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0467 OCEAN STREET
r7 c e S+,,z-ee4- 11 4 1 t �A �tME Town of Barnstable *Permit# G� Expires 6 months from issue date Regulatory Services Fee BAMSTABM • 9� MASS.s9. `0� Richard V.Scali,Interim Director plFO MA't� = Building Division Tom Perry,CBO,Building Commissioner Liu I I no 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 T( aAW=P j23�0 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY i a 60.1 ®Not Valid without Red X-Press Imprint Map/parcel Number Y _ 1 Property Address C(J`c 4,41 YL4 Residential Value of Work$ .— 00 Minimum fee of$35.00 for work nder$6000.00 Owner's Name&Address Contractor's Name d P. �� �� Telephone Number Home Improvement Contractor License#(if applicable) Email: �� y Yqr �� ��� `AC Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietorX-PRESSPERMIT ❑ I am the Homeowner I] I have Worker's Compensation Insurance DEC 12 2013 Insurance Company Name F Workman's Comp.Policy# __b�K PU N OF SIMMS' ABA Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) Re-side Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Prope Owner must sign Property Owner Letter of Permission. A cop of th Home Improvement Contractors License&Construction Supervisors License is 7ir d. I SIGNATURE: 9 QAWPFILES\FORMS\building permit f doc Revised 061313 77ke Cammonweakh of Massackusetts Depurhnent of Industrial Acciden& Office of Investigations 600 Washington Street y Boston,MA 02111 rv'rvrv.mas&gov1dia Workers' Compensation Insurance Affidavit:Bu lde.rs/Contractors/Electricians/Plumbers Applicant Information ^ Please. Print ' b Name Buduessoganirationadntdual): Address: I 1 -Ph City/Sta&Zip: F` T v ►� "nJ- e 7 Are you an employer?Check he appropriate bo=: Type of project(required): 1 I am a employer with 4_ ❑ I am a general contractor and i employees(full an+dlorpovt-time). * have Hired the sub-contractors 6. New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g_ ❑Demolition working for me in any capacity. employees and have wodcers' [No tti orkm' comp.insurance cep-insurance.] ❑Building addition required.] 5. ❑ We are a corpomfion and its 101-1 Electrical repairs or additions. 3.❑ I am a homeowner doing all work officers have exercised their I L E]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' 1311 Other comp.insurance required.] *Any z"b3irrdiztdiecks box#1 mast also fill out the section below shorwing their workers'compensation policy infini nrtion. I ffnmeowners who submit this af5dssqt iadicatmg they are doing aR woik and.then hue outside contractors mast submit a new affidavit indicatiq sack. :Contractors that cheek this boa must attached as sddid tW sheet showing the name of the sub-contractors and state whethet or not those entities bane employees. If the sub-contractors have employees,they in=provide&eir vwrken'comp.policy number. Taxi an employer that is prodding workers'congwisadon insurance far iwiy employees. Below is the palicy and job:site information (� ,k I� Insurance Company Name: �j 1 / Policy A or Self-ins.Lie.9: C—o�v-off 6 'tea-Z E�rpirationDate: Job Site Address: qG ( 0 G?,a. CitylState/zip: A Attach a copy of the workers'compensation policy declaration page(shoving 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 andfor one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fm- e 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 cerhf,I� der th pair andpenalties of perjury.that Hie information prmpided above is true and correct Si Date: - lC-> - Phone#: V 3 O icial use only. Do not write in this area,to be completed by city or town official, City or Town: PermitUcense# Issuing Authority(circle one): 1.Board of Health 2.ceding Department 3.CiVrown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 6 Town of Barnstable Regulatory Services } • =AENSY'ABLE, i MASS. $ Richard V.Scali,Interim Director iGg9- �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 r I, ep �n t' C , as Owner of the subject property hereby authorize n 04 cc to act on my behalf, in all matters relative to work authorized by this building permit. (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. .' Signature of Owner Signature of App antP -e PXPA (N Print Name Print Name Date Town of Barnstable Regulatory Services o,*IHE Richard V.Scali,Interim Director ti Building Division anruvsrmr E Tom Perry,Building Commissioner MASS. 9cb 1634, ��� 200 Main Street, Hyannis,MA 02601 iOlEo Me+� www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB.LOCATION. number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use an 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 he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\E)TRESS.doe Revised 061313 — r 41M Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS402512 DANIEL J JOYCE JR PO BOX 117 s WEST HYANNISS' 2672: �j,,�1 Expiration Commissioner 12/13/2014 ,per GTE-P� �✓l����` Office of Consumer Affairs&B smess Regulation -3 HOME IMPROVEMENT CONTRACTOR:. Registration:F-1,58158 Type: Expiration 92/17/20.13' DBA t._ DA IEL JOYCE CONS3RUCTION` . . '- DANIEL JOYCE \ LM `. 14 DOLPHIN LN. ` HYANNIS,MA 02601\tiL Undersecreti ry._ License or registration valid for individul use only' before the expiration date. If found return'to: X Office of Consumer Affairs and Business Regulation I 10 Park Plaza=Suite 517 t Boston,MA 02116 1 n Not valid ithoi t s nature AC"�� 12/1 /20 CERTIFICATE OF LIABILITY INSURANCE DATE(M2/2013 13 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DO ES N OT AF FIRMATIVELY O R N EGATIVELY AM END, EXTEND O R ALTER THE C OVERAGE AF FORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF I NSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING I NSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Atlantic Insurance Group Agency Inc NAME: Berkley Assigned Risk Services 530 Adams St A/C.No.EA): 800 634-4589 FAX No.: 866 215-8118 ADDRESS: PolicyServices@berkleyrisk.com Milton,MA 02186 INSURERS AFFORDING COVERAGE NAIC# INSURER A: INSURED Daniel Joyce INSURER B: dba:Daniel Joyce Construction INSURER C: PO BOX 117 INSURER D: INSURER E: West Hyannisport MA 02672 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 ADDLISUBIR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD MM/DDIYYYY MM/DDIYYYY GENERAL LIABILITY EACH OCCURRENCE $ D DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ ❑ CLAIMS-MADE ❑ OCCUR ❑ ❑ MED EXP(Any oneperson) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY ❑JECT ❑ LOC $ AUTOMOBILE LIABILITY ❑ ❑ O BINED SINGLE LIMIT accident $ - ANY AUTO (EM $ ALL OWNED BODILY INJURY Per arson AUTOS ❑SCHEDULED AUTOS $ . BODILY INJURY Per accident) HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS Per accident $ ❑ $ UMBRELLA LIAB ❑OCCUR ❑ ❑ EACH OCCURRENCE $ EXCESS LIAB ❑CLAIMS-MADE $ AGGREGATE DED ❑ RETENTION$ $ WORKERS COMPENSATION WC STATU- o OTH- AND EMPLOYERS'LIABILITY YIN TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE ] E.L EACH ACCIDENT $ 100000.00 A OFFICEIMEMBER EXCLUDED? NIA ❑ WC-20-20-002552-04 12/1/2013 12/1/2014 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100000.00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500000.00 ❑ ❑ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Election Category Election Status Name All Entities/Insureds: Sole Proprietor Exclude Daniel Joyce Daniel Joyce CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Town of Barnstable EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 367 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Hyannis MA 02601 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ti TOWN OF R Map � trl Parcel 6 Appli` �iorf#f" Health Division 2013 OCT 3 AJJDRte2rued /0`7-/3 fit Conservation Division Application Fee Planning Dept. ® Vx A;Armit Fee ( Date Definitive Plan Approved by Planning Board +G Historic - OKH A _Preservation / Hyannis Project Street Address Village Owner � e Address35 Telephone 17 r 60 7 3e?-x Perm' equest C �i. ; /� !-on eil 1 �� ir-1 n q TA:, P`✓d r v n Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new �. Zoning District Flood Plain Groundwater Overlay Project Valuation +� d� Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes 4-No On Old King's Highway: ❑Yes ❑ No Basement Type: gFull ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ftJ) Number of Baths: Full: existing new Half: existing I new Number of Bedrooms: 3 existingo ne , Total Room Count (not including baths): existing new 6 First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name In ��e l. 0 C ' Telephone Number Address v� � 1 LA � '� '►���� License# Home Improvement Contractor#MA jle&A r 1 J` CC Worker's Compensation #6/< _ ALL CONSTRUCTION D�BRIS RES rIING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE /� — ! FOR OFFICIAL USE ONLY �"- APPLICATION# R DATE ISSUED MAP/PARCEL NO. t ADDRESS VILLAGE OWNER t Y DATE OF INSPECTION: TFOUNDATIOR i, FRAME INSULATION 1 FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL. .5 GAS:, _ ROUGH FINAL FINAL BUILDING DATE CLOSED OUT r ASSOCIATION PLAN NO. 9 Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS402512 DANIELJJOYCE-JrR PO BOX 117 s WEST HYANNISPORTMA 'U267Z Expiration . Commissioner 12/13/2014 \. Office of Consumer Affairs&B siness Regulation ,f g HOME IMPROVEMENT CONTRACTOR",. `. Registration* 1:58158 Type: ` Expiration -'?J17t2013 DBA i' DA-I JOYCE CONSTRIiCTION ; - DANIEL JOYCE k =,, , 14 DOLPHIN LN. HYANNIS,'MA 02601 Uudersecreta ry,;. License or registration valid for individul use only `- •'r; before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation . 10 Park Plaza=Suite 517 1 Boston,MA 02116 t i. ,. Not valid itho,t s ature J� Tafti . Town of Barnstable Regulatory Services Msa Thomas F.Geiler,Director 1639. 16 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 j Property Owner Must Complete and Sign This Section If Usigg A Builder as Owner of the subject l property hereby authorize ( C n C O.7 C` to act on my behalf; in all matters relative to work authorized by this building permit i� C 7 OCe4fl sir. ,E A A, (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner ' Signature of pp3'cant ,37 /:�:/WZ cc_ Print Natne AtmtName Date QFORMS:OWNERPERMSSIONPOOL•S 612012 W ' Town of Barnstable Regulatory Services Thomas F.Geiler,Director 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 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street tillage "HONIEO'V IE : mane home pbone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow an individual for hire who does not possess a license oyided that the owner acts as supervisor homeowners t�engage r �. DEFINMON OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides'or intends to reside,or 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 EXENIMON The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15).This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a formlcerlification for use in your community. C:\Users\decolliklAppData\Local\Mcrosoft\Wmdows\Temporary Internet Ffles\ContmtOutlook\QRE6ZUBN\F.XPRESS.doc Revised 053012 The Commonwealth of Massachusetts Depanwwnt of Industrial Accidents Office of Investigations Vj- 600 Washington Street Boston,ALA 02111 . wwry masLgvv1dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plnmbers Apipficant Information Please Print Le 'b ' Name(Busine fion/"7' Ci � �� �� �3U Address. v 9 �n City/Stat&Zip: Phone Are you an employer?ebeck the appropriate boa: Type of project(required): 1�I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(fall and/or parWime).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. [ Remodeling ship and have no employees 1"nese sub-contractors have g_ ❑Demolition wodring for the in any capacity. employees and have woskers' [No workers'comp.insurance comp.msurance.i 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.]' c. 152, §1(4),and we have no employees-[No workers' 13..❑Other comp.insurance required.] •Any applicant thsr checks box#1 mast also fill out tine section below showing their workers'compensation policy informstim 1HomeOWDers who snhmit this affidavit ia&cadag they are doing all wa*and then hue outside conttacmn mmt submit a new affidavit indicating such. Zco=wmrs that check this boa must attached as additincal sheet showing the mate of the sub-cmx=tm and state whether or not those entities have employees. If the mb-contmacm have employees,they must provide their workers'comp.policy number. I am an employer that is providing work 'compensation insurmue for my omployw.& Below is thepolicy and job site information. j Insurance Company Name: e I k, Policy#cr Self--ins.Uc.#: GJ c—,)U_2()�0 0�S3- J j Expiration Date: Job Site Address: 7- 67 Deem/ City/State/Zip: 7< Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requited under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 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 verifiration- I do hereby csrbffy nt the an penalties of perjnry that the information provided above is bare and correct. Si /� Date: igyp r Phone M � if V-a 3 Official use only. Do not write in this area,to be completed by city or town o i'ciaL City or Town: Permit/License# Issaing Authority(circle one): 1.Board of Health 2.Building Department 3.C3ty/Yown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 6 f Massachusetts Workers' Compensation Insurance Plan �rkl Y Acadia Insurance Company .NCCI Carrier Code 33391 Administered by Berkley Assigned Risk Services ASSIGNED RISK SERACES P.O.Box 1100,Minneapolis,Minnesota 55440-1100 Phone(605)945-2144 Fax(866)215-8118 Toll Free(800)634-4589 www.berkleyassigpedrisk.coni CERTIFICATE OF INSURANCE 1.The Insured: WCIP Policy Number.WC-20-20-002552-03 Daniel Joyce Tax ID#: F 03.4548408 dba: Daniel Joyce Construction PO Box 117 Policy Period: From: 12/1/2012 West Hyannisport,MA 02672 To: 12/1/2013 Date of Mailing:2/20/2013 The Certificate is issued as a matter of information only and confers no rights upon the Certificate Holder. This Certificate does not amend, extend or alter the coverage afforded by the Policy listed below. This is to certify that the Policy of Insurance described herein has 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 Policy described herein is subject to all the terms;exclusions and cond'Itions of such Policy. Tl(PE OFINSURANCE LlIINILS OF tlABlt.l3'Y Coverage Part One state(s) Workers'Compensation Statutory MA Part Two Bodily Injury by Accident $100,000 each accident. Employers'Uability Bodily Injury by Disease $500,000 policy limit. Bodily Injury by Disease $100,00T-each employee. Should any of the above described policies be cancelled before the expiration date thereof, notice will be delivered in accordance with the policy provisions. All Entitieslinsureds: Certificate Holder's Name and Address: Joyce Election Election Town of Barnstable Category Status Name 367 Main Street Sole Proprietor Exclude Daniel 3oyce Hyannis,MA 02601 Date Issued: 2120/2013 Atlantic Insurance_ Group Agency Inc 530 Adams St Milton,MA 02186 _ Signature_ Email`c ommonwealth of Massachusetts 3 �5heet-Metal Permit P Ma / Parcel / Date: 62-z 13 Permit Q 2a 5-91F d Estimated Job Cost: $ q 000, Permit Fee: $ 10 ao Plans Submitted: YES NO-)- Plans'Reviewed: YES NO Business License# - Applicant License# 30 s Business Information: Property Owner/Job Location Information: Name: ��L°dranzrel y V ¢c Name: sc�dr a '(Is e Street: qq o 1yo n S4. Street: 40 Qf.,ei►,, s�, City/Town: vd(A Yaa City/Town: 44 q kn is Telephone: JS� Telephone: ((P 1-7 901 -015Q Photo I.D. required/Copy of Photo I.D. attached: YES NO X-PRESS PERMIT Staff Initial J-1/MM unrestricted license AUG 2 9 2013 J-2/M-2-restricted to dwellings 3-stories or less and commercial up to 10,000 sq. ft./2-stories or less TOWN OF BARNSTABLE Residential: 1-2 family Multi-family Condo/Townhouses Other Commercial: Office Retail Industrial Educational Fire Dept. Approval Institutional_ Other Square Footage: under 10,000 sq. ft. V*/' over 10,000 sq. ft. Number of Stories: 2 Sheet metal work to be completed: New Work: Renovation: HVAC ✓ Metal Watershed Roofing Kitchen Exhaust System i Metal Chimney/Vents Air Balancing Provide detailed description of work to be done: 2n�� Ll i SCo`�y 1-Ql1-Zr eb 0 k",@m 0C6A- NSURANCE COVERAGE: F. I have a current liabili insurance policy or its equivalent which meets the requirements of M.G.L.Ch. 112 Yes❑ No IM indicate the type of coverage by checking the appropriate box below: f you have checked�xaz k liability insurance policy ❑ Other type of indemnity ❑ Bond ❑ DWNETS INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the Massachusetts General La s,and that my signature on this permit application waives this requirement Check One Only OwnerX Agent ❑ Sign a ure of Owner or Owner's Agent 3y checking this boxi, I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and Iccurate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be n compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Duct inspection required prior to insulation installation: YES NO ProgPess Inspections Date Comments Final Inspection Date Comments Type of License: Y ❑ Master , r `lie ❑ Master-Restricted ity/Town ❑Joumeyperson Signature of Licensee rmit# ❑Joumeyperson-Restricted License Number. .e$ ❑ Check at www.mass.govldpi saector Sionature of Permit Aboroval �- n. ES p ' 2, ® p11u1�;.. M�RA',at"g, �P Et t s COMMONWEALTH OF MASSACHUSETTS SHEET_METAL WORttERS AS A'MASTER-UNRESTRICTED ISSUES THE ABOVE LICENSE TO SCOTT `A FRANZREI & 9.9'0 14 A`I:N S T .� CSTCRVILLE. MA �2G55`=20J7 1306;8 (l9/28/14 249547i 1 ,a F{ 2194784a' den � 9901�AfIN STTTTTTT� 5? � dS�TERU;ILLE,tM�A }` ItV COMMONWEALTH'OF MASSACHUSETTS � SHEET METAL WORItERS { AS A :MASTER-UNRESTRICTED ISSUES THE ABOVE LICENSE TO SlTT A F,RANZREB U90 MAIN S'T DSTCR.VILLC~ MA 02655=201�T 1306:8 09/28/14 249547; ?; . The Commonwealth of Massachusetts Department of_&dustrial Accidents Office of Inveskgatioirs '600 Washington Street, _ Boston,MA 02111 wwN.massgovldia ' Workers' Compensation TnsaraIlCe Affidavit; Ririltlers/Contractors/Electriciam/Plumbers Applicant Information Please Print Lej_b Name Pusmess/Organizai mOhdivi �Go` rcd Y)il' Address: Q R 0446CI S} City/Sta&Zip Ae..-VI a D Phone.#: (50�� ' o?�d`,g -7� Are you an employer? Check the appropriate bom - Typeject(require : L❑ I am a employer with •4• [] I am a general con ra�-t or•and I � employees (inn and/or pall lime).* have hired ffie sib cnutractms construction . [2. I am a'sole proprietor or part=- listed an ihe-atfarh sheet; deling ship and have no employees These sub-U�nis have 8. []Demo}ifian working for me�any capa.ci ty. employees-and have wags' [No workers' camp.iE�U con3p..insunumeJ' 9. 0 Bmldpg addiEmn required.] 5. [] We are a corpotation and'fts 10.0 Electrical repairs or additions '3.❑ I am a homeowner doing EM.work officers have exrrrised theff 11.0 Plumhr ag repairs or additions myself [No warJ=' comp. right of exemption per MGL 12,�Roof repairs insurance required_]t c. 152, §1(4), and we have no employees. [No worktas' 13. Other -4V ACG comp.msnrance rr#red.] *Any appEcant ffiat checks box#1 cant also fill out ffic section below showing the r workers'campeasatim policy fi f mnation. t Homeowners who submit1his afnduit mfcafing they a=doing all work and thin hire outside cant ac a�m fast submit anew afndavftindicating such. tConfraetcas that c1=r .t1ds box mast attached an additional sheet showing the came of thb sub-c- actors and state whether ornot those entities have employees. If the sub-contmtn$have emPlQyees,they mustp-nd'e 9ss w-kern'coanp.poHcyuambcr. I fo an employer that isproviding workers'compensation insurance for mY employees Below is thepohky and job site information. • Iusurance Company Name: Policy#or Self-ins.Lic. Job Site Address: Attach a copy of the workers cnnzpensafion policy decIarafiun page- (showing the policy munber and eapirafion date). Fafinre.to.secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of¢gal penalties of a finE up to $1,500.00 and/or one-year imprisomnertt as well as civil penalties in the fozm of a STOP WORK OADER and a frie of up to S250.00 a day against the violajor. Be advised that a copy of this statamerit may be forwarded to the Office of Investigations of the DIA for msm=e coverage yeriftcadon. Ida hereby certYfy un the pains-and penalties of perj�f ult the bnf rmmian provided above is true and co _rrec Date: l R Phone 4 ed 1 Q use only, Do not write in this area,to be completed by crty or-town official City or Town: PermitlLicense# .Issuing Authority(circle one): =1.Board of Health 2.Budding De artnaent 3. o P City/Town wn Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Carctact Person: Phone#: i ,.:,� �- rofzHE Town of Barnstable } t Regulatory Se,. �. * rvic es1619.MASS ��$ Thomas F.Geiler,Director J. Buwiiding Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www-town.barnstable.ma.ns Office: 508-862-4038 Fa): 508-790-6230 Property Owner Must Complete and Sign This Section If Usi_fig A.Builder as Owner of the subject . J PtoP�y hereby authorize to act on my behalf in all•mattes relative to work anthotized by this building pPrn,if- (Address of Job) Pool fences and alatms are the res onsibili of -responsibility the applicant. Pools are not-to be filled-before fence is installed and pools are not to be utilized until all final inspections are perfotmed and accepted. S e oof Owner Signature of Applicant Ot.✓�R r� (S-( Ste- Fri n-2_reL Print Naive Print Name Dat QF0xMs:0VMWERMsSI0Npo0U IH Town of Barnstable L Regulatory Services Canxxsragr�, Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town..barnstdb1e.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village ':HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFIPIITION OF HOMEOWNER Persons)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended 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 minima__ n 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 ifthe homeowner engages a person(s)for hire to do such work,"that such Homeowner shall act as supervisor." . Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15).This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt f TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION - 5 1 C Map Parcel TOWN T . Health Division Date Issued 2913 JUL 31 P!'I �: 4�S Conservation Division Applica ion ee Planning Dept. Permit Fee . �3 Date Definitive Plan Approved by Planning Board t1 ;f Historic - OKH _ Preservation/ Hyannis Project Street Ad ress e ek/ 45 r . Village Ci n tQ Owner�-T 1Pu e S���r �`S� L 0� / S Address�S � 1 Telephone__ G 1 7 a Permi equest r e N�0 c/Q ve Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new. Zoning District Flood Plain Groundwater Overlay Project Valuatior/o 1 iX Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) C� Name hA, Telephone Number 6 ` T v� ✓ � _ �� �� Address I� °�'a ��� �^ �� C.4A ' License # /0 a Home Improvement Contractor# $ f Worker's Compensation #&-Ie"�O'ay 'V° �S'S L "0? ALL CONSTRUCTION DEBRIwo ESULTING FROM THIS PROJECT WILL BE TAKEN TO v M4C ^t�� �� d7 SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# ' DATE ISSUED > MAP/PARCEL NO. b 1 ADDRESS VILLAGE r OWNER r ' DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE d ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL r GAS: ROUGH FINAL R. FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations ' 600 Washington Street s' Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): 1-A (t Q r V Y C Address: �� ��"�� City/State/Zip: a n n(r�' A •— Phone#: �� �( � �� D ' y 3 31 Are you an employer?Check the appropriate box: Type of project(required): 1.Y 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. ❑New construction 2.❑ I am a sole proprietor or partner- .listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have g. Demolition working for me in any capacity. employees and have workers' � 9. ❑Building addition [No workers' comp.insurance comp. insurance. 10.El repairs required.] 5. ❑ We are a corporation and its p ' s or additions 3.❑ 1 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 employees. [No workers' 13.❑ 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. 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. I � Insurance Company Name: Policy#or Self-ins.Lic.0, Expiration Date: Job Site Address:�C 7 Oceei^ City/State/Zip: AvanALT 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$1,50.0.00.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 certznder t pan d penalties ofperjury that the information provided above is true and correct ? Si ature: Date: -7— J (— I 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#: f 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"eve state or local licensing agency shallwithhold p , § ( ) ry g g y the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance.coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASWE Revised 4-24-07 Fax# 617-727-7749 www.mass_gov/dia Bte--rkle.nylMassachusetts Workers' Compensation Insurance Plan Acadia Insurance Company NCCI Carrier Code 33391 Administered by Berkley Assigned Risk Services ASSIGNED RISK SERVICES P.O.Box 1100,Minneapolis,Minnesota 55440-1100 Phone(605)945-2144 Fax(866)215-8118 Toll Free(800)634-4589 www.berkleyassigneddsk.com CERTIFICATE OF INSURANCE 1. The Insured: WCIP Policy Number:WC-20-20-002552-03 Daniel Joyce Tax ID#: F 03-4548408 dba: Daniel Joyce Construction PO Box 117 Policy Period: From: 12/1/2012 West Hyannisport,MA 02672 To: 121112013 Date of Mailing:2/20/2013 The Certificate is issued as a matter of information only and confers no rights upon the Certificate Holder. This`Certificate does not amend, extend or alter the coverage afforded by the Policy listed below. This is to certify that the Policy of Insurance described herein has 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 Policy described herein is subject to all the terms, exclusions and conditions of such Policy. TYPE OF INSURANCE z � UMiTS OF LIABILITY Coverage ' .x w Part One State(s) Workers'Compensation Statutory MA Part Two Bodily Injury by Accident $100,000 each accident. Employers'Liability Bodily Injury by Disease $500,000 policy limit. - Bodily Injury by'Disease $100,0007 each employee. -- -- Should any of the above described policies be cancelled before the expiration date thereof, notice will be delivered in accordance with the policy provisions. All Entities/Insureds: Certificate Holder's Name and Address: Joyce Election Election Town of Barnstable Category Status Name 367 Main Street Sole Proprietor Exclude Daniel Joyce Hyannis, MA 02601 (: Date Issued: 2/20/2013 Atlantic Insurance Group Agency Inc 530 Adams St Milton,MA 02186 Signature_ _ bLOZ/£NZL lauoIssiwwoO uogejidx 'ZL9ZO dItii 11HOCISINNVAH imm „ LI I XOg Od -, Rf-43AOf f'13INVG Z LSZO L-S3 :a s u aoi-j joswadn5 uouanitsuo,D spiepue;S pue suoi;eln6a8 6uippriq to pjeo8 nA f3adeS oilgnd Io}uawpedag- sBasnyoesse jN int License m or registration valid for dividul use only \ Office of Consumer Affairs&B i smess Regulation HOME IMPROVEMENT CONTRACTOR. before the expiration date. If found return to: Registration: -1,58158 Type: Office of Consumer Affairs and Business Regulation Expiration 12/17420/3 DBA 10 Park Plaza-Suite 517 g _ Boston,MA 02116 DANIEL JOYCE CO,NSTRl1CTlON%, i ter _ \� > - DANIEL JOYCE l ... 14 DOLPHIN LN HYANNIS,MA 0260f Undersecretary Not valid itho t Mature MAM Town of Barnstable Regulatory Services Thomas F.Geiler,Director. Building Division Thomas Perry,CBO Building Commissioner 200 Main.Street,' Hyannis,MA 02601 ' www.town.barnstable.ma.us ' Office: 508-862-4038 , Fax: 508-790-62a30 Property Owner Must Complete And,'Sign TWOSeci on if Us*'ng A Builde, I• sP� ,•SLE ;as Owner of the subject'property hereby authorize t` d to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) ' Signature of Owner Date Print Name If Property Owner is'applying for permit,please complete the Homeowners License Exemption Form on,the reverse side. QA W PFILESTORMS�buildur I g permit formslE}TRESS.doc '• . . ' • � :. . ... • . •. .. ' : •' , �tME Town of Barnstable o Regulatory Services MAM t toss �• • Thomas F.Geiler,Director 59. Building Division Tom Perry,Building Commission 200 Main Street, Hyannis, MA 02 1 www.town.barnstable.ma. s Office:. 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE XEMPTION Please Prin DATE- JOB LOCATION: - O � AJ number �t village / Z� - / / Q HOMEOWNER": { 'TS�' naff1b / home pho # work phone# CURRENT MAILING ADDRESS: ✓U�` J7 2Af city/tow4 to zip code The current exemption for"homeowners"was exten d to include owner-oc ied dwell;---of six units or less and to allow homeowners to engage an individual for hire who d es not possess a license, vided that the owner acts as supervisor. DEFINITION OF HOMEOWN Person(s)who owns a parcel of land on which h she resides or intends to reside,o which there is, or.is intended to be,a one or two- family dwelling,attached or detached structure accessory to such use and/or farms ctures. A,person who constructs nibit thdn'one home in a two-year period shall not be consid red a homeowner. Such"homeowner"s 11 submit to'the Building Official on a form acceptable to the Building Official,that he/s a shall be res onsible for all such work erf ed under the building ermit. (Section 109.1.1) The undersigned"homeowner"assumes esponsibility for compliance with the State Building C e and other applicable codes, bylaws,rules and regulations. The undersi ned"homeowner"certi es that he/she unde'ratands�th-e Town of Barnstable Building b ep ent minimum inspection proce and.requi nts and t he/she will comply with said lirocedures and requirement. Signature o o owner Approval of Building Official Note: Three-fam'y dwellings containing 35,000 cubic feet or larger will be required to comply with the State ilding Code Section 127.0 Constructi Control. HOMEOWNER'S EXEMPTION The Code states t: "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 con ction Supervisors),provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowneishall,act as o . 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 rase,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. n.�..mr�i rn�rnnl�c�L..:1J:�..---:•F.....1 CVDD CC Ann .. .. _ . is use% " FIRST FLOOR FRAMING R30 A %mm4st EXTERIOR 2X4 WALLS HIGH DENSITY R15 nnv 1 � ;� WNSER/DRyER SLOPED CEILINGS 2ND FLR HIGH DENSITY R25 N ROOM '�+ - r+ FLAT CEILINGS 2ND FLOOR R30 At, . wx. . RRY—Yon IV, e a v : � � :-.a� .� g:. � - � � .:� .�.. ..ern, �r• � 'ff 4 ti e KITCHEN t-1 z DECK BEDROOM,# ENTRY '? 'S DN #. -d ; 3 11. 3' k .:$ ::"°P I i r ^a P F.'fir,'. •a 4R. a _ M.44 � I BEDROOM#3 FRONT ENTRY ENCLOSED PORCH 467 OCEAN STREET -TISE RESIDENCE - INSULATION DIAGRAM t�w 'own of Barnstable *Permit# Expires nths fro X PRMf Regulatory Services Fe Thomas F.Geiler,DirectorM Building Division TOWN OF BARNSTABLE Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY 4�z q CA4 d)�Not Valid without Red X-Press Imprint Map/parcel Number Property Address 40 ) CeGn 5+rce+" I �AAIJ AA A Residential Value of Work ©�D Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address �I l�� eA 4CA S 44 r� J S Contractor's Name Telephone Number 6(— o�3 9 r �� � ®y J� ' � � 7 7 � Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ! 0 ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner RI have Worker's Compensation Insurance Insurance Company Name 9 ` r le_ Workman's Comp. Policy# do"a'0 —00 d" S Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) W1�Co���� Re-roof(hurricane nailed) (stripping.old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is re ed. SIGNATURE: u Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 053012 The Commonwealth of Massachusetts Depa-phnent of Industrial Accidert& -� Office of Investigations 60,0 Washington Street Boston,.MA 02111 . wnwt}.x as&gvv✓dia Workers' Compensation Insurance-Affidavit: Builders/Contraactors/E-lecti-ic-ins/Plumbers Applicant Information I p lease Print Legibly Name(Business/Orgauizationllodividuai): Address, city/State/Zip: 4 ly C,4 4 k M A 0 �-C 0 ( Phone##_ Z Are you an employer"Zbeck the appropriate box: .0Type of project(required):1. 9; I am a employer with 1 4- ❑ I am a general contractor and I employees{full and/or part-time).* have hired the sub-contmetaus 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet, 7. ❑Kemodeling ship.and have no employees These sub-contractors have 8. ❑.Demolition woricing :for me in any capacity. employees and have workers" [No workers'comp.insurance comp_mgurance.x 9• ❑Building.addition regltui:ec1.] 5. ❑ We are.a corporation.and its 10.❑Electrical repairs or additions I❑ .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.� reps Roo€ 2 �OrD QQ insurance required.]s c. 1.52, §1(4),and we have no1� employees-[No workers' I I EI Other camp.msuranm.required.] Any applicant that checks box#1:mast also fdl out the section below showing their workers'compensation policy informaatiaa Homeowners;who submit this affidavit indicating they are doing all wed and then hire outside contractors must submit a new afdnit indicating such. lContractors that check this boa must attadW am additional sheet showing the name of the sub-contractors and state wbether or not those entities have employees. If the sub-contmaors have employees,.they arnst provide their Workers'camp.policy number. I am an employer that is proi4ding workers I compensation ins muce for myemplojw s, Below is the policy�jab site informazhar>. p U Insurance Company Name: �pJ Policy#or Self-ins-Lic.#: WC r 10-�D 00 ���- " b Expiration Date: Job Site Address: ''-1 b I 0 �.aA Sore eF City/Statezip: 0 ` C'I n"If 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 lend 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 cer ' under e=aNts o,fpet7itry that the inforntalion protrided above is true'and correct si Date: Phone#Official nw only. Do not write in this area,io be completed by city or town of ciaL City or To m: Permit/Ucense Issuing Authority(circle one): 1..Board of Health 2.Building Department 3.City/T.own Clerk 4.Electrical Inspector S.Plumbing Inspector 6.other Contact Person: Phone#, 6 Massachusetts Workers' Compensation Insurance Plan `/ Ber1 \ V Acadia Insurance Company NCCI Carrier Code 33391 y Administered by Berkley Assigned Risk Services ASSIGNED RISK SERVICE".) P.O.Box 1100,Minneapolis,Minnesota 55440-1100 Phone(605)945-2144 Fax(866)215-8118 Toll Free(800)634-4589 www.berkleyassigneddsk.com CERTIFICATE OF INSURANCE 1. The Insured: WCIP Policy Number:WC-20-20-002552-03 Daniel Joyce Tax ID#: F 034548408 dba: Daniel Joyce Construction Policy Period: From: 12/1/2012 PO Box 117 To: 12/1/2013 West Hyannisport, MA 02672 Date of Mailing:2/20/2013 The Certificate is issued as a matter of information only and confers no rights upon the Certificate Holder, This Certificate does not amend, extend or alter the coverage afforded by the Policy listed below. This is to certify that the Policy of Insurance described herein has 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 Policy described herein is subject to all the terms, exclusions and conditions of such Policy. TYPE OF INSURANCE` LIMITS OF LIABILITY ,,. ` ;, 4 Coverage State(s) Part One MA Workers'Compensation Statutory Part Two Bodily Injury by Accident $100,000 each accident. Employers'Liability Bodily Injury by Disease $500,000 policy limit. Bodily Injury by Disease $100,000----each employee. Should any of the above described policies be cancelled before the expiration date thereof, notice will be delivered in accordance with the policy provisions. All Entities/Insureds: Certificate Holder's Name and Address: Joyce Election Election = -Town of Bamstable Category Status Name 367 Main Street Sole Proprietor Exclude Daniel 3oyce- Hyannis, MA 02601 Date Issued: 2/20/2013 Atlantic Insurance Group Agency Inc 530 Adams St Milton, MA 02186 _ Jr Signature_ ' --� Massachusetts attrnent of public Safety -R gulations and Standards Board of Building Construction Super*,isor License: CS-102512 k ter. DAWL J JOY Cy": 0 VV BOX 117 N19TP MA 2672: _ WEST)<IYAN � '�� .` Expiration J M ��jt • ' �r 12M 312014 Commissioner }:1 C.n:aaaaesaapun ' L09ZO dW.'SINNb,IH + � ash , 4 'N-1 NIHdIOO tq i�l t }1 30 for 131Nea +' ' rvortona� roP 30kor 131 da _3 . b84 £lOZ7L°IZZ;L :u01;ej1dx3 adA.L 8B18S`L<=�'':uo � ;( ' 2iOlOt/ZIINOD IN3W3AONd1;e�;sl6aaW1 3WOH 'uoye�n$vaa��s�s�auls s ? f` -'IeJ3V-zawnsuoO jo aar z�ema��oz�cco �JO aanle s J ioy;r pyen;oN 9ILZ0 VIV`uo;soft ao►lu►ngag.ssaursng pue srtr IS ai!ns-ezela)1.1ed OI :o;it-mlar puno 33V�awnsuo��o aawb XWO asn J JI 'alep uogeardxa ay}aao�uq luprnrpur aoJ P►UA uolJea;s12a.r 10 asuaar7 f IKE } BARNSTABLE, •` 1659. ,�� Town of Barnstable. AjED MA't A Regulatory Services Thomas F. Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-7906'230� �`' V. Property Owner Must f" Complete arrd`§igif-T-h-sf9- —n , If Js-Aig A BuiWir 1LAf 1, �`y • ��� ; as Owner of the subject property r—p hereby authorize �� -� S �'Ce to act on my behalf, in all matters relative to work authorized by this building permit application for: `7 oG��J • (Address of Job) Signature of Owner Date WS�� Print Na e If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on-the reverse side. QAWPFILES\FORMS\building permit formS\*EXPRESS.doc Revised 070110 °FINE T � Town of Barnstable Regulatory Services 3ARNSTABL.E, ` Thomas F. Geiler, Director 9 MASS. F1639. Building Division Tom Perry, Building Commissioner 200-Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-403 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: - , / JOB LOCATION: G 1,j • ~ / AU I n ber st et''^^ village "HOMEOWNER": i �/ ^ -7 cl#Z na a �home phone e##., work p one# CURRENT MAILING ADDRESS: / • a city/to \dedn state zip code The current exemption for"homeowners"was o include owner-occu i dwellings of six units or less and to allow homeowners to engage an individual for hire wt possess a license, vided that the owner acts as su ervisor. ITION OF HOMEO NER Persons)who owns a parcel of land on which 'des or intends to side,on which thereis, or is intended to be, a one or two- family dwelling, attached or detached structure o such use a /or farmstructyres.'A persor.,whocohstrutcts`rnkre tha none home in a two-year period shall not be consideo er. Suc `homeowner"shall submit to'the Building Official on a form.acceptable to the Building Official,that he/she s on 'ble r all such work performed under the building permit. (Section 109.1.1) The undersigned "homeowner" assumes responsibility for co lianc with the State Building Code and other applicable codes, bylaws, rules and regulations. The under igned "homeowner"certifies that he/she and stands the ToA Barnstable;;Burlaigg,Department min 4 imurp inspection proc res and ui ments and that he/she will co m ly with said procedure and requirements. ; f ignature oT Homeowner Approval of Building Official Note: Three-family dwelling containing 35,000 cubic feet or larger will be re ired to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any h eowner performing work for which a building permit is required shall _ exempt from the provisions of this section(Section .109.1.1 -Licensing of construction Sup rvisors);provided that if the homeowner engages a person(s)for hire to do:s'ch,work,that such Wbmedwden fhatl,act is supervisor." Many homeowners who se this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisor ,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 070110 Engineering Dept.(3rd`;floor) Map ,3(;)4V Parcel '.0.3J1 6461� Permit#" �5 House# �lp '`�C3 ` Date Issued Board of Health(3rd floor)(8:15 =9:30/1:00-4:30) Fee, Conservation Office(4th floor)(8:30-9:30/1:00- 2:00) Planning Dept.(1st floor/School Admin. Bldg.) Definitive pproved by Planning Board 19 ; s _ BARNSTABLE. MASS TOWN OF BARNSTABLE' 'E°"°' i Building Permit Application , Pe' eet dress 4-7 (.C_ / Village Owner C Address 020 S441 it 1P �l -�1(y Telephone i Permit Request 1 e.First Floor square feet Second Floor square feet Construction Type 3�)'(� •�'?� [gal S44 -( - �C�1 Estimated Project Cost $ I�0 Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family Two Family ❑. Multi-Family(#units) Age of Existing Structure AV Historic House ❑Yes .9vo On Old King's Highway ❑Yes ZWO Basement Type: 6F-ull ❑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 New �® Total Room Count(not including baths): Existing New First Floor Room Count 4- Heat Type and Fuel: W'as ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name Pi- _ Telephone Number«,�7� Slj�,r-)E3L[ 6 Address _ � �[i�.� - License#— CS CX� S ct-1. c � w o-t ci Home Improvement Contractor# V Worker's Compensation# 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 Y(A SIGNATURE DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) ti _ FOR OFFICIAL USE ONLY _ t 1 J' PERMIT NO. _ _ - _ • � DATE ISSUED ' MAP/PARCEL NO. rya,, 't-J+. , •y = � t°, S '€- ADDRESS VILLAGE OWNER DATE OF INSPECTION:', FOUNDATION FRAME INSULATION r . F k h ti -- - t � .- ems- • ` � t FIREPLACE - - ELECTRICAL: . ROUGH ' FINAL PLUMBING: ROUGH FINAL , - ' GAS:- ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. i' r t i f {sy . �r �THEt� The Town ®f Barnstable K"st g► Department of Health Safety and EnvironmeIItaI Services BuiIding Division 367 Main Street,Hyannis MA 02601 r Raiph Cmsstr- Office: 508-790-6227 Building Com.m'- Fax: 508-7 90-6230 For office use Only Permit no. Date AFTMAVIT 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 more than four owner occupied building containing antes least ce or building be be done by registered contractors,its or to with structures which are adjacent to such g certain exceptions,along with other requirements Aa Type of Work: � � -� r` Est. Cost Address of Work: Owner's Name Date of Permit Application: C frr I '1 I hereby certify that: Registration is not required for the foIIowing renson(s): Work excluded by law _Job under S1,000. BuiIding not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THE A WN PERMIT OR DEALING HOME IMPROVEMENT WORK D WITH ORNOT�H CA AVE CONTRACTORS FOR APPLI ACCESS TO THE ARBITRATIONPROGRAM OR GUARANTY FUND UNDER MGL 147-A SIGNED UNDER PENALTIES OF PERJURY . I hereby apply for a permit as the agent of the Owner. L(. �� ��,r��.,,J � �-['��' - '�� �`L( �- 1r Contractor name Registration No. Date w T/r c• C11111r11 r11111'Culth of 1fassuch usctts N t! =t.�= Qc prrrtrrrc•Jr1 of ludurrrial Acridents Y ! Offee-7flayestlyallotts 600 11 a.di igrurl .Strect _ '4• `�I a ' Bmworr.Mass. (12111 Workers' Compensation Insurance Affidavit 1y Iicirtt in format inn-*' Ptc•tse PR TNTIeriit_i,v —�•Y�—V—__-- name• , Inc^tion• city nhnn 1 am a homeowner performing_ all work myself fam,a sole proprietor and have no one working in any capacity I am an empioyer providing workers' compensation for my employees working on this job. cmmi • nv nnmc- ltlrlrrcc• clft•• nitenl•�• r inenrnnrc rn Helier f! [ �eo sole rr�vclr a ;encral contractor, or homeowner(circle one) and have hired the contractors listed below wno o�vin= ers' compensation polices: _ cmmr•rns• nnmr• Sm -' 1 y -) nrlrlrree• �d-� v � �� �f l� inenr^nrr rn �Lcw — ...T_ � � �_- �. �- .. •�= -. � �Sr��,:�-fit T• I!�-^•1: -_ �• _ ����^,��—_ emmr.inv nnrnr- ntitlrrcc• rir�•• nftnnc i1• - Helier• incrrrnrr rn - - _ Altach additionai sheet if neces]arv`- - Fariure In becure cut•cr-mc as required unuer t:ectton=SA of 111GL 152 can lead to the Imposition of Cnmtnai penaities 01'2 line up to s1.500.00 anuiur unr cars' imprisonment a+ s�cil as tit it penalties in the form of a STOP 1vORK ORDER and a fine of 5100.00 a dad•against me. I understand that n corgi of Ihis statClflCftt ma♦ be fur,%vnrded to the orrice of Investigations of the DIA for coverage verification. /do hercbr cc i wider the ptri+rs andpenalties of perjurt•that the inforntarion provided above is true and correct. Datc 1 Print name ,ir t�✓7 Phoned ' otTiciai wtc orris do not write in this area to be completed by cirr or town ofrciai ' (+ [ city or Town: nertnit/liccnsc 0 r1l3uilding Department QUccnsing beard L check if immediate response is required Q Jcicctmen•+OITcr I' ,. 011e2lth Department phone N: contact person: r'rVthcr Information and Instructions Massacliusctts Gencrtl Laws chapter I5� section _'S requires all employers to provide workers' ctnnpensat*rIf nn emnim-ees. As quoted from the '•lay+•". all emplitree is dcflned as every person in the service of :uuothcr und::r cortraci of hire. express or implied. oral or mrincii. An enzplorer is defined as an individual. partnership. association. corporation or other legal entit%. or any t+%o or the fore--oink_ cn_uaged in a joint cmerprise. and including the le-g-al representatives of deceased employer. or;;tc rccciver or tnistce of an individual . partnership. association-or other legal entity. employing employees. Ho%ve� owner ofa dwelling house ha+•ili not more than three apartments and who resides therein. or the occupant of;he dw chine house of another ++•ho eillploys persons to do maintenance, construction or repair wort: on such dti+elIin or on the __rounds or building appurtenant thereto shall not because of such employment be deemed to be an er::c ,S also states that e�•er�• state or locnl licensing agency shall withhold the issuance of 11GL chapter !52 scctirnl •1111+-:tl ofa license or permit to operate a business or to construct buildings in the commonn+-calth for sn+- icnnt who (ins not Produced acceptable evidence of compliance with the insurance coverabe required. .aaL�.:ionally. neither the conlillonwealth nor any of its political subdivisions shall enter into any contract for the p::f6rniz:;ce of public work until acceptable evidence of compliance with the insurance requirements of this ch= been prczented to the contracting authority. Applicants g P!:�se 'ill in the %vorkers' compensation affidavit coin pletely,by checking the box that applies to ;your situation c:. sucpiy in_ company naives. address and phone numbers as all affidavits may be submitted to the Department of 'ndustrial \ccidents for contirmation of insurance coverage. Also be sure to sibn and date the affidavit- 'Ilse it should be rcturned to the gin or town that the application for the perinii or license isbeinc requested. r :he Dcparttneiit ot%Ind6strial .-accidents. Should you have anv questions regarding the "law" or if you are -eq::: o ubt e a �+ori:crs' compensation policy. please call the Department at the number listed below. City sir Turns p1:e, �e pure tha: the affida+ it is complete and printed legibly. The Department has provided a space at the 5or:CT7 tlne =.�• aa�it for you to fiil out ill rile event the Office of Investigations has to contact you re`arding file applicant. E be _ to fill in the permit/license number which will be used as a reference number. The affidavits may be re:ur;e a. mail or FAX unless other arrangements have been made. rJcParttne:nt bN The -Office of Iin+esticstions would like to thank you in advance for you cooperation and should you have any quest pi_cse do not hesitate to _give us a call. The Depart;nent's address. teiepilone and fax number. - The Commonwealth Of IYlassachusetts- Department of Industrial Accidents -• Office of Investigations 600 Washington Street Boston, Ma. 02111 fax r": (617) 727-;749 phone =. 6 i-) -7---=900 c::T. 406. 409 or - , - 1 1. 144 kl' Q Y•"45T'Y;G,k iaC x �ua• ` „aax�..c a i Ss! f �Y �'tl'11 h'� b t p - ',✓, .naa�q,� }t9 m .,`tS r - t! _.N ab d.4'" :� lt / QUA' :�. h.,e4 ��-/ �+ Y�. OAP 7 C 0 y #. i� ��y CPU � {�4'�'h,�h�✓,j.-�� �q= 9a'M Ma fir � '_ yjC" add r.,. 5