONNzs NEwa.aBEAMs O C a `-NEW 1?'GYP BOARD 2.10 RAPERS - P a Nev aMPsoN Hz s': ON 1.3 STRAPPING ? - CONSTRUCTION TO BE REMOVED ' AT EA HRAFLTFR' A —I'� h 39 .. HURRICANE LLIPS �16'eF NEYV2.6 WALLWI. `--J N - RISTALL Y_WY BARN nr EACH RAFTER • _ _. GYP Bo.ON Borth. - NEW CONSTRUCTION - _ - IR•]J) (PROP-A=VENTS. Z ^' C SIDES - INSTALL NEWT BAIT INSULATION - - m - , TORAGE «.. vEV Ta G) a-.« _.a , ,• .(R-301W(PROP.A.VE.�TS&SOFFIT I - [ _ l ., v Im`W BEDROOM GAMEROOM VENTS S oo R1 .. w..,. _xls c,vAULssslc rl NOTES: ' . L R&VIN r . IRsr FLOOR + e N=W 6'OAT' EXIST 2.6 WALLS&S:,IHG 3UBFLOOR INSU'_(R=191 TO RE'.1NIN FIRST P_oORa 1.) CONTRACTOR IS TO VERIFY ALL EXISTING CONDITIONS - roP OF Fur_ EXIST z.lD,g16•PE SUBFLCOQ e TOP OF�LAi- EXIST.LIt's@16'ae E%IST2+:DY$1SOE. BDIMENSIONSINTHEFIELD - Ewsr:srEELBEA&1_j. - 2.) CONTRACTOR TO VERIFY ALL INTERIOR&EXTERIOR MATERIALS. - NEWT BATT DETAILS.&FINISHES IN THE FIELD WITH OWNER a � EXIST. ' = INs-IB=BTB.J . 3.) ROUGH OPENING HEAD HEIGHT OF WINDUNS AT BASEMENT - EXIST. .FIRST FLOOR TO BE T-8"ABOVE SUBFLOOR• • BASEMENT 4.) ALL NEW CONSTRUCTION TO CONFORM TO 780 CMR MASSACHUSETTS STATE BUILDING CODE,SEVENTH EDITION - - r - '' • - ' EXIST.LONG FOV'• WALLS- 6.) FOLLOW ALL MANUFACTURER'S SPECIFICATIONS FOR INSTALLATION OF ALL Top of slAa. roP c=5La8 _--- • ! « SIMPSON COMPONENTS 7.) VERIFY ALL PLUMBING&ELECTRICAL DETAILS W/OWNERS ON THE SITE ,Y DURING FRAMING CONSTRUCTION _LE_� - 8.) .THE BUILDING SHOWN ON THIS PLAN WAS.CONSTRUCTED IN 1988 &HAS REMAINED A WEATHER TIGHT SHELL SINCE THAT TIME., SECTION @ STORAGE ' 9.) EXISTING HOUSE CURRENTLY CONTAINS THREE BEDROOMS. - B ' THIS PROJECT ADDS A FOURTH BEDROOM'WHICH THE HEALTH DEPARTMENT SECTION @ BEDROOM/GAMEROOM HAS REVIEWED AND APPROVED DUE THE EXISTING SEPTIC SYSTEM SIZE. r � `®Ii�` .,., C•O1'UI I BAY DLSIGN, LL(. �IT (�1�1,T(AA`/r ° EJR JR JMr�;1J•5`..RE 'JU°Dn" DWG. NO. LL111�'-1 NEW.1_/ V V REM t/ D L_I LI1 tl G FOR -R *. `. h.E P.•�.cs vE To. R o .. • cJ's TI CrICf.DIE 3LII ix rR._ICR SCALE 4,3 BRE�)WSTE13 ROAD , _ Ea SBl JR(hf.J1 I:Vi nI \SHf I E.nll I\. 02649 e - T C J \P I OIs RVLi1-E . • -w - • J .VLh6 W i.Ol T D Fv IIr;(FE Pit.Wffl274-IIG6 NIBLET RESIDENCE )�4r• �: or, <. r A E ES 4'OF. CRR SO JHO D TI IF.;E JRA.A S 4F SOLELY I)R T F $E p ) (M FOWtE H.E[ YOD- SC CF )39-9402 - 3 ,L `� C PAM 5 EO 4C E. R N 160 HILLSIDE DRIVE CENTERVILLE, MA �/8/2009 FFCr�URALEf.JPrftWH PRO CLTIOfI (EJUsnHG1 G7 O I 3 ["• z NEW DECK EXIST EXIsr Msr. c m r � !7 IVERIFv DECKING L EXIST C3 bI RAILINGS VATERIALS - r - TTI,M WOA'M IERSI Cn y EXIST. O O 2n.vz raz BATH, 00 � m (Fxlsr:lc) - ma (EXISTING) m I - - F.V si REMODELED EXIST. I, ;EIUSDN01 C Z O 0 - Exlsr 5 BEDROOM# BEDROOM#2 -� B I m r EXIST. b«i Al _ I, BATH EXIST. «� o BATO °��" �� � CLOD; I :: O O KITCHEN 70 . 1 rInCSInucNrlV, mT A9 I1ABDVE I 1 .-. .M ' ` M - L r,_'a L__J T6.6S I NEWS ^s' EXIST. CLOS. j�I O � HALL, HALL UP sna 2D•aa• i I - _ M. M - SYON^cR FOLDING H I ,'Y - GAMEROOM DII "_= EXIST. EXIST. bs z m m 0, . -_ I I MYOUIGHT O HT I DINING PATIO m O 2B•co VE z� - 1 _ II r-� r-1 I up b F F 1 51(YLICNT 1 IiLO J.I 1 SxYLIGNr� �I I I I I. __ I � -_ .,o- 180� I eco o I 1 M0� I L_J L_J C Os. L--J I'---J 1 NEW 2g•, .s EXIST EXIST _ EXIST- - _ - BEDROOM#4 e= I BEDROOM#1 n ON. 4 EXIST. N' I s Ove r1 rxrucir� _ i LIVING I ABo�E � 'L——J L——J �'�- IExIGnNGI o • EXIST t FXIST u m rn R M . 1 >> (� Ewsf. MST MST MST .. :I EXIST EXIST EXIST © 7 az Tit >i b m�] .Af2 o Sdx IS.D. 26-PS .—t;,I; Z y m p� (EXISTING) (EXISTING) (EXISTING (FISTING) (EXISTING) C13 M t/ 1mA FIRST FLOOR PLAN �y ter" NEW CONT gIDGE VENT -'1 UJ 177 NEW CONT.RIDGE VENT - p (n ` (REMODELED AREA=676 S.F.). 2 MST,2.13 PAF ER— �n 9[77 (EXISTING HOUSE=1400 S.F.) OO SMOKE DETECTOR I Exlsr i00Fs-gUCTUREr CV/a:r - O rn = (T7 _ Exlsr. EXIST z.i0RAFTERsn - - ©CARBON MONOXIDE DETECTOR _ ;a °�- C3 C7.m - ROOFSTRUCTURETOREAWN LEGEND:' TOP OFPIATE .. frt=r p c lT9 EXIST,5.12 BEAM CIIJJ 'V _ ," TOP OF PVI-E EXIST.NOODOUssETs - ioc BEAAIS Z _ 0 r—0 \ EXISTING WALLS ABOVE TO TIE IN MST Q - „q SCANECLIP s _ `NE'N trl.D,SO-3 z.TU RA ERS - --' -CONSTRUCTION TO BE REMOVED AT—RARER NEW SIIAPSONH2s Oh I.OSTMPPRIG --� 3 IS'.. .. IRe,OIL YlIPA7P.A.VENfa NURRICECLiPS NE'NL6WALL Vtl AN EM NEW CONSTRUCTION •F.r Z M A,'aGN AAFTER GYP BD.ON BOTH - STORAGE G7 SIDES INSTALL NEVI P BAIT IISULATION IR-W)Wl'PRO-.MVENTS A SOFFIT - BEDROOM GAMEROOM VENTS EXIS_Z(q,VALLSSSIC4 M W • NOTES: lRs, OOR p TO NES-Iml WA EX lLs S=11113 • _ __ _ - -- -L _ -„ aUBFL00R INSU_(R=19) TO RE!.WN TOP OF PLAT EXIST 2.IT. i6-ec FIRSTF-ooR ; - 1.) CONTRACTOR IS TO VERIFY ALL EXISTINGCONDITIONS s..FLOon &DIMENSIONS IN THE FIELD TOP OF SLAT -_ MST.2.IG,Ale ac EXIST 2.!Ps Qi le Rc .. MST.STEELSEAY— 2) CONTRACTOR TO VERIFY ALL INTERIOR 8 EXTERIOR MATERIALS, - NEIV.-MTT _DETAILS,&FINISHES IN THE FIELD WITH OWNER - A INSUL(R=]0) A L= EXIST'. 3.) ROUGH OPENING HEAD HEIGHT OF WINDOLNSAT z BASEMENTEXIS - FIRST FLOOR TO BE 6•-B"ABOVE SUBFLOCR' p� ` BASEMENT 4.) ALL NEW CONSTRUCTION TO CONFORM T0;7B0 CMR MASSACHUSETTS Barnstable Bldg.Dept. �. .. STATE BUILDING CODE.SEVENTH EDITION` I Ewsr.CO.. TOP OF SLA9 FOtrKA WA S 6) FOLLOW ALL MANUFACTURER'S SPECIFIOATIONS FOR INSTALLATION OF ALL , Approved by: roP o=sue SIMPSON COMPONENTS j - 7) VERIFY ALL PLUMBING&ELECTRICAL DE?AILS W/OWNERS ON THE SITE DURING FRAMING CONSTRUCTION Permit#1 • r •.: �I 8.) THE BUILDING SHOWN ON THIS PLAN!NASCONSTRUCTED IN 1988 &HAS REMAINED B SECTION @STORAGE A WEATHER TIGHT SHELL SINCE THAT TIME. 9.) EXISTING HOUSE CURRENTLY CONTAINS THREE BEDROOMS. ° THIS PROJECT ADDS A FOURTH BEDRO01.1 WHICH THE HEALTH DEPARTMENT Al �L A SECTION @ BEDROOM/GAMEROOM HAS REVIEWED AND APPROVED DUE THE EXISTING SEPTIC SYSTEM SIZE. _ A, SMOKE DETECTORS REVIEWi ULK1/� I ME.ES,Gt.EA;HAIL BE SCALE IIOTITIED;F a;m _RRORiOROARssiGNsAREFOU::DO.1 DWG. NO. L� 1 N E y d R E ICI O D E L-I N G FOR - � E UI DEPT. � DATE MESE DPA':.N::s CUTUI'I'B.'\Y DESIGN, LL(: C,I;ST:,UG TIGI:TILE DIJLD!NG D:NTR.:C,GR 1W; I/4,. _ ,i'_U" in PI['.a JW\NvSGs iF=oNsi�ciloe AT ` 4;3 BRE��'STER R0:4(D1( y T•It\SEIPEE:NIA. Q2649 C.O1:A.c:ICESWITNOUT:IOnrrINGTFE Al G PI►.soLg)274-1166 NIBLET RESIDENCE � DATE CEIGFO—IFANY[LI'"OROARSSEC VVV n IF,SE ORA'NINGS ARF SOLELY FOR THE--sE FAX ffl i3J-9402 * FI EDEPARTME DATE EDWNERNDIEDSTTDMaRU9ECP NI\ 4 THEiE OP.A•MI::S gEDII RES*NE'f.RIT1=11 160 HILLSIDE DRIVE CENTERVILLE, N/I //H�2OO9 ARLYE ECTURA COP IgIGNi PROc OJII ®OT�i SIGNATURES ARE REQUIRED FOR PERMITTING ACT DTECT I 4— B•T -9'p NEW PT 6,6 POSTS ON IFXISTRIG) I - .. - - .. _... IT DIA CONCRETE 50NOMBE9 • 2.AT 2,10, TO 4V BELOW GRAZE.USE .. .. •.. ... r - - 51MPSON ABU 66 POST BASE 1 L THRU BOLT INTO PLAT FR t AM W1 E 55 WWpNARE . i P T 2 a 10 l=ODER BOARD ITG BOLTED TO sOUO BLOCKIND WI(2)_EOGERLOK BOLTS , •Sot WI l0.5T5 HANGERS AT BOTH ENDS - b e.l i EXIST ——————————— IEJOS-INGI 17 TIN .•-pc - - IEXISnNG) 1p Al e= I EXIST._ h I O .. UTILITY �� pev2 G EXIST. EXIST. S � - (,3f 0. � BASEMENT BASEMENT FAMILY e ROOM uv RN _ _ I •. - -EXISTING 2.IOa - y I - E%ISTING 2a IDa ®16'>c.: ®16a� IEXIsnNG) (EXISTIA) t1 - _ N1 q„ I CONCRETE SLAB Al A y 2 IT-pt E)IST. EXIST I F m fExlsnNcr i I �� ,Aw 25, N AW 251 N - ANOERSEN - A.251 CENTER NEW.WINCOWS'000F - - - I - - - TOP OF PUi E -UNDER WINDOWS ADOYe. I - - _ . (EXISTWGI • a - - NEW DECK a 3'd! 16-pe 2B'p! RAILINGS F . J - (EtIsnNG (EXISnuo) - (--snNGI - - ■ ❑ FIRST FLOOR✓ SU_�FLOO_R < TOP OF PIT. ' BASEMENT PLAN , 1 EXIST. • � a TOP2 nATE - '•� ®.. _ MIST. LEFT E L E VAT I O N . F a a alLl rap OF LUTE ED oo ao a FIRST F-OOR z -BLaoFt - - .. - x .. ...,. TOP OF PATE .. - - ' V_IY DEC<RAIU•VGS _ • ❑.❑, .. 'FI.RST FLOOR 'OP OF PLA1= REVoYE EXIanNG•O H CODAS S INSTALL:IEWZp DOUBLE CCORS - REAR ELEVATION NEi'1'I/AlL FRAI.•'rIG3 - I - TIF JF i_B FRONT ELEVATION TDw GN=<15FIG . - TPE:ESIGlICT:HALL EE t O 1FEO F V�I' � C'UTUfI B:\ti UL�IGN:LLC NEW REMODELING FOR . SCALE ERRD>>Ga,.1.;;IGNSA, DD�N p,�/G. NO. ' 1NESE ORAINI.GS PRIOR iO.T..Ri C•. 43 BRI WSTER ROAD GDNSTRUf,IZN THE BNLJ NG C.,N Ti?C•JR ��L ``11 ` ) - - _ ,1 - WILL BE RESPO H aIBLE FJR rHE"O`I(ENI.. - lyl:\.]f ll'I_L .Ni:a. UZb4�) 1./Y.: - I'-�' IN THESB GR NI tGSIi CONSTRUC"ION-, PI I. soy;_i4-I Igo NIBLET RESIDENCE _ GOMKENCEI.WNIGDT'IDTIF•:NTYE 1= J I nE51GNER OF ANY E3ROR5090•.RSGoNS \l( 8 ) �1 ) r THESE URAWIHGS ARE SOLE_',FDA-L.E .:1.\�.�I�O�JJ(�-��YI�L _ • D.A �.E OF THE O'NNE3 VO TEU<.V�JINER JSE�F .' r l l _. � ., 1_ ': .. '. 't - THESE DRAWIT11i5 RED JIRES THE'NRN•N • 160 HILLSIDE DRIVE CEN I ERVILLL, MA 2009 :R�HtmC-uRA�Er, R.lHl l T'I; ?/8/ . ACT OF ID):