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0435 HUCKINS NECK ROAD
y,� �lilG'K 1 NS l�E� �� � r - - • (�� 3���d�r.,Perml - 0�7oL1 Town of Barnstable t# Expires 6 montt"om issue.date ' Regulatory Services Fee Thomas F.Geller,Director "`7 Building Division PERVA'T Tom Perry,CBO, Building Commissioner. ` O 2 2007 200 Main Street,Hyannis,MA 02601 MAR www.town.bamstable.ma.us 1. Offic : r - NSTABLE Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY 2 !L Not Valid-wifkvut Red X:?ress imprint Cap/parcel Number �3.3 7 roperty Address Residential Value of Work o m Minimum fee of$25.00 for work under$6000.00 7. 1wner's Name&Address !ontract6r's Name 1-n elephone Number [ome Improvement Contractor License#(if applicable) A)� onstfaction-Sttpmvisor's-)J OCM27 ]Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑/I am the Homeowner �( I.have Worker's Compensation Insurance. asurance Company Name `O2 Vorkman's Comp.Policy ,opy of Insurance Compliance Certificate must be on file. •emut Request(check box) dRe-roof(stripping old shingles) All construction debris will be taken ❑Re-roof(not stripping. Going over existing layers.of roof) Rd-sidelop- '. ) ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town departmentregulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission, A copy o the Home Im ovement Contractors License is required. 1IGNATURE: -F W74rl� I:Fonn.S:expmtrg evise061306 f PERM,IT+PAYMENT RECEIPT ; TOWN OF BARNSTABLE BUILDING DEPARTMENT 200 MAIN STREET " HYANNIS, MA 02601 DATE: 03/02/07 TIME: 13:26 -----------------TOTALS-----------------+ PERMIT $ PAID 192.44 , AMT APPLLIED: 192.44 CHANGE: .00 APPLICATION NUMBER: 200701199 PAYMENT METH: CHECK PAYMENT REF: 3407 The Comrnonweatth of Massachusetts Department of Industrial Accidents Office of Invesdgadons r n w . ' 600 Washington Street Boston,MA 02111, ww.mmass.gov/dia ' Workers'Compensation Insurance Affidavit Builders/Contractors/Electricians/Plumbers Applicant Information - Please Print Lmibly Name(Business/Organization/Individual): hf �jyl<S Gi�Dibs ���IOf9��it Address: �1_ City/State/Zip: ,%,,,/ A Ol io/ Phone.#: .6 ;3 ,2,P Are you an employer?Check the appropriate box: ;Type of pioject(required): 1,❑ I am a employer with 4, ❑ I am a general contractor and I 6, ❑New construction . ' ac employees{full d/orpart time),* . have hired the sttb-contractors 2. I am&'ole.pioprietor or partner- listed on the-attached sheet. 7. ❑Remodeling ship.andhave no employees These sub-contractors have g, Demolition -Working for me in any capacity. employees and have workers' [No workers' comp,insurance comp, insurance.$ 9. []Building addition required.] 5: ❑ We are a corporation and its 10.❑•Blectd.cal repairs or additions 3.❑ I am a homeowner doing ill•work officers have exercised their 11. Plumbing repairs ❑ g s or additions myself,[No workers'comp. right of exemption per MGL p insurance:required.]t A 152, §1(4),and we have no 12.[ `Roof repairs employees, [No workers' 11F Other /,�� j comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policyinfommn on. t Homeowners,who submit this affidavit indicating they are doing all work aud.thr,•n hire outside contractors must submita new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether ornotthose entities have employees. If the sub-contractors bane employees,they must provide theit•workers'comp.policy number. lam an employer,that is providing workers'compensation insurance for my employees. Below is.the policy and job site' information. J_ Insurance Company Name:_ Policy#or Self-ins.Lic,# Expiration Date: ~ lob Site Address' City/State/Zip: Attach a copy of the workers' compensation policy declaration page'(showing the policy number and expiration date), Failure,to secure coverage as required.under Section 25A of MGL c.' 152 can lead to the imposition of criminal penalties of a fine tip to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK,ORDER and a fine of up to$250.00 a day against thq violator. Be advised that a copy of this statement maybe forwarded to the-Office of Investigations of the WA for insurance coverage verification I do hereby certify under rtthe pains-and penalties of perjury that the information provided above is true and correct. Si e• Date ' 102_ - Phone#: RY &Q 'y6/1✓� Official use only. Do not write in this area,tb be completed by,city or town ofj4ctaL 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 ContactPerson: Phone#; ®® F��g��'pyq� ®g®{®@^ Bp pp ,/IDS ® gq spy g®,�eq. ®�®� fj n - I .J:LS.bi�UJ1 HHam.BLSV'rrn all .PL J. I I UUUU113 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 bean 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 ehapter..152, §25C(7)states"Neither 6e commonwealth nor any,,.ofits political subdivisions shall enter into any contract for,the performance of public.work until acceptable evidense'ai compliance 7ithtlie 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-conti•actor(s)name(s),address(es)and phone number(s)along with their certificate(s) of insurance. Limited Liability,Companies�(LLC)or Limited Liab lity 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 perznit.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-insuranc(elicense number on the appropriate•lind. ._..City,or Towp 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 permittlicense number which will be used as a reference number. In addition,an applicant that must submit multiple permitnicense 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 ao not hesitate to give us.a call. The Depaztment's address,telephone-and fax number:: Th.4 COMM011WWth of Ma chusotts Dip caxt of Jh�i€al A.cdde�ats 0fri"of Tuyestfga s ' . • �QQ� gror���eet • B6ston, 02111 Tel. 617-' 7-000 cxt 406 or 1-477-MASSA.FF Fax*617-7274749 Revised 11-22-06. WWW.Matss_86v/din DATE(MM\DD\YY; AI:1/1:11® CIERTIFICATE OF INSURANCE - - THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIO 1,PRooucE� ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICAT 0 .BRIENS CENTERVILLE •INS HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND 0 PO BOX 610 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE CENTERVILLE MA 02632 COMPANY 28SBK A THE TRAVELERS INDEMNITY COMPANY INSURED - COMPANY HOLMES, STEPHEN M B P.0. BOX 2537 COMPANY --- HYANNIS MA 02601 C COMPANY i D jCOVERAGES : X. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOP. THE POLICY PERIO1 INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO _'HICi THI'. CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EYCLUSIO S AND CONDITIONS OF SUCH POLICIES.(IMITS SH0WN MAY HAVE RFFN AFDUCED BY PAID Cl AIMS. ' TYPE OF INSURANCE POLICY EFFECTIVE. POLICY EXPIRATION !'.1NCE POLICY NUMBER LIMITS LE - �. DATE(MM\DD\YY) DATE(MM\DD\YY) , GENERAL LIABILITY }. GENERAL AGGREGATE I S COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG. CLAIMS MADE OCCUR. PERSONAL&ADV.INJURY 5 i EACH OCCURRENCE I OWNER'S&CONTRACTOR'S PROT. S FIRE DAMAGE(Any one fire) 1 c MED.EXPENSE(Any one person)I c AUTOMOBILE LIABILITY COMBINED SINGLE ;S ANY AUTO + LIMIT 1 — ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS 1 (Per Person) HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per Accident) PROPERTY DAMAGE S GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S ANY AUTO OTHER THAN AUTO ONLY: - EACH ACCIDENT S - AGGREGATES EXCESS LIABILITY EACH OCCURRENCE S I�UMBRELLA FORM AGGREGATE S OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION AND - '-' — A M A - STATUTORY LIMITS N/A. YE AIEMPLPR'SUAeIUTY (LIB-743X126-3-06) 04'-24-06 04-24-07 ( EACH ACCIDENT n Oa-ITHE PROPRIETOR/ INCL DISEASE-POLICY LIMIT 1 c PARTNERS/EXECUTIVE , ,- 5n�; OFFICERS ARE: x EXCL DISEASE-EACH EMPLOYE"_ - 500,( OTHER - - - - I i DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. CERTIFICATE HOLDER'; CAIVCELLATIaN I . SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1 EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO M 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO T LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION C LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 26 S(3[93j 6 CORD CORPORATION t AC ORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YY) EPHR1 08/24/06 RODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 'Brien's Centerville Ins Agy HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 59 Pine Street, P.O. Box 610 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. :enterville MA 02632 ?hone: 508-775-0005 Fax:508-775-6772 INSURERS AFFORDING COVERAGE ISURED INSURER A: Arbella Protection Ins. Co. INSURER B: Stephen M. Holmes INSURERC: P.O. Box 2537 INSURERD: Hyannis MA 02601 INSURER E:' :OVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. SR POLICY EFFECTIVE P LI Y EXPIRATION I R TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000. A X COMMERCIAL GENERAL LIABILITY 8500024934 06/17/06 06/17/07 FIRE DAMAGE(Anyone fire) S 100,000. CLAIMS M,.DE IF OCCUR - MED EXP(Any one person) $ 5,000. PERSONAL&ADV INJURY $ 1,000,000. I GENERAL AGGREGATE $ 2,000,000. GEN'L AGGREGATE LIMIT APPLIES PER: - PRODUCTS-COMP/OP AGG $ 2,000,000. Lr-- X POLICY PROJECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO - - (Ea accident) $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ I PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC S AUTO ONLY: AGG S EXCESS LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE S DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND I TURY LIMITS I ER EMPLOYERS'LIABILITY E.L.EACH ACCIDENT S E.L.DISEASE-EA EMPLOYEE S E.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Carpentry, Remodeling; Ernest B. .Norris & Son, Inc. is listed As an Additional Insured on .the above mentioned policy with respects- to jobs performed by th6 Insured for the Certificate Holder. „ CERTIFICATE HOLDER N ADDITIONAL INSURED;INSURER LETTER:_ CANCELLATION EBNOR-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATI d � SYI- te hen B. 01 3, n r. ACORD 25-S (7/97) ©ACORD COR ORATION 1988 a t .. BOARD OF BUI�DI AW G M ULATIONS t �cense "CONSTRUCTION SUPERVISOR b Nu b S'j. E 13% Trno , r ona �u Rest ¢ �r5t dg 00 l I STEPHEN M H01MES 'f BOX 2537 i �HYANNIS'MAr0260 Commissioner' i y {-s.A fit r" r,e `? ✓/ � 40✓I7iirlx0��n!A{P,CLI.[/G O�i,i��4f�kkLG k Board of Building Regulations and Standards + 4 ;o R HOME. IMPROVEMENT CONTRACTOR a n x Registratio \1Q3479 EX p fationa-718 2008 '` , Ype. df idual . STEPHEN WHO ESi �6 i r, of St;0en'Holm es _ ry r 38 PRISCILLA ST. Hyannis, MA 02601 De a dminiger for ' l P A X , %�.v/.,a;; ,�";�-Yt''.`Y--�.4��1'_-. BOARD�OF*BUILDING REGULATIONS ` '' y- ` icense• CON$TRUCTIOiV SUPERVISOR y Number CS_ 000027 ' t r� 45 Expire �,0113.0/2008 Tr,no: 13911 ., `onc 1-.1" 7 STEPH5N M HOLIV1ES�t z jr PO'BOX 2537 � HYANNIS MA 02601 r £ Cominlssloner ------------ �.. - .�- Board of Building Regulations and Standards +-a _ HOME IMPROVEMENT CONTRACTOR Re istrat n: 9 /5t-\h y 1 Q3479. Expiration �7/8/2008• _ ��V Typ nd vidual '"" STEPHEN M:HOLMES _ V .- Stephen 'Holmes ~�`� i•"* 38 PRISCILLA ST. " r+ Hyannis, MA.02601 Deputy _._..._. ._ W, . r t 02/21/2007 16:37 FAX 17816479310 LEISMAN INSURANCE AGENCY Z 002 . Of$arn Regalatorp Ser tes. F4'-1 200 Maia Street, $yawis,3}ik.02601 Fax: 509.790.6230 Office; 508-g�2.gA38 _ property Ovmer must complete aid,Sigra This Section U Using A BiiUdex `�\��,,,� _, ls�csw-��• `� - as Owner of the subject pYopertg �JO� iY • /�/•�I�S to act on my behalf, hereby autboaze +. unit 2 licatioa for: '.. . is allinn s relative to work'o aAwliZedbp•this V l&3g pP •, . (Addtess of Job) Late sjpature QFo�s:o���5� • • . Z00/Z00ln MOOLL905 'KVd 90:OT LO/TZ/ZO TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 22 Map Parcel T0 OF EPA rpi�f#fABLE (b 9 Health Division RQate u d �rM Jr �� —� Conservation Division ,5. �� ree �3-CJ�� �02 PLAY rFee ®a Tax Collector 6 D N L —SP�� �� 'Jl'il1SlOSd Treasurer L Planning Dept. 1 Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address 43_ 14t/c I: 14ts e cl, !? b Village Owner Address C3 f~2 C t-T k 17 D �R I ye- Telephone `2SO 9--`7 �� i�,�f I`� �� ® �-4 i Permit Request R-e1'd-,QC -, EX-I S"T' C Mc. h e G r—. so r=1, J \ cached,,&40 57&A&D rkecid CoA1_'Qo 'w4�rdxL) Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Valuation 4,®a®- _-- Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathiered: ❑Yes ❑No If yes, attach supporting documentation. 2 Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑No Basement Type: ❑ Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas Cl Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn: ❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use — Proposed Use BUILDER INFORMATION Name H, c f&;p D49 C-4oFCP. C_Mz a��i.Telephone Number s D�(���_9 �/1 `3 vv Address f w P S T i be_ A v e- License# (n°1,.`'� /5`7 ( A rl e, 1'\%A 55, G a`?6 D Home Improvement Contractor# M(a a 3 f i Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO 12) (/ ,q 1b I.s P(3 S-A L, SIGNATURE l'Lyl DATE FOR OFFICIAL USE ONLY t i 'r 4 � r� �w I PERMIT NO. f DATE ISSUED 'MAP/PARCEL NO:' 4 t r r ADDRESS - VI.LLAGE OWNER DATE OF'INSPECTION:• FOUNDATION FRAME INSULATION _ FIREPLACE 1 x ELECTRICAL: ROUGH FINAL s } PLUMBING: ROUGH FINAL k GAS: ROUGH FINAL FINAL BUILDING i DATE CLOSED OUT ASSOCIATION PLAN NO. � l r q _,t t • J . The Town of-Barnstable ' Regulatory Services ` Thomas F. Geiler, Director -Building Division Peter F. DiMatteo, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION ' MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing.at least one but not more than four dwelling units or to structures which are•adjacent to such residence or building be done by registered contractors,.with-certain exceptions,along with other requirements. E 5 c t'_ Type.of Work:R C r? T I � IJC stimated Cost � G _ �G.� � Eli {� E Address of Work: 3S uc K -eetG k C e i H L J Owner's Name:till , ►S Date of Application: 4 I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: ' Date Contractor Name Registration No. OR q:for=:Affidav :rev-122001 Department of Industrial Accidents '� �°--•- _ � � 0197c�oflav�stigatlaas _ — 600 Washington Street Boston,Mass. .02111 Workers Compensation Insurance Affidavit JV y l I� i / J to �•I /`t / phone 4 ,56 I omaosenerperforming all work rs elf. 'Ie r IIetor an v ve o one wb rlQn in ace S G L E✓ a� . /n%O/% �G% I am a so ravidin workers co ensation for my employees working on this job. 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J;ir ^±:}$%:? }�:<•:t:•{.vpiv ...:•.......... ... ...r.n.,...:/}. fi.x•rvv:v.....fi.....................r...;.:,{.........-+u.n..... .,.• .....r...r. :.....n. r.xr.....n ....t...r............... ....:.....n _.....:..fifi........:.....:..at:•wnv„ ...:}i:};hY•}:{}f..}i: -:.v:fit ..r r:r.v:u: :•::::... r:•:rs...r.r. rr .....::.{r..x......x x.. ... , .. 0 ��:}••i}}•- .x{,•.... _ .......:v...!..........r......:...t .,{r.........!.r..O..nwn..r.. .:.,....v........:r:•....x....v..:.. ,Y......,........... ....... ., ..:...:::::::r::•:::•rar:,{•rr::.;:..y,:•:{.�:::•:::F•::.<•r.{• y:.: .,. ::...:.:•::-r.y:•: ........ ..r....;,..;. r:•:... ..... . j� !ailnre to secure coverage as r eq�red tmder•5edion innposition of erianiml penalties,of a Sne to SI',500.00 and/or 25A of MGIo 152 can lead to the Due yew+imprivomnent ai wen as civil penalties in the form of a STOP WORK ORDER and a fine of SI00.00 a day against me. I mnderstmd that a :opy of this statemeatmay be forwarded to the Office of Investigations of the DIA for coverage veriftatiorL do hereby certify under the pasns mad penaikes of pedury that the information provided above is true mad correct �o 117�, �� Day Signature ,�— c f2- ��( Ci f4 A L� Phone# O P" �y Print name T - oi$dai use only do not write in this area to be completed by city or town oindal city or town: peiinit/license# [3Bunaing Department ❑Licensing Board Selectmen's Office ❑checkifimmediate r•aporae is regirired ❑ (]�_ HealthDepattnent phone#; Other contactperson: (ivv�9195 PI Information and Instructions sachusetts General Laws chapter.152 section 25 requires all employers to provide workers' compensation for their [ovees. As quoted from the "law'; an employee is defined as every person in the service of another under any contract re, express or implied, oral or written.' !niployer is defined as an individual;partnership, association, corporation or other legal entity, or any two or more of bregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or tee of an individual, partnership, association or other legal entity, employing.employees. However the owner cf•a Ming house having not more than three apartments and who resides therein; or the occupant of the dwelling house of her who employs persons to do maintenance, construction or repair work on such dwelling house or on the.grounds or ding appurtenant thereto shall not because-of such employment be deemed to be an employer. -L chapter 152 section 25 also states that every state or local licensing agency shall withhold the;issuance or'renewal license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has produced.acceptable evidence:of compliance with the insurance coverage required. Additionally,.ineither the unonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until compliance with the insi»nce requirements of this chapter have been presented to the'contracting eptable evidence of aority. plicants ase fill in the workers', compensation•affidavit completely,by checking the box that applies to your situation and )plying.comp=y-.names, address and phone numbers along-with a.certificate of insurance gas all affidavits may be )mitted to the Department-of Industrial Accidents for confirmation of insurance coverage: Also be sure to sign and. Ee the affidavit. The,affidavit should be returned to the city or tow'that the.application for the permit or license is ng requested, not the Department of Industrial Accidents. Should you have nay questions regarding the"law"or if you required to obtain a-workers' compensation policy,please call the Department at the number listed below. ty or•Towns rase be-sure that the affidavit is'complete and printed legibly. The Departnent.has provided a space at the bottom of the adavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please .sure to fill in the peimitllir se number which will be used as a reference number. The affidavits-may tie returned in Department by mail or FAX iinTdss"btliei`aiiaugemeats bave•been'made:• ._.. .:........ _.. . . ne Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. ease do not hesitate to give us a call. ae Departnent's address,telephone and fax number: .'' . The Commonwealth .Of Massachusetts' Department of Industrial Accidents Olflce of lottestlgatlons 600 Washington Street Boston,Ma. 02111. fax#: (617) 727-7749 phone#c (617) 727-4900 ext. 406,409..or.. 375. Board of Building Regulations and Standards One Ashburton Place — Room. 1301 Boston , Massachusetts 02108 Home Improvement Contractor Registration Registration: 106031 Expiration- 7/21/02 Type: DBA r HONE INPROVENENT CONTRACTOR Registration: 106431 CHACE CARPENTRY Expiration: 7121102 Peter . Chace Type: ON 93 Westside Ave N . Attleboro MA 02760 CHACE CARPENTRY Peter Chace 93 Nestside Ave ADMINISTRATOR N. Rttlebor HA 02760 BOARD OF BUILDING REGULATIONS License- FONSTRUCTION SUPERVISOR Number:;IG_ 023157 ' Tr.no: 20251 � PETER M CHACE t 931NESTSI0E AV . � � M"a_x 5 e N ATTLEBORO, MA.OY7G0 �"�'`'� ' ' If Administrator f nD all LE �7 MAY - 12002 BARNSTABLE CONSERVATION o i r . v. A, �Q F. 0q) TI n J �� - - Q s i P -T-.6 4 E s I- G A-Tio ! �� r N cf-I . ..f- G L,,sl4 )vw, S7� f2 s e P•v C, A C. QIt FA c , S , �� / 1 m r f4G.�N��. J k '� 2ovt�IrJ r3 °e !v C, H v w S i a Ta to P, % 0,5AM AP I?aa>-c,- 435- � ; -tea b 55 L C -1 w s _v c. ' m ID C e Nr ���--� e �''_lL �`� - �3vic� r�'4 e �Prz hC 144c e h /aA r- 9.4r,e er��Y • � JZ, r' DAVID M. BANASH f ATTORNEY AT LAW 105 UNION WHARF " BOSTON. MASSACHUSETTS 02109 (617)227-0670 TELECOPIER:(617)227-7733 e - r • 4 r -,q i . 1 .- ' s J) c o I Nil t1 I I r C.n i I � A � ACO►3DTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYY"' PRODUCER R. 'A. Reinbold Insurance Agency, Ihc THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O. Box 68 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR North Attleboro, Ma 02761 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# INSURED Peter Chace d/b/a INSURERA: Maryland Casualty Company Chace Carpentry INSURERB: 93 Westside Avenue INSURERC: North Attleboro, MA 02760 INSURERD: INSURER E:. COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLiCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION LTR NS POLICY NUMBER DATE MM/DD Y DATE MM/DD Y LIMITS GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY - PREMISES Eaoccurence $ CLAIMSMADE [XiOCCUR CFC 27423202 114-1,4-0.1 11.-14-02_ MEDEXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'LAGGREGATE LIMITAPPLIES PER: 'PRODUCTS-COMP/OP AGG $ POLICYLI PRO- LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON-OWNEDAUTOS (Per accident) $ PROPERTYDAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WC STATU- OERTH- EMPLOYERS'LIABILITY TORY LIMITS ANY PROPRIETOR/PARTNER/EXECUTIVE - _.E.L.EACH ACCIDENT $- -. OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ It yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS ` CERTIFICATE HOLDER CANCELLATION Town of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Barnstable, MA 02630 DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL ;g Q DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ENTS OR REPRESENTATIVES. AUTHORIZED REPRES IVE ACORD 25(2001/08) c ACOR ORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25(2001/08) STANDARD LEGEND NOTE:not all symbols will appear on a map t� GOLF COURSE FAIRWAY ' v ^ EDGE OF DECIDUOUS TREES ' MA 233 _ EDGE OF BRUSH ORCHARD OR NURSERY 4 - ��V # 455 \ 7-V--V-V EDGE OF CONIFEROUS TREES MARSH AREA --- EDGE OF WATER DIRT ROAD V,:-:- DRIVEWAY PARKING LOT PAVED ROAD —. — DRAINAGE DITCH — — — — - PATH/TRAIL ' Xp PARCEL LINE MAPIID -* -MAP# IVI 21 -<—PARCEL NUMBER 1\ #1e60 < HOUSE NUMBER (v` MAP 23 � C'•� 2 FOOT CONTOUR LINE ' . 10 FOOT CONTOUR LINE a _ —tt� 30 233 _ ___------ - # 430 Elevation based on NGVD29 y) �,4.9 SPOT ELEVATION # 435 � STONE WALL -X—X- FENCE RETAINING WALL —.TT RAIL ROAD TRACK STONE JETTY j SWIMMING POOL \ PORCH/DECK BUILDING/STRUCTURE 1 - DOCK/PIER P 233 HYDRANT 6 VALVE 0 MANHOLE 0 POST p FLAG POLE T O W N O F B A R N S T A B l E O E O 0 R A P H I C I N F O R M A T I O N S Y S T E M S U N I T v SIGN ® STORM DRAIN N PRINTED SCA"IN FEET *NOTE:This map is on enlargement of a **NOTE:The parcel lines ore only graphic representations DATA SOURCES: Planimetrics(man-made features)were Interpreted from 1995 aerial photographs by The lames a TOWER I"=I00'scale map and may NOT meet of property boundaries.They are not true locations,and W.Sewall Company.Topography and vegetation were interpreted from 1989 aerial photographs by GEOD 0 UTILITY POLE w a 0 30 60 National Map Accuracy Standards at this do not represent actual relationships to physical objects Corporation.Plonimetrics,topography,and vegetation were mopped to meet National Mop Accuracy Standards 111101=60 FEET* enlarged wale. on the map. at a scale of 1°=100'.Parcel lines were digitized from 2000 Town of Barnstable Assessors tax maps. 4 LIGHT POLE O ELECTRIC BOX `oFTHE TpH� The Town of Barnstable NWP O,' r 9AR9STA9LH.ASS Department of Health Safety and Environmental Services 7 M . 0q i67q. �0 °rFo Mpg Building Division 367 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 PLAN REVIEW Owner: l Map/Parce ) , 23 � Project Address: 1:b�y Ic'.4 Builder: Ohe following items were noted on reviewing: 1 1 , Reviewed by: J ram _ Date: q:buildinglorms:review r , TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION O 1 r Map Parcel Permit#'. Health Division 7l- �� Date Issued � � Conservation Division �ZN`A Fee 2 Tax Collector I �� J Treasurer �a���, 3=a.3�c�op SEPTIC SYSTEM MUST BE INSTALLED IN COMPLIANCE Planning Dept. WITH TITLE 5 Date Definitive Plan Approved by Planning Board ENVIRONMENTAL C007 AMID Historic-OKH Preservation/Hyannis Project Street Address CV4,, U Qzy- Village Ceoi Vikkc Owner W FL ��l -t T'4�� , S �i t 'f : A dress _4 GR. Ch*1-0 '491"e - Telephone f w�cci r• t«rL•Ay r11'� 1�� 6veai#t,�m4 6 Y13 Permit Request C o -e :r � f 6--Dykeqo s I 0=r o f--A RAJ Pl e 11,4 T9 ri x r V M-3 Cokvep-T pITkttt6 CAA-X(.e fit r'o UTts,1 P Fy rZo&t-f Tekn S Tv by 9 Ir"i-0 t,k c� CliAW6F'S I y f L,C,a rL )2 S Q- e P-Ais Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Estimated Project Cost Zoning District b 1 Flood Plain Groundwater Overlay Construction Type w Qo b F yt,Abie Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure So+ VS! Historic House: ❑Yes O-Prd'o On Old King's Highway: ❑Yes a-tVo Basement Type: I❑Full Crawl O'Walkout tether Pubh Ar-.w,ih Clt ,-o F Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 5'f 0 ' Number of Baths: Full:existing new Half:existing 0 new O Number of Bedrooms: existing S new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas UZi ❑ Electric ❑Other Central Air: es ❑No Fireplaces: Existing f New O Existing wood/coal stove: O Yes Detached garage:❑existing ❑new size Pool:❑�exsi ting new size Barn:❑existing ❑new size Attached garage: existin ❑new size Shed:9stir ❑new size Other:9 9 99 Zoning Board of Appeals Autho ' ation ❑ Appeal# Recorded❑ Commercial ❑Yes o if yes,site plan review# Current Use 32?-S i 6-te w ue Proposed Use __ S 0 t3l,14, BUILDER INFORMATION Name,B,�!�°(A F j. C 14Ac P C 14A(,e. C AT;,1R i Mphone Number d 9 Address '7' -� \,j.e 5 S i ,b--,- A v -e. License# 0 h/1- ThiP-) ASS , G 1 7 60 Home Improvement Contractor# 3 1 Worker's Compensation# 4 0 9 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO C; 14 S i 1Z° IJ U I` n S 2 2 �s nl�s r>SIGNATURE DATE �Y 14 P-cK FOR OFFICIAL USE ONLY r 'PERMIT NO. t t DATE ISSUED - f MAP/PARCEL NO. 'L ADDRESS ram.«:. VILLAGE OWNER ' ' Y DATE OF INSPECTIOI ' ` ' FOUNDATION FRAME J.,.../12 , . INSULATION + FIREPLACE » } ELECTRICAL: ROUG � "`., FINAL PLUMBING: ROUGH;, FINAL = GAS: ROUGH FINAL t F .., ( &C j 4 FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. r — _ The Commonwealth of Massachusetts Iff - Department of Industrial Accidents Oflfce offarestfoo foes 600 Washington Street V `` Boston,Mass 02111 'workers' f�m ensation Insurance davit name P e•l -e(2,1A G• 14 AGe--I �U'. t�, /4- 9AC C 17, N-L!ILL- location:4 S.r 5 t Qe- AV'� p city ,��• /�=j7'l.� �� �}SS, Q r�.7 �� phone# ❑ I am a homeowner performing all work myself. I am a sole p netor and have no one rkin in any capacity Ow-0 am ///%//%///%/�%%%/%///, I am an em lover providing workers' compensation for my employees working on this job.::: :::: ::::::::::::::::: :::::::::::::: :: con anv name: a ire ss. :.:...:.;:.:;.... ::.:.;.;:: :.. ::.::::....::.:..... :.....dtv ::; ::> :>>>:::::::>>:::::::::;:.:;::: :: insurance co. ........... oiicv#' ❑ I am a sole proprietor,general contractor, or homeowner(circle one)and have hired the contractors listed below who have thee followin workers' compensation polices: g ...............:....::.::::::::.:.::.::.::. ::.....:.::::::...:...:.: :.:::............: :::............: com stivname: address. :.:.: ::.......................................................::::.:.:::..::.:.::.:.::.;.::. //.:{•';::� ':: :::i�::. :ar::` %' :$:iso- ::; :::•::•:••::•::-::.r+:•:;tc;•>:�:::•r;;::•::;:::;:a:;:o:;�: •.. :. <::.:< . ;:.;;<.;;;.;:;.;<tisuxa: : : : ; »>l IN address:. ...:.::::.:.:::::::::::::::.....::::::::::.::. :::.::.:::::..::::::: ::•.:::....:::::.::::.:::.::::::::.::.............:....:: .::: ;. .. ... .:::.:.:., phone .......... ,.. A ><"?'>`> o 11 ie prance gyfiuid re to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification I do hereby certiJ&under the pains and pen of perjury that the information provided above is trw.and correct Signature�_.? -� ,j�-�'J, Date A P-G I4 5-3 or o �jei�— 1-�1, C�4A U'e- 1�# - Print name - official use only do not write in this area to be completed by city or town official City or town: permit/license# QBufiding Department ❑Licensing Board ❑checkitimmediate response is required ❑selectmen's Office ❑$ealih Department contact person: phone#-, ❑�er�—.�— (lensed 9/95 PIA) Tint3at App mdu ' ' Tabla3S2.ib(ecatlaaed) . Prpesiptfre Packim for daa and TwIe-fmady RatdmsW Building Seated with Foal Fack . MAXIMUM 141affiHUM � GIs cdRug Wail Floor 8a� Slab lim=gCowing �K) Rrvai� B-�i. Rrvaiud Wall Pb a� p�� Arv� &vslue� 5"1 to 690 Hn Dais' DeStee Da Q 12Y. 0.40 3E 13 19 10 6 Norcmi R 12% 032 30 19 19 !0 6 Nosm i S 12-A OM 3E 13 19 10 6 ES AFVE T 13% 036 3E 13 23 WA WA No=ai U 15% 0.46 31 19 19 10 6 NomW 'r i�ri itg4 �e i3 Y NA WIA 25 AFUE W is% om 30 19 19 to - 6 ES AFVE J[ IE-/. 032 3E 13 23 WA WA No:mai T I EY. OA2 3E 19 25 WA WA Notaml Z IVA 0.42 3E 13 19 10 1 6 90 AFEIE AA 1E-/. 03o 30 19 19 10 6 90 AFUE 1. ADDRESS OF PROPERTY. 43 e G; C-e R TY rL V I �.►�� 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: 4. %GLAZING AREA(#3 DIVIDED BY#2): S. SELECT PACKAGE(Q—AA-see chart above): NOTE. OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. P BUILDING INSPECTOR APPROVAL: YES: NO: q-fo=4980303a • 9UABL Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Cressen Fax: 508-790-6230 Building'Commissione: Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal, demolition,or construction.of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: ft i2.1 G A R h Pb et,f^I?N 6 Estimated Cost-1 ost °�-�O Address of Work: 4'3 5- yL1'L-i k5 fit e c,V, rLb C' K �'' i�^ . Owner's Name: P e A-'-LY 7Y1vS 1_ — Date of Application: H AR444 613 -®a I hereby certify that: Registration is not required for the following reason(s): Work excluded by law C]Job Under$1,000 Building not owner-occupied C]Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME n"ROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A.' SIGNED UNDER PENALTIES OF PERJURY I hereby apply fdr a permit as the agent of the owner. Date Contractor Name Registration No. OR Date Owner's Name q:fbr ms:Affidav s. DEPARTMENT Of PUBLIC SAFETY 'T ? CONSTRUCTION SUPERVISOR LICENSE Number Expires: - Restricted-TO: 00 PETER.M' MACE 93 WESTSIDE AVE N ATTLEBORO, NA 662760.__... ,. - ' HOME IMPROVEMENT CONTRACTORS REGISTRATION Board of Building .Regulations and .Standards •` One Ashburton Place — -Room 1301 _ lz Boston , Massachusetts 02108 ` t - HOME IMPROVEMENT CONTRACTOR _ a i as . .. Registration 106031 Expiration 07/21/00 ,w � Type — DBAr � � _ 'T, ean, ,,,HOME IMPROVEMENT CONTRACTOR 1 Registration 106031 CHACE CARPENTRY k ; Type,- DBA Peter M . Chace -- 4 Expiration 07/21/00 4 93 Westside Ave N . Attleboro MA 02760 CNACE CARPENTRY 1 Peter M. Chace i`_/ w � Iestside Ave •. oMA021 TOR N. Attleboro 60 s . r y C�2c��Q�2t] ki5- 12D /lip={ i t f V CIC) nC - Nj O' i Ct, apt M� %4 �0 T.,�.a':1.'.`.. 1•'y fir. .�� �,� �• .' 3 1�,. / Z ,' . r y , ''f.` .. •�' �, ./ - 1 /' .". �'tr`�i,�..:: .;tom �/,� � _�� .. eL 1 Aa Ist CN ietcp'`- ' � c CIO � H . )-x- Cw� '� . � ` � . � LL___L__�_L-__-L_�__ -__ __L___-� � , � — ' t -CHACE BUILDING SUPPLY Tim Hassell 22 Mar 2000 8:24 am 129 WASHINGTON ST. , FOXBORO, MA. 02035- (508)543-7316 FA§TBeam@ Engineering Analysis @ 1996-2000 Georgia-Pacific Corporation Version: 3.1(95/NT) Project : CHACE.FBD Information : Ivl beam for 435 huckins neck rd. centerville ma Mario# : Beam - Floor Desc : Usage : Beam(Floor) Repetitive : No Spacing (in.) : 0.0 Max Defl : LL= L/360 TL= L1240 Composite Action : No 3.5", 565 psi 3.5", 565 psi 1 16' 0" LOADS Project Design Loads:Floor:Live=40 psi,, Dead=10 psf,- Live+Dead Ld(T) Live Ld(L) LDF Location' Shape @Start @End @Start@End Span# Stairs Ends Additional info. 1 Span Carried(psf) 50 40 100% 0 0101, 16'0" 24'0"s.c.- Uniform(plf) 16 0 0 0 16'0" Self Weight 'Dimensions measured from left end when span#is 0 otherwise from left end of the specified span. SUPPORTS(Ibs) 1 2 Max R'n 4930 4930 liax 100% 3840 3840 htin R'n 1090 1090 Wn 100% 3840 3840 CL R'n 1090 1090 Min Brg(in.) 1.66 1.66 [Based on bearing stress below) Erg Str(psi) 565 565 DESIGN f Value Span X Group Allow LDF Ratio V`(Ibs) 4230 1 14' 10" 21 11844 100% 0.36 hl(ft-lbs) 19719 1 8'0" 21 29340 100% 0.67 Lf?n(lbs) 4930 0 0.01. 21 10382 100% 0.47 See Note#5 iitRn(lbs) 4930 0 16'0" 21 10382 100% 0.47 See Note#5 LLDefl(in.) 0.50 1 8'0" '' 21 0.53 U387 Defl(in.) 0.64 1 8'0" 21 0.80 U301 USE: GPLAM 2.0E 1.75x11.88" 3 Plies Grade selected by User G-P LAM tm Georgia-Pacific Corp. NOTES : i.Designed in accordance with National Design Specifications for Wood Construction and applicable Approvals or Research Reports. =.Provide lateral support at the bearing location nearest each end of the member. Continuous lateral support required for compression edge. 3.Loads have been input by the user and have not been verified by Georgia-Pacific Engineered Lumber Technical Services. 4.Design valid for dry use only. 5 This reaction is based on the combination of loads&duration factors that produces the highest stress ratio and may be less than maximum reaction. Therefore, when reaction values are required, use Max R'n from 'Supports'section above. 6 Bearing length based on design material;support material capacity shall be verified(by others). 7_When required by the building code,a registered design professional or building official should verify the input loads and product application. S.This engineered lumber product has been sized for residential use.A concentrated load check,per the building code,must be performed for commercial uses. R.Verify that load is applied at top or equally from both sides. 13.Nail plies together with 16d nails @ 12"o%along top and bottom edges. Nail from alternate faces, 2"from edges. 11.Company,product or brand names referenced are trademarks or registered trademarks of their respective owners. 12.Load Combinations:10=D, 20=D+ 100%,30=D+115%,40=D+125%, 50=D+133%, 60=D+ 100%+ 115%, 70=D+ 100%+125% 80=D+ 100%+ 133%, 90=D+ 100%+ 115%+ 133%/2, 100=D+ 100%+ 1155/./2+ 133%, 110=D+Commercial Ld(100%) ,3. Group=Load Combination Number+Load Pattern number.(For simple span,Load pattern=1 for LL 0 for DL). Page 1 of 1 . r XISTIh�L 11 -0 NAj nwt N&P#QCs I i y q M►ro,PLVN . a TA( OA&M Mawk POCL GDR r pjAfllt�?yy LAV Tim - LOv � W C� ► ' ` la` Nfw WINPOwS o (S�f0to Oo- �A tv 44L.t � Q T-� s VI) Ob J................................ .......- ---------------------------- ............ ................................. ------------------- ---------------------- 23'6" %-------------------------- OK .........................--------- FL ...t.....L..A.. -------------- -------------- - - -- --- - -- --- ---------------- - ---- - 7 Z ... . -- - . . -- . . . ......... - ----- I . . - ---- -- ------ .. ................................................ .. ........................ - ...... ..... .. . .. ... ...5.1 Y .. . ........... .. .......c.. r -------------- l ........ . ..... m l ......... ....... - ---- ........... ........... . ...... . L--------- -- --- -- �5 ................ ................- -------------------------- ------------ -------- --------------------- -------------------------------------------------- ---------------- ------------ --- -- ------------- ....... --------- ---- -------- ------------------------- -------------- ----------------------- ------------ -... -.--------------- --------- --------- - ----- V) •`on i, i �s z � z X O to z r 0 o � 1 1 Z g ; m r i ' � V V {00, ,x IK �Al f 12 n F V' t d y z a 13 INI It a. z c4 tea' 0pe Z Assessor's map and lot number ..... ................................ d,0,*PTHE TOE -Nwage Permit number ......................� .r. ........ ...... .. ... ...... Xllro / 21ARN9'TABLE. House number ........... .. ............................................... MAO& 039. -4 0 MAI Av` TOWN OF ; BARNSTABLE i4ty) wl�rt"/ T�) ONT14 Is c) 7-u fl, 2� BUILDING,,-, INSPECTOR ? 40APPLICATION FOR PERMIT TO ......ADD..........0.0(Z-M.4C-/t ..................6 .................... TYPEOF CONSTRUCTION .............4�!Q. j)...... ......................................................................I..... .................:`>� ............19..@< TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: , / Location .................................#uc-1<11VC......./u ............................ ....e 1).......................................... ................................................................................................................... Proposed Use ......... /4 ...................... ZoningDistrict ............... ..........................................Fire District ................. .... .............................................. Name of Owner A4... A&).......Address ...4.... ....... Name of Builder Address ... ....................... Nameof Architect ..................................................................Address ................................. .............................................. Number of Rooms ..................................................................Foundation ............../j0,0 F- ................... Exierior ............. ................................................Roofing .............. ........................ ...................... Floors .................. ....................................................Interior ............. .... ......................................... Heating . ...........g64........A(.q .......................................Plumbing ................ ....... Fireplace .................--7—.- ............. ............................. .....................Approximate Cost ................. ............ `o... � J Definitive Plan Approved by Planning Board -------------------—-----------19-------- - Area Diagram of Lot and Building with Dimensions ,Fee ...... ................. SUBJECT TO APPROVAL OF BOARD OF HEALTH 2 Z3 ,4t ; ? ID 4c� OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS .1 hereby agree to conform toi all the Wes and Regulations of the Town of Barnstable regarding the above construction. Name rn ...... % ................. ... ... ... ..... ..Construction-Supervisors License ......... LEISMAN, WILLIAM 4=233-047 No ... Permit for ....Build Addition ................................ SinglSingle Family Dwelling e................... ............................ Location ......435 Huckins Neck Road .......................................................... Centerville ............................................................................... Owner .....William. . ...L.e.ism.a.n................I............. . . .... . . ...... . .. Type of Construction F.ram.e................................ ........................................................... .................... Plot ............................ Lot ................................. March' 13, 86 Permit Granted ............................ ..........19 Date of Inspection ................... ..........19 Date Completed .................... ...................19 �:!s :21 oy'7 -%/-� /104r Assessor's map and lot number .............................................. ze) I THE yoF ---Sewage Permit number ........................�F.G SEIMC SYSTEM MUS ....... ......... INSTALM IN CMPU STAX House number ... MAM ou ...... ............................................... . TM 5 6 ENVIRONOWTAL CODE 11039- SrfOXMIELATIONS wjvtj1Ao,,f-wjaeTD TOWN OF BARN 14 in TA!S TULY /a, iqe>(o ;- B,UILDING INSPECTOR .APPLICATION FOR PERMIT TO ... ......... .................6.466ko&f....................... .............. F ...........0- .........................................................................TYPE OF' CONSTRUCTION ............:�0� .. IM .................. ........... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby ap 1* , for a permit according to the following information: Location ..................................................... .......................................... ProposedUse ............. ...................................................................................................................................... ZoningDistrict ............. ...........................................Fire District ...............C.....0.............................................. Name of Owner Ag.. xg( AA.).......Address ...4....0.4.60...../?.o........61.� .....IM .. . . . Name of Builder .5. 6..4---15. 0 PW Address —40.1.1 . .... . ............ . 4W Nameof Architect ...................................................................Address ..................................................................................... ..................... ................................ Number of Rooms ............... ........Foundation ..............X/0 4) ........... Exterior .............5.kw ................................................Roofing ...............&x7A 4.A ..... . ................................................ ....................................................Interior ................Floors ................ ......... ...................................... Heating ............./46....... ........................................Plumbing .............................. ...... Fireplace ................!7777=..................................................Approximate. Cost ......................�/...;.4......0 . Definitive Plan Approved by Planning Board -------------------------------- Area ��,�...C �`- "C.........,.. Diagram of Lot and Building with Dimensions Fee ...... ............................ SUBJECT TO APPROVAL OF BOARD OF HEALTH 1�lc Aa� 0,0 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Bar stable regarding the above construction. 6.. .........Name....... .................. .... .... Construction Supervisor's License ......................... .......... LFISM,�N, WILLIAM 29031 No Permit for ....................................Bu ildAddi t ion Single Family Dwelling . ................. ......................................................... Location .....4.35..H.u.ck.in.s...Ne.c.k..Ro.a.d............. .... . .. .... . .. Centerville .................................................................. Owner ...........W.i.1.1 i am...Lei.s.man...................... .. . . ........ ...... . ...... Type of Construction ...Frame......... I.......I............ ....................................................1............................ 3. Plot ............................ Lot ..................... .......... Permit Granted .........March...13, 19 86 Date of Inspection_ Date Completed .......... .......9z jr cc 0 0 Is 01 ri 0 M Assessors offioe (1st floor) s ? �F THE essor's ma `and lot number ... map"a M _ SEPTIC SYSTEM MUST �• of. Health�(3rd floor): r r e , ` ' • a r,, ( � .. .:�• 1ST�l�L�,E® IFd C�OI1 PUA age• Permit number f 2 TITLE 5BAHd9TdDLE, Erwineering. Department (3rd floor) i -ENVIRONMENTAL rb3 e� .� House:number ......... ........ ....... .. .'1� . �....... ?'�... .L` o eAY a� WITH r r y; EN NT . APPLICATIONS PROCESSED -8:30:'-,9:30 A.M. and 1:00=2:00 P.M.,only'• a -.TOWN iCRU Y P P4R`Q 3. .. :� A eta � N, OF BARNSTAB LE $ Astable C ;�sorvatiCn. 4a .c . { UILD*ING fHSPECTOR / igned Date APPLICATION fOR PERMIT TO' . C ,.. C... ................... �C�cf'e,^ TYPE OF,-CONSTRUCTION 1�...r �-��t..............................:. v �• .. . TO THE INSPECTOR 'OF BUILDINGS: t The undersigned hereby applies .for a permit according to the following information: Location ........... .......1. ...... 1 ................ /..` 'J.. .... ........................ r' ProposedUse ......./ .. !.. .................::........................................ ..... / :Fire District ©c 'Zoning District ....(...................... .............................................................................. -Name of Owner �6/•r j . .. /�C .� ?W ✓..........Address l...Q GGIc ....` � .... W9$1!z3 17�1......... ... rS ... .... �. Name of Builder ....(..11t.Gs.. -. � ��........Address ....��`lf ���� ( Name of Architect ....:............ ....Address Foundation ...,.W,6c& Number of Rooms ..:....... ..................................................... ........... . ......................:. ���... ............................... ... Exterior ...... ................Roofin .......... . Floors ........ ........................................................Interior ........... ../CC�e . . _ •Heating_ ........G.IG!:.d.� '...............................................Plumbing�•......��Et! ................. ...............�.... ..... / � 1 . F Fireplace ...../V ...................................................................Approximate Cost .......1��! O .i . d.by Planning Board'-- ________ . A Definitive Plan Approve rea Diagram of Lot and Building with Dimensions Fee � .� SUBJECT TO APPROVAL OF BOARD OF HEALTH. ry . - �` --- N. OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above -. construction. Name ............. .:. ..............Afto ... ' Construction Supervisor's License '�-� [.. ....1.. ,�q. � ,WILLIA ENC OSE BREEZEWAY � y No 2...... Permit forte'. ... .;-v. ................... : YSingle Family Dwelling... 435 HucknsNec1e Road Location ... .. .g. ................. S; Centerville �' ,' ✓ , '� �3 ? ...........�. �. .......,.......................... Owner: William Lesman y ' Ftame �. _ Type of Construction ........ ...` ' r . r ....ti........... .i .............................• .... .. .. ,........ ........... Plot .......................... Lot`................................ t t t October 31, 86 Permit Granted .....1•9 Date of Inspection .....................................19 n �- Date Completed ......................... .......19 ' r ,' s�,,, ' ra `1J - ... " f� �/. A 1 � - n . ~�\ /`•1 . t x • a , T Vi it Ira dc Assessor's offioe (1st floor): ' Assessor's map and lot number .. ,.. . o THE>o r$oard of Health (3rd floor): Sewage Permit number ...........5O (`1��.................... t Z BARNSTLELE. i Engineering Department (3rd floor): C �o VAea S' � L` F' O i639. House number , APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only i TOWN OF BARNSTABLE , ,BUILDING INSPECTOR u APPLICATION FOR PERMIT TO ¢-- r/ o�{'�-a.fib_ TYPEOF CONSTRUCTION ...... :............................................................................................ ................ ��.....------......,9.._ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ........'Y.;���.s"........./.. U� lx'//1/� /V.e /�...../�� �rf(/J /CU�.... .............. .... .................. ....................................... ProposedUse ......./�.(..0—P.,................................. .................................................................................................. ZoningDistrict ....................+ .. ....!......................................Fire District .............................................................................. Name of Owner .( .�.l.�l l!�!..... F.� � 7W�±-✓ .1...Address ........ .�f2CGfc...... A Wfz'-..1 i✓ Name of Builder ....(...(.{CJ� e1 .. 7...�f 1 ?/64/L........Address ......C ..................� Nameof Architect .............. ...............................................Address ............. ..................................................................... Num .[ber of Rooms ..........J.....................................................Foundation .........� ....................................................... Exterior 5'!Ix .../............': ...Roofing .....41�1*......................................................... f.>.?.��) Floors ........................................................Interior / ..a✓u ( l { Heating .. ..................Plumbing l...... .......................................... Fireplace �O ........................................Approximate Cost ......- `-�.:.� .'%'`^c........... Definitive Plan Approved by Planning Board ________________________________19________ . Area x .. ...� f Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH �w a v r- ti 0 r 5-6 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above 4 construction. Name ...............�.f? ..... ..................................... Construction Supervisor's License / ....!............ LEISMAN, WILLIAM A=233-47 a .ti 30122 ENCLOSE BREEZEWAY No ................. Permit for .................................... Single Family Dwelling .......................................................................... Location 435 Huckins Neck Road ................................................................ Centerville ............................................................................... Owner Willism Leisman .................................................................. Type of Construction ...,...Frame ............................................................................... Plot ............................ Lot ................................ f October 31, 86 Permit Granted ........................................19 Date of Inspection ....................................19 1 Date Completed ........................................19 { V V To - T i I ®t ?off T W04 /tol f�i^ 15 AN- S qAk 7,<- �6' rljks V title. Q010a ��l �� ®2- VU 1f 4A► i N � � � �� �i � III Assessor's map and lot number ...c�Z3 3 .................... .................. *THE moo toy "'Sewage number ............:......... -SEPTIC SYSTEM MUST BE INSTA umbe.r ............. .......... LLED IN T�E�PL6,ANCE I L House ni .. ........ ..... ................. WITH TL 39- EN , rasa VMONIVIENTAL CODE AkQ Op TOWN OF . jBARNSTAB- OX)Pj_,6r TO APPi'OVAL Or ; , SAMSTABLE CONSERVATICIM z. COMMISSION BUILDING INSPECTOR ' APPLICATION FOR PERMIT TO 4..............4..............................................................;e........� ........... 9:9 TYPE OF CONSTRUCTION ..... ...... ..................... ........ ................ ............................... TO THE INSPECTOR OF BUiLbINGS: The undersigned hereby applies for a permit,according to the following information: Location................ ...........o............ .............6.........✓I .. ...... ...... ProposedUse ................. .................................... ..................................................................... ...... ZoningDistrict. ........................ ................................................Fire District ....................................................................... ter; JX Name of Owner ..P45.7 ..... ................Address. .......................'.6............................ ................... 00� ....... ..... Name of Builder' .*0 ............Address .... .........../45-1 .... Name of Architect ..........................Address .... ........... ......................... Numberof Rooms ..................................................................Foundation ..................................................................... . ....... Exterior ...4:��4; .... iV ..........Roofing ......... . ......................................I............ Floors ......... ....... ..........................Interior ......f:�.t....... ............................................... .................................... Heating . ................................................... .............................:.Plumbing .................................................................................. Fireplace ... . . . . ..... .................. . ........ApproximatI e Cost ... .... ........ . .... .. . . Definitive Plan Approved by Planning Board ----------—--—--—----------- Area 4 ........ .... nd Building with Dimensions ..... ........ .........Diagram of Lot a Fee SUBJECT-TO APPROVAL OF -BOARD OF HEALTH 1k A /71F OCCUPANCY PERMITS,REQUIRED FOR NEW DWELLINGS I hereby agree to conform-to all the Rules and Regulations of the Town of,Bornstable regarding the above construction. Name ..................... ......................................................... MIL:�ER, D. A. A �43781- Build Garage ILI,,E 7 'M I 4P No ................. Permit for .................................... Single Family Dwelling .. ................................................................. ............. � Road Location 435 Huckins Neck........................................... .................... Centerville .................... .......................................................... D. A Owner .....................................-. Miller............................. Type. of Construction Frame........................................ ................................................................................ .........Plot !n.. Lot ................................ 'Ile ....... ....... Permit Granted ... ...........?.j982 Date of lnspection .'k,.012.?.//?./19�ll,-Z-iI 9 Date Completed -//-,:'J.........*....... 19 441, 41 41 At Assessor's map and lot number / *THE T0� Aiewage Permit number ...................... ........ d� ♦� House number .............. ................. 04)............ 'BAsasrsnLs, ,� � 639 9� TOWN OF , BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..... ........... ........... TYPE OF CONSTRUCTION ...........d .,lam � �/ �Q'� .. . ... .. :°•.. ............. .... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: �F Location ..........:.... b..�o�l�......... .:S.........: !.�:!rZ-�.... .....� ProposedUse // v �--` '�d,.C� ......................................... .... ...... ........................... ........... t Zoning District ..........: ............................. .Fire District. . .. ....... /......................... Name of Owner : .✓ ....... %j''> -.,_...,...............Address .........`..................................... .... � Name of Builder' . �.�.�`-�`�.. ,( 1..'.✓. � !�.�. Address �`s�... �sa�°' �.,d,�i�s?v7�i+°.� Name of Architect s--�........ ...........Address .....................................f-� ........................................... Number of Rooms .....:......:......................................... ........Foundation . ... � � Exterior ...4/�4�... ...........Roofing .. ��"�.... :... Floors ....Interior .....' �..... •'� ........ .. ,. Heating ..................................................................................Plumbing .................................................................................. Fireplace ................................................................. ............Approximate Cost .......................................................................... ..... �- Definitive Plan Approved by Planning Board --------------_----____ � 1 ......A - ------19 ------. Area .. ....... ....` ,j........... Diagram of Lot and Building with Dimensions Fee SUBJECT TO'APPROVAL OF BOARD OF HEALTH r y� s • P � OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS t � i r I.hereby agree to conform to all the Rules and Regu lotions of the Town of Barnstable regarding the above construction. Name ................................................. ` 'I MILLER, D. A. A=233-47 Z4378 Build Garage No ................. Permit for .................................... Single Family Dwelling ............................................................................... 435 Huckins Neck Road Location ................................................................ Centerville ............................................................................... Owner .. D. A. Miller .............................................................. Type of Construction .......................................... ............................................................................... Plot '........... Lot ' Sept. 16, 82 , Permit Granted ........................................19 Date of Inspection .......19 Date Completed ......................................19 , t A r V e j i - L . 1 a is A z jai: :Cwfi59. !ar 1 f Alt , A { 1 z � n x s c � I w i Iry a � o u ' 3 ir i I-P `N c P IS Ila, ob Z o t-71 o p � _ Z ,