The URL can be used to link to this page

Home My WebLink About0065 TRINITY PLACE n'4�di �'�vrJj �G� l �.pj ,. t�� y 1...: ., .- s .,�: n: ,_ � "`"` �� .m - rf� � ,h a �� ,.,fin �� f � f� � w; al -� �. „� ., - i ea n •, .. ..... .. �. { r r, . .. � - ,. _ _ � �. ,, ., .�. a y, .� .. r - '. � n_.n. ate,'. i .� w� .. �, P, e. .. .. - .. .., .: � � '„ .. ,: - .. ,. �.. s.. .. .. .. � - � & ,. .� .. ,. .r � _ :. _:. �' � Sr ,'. .. .` r _ �' � � �. ,. .. .- ,. n . ,� '. .. - ., _ ., ., .. .. �, .. �. . ,,. -. .: �. .. - _ � .. .. ,. � ..� �, � r � ., _ .� �. - �� .' .' a - :. _ - , �i". ,.. .�.. - ., .� L * .. o .. .. �. .. .. ,. f - .. .. �.. .. s �. a y.,. � �. - ,. _. .. ,. �,, a�. w. ,. � � .. r _ .. .. � - - ., _. .. . .. �. � �. ,. .. .. v � ' � .. - � 1 oFt► ro,,, Town of Barnstabler # Expires 6 months from issug date �3 Regulatory Services Fee M � • BARNSTABLE, + 9 MASS' � Thomas F. Geiler,Director 1639. ♦� Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY-Not Valid without Red X-Press Imprint Map/parcel Number o U Property Address r. tC-k Residential Value of Work �� Minimum fee of$25.00 for work under$6000.00 1-7 Owner's Name&Address —1 U �< ( Contractor's Name DA n ('( .� y y�r� Telephone Number 7 7 Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance , - RE PIT Check one: _ I am a sole proprietor N O V a 3K Z n g I am the Homeowner ❑ I have Worker's Compensation Insurance `"OWN OF BARNSTABLE Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit: Permit Request(check box) 1 Jr [qRe-roof(stripping old shingles) All_construction debris will betaken to `'� ( G' �� ❑ Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders.,U-Value- (maximum.44)#of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,eta - ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors is use&Constr ion Supervisors License is- SIGNATURE: Q:\WPFILES\FORMS\building perm t orms\EXPRESS.doc Revised 090809 - Massachusetts- Department of Public SafetN Board of Buildin- Regulations and Standard Construction Supervisor License- License: CS 102512z; " Restricted to 00 • � rs DANIEL JOYCE JR PO BOX 117 Y WEST HYANNISPORT, MA 0267 - - - ! Expiration: 12/13/2012 Commissioner Tr#: 102512 -' a�✓�aaaaclzuoetla*j Board of Building Regulations and Standards I tiicense.or.registration valid for individul use only ''HOME IMPROVEMENT CONTRACTOR 1,e re'tlic-expiratio❑date. If found return to: _ dk , Board of Building Regulations and Standards Registration: 158:158 One Ashburton Place Rm 1301 Ezpraton`=1 Z17/2009 Tr# _2ti2494 Boston,Ma.02108 1kk= _Type- DBA F- DANIEL JOYCE CONSTRUCTION= DANIEL JOYCE aft.14 DOLPHIN LN HYANNIS MA02b0j. Administrator Not valid with ut srg ature The Commonwealth of Massachusetts Department oflndustrial Accidents r'r Office of Investigations M t 600 Washington Street Boston MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information K I r (�^y Please Print Le ibl Name (Business/Organization/Individual): 4i 1� l V e Address: I Cr d ,P (1 A City/State/Zip: C► W1 Phone #: 7 7 Are you an employer? heck the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6..El New construction 2.XI am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ( ��ship and have no employees These sub-contractors have am ❑ Demolition working for me in any capacity. employees and have workers' 9. Building addition [No workers' comp. insurance comp. insurance.1 ❑ required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I I.❑ Plumbing repairs or additions myself. o workers' com right of exemption per MGL Y � P• 12Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp, insurance required.] *Any applicant that checks box 41 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this'affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic.#: Expiration Date: C� p Job Site Address: r-. n.' 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 certi n r the pains and p alties of perjury that the information provided above is trice and correct. Signature: Date: Phone#: / ( � Official.use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector S. Plumbing Inspector 6. Other Contact Person: Phone#: r � . Information and Instructions Massachusetts,General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s), address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies (LLC)or Limited Liability Partnerships (LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. -The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a.reference number. In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's,address, telephone and fax number: The Commonwealth of Massachusetts .Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 t Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 4-24-07 www.mass.gov/dia I ��Me rod Town of Barnstable yr Regulatory Services �s"s",r Thomas F. Geller,Director 163;A. A�0 Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, ( � y Pir1 , as Owner of the subject property j hereby authorize r ,� /` � C 9 to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) ig e W Owner Date J Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS:OWNERFERMISSION oFY�ram, Town of Barnstable o Regulatory Services HARNSTABLE Thomas F. Geiler,Director MASS. 1639, ,�� Building Division °rEnY A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# r CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is,or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner.hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that hdshe understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILESTOR.MS\homeexempt.DOC r f E P`oF1HE,q,�� The Town of Barnstable BARNSTA . MASS. O� Department of Health Safety and Environmental Services Y 163q' �0 °fEO Mpy Building Division } 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection -T-1 C Location Permit Number Owner Builder rc, r� One notice to remain on job'site, one notice on file in Building Department. The following items need correcting: Z�tY'_ RR M C-L �e�� G �: �1, -Q 0� a C C R- c' e C 1 A 1 PC'/-f 1 s C 11 41 r C k' U (' L i A S- L Uj Ck Ca ci�I C `A , 1) v0Cr, S,� 1 � J ,� a � j a k1.�4caL-3 i S Ooyc roar Please call: 508-862-4038 for re-inspection: � }f Inspected by Date 2 , J •_, TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 2 800& ' Parcel s -�`�" `� Permit# Health,Division n-Lfq 'i—r503 y ON LJ Date Issued 2— O 3 V Conservation Division CI of _ Application Fee Tax Collector Permit Fee .9 Treasurer SMC SYSTEM MUST BE Planning Dept. WSTAUA IN COMPLIANCE "TIC THE 5 Date Definitive Plan Approved by Planning Board )( RONMENTAL CODE ANIP Historic-OKH Preservation/Hyannis TOWN REGUL0EONS Project St eet Address CL Village V t Owner rte Address �S ^�� t Ig9 , Telephone no '— 7 Permit Request �`—�-�� or --7 zg92 Square feet: 1st floor: existing, proposed 2nd floor: existing proposed _ Total new Zoning District 7 Flood Plain ® Groundwater Overlay Project Valuation fM_QO' Construction Type O Lot Size zl(e sb Grandfathered: ❑Yes ®'No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units)X_�Id Age of Existing Structu Historic House: ❑Yes King's Highway: ❑Yes ®Tlo Basement Type: �Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) 69eA Basement Unfinished Area(sq.ft) Number of Baths: Full:existing 7- new �` Half: existing new �— Number of Bedrooms: existing new • Total Room Count(not incl ing baths):existing � new 3 First Floor Room Count Heat Type and FFuu I: Gas ❑Oil ❑ Electric ❑Other Central Air: Yes ❑No Fir places: Existing 9_ New ® Existing wood/coal stove: ❑Yes Detached garage:❑existing w size AWN Pool:❑existing ❑new size Barn:❑existing ❑new size --7Attached garage:❑existing U`n"ew sizeZNXZ(- Shed:❑existing ❑new size Other: 0Y. o (WrA W Zoning Board of Appeals Authorization El Appeal# Recorded❑ ' Commercial ❑Yes ®'No If yes,site plan review# Current Use Proposed Use y (� BUILDER INFORMATION Name kY. D Ct \�(�Gn� Telephone Number sb3— S Z q 6I • Address �� License# Home Improvement Contractor# Worker's Compensation# _V t AL ONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO —rnC_Jn Q� u1nee SIGNATUREI)AKDATE �� ti I 1.._ FOR OFFICIAL USE ONLY ' 4 PERMIT NO. DATE ISSUED - s MAP-/PARCEL NO. r ADDRESS " VILLAGE / OWNER DATE OF INSPECTION: FOUNDATION IJE D FRAME x INSULATION kc, F FIREPLACE ` ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH `' FINAL- e GAS: ROUGH FINAL- ` - - - FINAL BUILDING DATE CLOSED OUT - --- _i ,c1 1 ASSOCIATION PLAN NO.! 1. 1- it — ti, C�yl+ �- I+ f t ; i CQ � r �� -� � � � �r �� (� / , � 3 � �� I i'2 vv\ Ca { r T � _ The Commonwealth of Massachusetts ,Department of Industrial Accidents excs oflQyestiffIv s 60o Washington Street Boston,Mass. 02111 ` Workers' Com ensation In urauce Affidavit / tee: hone# �.� ci all work myself. [] I am a homeowner performing i am a sole rietor and have no one workin in ca achy rl //Ga so/% %O% %/%///�l//////%////%/W///////////g/o///%%%%//b%%%%////////%�///%/%%//%%%/%%%///%%%%%%//G% ///%%%/% co ensation for niyemployees:.: orkels : ; , :•t};:.4a. }"?•::? ?Y y24t+:r i;•C FLY ..a din }n: t. {rr: :•' , }. r+ }tY,.• N•r}eI IOvi g rti�',••:�i,''.;:i•'•i�:?.::�;:Y:�Si<:::::•..v:.:rr :{..y... .'.:••T..r. •}.},n+.,•::..; .rY^•. ..¢y^;.;t'§:>�c;s;:s:!Y?tt an em topp n !t{.>:?.::i<?i]i r},,}::r. :{.:: {.. .? :>f r }..^:r" <+.i{:<r • :rf+ ,.�Y+.. . <;x,. O•}.;. I am J,.. .4. tax+.•.:;..}:i:T`X?•},..::..v:. :.}...::{?i•:{••rx x<•..}'4•}:•:•'•::;5.}}}> +`'::ii.i: ?..;v}+1 y}., :.f:,/rR•: y,L., : + .a f'+K"fb.rr:4..:. .•P ra>•,++:•'fp';t};:iSr:{;?..,:.Cv.::••:v.•n.. .:.,{r+}•:a'f.;.;;.; i?{%}. ^+Y.:. ....?4`?C.:+3^v� ]4• A +Cw v•r`•r',n xr�•a••+ ..:F. :.:^•:�ii i`•.t`+.%i' .+}n•n• :::.".;.,.. ::••rin .n.•:^+:• .vn.,•,•.v?,.,•, ...i:•: ,,J f. }::a+{''•r,A• •i:?.: ;f..}..:•.,::v1•'•{•$:+. ••:]+{,+n...,... ..:,KY'•iu?�}.;''.. {:. ..+:}'y`, •ay.•tY'}`.••�,`•4{:.v 4`'..+v74a\}.Fn;Yn:.} },x{.}:•x{;::{i:•:•::.:r..:.::.•.n•.L. vn.}.;.. : ,•::c°.ui.:.;}:.. rr.:n......r...?•:c+}+n::5:;i:?:::4••.}r'•:xr}::}•. ...r..:••}•{.r} .r.;.rX:•:•t�{r.w++ ., ..{:•.••:, r.i:•., •.}:)••.-••4•}i:r. {:;}y+:"'. :ra.: ...,:+.v•}...»v;!},a �:::}:f.?• .:•]:r:++}r}:r.}:C•:{•:v: ,:rx,•:•.•.., .,w: •ri::•rn "�'^•:'•++ .. ,.... .,•:::... ..{... ,.:x. ,,,.. .r.. .:.,. 4n..... i•,::fo}.{£K.{s,,.;4,{+•rxr}}:,•.}r;;-?y?{.}?{::>a:-•}.}q{.}?;:,,:;•,,xn"!,fi�v.y}.:.:{G.ora�v....r.4.. .}....:;?:.,...;.�,.t;•, .n.r.�;y;+•, :.3.r.:::u:•.":•::.v:{•... .,.t..rn4 x.. »:•a+};.}].• `•' rFr� :i ....n n:?.. ..r..]:. it... v.4,.. / v:+:4•++ ::f.£,!2•}r:>r;:r?c•i 'o- +:'s}:;Yi2;ky r::i}r.^..,0:.'.::•, : ...i•! ..vr:?+•} :,+:h}x ti?'•{Yv.,n..w.vA+, ••r;.}:. {x: 'l.y+'}:•v'�'F.•}}'i•:kr::,'+}:^':: �L�� ?L,v: .. '{::.::...a :i:Y•aR.x ::fa. ::tt•s.; .:; ?4}.•y:4Y:x ::•:ta,:.,J,:>{i�:; .5+. ,;4{n::4•r:•} "•a: .r}r::•.•r..a.}•.:{+;':;:i ,4ta},.,. .3Vo.b.::.r.• r F•'4:•:n•. :'}:i}�.K .r�., $IIltiil ...?n:•>.:..r •:.:?.;#?:i`; :.nc'• .f;#}:::�.,•.Jr.,, ,4{,•.c+. :.�:r...fi :rasa .:::.: .. " r..{:Y.,'<:{,•::::•.£:�}:Ir:v?{.',••:+ :•',•:,vw•:.,<•++ r,'.�' r, , .3• •1'.^. :..�•. ..}•.:•::':,'•.`a:{ii{v^:• `•c:.{+. .. :.:5'•::{:+•!,. ..a:•,:+.,n. a,.•r .r+,•:r ,}:tt`•^'•vti'x'• ^., .+�i�:�`':#ti•: ......;:.•:�.:.r.:?.;,.;.:::!•.{7:'i}:':ni}K.:. .. Y•. •ax^. ;F:++•x..:r.t�..,.... r,.x•:••..,.:::n•{•:n:•:?.x :.t.:;:.<::.,.:..? •,,..r .r ,:+n•r...,...:.n•::•r.:t...,f•.n•..c..:rri.c t�'w'n n]r:.:••..Ctr,,, .......:nba., t.{.,}.;.:r...•::••...}..,•r:•.?..::.p:•.}}}'•}::?.,+4:};}{%.5;.{.• , .,,.,44.:j.:i};•r{'x•;{•.,,, H r ,+• :.n•r�ra. x•......•:w:;.:...:......-..-.v.YY,.rt n.5'y.f.:.r.:r•r..:,•:.,.:ntm4::..::vt..,...:.+3.:r..,r.:•.,:,.:..;;}� .:.: »ti#.,{..:•::::•+Y•}.}rr5r^•-;+.'+. .;v,,,.}r wr.••.,X.. �ii��i:CY::.v..: y.ro:.+::o.:.].,:..i....•v•. ,:.:L':d:»•.v.::::.:v::::r,c:::.,•r,/.ry,4{.;} 4•,..;,.:+n,;a•:.;•:i ...,••:!C::Y..r.,#..,.„r::::.}:n.}+::.;.<{..<::.?•+r}:•}.J..ry:•:,• ..,„t!:•:.?:.:ny,s.aiw ,'}. ir,.,.•r:?:}.+,.;:..+!...x: :.{• ...t'rft.,J.=,, ni.:i+•.,.+ :»u.::*t.,tnrf:Y,,.fn{.+:..&+.+:{+•x.},;t;.,,•;.. :.rkv..r.:r..;•:{{...... rr+v:..:;..5•r,.+'+•.: ^�• .•.t- F..22:. ..,{.}. v:...•'f?•i Yi?ayx{.i.-}) ^.:,.:•.v7.:.r{...f.n:•r. ?.;{. :•:,.:. r.,.:,+:{?:'•:t:::r...:::::. + '*&,1+k 7:2cY:;::h .yc:v••,.qr{%:,;:•::!vr:••...;.x: :$•.:r.:�:Y•r..,}.:..a...v: r:r{-;.;.;.nay,n{}.,]a]: ,^.•;} r.:•..rr.•: .:..... •• '., .,•-n r::i}i}xar r:.vt}{6 .f{.£{}.f'CLw+i,c• f4i T •"•tir:q. :a?.F,4:::C••:i}::.vnia{n:}::a}..}FY•:k•;x,{..:fi>v,{•,,,•f}{.4; ;.••^^C:,r,4'+' r.fi'•F\:::•ti�$;.}'':•''•,'{v •$, {}•+ '•::.;{:•.'r .{"•a:';.pr..,,:...y i, +{y+} •y.,j•}.+* .di Ya•.frf::;'r.• a}'!.•{•, ?ac a•:•ra:iii;y.}>} :,,.... }•. ,v.'3. t:+•+#.<}ri:•• MORE., ;'`'• `{;?}>f••{;'4` r< '.`•:'s•::tYtir: ,:n••x• ?a:+r{v4x{r,.}i.:i., :.v...r:•.}•:t:.;.::.}:•. :R:v }}r. .a,,.i, .v.•L ..,Ro-•,b•nn ...n.• i�4 . f!ESS1'.}.. 4}rr:+'•:{..x'r} '•?!. .:i,•:::•}.. .n..a:t...::::v:•J.•.•::.:::•::..:n<•.,x;r+ .Y:nfO. "�.:y,C2J. .{.;,, a;........y,.,.}. � }$t� :•:Y+;YJ+{.,. .., t.. a>.,:.. :•»n....ti.:n....; ... n:{a3v.w 4 r r...n:. .v}ay..:2ik5f•:Y ra ;}.;..,:. •:YtY .4,+t:• .t a::r{•,•4r•,.w:...4::;y>.:::....x;::Y.:. :•.t;.y. +•},{. :: :t.a`�w •{:?{.rrrtf...", /{ ... Y••r...,•v.,3.. . .•:4. :,}:•:."}+rt:?::,.: }y•+{?:.y, ..}:•:a^ a . +C?ro;.y, .:r•.•+n•r:}'...r•'Yr�"{{.?.,.4..•.v.vi' •r. ,.. ..?r i.'.:..... r... x :.+{::}v:•.:r•v.:va•..•n;;r': ,n:+....Y ..++.f:.tt..rn.. r.::_ ••^;;.,,;: r C•r .. ... ,.4... :..: .. .4,... .. .. .+ ,. n ... ..+:{.:rr:•:;:::••:;,, :t,:•,t••:• .y�r.:n�:it;r:.}S."•+ �;;`.,.:;{,:i°'•i;';�:. Y:?:;3.4:b..•F.::�:ya...4.,r..: .,..K?.�}.>�:a•`e•:K3: .•? ....ny,.T.^r,,a;}rx:,+n.: .v..:::.,;.L}...j?.�'rd.. 3a'4:)\•rn.,:...;},.. ,t{.::wr.:w::?:a:>::;i:5:::tiSr':Y}:i :^rt...... •: :!}�r.:'cif.;•:•...:..,}.x.;;•:.xavri]:.{• .;,.na..:!:{:.•:N?.,;.rf,.A:,:•.a};5,.: :.�{•c3:•:::•n•:..r:.:,•..,.•.p T•:::-r.:,:..,.;;,.}:.:.:....: 11QIlE��a•rr.a::::t'. , �';•. ..,'{•::T.:.•?.•:}?;r,• .,v.v}:{.x::! .v]::u r�>}.•...:v..;vv+.,. r,•:.•:•nv•.•::.K...,.•: •.:::.:...}.,r,y.;r{;{{....:v.... .v...r..., ..:..vx•:v .v+}::;{:{•'}j:;+{•f:s +r.v::;`.::•:• ::+:::•:�, >.{:..;.ry•v:x• ;?•x•:f! v:fv:.•:..+.: i:....r{4:•Y+•:4:...C `' n. ..'r.+':. .....,v. ,r n/a •:t:a9'r•...:. •'';v;:. .�:c:•.v:<•f...}.;{•r;k?a: v.}.pb,';f.}}+i':,}:}rGs,.,:.,Yrh:f:;?i ?;:• ' ,trva,'!rT,, }+`.:fY ;=•` x:£•...n.;.rf:., .:.:^+:t+ro:.a:::• ..�,;;. >:;{,:�,�.,}}.......... ...+.. ...:�r.:...:•r:+:a5;.y.r::•:;{•::::. .C::: 4i::••ri'•r::v.;. •M:. •r}:::•na•}::.v:.af{,,,.:.r"fi:x +} .{. .;<..f•:••a n,;}.�.iy 1 {f �.r;?;,;{;t.L.,vYK;'•�r+f.' Y •• G::n,vi•r•::�:;•r�;':i ...w};..4wK;•�+!•}y:::x, + .:,{:a::.4:i:Y:?{t:t::{:{v.y :.};{a,Y.};n., 4.s¢{t•.'}••.•.n:::Yi'r::+:.fi`..Y•.•:',••,f;'t:;fi::: .�7} .:%}:'`�•.Y;:r;��.,• .�:•{+•. •Q {+c.4}+r:{i}}.::•::•:. ...•tr..;k4;.';r`:;.},.y;;.;:•.... S:•:Y': .:'].�t:v.5r{.y}}}}v.., y ,•:'}„ •..tia.?:{ -a ;•r. }ii i•ir,:;:/^}i:.:. rvr •Y+} : v.;.+:�};5;:?, •:.4,hvaf?r::aR.;<}:cv,:ati}.:`• .r{.. ...ct ..fit... ?:?}r.::1<t:iio'•:;iSi{f .:a. +f. •d•:tx.s.. 1:.4 v.n.r 4 :,..:.. •:••,• ..a}>}•rr•?a:fa;{?:rtf5::.;Yri}:..4{.;?. a. .. •$:},..:}{;n:v{.::::.r..::..,:f:: "•:v ,...:•:•..,r.. r Yr!.`}. {: v.i:: +.:^+:•r.. r.......a:.:f,:.v...,., ., r y.>...4...:,.:y, .h�.,,:•n•:...+...:. :4}:{•.:;.-.:o:ar•f::::. .. a,:y: .:rY.:;v°5:':?:{tt{•: 'fw,,y:. :•} ., }:L.wLr..,•.:. :x4r,.r1t.:.t:...., {.,,;?.:::.{,?c.r•r:•:..x,.:a:1.•..:,. i,;(f:tfn:.t:..:; :•::.f•.f::•:;...•r.. n•..::.,n.,y.}.t:: nib..:5.;{Ifii ..,}:a:::• ,:..x" Y: },:: ',.,:::''i :;Y:i yrr{'Yr=�4.r.5 iia••?•;{r:::.::fr•.{<{r::.}};;+k:•},:rxY!..........:•{}• {{ru:�.:;y:�fi".r.;,• .{.;•:?.;..;,., f..•`,..;:. -n., f ...... �711i'�:• }ra�•:}:•.,•i.•.:•:r.r...:.a:.,S L...:..q..:•x•. t•..:,... .. K S.i• ...,. r. :.,t,.,wJ{>.,Y.,;}:x.,,..?;n::++•...'{•:.a.v::...}•r... . I am a sole propriet , general contractor or homeowner(circle one) and have hired the contractors listed below who • have � �t� compensation�Ol1CCS: •xa:• .^,;z {... , !:k�F'�::..a :::;;, ;a„ai, n' ;�•;;'?., wor ers compensation {•: Y.. :ui'.::^:So$r,{.;; }4a,:t;2.+:Cc.{i?i c,r '•f¢}'ir7 K ;, aa:+:er}wfi: y +�,e following {:L},::{.,vi}Y;Y ^}. .:}.a".:,,}. .{{.:T.:.{... K %n!:a+{+:Ni,Yky: �;:f• ++ r. .ny+:aY:•: l� .P.,..,,. r};a:}::•>t:y;cy..y. .yY:} .;3,.}:•+• a.\., .{.;.:}' ,•Y2, `{ y <S+•„' •,<•.,+,Kr::•v ?Y is,,• :}K s f,•}, r. '.. r.Y•, •/.t•'r,:;:•: '"i{• '.��f.`L•. ::.• .} .y.. •Y{}: :;Lyvr,. '$•' :•r"Ei+r.n,,.. :a ..•rc!r. n4i:::^::.,;+.;2:4•:: ::. •.,,.• •: ••.,• r.• .v.av x•. A L:d:.. nand... •.•?i: •..F }; r :}}: n}•...:•:�� •:h: ..4W.•v.r,: '?:+i: :j?rK v'r:4}`'.f,S''rv{{i'L. OWN{•.i,�f:T!i}{ t•.t}+{;{ G}:Y.;xtrxr•:� •.4v, {. 'aa:. `:f..:k.w.r. r•r•�ri:;r<;.�'�,+ ..Fbi;�,•.;t;:,..;r.t�?}.x.•.tv k?.;Sr.;. �. ;..<tyv: e;; .;y}:a}:d:aYt•. ..;{.:r:>•• ,;•r'.• •i'}}?y:.;;tvrR FJ:. :2• S.x 1.;,}.;t D2 .BIl f'IISIII ::art: r%' tS:k:;: ?i: ;.} :.3+...{. . :.cr:: :};rr.}..+.. r iC0 _}:... �?t? Yc: :•i e ::?+a:x; .x..0:?}{.a. . �f F� 3i:: ....,. .. -f< „+.?:c.{• .:2 t;y.,,. }:+}^ar••. C+,•} ..9 i.n't;!vsF,<.v}.KYY •+rr.?+:f.',}•:%+ti•:�^r rxYti?%?YiE:':kf:}:•�,�: }t:•. iyaa{r v}:<£{•: r•+ra Y} y'r yY;{•}}•r�f4:'+�:RA,..a.. {... .n. }.f}•.:.:..:.6...3.x?•:?Gf.. ., }::f'r'}];.•..;.+:+,.;%;;;:n.,. .•{•. ;�}x:• '•g3•.}? ?::,•:y.:y.$]::y•+:;;=L+,...:•},:;�;a{l�iL.vy`�w•:•`:Gv!cu}},.•} «�##%r.:,.:.L..h`:� '•;t Yi+,i,`4:t{.}c}r;:a}: >';{•t>.a]xBr.7,:.:}•.}+i..}. . .;; 7 4},Y,?. }};.;4;{r r`�'+:? :�.;} .. Ly!;+' %:r#•�:.: S.t,•},{:;.}:.jc:f.{•)v..rt<.. . ,,..,, .... {;,vxt•}..: r.;i:. :?}!?•}a+Y{ y ,;?• '•}• }t}3i•.;iMa`.9•i:.' '•:.. :.•r} .:.:..: ..:.::•... .r;'.y...•r,•f{sca-• ..,.��:•. {irr.: •+.:...>r:n:.. •+�xo- {; ':.::::.,•ff}y].S:••v{:+•;i� +^ y�+;' .::G:- L£;L r{j`: ..;..,xtc,v,{•••+r... •R}';:i'•: i+,:•f:• +',v'•.'•:};Yo;..;.. �•:�•.,{vs4�.yr,;:': r, :{f :•':S:R.;.:;�:f�$�} . ..r•x:••f}:^•{.r'•r:ttt.;uiK:YV•;+• 'i:.?;.}? .."::•}{ '3,+ ;,.y$'';' .. ;ty •.+';�a:•:.<;it:Ki: . y 3� H?r.}rr,..,f:c•v:'v r•a}•.Qir4:'r:+Y${.'iti }•i'yy:�•.•{ by,i.r r•'r'•... ... ,• x t}v;i;..Y' .: i,r,,gr.,:v}G:.,a`t .}f ;. . + f.. ,, :: .aa • ' }!4}., 4'•;•i:i+q':;rrn;.y,'•.•,,.�,c:,? «'i?r4+�n :#''`•� ^'�K+ • .}> ?:5::•,;:..,Y;{}r.+<•:.:�?£r]. r,„• .rf .;rt::� r ... v,.,?n.•n•:.......:,:• :+ jt � •''� � •'.:aa�' :'S:W''i`f< ..rr„}.:r'+r•,.�yL'i Y:�� v f:; �. •,.. f a3} :•.�'4.�:::r.;{}:.n•::}.4:`•. rr.yaf:• v::.a... .. a:,{i:y}ir......r ,� .,{x,,; }?� ::�:'fy•::.:,+.�'..,+tv.?;x{?{,e�.�'�.•y :.v....:,...v?.,,.. :: -. r. ;,?'xs>f,G�w�}�� .+qqp•.: r�• }:�: r ^ :•.'•:•;':ix?•:{a h'ca�...::f...:.v.,,. r'�ti't:;.}+:}:>;xv:;:t.:,:6ivii:{2 •`'r$?i'' >.:.} SS'S;:'•:t; a^. ...,::}..:.,.i... .y�iy'a'a'}�'ii`': -,Gn,,i{•:_'{?+?!+f+ir ::4,. ;afiq•'Lr;+Y.n,,i i :},= a�ti;.. .}:'+j+,'4ff•! L,• fang K ; {nF.:+.'2..;{:G:{ i}}itity>:}'?• ?}a+}.+S/l,.'�? r?r}. •� b' �:�;Y7.;:`'•? :}:::•Yfi�i:Y''.rri;;t>.+;;}ti}�;�r.: :.r}^�•,,nr •`:•},:'r'x•'.{.'''' .yk i�2•.+�ry ?LLt•}ri•.{.n:..a.+•;•:.+hf;.a;�,:+•.y,r3'• u. �•,;kai"3;• .��,�ir:. ;�::r,'+,;:. ;frr:v f+; !nr y a }v k•{.. •:;:?!';>,}:.r{f,:{�;xt:.%dn OC�;iF :n.• ..•?�+ ,�� ":S?'::,y}•;,•r.{:.:: •s;::.f { �r'i+r f•�•F '.• �� L•+•+c?',..: Yr:. +•/�i %//,,��yrrrwY.Yt7+b ?•i{<irKsS:'ty'c:>,,,i}^3?r!: :s}; G ,�. r:v,;,SL;.'a'...:q:fx;,a ++:r_ys,4irx •:,fya f+R .,: ... �ti:f'SirCe~i�o:•.:::. •rrrr:•{.:.}Yt•fr:W?x:xY>.••''}•+•z::r }�:f'{r�'-:}afw.�<-,y •frau''�?/{S4'r�'�;�rC`•f,�: �Y'or+,;f•,.'r'••'d,:.};!: y?xi;:;{•i,5>i:::i::y'�} :;n:};rYi.t:•�,f+ri:4`•:•x•.•.. + `�'+.$.. r v� .7 ;i.�.r.xy.�:}:?:•i ayr ••r.,•yy.::••:..2>onr{fi. :y r};iy; nf. .�. "7? 3 •.. 3•..{a;::{ .,;,;••r.r'rf.{'9}'i •.;>?;r •.vi.f,,r••.a .:Li{ {v ,,;a,:,c .rS•:i,r.{f rY•v:'• a.v.. +:•ii�}}:{ .ti�'I ''Yi^,,,, f':+ •:v 7. ...Av.^•.•ai: i? •.?Y:'f•'' .'yy{4:v..{Y r.. r:'f.{ } ? i}:{•. r� v'•}}•t•Y/,.:' $ r:{$a ::y,' :i:({ ii. •rA{+. .{ /v•y•, :YY:}i Yv.+5v R'$yaf• ��[[ "•n t•xa:F{. }. :{.:�i. ,tom n....x'x{•�. •• n?+ ^ nn .{•• fa?+y„f.•,o::.:.:.v::.; :�.:.xn•.,r, , } ,•.. +•>:st>.a:..":.{.. ,..::.•'i•{. �� yY+ "�:}::t:}• :X'..n..,'a.?a.. : .:.r.:•.... .; 'r;`<ilf;..;;r.: ....;. .::.. '•.'t.:`r.::.. .+.Y:>n:{.:.o ,{{.}:};::b:isZh:yf?rrir`,.:;+.��,f�:Y}yo`�'S.{ :<:wrf`•,a.!.;:•::.p f. r::+4•' it::,::.•.{+ •r.,9 ..4n t, ?,,.f•.4....:::::r......... .x.. "{ :::.:... .:•.v:•,• .:..;4{{:.}y:}:i't�$:Y:•.,:;';4'i:,Y:.::Y•;;#:,'S+»+�,5;..:.£'P;a'•r. '4' K',,,,p+i•.:,,:it'+�•n ;}:.t;r., .,r^,;., ti<•(i}"}�i r..+w Ya•rr,.}i}Y. :}>x•:r:. +i%j<??i;:r>i?L:}M1air:T,.}:a:{C•}r:'{F,.v :}{I.•]t}l vrj{..,;n'•;•;}4 +]r,,•L�.}�Sq{?a••;iun�r:n':v+.Y�rr+..+,r'x•^y ry;:v :"a{4v.+',:y+:.`•.; ';;:4;;$•' HnV•:f1HIII :s}+ •r!'$:�'i;..:y,}.:>Y•.••L.: •. ;;?ni.,. r.,ty{ar`yi+.} :••t• .i:.:?r.ii:i•. ::•.Y.:, .r;.. ..fr•}:+S:sY•: r }.Y•r{., .:Yy•:: .••;A{�.Y;,•y?a4 :,.j};:fti?:•�3;,? ' :.,:.5 ..av r r .{frrata:L•i:}+. v.;::::+ f+:?:F•:..+}a:,,,{`'•''v',•+`•i:�u,�+; 5,..:.•r .?t;:y 9.::�`ir f9;}{. ;•}S. �,c•.at'a'+.r::�X,;.•...rg,•?•..:. YF••t:r a. ,S.�krr{•.:...:t:.{ ' •r.}:<a•}:.,:.:. :�.;x?r'}:.:: ::.tax?n,; i}.cY.:c:.•+,v�:•:S:{�C'��i�s:r..,�.,., rc L,�Y$is8':�•.::x•��.3 •:.>v:....: r:fr: ,vtr " f.::.r:::. `' ,�.n .}:�. »::•rna:.r:.,:•..w:a}, {a}.rt. Y•}'i iy.+:}r,.:,:;.y;:'t',•'i�•r'.•iaS,...:•r,:rrf,: •r„{: : :: Yr'•?rr''�••a•.•r•.�,{.,•:i:ta,.r f.^+iip:<i:ri.;n•:•.•{+n:r Y,'axf i •:,t. ,n...?.,;:.},.✓r.,v»••: :. :iL;r:{+.y:•.;}fYc:{., :. ::,;...}}fiY;:;.:::. .. .. . •: irL:}>:+.>•: ,..:{•�....f:r: x.?•..{{•...:.•.. :r r. {•{ , }n•..{. t,•n,+:.,:.. :. a r. ..:...a.i...... a•4L } ..+,.:. ,.: : ....}:•;..'.Y•:?},x.;•f.,}:::':.{:}:.},•{•r.•,{•::YS:v}.. •..{atat+...... ?}.,.? ...t:..;;{.::::.;•:•`,:•4rn �.,y;.;.,:.. a:.;,.r•.:..::v. •.Of•+.y^ •y;:;.,'aay+. `K:' .r, �,,�:.•.,: ''•:•< �. .v+}r,?:i}:C+^::v w:f+:•nv:v:.•.;v•:•:r•}r:.: ff+ 4'::::;:::..4y.Ly ` •:�. ..rY '• yy :. •' '+ +•yr{i:{ ..r:c •`}"{r Av,::;.,r;i,'L,• •rr,/,i$`++i}}:'� r� ':i s{i::> .atv. •::}wt:4,:?;.' t�S:iyy,:y]:;4.';4kt•)i+,?r,a•'•y�'f.-..r4:}S%ec'�f}(•.a..:..} ,:r+c%n:-:�::•.n, }:•r+• :.'2;�i '}•�'j:yC•r.ra:: : � r:::?x}:+-i:":ti:?]'l.•:•}h.:.:l. ..:..•x:.•:::.:v.::v:+:f•:,:n.{..{{:{v{tii•:•:ti�::x'v:•:t:'}r:,'.;:w::^.v.;{r:r.n.,4?a?f{•:Lv.Y,.,+,•?.. :... <n..v ... ..:.:.......'••:......:..::}:n.:.v...•.»?•:n+w••.n.;...n••n]...::nv:::x•{!•}<}}:..... ', •:rY Y1.4=?v:ir"v?,.'{?.i 4:?'+.+': k?:r•+::{w ,, 4,,,+r lldt#YE35. ,:.r n•.:.;K{:x.r:::::n•::, �;;: {'tt>:?r.{:{:{,..{Sl} {i, .. ,•a.;.i:.,$r s{'a} , �2. •i�}Tn::Y�+`t`.:: •{::a}:;•y.•:L•£?•..:>:::...,..::. ...:r: ..{yi., .,.a„x•: ar. ,:•. r::x .:,,.... .r ..{...., ,+........./..:•?•.v:•:.w•}•.;,..{:.fu:•:;{:3;+]:},:{,x•>•..,:::r::{:}v;r•;'?:::••'•a•::.; ..,L x. rir:,• ..%r.>.•. :•`:L n .,x r ,}ram.... 3r. •r?Y••:..,. ::. ,•....::::•n?f r.:•.:,v::::t .r<:ra.:•::.•:........};., r.,.:......:a:::... i:.};....x,.,; t,n;. 2}g�•`++`5 + .. 4....r..,........?{...,.} r:.r..}. .v.....r........ .....fva;;{.:{•i:v4..,:.v::n.......n:r}}}'•}:::.{r...,•,.....:�•}r:+•.:,•: .,.....; Y.�i;.:a}:i}'• 'SSC.:. .f•...:..., :}.r:n.n....,.y.. ..F•::•.,•....}:::'•.n.:. ..,r•:... •:..t+:.:.3.`-{x?;:::,,.};{x.?.•atr.{{4}.»••;?{;:r}.vw•:^•.Y....A r ..5. ,Yx`.�.. a,{ •a :•: n,{.y,".....::::}•ri}.}+t•.....:•.•,.4+. {4}::+•.x•::3.:...::..rn•...n .;:{:•{•}:•>:;•:•.. i..::•.>'{.;•...v ,�::r{ni,;..,},:},}:x:r•::_:...,, B:'fFr.....:.. i}?:�ai•.,.};.; ...3:,.,./r.,:.t:•.�•::;•.:•:::.•...:•::•.:..n,3,:::•...r.:?'}:..:...::........4..,�t:.}:} ..r ...:.:::.,:....,.:::::.v.,,.}.L:•:. .:.::... �� .. .... x•}rr:=4S3^•:F�'..:?C;:}YCaS�{):�K;E}j;:r•:?•.x:: r:r. .::,.::::••::•...:;>,;•:•.:;,;a.•rj:...:v:t•. ::}:r::.S:r::,+:nri+„•.;;,},.,..a?,�,,,aa::.,,;..t:::.:.n. ....... ..:.:.. .... ... .. .; }S:.• he.:::;y::• }a r.F'^.,?,. .✓•, ,{...+}Frr.¢.. .:.f.. :r•Y+hY riv:v}}.;S};r•C•:{i?n)i n}'."'v`f.+'rra:;�' r+ }{•r 5..i`;+ :rfi.f,...r..rn:.:iK,ty;::.{vr:,'•:•:a:r.. a$r...:. n:.!n}i.. ^n,.:. . rvv.{+i::.t., .t.+,:,o:.rr..••ra•r.?{Y,. n;io-:aa:,Gfi+,rc•xw.,;, trt.;r,•,•}r'•t;.••:;: a.. +•....:v::.....,,..rt•:..:vxn•.rn ,:.•:?•:...o,::n•:•.•..,•. n!v•::::....,....... ,:•.v:•+r}r:+r':::::.:..Y%+'i:•:i;::,.,•.:•:.:.:c:++: r•.. ...},5.,t,{ Jna}:•;r.+r+' :,...::::•.:.+,..rr.:..:•:::::f....:..t.?.. :;..: •,::::.}•::•+•r:•Y•xx::r.vr...r.;•::::}..v:.f.:..L.nn•:::r.,.:.x. }r. Y•:. n•LfSs':"+$ a?'r?vZYx'x•x k.v.Y.. r.. .. ::!•n•{•::a.nt•::..:...... ...... .... .:..... yw:aarrf; ar.::,•.:r.}:..;r..::.. .•::n{,;.,...,, f+}n.*•cx:•?•r�47`.i;,.,.. wv.Y�:•+ :•'•i?rr q:.;.i•.n••:,:G.,ay.; ,<,, :.},v;.}:?•..r":.:"•;:Y::s: . . . :rrfv:,}, {;:L!+.tr?. :?/.••;.+;::+rxnav•.v:v{:.x.;,,,!o}fi:};;v+yrf?•Y{i5•:'`.•";:s't»ttri+}'/.•t„•.<. .,.,,{x ...:'t'•. rtv,Y: .. .....:.v:mxF:rxLr..::.}•a:i:`.':-a::•.;, :..,.. ,'j.;f... .+f•:+•x',.,{..::r•r:,}a••a a: ::.,:tr•:a,..:r:.}4, :4»"•.'+,•,a,r:;r.a,%,. `.•:},r,�'-•fi . ........nn.••......••:...ft-r./.. .. x,x:...a.rf..r.>:?; ,:u..^:r:.. :.r..S..v•r.. .,.,i}`.b}}rrY{t}:•{•':�{^;.r:frrr.,}{{:,. ... ' ..:r.?.},.:nv..,<,.^..:•r...:..::....:fr.l:r....r{a: q.:...•ia•...:f•::i >2••.:...:,..Kr,t..w.:.. }Y3}:•. ..n..r:.•r.•.v:;:}...;......{•.a.:. .. ;11+n+c..'}•„Y.i.{'...y1,fit�t ,.s•4},.•`J:•rr:>.Yr}n$+ c•?., ,}•} rrrSi ::.c•.?�;.S:at>fi+,:.ar.n:+:.: g{v,:r..,::.y::•:.::.}{.{}.}+}+:•.a+•}:-::.raYf::.x}.;a>it•':c•;f} i{F:ccfai`.• 4.<{ay.y,Y•{;r.•:?n;+aty r;:u;it••L::•+al-i+•:.}]r+•?•^•>:.: :ff?v:Goa•.».fir.a?na n :Yr,+,?+,•'Sri:4i?•?•'.'..;Y:;{.g•,•.9?yY?•:F.{;:{ffn�'.+:.+,L•''•;';.?:{,::•[•••S,r:a:i:.y,.;•.?.t..a:,•v].,.;..:}•r •`t:•}}:i?La}S}•.i•+-.,•., ..........:q,:. ..,{..n:•}ii??•v:•ii.?'?'.�4ti•:}??,�;�r'`)}??;�}.?r'+v}{x4�(tit#:t:i r0:istiti{Si.'+i:�nfHi'{'fti�iR{::L•:4`V=.•:..:,}x,•.......::\... /�/� :'I��Q'L's.II�Pi:�Qi•:•:]}:•1a+:;':;r.,:•nf.titti.;ty4..:.:. '.:- uuu4n of a 3„aeup to sl4 .w io u/or Fie to aecme coverage as txgtdred mtder Section 25A of MGL 152 can lend to the mposition of ermsinalp one y , prisosunesd ty�,w penalties in the form of a STOP WORK ORDER and a One of S100.00 a day against me. Iunderstaad that a copy of this stat.ementmay be.forwarded to the 0MCe of Investigations o[the DIA for coverage veriffcation. er ms and pert 'eS ofP�J1'thrtt the information provided above is trtp an carted ' I do hereby certifyundthe ai P ` Date Signature �? �5�°t, WL , 6'C � Phone# Print name_ offid2l use only do notwrite in this area to be completed by.city or town official perudtliicense# • ❑BuUingDepirtInEl dry or town:— ❑Licensing Board ❑Selectmen's Office rherkifimmeal MPonscisrequired ❑Health Department _ ❑Other ` phone#; contact person: (,A"d 9195 PIA) v Information and Instructions Massachusetts General Laws chapter�152 section 25 rewires all employers o provide seroiceeof anothercompensation sation for their ract employees. As quoted from the `law , an employee defined as every person of hire, express or implied, oral or written. - r An employer is defined'as an individual, partnership, association, corporation or other legal entity, or any two or more o 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 o of a wner 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 section 25 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,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. '. FIAN! Elm Applicants k Please fill.in the workers' compensation affidavit completely,by checking the box that applies n to your situation, be suyplying company names,'address and phone numbers along with a certtfccate'of,ncnran Y submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and should be returned to the city,or town that the application for the permit or license is date the affidavit. The affidavit. big re�,uested, 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. WIN M&A PON City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided theme appli at cant.b Please f the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding app mitllicensa number which will be used as a reference number. The affidavits may be retmmed to be sure to fill in the pez 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 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 amce of 111Yesugauans 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 nbone#: (617) 727-4900 ext. 406, 409 or 375 oFIME, - Town of Barnstable Regulatory Services saxxsrAX , • Thomas F.Geiler,Director bless. 16s9• �� Building Division PIED Mp``l A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 _ r 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. pra(k'l-"Type.of Work: 0(\ Estimated Cost S ®o ao Address of Work: Owner's Name: Date of 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 MROVEMMNT 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 n,+P Owner's Name 5 • i no CMR AppaWh I Table J3.1113(continued) . preaeriptrve Paekagea for ace and TW*42=4 Faddentizl Euildlags E;eated wl th Fossil Fuelzr • MAXIMUM MINIMUM _ ; Heating/Cooling Gig Glaring Ceiling Wall Float �� paimeta Equipment Efficiency Ares'('/•) U-valttes R-valud R-values A-values R-w� � R Valuaf Paelcage 3I01 to 6500 Heating Degree Days' 6 No I2'/s 0.40 38 13 9 rmnI R 12'/e 0.52 30 t4 0 6 85 AFUE 5 12% 0.50 38 13 19 10 Normal 13 25 NIA N/A T 15% 036 38 tS NomW U 15'/, 0.46 38 19 I9 10 95 AFUE 13 25 NIA 1V/A y 15% 0.44 38 B 95 AFUE Qy 15% 0.52 30 19 19 10 Normal 13 25 N/A N/A 3{ 19% 032 31 NIA Normal y 18% 0.42 38 19 25 NIA 90 AFUE 13 19 10 6 Z 18% 0.42 38 5 90 AFUE AA 18% 0.50 30 19 19 IO - 1. ADDRESS OF PROPERTY: 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: ` Z 33 �`A s C( 3. SQUARE FOOTAGE OF ALL GLAZING: . . , 4• %GLAZING AREA(93 DIVIDED BY 92): O9,3Z L ; g, SELECT PACKAGE(Q AA-see chart above): -- . NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY°REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION BUILDING INSPECTOR APPROVAL: YES: NO: t .. q-forms-580303 a { t 780 CMR Appendix J Footnotes to Table A2.Ib: lass doors, skylights, and Glazing area is the ratio of the area of the glazing assemblies (including sliding-g basement windows if located in walls that enclose conditioned space, but excluding opaque doors) to the gross wall area, expressed as a percentage. Up to 1%.of the total glazing area may be excluded from the U-value requirement. For,example, 3 ft of decorative glass may be excluded from a building design with 300 if of glazing area. z After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table 11.5.3a. U-values are for whole units: center-of-glass U-values cannot be used. - a.- -. The ceiling.R-values do not assume a raised or oversized Truss construction. If the insulation achieves the'full insulation•thickness over the exterior walls without compression, R-30 insulation may be substituted for R-38 insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. 4 Wall R-values represent the sum.of the wall cavity insulation plus insulating sheathing (if used). Do not include 'or siding, structural sheathing, and interior drywall.For example, an R 19 requirement could be met EITHER eaten all requirements apply to cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. W r q pP Y by R-19 ca ty wood-frame or mass(concrete,masonry, log)wall constructions,but do not apply to metal-frame construction. °The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces, basements, or garages).Floors over outside air must meet the ceiling requirements. •The entire opaque poition of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade walls. Windows and sliding"glass doors of conditioned basements must be include_d with the other glazing. Basement doors must meet the door U-value requirement d-scribed in Note b. The R-value requirements are for unheated slabs.Add.an additional R-2 for heated slabs. 3 If the building utilizes ele6tric resistance heating use compliance approach 3;4, or 5. If you plan to install more than one piece'of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency rnust meet or exceed the efficiency required by the selected package. For Heating Degree Day requirements of the closest city or town secTable J5.2.1a k NOTES: a) Glazing areas and U-values are maximum acceptable levels. Insulation R-values are minimum acceptable levels, R value requirements are O insulation only and do not include structural components. wy.•. b) Opaque doors in the building envelope must have a U-value no greater than 0.35. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b.If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door, " One door may be excluded from this requirement(i.e.,may have a U-value greater than 0,35). c)If a ceiling,wall,floor,basement wall,slab-edge, or crawl space wall component includes two or more areas with the component comp lies if the area-weighted average R-value is greater than or equal to different insulation levels, P P the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). ' SHE Town of Barnstable P�p Tp ` Regulatory Services BAMS BM ` Thomas F.Geller,Director > 9YAM Building Division lop µpi( - Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder 1 ! ,as Ownez of the subject prop ettp hereby authorize e r,2ad to act on my behalf,. in all,matters relative to work authorized by this building permit application for: (Address of Job) S' of Owner ate 'e/ Print Natne Q:FORMS:OwNMERNMSION 1 BOARD OF BUILDING REGULATIONS V License: CONSTRUCTION SUPERVISOR Numbed�C�; 063172 Birfhdafe*Q9/21l963 `. Expugs09 Ct2003 Tr.no: 4995 i MARK D GRANT4' _ PO BOX 8/39 PLEASANT3 E DENNIS, MA 02641� ' Administrator Board of Building Regulations and Standards One Ashburton Place - Room 1301 Boston, MaOd usetts 02108 Home Improveme tractor Registration Registration: 129461 z « Type: Individual Expiration: 9/8/03 Mark D. Grant Mark Grant P.O. Box 8 E. Dennis, MA 02641 fp = Update Address and return card.Mark reason for change. Address Renewal n Employment Lost Card 72- TJ/L✓727ILOOtI!/CQGU2 a��ac/zuaeJa Board of Building Regulations and Standards License or registration valid for individul use only HOME IMP'RQVEMENT CONTRACTOR before the expiration date. If found return to: Board of Building Regulations and Standards Reg tration_A2- 9461 One Ashburton Place Rm 1301 ExPu$tlarfi 5/8/03 Boston,Ma.02108 t== yp_1j�'dividual ark D.Grant � r +`t ark Grant 1 Pleasant St. Dennis,MA 02641 Administrator Not valid without signs e l 3 ) CAPE ATLANTIC C00 OCEAN BAY / aRa tE 2 Q NANTUCKET LOCUS - - ROUTE SOUND _PROPOSED RENOVATIONS - CAPE COD,NO SCALE)SSACHUSETTS NO 65 TRINITYPLACE ( � � - - CENTERVILLE MASSACHUSETTS, 02632 AUGUST 01, 2003 SMOKE DETECTORS O.K. • RNSTASLE BUILDING DEPT.' NFIA•./SMOKE D=TECTOR REOUIREMENTS CLIENT: ARE N, 'h'1_AIN. EVEN THE ADDITION OF A a JOE & BETH O'BRIEN NEW BEDROOM WILL TRIGGER AN 65 TRINITY PLACE U CEPGRADE OF THE SMOKE DETECTORS r REV, CENTERVILLE MASSACHUSETfS, 02632 _ V�i FOR THE HOLE HOUSE. YOU MUST SHEET INDEX NO. ENGINEERING AND ARCHITECTURAL CONSULTANT: PLAN ACCORDINGLY AND HAVE YOUR - T-1 TITLE SHEET A 0 A-1 PROPOSED ELEVATIONS A TURNING MILL CONSULTANTS, INC ELECTRICIAN TAKE OUT THE APPROPRIATE q A-z PROPOSED FLOOR PLANS DEVELOPERS, ENGINEERS AND CONSTRUCTION MANAGERS PERMIT AT THE FIRE DEPARTMENT. A A-3 FOUNDATION&FRAMING PLAN A 88 TUPPER ROAD, UNIT 3 - GARAGE SECTION PO BOX 1159.SANDWICH, MA 02583 - ... PHONE:(500)BBB-4383.-FAX:(5DB)BBB-4248 MASTERHATH - . MUD ROOM ROPOSED SIDE ELEVATION , PROPOSED MASTER BATH(a) scAee:,re-er 1 0 i 2® sCAUP:VB'c' t 0 10 1 2® A-t . Sabinfeet - _ - We In feel e _ ee e �Ie� .m FH L-j E-11 ---------------- --------------------- PROPOSED FRONT ELEVATION -,-- PROPOSED REAR ELEVATION a SCAIE:tR•_,• A-� -1 0 1 2 3 4 5 6 1 9 scJ :,AP=t• ® 1 0 11 0 1 2 3 4 5 6 7 8 A-t sa(e to fat Sde b fret TURNING MILL CONSULTANTS, INC Designed by SHM7 NUMBER SCALE DATE PREPARED FOR SITE LOCATION A-1 DEVELOPERS, ENGINEERS AND CONSTRUCTION MANAGERS Drawn by . 88 TUPPER ROAD, UNIT 3 Checked by - aOxT TITLE PO BOX uss, SANDWICH, MA 02883 Approved by • SCALE: 1/8" = I• 08-0>-03 JOE &, BETH O'BRIEN 65 TRINITY PLACE PROPOSED PHONE:(806)888-4883-.PAY-'(808)088-424e - CENTERVILLE MASSACHUSETTS ELEVATIONS 5 BATH BEDROOM 13' BEDROOM B•%7• '. CLOSET GARAGE DOORS 4 4 �4 o 24• _ GARAGE AIR . 41 UP 24' AIR• 14' DOWN .BONUS ROOM MUD ROOM : PORCH WALK IN CLOSET L 27' �_— 27 L PROPOSED GARAGE / FIRST FLOOR PLAN , PROPOSED 1ST FLOOR PLAN z 9CAU°:1APe 1• A_2 .' - 3CAlE:VW.1• _ p-2 9eaiein feet - Sine lO fee, _ - 7•_0_ 0. 3 � ® ® PROPOSED MASTER BATH PLAN a SCAW:v :1' 1 0 1 2 3 4 5 6 7 8 1,a-2 Seale l0 feel Bi TURNING MILL CONSULTANTS, INC Designed by SHEET NUMBER DEVELOPERS, ENGINEERS AND CONSTRUCTION MANAGERS Drawn by SCALE DATE PREPARED FOR SITE LOCATION A-2 BB TUPPER ROAD, UNIT 3 Checked by SHEET Trn.E PO BOX 1159, SANDWICH, MA 02563 Approved by • SCALE: 1/8" = 1• 08-01-03. JOE & BETH O'BRIEN 65 TRINITY PLACE - PROPOSED PHONE:(608)BBB-488O—FAX(608)888-4E46 CENTERVILLE MASSACHUSETTS FLOOR PLANS r The Town of Barnstable Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis,MA 02601 j 862-4038 1 790-6230 PLAN REVIEW ner: �J�" 1 Map/Parcel:7`fi 8 ectAddress: Builder: !\My-VL �� VC' -yA COVA*. e following items were noted on reviewing: qn- r � =d Cz t ) 1 n L�IU V^ C�l'►^ 1� 20 19- v iewed by: . r . 7T.,. 77 - 34 +. 4 3 't FN b:. 44'.t IKut>:Rkbr" �. N N .,U 880 S.F. : EWER 41 f ,.. ; r . f CERTI FI ED PLOT PLAN: LOCATION dE-h�TERVILLE MASS.i. .CERTIFY THAT THE FouNDA -ioW ,SH.OWN HEREON COMPLYS' WITH SCALE I'a 4o' DATE 10(i 8 Ibq THE SIDELINE.. AND SETBACK REQUIREMENTS OF THE TOWN Of PLAN REFERENCE BARNS'f'A131-9� AND IS j.JtT LOCATED WITHIN TH.E . FLOODPLAIN. PLAQ eoQY- IZ9 ?AGe ►3s' DATE : BAXTER NYE, INC. THIS PLAN IS NOT BASED ON AN REGISTERED LAND SURVEYORS INSTRUMENT SURVEY AND,THE OSTERVILLE—. MASS. OFFSETS SHOWN SHOULD NOT BE USED TO ETERMI'NE LOT LINES, APPLICANT S SI $ RoWf-J f RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 b G FEE VALUE WORKSHEET NEW LIVING SPACE p 9-2 9 square feet x$96/sq.foot= U x.0031= 2 1 plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0031= plus from below(if applicable) GARAGES(attached&detached) �- square feet x$32/sq.ft.= 2 0 x.0031= `�a ACCESSORY STRUCTURE>120 sq.ft. 4 L} >120 sf-500 sf $ 35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 _ >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00 (number) Deck x$30.00= (number) • Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fee,� � I i i ; I, I 1 -34 6'$.1sTK6 44'�+_ � J - - _ J 7- N i I � I I �5/ 1 I' BAX-fEA > ' _ _ r , I ` •. 61d 24@4 9fct j. 12 0' CERTIFIED PLOT PLAN LOCATION CE1.)TE:Rv►LLE , MAs�, I CERTIFY THAT THE ,FouNDA toN ,SHOWN HEREON COMPLYS, WITH SCALE DATE 1o+1 $ ,�� THE SIDELINE - AND SETBACK REQUIREMENTS OF THE TOWN OF PLAN REFERENCE B ARNSTA,BL 9 AND: IS �Jo—F LOCATED WITHIN THE : FLOODPL' AIN. :PLAk3 8®raL izq \?A&e I35 DATE BARTER NYE, INC. THIS PLAN IS NOT BASED ON AN REGISTERED LAND SURVEYORS INSTRUMENT SURVEY AND THE OSTERVILLE— MASS. OFFSETS SHOWN SHOULD NOT BE USED TO DETERMINE LOT LINES APPLICANT T. 13f--wwN o�7N�>o TOWN OF BARNSTABLE Permit No. . .3308...... BUILDING DEPARTMENT a I TOWN OFFICE BUILDING Cash .............. 7 .Yl 679• HYANNIS.MASS.02601 Bond X CERTIFICATE OF USE AND OCCUPANCY Issued to Joseph O'Brien Address Lot #4, 65 Trinity Place Centerville Mass. USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR U?ON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND.IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. March 13, , 19.... 0......... ... Building Inspector 1...,M.,�,,.Jr .-..n,..�,.n;.�,;Y^.,er�;,.,.�-*... %"^�`'�-'�.-'�.---w.I'-.fls'�-+'Y•.-.-�-"a�'�`-.>rr�1'�i'L.•._,y,.,r'i�^'71"-''.""''V'"- y^'�'"y,....?`+f:-^�'.----`.-.-..'•�•`—./' o, TOWN OF BARNSTABLE Permit No. .�3,30$,,,, BUILDING DEPARTMENT a I TOWN OFFICE BUILDING Cash HYANNIS.MASS.02601 Bond ..... .......:. CERTIFICATE OF USE AND OCCUPANCY Issued to Joseph O'Brien `, Address Lot #4, 65 Trinity Placd' q Centerville, Maass. USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND.IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. March 13.!........:, 19....90......... .. '. � Building Inspector „ 7 a , ,.� °•� TOWN OF BARNSTABLE •`f °" BUILDING DEPARTMENT Z asaa�T % TOWN OFFICE BUILDING t639' �� HYANNIS, MASS. 02601 1 MEMO TO: Town Clerk FROM: Building Department DATE: /3_ J cj g/e An Occupancy Permit has been issued for the building authorized by Building Permit #........`3..�3��.�8' ......._. ........................................................................................_................ .......... .._..... issued to-\l........._..n-...:..13 r..!.�J................ ..... ...... 5... ...... ...�J!.v..�..;�....... Please release the performance bond. TOWN OF BARNSTABLE, MASSACHUSETTS BUILDING P " RMI t DATE 19 PERMIT NO, APPLICANT ADDRESS (NO.) (STREET') I C 0 N T R'S LICENSE) PERMIT TO STORY- NUMBER OF (_)(TYPE OF IMPROVEMENT) NO. (PROPOSED USE) DWELLING UNITS AT (LOCATION) ' ZONING (NO.) (STREET) DISTRICT ` BETWEEN AND (CROSS STREET) (CROSS STREET) SUBDIVISION LOT BLOCK SIO E BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTI� TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) R":MARKS: AREA OF. VOLUME - ESTIMATED COST PERMIT s . (CUBIC/SQUARE FEET) FEE OWNER ADDRESS BUILDING DEPT, BY THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PARI THEREOF. EITHER TEMPORARILY C ► PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST IL A PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE 08TAINE FROM THE DEPARTMENT OF PUBLIC WOrKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDIT101 OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING AND I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MINAL IN IRE INSPECTION TO LATHE FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPRO: S 1 I�V�lL ��• 1 4 / JA�1- 2.b• 2 k �:� mw �• �` `to 3 HEATING INSPECTION APPROVALS ENGINEERWG DEPARTMENT 1 OTHER -- p BOARD OF HEALTH 4' Q b WORK SHALL NOT PROCEED UNTIL THE INSPEC- I PERMIT W!LL BECOME NULL AND VOID IF CONSTRUCTION TOR HAS APPROVED THE VARIODUS STAGES OF I WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE INSPECTIONS INDICATED ON THIS CARD CAN CONSTRUCTION. 1 'PERMIT IS ISSUED AS NOTED ABOVE. ARRANGED FOR BY TELEPHONE OR WRITL 111 NOTIFICATION. I =� �X1 (7j I f i 1 I y �: ! !• tji 1it . r I I t�l I t 1 II i ' 1 � Imo--- I ! ,,�'I ��I�• I ! '�,'� Hit J ii = Q i ' I 1p1' I � {II' li�;�• li i� � IIII I I I ll d j IAi I' !LtII' I � I( �� • !,I I, I� I tli I!I� � ! I II'I II i�jl;l / i I ! L i I { { ow Mellon 0. I I 00 m r aml p I l t i I I , A .�4A4Aj '1 it � I i iliLjl }I�IIi II I; i I i ! I I fl i �r a )11 } l i i� I �I II ' I a� 11 t} I �' I I 1:�.-�; �� • Ili{ II Illi tl -1 tt to if 1�� I I � '.II tll� Ir!— ��I ;�'� 1. �..up�� { FIT i .`•!'f� },} V I { , h7� 3. j i !�. t 1p l ILILIII TD, I , I � .. l.b �� _ i •�� II �1. 1 �1 1 Sa_ ��1'. i F—F.�!!�'�, �� F r ' t it l I l a s , l 1 { i f i - i I av,av /T7 �. f ! 1 `;i-.�� \ �� +�vn+_.4'• Aga k •�.� !z j , i �,�� -- _�'. � it ice• _�____Sf Ei . •• - iii - - 13-6" { i { i � T r ► �� iL 6• .� �r s • tp ' i Q' L. 11HII I i i 1 I L I I1 i f ' I J �D\ eL A I { r iti W �- n .7J �1 d 7=G c �I LZ 5-3 I -c l 9! r m; 0 0 r �r y a h o ,! J Ll I v � ao 1 � n N� 1 \ I U � - O �, p Assess'or's map and lot number ....o .. .t .:...........V. ......... PROF 7N E tp�4 Sewage Permit number ..... c"...Y..y: ....�,n...:...... 1 • / s/ /�„� I l/� Z H6BB^S LE, & . ............ i House number .......................... ... .................../...... 90 p 1639. \0� E YPY a' A P P R 0 V ETOWN • - OF - BARNSTABLE et le C nservationzcoLlsiuon 4 ILDING INSPECTOR S fined IDatA ,(�� k t: • APPLICATION FOR PERMIT TO ....... .4.........................................1.:.:✓�sT�`•.�� 1.�-:.�...........:.......: TYPE OF CONSTRUCTION ...�G?.�1�........��.�....k!'.!:!:�............................................................................. �..-...1..........................19. %.7 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies ifor a permit according to the following information:. Location .. ? ...... ........�✓Z+.4�I.J�l........t: .(,:� fo ................�:.C1:6��r�.:-v�.�.I.':�'...............d.:!.��............ �..�.�.�... Proposed Use ... . ��. .e...�.]:L�ell. l� e•.. ........... :..1.b%dcp.......:..................................................................... � ZoningDistrict ........................................................................Fire District .....�..+�::............................................................... Name of Owner —Twe......... .�. k s .t�l.........................Address ...1` .:.......Cei.!l.......... Name of Builder 2.5,.k .-.n........ 1�w6'1... ............Address 1. f�' r7A... 1.e.m .....t�,�<.......C, ............. Nameof Architect .........k1o. .............................................Address .......A:........................................................................ �O u>it Number of Rooms ....... ...................................................Foundation .....................4. ......... ............... Exterior ...0.4fl.c4A...........5.h..'`.�.%LL..4e;s....J>,..(%O oofing ........4r-_,,64a,-f................................................ Floors �C 2 . A. ?.a�........ ..1.41.. ..............Interior ...�� , . .!!�4I. .................................................... Heating .. ..g!��......... ...............................,...Plumbing ..../....l.A......../... ...................................... Fireplace ...%n ............�/ -c........................... .............Approximate Cost .. . ...0v .�.............................. Definitive Plan Approved by Planning Board !�--L_1—U --- �!__��9 Area7.�a?.-:s..... ........... Diagram of Lot and Building with Dimensions Fee ................... SUBJECT TO APPROVAL OF BOARD OF HEALTH L ' 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 -. L_�...! ...-_r ........ Construction Supervisor's License ... 1. jam................. 7 O"BRIEN, JOSEPH No ....3.3.3.0.8. Permit f B ild 2 Story Gr. ....... ..SW..` Sin le. Raail amw e 1 gg j.c Single. ti Location 6...5. rFrinity Place . ................................ Centeo -.11A.I...................................... Owner .....B.r.. i.e.n................... Type,of Constr6ction ...:L...VM ....................... ...........................4...............;........ ........................... Plot ........................... Lot ............. .................. Permit-Granted ..,..October 20........19 89 ............................ Date of Inspection ....................................19 Date Completed ....... .............19/Pv t Assessor" . . is map and lot number .... .. .: ....... � ' THE / f T� Sewage Permit number ..:................/. ...........�....:............:..... 33AUSTADLE, i M House number .......................... �::.......r�:....... ............�}1.. - �9 am a• TOWN OF BARNSTABLE BUILDING ANSPECTOR Im APPLICATION FOR PERMIT TO E / n+ i,,,,,;,,,,,,,,,,,,,, TYPE OF .CONSTRUCTION .... .........r '............................................................................. ..........................19.A 9 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: �,,/) Location ..A �.......�....................}�?1. � .... .-....: ...............C'Cn:�,P,:�2v!.�l:e.............s'.!.� .. ........�?. (,.,. ... aProposed Use ... . '. .p................ ... ............ .�`.'I°,!. p rl .............................................................................. / Zoning District ........................................................................Fire District ..... (It...�-.Q.......................................................... a Name of Owner ,7r?f........0.........':: '..<. .......................Address .�t�.. .,f�r'� 1!�aT�rte,...r?X.:.......`....�,!',�....... a Name of Builder .......... ................� !; ........... ... ........Address .1... ,l�r+�.....��d��'. 1... tty:.......og? .�. ..,........... P Name of Architect ..................................................................Address 1,1..4 Number of Rooms ...............................................................Foundation ..�f Du r�c.!..1........... A4'lC.,r4 .................. � f? Roofin .. .. . . .................................. Exterior ... car!Z......................fi .......::............. r g �� r� / ................. n � / Floors ....;h+�...!l,.,:.•...........Interior �� . Heating ,4�re .......... .......................................:.................Plumbing .... ...: <�:.........',�4 .'...... r. 4 Fireplace .... YL'.......... «. .......................... .............Approximate. Cost .. ..X� o .00. j. .. /Y _A_U,` __19�f/��9 Area Definitive Plan Approved b Planning Board _. ...?.92...: ......, 3......... PP Y g Diagram of Lot and Building with Dimensions Fee . . ...............✓ SUBJECT TO APPROVAL OF BOARD OF HEALTH 1 I t � 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. 41.2 ........ Construction Supervisor's License ....3'7''•...4n................ i J O'BRIEN, JOSEPH A=248-008 t s No A.119 .. Permit for ..Build...2 Story ........... inglg...j amily„dwelling.......... Location ....T,Qt,....#4.,,.,,,,,65... rinity,.,Place ..................: ............................... a Owner e h O'Brlen Type of Construction ...F MP.......................... ........................................... .i. .......................... -L "a Plot ............................ Lot .:........... Permit Granted .....Q9I.Q.b.e-,:... 0.,.......19 89 Date of Inspection ....................................19 Date Completed ......................................19 PERMIT COMPLETED 111;-0/ . - DOUBLE 2'X6'P.T.SILL(TYP.) ... . ——DOOR c TGi=-16 O.C., DOUBLE _ I - B;GI 9o05�=J `f�'-'i�'V4')(16 LVL�- r'----------- —I - I I - (TYPICAL) ..., � ,. WINDOW ——— —.———10'X20" I I I I EXISTING . I FOOTING FOUNDATION ' STAIR I I I L————— I� OPENING 1p•. I-------- I I 6'TYP. . n I I I 24' DOOR TO - - CSTIN ELLARG 7e 14' - / 24,' 1I r i �\r e Cti LYJV' L • I � I IIIr J rF OOU9LE 2X6' I ,. 5' P.T.SILL(TYP.) ----------------- I 2'X1 D'JOISTS 10. ..,I 16 O.C. (TYP.) 2XIY'RIDGE BOARD.- PROPOSED FRAMING PLANz PROPOSED FOUNDATION PLAN SCALE:1A1-=1. 1 0 1 3 3 4 5 6 7 e A-3 _ SCILLe:v6^eT 1 0 I 2 A_3 121�2'X72'ROOF JOISTS, ® . 12 sale to feet SeaktufeetQ12 . 2 X6'CEILING JOISTS - DOOR OPENING FROM GARAGE - ` AIR's —FROM TGI L—O.C. GOM ARAGE 6C. 9005 — III 6.-6. 10, . r . I W GARAGE SECTION , .. - SCALE:IIS•v l• A-3 1 0 1 2 34 5 6 7 S. ` Sak 1.fut - TURNING MILL CONSULTANTS, INC Designed by SCALE Numm DATE PREPARED FOR SITE LOCATION A-3 DEVELOPERS, ENGINEERS AND CONSTRUCTION MANAGERS Drawn by 66 TUPPER ROAD, UNIT 3 . Checked by PO Rox 1159, SANDWICH, MA 02583 Approved by SCALE: 1/8" = T' 08-01-03 JOE & BETH O'BRIEN 65 TRINITY PLACE FOUNDATION & CENTERVILLE MASSACE USETTS FRAMING PLAN PHONE:(fine)eee—area..PAx:(fi6e)eee—azae - GARAGE SECTION pew- "TEST -z- TA ' P-7353 /Zo � / TP�1 d -r-p*-Z Z. . Sobsail Sul.soi ( 1 /Nowt 24° Z. Z4" 38,0 / A2 Al Stn.fi Sfrc.+ fL� >� h1'1 ceQ orvi 3lal / // �� /� / V ?11.cl1ur-1 bamd / / , / N f SA„& 35.b y D. i // /i / t` w 1, 00 Sv Ile % // % pp 10 V ►N1<J,u,.•. .,,. %•: t_,�, Aso, , � S/•/�` , Sa..bQ A� 1 / I / (,OV. G.V kr� AA i 00 Im . .. �, 20.Z IZo'r �, ..i 30.C r' Yp►� /' OF d i STEPHEN o RBCHARD ALLYN A tiG�`�� ✓ i s yw 1 WILSON i v BAXTEFi N" l.. . . . . .. r 0tF�GIS4� �,p ISTERE� 0 Al- / / slp� SO j MA AIM I . YZOy !. , LV fill o/lf, i y► .. i $rcaiLOJ4 _�olC.-i-�31tISQ s $Q �,��, l � s NU Lg-.FA%41 LY 3 BMN2�� Nv c izt�Ac�� 4 R I Nl>c—p- /VO TLS IT c7G1(C. VCTi.LCI .tk�:P�ig1_•.( IV.Ca. L�J • ham. USG I do o cogLNL• TAN K --- sum•fo�cP__l=an ba5l ctl. Scruic.c4._._..------- —•-- ------ ---... bI U5M /000 Ci•dtL W�2 "srdi� ; SI bE'VJALLA / 78 5, F 5,F x 2 . S q9s C-rP, p. �CJTT'D M1=A S.I✓ x 1, O = 79 U.A D• TbTA I.. `TOI&L- T:�dILY F-LbW V D. T-15U=0LAr t 0Kl s,,MZr•c; W (N htl N OR LESS TIEST I-1bLE (-rc4,r +o c.bovc, F ,.a _ V G i /OQp .. INv ntsT. INv try ills". Ik)u so.o. G%A1- qz.o f3O�t 4&5 p TN �.d1 4J�. ., wrtH IIJV. IIJv, j .. . N , Vl.r=V.36,3 �- TFt1►JITY lm-La►c-6 }-- 1-.L i F�'. I. \ L.E I =40,Cb�� Zor Z NGVi> WO 1..E P4- g14. 1 H>=210W CdMPu(S WITH 'T4E 51DSU).11~ Tmmb LA ��y.�T'�ZVILL� '`+'' MAIM ANt� 5ETSA4V- $�'EQUI IZ�.ivl f~r. jT.5 OF 'T'Hg I : I L Oe-'A—rvzt:� WrrPIN THE FLOOP P�;1W. , .i j•.1 N , . , _ ._ . -TN is r�tu 1S�,iorr.�s .:�.' ` t� • :. 1t7..' N N` `Sty 8 9 o u HAS w . !M. ... I