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TA { 3 5 CV- tax V/) cv, p(),S4 Llc�, Cam 4j� L,;Io �� 1YW4C Building-Demolition-Accessory B-17-4169 Barnstable Historic Building-Admin Building- Inspectol Conservation Health- Inspector Utility Shutoffs B-17-4193 Building-Admin Building- Inspector Conservation /(",C) U—) a 05146 - Existing Large Tree Existing Pike Estate IN H _ V 444 G W�� ^d �3 �'3}t 3 +r "[ -L x•p"' 1 I ' Shrub Plantings - q � .a '` ,���'-�.�€ •�� '�� ,fly r�r �r z.�.{ '� . � .. .k:. t,` , . •� ,,tom ar�n�' C ME � x a� Center Tablet in 4 ' - .. ��tt �� ' ram" � Y L q �"'�� 41 ;f #•N �'�,3,.' . -China Pink Granite 3'-10"x8"x4*-4" . .� � �: ,,,. ,mac � � ,�'�`•#�`�.4'.- Side Wings in China Pink Granite kq�" 2•_3"x6"x3•-4" 3' Bench in Bahama fftEnhanced Patio Paving 3 Tom., rfi " Blue Granite . , - " �, w�}�3a�w� -� •fir :t„s d������`�''S`•�.��'� _ `. '_ - . Existing Rolled Curb Angel of Hope Memorial - off, . - Arlington Memorial Park s - .r MONUMENT DEPARTMENT PLEASE CHECK THIS DRAWING CAREFULLY! We assume no responsibility for any errors, or p q omissions when this "approved" drawing is followed. FOLIO# 8/27/13 Work cannot be completed on this order until this drawing is SIGNED AND RETURNED OR FAXED. CEMETERY Approval Signature: Date: PLEASE CHECK ALL SPELLING AND DATES BEFORE SIGNING DIE: SHARMEN PINK DIE: WING DIE: WING ' SHARMEN PINK 3'-10" X 0'-8" X 4'-4" r SHARMEN PINK 2'-3" X 0'-8" X 3'-4" ALL POLISHED 2'-3" X 0'-8" X 3'-4" ALL POLISHED THETEARS ALL POLISHED FOUNDATION 4 HAND CARVED ANGEL T HETE SEE ACCOMPAN/NG ' k S PICTURES'i THETEARS' FOUNDATION FOUNDATION RREMRH SHRWSE RACE JESSE CURTIS SLACK LUKAS BRHIM SWDER VIRCEOT SAVERIO BRI111O GABRIEL SLACK RRIELIA MAE HRTT EWWA AM)ELIZABETH DERRICK C�)).�.,� MIRDELYOM BIRIRERD PILOM CHRISTOPHER JOHI ROGERS A. SKYLAR FRITH HOPF ZEL'!l� p JRWES PRTRICX WALSH JR. BRNYLEIGH ELIZABETH WULLflM EMWIR GRACE WCHOLS MATHRNEL IAILCHOIRM JUSTIM CASE LAUZOM DRMIEL XRUIER IMORRLES i• 'i i Ryon THDIMRS STOODART AUBREY ROSE KEEMA BREMDRM GRIFFITH TESSA JOY BLUWBERG OOMOVRM JRWES DELAY SON.BLRBE ROD BRMLEY I NWS E STEPHEM AMDREW KRRUSE ORIHAORL JEFRRSOA BELGER OLIVIA ROSE BOMD MIM'D'NMIWL JEREAWW BERRY CLARICE WARIE COBB UILLR BRBIES MRTHRM ZACHARY BRUIISOM ELIJRH ROY SCOTT HILL PAUL DRUID SICILIAN RDI D BEMJAMW RIBLE JOHM LOUISE KEITH WOMTAOR ROSE HULSE JUSTD PATRICK GORWM CARTER MHCHREL DCDOMMELL HENRY RITSOM KOORAD WICHAEL CONEY EMMA CRTHERDE OSTRPOWCH AMERY RRUCH WILES JOSHUR EISERHUT RUR GDMZALEZ COFFER JOHM WCGDLEY � RILEY HAYES EISEMHUT CRYLR WARIE WHITMEY ELIZABETH GRIL LRMDRY ' LEURMI RATHERWE RRTUKOVICH JORDYM DOMMIOUE DNRLL WBAIEL RRPHREL AN EPCHEL amISROELLfl RAT SHUN TRIMMER DERM GLORY LOGAM WALRCHY COX Hamm ROSE GRAHAW SAIIIAOTHA MICHELE MASH REMEE LYMM LUKR UWPHRESS XRWEROM DRYE WH17RKER CHARLES F.SAWYER IU B i F CHRISTOPHER WILLIAM SCOTT WILLIAW F.SEUERDO IQ 1 ADDISOM WEDOW ELIJAH SRWUEL STIO _ JEN LOCOS ELWELL DHWM WARIA CHESEK BRRYDEO WICHAEL WAGUA JAWES A.WASOM III If COMRAD WICHAEL URAM MITCHELL EUELYM WATILDR SCOTT t TREOTOM STEUEM YALLERO GABRIEL ALEXRODER COON BASE: BASE: SHAMEN PINK SHAMEN PINK ALL POLISHED BASE: ALL POLISHED 2'-8" X 1'-2" X 0'-6" SHAMEN PINK 2'-8" X 1'-2" X 0'-6" ill ill POLISHED CHECK AROUND TOP ALL POLISHED 1" X 1" POLISHED CHECK AROUND TOP 4'-8" X 1'-4" X 0'-8" 2" X 2" POLISHED CHECK AROUND TOP Y 4r e�ti! itAMW .:'� • Tilli.' t •"l:,.. e,y y pw„ss 3 4 ro-_ 1i a r• Fyn t I T t l: Sy p - ',t•1f 'r -1 �klrt�y ... s! t:��f a �.1'r ,•'r�� �,'« ..,2, �1 r�Cq. �� F. ,h?pk,�yr,;g�,yw'. {*� � t. 4 r 'w- ,r�r,. -�'tS,is -�!.� �1. 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G,x,• i _a,+ •7.�+���`�'±�.. ^�, t3.P a '�} ;�qt�?j'!'Y:� =i 3• F .�'� e. a e y, ?� .f` }a •eT ti `�* ak$. �F �?,,'t R ,,�r :•u`, 1 r e z• .:5rf _ t t ty.� y 4t i t' a '`a ryL•a 'xt r, r�r_ .��->!Ir��. +'�� ` ..°t .,t}` 3?;}�i �a�i,^ti "`" '� '�� 5'r•° ��yac��,w�`^��:�!!�'4���z�` ���'+�;rta�`�„a��E �.`�`;��:�;� �ak.ss•a '�: �..,....,.�,,•�r. sc x+ �i r• �.t'rrCu•Tc..4l.•-.-. :5� '';: .- � -.:- .,.cy-t".�.�- �..T-cd,.P�;-�,�i�t3«>�n. .rs�- ;'Svc,. -..,,,.. ..Ye_ - 3..e+••;'�2r.. f 00000 Sprint LTA - 11 :13 AM 77% M Thread 8 of 9 Dimensions: All granite used for the "Angel of Mope" memorial is Shamen Pink (same granite used in Tiananmen square sculptures and pavers) Center tablet: 3 10 x 0-8 x 4-4, polish 5, half sere with sculpted angel Center base: 4-0 x 1-4 x 0 8, P5 w/ 0-2 x 0-2 cut back Side "Wing" tablets: 2-3 x 0-6 x 3-4, Wing tablet bases: 2-8 x 1 -0 x 0-6, P55 W/ 04 x 0- 1 outback Benches (2) : (Bahama Blue granite) Seat.(s): 3-0 x 1-2 x 0-4, curved seat, polish 5 Legs): 1 .0 x 0. 4 x 1 -2, polish The SGX glass component provided by Milne was recessed into the granite (by sandblasting) and adhered using silicone, y 2 Luciano, Christopher From: Perry, Kim Sent: Thursday, December 28, 2017 12:23 PM To: Luciano, Christopher Subject: FW:Angel of Hope what do we need for the town to get the permit going?? Will this work? I also.have photos From:Sarah [mailto:saraheslack@aol.com] Sent:Thursday, December 28,2017 12:01 PM To:Steffaro, Michael<Michael.Steffaro@Dignitymemorial.com>; Perry, Kim<Kim.Perry@Dignitymemorial.com>; Hass, David<David.Hass@Sci-us.com> Subject:Angel of Hope This is all the information that I have regarding specs we used on the original TEARS Angel of Hope monument.I'm not sure if Michael would have anything more detailed from the NJ monument? 1 ^ . r Sent from my Whone 3 160 W Main St - Google Maps Page 1 of 2 Google Maps 160 W Main St va Alt aIt,4, 01 k a r ► ' call a Vt r k a m x a 46 Afi -41 z w, ' . ," .�•9� shy„, "e i"a 't :. � $z a4 ✓ ° �' fir@ "' � N1. F . . f 6 *V ` r, w v. ,r ,Z. Y. ti ff T n Image capture:Sep 2017 ©2018 Google https://www.google.com/maps/@41.6476322,-70.302531,3a,60y,18.65h,87.86t/data=!3m6!l e l!3m4!l syENigauLcCOQV600Z2... 1/16/2018 160 W Main St - Google Maps Page 2 of 2 Barnstable,Massachusetts Google,Inc. Street View-Sep 2017 s a https://www.google.com/maps/@41.6476322,-70.302531,3a,60y,18.65h,87.86t/data=!3m6!le 1!3m4!1 syENigauLcCOQV6OoZ2... 1/16/2018 . Legend + 0 A Wit i 0 Road Names Poll s+{. - fib .. '� ,.�, � F ,. '"'� Y i ♦..•" J •� "7 4n A i. A s "290 o } ■ .� .s� ng,. ri � �. " x� l� 2F'"t . 1- r- "'n x �.�= IJf _ i., `"q " .,�. �.....(►,.,y�rM"" .fig ;� ,�yg �• ! =y . m, v � ' a � r •i r,.:. SA 7, f �"'�+;� 'hN"`�-{'�, � •++w� _""`-" - Y�' ����a..,,�r ...rw rr r- � , y _' � r �J s {a.�.,.,,maa Y ti J 2 i F Map printed on: 12/22/2017 This map is for illustration purposes only.It is not Parcel lines shown on this map are only graphic Town of Barnstable GIS Unit adequate for legal boundary determination or representations of Assessor's tax parcels.They are Feet regulatory interpretation.This map does not represent not true property boundaries and do not represent 367 Main Street,Hyannis,MA 026oi 0 21 42 an on-the-ground survey.It may be generalized,may not accurate relationships to physical objects on the map 5o8-862-4624 reflect current conditions,and may contain such as building locations. Approx.Scale: i inch= 21 feet cartographic errors or omissions. gis@town.barnstable.ma.us 4.V.VXp.9XM ft ' i318V1Ii31W3� aeMoU io/Pue Sqn 4S £%SONL NVld BIG X W) ^ P-03 P0dAm8 AZ x.M asm 4.1l.£xP.SK M.£.S 2x 13"ISVl.ONIM. ' PMM.L.Lx.£WHO- EX ,me ms'Wims*PI3 (USl)AVMM'MM „ 4 x f.. J � 'tin. v c..tr••1 ,.�+' �, � ��y"`»_ FJ 2 v £ Ff by ' r:»•,an:».v,we-. ...,.'.-rr..iv s.tiN�+.'Ar:�.a:rrt,.'ni�. ':_.. ^>>a..n.�zn�-. � l' 9. •F r - yr"4 .. 6 l p lJj'� � ���G� Z o 4�j zl ��s9 i � � I � � � I e r s� �� ! � � � S�s � � , I L L Z .� � I �,� - , � s� '� © g � � �''� ) \ .t^'4 a•+i ] '� CSC f 1 { tt 1 r t z 1 r i 5 s � a14��� WSA WILLIAM STARCK ARCHITECTS, INC. June 09, 2016 Patrick Franey, Building Inspector Town of Barnstable Building Department 200 Main Street 3 Q Hyannis, MA 02601 n Re: Accessibility Improvements at Doane, Beal &Ames w Dear Mr. Franey: Enclosed, please find Construction Control Report#1, dated June 08, 2016 for the above referenced project. If you have any questions, please don't hesitate to call. Sincerely, WILLIA A K ARCHITECTS, INC. od ey acques, R.A. i President RJ/md Enclosure Doc. BldglnspCCR#1Let 126 Cove Street www.StarckArchitects.com 10 Dorrance Street,Ste.700 Fall River,MA 02720 Providence,RI 02903 tel (508)679-5733 tel (401)519-3647 fax(508)672-8556 Page 1 of 1 fax(401)519-3601 CONSTRUCTION CONTROL REPORT William Starck Architects, Inc. 126 Cove Street, Fall River, Massachusetts 02720 10 Dorrance Street, Suite 700, Providence, Rhode Island 02903 To: Patrick Franey, Building Inspector Project: Accessibility Improvements at Town of Barnstable Building Department Doane, Beal &Ames 200 Main Street Location: 160 West Main Street, Hyannis, MA Hyannis, MA 02601 Permit#: B-16-1077 Report#: 1 Date: June 08, 2016, 10:00 AM Weather: Sunny, 70°F OBSERVATIONS: 1. All sonotube holes were measured to a depth of 48" below grade. See photo below. 2. Ramp framing was underway and appeared to be in accordance with construction documents. 3. The work observed appears satisfactory and in general conformance with the requirements of the submitted contract drawings. = r. IgK t. Reported by: Ro a cques, R.A., LEEDTmAP Copy to: T n Soares, AJ Soares Construction, Inc. Ki Perry, Doane, Beal & Ames TOWN OF BARNSTABLFJ BUILDING PERMIT APPLICATION D 0 z� - �V Co - JC"l-7 Map Parcel Application.# Health Division Date Issued ^ Conservation Division / Application Fee Planning Dept. Permit Fee ���•0 0 Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis ProjecfStreet Addresses lt'e 0 (Vi1Iagea-Z__ �/S Owner 0! 44A-& �L ��S Address Telephone Permit Request [0911,a Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Q 0100 Construction Type W�?4 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: O existing 0 new size_ Attached garage: ❑existing ❑ new size —Shed: ❑ existing ❑ new size _ Other Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ �. --g Commercial fifes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) /� f Name ` Telephone Number 3-0 e p Address �S 0ccr 5;— License# Home Improvement Contractor# �Email `�A/�.t '7 'C `(/M(457 Nr�Worker's Compensation # ALL CONSTRUCTION.DEBRIS"RESUL-TING.FROM THLS PRQJECT WILL BETAKEN T�J SIGNA URE DATE-,- �� �` FOR OFFICIAL USE ONLY y f APPLICATION # DATEISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. Ac RO V CERTIFICATE OF LIABILITY INSURANCE14/28/2016 DATE(MMIDD/YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER CONTACT NAME: Hadley Insurit Group PHONENo, 5 8- 8-5 FAAX No: 0 - 673-0322 246 Durfee St E-MAIL Fall River MA 02720 ADDRESs:C I INSURERS AFFORDING COVERAGE NAIC# INSURER A: e O ectio 360 INSURED SOARE-1 INSURER B:Arbella Indemnity Ins, Co. 10017 A J Soares Construction Inc INSURER C: 55 Prospect St INSURER D: Somerset MA 02726 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:2117484927 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL UBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD/YYYY MMIDD/YYYY A GENERAL LIABILITY 8500040559 8/1/2015 8/1/2016 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $100,000 CLAIMS-MADE lx�OCCUR MED EXP(Any one person) $5,000 PERSONAL 8 ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY PRO LOC $ B AUTOMOBILE LIABILITY 1020013870 2/10/2016 2/10/2017 COM Ea accident $1,000,000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X AUTOS SCHEDULED AUTOS BODILY INJURY(Per accident) $ NON-OWNED PER X N ea cdentDAMAGE $ HIRED AUTOSAUTOS $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION 9099950815 8/8/2015 8/8/2016 WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/NER ANY PROPRIETOR/PARTNER/EA—U I— E.L.EACH ACCIDENT $500,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 367 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis MA 02601 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD O„ s �� Town of Barnstable Regulatory Services Richard V.Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 5.08-790-6230 Property Owner Must Complete and Sign This Section. If Using A Builder I C 1//��r S 6el GS-, as Owner of the subject property hereby authorize Av'r)'lD +� SC���z-�' to act on my behalf, in all matters relative to work authorized by this building permit application for- (Address of Job) a Signature of Owner ' Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. I QAWPFILES\FORMS\building permit foams\=RESS.doc Revised D40215 ALDERWOODS (MASSACHUSETTS), INC' LIMITED POWER OF ATTORNEY TO WHOM IT MAY CONCERN: This limited power of attorney authorizes Kim Perry, to act as agent and attorney-in-fact for and on behalf of Alderwoods (Massachusetts), Inc., successor by merger to Loewen Cape Cod Holdings (1991), Inc. (the "Company"), in all matters pertaining to securing a building permit and the work authorized by the building permit for the facility known as Doane Beal &Ames, located at 160 West Maine Street, Hyannis, MA 02601. ALDERWOODS (MASSACHUSETTS), INC. By: Curtis . Briggs, President STATE OF TEXAS ) ) BOUNTY OF HARRIS ) instrument was acknowledged before me on April a.9 , 2016, by Curtis G. Briggs, President of Alderwoods (Massachusetts), Inc. Az Not Public aA••pY° JANET KEY NOTARY PUBLIC '�oc STATE OF TEXAS MY COMM.EXP.11/17/16 I Mass. Corporations, external master page Page 1 of 2 w` s . r n, • R • R .a iwp�,^ $S r• ,e+ Corporations Division Business Entity Summary ID Number: 043100570 lRequestcertificate New search Summary for: ALDERWOODS (MASSACHUSETTS), INC. The exact name of the Domestic Profit Corporation: ALDERWOODS (MASSACHUSETTS), INC. The name was changed from: LOEWEN MASSACHUSETTS HOLDINGS (1991), INC. on 12- 13-2001 The name was changed from: HAFEY HOLDINGS, INC. on 09-30-1991 Merged with BYRON'S HOLDINGS, INC. on 09-30-1991 Merged with LOEWEN EASTERN MASSACHUSETTS HOLDINGS (1992), INC. on 01-10- 2002 Merged with LOEWEN CAPE COD HOLDINGS (1991). INC. on 01-10-2002 Merged with DOBA-HABY INSURANCE AGENCY, INC. on 03-25-2010 Entity type: Domestic Profit Corporation Identification Number: 043100570 Old ID Number: 000343840 Date of Organization in Massachusetts: 09-21-1990 Last date certain: Current Fiscal Month/Day: 12/31 Previous Fiscal Month/Day: 01/01 The location of the Principal Office: Address: 1929 ALLEN PARKWAY City or town, State, Zip code, HOUSTON, TX 77019 USA Country: The name and address of the Registered Agent: Name: CORPORATION SERVICE COMPANY Address: 84 STATE STREET City or town, State, Zip code, BOSTON, MA 02109 USA Country: The Officers and Directors of the Corporation: Title Individual Name Address PRESIDENT CURTIS G BRIGGS 1929 ALLEN PARKWAY HOUSTON, TX 77019 USA TREASURER MYRTLE L ]ONES 1929 ALLEN PARKWAY HOUSTON, TX 77019 USA http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.aspx?FEIN=043100570&... 4/29/2016 Mass. Corporations, external master page Page 2 of 2 SECRETARY JANET S KEY 1929 ALLEN PARKWAY HOUSTON,.TX 77019 USA ASST MICHAEL G TRIESCH 1929 ALLEN PARKWAY HOUSTON, TX TREASURER 77019 USA ASSISTANT SUSAN L GARRETT 1929 ALLEN PARKWAY HOUSTON, TX SECRETARY 77019 USA VICE PRESIDENT CURTIS G BRIGGS 1929 ALLEN PARKWAY HOUSTON, TX 77019 USA VICE PRESIDENT LORI E SPILDE 1929 ALLEN PARKWAY HOUSTON, TX 77019 USA VICE PRESIDENT MICHAEL L DECELL 1929 ALLEN PARKWAY HOUSTON, TX 77019 USA DIRECTOR SUSAN L GARRETT 1929 ALLEN PARKWAY HOUSTON, TX 77019 USA Business entity stock is publicly traded: The total number of shares and the par value, if any, of each class of stock which this business entity is authorized to issue: Total Authorized Total issued and outstanding Class of Stock Par value per share No. of shares Total par No.of shares value CWP $ 1.00 100,000 $ 100000.00 265 Confidential El Merger .I Consent Data Allowed Manufacturing View filings for this business entity: I, - 3 10 v Administrative Dissolution Annual Report Application For Revival Articles of Amendment s View filings Comments or notes associated with this business entity: New search http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.aspx?FEIN=043100570&... 4/29/2016 The.Commonwealth of Massachusetts z Department of Industrial Accidents o I Congress Street,Suite 100 p" Boston,MA 02114-2017 www.mass.govldia lVorkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERNUTTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Orggaaruzatio ndividual): Address: City/State/Zip, Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.f ram a employer with employees(full and/or part-time).* 7. New construction 2.M I am a sole proprietor or partnership and have no employees working for me in 8. F1 Remodeling any capacity.[No workers'comp,insurance required.] 3.[—I I am a homeowner doing all work myself.[No workers'comp,insurance required.]t 9. ❑Demolition 4.FJ 10 Q Building addition I am a homeowner and will be hiring contractors to conduct all work on my property. I will - ensure that all contractors either have workers'compensation insurance or are sole I L Q Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.Q I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance.t 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.Q Other 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. 1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Q/� Insurance Company Name: Policy#or Self-ins.Lic.#: 10 ! 77, Expiration Date: �f Job Site Address: mil/ /7Y�y/�.CS 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 MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. 1.11 I do hereby cer ' u th i d penalties of perjury that the information provided J above is true and correct. Si nature: __ 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 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or.other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants , Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit,for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 0211472017 Tel. #617-727-4900 ext. 7406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 02-23-15 www.mass.gov/dia t , 1� Massachusetts - Department of Public Safety �! Board of Building Regulations and Standards Construction Supervisor ' License. CS-017446 a ANTHONY J SOAjtES � fi 55 PROSPECT STD '-,L-�k tam s SOMERSET MA%02726 Jam,, "' , Expiration 07/13/2015 Comrnissioner. ��`Le (QIbrJZ7vtryst tue�GL��fb�(����ZJJCCC{ZGLJe�J , Office of Consumer Affairs&Business Regulation =BIOME IMPROVEMENT CONTRACTOR egistration: 1,02029 Type: Expiration s 6/30/2016 Private.Corporatic A.J.SOARES CONSTRUCTI$N ING" �t � Anthony Snares 55 Prospect Street Somerset,MA 02726 Undersecretary Shea Sally From: Lt. Don Chase[dchase@hyannisfire.org] Sent: Wednesday, January 21, 2009 11:38 AM To: Perry, Tom; Shea, Sally Subject: Permit ok's 1) All set for Stride Rite (both): demising wall for storage space and retail tenant fit o ut. 2) All set for casket lift (elevator)for stiff stuffing at Doane, Beal & Ames l co a �• V�c��•-, Thanks Don TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION. 07 M Parcel',, ..-Application w ` 2O} Health Division Date Issued z �� Conservation Division Application Fee Planning Dept. Perm it Fee' Date Definitive"Plan Approved by Planning Board Historic =OKH, — Preservation/ Hyannis Project Street Address 160 West Main St Village Hyannis Mark Tomkins, General Manager Owner SCI Corp- Doane Beal & Ames Address160 W. Main St. , Hyannis, MA 02601 Telephone 508-775-0684 Permit Request C�ci't ( ZL/r� / e e�C' / svti���' /fyClrx0-1' Square feet: 1 st floor: existing 3600 proposed 1260 12nd floor: existing proposed Total new Zoning District, Flood Plain Groundwater Overlay Project Valuation 4800.00 Construction Type wood Lot Size Grandfathered: ❑Yes' ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family U Two Family ❑ Multi-Family (# units) Age of Existing Structure 80 Yrs. Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: 'U Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area (sq.ft.) 3600 Basement Unfinished Area (sq.ft) Number of Baths: Full: existing 3 new Half: existing new Number of Bedrooms: none existing _new Total Room Count (not including baths): existing 13 new First Floor Room Count 9 Heat Type and Fuel: Gas ❑ Oil ❑ Electric 0 Other N Central Air: UYes ❑ No Fireplaces: Existing 2 New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage:Uexisting ❑ new size _Shed: ❑ existing ❑ new size _ Other: IJO Zoning,Board of Appeals Authorization ❑ Appeal # Recorded ❑ r Commercial ❑Yes ❑ No If yes, site plan review# N cn Funeral Home Funeral Home ur; tv Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) r= - Name Fulcher & McSweeny Telephone Number 508-237-3269 Address 90 B Rail Road Ave. License # 17564 P.O. Box 908, N. Eastham, MA 02651 Home Improvement Contractor# Worker's Compensation # 782x544808 ALL CONSTRUCTION DEBRIS ULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE O f FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ? ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION ' FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. ^_,.. A Roma, Paul From: Perry, Tom Sent: Wednesday, January 21, 2009 4:15 PM To: Roma, Paul Subject: FW: Permit ok's -----Original Message----- From: Lt. Don Chase [mailto:dchase@hyannisfire.org] Sent: Wednesday, January 21, 2009 11:38 AM To: Perry, Tom; Shea, Sally Subject: Permit ok's 1) All set for Stride Rite (both) : demising wall for storage space and retail tenant fit out. 2) All set for casket lift (elevator) for stiff stuffing at Doane, Beal & Ames ,Thanks Don 1 L The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information lease Print Le ibl Name(Business/Organization/Individual): Address: X City/State/Zip: / yij�, Phone.#: lJ vZ to Are you an employer? Check the appropriate box: Type of project(required): 1.®I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. El New construction .2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7.. Q-Ken�odeling 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.# 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 11.0 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. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the subcontractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.M Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. l Si ature: Date: 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#: i - Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their.employees. Pursuant to this statute,an employee is defined as"...every person in,the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall . enter into any contract for.the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractors)name(s),-address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies.(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of 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 maybe 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 bdm 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: _T`he Cornrnonwealth of Massachusetts Dcpartm,ent of Industrial Accidents Office of Investigations. 600 Washington Street Boston,MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 11-22-06 www.mass.gov/dia a Re,,tmcnt of Public Safer Board of Building Rc�� , Construction Su `Ulati0n-S'tnd Standards . License: CS Pervisor License Restricted to: ,00 17564 BARRY P MCSWEENEY .3 ROWE ST, STONEHAM,-MA 02180 t��OpO1`�iunrr Expiration: 7/9/2009 f Tr#,,.64 0 �✓1 RigWax C1-1 1/9/2009 4:34:11 AM PAGE 3/003 Fax Server ACORD. CERTIFICATE OF INSURANCE DATE(MM\DD\YY) o1-o9-o9 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE KERRY INS AGCY INC HOLDER. THIS CERTIFICATE DOES NOT AMEND,EXTEND OR PO BOX 1945 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. NORTHEASTHAM,MA 02651 COMPANIES AFFORDING COVERAGE COMPANY 28SHB A TRAVELERS INDEMNITY COMPANY INSURED COMPANY FULCHER RUSSELL D.'DBA B FULCHER CONSTRUCTION- COMPANY PO BOX 908 C N.EASTHAM,MA 02651 COMPANY D COVERAGE THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE MSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WFNICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSI WH AND CONDITIONS OF SUCH POLICIES. LIMIT'S SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, Go POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER DATE(MMOMYY) DATE LIMITS GENERAL LIABILITY GENERAL AGGREGATE $ COMMERCIAL GENERAL PRODUCTS-COMP/OP AGO. $ CLAIMS MADE OCCUR. PERSONAL&&ADV.INJURY $ OWNER'S&&CONTRACTOR'S PROT. EACH OCCURRENCE $ FIRE DAMAGE(Any one fire) $ AUTOMOBILE LIABILITY MED.EXPENSE(Any one person) $ ANY AUTO COMBINED SINGLE LIMIT $ ALL OWNED AUTOS BODILY INJURY(Per Person) $ SCHEDULE AUTOS BODILY INJURY(Per Accident) $ HIRED AUTOS NON-OWNED AUTOS PROPERTY DAMAGE $ GARAGE LIABILITY ANY AUTOS AUTO ONLY-EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGREGATE $ EXCESS LIABILITY UMBRELLA FORM EACH OCCURRENCE $ OTHER THAN UMBRELLA FORM AGGREGATE $ WORKER'S COMPENSATION AND A EMPOLYER'S LIABILITY UB-782X5448-08 08-21-08 08-21-09 STATUTORY LIMITS X THE PROPRIETOR/ EACH ACCIDENT $ 100,000 PARTNERSIEXECUTIVE INCL DISEASE-POLICY LIMIT $ 500,000 OFFICERS ARE: X EXCL DISEASE-EACH EMPLOYEE $ 100,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/RESTRICTIONSISPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE THE WORKERS'COMPENSATION POLICY DOES NOT PROVIDE COVERAGE FOR FULCHER RUSSELL D.. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE DOANE BEAL&AMES EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF 100 WEST MAIN STREET ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. HYANNIS,MA 02601 AUTHORIZED REPRESENTATIVE ACORD 25-5(3/93) Charles J Clark Towu of Barnstable ,. HARNSrABLrk MARS. R.egalatoxy Services lFD MPS A Thomas F. Geiler,Director Buildzng Division .Thomas Perry, CB0 Building Commissioner 200. Main Street, Hyannis, MA 02601 wwiw.town.b arnstable.ma.us Office: 508-862-4038 Fax: 509-790-6230 P top er r Owner Mus Y Co n'lete.and Sign. This Section If Using :A.Builder �eJr►/. ,�'��� %9�sc as O�rner of the subject property :by authorize Fuleher (', McSweeny to act on my behalf, l matters relative to work authorized by this build r g pernut application.for. 160.West Main St:, Hyannis, MA 02601 (Address of job). ob) Jan. 8, 2009 iture of Owner Date Name 'ILES\FORMS\building permit forms\EXPRESS.doc ;020108 OY x rte r� Regulatory Service Thomas F.'Geiler,Director *. BARNSrABLE, - '"`" Building Division y� . 1639• ,erg °r�u rat a Tom Perry,Building.Commissioner .200 Main Street, Hyannis,MA 02601 wvrw.town.b arnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print, DACE: � 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 dwelings of six turits or less and to allow homeowners to engage an individual for hue who`does not possess a license,provided that the ouaier acts as Supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides of 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 structure 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 sha11 be responsible for all such work performed under the building pernut. (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 t'hc 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." a the are assuming the responsibilities of a supervisor(see Appendix Q, Many homeowners who use this exemption are unaware that I g P Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness of1cn'resu1ts 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 Supenrisor is ultimately responsible. applica tion, , To ensure that the homeo��mer is fully aware of his/her responsibilities,many coirununitics require.,as part of the permit app that the homeommer certify that he m he/she understands the responsibilities of a Supervisor. On the last page of this issue is a for currently used by several towns. You may care t amend and adopt such a forrr✓cerlification_for use in your community. Q:\WPFILBS\FORMS\homeexempt.DOC Ill 99 , r NEW CONSTRUCTION ADDITIONS REMODELING (508) 237 3269 RUSSELL FULONER BARRY MCSWEENFY Sign AB , * TOWN OF BARNSTABLE Permit MASS. 039. A� Permit Number. Application Ref: 200800510 20070130 Issue Date: 01/28/08 Applicant: LOEWEN CAPE COD HLD '91 INC Proposed Use: FUNERAL HOME Permit Type: SIGN PERMIT Permit Fee $ 25.00 Location 160 WEST MAIN STREET Map Parcel 29002 7001 Town HYANNIS Zoning District SPLT Contractor PROPERTY OWNER Remarks REPLACE EXIST FREE STAND SIGN W/24 SQ DOANE BEAL & AMES DOANE, BEAL &AMES FUNERAL & CREMATION SERVICE Owner: LOEWEN CAPE COD HLD '91 INC Address: C/O ALDERWOODS TAX DEPT PMB 6126. 250 H ST BLAINE, WA 98230-4033 Issued By: p POST THIS CARD SO THAT IS VISIBLE FRAM THE STREET ��'� � ^��' M� �ow-��- I �� � , w •Y Town of Barnstable 'f C;WN Rdgalara4EServices Thomas F.Geiler,Director Call f4r,d y ' BARMARIA2097 DEC Wuifd nk Avision �,uct Thomas Per ry,CBO on y ��PSfi011 S. . 2:�rSt <oa st sign-t 200 l et, Hyannis,NM 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Permit# Application for Sign Permit }tea fee I Applicant: Ea5 f Co a,,+ Si q/1 O r Map&Parcel# 2 90 .0 a 760 1 Doing Business As: /1i1 A Telephone No. 71)# g 561 q 3 g Z Sign Location Street/Road: 60 , ►M a!r1 5*-e-e Oki h; S Zoning District: Old Kings Highway? Yes rTo Hyannis Historic District? Yes(o eVfjh?S5 Property Owner _ l Name: S �1 rhahQ��vn ey1"1 Telephone: 7 13— s a s- 7y1 R *„IV0 Address: I g a q fli f f n 'pk-wexy V Village: /YI,+ 7 7oliq Sign Contractor L e) Name: d$-" L"p a ST Si a Y) Telephone: 711, �S g,q 3�2 C Mailing Address: Id-5 Np{-A 5 i4 e S�b-e- l4 k l 1,IM 4 21$4> Description Please draw a diagram of lot showing location of buildings and existing signs with dimensions,location and size of the new sign. This should be drawn on the reverse side of this application. Is the sign to be electrified? Yes4o (Note:If yes, a wiring permit is required) Width of building face �— ft.x 10 odd x.10= S+Ft.of proposed sign 54 Cf�es-�„dincj 5�5h� • I hereby certify that I am the owner or that I have the authority of the owner to make this application,that the ; information is correct and that the use and construction shall conform to the provisions of§240-59 through§240-89 of the Town of Barnstable Zoning Ordinance. Signature of Owner/Authorized Agent:,a F45-f coast' Si4h Date: Ia l 6 Permit Fee: Sign Permit was approved: Disapproved: xx- ZZ Signature of Building Official: Date: Co �N CD; In order to process application without delays all sections must be completed. U0 Rev.9/12/06. J � r 1 Ys D��V - { 3 Jllignity' Existing 4 ♦ 1v =112° Site Photos Proposed q Not To Scale �o Description: Remove and Dispose existing wood sign, r . Manufacture and install 1(onel Double faced,Non-illuminated post&panel sign. Details: Sign faces to be.125"aluminum with T filer All copy and graphics to be 1st surface vinyl. colors: Sign faces,filler and uprights to be painted semigloss black. 16"Dia.x 20"Deep Concrete Footing 3"Square Tube Upright f Concrete Footing vnyispnr° o iN°M Matte EWtk 196Soa2j l'—J" O Den Gre¢n I7R5bei . Q"M Sedn CWd 17R5.7a1) ❑?MwRile refi5biei Layout for New Post and Panel Sign Scale:Yz"=V-0r' DOANE, BEAL & AMES FUNERAL SERVICE• 7208 WA LTO N ac.*ft Production: Date: CI',entSCl-7208 mraoananm.�ar.aRemeor�arem°ma Revision: sgneAbemewerhrtadvMl20\IbA/C.AN Buyer: Data: 51GUAGE Address:ir>OWM81n SL nraee'0'o7wakw,Emry ee�aeaN«mKnbnrdm me 1 Eg FL'NE L E P'( PdpwyekcEkel eervke lu tlasryn n�M anal m"wn e"w rmrlw br w°M wamn an wt°m.m w amecE°n Er,l ine rslroralElih r mo Euyei, f rra�y mn,mo°. I.oceLen:1'1�'ANNtS MA You era MeuMoi°etlmaMw uere amv nEa la anyone Aluxi,lam Eedom Elaaterdent¢altlr Na prwnare 1 1 �rr110 Sates: Date: °uGda pur oryanv'eea°norre ltb Ee repWtlueld used eBRemrnl elmeled hereb,In tale tlrvedehre ;,wmie�r.•e" Sales:GW Designer. SS mrcdveldbimdlnaytarRbn. Eli, epeclkatlonsoftRepuaitelergreemsrd �k,� ►. nt "«m,,.,«n .;ram.° Dae:09.08A1 PM PG Path:H:ISCt1LOCATIONNS47208HYANW1AA edlhdavnadetlmN9eRa1p°vim w a r 1�~ M t- gm � 1 Existing r ,��r; =1/2" Proposed Site Photos q Not To Scale 00 Description: o Remove and Dispose existing wood sign. Manufacture and install 1(one)Double faced,Nor-Ruminated post 8 panel sign. Details: Sign faces to be.125"aluminum with 1"filler All copy and graphics to be let surface vinyl Cobra: Sign faces,filler and uprights to be painted semiyloes black. 16"Dia.x 20"Deep Concrete Footing 3"Square Tube Upright Concrete Footing ' Vinyl 6peee W Alan a.*I?a56227726Lai 1-4" � :+bl DerkGresnL ; �ii ?IA Satin Gold lr/':5-77P ?M wnaa ISs5b1o` Layout for New Post and Panel Sign Scale:Ya"=V-0" DOANE, BEAL & AMES FUNERAL SERVICE 7208 WA LTO N nbba cgndea once eqy eonpb,bmba Buyer: Date: Production: Date: Revision' s rmeldbm b,..dwith120VohAX.AN uY r i1 Clime SCI-7208 mnoursenod 4,noee.e4d nme dlkmrembmse '>P 5 1 G u A G E Addtsss:160 W Main St pror°M of wJmrt piney be u:d b v.monnn..dA me 1 s t 7 F RUNE F Y P mery ek4trkdservke ro ha signals pnd MOO WM Pb-e Uw°W Wehm bM Mudiere°e mnneNmn e',bthe reap .'of de boyar. � 1 .Mrq r.nwmm.". t.ocatiort HYANNIS MA voa are mt n mor deu mayinpe n anyon. AS Work IS to oe sere In acmNnnm upA the puRMse m.n,w nruro odeft, Mesa .norm aeee Rpmd-d.used. egreemant Nmclard harem.mcaaeelvedan4a Sales: Date: °:Arwibm,..oa Sales:GW Designer: `SS [ertd—NbkbdinmgbMe° bemeen pre 6aCCmbal)M Nine rcnase apreemeM t+•ff PG Path:H:ISMOCATIOGUS47208HYANHIS MA adhbdmwnp,hadB.inpana p�yel +. ' f�1 • W/22/2007 10:55 7813970115 TRAVEL AGENTS NE PAGE 01 ACjW. CERTIEICArE OF LIAIJILt'T`Y RAN 08720 200T aeuage (781�322-2350 1PAX: I�S1)521-193+5 CSRTWM IS81JSD A W TTER OF INFORMATION ONLY AND COWNS NO RitaMTS UPON THE CdIMMATE fteoCott a Soo Tnn=amm Agency "*LOW THIS CEMORflPICAT@ DOES NOT AMID, 6XT6N0 OR 963 8aatels�a Avm>nitei AL BY POLIc BSi.OW. Malden M h 02149 AFFOlR11MDC+CCWMM MAIC0 alluimp @01mtvarlylovills RUT COAST SIGN CCUPANY I=. INSURM t 125 NMTR STREST of STOUR M, Mh 02190 BIfLTREti l^ THE POLE of IWW3M USTED— 8M IBsuEo TO MMURIM NANIM ABOVE M-MWWY"PMW WWCATM WMM MSTANCINo ANY REOUIREMENT,TERM OR,CONDTTTON OF ANY CONTRACT OR OTHER DOCW M YATM REMMT TO WHICH THIS CERTMATE MAY BE W IED OR MAY PERTAIN, THS INSURANCE AFFORD$C 8Y THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDRIOM OF SUCH POLICIES. ORAL LIAMIR Y It 000,0 XCQMMEkWK QENP.R�AL f _ 100,0001 A pAgmAm a]amm GZ 7J3760 7/10/2007 7/10/2008 MW gg Ulm am amsma 0001 -zoom ILMVKUW 1,000,004 QpwMLmwBwM = 2,000,00 WM AGWOATE LNin APPLU PM: 1 2,000,000 AUTOMOM UAB&M COMBMIEO SVNQU LOST (b govan-i a ANYAUTO �.. ALL OWNED AUTOS o0ou WJURM f $croso w AUTOS (Par pwm) HOOD AVM Booty CRY a NON4NOM AUTOS (P`°0°a0"h PROPERTYI)AIMiE S OARAGB UAGILRY AM OWY_EA ACCMWT • ANYAUTO OTM9:RTm W .r.AA= a AUTOONM WOMARJUDOM"UMMY _ occur CLAW MADE R f 06DUCTSILE s vmraam C01p41SATI NI AND LL#AL IY AMY RMTQKPAR"JRRVMCVrM ELEAC34f �f�tCLUD6D'� f tU3dK Ia"m M OF OPERA1Ni118q,OCA ADDS DY PROYIBIOPIg SIM" MV (P THE AMM WSWIM POLIO 06 0MICELLEQ =I= THE MWMMV WIN THOWIF. Till MIM SQUAIM 1A" DWAVM TO MAL 10 a►YS V12IMM NOM TO TM CEMOWAIR NOLA=pA M TO 7"LEFT,BUT MLVM TO 001g$KUL.WPM NO OBUOATM OR LIAQIJIY OF ANY MM UPON THE IiBi1 oeeph Schmlaick/PiR ..."�..�' AGOM 2b(2001 ) ___. _�.. OACM COMIMATION 190 Mumma. Pa>a 1 ax ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION � d Permit# 7 / Map � ��� Parcel 0 d! 6 Health Division Date Issued 7 G Conservation Division 4'l-Pi A LJG� 13 ION 4:/,'pplication, Fee � Tax Collector Permit Fee Treasurer yi .rlSlU�,a Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address b (--) by V\all Village VVy a4--) n S Owner r�c!` dz� Address 31) /%/ern Sf,, t'in��n/l��►' o N !rS2z)7 Telephone —7 —D L l 0-C-) Permit Request 2 Co Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater OverlAy Project Valuation AZ /,L5-7)0 Construction Type y_ 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 y<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:Cl 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 4s ❑No If yes,site plan review# Current Use �SU►7 v-e—1 �+Ofi c Proposed Use BUILDER INFORMATION Name 62z � �'c�f// Telephone Number -- .���'/'�0,3 Z Address Yof License# 0-5:6 /3 ON b2��d Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �f/`fD_-)0 k 1 SIGNATURE -A DATE / / y w - FOR OFFICIAL USE ONLY Y ' PERMIT NO. r, r. DATE ISSUED -- MAP/PARCEL NO. _ r ' ADDRESS =` VILLAGE OWNER DATE"OF INSPECTION: ' <<7 FOUNDATION FRAME s INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL r r r r PLUMBING: ROUGH FINAL r f 1 k GAS: ROUGH FINAL ` FINAL BUILDING r DATE CLOSED OUT ASSOCIATION PLAN NO. �= f' —- l 06/18/2004 10:25 15087756854 DBA HYANNIS PAGE 01103 GEORCE L) VIS BUILDIE✓RS, YISTC- 9 New Venture Drive, Unit #7, South Dennis, MA 02660 phone (508) 394-0832 fax (508) 394-5460 June 14,2004 Mr.Jerry Tilton Doane,Beal& Ames 160 Nest Main Street Hyannis, MA 02601 Froject Garage roof assembly L P,A.RTIES&PRICE This contract(hereinafter referred io as "Agreement") is made and entered unto on the date noted above,by and between Doane,Beal& Ames,(hercit a referred to as"Owner"),and George Davis Bullders,Inc.,(hereinafter referred to as"Contractor" or"gdb"). In consideration of the mutual promises contained herein,Contractor is pleased to perform the following work for a sarrn of$21,500.00, subject to all changes and allowances,as described below. M SCOPE Of WORK AND ALLOWANCES L Procurement of the required building permit 2. Remove approximately 40%of the existing sloped roof assembly on the back side of the garage. 3. Install a beam to span the distance from the existing"inner"wall to the common wall(apptox. 16'). 4, Install new rafters to the new beam, This new section of roof assembly will.be contiguous and "plane"with the remaining,original roof section. This will eliminate the secondary,steep section of the original roof section, 5. Remove the"blocked"window at this area. Patch&match the interior surfaces, .Finish interior painting and/or wall paper is"by others" 6. Re-frame the low slope roof on the rear,including increasing either the size or the fregwncy of the existing ratters. 7, Replace the 8'(approx.)wall supporting the low slope roof. 8. Install new roofing over all affected areas.(entire sloped and low-slope areas on the back of the garage) The new roofing on the pitched sections small match the existing. low slope areas are to feature EDPM Rubber membrane roofing. 9. Replace any siding on the walls adjacent to the affected areas in order that the roof flashing may be property installed and affective. )O. .All electrical is"by others". Option—Contractor to provide electrician and supervise work—Add $ 1,750.00, 11. Priming and painting of any affected exterior surfaces. 12, Removal and disposal of all debris resulting from our work. E01. GENERAL CONDITIONS FOR THE AGREE1VIlrNT A.Exclusions This agreement does not include labor and materials for the following work: I.Project Specific Exclusions: Structural engineering of any kind. 2. Standard Exclusions: Unless specifically included in the "General Scope of Work" section above. this Agreement does not include labor or materials for the following work:engineering fees, or govenunental permits,and fees of any kind, Testing,.removal and disposal of any materials containing asbestos (or any other harardoui material as We Make Your Dream HOMES Come True: 06/18/'2004 10:25 15087756854 DBA HYANNIS PAGE 02/03 defined by the EPA). Custom milling of any wood for use in the project. MoNizug Owner's property aroond the site. Labor or materials required to repair or replace any Owner-supplied materials. Snow and ice removal. Repair of concealed underground utilities not located on prints or physically staked out by Owner wbich are damaged during construction. Surveying that may be required to establish accurate property boundaries for setback purposes (fences and old stakes may not be located on actual property lines). Final construction cleaning(Contractor will leave site in"broom swept" condition). 3,Owner Selected"floor","Display",or"Sfrgbtly Damaged"Products:It is the policy of the Contractor that all material should be delivered to the site in its original, undisturbed packaging. Should the Owner select and/or specify that a°'floor or display product be used, it shall be handled and installed at our rate of S 48.00 per hour, from start to fmish. Furthermore, no guarantee or warranty is provided by the contractor on either the product or the instaUation. M Date of Work Commencement and Substantial Completion 1.Commence Work—To be Discussod 2. Anticipated Completion— Approx.2 weeks after start. Construction time does not include delays and adjustments for delays caused by: permitting,inclement weather,additional time required for Change Order work,and other delays unavoidable or beyond die control of the Contractor. C.Change Orders: Concealed Conditions and Additional Work 11.Concealed Conditions: This Agreement is based solely an the observations Contractor was able to make with the structure in its current condition at the time this agreement was bid. If additional work concealed conditions are discovered once work has commenced which were not visible at the time this proposal was bid,Contractor will stop work and point out these unforeseen concealed conditions to Owner so that Owner and Contractor can execute a Change Order for any Additional Work.in the event that Owner is unavailable at the time that the deviation is discovered,and it is in the best interest of the p►vject to continue,Contractor is authorized to do so,providing that the Change Order is presented to the owner as soon as reasonably possible. 2.Deviation from Scope of Work: Any alteration or deviation from the Scope of Work referred to in this Agreement iavolvintg extra costs of materials or labor ( including any overage on Allowance work and any changes in the Scope of Work required by governmental plan checkers or field building inspectors) will be executed upon a written Change Order issued by Contractor and should be signed by Contractor and Owner prior to the commencement of Additional Work by the Contractor. In the event that Owner is unavailable at the time that the deviation is discovered,and it is in the best interest of the project to continue,Contractor is authorised to do so,providing that the Change Order is presented to the owner as soon as reasonably possible. 3.Contractor's Rates: By Default,any additional work that is completed outside the original scope of work or is not quoted as a"fixed price"prior to such work being started}shall be billed at our labor rate of $ 48.00 per man/bout. Material, Sub-Contractor Labor, and other expenses associated with such work shall be billed at Contractor's Cost,divided bv.80. B.Payment Options: 10%Deposit to schedule work,balance per progress billing. Or—30%Deposit to schedule work,balance upon completion, 2.Adjustments A.djustnnexrts for Change Orders and Allowances will be billed during the course of the normal progress billings. I� 06/18/2004 10:25 15087756854 DBA HYANNIS PAGE 03/03 E. Warranty Contractor provides a.limited warranty or all Contractor-and Subcontractor-supplied labor and materials used in this prolact for a period of one year following substantial completion, No warranty is provided for material that is provided by the owner. No warranty is provided for material that is existing that is moved and/or reinstalled during the course of the project,iutcluding any warranty that existinglused materials will not be damaged during the removal and reinstallation process. One year after substantial completions of the project, the Owner's sole remedy (for materials and labor) on all materials that are covered by a manufacturer's warranty is strictly with the manufacli=, not with the Contractor, F.Dispute Resolution and Attorney's Fees Any controversy or claim arising out of or related to this Agreement of an amount that is the =�dmum of the litrnt of The Srttall Claim. Division of the Municipal Court in the Barnstable County,must be beard in that court. Any controversy or claim arising out of or related to this Agreement which is aver the dollar limit of The Small Claims Court may, at the Contractors discretion,be settled by binding arbitration administered by the American Arbitration Association in accordance with. hie Construction lodustry Arbitration Rules. Judgment upon the award may be entered in any Court having jurisdiction thereof. The prevailing party in any legal proceeding related to this Agreement shall be entitled to payment of reasonable attorney's fees,costs,and expenses. G.Expiration of this Agreement 'Thus agreement will expire 15 days after the date at the top of the .first page of this Agreement if not first accepted in writing by Owner. E Entire Agreement This Agreement represents and contains the entire agreement between the parties. Prior discussions or verbal representations by the parties that are not contained in thus Agreement are not part of this Agreement. The written word on this agreement prevails over the plans provided. 1 guarantee that all our workmansbip and materials will be of high quality. Additionally, we are licensed,registered,and fully.insured, Our signatures indicate that h e read,we undcrst 2and we accept all provisions f this grecmeru. Omer !Date r. e��Ti19on Contractor G ��---�`. )Date 11dr. t:r�n a D)pvis k f —_ :) 1!►r' t,•or►rn►rrn lrr'ultlr o/ ,1/rtcsurlru.cc'll.c ' I)rltnrtit► itt of bithistrinl At-eirlrn[c Office o//nvcs!/psi/ons f /INl II'rlsltiogforl ,Strrrt 111?srorr, ,1Iasi. 111111 rkrr ( .,mlirncalinn Intnranre Affir(n4tl -- ON aamc• GPmr Davis--Builders, Inc. location_ 9 New Venture Driver Unit #7 Cky South Dennis, MA 02660 508-394-0832 ohonc r ❑ I am a homeowner performing ill work myself. ❑ 1 Ftm a sole proprietor:1nd hive nn nn- wr,tbutp In Inv r,p,1r•itN• (� I am an employer providing «nrkers Corti l,eitsmion for m)• empin)ecs wnrkinr on this job. mmoanyn me; George Davis Builders, Inca Itddcc�; 9 New Vetltut-e Uriv�r UFtiL N7 city.; South Dennis , MA U1660 ------.__-- --- _. Dhonc.M;_�508 ) 3 9 4 -0 8 3 2 in�uxttxcso. AIG WC 7682891 ❑ I am a sole proprietor, general contractor. or hnmen%%ner (cirri, one) -in(] hive hired the contractors listed below who n... the following workers' compensation polices: L4mtlter arms; tstdtcss dty.: Dhonc b: LIl3-I1IA.ItfSs4� N e umpany nimr l�drrn: city: Ica L!)IBUIt[SS4. _ _.Itoli�a Failure to secure covers a of rt uired under Stctinn 2t. of�11;S 4 \ I. 152 ten Irsd to the Impn/iflnn of e►Irrtlns)ptnsltln of s fine up 10 111.500.00 ond„r one rein'lenprisnnrnent of Mcll n CIO nrn+ltirt in the farm of s ST()p %%,OrtK t)nl)FR and r fine or s100.00 a doe etalas1 me. t understood that ra COPY of this stotemtnt mev be fnr«srdtd to the Office of ln.esufstinnt of the f)Is for tn.erste .erifltoNon. do hertbr cerrifir under rhr t and(rnnf)rrr .r Mri thar rhr inforr.rgnnn o6de�alo', it true and correct Sienaturc 6/46 Print name George Day.i s - 508 ) 3 9 4-0 8 3 2 Official tote srl• do♦w...:r.,w..�rt n r� to i.:cn. ,r city or sw•.' _ j __...._._.. ---_ --'---- _,_.. ----..._. •-- -._. _• fnmplrrntr ` --- '.(�RUildrn'� Otps�rsreent �. �- _ Q� Itensint Rood. 0 tfrd N �wrrdistt �str,.,tr t rt�u.r.4 Q$cletlmen's URltt 011trilth Deportment r�tr frrwsq: -- 001her I• � f i . AM ' License: CONSTRUCTION SUPERVISOR Number:'CS 056130 � �.. Birthdnt&'&29/1968 6 Expiresi"03/01/2005 Tr.no: 8580 t Restfllcted: 00 G'EORG'E F DAVIS 9 NEW VENTURE DR S DENNIS, MA 02660' I Administrator M y t f 1 • TDO'Il!/1IZ49ZfWe l.�/G'�J��� Board of Building'Itegulations and Stagdards HOME IMOrROVEMENT CONTRACTOR Re9IStration: 167333 Expiration: 7/31'iM 04 1` Type baA v GEORGE DAVIS'6UILDERS , I George Davis 9 NEW VENTURE DR. UNIT 7 So. Dennis,!MA 02660 _ 1. µ w _ K too _-_ - ---- rt-� ,. IN ca g _ _ �o •�(/ „�,s/ Wiz. . i _� #, x� •�.�t � rr� ,e„r t_ .!°r"�'- f r ?7 A��')j� J a '•ti. y t � � _. - rlyy�k�� N:� � 4• * � y +s� �� # ti j Mr�*$ '�O t�� "y,n 4 z.i* <�~ ,� e' h wxy,yi � a' x:�x �'* *�"'F,�A�`' z � � � �� •.�'•S r;.�� f f� pA ol - �'. •: y<. �� _ �••. r - .�eW�ra��� it �aM Al r I �� • i+ �- ~ ,y-e• � �x'_ jam• y�. i i i _ ��.. _ � -r3F � F ' . y t3_ ,A yy jl 4 •. t u Y� iariw_sf ;: � 'ty i e i t - ` 4 ------------ s) q� iaa' r a o o � ,���•� a i +V <RN 4 3' Y t y 1 NAM 08/17/2004 13:16 15,083945460 PAcwE 01 GEORGE DAVIS BUILDERS,INC. 9 New Venture Drive,Unit#f7 South Dennis,MA 02660 509-394-0832 Phone 508-394-5460 Fax To: Dave Mattos From: George Davis Date: August 17, 2004 Fax#: 5M790-6230 0 l.✓, In Al' Pages to follows The attached relates to the Doane, Beal & Ames application from George Davis Builders, Inc, If you need any additional information, please feel free to call me. Thank you, George Davis 08/17/2004 13:16 15083945460 PAGE 02 From Joe Meoora 808.892.9007 Tc:31111 Delis Date'Sl`7/2004 -irne:12:54:04 PM Page of 1 BC CALM 2003 DESIGN REPORT -US Tuesday,August 17,2004 12:53 Triple 1 3/4" x 9 1/2" VERSA-LAM(F)3100 SP FlIe Name a Davis_'-'Done Beale Ames BCC RB01 Job Neme; DOANE EEALE B AMES Description: Addreo0: UNIT 7,0 NZW V611rTUR6 OPIVC S11P.r.Nier: City,State,Zip;SOUTH DENNIS,MA Designer: Joe Madero Customer: GEORGE DAVIS Company: SHEPLEY WOOD PRODUCTS Code repoft ICB0 5512,NER 629 Mlsc: ,rt2 — � 1 mandero Lott-30 pf l tb psi 132 BU 61 2054 Ds LL 509810s LL 1'40lbs ILL 1078 bs OL 27861os DL 299 Ds DL Total Horisordal Length-2r41-30 General Data Load Summary version: US imperial ID Description Load Type Ref. Start End Type Value Trib. Dur S Stardara Load urn.Area left OD-Moo 23.01-00 Llm 30 psi 11-OCL00 1150/; Member Type: Roof Beam ueac 15 psf 11-00-00 90)A Number of Spans: 2 Left Caribiever. No Coltr1D18 Summary Right Cantilever: No Control Type Value %Allowable Duration Road Case $pen Location Slope 0112 Moment 105441'1-Ibs 43.8% 115°M 2 2 Left lVeg,Moment -10544P-Ds 4330A 115% 2 1 Rignt Tributary- 11-Z-00 End Shear 2729lbs 24.6% 115% 4 1 -Left Cant Sheer 4083Its 36,6% 1151/0 2 1-Right Uplift 418 IDS rue 4 2 R grn Total Load Jeff. U403(0 441") 44.6% 4 1 Live load: 30 psf Live Load Dell. L1600(0 297") 40.0% 4 1 Deac Load: 16 psf TotAI Neg.Dell. -C 072" 9.5% 4 2 Partiton load: 0 psi Max Deft, 0.441" 44.1% 4 Duration: 116 Cautions Disclosure LprR of 418 Its found at span 2-Right. The ccmple%r*ts and accuracy of the input must be dill by eryone Notes who would rely on Ina output as Design meets Code minimum t L(`80)Total load deflection cetera. evidence of sultabiliM for a 1 sIRn meets Code minimum IL/240)Live loaa deflection chteria. particular application. The output Design meets arbitrary(V)Maximum load deflection 01e1a. abode is based upon building Minimum bearing length for 80 is 1.1.11 code-accepted design properties Minimum bearing length for 81 is 3". and analysis methods. Installation Minimum beering lengir for 82 is 1-Ir". of BOISE enginearec wood Member slope=0,consider drairage. products must be in accordance En1erQdlViselayed Horizontal$pen Lengths)=Clear span 4 1/2 n1n.end bearing+112Intermediate bearing with the current Instolial)on Guide and the appliceole building codes. Cenrteollarl Diagram To obtain an quellationstions[ Ida or if Nailing schedule applies to both sides of the member you have any questens,pease rill 9 pP 1800)232-0788 before beginning Member has no side loads, product Installation. Connectors ere'. 150 Sinker Na!;* BC CALGM,SC FRAMER®.MO. BC RIM BOARD TM BC OSS RIM a BOARDT" BOISE GLULAM"', b,3 VERSA-LAM®,VERSA-RIMO). c=5-10, S i T VERSA-RIM PLUS, d=12' -�--t—e e VERSA-STRAND^' 0, " VERSA-STUDS.ALLJOIS70 and AJS'"are traosmarks of ,..�` . ;-;l Boise Cascade Page 1 or 1 A TOWN OF-t-B . RNSTABLE BAIRONST Office of the Building Inspector MASS. 39. am Date ..,August . ...... .. . ...... Fee ......$.2.5...0.0.............I................. Permit No. ................... PERMIT TO ERECT SIGN IS HEREBY GRANTED TO ..........D.oan.e....Be.a.1...&...Ame.s.................................................................................................................. .......... ........ .. ......... D/B/A ............................Funeral Home ...................................:............................................................................................................................. LOCATION . 0.......W.es.t.....Mai.n.. ..St.r...ee... n ...... a U ....................................................... .............................................................................................................................................................................................................. ANY VIOLATION OF THE SIGN LAW WILL CAUSE IMMEDIATE REVOCATION OF THIS PERMIT 7^ ------------------ /guilding Inspector TOWN OF B-ARNSTABLL L BUILDING DEPARTMENT t aaaarr } TOWN OFFICE BUILDING wa ' HYANNIS. MASS. 02601 �•■.r► APPLICATION FOR SIGN PERMIT DATE 19 VG Application is hereby made for a sign permit in accordance with the description and for the purposes hereinafter set forth. This application is made subject to• all Rules and Regulations of the Town of Barnstable ,now in force or thatmey hereafter be enacted affecting or regulating thereto and which are hereby agreed to by the undersigned applicant and which shall be deemed a condition entering into the exercise of this permit.' INSTRUCTIONS 1. This application must be filled out completely. 2 A drawing, in duplicate, showing the shape and dimensions of the sign, lettering on same, height, method of securing to building, or if freestanding, method of erection. Drawing must show sizes of structural supports, and size and depth of foundation. SIGN LOCATION Street- Rd. .Owner _ --- Zoning District �.� -Fire District lA1AY11rlt S OWNER OFF PROPERTY Name Yam/� IlGYY! t� Address City )y"IVIYI S SL ° Zip �%2601 Tel No.( ) Area Code SIGN CONTRACTOR Name \�l yy-\ Address l0 fn Sit �/�� City St. Zip Tel No.((g(j ) Area Code Type of Construction Free Standing or Attached DESCRIPTION DIAGRAM OF LOT SHOWING LOCATION OF BUILDINGS AND EXISTING SIGNS WITH DIMENSIONS LOCATION AND SIZE OF THE NEW SIGN TO BE DRAWN ON THE REVERSE SIDE OF THIS APPLICATION. Is there any electrical wiring required for this sign? Yes No - If "Yes." who is the electrical contractor ? Area FOR OFFICE USE ONLY DATE DATE DATE Permit Fee DEPT. ROUTE RECEfVED APPROVED REJECTED INITIALS PLANNING Mail permit to: & ZONING ELECTRICAL INSPECTOR i BUILDING i INSPECTION �3 I hereby certify that I am the owner or that I have the authority of the owner to make application• that the informatio- given is correct and that the use and construction shall conform to all the Rules and Regulations of the Town of Bornsrotl which are imposed on the property, t. Phone Signature of sign owner/authorized agent LY�lOTJT�t Inc.. OLD MAIN STREET - SOUTH YARMOUTH - MASSACHUSETTS 02664 TELEPHONE 398-2721 ,vtc Al goo TV 16 NNO Cie . ering Dept. (3rd floor) Map o 9® Parcel 7 o 0/ Permit# is '7 7 House# 166 Date Issued 9 I J ITB�oardf Health(3rd floor)(8:15 -9:30/1:00-4:30) � �, -?"(o-f7 Fee ff S O,CZ) Conservation Office (4th floor)(8:30- 9:30/1:00-2:00) Planning Dept.(1st floor/School Admin. Bldg.) oFINV (9ject a Plan Approved by Planning Board 19 • BARNSTABLE. ' MASS. j► t639.p� TOWN OF BARNSTABLE �PPIacANT . nsEwEx CONNECTION PERMIT FROM THE Building Permit Application ENGINEERING DIVISION PRIOR TO CONSTRUCTI01�treet Address . 160 West Main S T r e e t Village H y a n n i s Owner Daone .Beal & Ames Inc Address same Telephone 7 7 5-0 6 8 4 / Permit Request repair roof-re-shingle *; #-Pc First Floor n/a square feet Second Floor square feet .Construction Type Estimated Project Cost $ 6 , 0 0 0 . 0 0 Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) *e of Existing Structure 4 0+ 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 No.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 Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) :t . ❑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 F e r arll e m e Proposed Use unchanged Builder Information Douglas. L . Williams dba Name American Home & Environmental Telephone Number 775-1500 Address B o x 1069 License# 016981 c e n t e r v; i l e , Mass , 02632 Home Improvement Contractor# n/a Worker's Compensation# W C P 0 0 15 14 7 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 By container company to approved Site IGNATURE DATE(N� BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) �yti FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL s PLUMBING: ROUGH FINAL GAS: ROUGHf'r ti FINAL FINAL BUILDING «c ra .DATE CLOSED OUT / ¢xa n ASSOCIATION PLAN NOS'; Tile Cunrmonf+-call,I of?I tassacbusctts Department of Industrial Accidents A.l8 coo "es go ass r~ 6011 If•asitingto»Street X ` Boston.Mass. 02111 Workers' Compensation Insurance Allidavit ARniic�_'' . Please PRINT Ie Ly •�••�?...' nt tnformatiirn nameo location- city phone# I am a homeowner performing all work myself. 17 1 am a sole proprietor and have no one working in any capacity L _.:._. ® I am an employer providing workers' compensation for my employees working on this job. company name: Douglas L . Williams Custom Bldg dba American Home & Environmental Id • box 1069 cit Centerville , Mass phone#• 775-1500 incur•tnceco Eastern Casulty policy00 WC P0015147 1 am a sole proprietor,general contractor,or homeowner circle one and have hired the contractors listed below who have the following workers' compensation polices: COM0211v na c• address- city, phone#• �urnnct co policy# a �- -�� ..,-;..�•;;;•.:- -- K -�...s.-ea�-err—�+rs-.ci-ns•�,.eLq►^ss"nV«n•�4�...�5.,�7RR�'+7 '=R'77"-*-'4 _..u.ti r COMMInv name, address: cite phone#• iecur�n n rn polity# :Attach additionafshiii if'tiecnsa c'��.:::".'plt^s�.�;;.�'..hd+r!C.sp:!+4�.:.n:.i Failure to secure coverage as required under Section 25A of AiGL 152 can lead to the imposition of criminal penalties of a fine up to S1.500.00 and/or oneyears'imprisonment as well as civil Penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. 1 understand that a copy of this statement ma'•be forwarded to the Once of Investigations of the DIA for coverage veriliention. 1 do herebt•cerrif•under the pains and penalties of petjuoy that the fnfor iarion ptmfded above is trae and cotfea Sicnaturc Owe Print name Douglas L . Williams Phone# 775-1 r,00 . r 4 afrciai use only do not write in this area to be completed by city or town official city or town: permit/Ilecuse# MBuilding Department Licensing Board C3 check if immediate response is required O5efeetmen's Otlict �11csith Department contact person• Phone t!• Mother 4 I revised;,V5 P)AI information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for theil employers. As quoted from the"law", an employee is defined as every person in the service ofanother under any contract of hire, express or implied. oral or written. An enzplurer is defined as an individual. partnership, association, corporation or other legal entity, or any two or more 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 dweilins: 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 hou: or on the ,rounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that even•state or local licensing agency shall withhold the issuance or reneival of a license or permit to operate a business or to construct buildings in the commonI•eaith for any applicant,vi•ho 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 1iz, been presented to the contracting authority. Applicants Please f11 in the workers' compensation affidavit completely, by checking the box that applies to your situation and suppling company names, address and phone numbers as all affidavits 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. ... ...._: ....,.;-: _ :...... . i�„ '..:;.+.."ram :;•: . .�::=.: . . City or Towns 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. Plea:. be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be.returned tc:. the Department by mail or FAX unless other arrangements have been made. The Office of investigations would like to thank you in advance for you cooperation and should you have any questions: please do not hesitate to give us a call. -, ' - - - . : _ sue. :.•s" The Department's address. telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents r- Office of Inuesdgadons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 i s J _ T m � F f - � ► 4F �yr 1 ih� •, : . : The Town of Barnstable ' $ Department of Health Safety and Environmental SeMces Building Division 367 Main Street,Hyannis MA 02601 Ralph Crosser Ofrj= 508 790-6n7 Building Commission( F= 508-775-33" For office use only Permit no Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alte:adoas,renovation,repair, Moderui=dou'convey improvement,.t+emo�al, demolition, or construction of an addition to airy pre-existing owner occupied building containing at least one but not more than four dwelling units or to stractr=which are�jaesrtt to such residence or building be done by registered contractors,with certain exceptions, along with other requirements- 000 . 00 Type of Work Re-roof $6 Address of Work: 160 W . Main STreet , Hyannis Oaner.Name: Date of Permit Application: 3 6 9 7 I hereby certify that: Registration is not required for the following reason(s): x x x x Work excluded by law Job under S1,000 , Building not oamer-oocupiod Ow=pulling own permit, Notice is hereby given that: CONTRACTORS OWNERS PULLING THEIR OWN P WORK G DO NO wrmT HAVE CESS TO TIC FOR APPLICABLE HOME IMPRO ARBrIRATION PROGRAM OR GUARANTY FUND UNDER MGL c 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the ov►mer. Registration No. Date Contractor name OR ' [lwner's name . Assessor's Office(1st floor) Man A ?to Lot 14/,d0��/�- Permit# 37SG/9 Conservation Office Oth floor 3 2 1- Date Issued ZZ ZZ9 r Board of Health Ord floor /t- �'PLICANT A. /"- Engineering Dept. Ord floor House# � Planning Dept. (1st floor/School Admin. Bldg.): i „�„��B,a, t Definitive Plan Approved by Planning Board 19o �� (Applications processed 8:30-9:30 a.m. & 1:00-2:00 p.m.) TOWN OF BARNSTABLE Building Permit Application Proiect Street Address Village ym Fire District Owner DplJqu:� q3-mL- i-n Address Telc hone Permit Request: I`�P MC-P- G1� ��-� I�T �1'i CCU 09 5\ ylC-rdeliz- UI 114 tzo .( Zoning District Flood Plain Water Protection Lot Size, Grandfathered Zoning Board of Anneals Authorization Recorded Current Use Proposed Use Construction Tune —, Existing Information Dwelling Type: Single Family Two family Multi-family Age of structure Basement type Historic House Finished Old Kings Highway Unfinished Number of Baths No. of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name "��iZA�I/r� ��t iJti- Telephone number -Sqs-�6 2- Address ( oa 'IEEW4-1 License# 06085 �NN S l Home Improvement Contractor �# 61 C y 2Z Worker's Compensation # "t4��►-ems ^ 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 Proiect Cost SIGNATURE DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) BPERM T 3/2 7/9 5 FOR OFFICE USE ONLY 290.027.001 160 West Main Street Hyannis ADDRESS VILLAGE Doane Beal & Ames OWNER DATE OF INSPECTION: - FOUNDATION FRAME INSULATION t FIREPLACE ELECTRICAL: ROUGH FINAL ` t PLUMB ROUGH FINAL GAS: . ROUGH FINAL - FINAL B G: DATE CL^ UT: `+ ASSOC IA PLAN NO. + ` f .. COMMONWEALTH . DEPARTMENT OF PUBLIC SAFETY _ Massachusetts StateBulldlag } OF ONE ASHBORTON PLACE Coda Is aareo for reremleo MASSACHUSETTS �; BOSTON,MA 02108 gtfA/t/faeces: a L.I CE=N':::E-: ! ..i CAUTION EXPIRATION DATE �:�1./ j-� CON:': TR o : :I_I 'i:_I V I':I_IF� p FOR PROTECTION AGAINST RESTRICTIONgallrle to poteees a0eflil EFFECTIVE DATE LIC-NO. THEFT, PUT RIGHT THUMB NF.N`r.. MassachwaWtaStateB�tr�O 06. _;o 1 ,;,`-, ; t=�c_yl-,cjE,:Io PRINT IN APPROPRIATE podoJsoaseafort�' !��' i BOX ON LICENSE. of tRla//aenae• (, o i a r - TI-1IDIvIAE- V pI•A I L_1�R0l--If' � BLASTING OPERATORS :. . �"7;:;(i— /._.:;?68 ` m 107 BE:A C:i :aa - MUST INC UDE PHOTO. EIE:NN I' MA (:)2 1:$ 1 PA� PHOTO(BLASTING OPR ONLY) FEE: 1 1 NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY` { ` STAMPED-OR-SIGNATURE OF THE COMMISSIONER � +" r HEIGHT: i AUG � AIR DOB: j i ffilln j. 1/.L UI• N �� THIS DOCUMENT MUST ,3` p SIGN NAME IN FpJLW. fiv LINE CARRIED ON THE PERSON 6' , I SIG EOFLENSEE i J.� THE HOLDER WHEN'ENt IfD^I� ~ OTHERS-RIG +{UMB AINT GAGEDINTHISDCCUPATIq.J ISSIONER. 'x:5• .2"' 'N"b. t F;Ka' y+. #� k yy}'` F'E` r*sH'k' y V ��� nNONEIMPROVENENT�CONTRACTOR`� , ' Registrationnnnnnn 101422 'xF. XEIP ration 06/25/96 Y� r4 . ,;� - ���Phllbroo��Engr� Con tructio fisF . pl IZ ��.�,•o'�� 8�#�B,eacb�Street :� - i ems_, om.monwea& o f MaiiacLietti 2epartment o1 Jndujtrial Jccidenfd a ' 600 UVasltinyton Street James J.Campbell t%,oston, /f/aiJacLietts 02111 Commissioner Workers' Compensation Insurance Affidavit I, -T- VAfzNUm (licensee/permittee) with a principal place of business at: ( y sozkUl ST s -Dtat,4WIN , (city/sate/zip) do hereby certify under the pains and penalties of perjury, that: () 1 am an employer providing workers' compensation coverage for my employees working on this job. Insurance Company Policy Number () I am a sole proprietor and have no one working for me in any capacity. 1 am a sole proprieto eneral contractor homeowner (circle one) and have hired the contractors listed below who have t e o lowing workers' compensation policies: �Gl 13SC.. 1�03'� HS 0� Contractor Insurance Company/Policy Number o e 6)-�A,JU W1�3 5-LNA4 UWuo ) G LA 361 7-3Z Contractor Insurance Company/Policy Number Lb TY) N ULA- fZh,l-aft ) U1 0 D 110 iz 915 1 T A 5 L) Contractor Insurance Company/Policy Number () I am a homeowner performing all the work myself. I understand that a copy of this statement will be forwarded to the Office of Investigations of the DIA for coverage verification and that failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties consisting of a fine of up to 51,500.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day against me. Signed this Z Li day of 19 5 S Licensee/Permittee Building Department Licensing Board Selectmens Office Health Department TO VERIFY COVERAGE INFORMATION CALL: 617-727-4900 X403, 404, 40S, 409, 37S BUILDING DEPARTMENT CONSTRUCTION. SUPERVISOR FORM PLEASE PRINT; i JOB LOCATION: NUMBER _ ^ STREET VILLAGE OWNER OF PROPERTY: C,c1121 CONSTRUCTION SUPERVISOR: V11 VM��1 2-�yIZ OO 3 ^U� "3 NAME LICENSE NO. PHONE NO. ADDRESS:, y �tM G-k S'T% -b aJ lS i „A LICENSED DESIGNEE: (IF OTHER THAN SUPERVISOR) NAME LICENSE NO. 2.15 RESPONSIBILITY OF EACH LICENSE HOLDER: 2.15,1. THE LICENSE HOLDER SHALL. BE FULLY AND COMPLETELY RESPONSIBLE FOR ALL WORK FOR WHICH HE IS SUPERVISING. HE SHALL BE RESPONSIBLE FOR SEEING THAT ALL WORK IS DONE PURSUANT TO THE STATL BUILDING CODE AND THE DRAWINGS AS APPROVED BY THE BUILDING OFFICIAL 2.15.2 THE LICENSE HOLDER SHALL BE RESPONSIBLE TO SUPERVISE THE CONSTRUCTION, RECONSTRUCTION, ALTERATION, REPAIR, REMOVAL OR DEMOLITION INVOLVING THE STRUCTURAL ELEMENTS OF BUILDING !. AND STRUCTURES ONLY PURSUANT TO THE STATE BUILDING CODE AND ALL OTHER APPLICABLE LAWS OF THE COMMONWEALTH,. EVEN THOUGH HE, THE LICENSE HOLDER, IS NOT THE PERMIT HOLDER BUT ONLY A SUB— CONTRACTOR OR CONTRACTOR TO THE PERMIT HOLDER. 2.15.3 THE LICENSE HOLDER SHALL IMMEDIATELY NOTIFY THE BUILDING OFFICIAL IN WRITING OF THE DISCOVERY OF ANY VIOLATIONS WHICH ARE COVERED BY THE BUILDING PERMIT. 2.15.4 ANY LICENSEE WHO SHALL WILLFULLY VIOLATE SUBSECTIONS 2.15.1, 2.15.2 OR 2.15.3 OR ANY OTHER SECTION OF THESE RULES AND REGjLATIONS AND ANY PROCEDURES, AS AMENDED, SHALL BE SUBJECT TO REVOCATION OR SUSPENSION OF LICENSE BY THE BOARD. 2.16. ALL BUILDING PERMIT APPLICATIONS SHALL CONTAIN THE NAME, SIGNATURE AND LICENSEE ,LUMBER 01 THE CONSTRUCTION SUPERVISOR 14HO IS TO SUPERVISE THOSE PERSONS ENGAGED IN CONSTRUCTION, RECON— STRUCTION, ALTERATION, REPAIR, REMOVAL OF DEMOLITION AS REGULATED BY SECTION 109.1.1 OF THE CODE AND THESE RULES AND REGULATIONS. IN THE EVENT THAT SUCH LICENSEE IS NO LONGER SUPERVISI: SAID PERSONS, THE WORK SHALL IMMEDIATELY CEASE UNTIL A SUCCESSOR LICENSE HOLDER IS SUBSTITUTE? ON THE RECORDS OF THE BUILDING DEPARTMENT. I HAVE READ AND UNDERSTAND MY RESPONSIBILITIES UNDER THE RULES AND ,REGULATIONS FOR LICENSING' ( STRUCTION SUPERVISORS IN ACCORDANCE ,KITH SECTION 109.1.1 OF THE STATE BUILDING CODE. I UNDERS THE CONSTRUCTION INSPECTION PROCEDURES AND THE SPECIFIC INSPECTION AS CALLED FOR BY THE BUILD' OFFICIAL. INSURANCE COVERAGE: have a curren I' bilit• in i+y insurance pelic or cs substantial equivalent -+ .- Y q ent which me-Is Yes No ❑ the requirements of M�Lh.152 It you have checked ves, please indicate the type c,vera.ge by checking the ap;rcpriate box. A liability insurance pciicy O;her type of :ndemnity❑ Bond ❑ OWNER'S INSURANC=WAIVER: I am aware that the ucensee does not have the insurance coverage requires �y Chapter 152 of the Mass: General L:ws, ana that my signature on t„is permit cplication waives this requirerrer. Check one: . Signature of Gb.ner or Owner s:.gent OwnerU Agent ❑ 1� 1 SIGNATUREcV � BUILDING OFFICIAL APPROVAL: - I 32'-0" SCOPE OF WORK - • Strip affected areas of asphalt roofing 22'-0" 10--0" Re-frame rear wall (Wall "A") • Re-frame inner stud wall (Wall "B") • Install triple LVL to support roof Install new 2 x 6 rafters in "Area 1" • Sister existing rafters to LVL as necessary • Remove existing rear window (currently blocked and inaccesible • Patch & Match exterior walls as necessary • Re-roof affected areas (approx. 6 sq.) o. c �a— Area"1" G• Ceti I Ifl �;tExisting 2 x 4 stud walls t be re-built as necesary 000 T _ Solid Posts to Foundation II' I li ,, i 00 �I New'2 x 6/16!'o.c. to be installe N i II irf place of exsting 2 x 4 rafters This ENTIRE space is an IIi M "unfinished" storage area an B f I I� � I � i I I NEW 3- 3/4",ix 9 1/2" LVL's L j1 I 0 o O 400 "Sister" lower sections of the I ( I 40 a? �0. existing rafters to provide proper bearing on new LVL(this ry+ section only (The exsiting rafters do not meet I �+ H c the new LVL with out extending I o them) �; Q ` p 1 m p GC h > -_- �. •CC � rn � O C p = 0 Solid Posts to Foundation 40 Property of George Davis Builders,Inc,; Do Not Reproduce Remote Uo ter PERSONNEL PROHIBITED CID Fa Ra 3 FrameR1 3 DESIGN SPEcO46ICATIONG — —r 5M lnts lock 96 3 SM tnledock Coslomer Door PI} Df1d - Customer Door - 55 Shaffway CAPACITY------1000 Pounds on a 18 Inch Load Center Lower and - I I' Right! 44 Middle Level Left Access on DRIVE-------- Electric/Hydraulic - Trove! Speed 15 fl/min Upper Level Access on 44 Litter 52 Clear 37 Platform 40 Leff Side 1 94 1 Right Side POWER--------30 HP, 220 Volt, Single Phase, 60 Hertz Clear 92 LFront - f CONTROLS-----3 Pushbutton Stations, 1-2-3-(Pull to Reset)-Slop; Self-maintained with Upper. Middle and Lower Limit Switches WWWWWWW/ %:� to be 110 Volt, 60 Cycle Circuit in NE/tiA /Enclosures. i Shaftway 96 - NOTE om'h^a,ai41oe 2 INCLUDES---- Side Thrust Rollers senrtH/o o SIr,cNe rncode _ � d Sti9nhg/M IM 6 LaoG �I (I y� III I _ 91 1/2 , __-- Fulling Platform Safety Device Point to be Container Blue or Grey Enamel 76 Customer to specify Color ---- TEFC Motor �---72 Across Rails ---- Manual Lowering Valve j Two Cams L I - ---- wo s -- - Minimum Most --_� ---- Remote Power Unit with 10'Hose_ t I / .. - -- - -- -- I - - - 80 PP Y 11 NOTE:Shaftway with E/ectro-Mechanically Interlocked Gales/Doors to be supplied b Others. I f !1I I 48NMI8'6 E 'I 48 _ NOTE-Minimum Depth Most must be secured to a Structure capable of Supporting the Unit & Load. ,I Upper Level Access on Left Side v/ _- _ Platform has Solid Backplate; 48'high solid Guard oh Front; RLE�L =� / '�"m ®"'�' l Dual Safety Chains with Snap Hooks on Left & Right Side. 170 Overall 1 Lifter 52 - 2 T -4 Height Shaftway 55 / j Shaftwdy 96 80 HYDRAULIC RAM Property Of _!III I GIANT LIFT EOUIPMENT MFG. CO. INC. ` Travel . NOTE: '+ ' Customer to I� :, _ 185 LAFAYETTE ROAD ' Specify Dimension I l Middle Level NORTH HAMPTON N.H.03862 84 Access on (603) 964-5127 Right Side Raised Height 110 t I ' 'raa'ieLEveL ' � -_ -__•• __--• •_ j/ APPROVED AS IS ❑ 1 Travel 104 'i// APPROVED AS NOTED - ❑ 80 DATE 84 ,Splice AUTH. SIGNATURE l ! RIDING THE CONVEYOR IS _ - � DANGEROUS 8 STRICTLY FORBIDDEN /� t• S' Travel w - 48 v ,TO ALL PERSONNEL f j i •-"' Lower Level NOTE :Customer Indicate Approval Above �/, heck appropriate Box. Date and.Sign ' # Access.onAS - - JOB: #8351 CO INC. I jWWWWO, GIANT LIFT EQUIPMENT MFG.NORTH HAMPTON N.H. ®®pro® ®s0 Ames Hyannasr MA Platform/j conge from v0s. Accurate Ellevator & LO�tr �+®.LB'z 9 t 'to 60'z 9c',- 03 Dec 08 A Shaft- ch-gld from 75'z 9•to 55"z 96', MlddebDTOUgh, MA added mote P wer Uni�Q^wnn t Vim-Y/v FPOM N/aGCv DATE SCALE OWN CHK'D APP'D DWG N0. t file:6351A-OL6333B-68x96-itOH-6L-mid09-RJS-1K' NO REV. DATE APPD 20 Nov 0 V16 Jan I _ - FOUNDATION IS PRESENT O.G. TO USE _ __ -_- _ _ `• 22,_22. 50NOTUBE5. TYP. OF 3 LCCATIONS •_ 40 OVERALL - G.G. TO FIELD VERIFY 21'-q2i r %N .� h 2X10 LEDGER WITH f 0 EXPAN540N % r EXI5TING DOOR, FRAME, HARDWARE AND EXISTING DOOR TO BE OVERALL -G.G. TO FIELD VERIFY BOLTS INTO THE EXI5TING FOUNDATION 51_q,I II ACCESSORIES TO BE REMOVED AND STORED. - RELOCATED. EX15TI:NG OPENING 3 12 O.G. ST1466-EFEV ,•:..- 5AW VT AND REMOVE EXISTING BRICK A5 REQUIRED TO BE INFILLED TO MATCH WALL 5'-34" 11'-24 5-3 - 1 11 I- A ING 01 FOR.NEW DOOR OPENING AND LINTEL ASSEMBLY AND EXISTING BRICK / / / _. 1LZZZZ_L11X / XIS G ILD 6 EXISTING WINDOW / IS G ILD 6711 I I - WELL N _T - 3'-S'(i SAW) 2-*1"( 4549 x 2-'i"fi;3 a''4tJ 2�-6"( �) WILLIAM STARCK 7-� (��sJ w — w w w w w`� —'w s as ®� —_— i �,._ _•. -.:T-_ � ��_1 __- � ARCHITECTS; INC. At ( / O _ , E M COVE STREET _ / m : j I I j - Z ! -_ -_. _- — FALL RIVER.MASSACHUSEM 02M m — a 1 I -Z� _ , I � � -ANDI#lE � �Y �' I - 679S'733 ---- - I -� ! 1 c F.50&672,8556 1 W W W SLARCKARCHITEC TS COM AD 2'-b"( JI ILII (2) 2XIO 1 • _ — _:_-- - Z- f#4437 t �, \ �5 L � - f4) RI5ER5 ® bf'2 U 2-�'" 54i DN _.. _, ° �.. — l 1 ;. (3)TREADS a I -- ( I I ' = /a TAG CAMP05,TE -- - -- _ u ° _ m O r':DUr 1. EQUAL DECKING « - m m 1 ad 2�3 ( 3420) - - - -- - - \ (. ) 2) 0 - -- I+ ..✓ _ 1 � IT A .LEVEL I I \ 4 A JALI in L NDINGLu f OUTLINE O NEW 12 'L CONCRETE SONOTUBES I n o t- TYP OF 15 a - `� - 1 . 1 : L-4 (�.�J G.J, -_: Z'-3'(i34�'I I'-4"(��7 . _ _��__ _ 10 1 ,^ - - - - - -a - ` tD {� -- — 1 I 4 (3983� 42gr �. .:_. 2-4 ( 24 r-V 61l 12"� SONOTUBE ,�,.,��^ � - � I TYP. OF I5 2 5 3 4 O 4 REFER TO DETAIL q �, f O ° i ON THIS SHEET / _ �? REFER TO FLOOR c� JALL RAMP SLOPES / L L Ff�AMIN5 TO � PLAN 3 ON THIS • `��,f �,1'O HAVE A MAX OF SHEET FOR COLUMN a !2 SLOPE 03%) itAMIN6 a :� LOCATIONS I AND A MAX GRO5S NEW CONCRETE I , aLOPE OF 1:50 FOOTINGS (DIMENSIONS ARE f2.0�� a d TO THE GENTERt.iNh 1-M G.J. iOF ,+F- WOOD��4x4 P.T. WOOD r'05T TYP. OF 25 d � !J`rT5 I a � a (2) NEW'P2"O CONT. METAL. I a 0 ' EXI5TIN6 BRICK WALK TO ° ! RAILING WITH BRACKETS • Ecn X REMOVED (N ITS j AT EACH POST. (PRIMED o d /n v ENTIRETY ° .! AND FAINTED) © d NEW 5" REINFORCED C� CONCRETE RAMP lyuj r OUTLINE OF NEW RAMP 4 = I .. 6Xb-W2.q X W2.q KW LOCATION (BRUSHED CONCRETE _ - d I ) ' o I t,JJ Cn % .J1__ a - - (332.W7 `% : • -., 3"-O'(�I.gTJ _qp1.-�� _'�3-t'(�2,�') � - _ r r w I O.C. TO ENSURE SMOOTH o - r, w TRANSITION FROM NEW 5 APPROXIMATE LOCATION CONCRETE AND BITUMINOUS O 1_« 1 .fit.) �'. ... .... —. ,. _ ! i« t � .. C � � t OF BITUMINOU5 CONCRETE _ _ -6 1451,56) / O-, f l ) \ Al.r o Q PAVING PATCH �---/ (, _ _._.•._ � r O� � I TO BE REMOVED AND - W REPLACED A5 REQUIRED J Z .. FOR A FIROPER RAMP N<_.- Q W _ _ - � 2 N�1� i��MP �LOOfi� PLC 3 .. o 1 �X I STI NC/ DEMO P�.�N NSW RAMP ����I NC PL N �� w w , A1.l OUTLINE OF EXISTING ALI ALI SCALE: = 11-0„ SCALE: _ 1'-0" z ' SCALE:I/4" = 1'-O" BITUMINOUS PAYINr p ' J Q 51 TE NOTES: G>=NER4L NOTES O I. AT ALL LOCA TIONS SPECIFIED TO RECEIVE CONCRETE AND/OR BITUMINOUS PAVING, I. THE CONTRACTOR SHALL BE RE5PON518LE FOR THE PROTECTION OF ALL MATERIALS i CONTRACTOR SHALL REMOVE AND DISPOSE ALL ROCKS AND BOULDERS To WITHIN Ib FROM AND EQUIPMENT/APPURTENANCE5,AND MAINTAINING SAFE CONDITIONS WITHIN THE THE EARTH15 SPECIFIED NEW OR EX151 ING SURFACE. PROVIDE GLEAN COMPACTED GRAVEL PROP05ED CONSTRUCTION AREA. THE CONTRACTOR SHALL DE51ON AND INSTALL 3 MIN. o FILL IN PLACE OF REMOVED ROCKS AND BOULDERS. PROVIDE NEW PAYING ON COMPACTED ADEQUATE 5HORIN6 AND BRACING FOR ALL STRUCTURAL OR REMOVAL TA5K5. THE f SIDE S W GRAVEL ON COMPACTED EARTH IN ACCORDANCE WITH 5PEGIFIGATIONS,NOTES,AND DETAILS CONTRACTOR SHALL A55UME 50LE RESPONSIBILITY FOR ANY DAMAGES s INJURIES I COVER28 HEREIN. RE51!LTING FROM.AND DURING THE EXECUTION OF THE WORK. "- 2. THE CONTRACTOR SHALL`PROVIDE ALL EXCAVATION DEEMED NECESSARY TO COMPLETE THE � 1 a. THE vONTRAC70R SHALL BE RESPONSIBLE FOR REMOVAL OF ALL DEBRIS FROM SITE; NEW WORK, Y�ALKwAY CONTROL JOINTS SPECIFIED THE INTENDED I $, =' o , � REMOVE AND DISPOSE DAILY. \ / � � _+:} �, o _ Eyy 3. GRADE AND RE SEED ALL LAWN ARFA5 DAMA6��D DURING CONSTRUCTION. PROVIDE N , ♦ TO BE PLACED A5 SHOYvN ON 3. GOhTR,AGTORS SHALL VISIT THE SITE AND CAREFULLY EXAMINE TIfE AREAS IN QUESTION •► - � f "' AT DAMAGED LAM AREAS AND OTHER AREAS WHICH MAY BE „ \/ 4x4 P.T. WOOD P05T GRASS SEED AND/OR 500 ALL `�"'" ,.� THE..FLOOR-PLAN.- JOINTS 70 ; ! A�TO CONDITIONS WH!GH MAY ADVERSELY AFFECT PROPER EXECUTION OF THE WORK. 5HOWN OR DE50RIBED ON THE CONTRACT DOCUMENTS. PROVIDE MAINTENANCE AND'WATERINv, ' - . �y BE TOOLED AND CAULKED 'I DETERMINED R / I L I MINIMUM OF TWICE PER DAY FOR A MINIMUM OF b0 DAYS,OR UNTIL THE OWNER AND/OR ALL DIMENSIONS AND QUANTITIES SHALL BE E D O VERIFIED BY THE 4x4 P05T AND A f .. , , ;, � NEW HANDRAIL POST FOOTING o I CONTRACTOR. NO CLAIMS FOR EXTRA 005T5 WILL BE ALLOWED BECAUSE OF LACK OF f ! - RAKING BEYOND "i 9 (BEYOND) ARCHITECT ACCEPTS THE LAWN AREAS, IN WRITING. � (BEY J WOOD FLOAT FINlSFf I ARY TO FULL KNOb�ILED6E OF THE EXISTING CONDITIONS UNLESS AGREED TO 1N ADVANCE WITH to REVISIONS: 4. REMOVE AND DISPOSE AND/OR TRIM ALL SHRUBBERY AND PLANTING A5 NEGE55 tp w • 6.C. TO MODIFY EXISTING ARCHITECT BEFORE REMOVAL OR THE OWNER /Of7 ARCHITECT. z i.. PE I CONTINUOUS CHAMFER PROPERLY COMPLETE NEW WORK. CONSULT O1nNl_R AND RG [� O P05T-BA5E EQUAL TO 1.50 (2.OS5) 5L0 6RADE TO MATCH HE16W OF 4. THE CONTRACTOR SHALL BE RESPONSIBLE FOR PROVIDING ALL DEMOLITION REQUIRED ° TRIMMING OF ANY LANDSCAPING. ,, : _ z a X—X-x�-X-. NEW p SIMP50N TIE. a yLOPE Y WALK IN DAMAGED BY THIS CONTRACTOR DURING FOR. A COMPLETE'AND PROPER JOB,WHETHER OR NOT REFERENCE 15 MADE BY O - _ 1.1; (5.3�) SLOPEY4 FOOT Y 5. REPAIR EXISTING PAVING AND GURd G Q N 1! - GRADE CONSTRUCTION: SAW-GUT EXISTING PAVING FOR CONTINUITY MATCH OF !COTES AND DESIGNATION5. z o NEW 12 � CONS. FILLED _ -- -- - _ - x X-x-�- - O - UTILITIES IN AREAS OF NEW F- O 6. THE CONTRACTOR SHALL FIELD LOCATE AFL UNDERGROUND 5. ALL WORK SHALL COMPLY WITH OSHA,FEDERAL,STATE BUILDIN6,AND FIRE AND • SONOTL'$E. BOTTOM OF L 1-_, • I=I 11i_-_ E - : y 2x10 WOOD .JOIST I;- . _ _ CONSTRUCTION. CONTRACTOR SHALL AL50 COORDINATE ALL INSPECTIONS AND UTILITY L1FS/SAFETY CODES WHICHEVER 15 M05T STRINGENT. 4 f50NOTUBE TO BE 48" ITI' LOCATOR PRIOR TO BEGINNING WORK. LOCATIONS W1TH AN UNDERGROUND UTIL E5 6. TNE:GONTRAGTOR SHALL GHEGK ALL DIMENSIONS AND ACCEPT RESPONSIBILITY FOR 2xIO LEDGER I_ DESIGNATED BY THE OWNER. - MIN. BELOW GRADE. = IDE COMPACTED 5 CONS. SLAB ON GRADE. 7. STRIP TOPSOIL AND STOCKPILE ON SITE IN ARPA(5) ; » o DIMFN510NAL CORRECTNESS. .' %8"� ANCHOR BOLT'S � :- _ :i I �. 'I. THE CONTRACTOR SHALL CONFINE H15 OPERATIONS TO THE AREA(5) DESIGNATED BY " =i,: INEERED FILL W/ - bXb-W2gXN2q Z O.G.STAGGERI?> « W/ NW AT 2 a i FROM TOP ON CHAIRS THE OWNER. aSSG OPTIMUM DENSITY. 6• q» n S. THE CONTRACTOR SHALL PROVIDE ALL REQUIRED EXCAVATION DEEMED NECESSARY o T w ,0 PROVIDE THE INTENDED NEW WORK. .... GCNC�ETE! :� O i q. REPAIR/RE5 FORE TO ORIGINAL/NEW CONDITION A7 NO COST 70 THE OWNER ALL ; ' q S®NCTIJ�� DETAIL. E/:- 6 JCIST CCNNj GTIC�I , //�� . EXISTING ITEMS,.MATERIALS,SURFACES,LTG. (INCLUDING AREAS NOT DESIGNATED FOR +- �t/�C���E ��L� DETAIL NEK CONSTRUCTION 5HOWN ON THE DRAI^1IN65) WHICH ARE DAMAGED DURING SCALE:1/2i' = It-O" , i //� o A1.1 5CALE:1/2 1-0 1'`LI SCALE:112n 1' 4 GON5TRUCTION�°ALL RELATED 005T5 SHALL BE THE SOLE RESPONSIBILITY CF THE CONTRACTOR.. EX15TINO WINDOWS TO X r REMAIN 10. REPAIR E�!STllr�PAVING AND GURB4N6 DAMAGED BY THIS.CONTRACTOR DURING E`XISTINcG DOOR TO BE o GOL5TRUGTION: 5AW-GUT EXISTING PAVING FOR CONTINUITY MATCH. RELOCATED. EXI5TING ---= _.-_--- - DECORATIVE POST GAP -_ --; - 5'-0' MIN CLEAR LL. THE CONTRACTOR SHALL FIELD LOCATE ALL UNDERGROUND UTILITIES IN AREAS OF NEW a o OPENING TO BE INFILLED -- ------. _ EXL,TING BUILDING BEYOND I t p CON5TRUGTION.: CONTRACTOR SHALL AL50 COORDINATE ALL IN5PEC710N5 AND UTILITY TO MATCH WALL » » _-r _�_�:._. --- - ! ;---�, _ : . _. ____ ,, BETY�EhI HANDRA{Ly 2 x6 P.T. TOP'RAIL 77 LOCATIONS WITH AN UNDERGROUND UTILITIES LOCATOR SUCH A5 DIG SAFE PRIOR TO .I _ A55EML3LY AND EXISTING �'�.-, .___.T ,, � -T -- I r- EXISTING OVERHANG ; � r .--- -'-� BE INNING WORK. a Y « p G BRICK FACADE' a � . _ L-:._____i- -- _�_�__.J _1_ �_ , '- ! �. -- -- 2 x6 P.T. WC10D RAIL SCALE. COLUMN TO REMAIN AS NOTED , II _1 �- « p DATE.�__ _.ram' 08.18.15 , -POSTS BEYOND TO BE tL � � \ i r _ r 11/2 VIA HANDRAIL Z I L tGUT FLUSH BELOW TOP _ TYP: oQ - j DRAWN B� I --- . : Y. NJVEXISTING BUILDING O �-- «RAIL O ) ILL, S 4 GOMPGSITE ii » NEW 4x4 POST 2xb TOP RAIL AND - ,A ! JOB NUMBER. 15-092 2 x2 WOOD O z II j� � ' , _ � - • 'DEGKIING,COLOR TO BE I - m m p I 3 TREADS I IN ,« n ( J 5 ® I M � : NEW 4X4 P05T W/ O - , SIDE RAIL. _ a.. SELECTED BY OWNER. I « • BALUSTEiZS � 6 O.G. TYP ! --� _ _ , , _ O 2 x6 P.T.woOD RAIL DRAWING NAME. jI o 'd- r ii � �.. i a 4 Rl i , , r '., , :. !- � i� , POST GAP TYP F- m I O « « I I E. _ o P05T GAP SELECTED BY - �- 2 xl0 P.T. WOOD JOIST i n i _ � � 2X10 WOOD JOISTS «. FLOOR PLANS a OWNER. TYP. � �. �-- « ( ) I I � i AT 12 MAX N G _ 0 ENTER il s � � 2 2 x8 P.T.P .TRIN6ER / COMPOSITE , _ 5r BASE EQU 2 NEw m CONT. METAL -- i O �' AL , 5 8 GARR{A6E T:: . 2 , : - -- __ W1 / BOLT SECTIONS, DETAILS DECKING SELECTED _ _ , ! : ,� _ _-- ------- p —�_--------: TO 51MPSON BASE x " RAILING WITH BRACKETS :. � _ i - _ _ _ Y WNER I 8 LONG COUNTERSINK -- v - ._ - __ GB5Q44 , , a-ADD NOTES A5 REQUIRED(PRIMED d NEW COINGRETE RAMP - �d � ,� .::_ - 2 PIS P T � - 6.G. TO INSTALL _;a o 2 PAINTED)CONNECTED TO on : 6.G. TO INSTALL .• .VINYL LATTICE AT ----- ' , ,I P05T BASE EQUAL TO ----- p � NEW WOOD RAILING p 0-O (31.q'i) i. 1 VINYL LATTICE AT NEW RAMP OPENINGS SIMP50N BASE C,55044 s , SYSTEM. TYP.BOTH SIDES REFERENCE ti NE:W RAMP OPENIN 75 DRAWING NUMBER. JEW 12 GONG. a 4 x4 P.T. HOOD POST ,•. : — -- — �, . PREMOLDED JOINT FILLER NEW 12 � CANC. FIILLED ..: _ — . 5" GONG. SLAB ON GRADE. c FILLED SONOTUBE. M HANDRAIL ENSURE SMOOTH SONOTUBE. BOTTOM OF 3077 M 2XIO WOOD JOISTS W/6X6-W2AXW2.q WWF AT FOOTING. TYP OF I A I /a GOMP051TE a O OF TRANSITION 2 FROM TOP ON CHAIRS , DECKING SELECTED 509?TUBE TO BE 48" MIN. ' • 12"O 50NOT'UBE o �ONOTUBE TO BE 48 P05T BASE EQUAL ,- , I_ 1 2 x2 WOOD � . 0 0 NEW ASPHALT PAVING BY OWNER BELOW GRADE..(TYP) • • g , TIN.BELOW GRADE. TO 51MP50N BASE: « *,^ � « BALUSTERS ® b« O.G. TYP) Ai m I II 1 2x12 WOOD NEW 5 RE1'Nr-OP4ED PROVIDE COMPACTED 1/2,1 (1) LAYER IY TOP COAT GB5Q44 [OUTLINE OF CONCRETE 5TRIN6ER5 CONCRETE RAMP:W/ ENGINEERED FILL W/a5% (1) LAYER V2»BINDER HAUNCH BEYOND. q X ' q WWF o TYP Oi 3 6Xb W2. ,�12. OPTIMUM DENSITY. �I �, �'LCNCNT ' YTICN 8 C I p ,WOOD FLOAT FINISH) I-<-- SECTION AT RAMP COMMENTS: A1.1 5CALE:1/4" = 1'-0" SCALE:1/4" = 1'-0" SCALh!/2'= I'-0" 1 i 1 _ ; Remote Power Unit CP 1 PD,2EbqS0XNEL PRORMiTED , P.B. P.B. OFROM RMING 3 Frame 3 DESiGN SpEORGA TONG � SM Interlock 96 3 1 SM/nlerlock 1 Customer Door P I t and Customer Door i 55 Shaftway CAPACITY------1000 Pounds on a 18 Inch Load Center Lower and ' Middle L e vel ht , Upper Level 44 Left Clear 37 Ri g 44 Access on DRIVE -------- Electric/Hydroulic - Travel Speed 95 ft/min I Access on Llfter52 Platform 40 1 Right Side Left Side 1 94 1 POWER--------3.0 HP, 220 Volt, Single Phase, 60 Hertz Clear 92 Front CONTROLS-----3 Pushbutton Stations, 1-2-3-(Pull to Reset)-Stop; Self-maintained with Upper, Middle and Lower Limit Switches 3 ice/ No V////// P/////////N/r////// to be 110 Volt, 60 Cycle Circuit in NEMA / Enclosures. Shaftway 96 NOTE:Minimum Depth Most must be 2 secured to o Structure copab/e INCL ODES---- : .Side Thrust Rollers of Supporting the Unit & Load 91 1/2 --- Falling Platform Safety Device j ---- Paint to be Container Blue or Grey Enamel 76 I Customer to specify Color J � ---- TEFC Motor 72 Across Rails ' � ---- Manual Lowering Valve ---- Two stationary Cams ---- Minimum Most i . Remote Power Unit with 90' Hose 80 NOTE. Shaftway with Electro-Mechanically Interlocked Gates/Doors 4 ` to be supplied by Others. 1 48 86 48 k NOTE: Minimum Depth Mast must be secured to a Structure capable 014 of Supporting the Unit & Load. Upper L e ve( _ Access -on 40 L eft Side d Platform has Solid Backplate; 48" high solid Guard on Front; UPPER LEVEc _T7 - - -- _- -- _= s Dual Safety Chains with Snap Hooks on Left & Right Side. 170 Overall Lifter 52 2 1 -- -- -- -- , -- 94_ -- -- � Height Shaftway 55 Shaftway 96 80 HYDRAULIC RAM Property of b GIANT LIFT EQUIPMENT MFG. CO. INC. L,J� Travel � /`;/d��: ' * � Customer to ®� \; 185 LAFAYETTE ROAD r L Specify Dimension NORTH HAMPTON , N.H. 03862 Middle L e vel 84 Access on (603) 964-5127 Righ t Side Raised Height 110 MIDDLE LEVEL No - APPROVED AS IS Travel 104 APPROVED AS NOTED IF 80 DATE 84 a AUTH. SIGNATURE RIDING THE CONVEYOR IS Sp/ICE' h DANGEROUS & STRICTLY FORBIDDEN Travel g 48 TO ALL PERSONNEL NOTE Customer Indicate Approval Above � Lower Level Check appropriate Box, Date and Sign A ccess on Left Side I IL __ -LOWER1EVEL r JOB:o *835{�U it 6 / n1l GIANT LIFT EQ 3 40 1 94 1 NORTH HAMPTON N.H. 1 Lifter 52 2 Pit 96 / Doane Beal] � Ames NriJy�1n Ns, MA Platform change from Pit 55. 48' x 9 • to 40' x 94•; Nl��o QC�C��IP�to C��C�yal oO P & Uft Coo . 03 Dec 08 Shaftwa thong from / 75' x 9 ' to 55, x 96'; MDdd eborou C)h9 MA o oq O O O 0 0 o added mote P wer Unit G3�J� 0000 Laft Soda VJ8 ��o�� Moc� VV DATE SCALE DWN CHK'D APP'D DWG N0. file:'6351A-0463336-48x96-110H-6L-mid09-RJS-1K' NO REV. DATE APPD 20 Nov 08 1/16 Jan �_25y9421n1 I F r I I I s s t L i n i I , V I 1 O j 7 i a ti -I � I I. �I r I t I , i I , I _ I € • i i 4 <I E r , r , , t_ I r , r s G a; V E I r a qq a I , y I I, r t C i i , s , ,