Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0547 SHOOTFLYING HILL RD
'�%' ( } b {- � N Y 'S r T " Y t ; .I f ,..K �t +_N., r. .0 _.V' [ elir7l iTN'i4 tom. �'£�} + Fitl��y, ��y+{� fll.T'flC YfIJ+*v: rS'++3�CaLSiZs. %r °'t ip i(�"at�t°�g f c t f'1 , n ii r ( a { Vt f M a .' 1i Y i� ,{ U -:1: -�: Poly + o.'..t.+' > I, d. , : '�b ` a' >' m ! x , r v � q. T, 4 9 ,x-,'! as ff• "'r ,r ,a�. it d y -„` 11'• „;tE +a.+. k�' \ Ft°' 'Ni "1:` r' .i t i.1 "E ,t ''%' .P'q- �;7 ,, ,_,r .Yt .4. P r .i ^ a r, "_:., f P .. ,t ;:1, rrlit�' `a '+ ,,It h %,' 4 N+°,,:. Y d ^v wpp 1,3f ,q, a. �.h= A :n "r H 9J d'.' ad ,a� � :i y1t �° B• 4. 'a ; q y1 1 h�: °'1 T' N `'fir+ 4 '", a d!, '.n N r, sr, ,..�K� 1 ; .„'i �, ,,11 .. , . \, a �' t +�� ;., , ,.r 31 g ;;� ,.y,, a P V r F "W. *rkY. t,. ''.TI` L t �t,',f tt �''� m aF, 4 yrt e r" m .% a a ,., +'Y d r .4 r M r fl.^ Y' r { ,t�' '-c 7. �' f r. 4Y.0 n •m:� ' t % `!1,^ .V{. `v� 'S' a s, %: �' M ° 6�+ 1 t,V` o, W ! k Y' ! q o ,'A ,J t 4 p "h i P+ M A `A 4'� i 4 f, I '.'r vt.. N` �' '�4. L Y i'yy,, aft' ''L "R .r '9;�' �, +}' ,�:�. ,r it # n, ' .A, roC `' .' M: QN+ y%'* t ;. 1 'f i V r� 9 11 �y,, �, 'Ytc U. , as,ip t t,. t a. .+ 1� a M'. ,v•Q 'N fir to a & v e a k 0 4 Y! w ,;m, r: M u +' 4 1 ,6 ,r 1 - 1 1q ib �I fe J... - a A. �. d5� i:: YI t,y.. % t � y. M a• Wy.• e 'n r( ss+ '.Yrmt" +� 9 o. �'t.. � n t �! yy i 1, y„ '1. ;f F a' P, 'A" ,�, tk Y., O ''1 k' rt Y'.f ':'O ... 4 p .a.` i t t Pt a t f l}` .ay a 0 r d .a, a' ,:� �b a, .5 .? %± >i ,V t1 r �m' t. �f^ <. 1 IH, Y u (.. .t. 5ti'�w 4� .d tr a e P.: al ��'L. 4' +y(� .�_JZ;... "..`r.., �••--,,,,� ^+ a�".'.' -. .,,.:p';aFyr.r-- ..+t•.—•••,T•.r- ..p,�+r- v+_^„'P'=„�C-+F'n'_..,..`=:.._ ;:vv B 1, t� �'.:1 f. •tl V^ y $ p .�[� d ' 1 'i'-' r1i �[ r 7 % , , {4 .f� , Q .; `..k s, 2 U t� , V' ff - pp `Y x e g t `:^VY •V .` r k, .r .rl Y ,Ir t,d 1 u'f �' i'. P:. ,rT'F t 'A i. �:'' d k t' V N.'< tL °ara + u f+ a a , 3 } Y ° ; c t.,f v i, `>h r 49 1#t a e' $• ill a` n P. ,Fi, ftaw a,o., �� P:","+9 - , ; ' r, 4 r; V A %� n "r�r A 1, ,Y 'd ast Y ri .i 'w a ,, 6 ) it f P Y b .A I; � 'h' u w. ..• r r. - rA'. ' ti „ . ^ . N D ` k f yy ,,y A` P. y P� r _ 8 e 'P iA�.tt. j- r s gyp. '� .%+.. b A % � d"tit,`:' P ° :"+ •\^ra .1 Jam. P, �.,•,, �', �. n {- x u,, '. '. is .,rr " i % t' a + a' �t s x r i t yrr„ t .1 '`4, a 1 ," `b i 7' 'I r, .'l ''a'"`,a n 1` i.a i Y �f Y+ ;(�:o .{•• a. :'�' F ,'dip,'' " '.v,M 4" 'Q' n lr sF e ,' # hi 4 t y �,' 4, R +� x 'r v a 'f`u w rt h.. ! It... ,A Yi ,.Ir. '`� Via,, J C ,� :ngtPv1{ *s r,yA,',�,,; uy`' 1{e': I Y.. S, a t t" r t ',w'f,.:. 'C..., $ IY'- �.l �" '. w ` ,.n , ff� r {rd f '' 's Yy �ri .R 4',. aIx ,� :'t' b. +a .,,, ,n.:a q ,1 , It +3 4 t" .I a t� ! �a ,l a _ ii 'it"' d K` '#tl, 'n' r u 1 a .} n q. f' a N d .. 4 D b` ;1 , ,. .,. i ,. .,,:;,,,, .". ., ,da.. ,:_. ! ..t.. ., ,.,._:'.,. .r .,:„ a,r�,..».:! .xr._._..,:,� .. ,... ° ,. ....,�,.,. .. ,......r r.�_.e,_.._ ....�s._� ,„S.� ..,. _ ..., . , ..,�,$'r�c..,.. ... ._ x, Kr ----- , . Town of Barnstable Building � •x <- ,�� fig, r� � E t Post�Ttiis CardSo That rt is�V;is�ble-From Lhe:Street-,ApproYed Pians Must be;;Retamed on Job and?this Card Must:b'e�Kept �• , * BARATB['ABLB. "' ':�� ,, gar. � .: "" s s""'• ''..: ��. �. .; ;_i '', i. � ,�. � ;,''.. �,x � � � a� �': '�`.� �;',. ._ r � Posted Until Final Inspection Has been Made � � 3° � � ��, � � , • ° Where a Certificate of0ccu anc r Re u�red such;Build�n ,"shall Notbe Oceu iedwuntit�•a.,Ftnallnspectionhas been,made �� 1111 Permit NO. B-19-932 Applicant Name: FABULOUS HOME IMPROVEMENT INC Approvals Date Issued: 04/26/2019 Current Use: Structure Permit Type: Building-Addition/Alteration-Residential Expiration Date: 10/26/2019 Foundation: Location: 547 SHOOTFLYING HILL RD,CENTERVILLE Map/Lot. 193-025 Zoning District: RD-1 Sheathing: F,' f> Owner on Record: ROGERS,DONNA Contractor Name ,FABULOUS HOME Framing: 1 AF sIMPROVEMENT INC Address: 65 SCUDDER BAY COURT �• ., - . Contractor License; 172023 CENTERVILLE, MA 02632 � � �k Chimney: Description: Remodel and Alter Stucture in accordance with plans dated EstProlect Cost: $ 17,000.00 t� Insulation: 3/19 2019 attached. (siding). y Permit Fee: 171.70 / ` $ �� g Final: l FedPaid: $ 171.70 4/26/2019 Change of Contractor from Fabulous HomeyId Improvements. � � s� �4,Date 4/26/2019 Plumbing/Gas 4/26/2019 Homeowner is acting as GC. � A Rough Plumbing: Project Review Req: NO WORKERS COMP SUBMITTED FOR APPLICANT PROPERTY OWNER AUTHORIZATION FOR APPLICANT.SMOKE Final Plumbing: g„ Building Official DETECTORS SHOWN ON PLAN-IS THIS AN.aUPGRADE , .. Rough Gas: This permit shall be deemed abandoned and invalid unless the work authorize"his permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved applicationland thelapproved construction documents forAwhich t ;s permit has been granted. Final Gas: a . . All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by laws'rid codes. r This permit shall be displayed in a location clearly visible from access street or road land shall be maintained open'for public inspection for the entire duration of the, .Electrical work until the completion of the same. ' r Service: The Certificate of Occupancy will not be issued until all applicable signatures�bythe Building andF ri e®ff aIs are prow d�eil on this permit. Minimum of Five Call Inspections Required for All Construction Work: Rough: 1.Foundation or Footing Final: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Low Voltage Rough: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.PrAor to Covering Structural Members(Frame Inspection) Low Voltage Final: 6.In'-sMation 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Final: Work shall not proceed until the Inspector has approved the various stages of construction. Fire Department "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 All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT �INE r, s 4�' O Application Number... .`..�... ...... . �T s * BARNSTABM s MAS& Permit Fee.......................................other Fee........................ 039. Total Fee Paid............... 43b................................ ...... TOWN OF BARNSTABLE Permit Approval b on...................... BUILDING PERMIT Map. ......L . ....................Parcel........... . ................. APPLICATION Section 1 — Owner's Information and Project Location Project Address � 4-7 5hoo-I- RqIvLq H d I 1 `J Village Ban) e- ;�.Owners Name ®It1 y\-0. V 1 S �� r u i C) fir' He J ` X Owners Legal Address 8 x City. Oev)-�r U i I I'f X State U V -zipD,( 3� Owners Cell# -7? ) • f. 7 E-mail d0 Y) r1 a &Sk!QY)re-Soqrce-s.us.coKj Section 2 —Use of Structure I Use Group ❑ Commercial Structure ovS@ ,000,cu c fee s �> ( ❑ C ercial Structure und6 15,000 cic f ! Single/Two Family Dwellin Section 3—Type of Permit F ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure Chang&f us- El Demo/(entire structure) ❑ Finish Easement ❑ Family/Amnesty ❑ Fire Alarm ` Rebuild ❑ Deck Apartment ❑ Sprinkler System ❑ Addition ❑ Retaining wall ❑ . Solar x ��Renovation Pool ElInsulation i Other-Specify. RkV,-,A-'-i Y-k I C 4, --Section 4 - Work Description . a f vha . 1 + Ct 1 4C r S cA-u r e 'I h &cc-0 r-doh u- o 1 a h s do4t d j q a cited. 5► &Ih Last undated: 11/15/2018 Application Number...................................................... Section 5-Detail Cost of Proposed Construction /-7 K Square Footage of Project /00 0 W rax. Age of Structure 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 t r [Wiring ❑ Oil Tank Storage ❑ Smoke'Detectors lumbing ❑ Gas ❑ Fire Suppression 12 g Y �' Y Heatin System t L2l Maso ' ` Chimney' f t ❑Add/relocate bedroom Water Supply Public ❑ Private,' Sewage Disposal ❑1 Municipal YOn Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: J U w►) Of I am using a crane ❑ Yes t�No . '. Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland,coastal bank? . Yes 0 . No Section 8—Zoning Information Zoning District 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 l El. No 3 Last updated. 11/15/2018 Lauzon, Jeffrey From: Lauzon,Jeffrey Sent: Wednesday, April 24, 2019 8:32 AM To: 'FABULOUSHI2014@GMAIL.COM' Cc: Lauzon, Jeffrey Subject: ViewPermit, Permit No: TB-19-932 Applicant, Please b advised that the above application has been reviewed and the following is noted: o property owner authorization for applicant has been submitted. ^-_72) No worker compensation submitted for applicant. Exact scope of work unclear. tA?' Engineering requires an original signature and wet stamp. The application is denied pending the submission of the required documents. And, if aggrieved by this notice;you may file a Notice of Appeal (specifying the grounds thereof)with the State Building Appeals Board within forty-five (45) days of the receipt of this notice. Respectfully, Jeffrey Lauzon Chief Local Inspector (508) 862-4034 jeffrev.lauzon(dtown.barnstable.ma.us A 1 r .. 'u} u, �'f.�1 REMOVE CHIMNEY O O rETim ® ® ; .. ® ® REMOVE WINDOW V J V 10 _ U J 0 O SECOND FLOOR --- - - 0 uy 0 0 . : ®®® - _ REMOVE WINDOW I-. M . REMOVE WINDOW nn FIR5TFLOOR ---- ----- — — ———————— — ——————— O N REMOVE DOOR m m I EXISTING REAR ELEVATION r--y Z-I-_-------- ----"1 L_--_, .SCALE: I/4°=1'-O":. p (3)2x8 ' I I IYI 1�1 I r----I - I Ivl lol O I INl I Q_ I I 1 I (3)2X8 I - LEI' 1 ^ I I I FULL BA5EMENT O _� 1-1- v I I I I CRAWL 5PACE -Z �' lol I I N O REMOVE CHIMNEY �j O Irol I I s K 1,GV. .7 INI I I if) L cn LI—1TII JI—II--- ——6"—x 8—"B—EA_MLJ �__-_---_— X �L�n �f o „ 7I3 EXISTING FOUNDATION PLAN 5CALE: 1/4'=I-O p j.1I ..y`7.' I I I LEGEND 05 'G wo 7 z 8O f 61 UG a EXI5TING L TO AI - { - - I I I I ELECTRIC PANEL CONCRETE BLOCK WALL ®_� M OE OI I I I CONCRETE WALL UP uj O � - -^ lD O U x _ IL DECK Q O GA5 METER ru C) BATH H h BEDROOM p2 DINING KITCHEN .. N ✓ CLOSET - - O DN LIVING ROOM- - BEDROOM N i _ O41 REMOVE CHIMNEY '+ T-G 1/2°- LLB CL05e U OF ® ® � SECOND FLOOR -------------,--------- --———- - N ,� EXISTING FIRST FLOOR PLAN ® ® ® ® ® ® L SCALE:1/4°=I-O' LEGEND - REMOVE WINDOW W 0-U15TING WALL TO REMAIN - _REMOVE WINDOW———_ ___ __FIRST FLOOR_ ®-EXISTING WALL TO BE REMOVED ——————- Al 0 EXI5TING LEFT SIDE ELEVATION - - 5CALe:1/4'=I-O" 75 N O 1 '. u^' CO- BEDROOM#3-- - BATH#2 BEDROOM#4 Q 3� 6 I m U 1 O maI a I ovo°o�------o o --------oRo --- U _x -,iDN � d I � Q o I I I .: a _L J 3'-1 I Fi1G'1 KNEE WALL - REMOVE CHIMNEY - O 2'-�0"11GH.IEE WALL N c0 v secON�FLODR___ EXI5TING SECOND FLOOR PLAN --------------- ---- ._ SCALE: 1/4'=P-0' LEGEND m® O-EXISTING WALL TO REMAIN ®-EX15TING WALL TO BE REMOVED FIRST FLOOR f s_ EXISTING RIGHT SIDE ELEVATION U - 5CALE:1/4'=I'-0". - REMOVE CHIMNEY _ V) L L _ ® N c � ` r REMOVE WINDOW "' REMOVE DOOR REMOVE WINDOW — 4 O _SECOND FLOOR . _ L Ln .. ®� D4 FIR5T FLOOR EXISTING FRONT ELEVATION 5CALE: 1/4'=P-O" a CUDLLO No.34774 STnUCTUIIAL 51MP50N 5TRONGTIE FJA 3/29/19STRUCT.ONLY Q @ M L� --------------- --- o ®' r-i-r- r----- - i d m I I I i (3)2x8 I Q p °- �® I I ICI I I N I EXIST.DECK,NO - I FRAMING WORK - I I IWI I o % I lol I N a. --————-- _! I INI I m e a I I I (3)2x8 I 4 16 ZA mmm 0o0m0 mm mm� ADD SIMPSON FJA @ 4'-0; I I I I ADD FULL LENGTH ALL AROUND FOUNDATION X N i I i I 2x8 @ I G"O.C. f I I I LL. N O I I I I I ADD 3�°LALLY @ INFILL OF N.. +}4'-8"CM I MA5ONKY BASE OVER O EXI5TING BA5E FOOTING -AURENgCD} L ABPNN- ETf E O IIIII I I Iq o � L N ADD 1 3/4`x 7 III T�p-�g 18 ADD 1 3/4'x 7�I/T R/L ADD 3 Y LALLY BELOW NEW r 4--`-' i-- - -x - LVL 5TUD5 @ 2ND FLOOR: "�-� - EXIST.6°x8°BEAM -t-- --- ITT.Gx-5-ESE y.- NEW FTG.2'x2'x10"A5 U ADD BLOCKING TO$TUD5 L j -- NECESSARY @ LVL ABOVE T-1C4 T-I 14' 4'-1 I4' EXIST.COLUMN EX15T.COLUMN EXI5TING CRAWL SPACE73 Y - FX15TING FULL BA5EMEN7 - c P.T.-2x6 LEDGER W12 O ADD SIMPSON FJA @ 4'-0"; tEDGERLOK PER l 6°BAY O ALL AROUND FOUNDATION CONCRETE BLOCK WALL - CONCRETE WALL UP - (4)5IMP50N DTT 12 NEW DECK ABOVE I 1 P.T.2x6 DECK JOISTS @ I G"O.C. PROP05ED FOUNDATION PLAN I �� I -- -- 1 2"DIA.PIER W/51MP50N 5CALE:1/4'=I'-o^ A5U46T0(3)2x6 P.T.BEAM. � LEGEND B - 0-EX15TING WALL TO REMAIN A 6 I 7'-8" I 7-8" 1 (3)2x6 P.T. Al ® NEW WALL 25'_0" 16'r0` A 40'_10" A-6 FI - - p` MICXELF. � rl• � �.. z cuoao 1> -{� CD cV srnucrurn�I�` J O - _ - 3129/19 STRUCT.ONLY - 0 O U c x 0 .. : .. _ EXISTING PT.DECK TO BE REPAINTED• - - 0 0 GA5 METER O B Q � 2 O - O OI ow zEr. O ni cT) NEW a KITCHEN - 00 ISTING EXI5TNG BEDROOM#2NEW o p 00 DIN N �^ ATM#1 N I V - 15w. 4'-0" _ —_----- N DN NEW(4)1 3/4 x 11 71F' VL(+/-2 1'-0) GANGED 5TUD5 EQUAL TO BEAM - - EXTEND BEAM TO FOUNDATION WALL r— Q EXI5TING BEDROOM#I EXI5TING LIVING ROOM. . 11 > N -n n - L .Ybl C lZ CLOSET UP U .. .NEW DECK .. .. V V = G'x I G-0" c 6 c (� m >+ B A-6 _ GENERAL NOTES , p A -THE CONTRACTOR SHALL VERIFY ALL DIMENSIONS AND EXISTING CONDITIONS PRIOR TO THE 5TART.OF WORK.NOTIFY OF ANY SIGNIFICANT CHANGE5.IN 'A-G DIMENSIONS OR CONDITIONS. 5'-72 9'-I O" 5'-3" 7'-10 4' 7-10 y' -CONTRACTOR TO VERIFY ALL INTERIOR AND EXTERIORMATERIAL5,DETAIL5, AND FIN15HE5 IN THE FIELD.WITH OWNER. 25'-0" 1 G'-O" .-THE CONTRACTOR SHALL PROTECT THE FACILITY FROM WEATHER AND MAINTAIN 5ECURITY DURING ALL CONSTRUCTION WORK. THE OWNER WILL BE RESPONSIBLE FOR ALL A5PECT5 OF THE PLAN AND FOR ANY PROPOS ED FI K5T FLOOR PLAN CHANGES TO THE PLANS AND CHANGES DURING CON5TRUCTION. - THE OWNER IS RESPONSIBLE FOR OBTAINING ALL TOWN PERMITS AND BOARD 5CALe: 1/4'-1-O" SIGN OFF5 TO 5TAKT CON5TRUCTIOW LEGEND - -THE 5TRUCTURAL ENGINEER AND OWNER WILL BE RE5PON5113LE FOR ALL A5PECT5 OF, -0-EXISTING WALL TO REMAIN THE PLAN AND FOR ANY CHANGE5 TO THE PLANS AND CHANGE5DURING CON5TRUCTION. ®-NEW WALL - - - .. 4 Iz' b'-104' 4' 12In .. A_G .. l9 .. - N O O �Co Co.o C4.4er _ NEW WINDOW to `> 310 O 13ATHI#2 EX15TING BEDROOM#4 - - 0 EXISTING BEDROOM#3 �— - Fk� to __________ _ o RIDGE - - ---o --- -0 ------ - a aREU5E EXISTING INTERIOR"DOOR5 e e DN NEW NEW -• CL05ET rCLOSET - .. CC). ttjl� NEW NEW EXIS'ING 3'-:1•NIGH'N.WALL N - : - - - OO - CLOSET CLOSET CL05ET co 2-:O'hirh rNEE WALL - - N L m 3,9 9'_I 3'-9" 3-11. 7-1' 3 I1 O O A 251 00 A G 10-O" - - - EXISTING DIMENSION EXISTING DIMENSION j 41 PROPOSED SECOND FLOOR PLAN O v SCALE: 1/4'=V-0' V J LEGEND - 0 EXISTING WALL TO REMAIN. •®-NEW WALL -----------= 5ECONDI'LOOR_ - +. FIR5T FLOOR _ ---------__-I------------ ------- 17 PROPOSED LEFT SIDE ELEVATION SCALE:1/4"=1'-0' - o � ,NEW OPEN SECOND FLOOR p r--------� I I I I I U xs I I I I I I I I I Qo NEW OPENING5,TYP. --- - I 1 - FIRST RST FLOOR ----- ----`--------- _---wr ----- - --- ------ - O N m PROPOSED FRONT ELEVATION of -. SCALE: 1/4'=1-O° N .0 Q SECOND FLOOR N 2 FIRS ---T FLOOR- - L ---- ------------- PROPOSED RIGHT 51DE ELEVATION SCALE: 1/4"=1'-0' 73 - r------------- --'� ' y nmNEW OPENING5 TYP CD >, a III O I o - SECOND FLOOR --- �F----------------- i- - I NEW OPENINGS TYP. I \ / II F 2 2 O O ' . FIRST FLOOR---- ---- ( ----11-----1-L' -- I- - . ' B PROP05ED REAR ELEVATION SCALE: 1/41=1 b° - s, 12 - MICMELE t?, O In .. rio. 34774 STNIICTUICTUV L 75 N D C) _ . 4-1 < w (� ih z - 3 '_G g w - _. _ 3/291195TRUCT.ONLY �- OEX15TING BEDROOM#4 - Q O ti - EXISTING 2xG FLOOR 1019 - U x p X: ADD ILC XKING Nd' _ Q C) .. _ EX15TING 9R5T FLOOR . P.T.2xG LEDGER W12 _ EXISTING x8 FLOOR JOISTS U! GERLOK PER I G"BAY V.LF.-3/ PLYWOOD (4)SIMP50N DTTIZ - - P.T.2xG DECK JOISTS @ I G"O.G. O (3)2xG P.T. O w N ADD BLOCKING @ BEARING m EX15TING CRAWL SPACE ADD 51MP50N FJA @ 4'-0"; ALL AROUND FOUNDATION 12°DIA.PIER W/51MP50N 24'-O" 5'-9° ABU4G TO(3)2xG P.T.BEAM '^ V/ EXISTING DIMENSION NEW DECK A A CROSS SECTION @ BEDROOM #4 O O SCALE:J11=_I'-O° nU\ N EXISTING 2xG RAFTERS W O G O NEW(4)13/4"x 1 1 7/8"1 VL x 2 f'- '� _ GANGED STUDS EQUAL T BEAM iN NEW DINING ROOM EXISTING LIVING ROOM WINDOW 5CHEDULE # , w 12'-4' - 12'-I' ID MANUF. UNIT TYPE UNIT 51ZE wxmHEADER- KING JACK EXISTING 2x8.FLOOR J I5T5 I V 75 q OA ULIABILTBY 5ERIE5: AWNING 3G"XIG" - (2)2xG 'I I - - W � ATRIUM 755 AWNING ADD BLOCKING © - FRENCH CASEMENT 48°X 30' (2)2x8 2 1 ADD 1 3/4"x 7 114"LVL FULL LENGTH ... .. - -- -1N _ O @ JELD-WEN CASEMENTS - 94 1/2" X 47 112' (2)2x 10 3 2. ADD 51MP50N FJA @ 4'-0"; j OD RELIABILT BY SEWES:- DOUBLE HUNG 38.I/2" X 40 1/2" (2)2xG -I I ALL AROUND FOUNDATION - - - O ATRIUM. 4GO WITHOUT J EXISTING BASEMENT L� EXTERIOR DOOR 5ChEDULE # EXISTING Gx5WICO[25@; ID MANUF. UNIT TYPE UNIT 517E HEADER KING JACK 12'-Ib2 10'-92 3.I I"O.E. EX15TI LALLY W x H 3.5"DIA.@ EXISTING STAIR MA50NITE ENTRY DOOR G4 112' X 81 112" ((3)2x8 3 1 E NEW/EXISTING FTG. @ (2)2x10OR 3 2 25'-0" 2'x2'x10°(V.LFJ Ln (2)13/4"x5 112"LVL 3 O EXISTING DIMENSION INSWING PATIO DOOR 72" X 80" (2)2x 10 OR 3 2, -- (2)I 3/4"x5 1/2"LVL 3 1 CROSS.SECTION @ ThE ENTRANCE - BB SCALE:114°=I'-0' Coyle, Brenda From: Donna Rogers<donna@design resources.us.com>` Sent: Thursday, May 09, 2019 2:05 PM To: Coyle, Brenda Cc: donna@designresources.us.com;donna@designresources.us.com Subject: RE: Workers Comp. Certificate r Importance: High �. . Hi Brenda I've reached out to the 'new contractor'which,I hired, but now he's telling me he can't get to the project until late July/August. With that said, I'm in the midst of trying to find a "new contractor"for the job. I will be in touch just as soon as I have any information which fingers crossed will.be,next week. Thanks Donna Donna M. Rogers Arts Award Recipient l _ C 781.361.2741 W+ ► F 866.300.9156 rrc From:Coyle, Brenda <Brenda.Coyle@town.barnstable.ma.us> Sent:Wednesday, May 8, 2019 11:06 AM , To:donna@designresources.us.com W Subject:Workers Comp.Certificate r Hi Donna, I still have not received your workers comp certificate for the contactor you're going to hire. Please give me a call as I am still holding your building permit waiting for this information. Thank you, Zenda G.yYY µ Permit Tech.. Town of Barnstable Building Department Ph: 508-862-4039 Fax: 508-790-6230 1 ROYTOLL-01 DEATON ACOROA DATE(MM/DDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 5/13/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER CRNTACT N ME: Rogers&Gray Insurance Agency,Inc. PHONE FAX 434 Rte 134 (A/C,No,EXt):(800)553-1801 (ac,No):(877)816-2156 South Dennis,MA 02660 Ao RIEs ,mail@rogersgray.com INSURERS)AFFORDING COVERAGE NAIC# INSURER A:Main Street America Assurance Company 29939 INSURED INSURER B:SafetyIndennnily Insurance Company 33618 Roy Tolliver DBA Roy Tolliver Construction INSURER C:Associated Employers Insurance Company 11104 P.O.BOX 396 INSURER D: ' Marstons Mills,MA 02648 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE ❑X OCCUR MPT7966Q 1/3/2019 1/3/2020 DAMAGETORENTETD SOO,000 PREMI E Ea occu e c $ MED EXP(Any oneperson) 10,000 + PERSONAL&ADV INJURY $ 1,1000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERA!;LA GREGATE $ 2'000,000 X POLICY JECT LOC PRODLIG COMP/OPAGG 2,000;000 OTHER: ° $ B AUTOMOBILE LIABILITY - COM e I NGLE LIMIT $ - 1,000 000 ANY AUTO 6234369' 7/31/2018 7/31/2019 BODILY% Y Per person OWNED Ix SCHEDULED AUTEOSONLY AUTOSpS BRODILYINJU"Y Per accidentXAUTOS ONLY AUOTOS ONLB PPe�acEcRfdent MAGE UMBRELLA LIAR OCCUR I EACH OCCUR ENCE $; EXCESS LIAB CLAIMS-MADE AGGREGATE DED RETENTION$ C WORKERS COMPENSATION X PTA TE O EFR ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $TH- AND EMPLOYERS'LIABILITY YIN WCC-500.5019790-2019A 1/23/2019 11231202O 100,000 OFFICER/MEMBER EXCLUDED? ❑N N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 It yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) "PLEASE NOTE THAT THE WORKERS COMPENSATION CERTIFICATE WILL FOLLOW SHORTLY UNDER SEPARATE COVER,AS IT IS BEING ISSUED DIRECTLY BY THE INSURANCE COMPANY* CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Design ReSOUrC@S THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 9 ACCORDANCE WITH THE POLICY PROVISIONS. c/o Donna Rogers '65 Scudder Bay Circle Centerville,MA 02632 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. /r O „Calq I I I � The ACORD name and logo are registered marks of ACORD F , YuseEsar� nt of'Public Safety. Bo � �i-l8tions.a6d Stan aards �r dion Pe, U M0U !�°' 3` Expiration: Commissroner.�� � f�. 1y22l2019 ..X � .,� � /F7/IJ7fI.+32lpPlf�lH t��.+y/-lQ.1J�7C�fJx��. •( .� �. �.l4iTllrS BL BuSfOlss•.e6 MT,CONTRACTOR ! Type: Supplement Card , r e I S"p+tioLpc , l � a i Application Number..................... Section 9—.Constriction Supervisor Name T Telephone Number : J60 Address o�ZZ SMI jt 57— City�f A- State �- -Tp License Numb License Type S Expiration Contractors Email@Ce # J�1 tA�5 ; 13 7 I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CUR the Massachusetts State Budding Code. I understand the construction inspection procedures,specific inspections and "r documentation required by 780 CMR and the own of Barnstable.Attach a copy of your license. Signature - Date f Section-10—Home Improvement Contractor Name_ 10470 nit 4 _Telephone Number .3r p Addres City / State zip Registration Number17,o?-O„� Expiration Date ® u I understand my responsibilities,under the rules and regulations for Home Improvement Contractors in accordance Witio CMR the Massachusetts State Budding Code. I understand the construction inspection procedures,specific inspectionsd documentation by 780 d the Town of Bamtable.Attach a copy of your IUC... Signature Date Section 11—Home Owners License Eiemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Budding Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date p APPLICANT SIGNATURE Signature Date Print Name _ Telep one Number 5Zb V 3 G co (3 Z S l E-mail permit to. o coos, t4� -0(�i(0 T....t—A-".14 in nn,v o =i Section 12 -Department Sign-Offs ' Health Department © Zoning Board Cif required) El 'ct ❑ Site Plan Review if ❑ :< y Histonc DLstrl C Fire Department: ❑ Conservation For commercial work;please take your plans directly to the fire deparbnent for approval,' r f J — j a Section 13-Owner's Authorization I, 0'r as Owner of the-subject property hereby authorize to act on my behalf] in all matters relative to work a thorized by this building permit application for: (Address of job) q11,10 Signature.of _ date -�z 0 Print Name , Last undated:2/92018 J r �oFtHe.r°k. Town of Barnstable: Building Department Services MUMSTASLE, « Brian Florence,CB0 " v� MASS. g . i659. Building Commissioner 200 Main Street,Hyannis,MA 02601 VAW.bainstable.ma.us Office: 508-862=4038 Fax: 508-790-6230 NOTICE TO THE BUILDING.DIVISION OF. CHANGE OF LICENSED CONSTRUCTION SUPERVISOR I, PO , owner of property located at 5 N o T I V\ �� l ( R' 8 �Pul �ier�b�e�' i that!- CI Fabulous k�ow � rvv vy� �I� Yl is no longer Construct�` ' �n o, y Supervisor listed on the application for the project under construction as authori d by building permit# - , issued on 2014, o I understand that the project under construction must cease until a successor licensed Construction Supervisor, is submitted on the records of the Building Division. PROPE Y O ATE q/forms/newcontr reference R-5 780 CMR rev:08/23/17 The Commonwealth of Massachusetts x 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): Address: C C /7rA 4 zrn City/State/Zip: Phone#: r >, 3 Are you an employer?Check the appropriate box: Type of project(required): 1.El I am a employer with .2- 4. I am a general contractor and I employees(full and/or part-time):* have hired the sub-contractors 6. ❑New construction listed on the attached sheet. 7. [ 'Remodeling 2.❑ I am a sole proprietor or partner- ship and have no employees These sub-contractors have g; Demolition workingfor me in an capacity. employees and have workers' Y P n'° [No workers'.comp.imrrance comp.insurance.#. 9. ❑Building addition required.] 5. F1 We are a corporation and its 10°❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing i airs or a&Mons , myself.[No workers'comp. _ right of exemption per MGL 12.❑Roof rep tZze insurance required.]t C-152,§1(4),and we have no t employees. [No workers' 13:❑Other comp.insurance required.] t "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 afda�' indicating s'u� :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not tho entities ham 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 joRue information. Insurance Company Name: A/6 114 1,1V vCC �,n Policy#or Self-ins.Lic.#: V1 C A 4 Ekpiration Date: .2,0o2,0 Job Site Address: = 't- �tTc��yin►Cr ��; � City/State/Zip: f� P v'�Ic 41A-- D��Z�' t 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 cetW#under the pa' nd penalties of perjury that the information provided above is true and correct Signafore: Date: •)-� 0 Phone#: ® o Off icial 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),addresses)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. s City or Town Officials F 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 permittlicense 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 of commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 - Tel..#617-727-4400 ext 406 or 1-877 MASSAFF, Fax#617-727-7749 Revised 4-24-07 www.mm.gov/dia /<0 6 r A)'1f G/ri<<'e ;t; )_;ood Cooker=/_1�., 171 >g/ a��/rd Mreas•: 1.7�mi, �i � .>��t��r� R Massaichusetts Checklist for Compliance (780CNIR 553f i.2.i.i)' e6 qq p Q Check 'TOWN OF'DARKSMOLE Compliance Re ( gust)1.1 SCOPE Wind Speed 3-sec. ust .....................��}i.t�.:•rA;� , .+�..'�.�....�...��...�. ,......!..........................................110 mph WindExposure Category.................................................................. ..................................I...........................B 1.2 APPLICABILITY Number of Stories ................................... y stories :5 2 stories RoofPitch .............................................. . + . (Fig 2) :..................I.................../" v s 12:12 MeanRoof Height ..............................................................(Fig 2)......................................... Z BuildingWidth,W ...............................................................(Fig 3)................................................� ft 5 80, BuildingLength,L ..............................................................(Fig 3)................................................. ft <-80, Building Aspect Ratio(LAM ......... ........I.........I..................(Fig 4)...............................................J _<3:1 z <g'8" Nominal Height of Tallest Opening ...................................(Fig 4)................................................ 1.3 FRAMING CONNECTIONS General compliance with framing connections....................(Table 2)................................................................ 2.1 FOUNDATION Foundation Walls meeting requirements of 780 CMR 5404.1 Concrete............................:................................................................................................. Concrete Masonry ...........I...........: 2.2 ANCHORAGE TO FOUNDATION''3 5/8"Anchor Bolts imbedded or 5/8"Proprietary Mechanical Anchors as an alternative in concrete only BoltSpacing-general ..........................................(Table 4)............................................... 4-9 in. Bolt Spacing from endCoint of plate ............................(Fig 5).................................... . L in. 5 6"-12" Bolt Embedment-concrete.........................................(Fig 5).................................................=in. a 7" Bolt Embedment-masonry..........................................(Fig 5)............................................ — in. a 15" PlateWasher...............................................................(Fig 5)...............................................2:3"x 3"x Ya 3A FLOORS Floor framing member spans checked ...............................(per 780 CMR Chapter§5)......................I............. Maximum Floor Opening Dimension..... .............................(Fig 6)...........................i ft<_ 12'or L/2 or W/2 Full Height Wall Studs at Floor Openings less than 2'from Exterior Wall(Fig 6)........................................ Maximum Floor Joist Setbacks , Supporting Loadbeanng Walls or Shearwall................(Fig 7)....1�. •.•••• • Lft <_d Maximum Cantilevered Floor Joists Supporting Loadbearing Walls or Shearwall...........:....(Fig 8)..................................................... ft s d FloorBracing at Endwalls...................................................(Fig 9).................................................................... Floor Sheathing Type ........................................................(per 780 CMR Chapter 55)........ l � Floor Sheathing Thickness .................................................(per 780 CMR Chapter 55)... in. Floor Sheathing Fastening..................................................(Table 2)..2 � d nails at in edge/ Afield 4.1 WALLS Wall Height Loadbearing .........................................(Fig 5)...................... .L 10 and Table . ft 10, Non-Loadbeanng walls.................. (Fig 10 and Table ... b <- Wall Stud Spacing ........................................................(Fig 10 and Table 5)....................i in.5 24"o.c. Wall Story Offsets ........(Figs 7&8)...........................................7 ft <_d 4.2 EXTERIOR WALLS' Wood Studs Loadbeanng walls........................................................(Table 5)..............................2x 4,1-" ft .in. Non-Loadbearing walls................................................(Table 5)..............................2x ft 5 in. Gable End Wall Bracing' FullHeight Endwall Studs............................................(Fig 10)........................................,;...Zy*'..:.............. WSP Attic Floor Length'................................................(Fig 11).........................................�. - ft>_W13 Gypsum Ceiling Length(if WSP not used)...................(Fig 11)............................................—ft_0.9W 2 x 4 Continuous Lateral Brace @ 6 ft.o.c. ..(Fig 11)................,............. .............................. tNQF ..a i � _ (IFic Imo`wind f_aNe 6)....... ........ ... jab le ...................................................... MICHELE CUDILO o STRUCTURAL No 34774 i 1?I�IC:�r DNS i Pp � � 14 i `I� �� e e ; '3�!t r� �sf vrtt�t;1 hi High 14 h2d errs: 110 t1 p13 W t`rii zone assach- setts Checklist for Compliance (780 CI IR i36i.2.1.1 Loadbearing Wall Connections Lateral(no.of endnailed 16d common nails)..............(fable 7)........................................................ Non-Loadbearing Wall Connections Z Lateral(no.of endnailed 16d common nails)...............(Table 8)........................................................ Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9). Header Spans ........................................................(Table 9).................................. ft_in.s 11'(3 SillPlate Spans ........................................................(Table 9).................................. ft — in. s . Full Height Studs (no.of studs).........................I..........(Table 9)........................................................ Non-Load Bearing Wall Openings(record largest opening but check all openings for comp is ce to Table ) HeaderSpans.............................................................(fable 9)................................ ft in. <_ 12' Sill Plate Spans....................:......................................(Table 9).................................L- in. s 12" Full Height Studs(no. of studs)....................................(Table 9)........................................................ Exterior Wall Sheathing to Resist Uplift and Shear Simultaneously" Minimum Building Dimension,W Z15 +� Nominal Height of Tallest Opening2 .......:.................................................................. ..�. 68" SheathingType.... .....:...................................(note 4).......................................... ...... 3 Edge Nail Spacing.........................................(Table 10 or note 4 if less)......... Field Nail Spacing..........................................(Table 10)................................................. .in Shear Connection(no.of 16d common nails)(Table 10)............................................ .s .....�1 Percent Full-Height Sheathing .... able 10 ......................:................7/1" % = 12,3 9 g................... R ) - 5%Additional Sheathing for Wall with Opening>6'8"(Design Concepts)�.�?fi... ..... 2h Maximum Building Dimension, L Nominal Height of Tallest Opening2.................................................I..................... 6'8" SheathingType..............................................(note 4)...............................................i...... Edge Nail Spacing ............. able 11 or note 4 if less)........... .. . in. Field Nail Spacing able 11 ................................................. in. Shear Connection (no.of 16d common nails)(Table 11)...................................'........... . I Percent Full-Height Sheathing able 11 ( /o_ ,� 9 g.............. (T )............. . . ... 5%Additional Sheathing for Wall with Opening>6'8"(Design Concepts).. ........ . ....�7,L ��� Wall Cladding Ratedfor Wind Speed?.............................................................. ................................................................ 5.1 ROOFS Roof framing member spans checked?.......................(For Rafters use AWC Span Tool,see BBRS Website) . Roof Overhang ................................................... (Figure 19).........../-6-ft s smaller of 2'or U3 Truss or Rafter Connections at Loadbearing Walls itox'S� S Proprietary Connectors Uplift.................... ............................ 12)............................................U=25,3 '2c Lateral.............................................(fable 12).............................................L= ...........:......................... _ Shear.......... ...y......... . . . . . (fable 12)....... Ridge Strap Connections, i collar ties of used per page 21..... (fable 13)..............................T= . . . . .. _ Gable Rake Outlooker......................:.................. (Figure 20).............. •— ft s smaller of 2'or U2 Truss or Rafter Connections at Non-Loadbearing Walls Proprietary Connectors Uplift................................................(Table 14)............................................U= lb. Lateral (no.of 16d common nails)...(Table 14).......................................L= — lb. Roof Sheathing Type...................................................(per 780 CMR Chapters 58 and 59).................. Roof Sheathing Thickness........................................... .........:............. �....'7 'n. >_7/1;6�" SP Roof SheathingFastening ............(Table 2)...�.d.r ... .....je ..:. (�G. � Notes: 1. This checklist must be met in its entirety, excluding the specific exception noted in 2,to comply with the requirements of 780 CMR 5301.2.1.1 Item 1. If the checklist is met in its entirety then the following metal straps and hold downs are not required per the WFCM 110 mph Guide: a. Steel Straps per Figure 5 b. 20 Gage Straps per Figure 11 c. Uplift Straps per Figure 14 d. All Straps per Figure 17 e. Comer Stud Hold Downs per Figure 18a 2. Exception: Opening heights of up to 8 ft.shall be permitted when 5%is added to the percent full-height sheathing requirements shown in Tables 10 and 11. 3. The bottom sill plate in exterior walls shall be a minimum 2 in. nominal thickness. pressure treat e - rade. tu OF SAS MICHELE���tia Gr® CUDILO �. 1 0.f STRUCTURAL e9 y No 3477� 2 /sTE- sSronaAL E�' E A. L'DCs►� re ' �►N'S�Rt�►EAIR'fb �4A I Tyr. d1�L•6t�'tYQ f � t tag • PhNf.1, SDroL YYS.P ATTACHMENT 0 N,OT TD g"GA�'� fi-o� V�.RT• #��SD �t��tZ.. �TT�G�1�Il�NT NOTES: Wood Strumwrl Panels shall be minimum thickness of 7116"sod be installed as follows: i. Panels shall be i umlled with srength axis parallel to studs. ii. All horiwatal joiats'sltall oc=over and be nailed to framing. iii. On single story construction,panels shall be attached to bottom piat s and top memberpf the doubie top plate. iv. On two story construction,upper panels shall be attached to the top member of The upper double top piate and to band joist m bottom of pastel.Upper attnchrttent of tower pane1 shall be made to band joist and lower attachment made to lowest plate�'tt`,s rust floor framing. v, Horizontal nail spacing at double top plates,bard joists,and girl shall be a double row of ad staggered at 3 inches on center per figures below:Vertical and Horizontal Nailing for Panel An=hzmnt r { I i ri cr- if , ► i ► � I J � U I� •+ •I I f . f z ctI ; 11 o I � i WOOD emc"TOLACL rkMEL WSP go>cAT Imco WSP ATTACHMENT No? ?p SGALE. , Aig l G L OR 1ZpWTA.L G I The'Contmonwealik of Massachusetts Department of IndustfialAccidents Office of Investigations 600 Washington Street t t Boston.,MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Naive(Business/Organization/Individual): OhY10 .I y 1 C) ers Address: CU LY-Pl' I Y C City/State/Zip: CQ"- er V 1 �' Phone#: 7?J-3 w 1 2_7 4 Are you an employer?Check the apprppriate bpi:* Type of project(required): 1,[1I am a employer with L1 1 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 mein any capacity. employees and have workers' r [No workers'comp.insurance comp.insnce.t 9. ❑Building addition � 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. Insurance Company Name: i Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of.MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations the DIA for ffisu ance coverage verification. Ida h eby certi nder ains and p nalties,of perjury that the information provided above is true and correct. Si tore �- Phone# -7U 1 . 7 cZ 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): r. 1.Board of Health 2.Building Department 3.City/Town Clerk 4.EIectrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: i 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 IndustrialAccidents 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 permittlicense 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. z The Department's address,telephone and fax number: The Commonwealth of Massachusetts Y_ 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 4-24-07 • www.mass.gav<dia I ACC>R1? DATE iMM/DorwyY) CERTIFICATE OF LIABILITY INSIRANCE 12/12118 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 A:MEND,,EXTENO 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:poiicy(ies);must have ADDITIONAL:INSURED provisions or be endorsed. If SUBROGATI',ON IS WAIVED,subject fa 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{sj. PRODUCER _ - ... NAME: JIM HINDMAN Schlegel 8 Schlegel Ins Broker PHONE' 508=771-8381 34 Main Street Alc No xt: a,No: 508-771-0663 West Yarmouth,'MA02&73 ADDRESS: schlegelinsueance@gmai).com INSURER(S)AFFORDING COVERAGE NAIL tl INSURER a: PROGRESSIVE INSURED �. � ..'... INSURERB: NGM L`.&L Property Maintenance Inc INsuRERc: TNEHARTFORD 127 Cammett Way Marston Mills,MA 02648 INSURER0: r INSURER E: _. COVERAGES INSURER F - CERTIFICATE NUMBER: REVISION NUMBER THIS IS TO CERTIFY THAT THE POLICIES OF:INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE IN NAMED-ABOVE FOR THE POLICY PERIOp' INDICATEp, NOTWITHSTANDING ANY REQUIREMENT;TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH:i His OERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCEAFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.L)MITS SHOWN MAY HAVE BEEN.REDUCED BY PAID CLAIMSus Iw LTR TYPEOFINSURANCE - IN D -POLICYNUMBER MMlDOJYYYY •MMlDO/YYW :LIMITS X. COMMERCIAL GENERAL LIABILITY .. _ - EACH OCCURRENCE 1000;000 CLAINISAIADE X OCCUR c s .Z� 1 ' a t PREMISES'Ea occurrence) 3 500,000 MED EXP{An ane oereonJ S 10,000 B MPP6637F GEN'LAGGREGATE LIMITAPPLIES PER� L 01129/19 01l29/20 PERsaNALSADVINJURY �. 1,000,000 POUC"i = I PRd•: . - GENERAL•AGGREGATE s $ .2,000,000 JECT LOC i-OTHER PRODUCTS-COMPJOPAGG $ 2000,000 * AUTOMOBILE LIABILITY COMBINED INGL LIMIT 1,OOD,000 ANY AU'i`O C Ea accident OV,INED BODILY INJURY Per A Si HEOUtED ( i Person) $ AUTOS ONLY AUTOS ) BO^^✓!LY INJURY(Por e�adent) $ , HIRED NON-0�'.fiEO .' .. AUTOS ONLY AUTOS ONLY PRO ER TY DAMAG 4 Per accadent UMBRELLA LIAR $ OCCUR EXCESS LIAS EACH OCCURRENCE $ CLAIMS-MACE AGGREGATE e DED RETENTION a —_ WORKERS COMPENSATION - � ,AND EMPLOYERS'LIABILITY ANY PRJPRIETOR;PARTNERiEXECUTTVE Y!N STATUTE: ER' C �(MandOPFIC t"in BIER EXCLUDED-) NIA 1K901927 E,L.EACHACCICENT _ $ 1.00,000 (Mandatory m NH). 03/19/19 03/19/20 �`' Yes, IPTIObe ord r E.L.DI! SEASE EA EMPLOYEE,$ 1.�i0,fl00 7ESC,41?TION OF OPERATIONS he;c:v. :. E L.:DISEASE-POLICY LIMIT S 500,000 OESCRIPTION OF OPERATIONS 1-LOCATIONS!VEHICLES tACORD'101,Additional Romarks Schedule may be attached rf mare space is required)', ATTN::BRIAN FLORENCE:BRIAN:FLORENCEfa�TOWN.BARNSTABLE MA.U..S. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEL ED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED N TOWN OF BARNSTABLE BUILDING DEFT. A ORDANCE,W1 THE POLICY PROVISIONS. 200 MAIN STREET HYANNIS,MA 02ti01 AUTH RI D REPR SENTATIVE r ACORD 25{2016/03) 1988-2015 ACORD CORPORATION. A)I rights reserved. . The ACORD name and logo are r I ered marks of ACORD �oFI„E r Town of.Barnstable ��. Bun ]Department Services : :AMSTAsrE. uiN iQ v�plf'o� �DQQBId Commissioner i8" t, asA_ 02601 www.town.barnstable.ma.us Office: 508-862-4038 "w""""'--�w—onn . - Fax: 508-790-6230 Ivr .r0 NOTICE TO THE 13UILDING]DIVISION OF LICENSE]D CONSTRUCTION SUPERVISOR ASSUMPTION OF RESPONSIBILITY i 4o, I, lonoaI Y t 1Q0 qe G _Xons upervlsor ice r # ,hereby certify that I have assumed responsibility for the project under_ construction, as authorized by building permit# l-1� issued to (property address),J-4 / Skoo � n— qi on 4 07 (p , 2011 . The following documents are attached: copy of my Massachusetts State Construction Supervisor's license or Homeowner's License Exemption form(if applicable) copy of my Home Improvement Contractor registration(if applicable) Commonwealth of Massachusetts Workers' Compensation Insurance Affidavit. Road Bond(if applicable) LIC E DATt q/forms/newcontrb rev:08/23/17 OF p IME .. . (:2 ............ TOWN of SARNSTA plication Number.. .. t * MAS&BARNSTAB��' MAR 2.6 pd 4 � mil Fee............ .......................Other ........... 163 3 Total Fee Paid............. J .....1. ...................... ...... TOWN OF BARNSTAN Permit Approval by...... . ..... ...............on....� ..� .. .. BUILDING PERMIT Map........ .....�. 1�......Parcel................ �........... APPLICATION Section 1 — Owner's Information and Project Location Project Address n— �w-rL�V�n�j Ur Za Village_6q,2iv5�/Q Owners Name ZiyN/q- lZoQ ey-C, Owners Legal Address Clty U, C State 4411fLl Zips~ z� Owners Cell# I �' E-mail Je5i Sovd&:S ` cow Section 2 —Use of Structure .. Use Group ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet Single/Two Family Dwelling Section 3 - Type of Permit ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire structure) ❑ Finish Easement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment © Sprinkler System t❑jAddition ❑ Retaining wall ❑ . Solar lr5 Renovation 0 Pool ❑ Insulation Other—Specify w p cc Section 4 - Work Description 1 "AAA �_/,1.I'd /J Lple 54!�vcl-116ee— (RA) , . ctoj. >A-,re c.c.g 1-t, Last undated: 11/152018 Application Number............ :.... ................................... Section 57 Detail Cost of Proposed Construction Square Footage of Project AQtD�., aP c4N-- e Age of Structure �0 4-/- _ - 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 Wiring ❑ Oil Tank Storage ❑ Smoke Detectors 2 Plumbing ❑ Gas ❑ Fire Suppression Heating System Masonry Chimney ❑Add/relocate bedroom Water Supply Public ❑ Private Sewage Disposal ❑ Municipal 2-On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: c y ni L9 t' I am using 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 Proposed Use Lot Area Sq.Ft. Total Frontage ---percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required Proposeda 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 Application Number...........:............................... Section 9- Construction Supervisor Name Telephone Number Address City State Zip ti. License Number License Type Expiration Date Contractors Email Cell # k I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with,780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your license. , Signature Date Section 10—Home Improvement Contractor I Name Telephone Number Address City State Zip Registration Number Expiration Date 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 11==Home Owners License Exemption` Home Owners Name: ny\ck, U V R0 yoric V s Telephone Number 7�) • -36 (• oZ-N)Cell or Number 7 g 1 .3 �74 I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 - CMR the c State Buildin erstand the construction inspection procedures,specific inspections and docum tation requir b d the To of Barnstable. Sign! C----Date -IAI- 6 ` .- _ I APPLICANT SIGNATURE Signs a Date t Print Name 0 Y)ria r V eo 'C VS Telephone Number 7 • 3(o 1. 71 - P E-mail permit to: Cii 0YMCk @ &eS( l V-,e OUrce S e Us•com 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 I, O n V-x 0, as Owner of the. subject property hereby authorize to act on my behalf, in all matters relative to work authorized this building permit application for: (A dress of job) Signature of Owner date Print Name r 4 �s l a Last updated: 11/15/2018 Engineering Dept. (3rd floor) Map 2 Parcel � 47(t"9 "Permit# House#' Date Issued _ = =-©o-.-. fl WOO) P �IHI IL phi + i' 4�J NLz� NsrABLE, 19 -ILL TOWN OF BARNS T ' T§TLTO °'fo"`''�09 . Bunlding P I , PP icat'on Project Streot Address ' c= - Village Owner Address Telephone — + -.Permit Request-74 P 4& - ' 1, First Floor square feet Second Floor U square feet Construction Type V pEstimated Project Cost $ 1�j� -CPS Zoning District Flood Plain Water Protection Lot Size /;��, Grandfathered ❑Yes EtNo Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes Urf io On Old King's Highway ❑Yes ❑No Basement Type: pull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing �_ New No.of Bedrooms: Existing �J� New .Total Room Count(not riluding baths): Existing New First Floor Room Count Heat Type and Fuel: as ❑Oil ❑Electric ❑Other Central Air ❑Yes pro ' Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ;r ❑None 2"Shed(size) X ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use _ Builder Information r Name HM� C-1- hel te`,,8-<�S Telephone Number �43c)— Address 4q$� &(-ewr t,L,- ,cryi 14 , License# �, 1 C-4 a r D,2.G 2/S Home Improvement Contractor# Worker's Compensation# lG� NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO` DATE /L4 BUILDING PER T DENIED FOR THE FOLLOWING REASON(S) . i FOR OFFICIAL USE ONLY PERMIT N.O. DATE-ISSUED- MAP/PARCEL NO'.' ' r ADDRESS' VILLAGE ' F OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL „ . GAS:- ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. t � r r +` The Commonwealth ojifassachusctts Dc•partntenl oj1»dttstrial Accidents ,3 - n+ -� Office ofinyes0211ons � ,- :w fi 600 If ashin;;tott Street Boston, Mass. 02111 Workers' Compensation Insurance Affidavit applicant information• Please PRINT lebibl��s , name• location- Citv 1+hon•# Lam a homeowner performing all work myself. 1 am a sole proprietor and have no one working in any capacity _ !.'....ta.:.,,,,,..... .+.,--,^r-T��': ...r!.--r7i�....er.->.r.RT�s�.r.c-..t1i'lo�.-y"*�T --�.�.....�.�.-u-..7.--..�.���,..�......•-..:-.--••'�'"—�'-• _ I am an employer providing workers' compensation for my employees working on this job. coniliany name, 4 addresc• ..--- city• phone#• insurance co. policy ,. ,'.. _,� r, ...y.„.,•,R•......,.rn...•,r.-w.n.l}-c....-......a,...c,,... �...r.a.�.�w.wroN�•i...•-•--.w.a�-�..a....r... .. I am a sole proprietor general contractor, or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: company name: n` address: qC13s GP-,.VT city. �����.�. �r 2�SCS phone#: inurince co 41-157•,e_r lsd policy# LUC P 06// 2-.r9 ;. - _ - ._.. •+r..rf�;;- �+�-o:'_ --:�.�w,^•4-' -_ ;�'r�-•-rcbT.�..�.�•��P7�.�7►+ .:..y'•F:,.r .-T,4.� - ���_��oi�'� :s.1.._ company name.* •tddress: city: phone#: jltcur tncc co polio•# .Attach additional sheet if necessary.• T T"� " 3� <_`',� "i' {'`-� -�� •� svui ;.i.a Failure to secure coverage as required under Section 25A of NIGL 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 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. 1 understand that a w copy of this statement may be forarded to the Office of Investigations of the D1A for coverage verification. I do hereht cerri t turd he poi air mlties of perjun•that the information provided above is true and correct. + \ �'- � Date /��� Signature Print name __Phone# 7 3 Z SOU 3 7 c• �officiai use univ do not write in this area to be completed by city or town official Cit.y or town: _ permit/license# I-(Building Department oLicensinn Board check if immediate response is required [3Sclectmen's Office r; 011calth Department contact person: phone#; rlQlhcr ireased 3M5 rta) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another any contract of hire, express or implied, oral or written. An etnplurer is defined as an individual, partnership, association, corporation or other legal entity. or any two or more c 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 dwellim_ house having not more than three apartments and who resides therein, or the occupant of the d\vclling house of another who employs persons to do maintenance , construction or repair work on such dwelling hous or on the `rounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that even 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. Additionaliv, neither the commonwealth nor any of its political subdivisions shall enter into any contract for the chapter ha e evidence of compliance with the insurance requirements of this p work acceptable p erformance of public ork p P P been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the boa that applies to your situation and supplying company names, address and phone numbers as all affidavits maybe submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign.and date the affidavit. The affidavit should be 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. ...-.. ��..w.w:JR•...,.,,, •..-t. ...y1•..:--.wr-...._rr.�..s'�w.!+w.'3'At.'—�f.q•...'n�„•A.O • - e i City or Towns Please be sure that the affidavit is complete and printed legibly. The Department fins 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. Plea be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned tc the Department by mail'or FAX unless other arrangements have been made. The Office.of Investigations would like to thank you in advance for you cooperation and should you have any question-c please do not hesitate to give us a call. 77=The Department's address. telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents -.•. .:�: Office of Investigations r 600 Washington Street Boston,Ma. 02111 fax #: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 I i ;lee Tiomvmo�u�ea/��,�oaati/uiaelta HOME IMPROVEMENT CONTRACTOR Registration 122419 Type - INDIVIDUAL R Expiration 08/30/98 {. JAMES MEDEIROS ,�J MES E. MEDEIROS G6�'' °4 "�45 GREATWESTERN RD ADMINISTRATOR HARWICH MA 02645 ti pFTME A . The Town of Barnstable = RARNSTABLL 9� MASS,1659. Department of Health Safety and Environmental Services prfON1D'�11 Building Division F 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner I For office use only I ' 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:• Est.Co t (� Address of Work: vJ Owner's Name J Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under$1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent-of the owner: Date Contractor Name Registration No. OR Date Owner's Name L ------- Application numb .. SFee ............................. J .. KAM Building Inspectors Initials... ........ ....................... s639. ♦� Date Issued WIA .....................�. .�. . .� ..................... 7OW N �$qF� Map/Parcel.........../ � .v ........... fVS7AD4E. 6A,�oS NBIOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION a PROPERTY INFORMATION Address of Project: ;r /Z2 NUMBER STREET VILLAGE Owner's Name: 0 vS' Phone Number 7X/ d la/. 7Y1- S.CO P" Email Address: Q,S/ h f DSO UY�P�Cell Phone Number ��I�ly 7 Project cost$ �� Check one Residential J Commercial OWNER'S AUTHORIZATION As owner of th ove proper ere orize �/ US ��4 to make ap ication for a b ' g in acco ce with 780 CMR �J Owner S Date: / TYPE OF WORK © Siding 101 Windows (no header change)#_g:q- Insulation/Weatherization Doors (no header change)# Commercial Doors require an inspector's review Roof(not applying more than 1 layer 9f shingles) Construction Debris will be going to CONTRACTOR'S INFORMATION Contractor's name r�v oc> Home Improvement Contractors Registration(if applicable)# .ZO j (attach copy) Construction Supervisor's License# S r� O (attach copy) Emai1 of Contractor A ViW<, OTZ V R6Ul—Lp G-.Phone number �IW 36 to?z ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY.IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED: APPLICATION NUMBER....................................................... *For Tents Only* Date Tent(s),will be erected Removed on number of tents total Does the tent have sides? Yes No " (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent Fuel source being used LP tank 20 lbs. or>Yes No ,if yes, a gas permit is required. Natural Gas Yes No , if yes,a gas permit is required. If food is being served at.your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3.30 pm-4.30pm. Commercial events may require Fire Department approval *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type y Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 : CMR and the Town of Barnstable. Signature Date t APPLICANT'S SIGNATURE Signature Date All permit applications are subject to a building official's approval prior to issuance. 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):- � p�pyGj Address: C UJI City/State/Zip: i�l --0�qf Phone #: SV9 'S6O 183 Are you an employer?Check the appropriate box: Type of project(required): 1. I am a employer with c 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' [No workers' comp.insurance comp.insurance.: 9. ❑Building addition required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no 13.0 Others" employees. [No workers' comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those'entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: _P� _ gd2T6001 Policy#or Self-ins.Lic. 000 Expiration Date: Job Site Address: S Z q 2 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 Si atur Date: 4 0/ Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing'employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone 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 cant'workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding.the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts - Department of 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 4-24-07 vvwu.mass.gov/dia r ATE(MM/DD/YYYY) A�" CERTIFICATE OF LIABILITY INSURANCE 01114/19 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 NAME: JIM HINDMAN Schlegel&Schlegel Ins Broker FX a/c°NN EXt: 508-771-8381 A No): 508-771-0663 34 Main Street E-MAIL West Yarmouth,MA 02673 ADDRESS: schlegelinsurance@gmail.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: NGM INSURANCE COMPANY 14788 INSURED INSURER B: THE HARTFORD L&L PROPERTY MAINTENANCE INC INSURER C: 127 CAMMETT WAY INSURER D: MARSTONS MILLS,MA 02648 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCEADULSLIM POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENT179- CLAIMS-MADE FX OCCUR PREMISES Ea occurrence $ 500,000 MED EXP(Any oneperson) $ 10,000 A MPP6637F 01/29/18 01/29/19 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY❑ PRO- ❑ JECT LOC. PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER O Y/N TH- AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100,000 B OFFICER/MEMBER EXCLUDED? N/A WC-021452000 02/09/18 02/09/19 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CORPOERATE OFFICERS HAVE ELECTED TO BE COVERED UNDER THEIR CURRENT WORKERS COMPENSATION POLICY CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN DONNA ROGERS ACCORDANCE WITH THE POLICY PROVISIONS. 547 SHOOTFLYING HILL RD CENTERVILLE,MA 02632 AUTHORIZED REPRESENTATIVE FROSTBITE_1@MSN.COM, DAIANE BENFICA @ 1988-2015 0 D CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD i i �-.-,_•A._ �e cpanunzarzwe�a��/�cweac�zuaella '�� � • OHice of Consumer,Affays�&,Buslness'Regulatlon HOM,EIMPRONEMENT RA�CONTCTOB j TYPE'Supplement Card I Registri6n .; Expiration j FABULOUS HOM "�R UE. ENT INC I` JOAO;DEMOURA 11 SIERRA WAY W.YARMOUTH,MA 02673 Undersecretary Massachusetts Department of Public Safety ti Board of Building Regulations and Standards License: CS-109981 Construction Supervisor } JOAO DEMOURAL 22 SMITH STREET I HYANNIS MA M01 n f = Expiration ! Commissioner` 12/22/2019 t 1-. 4 i I Registration valid for individual use only before•the expiration date If,foundrreturn Ao: ` Officecof Corisurner•Affa�rs aqd Business Regulation 1000'-Washington Street-Suite'710 j Boston,°MA 02118 j i I of vali without signature Construction Supervisor Restricted to: Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(991 cubic meters)of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. j DPS Licensing information visit: WWW.MASS.GOV/DPS j i { 2nd Floor 1 . TOP. OF SAS AT ELEV-94.00 2. WATER LINE TO BE DOUBLE _ 'Y�`-,,,._GENERAL NOTES TO ENSURE 15 FEET FROM SLEEVED WITH 2" POLYETHYLENT 1. Contractor is responsible for Digsafe notification, Verification of Utilities o BREAKOUT TO BANK PER TITLE V SCH 40 THRU SAS AND EXTEND of all underground utilities and pipes. 10 FEET EITHER SIDE OF SAS T and distribution box shall be set level on 6 "€o_ 3 4' 2" stone. Bedroom Bedroom i ckfill should be clean sand or gravel with no neov 0 in size. ' 4. This system Is subject to inspection during installation by Carmen E. Shay — Environmental Services. 5 0 5. The co ntractor actor shall install this system in accordance'0 itlentr V of the Massachusetts state code, the approved plan 1 st Floor . / U MV1 10tond LocaI`t�gulations. 9 6. If, during installation the contractor encounters any o Bedroom EDGE OF WETLANDS / , 9 soil conditions or site conditions that are different Kitchen/Dining m 5 — / �ypNO �- 9a from those shown on the soil log or in our design E OF j J a} /96 installation must halt & immediate notification be made to Carmen E. Shay — Environmental Services. 7. No vehicle or heavy machinery shall drive over the Living Room' Bedroom /j / -septic system unless noted as H-20 septic components. 8. Install Tuf—rite gas baffles or"equals on all outlet tee ends. 9. All Distribution Lines shall be 4" diameter Schedule 40 NSF PVC pipes. 4 BE HOUSE FLOOR SCHEMATIC / / / / 10. All solid piping, tees & fittings shall be 4" diameter Schedule 40 NSF PVC, pipes with water tight joints. . (Description Provided By Owner) 90 .` O 11. Municipal Water is Connected to ALL OF The Residence and Abutting 9t4 j LOT #4 C M Properties Within 150 Feet. 96 12,280 S.F. t/— THE PROPERTY LINES ARE APPROXIMATE AND O COMPILED FROM THE SURVEY PLAN BY CHARLES SAVARY of HYANNIS 9g w q , MA Failed ENTITLED: "Subdivision Plan of Land WAQUAQUET LAKE, Centerville, MA" CESSPOOL DATED August 24, 1952. PLAN BOOK 107, PAGE 43 PROJECT BENCH MARK AND IS NOT INTENDED TO BE A,SURVEY PLOT PLAN TOP OF FOUNDATION I IT SHOULD BE USED FOR NO PURPOSE OTHER THAN ELEV. 100.00 (Assumed f THE SEPTIC SYSTEM INSTALLATION. DECK EXISTING CESSPOOLS;TO BE PUMPED OUT AND FILLED IN PLACE 0 20 40. 50 u - NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE o d FROM THE EXISTING CESSPOOL/LEACH PIT TO BE DISPOSED OF AS PER BOARD OF HEALTH SPECIFICATIONS. M p EXISTING O I 4 BEDROOM CRAWL SPAC co SCALE:.-`1 "=20 Q�h ASPHALT HOUSE' FOUNDATION _. .� •- DRIVEWAY Io #547 PLOT _PLAN LL o o Fourl�AoN OF P R O P O S E.D SEPTIC SYSTEM UPGRADE 9 Q NEW { 0 - - -- -- - _``� —+ ,_`_. �."." --•- Septic�Tank w �gP� _ J``�_ .� PREPARED FOR 4ZX x • �' �ent `tl ' O p ...0 . Pipe AT 63 547 Shootflying oBOX 547 S HOOTFLYI N G HILL. ROAD Hill Rd ASSESSORS 193 PARCEL 25 .Q O O 'O O O O O OI]:, ,a�ayz a .. ' C ENTERVI LLE MA 3 98 I _ ° I >o. 5' of M4 PREPARED BY: —98 IMP S 80D 2>'35 W —96 SHAY �'NVIRONM�'NT�1L SERVICES Nor 94 94 A °o # 92 92 y s{ 90 90 a P.O. Box 1576 : 9. MASHPEE, MA 02649 •S'H 0 O T FL PING ILjL :R O-A D gjti Z .: �, �'27° sA►aITAa�P TEL/FAX 508-294-7498 (50 FOOT RIGHT OF WAY) : 1"=20' DRAWN BY: CES ATE: FEBRUARY 26 2019 SITE Locus PROJECT#547 SHOOT FILENAME: 547Shoot:d g SHEET 1 OF 2 6