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Home My WebLink About0054 ABBEY GATE wa •,e �II 9 �� c��l T � � _ - � -, , , E i ! � .. i 1 �i BIKE Shed TOWN OF BARNSTABLE Permit * E ARNSTABLE. - MASS. � ib ArF p 39. p Permit Number.- Application Ref: 201502278 20150868 Issue Date: 04/27/15 Applicant: PORTER, ALAN L & TERESA M Proposed Use: Accessory Structure Permit Type: SHEDS 200 SQ FT &UNDER Permit Fee $ 35.00 Location 54 ABBEY GATE Map Parcel 021060 Town Zoning District RF Contractor PROPERTY OWNER Remarks 10' X IT SHED Owner: PORTER, ALAN L & TERESA M Address: 151 OCEAN RIDGE DRIVE MELBOURNE BEACH, FL 32951 Issued By: PR f. POST THIS CARD SO THAT IS VISIBLE FROM THE STREET Town of Barnstable Regulatory Services Richard V.Scaii,Interim Director '"`ram Building Division 39. ,;j �� .=I � °' Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 PERMIT# l a -7 U FEE: $ SHED REGISTRATION RESIDENTIAL ONLY 200 square feet or less 5y oWe (fo /U Location of shed(addre s) Village —Z so 91 Property owner's name Telephone number /6), >( Size of Shed Map/Parcel# 0 3 -ao/� afore Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? If over 120 square feet,you must file with Old King's Highway fjA Conservation Commission(signature is required) !"�— Sign off hours for Conservation 8:00-9:30&3:30-4:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:110413 i -ti File number: 140819-2 UNREGISTERED LAND Atlorne : CAPE COD TITLE&ESCROW Deed Book 23694 Pa,e 85 Lender: Plan Book 271 Page 56 Lots 81 Owner: ALAN PORTER REGISTERED LAND Reg. Book Street Lot(s): Date: 8/20/2014 Certificate o fTitle Assessor's Mf1p 21 Blk: Lot 60 Census Tract MORTGAGE INSPECTION PLAN Scale: .1"=40' 54 ABBEY GATE ROAD, COTUIT, MA LOT 80 159.30' LOT 81 W 20,050 S.F. � 54 0CV � M O A `�! 0 0 O Q CV w O 134.30 g9�� ABBEY GATE ROAD CERTIFICATION 1 CERTIFY TO THE ABOVE ATTORNEY,BANK,AND THEIR TITLE INSURANCE COMPANY THAT THE MAIN BUILDING,FOUNDATION OR DWELLING WAS IN COMPLIANCE WITH THE LOCAL ZONING BYLAWS IN EFFECT WHEN CONSTRUCTED(WITH RESPECT TO STRUCTURAL SETBACK REQUIREMENTS ONLY)OR IS EXEMPT FROM VIOLATION ENFORCEMENT ACTION UNDER MASS.GENERAL LAW TITLE V 11,CHAPTER 40A,SECTION 7. FLOOD DETERMINATION r ` 159.30' LOT 81 j 20,050 S.F. # 64 0 Q � o o04 li-� co o 134.30' ABBEY GATE ROAD CERTIFICATION t CERTIFY TO THE ABOVE ATTORNEY,BANK,AND THEIR TITLE INSURANCE COMPANY THAT THE MAIN BUILDING,FOUNDATION OR DWELLING WAS IN COMPLIANCE WITH THE LOCAL ZONING BYLAWS IN EFFECT WHEN CONSTRUCTED(WITH RESPECT TO STRUCTURAL SETBACK REQUIREMENTS ONLY)OR IS EXEMPT FROM VIOLATION ENFORCEMENT ACTION UNDER MASS.GENERAL LAW TITLE VII,CHAPTER 40A,SECTION 7. FLOOD DETERMINATION BY SCALE,THE DWELLING SHOWN HERE DOES NOT FALL WITHIN A SPECIAL FLOOD HAZARD ZONE AS DELINEATED ON A MAP OF COMMUNITY #25001CO756J AS ZONE X DATED 7-16-2014 BY THE NATIONAL FLOOD INSURANCE PROGRAM. OF 41 Asp Olde Stone Plot Plan Service, L.LC NE J. tiN P.O. Box 1166 0 KELLYrn Lakeville,M4 02347- " No• 35036 05 Tel: (800) 993-3302 Fax: (800) 993-3304 U V 1-f PLEASE NOTE: This inspection is not the result of an instrument survey.The structures as shown are approximate o4y. n instru ent survey would be required for an accurate determination of building locations,encroachments,property line dimensions,fences an lot configuration and may reflect different information than shown here. The land as shown is based on client furnished information only or assessors map& occupation and may be subject to further out-sales,takings,easements and rights of way. No responsibility is extended to the landowner or surveyor,or occupant. This is merely a mortgage inspection and is not be be recorded. 9 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map LDT 0l Parcel d Zt0 60 Application Date Issued f U Health Division 2241 �(/y Conservation Division Application Fee Planning Dept. Permit Fee �� v Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address 5�Village Owner Owner 7;;ck Address sry TelephoneOg Permit Request &atiT7n&-c7- 3� r %?J Q-0V Ll�g -4r Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District . Flood Plain Groundwater Overlay C- - ► Project Valuation 3 Construction Type Lot Size J Grandfathered: ❑Yes ❑ No If yes,Aaftachnrporting docurn,2ntation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units)Age of Existing Structure Historic House: ❑Yes ❑ No On ighway❑1 ❑ No rn. Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use - - APPLICANT INFORMATION (BUILDER OR HOMEOWNER) c� Name /C � �r BLS ��2y Telephone Number Address (l a __5 License # C'4Wk1A,)i M* e)Zoe/ Home Improvement Contractor# Email A 4- 0 6D OC &' TdAU•G44 Worker's Compensation # ��OyZ�71i� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �GP SIGNATURE DATE 'Z �3�iy I ,j FOR OFFICIAL USE ONLY - iPPLICATION# DATE,ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME i f INSULATION FIREPLACE Y. ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING:. d DATEyCLOSED.OUT AS:S.,QC.IATION PLAN NQ. f . ... .... .... �`7t•e Caassrtrta�csueaft�i off'!�assaehrrsef#s -Depar&umt of Indtrstr d Accidents t`3, ice OfInvesagations 600 Wrashuigtan Street Boston,MA 02111 wmv.an=g&Wdia Worke& Compensafion.Insurance Affidavit-BiaTders/C:ont acfnxs/EAectdcians/PLumbers APPIkant Iufarmafaon Please Friatt Legibly Name 5n&,idwl): 0 Address. City/Stat&Zip: �� / 6V1/ OZa2/ Phone l 8L 1 • �� d Are YQU-an employer?Check the appropriate box: Type of o'ect �' l (required): e4uired): t_ am a employer with 12.:? 4- ❑ I an a,general contractor and I 6- ❑New cons r ioa employees(full an-Wor part-dine)* have hired-the sub-Contractars. 2_❑ I am a sole proprietor or partner- listed on the attached sheet 7- [9-�pdeling ship and haze no,employees These mb-OOIItractors Lave 8- ❑Demolition wo&ng for me in any city ci �_ employees and have workers' l _ ❑Building addition [ o,workers'camp.invtranre comp-msutauce required] 5_❑ We area corporation and its 10.0 Electrical repairs or additions officers hava exercised their ❑Plumbing I L airs or additions 3_❑ I am a homt3oum�doing all workg mP , myself. [No workers'comp- right of exemption per MGL I2-0 hoof _ , ( and we fume,no inntranre reC1II1IC'd-7 l 1• c 152 �14�� 13_0 Other employees-[Na worker' comp-msuranoe required-I *A.ny mph toot dheds boa-91 nmst also fill out the section below shntuing lea vimters'compcnsadc*pour}-++Ramnz T Homeon+net-s who.submit this afad z=inm uffirg they ice doing ag rcuk and then hire outside coat=rors= submit a naw afdarit in�rmt;,,v smch ZContr8crors that check this bm must s=rhed zm additia'W sheet sbotwmg the name of the soft-cant-AUs amd state vrhether oc Xwt those txntes 33ve mmplvyees. If the sub-contmctars hire empIayees,they must provide this workers'comp.policy numbez lam an employer fhatisprm�iding n�orkers'comperrsrrtion irtsurnrtcs for rtzy employees Belotw is fire policy arrd fob site information. p Insurance CompanyName: 59 Policy#or Self in&_Lic-;k lj4J�Q �Z��— Expiration Date: Job Site Address: tS CityfStatel7,ip��'i�i Attach a copy of the workers'co. e-asatitm policy declaration page(showing the policy umber and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition ofcrirninal penalties of a fine up to S 1,500.da andlor one-year impel as well as civil peuahies in the form of a STOP WORK ORDER and a fine of up to S?50.00 a day against the.violator_ Be advised That a copy of this stint may be fiarwarded to the Office of Im estigations of the for insurance coverage vacation Ida hereby cerfi irs arrrlpena rrry fltaffhe information prmadstl alone is bzta and correct SiEnattsre: (j Bate: Phone# �O / ��/• ®��j'c� Olokial use only. BLD,not mite in Olds area,to be completed by Gity or town of,,('ciaL City or Town:. PtsrmitlLicense# Tcs3iina Authority(circle one): 1.Board of Health 2.Buff-ding Department 3.Citv-.lI awn Clerk 4.Electrical Inspector S.P'luambing I-asgector 6.Other Contact Person. Phone#_ 6 information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Puusuantto this statute,an wTloyee 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 Iegal 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 herein,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 sus that."every state or Iocal Liceasing agency shall withhold the issuance or renewal of a license or permit to operate a business or to constract buildings in the commonwealth.for aay applicant who has not produced a rcept{ble"evidence of compliance with t he'iasurance.coverage requ.ir ed." Additionally,MGL chapter 152, §25C(7)states `Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the pe�ormance of public work until acceptable evidence of compliance with flue 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)nazne(s),address(es)and phone number(s)along with their certlficatc{s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partner�ips(L LP)with Do employees other than the members or partners, are not required to carry workers' compensation insurance_ rr an LLC-or LLP does have employees, a policy is required_ Be advised that this afdavit may be submitted to the Department of Indusrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The of fidatnt should be returned to the city or town that the application for the permit or license is being requested,not the Departrrient of Industrial Accidents. Should you have any questions regarding the law or if you are required to ob-ta-in 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 Investigation's 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 mu st ust submit multiple permit/hcense applications in any given ye.'r;need`only submit,,one afdavit indicating current policy information (if necessary) and under"Job Site Address"the applicant should write"all locations Ui l (city or t 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 tilled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e,a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: Thy Gommanwealth of Massachusetts _ Depaitnaat of hidustial`Mcuients - I Q-iTiCe of ve,stigatlous 600 Washington Stet Boston,NU 02111 Tel.9 617-727-4900 W 4-06 or 1-977-NL&S E Revised 4-24-07 Fax#617-727-7-749 vrww.mas,&govl ld'a i CONTRACT TO INSTALL OWENS CORNING BASEMENT WALL FINISHING SYSTEM Owens Corning Basement Finishing Division(the contractor)hereby submits this propcsal to sell and install the Owens Corning Basement Wall Finishing System and related items as described herein at the residential premises set forth below.This proposal shall not become a binding commilm9nl t(ntesrs and until it has been signed by the Contractor and the Customer. Contractor: Owens Corning Basement Finishing Systems a division of LUX Renovations,LLC. 60 Shawmut Road,Canton,MA 020 02021 Telephone#(781)821.0060 Facsimile#(781)821-8552 Federal Tax ID#14-1855297 Mass.Home Improvement Contractor Reg.#137943 Date ( ' ¢tywvtl�pr 2n l y Customer: Customer Name L1aLk a,od 5 run G-c rA^o-r Street Address Z1-4- 61,g . rC� City,State,Zip_ mil-. t 0Au. Telephone( S o r3 ) Lk20 0 1 -7"3 - This is a contract between the Contractor and the above named Customer to sell and install the Owens Corning Basement Wall Finishing System and related items specified herein at the Customer's residential premises identified below: Installation Premises: Street Address as cjbov2 City,State,Zip Scope of Work: Are Sketches and/or specification sheets attached? %/Yes' o No -AN aaachmente are Incorporated Into and bao rt a pan of Wa conVad Description of Work/Specifications: O.aona _rnwa,_9 s1e..n I sort Sknkcl.�� S�se5l1�S��-k Gcaa.+tboord t J o.JfY \�� b¢c �V`fOJ W.�� r r' to �l..r`l,.nd a.rPe 4"cud �rl�t t 't��oakr�cr,� Eb �.rc�ur� QI S r 1 Corn �ta�lnt' 1' t� � G;ok -r- -,------ F�-r- r st s 5 Work Schedule": - - Approximate Commencement Date 12 ck�V-y 20 IS " �. ram. Approximate Completion.Date: 2S J(MJ4r . 20 1 S "The proposed work schedule is`approximate anted subjecttor Flange! Contract Price: -- Total Contract Price: $ 3Cl, �q 4 Deposit with order: $ 3�{4 q o'Cash o Check# Balance Due: $ 35 $tt5 Terms: o Cash o Finance (Cash terms are 10%deposit,50%on commencement,40%on completion) $ 1 1�t y -7- F - _ -Due on Commencement_ _ $ Due on Completion DO NOT SIGN THIS CONTRACT UNTIL ALL PPLICABLE BLANKS ARE COMPLETELY FILLED IN AND UNTIL YOU FIRST READ AND UNDERSTAND THE ENTIRE CONTRACT,INCLUDING ANY ADDENDUM ATTACHED HERETO,AS WELL AS ANY ATTACHED SKETCHES,MATERIAL LISTS OR THE LIKE,AND THE TERMS AND CONDITIONS ON THE BACK OF THIS CONTRACT DOCUMENT. YOU ARE ENTITLED TO A COMPLETE,FULLY EXECUTED COPY OF THIS CONTRACT AT THE TIME OF EXECUTION. Witness our hand(s)and seal(s)below on this eJaA oA?- day of �ff.h nb o.0 20 t ttit LUX Renovatio LLCIAuthorized Repres I five: A 1 V I 1 Signatur d Title N L n Pd ame DO NOT SI N THIS CONTRACT IF THERE ARE ANY BLANK SPACES Custome Custo r ignature c _J P'nt Na C s Omer Sin lure Print Name Contractor may have certain lien rights in the-premises until the price is paid in full.You have the right to cancel this contract,without any penalty or obligation,at any time prior to midnight of the third business day after the date you signed this contract.See the notice of cancellation below for an explanation.of this right. "'Customer acknowledges receipt of a true copy of this contract which was completely filled in prior to customer's execution hereof. \I/1T1.10^0^A L1^01 I ATle%Ll Owens Corning Basement Finishing Systems • of New England Gardner,Jack&Susan 54 Abbey Gate Rd i Contractor / Agent Authorization From Cotwt,MA 02635 508-420-0173 , I� authorize Owens Corning Basement Finishing Systems of Boston to sign the building permit application on my behalf,to perform the work at: Home Owners Signature: Date: /02 al Project Manager Signature: 444� Av" Date: Z / 60 Shawmut Road • Canton, MA 02021 • Phone: 781-821-0060 • Fax: 781-821-8552 • www.ocboston.com Gardner,Jack&Susan 54 Abbey Gate Rd Cotuit,MA 02635 508420-0173 - rCONTRACT Customer Name A—k a.A Customer Signature I. SKETCH Contract Date i i 1)aca++bmr 'z-o►4 Sales Representative Si iature ATTACHMENT Customer Phone -SCA �rLo O 1-7 3 Contract Price , 2 3 . 5 8 7 8 9 10 „ 12 13 ,. ,s 18 17 18 ,9 20 21 22 23 24 25 29 27 28 29 30 31 32 33 34 35 39 37 38 M .0 ., 42 48 a 15 48 47 .8 49 50 , 53 54 85 58 57 58 59 8D I's - 2 - - 3 0-, _.. ZN I 711 7-4 10 12 14 At 1225 i ff I i 20 21 _ je 24 I a ,I 25 20 30 31 32 1.__L.._. 33 3. u I 144--j--•j ' i , NOTES: Each box equals one foot unless otherwise noted.This sketch is a good faith representation of the work to be done, it Is understood that all dimensions derived from this sketch are approximate,and that all locations of outlets,light fixtures,plugs,Jacks and/or switches are subject to change if necessary. INSURED INSURER A:Peerless Insurance 24198 Lux Renovations, LLC Owens Corning of New England. INSURER B:Pilgrim Insurance 60 Shawiliut Road INSURERC:Star Insurance CompanV 18023 Canton MA 02021 INSURERD: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:639296000 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 ADDLSUBR POLICY EFF MMIDD UMITS EXP LTR TYPE OF INSURANCE POLICY NUMBER A GENERAL LIABILITY CBP8512851 9/5/2014 9/5/2015 EACH OCCURRENCE $1,000,000 X CDAMAZE To RENTED OM PREMISES Ea occurrence $ COMMERCIAL GENERAL LIABILITY 100,000 CLAIMS-MADE OCCUR MED EXP OM one person $5,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER.- PRODUCTS-COMP/OP AGG $2,000,000 X POLICY PRO LOC $ B AUTOMOBILE LIABILITY PGC10007161409 1/17/2014 1/17/2015 COMBINED SINGLE LIMIT $1,000,000 ANY AUTO (Ea accident) BODILY INJURY(Per person) $ X ALL OWNED AUTOS BODILY INJURY(Par accident) $ SCHEDULED AUTOS PROPERTY DAMAGE X HIRED AUTOS (Per accident) $ X NON-OWNED AUTOS $ $ A X UMBRELLA UAB [X]OCCUR CU811953 9/5/2014 9/5/2015 EACH OCCURRENCE $1,000,000 EXCESS LIAR CLAIMS-MADE AGGREGATE $1,000,000 DEDUCTIBLE 10,000 $ X RETENTION $ $ C WORKERS COMPENSATION WC0428715 5/24/2014 5/24/2015 X WCSTATU TS - OTH AND EMPLOYERS'LIABILITY Y/NLIj ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? ❑-N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $1,000,000 DESC It es,describe underRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101.Additional Remarks Schedule,If more apace Is required) CERTIFICATE HOLDER CANCELLATION SHOULD.ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF;NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Lux Renovations, LLC 60 Shawmut Rd Canton MA 02021 AUTHORIZED REPRESENTATIVE V 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD Massachusetts -Department-of Public Safety' Board of Building Regulations-and Standards Construction Supervisor.l &2 Family License: CSFA-047809 PETER M MONA 136 RIDGE ST MILLIS MA 020334 :• i c� )ro,% Expiration 07/22/2015 Commissioner _ o4 Business e ulation Office of Consumer A fairs g 10 Park Plaza - Suite 5170. Boston, Massachusetts 02116 Home Improvemcontractor Registration Registration: 137943 Type: Supplement Card i S ! ' �� Expiration: 1/29/2015 OWENS CORNING BASEMENT FI 11- G PETE MONAGHAN to 60 SHAWMUT RD CANTON, MA 02021 { C 0'4 i %b Update Address and return card.Mark reason for change. Address Renewal n Employment Lost Card i SCA 1 20M-05/11 Vhe cpamiman�,/lea�o�G�aac�iscae%Id ' ffice of Consumer Affairs&Business Regulation License or registration valid for individul use only ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: �., Office of Consumer Affairs and Business Regulation egistration.j.j 43--I Type 10 Park Plaza-Suite 5170 Expiration�1-/291201 Jjk Supplement i:;ard Boston,MA 02116 OWENS CORN INdtAS'EME•N---INISHING SYS PETE MONAGHAN h 60 SHAWMUT RD CANTON,MA 02021 Undersecretary Notivalid ithout signature A O I l " ►'lV'�� Town.of Barnstable *Permit# Expires 6 months from issue date EWM IT Regulatory Services Fee 0 9.� �e� Richard V.Scali,Director prED MA'I A �f 2014 Building Division . Tom Perry,CBO,Building Commissioner r LF 200 Main Street,Hyannis,MA 02601 ��G /1 t�J�y TOWNOF ARM www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 j)� EXPRESS rLEWT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address -5-y 4,6d Cy C/�—%C Co t/)7 Residential Value of Work$S�Z p(fD Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address G� l�h / v.— f 2� yky oz 6 3s Contractor's Name Telephone Number SD Iq Home Improvement Contractor License#(if applicable)] ff Email: Construction Supervisor's License#(if applicable) (S .❑wcrkrnan's Compensation Iitsurance Check one: i ❑ I am a sole proprietor ❑ I am-the Homeowner. (�-sT-have Worker's--Co'm`pensation Insurance Insurance Company Name P/'��LS L ck� Workman's Comp.Policy# Copy of Insurance Compliance Certi cafe must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to -❑ Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) Re-side Replacement Windows/doors/sliders.U-Value , 30 (maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home r ement Contractors License&Construction Supervisors License is required. SIGNATURE: Q MPFILESTO 5buil ing permit fomu\EXPRESS.doc Revised 061313 �XE�OilRfflO7TtE��t O��[155Qf�1lsEttS Deparhnent of lidu3tiial Accidents 60 Office-of_&VMti�Ons 600 Washington S&eet Boston,MA 02111 wmv. nuss.gotldia Workers' Compensate€onhs=-aceAffiidavit BiFildersfContx-a�ctorsMectriciansMumbers Applkant Information / Please Print.Legibly Name()3ttsinewslOrganizafion(fndiiridnal)= 6A-a 5�� k. A- A-V , hyI !F- - Address WCiWStab-LJ;npq ) Y/&, Phone -- a your =Ioyer?Gbeck aPP:ropriate _T of o ett s atxt a Beal contractor and'I Yl PT J {��q)=— 1_ yer with 6_ ❑New oomstnrction {full with pact time}* v e m��sub�� am a sole proprietor or partner listed on the attached sheet 7_ ❑Remodeling ship and have no employees These se s and have g- ❑Demolition w for me.in an capacity- �p�Y�and a have workers' offing Y � ty- g_ ❑Building addition [1V'a urorir�ers'Comp:instuavice comp-insurance, 5_❑ ❑-Electrical are a corporation and its lU_ ectrical repairs or additions regnrred] officers have exercised their 3.❑ I am a hnmaou�nes doing all work I I4:1 Plambing repairs or additiom � myself [No workers'comp- right of exemption per MGL 12_.❑Pmof repair-- inmtsance required]t c-152,§1(4} and we bane no employers-[No Workers' 13_❑Other comp.insurance regmred.J; t wAny applicaat that checks boot,1 inn also fill out the section below shooing their vrmtirers"compensation policy infr rmatiarr_ T Homeowners Who submit this affidavit=&cating they are doing all irc*Lord then bire outride contractors must submit anew affidavit indir�c-rh f Dntrnctors that check this box mast attached:an additional sheet showing the mime of the and st—vchethec ocuut.base entities have employees_ IMP sub-contoictarshare employees,the}xmrst pruvide their workew comp.policy ntm3bes -11 am an employer ilia#is prmiding it�orke-rs'comperunlian insurance for my emp&yerm Bdots is the polc}rutd,job site informalian_ i Insurance CompanyName= 60 Policy#cr self ins Li��-`_—�/`}- C � Ex tratton Date. Jolt Site Address: ` / a (// �_j /J /`T� ( CitylStafelZip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requiredunder Section.25A of MGL c. 152 can lead to the imposition of'rriminal penalties of a fine up to$1,50O.Oa and/or oneyearimprisonmenty as well as civil penalties in the form of a STOP WORK ORDIRaad a fine ofup to$250-00 a,day against the violator_ Be advised that a copy of this statement maybe forwarded to the Office of Iurestigations of the DIET far insurance coverage vecffication_ y do hereby certi r reder tke prrin itd realties afperjury thatther information prot2ded¢bane//is true and correct Sitmat�re Date: r Phone i#_ Official use only. Dv not tvrite in this area,to be completed by ciijv or town official- City or Town: PerrffitUcense# Issuing Authority{circle one}: 1.Board of Health 2.Building Department 3.City T'own.Clerk 4_Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person. Phone#: 6 Information and. Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto this statute,an employee is defined as".._ever}+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 Iegal 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 IocaI licensing agency shaII withhold the issuance or renewal of a license or permit to operate a business or to coal-i=ict'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 — .`N 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 numbers)along with their cei f ificate(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 af.Ldavrit should a be tet shied to the city or town that-the application for the permit or license is-being requested;'not the Depart nent'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 eater'their' self-insurance license number on 6e ppropriate line. City or Town.Officials Please be are that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the Iaffidavit 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 permitllicense number which-v U be used as a reference number. In addition,an applicant that�must submit multiple pemitfhcense applications in any given ye-u,need-only submif 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 dr town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number. The Commonwealth of Massachusetts Deputmmt of Industdal Accidents Office of kvl�stigatians 600 washivan Street Boston,MA 02111 Te.I.A 617-727-4940 oxt 406 or 1-M-MAS 'E Revised 4-24-07 Fax# �jl -` 2 - 4° www.mas&go ddia OFTHE r, + + + + BAHNS"L.E, ' Town of Barnstable Alfa Mat° . Regulatory Services Richard V. Scali,Director. Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 wwwaown.ba rnstab le.ma.us Office: 50M62-4038 Fax: 508-790-6230 - - - -- - - . ------- - - -- - -- Property owner Must Complete and Sign This Section If Using A Builder l . as, of the subject property•. hereby authorize �"� �4.� e to act on�my behalf, in all matters relative to work authorized by this building permit application for: C (Address of Job) 0. Signature of Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. Q:\WPHLESTORMS\building permit forms\EXPRESS.doc Revised 061313 Town of Barnstable as Regulatory Services °FTHE r � Richard V.Scali,Director Building Division snaxsTnsre Tom Perry,Building Commissioner MASS, v 1 639- �� 200 Main Street, Hyannis,MA 0260.1 www.town.barnstable.ma.us Office: 5r08-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION DATE: S G Please Print JOB LOCATION: L/ � �Tf✓ �� T number / street villages / Q HOMEOWNER": !Ci �U r�P%l� Ze I T (C CJ name a ph # work phone# CURRENT MAILING ADDRESS: /town state zip code The current exemption for"ho wners"'was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an ' vidual for hire.who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who•owns a arcel of land on which he/she resides.or intends to reside;on which there is,or is intended to be,a one or two- family dwelling,attached or detached,sst,uctures accessory to such use and/or farm structures. A person who constructs more than one 1iome in a two-year period shall not be considered a.homeowner. Such"homeowner'.'.shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be"iesponsible,for all such work performed under the building permit. (Section 'Yhe.undersi.-nvd"homeowner"assumes responsibility for cempliance with the State Buildn.,b Code and utbi;r applicable codes, bylaws, rules and regulations. _ The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and-that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner perform:ng work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules &Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems, particularly when the homeom,;Er hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as itmould with a lic�nsed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of hisiher responsibilities, many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You.may care t amend and adopt such a form/certification for use in your community. QMVPFILES\FORMS\building permit forms\EXPRESS.doe Revised 061313 r ACQBDry CERTIFICATE OF LIABILITY INSUKANUt PRODUCER (S08)997-6061 FAX (S08)990-2731 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Southeastern Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 439 State Rd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 79398 N. Dartmouth, MA 02747 INSURERS AFFORDING COVERAGE NAIC ar< INSURED Gregory Cauley INSURERA Arbella Protection Insurance PO Box 63 S INSURER e: Travel ers Hyannis, MA 02601 INSURERC: INSURER D: INSURER IE COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDIN ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DIrt TYP!OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMRS NqRrBATE IMMIDOAff,_ a__ GENERAL LIABILITY EACH OCCURRENCE f 1.000,0001 X COMMERCIAL GENERAL LIABILITYDAMAGE TO RENTED f 100,OO CLAIMS MADE Q OCCUR MED EXP(Any arm person) $ 5 00 A PERSONAL&AOV INJURY f 1,000,00 GENERAL AGGREGATE f 2 QQQ OQ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG f 2 QQQ 00 ri POLICY PRO- LOC 8500015641 07/24/2013 07/25/2014 JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMB f ANY AUTO (En soddeM) ALL OWNED AUTOS BODILY INJURY S SCHEDULED AUTOS (Per Person) HIRED AUTOS BODILY INJURY (Per eodderd) f NON-OWNED AUTOS PROPERTY DAMAGE f (Per seddeM) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT f ANY AUTO OTHER THAN EA ACC f AUTO ONLY: AGO f EXCESSAIMBRELLA LIABILITY EACH OCCURRENCE f OCCUR CLAIMS MADE AGGREGATE f f DEDUCTIBLE f RETENTION f f —• TNC STA OTH- WORKERS COMPENSATION AND DRY EMPLOYERS'LIABILITY E.L.EACH ACCIDENT S 100,00 B ANY PROPRIETOR/PARTNER/EXECUTIVE 7PIUB7875A19503 9/24/201 09/25/2014 OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE f 100,000 N yyes describe under E.L DISEASE-POLICY LIMB 3 S00 OQ SPE�LAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS or any and all operations performed during the policy period CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE TIIEREOF,THE ISSUING INSURER WALL 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 ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES. 1AUTHORIMD REPRESENTATIVE 3OAN MARTIN ACORD 25(2001108) ©ACORD CORPORATION 1988 1 U Massachusetts -Department of Public Safety A Board of Building Regulations and Standard' Construction Supenisor License: CS-009013 GREGORY M CAALE 33A BARTER AW W YARMOUTH?AAjq- 1,I'A Expiration / commis�sionneer' 05111/2016 " . �e �Porn�rnaruueaCC�i o�C�aac�ucoetld Office of Consumer Affairs&Business Regulation OME IMPROVEMENT CONTRACTOR egistration: ;*3822 Type: xpiration:,=-11i"39/2:0:14 Individual GREGORY M.CAUL'•EY GREGORY CAULEY::w<<==; c= r' 33A BAXTER AVE. W.YARMOUTH, MA 026t'll'1 Undersecretary License or registration before the valid for individul use Office of C,onsuniPira ion date. If found return to;only 10 Park Plaza umer Affairs and Busine Boston,M ss Regulation 0211 Uite 5170 . 1 Not valid without s a tire OCEAN MOUNTAIN COMPANY, INC. P.O. BOX 1925 COTUIT,MA. 02635 (508) 367-2530 June 1, 2014 Alan and Terry.Porter 54 Abbeygate Cetuit, Ma. 02635 •ems., Estimate for trim replacement FRONT: 1. Left and right side cornerboards. ( L.R.) RIGHT SIDE: 1. replace sidewall shingles, four squares, strip, repaper where necessary, install new white cedar".extraV' shingles. ' 2.Replace left and right rakes and second trim board. 3. Replace dormer rake. 4. Replace louvre. REAR: 1. Replace left side window trim. (second storey) 2. Replace lower left window trim. 3.Replace kitchen window trim. 4. Replace garage door trim. S. Replace left garage corner board. LEFT SIDE: 1. Replace louvre. All new trim boards will be Azek brand pvc composite. Louvers will be wood, painted white. Labor: 30 hours @ $ 40/hr, $1,200.00 Material's: $ 600.00 Siding Labor: $1,200.00 I Siding materials: $'. 920.00 r � { TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Moz9ft Map. Parcel a00 Application # Health Division Date Issued S12 lt4 Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address J Village Owner ;�/�ti� �;Pa.,e°/r a Address Telephone J ,d Permit Request /� . .5 G��S.r / ��,1�u ��fbo d zv---- Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new ._Zoning District Flood Plain Groundwater Overlay Project Valuation a7 o L�6 r l-Construction Type lAe J J-) Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation: Dwelling Type: Single Family Two Family ❑ Multi-Famil% y (# units) p o 0 . Age of Existing Structure Historic House: ❑Yes ONo On Old King'sQHiLhway: dYesl1 No Basement Type: ❑ Full 0 Crawl ❑Walkout ❑ Other ID Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new — Number of Bedrooms: existing _new N Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No: Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) J Name ��'�� f2�,�v1/�TG.s�-/ Telephone Number 07? J 2;7, Address � � 'r eo,y e'i !� License # f O Fdl�; Home Improvement Contractor# Email Worker's Compensation # 1414 49194� � ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO I U JJ SIGNATURE DATE 'cn�/l—T4 FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP PARCEL NO. ti; • ADDRESS VILLAGE OWNER DATE OF INSPECTION: :> FOUNDATION t FRAME r INSULATION i FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING J . CLOSED OUT A :SO;.OPIkTION PLAN NO. F� a The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations I Congress Street, Suite 100 Boston,MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Ap0icant Information j� Please Print Legibly 6 Name (Business/Organization/Individual): & .�i CA --* &�V Address: City/State/Zip: ':'db UA b 6V'&&U Phone #: 15A " 115—(I i Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 2r2 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.t required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their I I.[] Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs I insurance required.] t c. 152, §1(4),and we have no 13.�Other t V IG1�� employees. [No workers' comp. insurance required.] 'Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. L I Insurance Company Name: � G Policy#or Self-ins. Lic. #: MCA ooiL Z i Expiration Date: Job Site Address:��' ate_ -)P�a L/ City/State/Zip: M a Z L 3 c5 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 cer tfy the pains and penalties ofperjury that lire information provided above is true and correct. Si nature: Date: O `� I Phone#: Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: CAPECOD-27 CVANGELDER A�CO�RQ� CERTIFICATE OF LIABILITY INSURANCE DATE 41112 DIYYYY) 1112014 { I 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 endorsement(s). PRODUCER CONTACT NAME: Cape Cod Commercial Rogers&Gray Insurance Agency,Inc. PHONE FAx 434 Rte 134 A/C No EYt: A1C No):(877)816-2156 South Dennis,MA 02660 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC N INSURER A:Peerless Insurance Company INSURED INSURER B:COMMERCE INSURANCE COMPANY Cape Cod Insulation Inc jNSURERc:Evanston Insurance Company 18 Reardon Circle INSURERD:ATLANTIC CHARTER INSURANCE GROUP South Yarmouth,MA 02664 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE J=wvo POLICY NUMBER IMMIDDNYYYI (MMIDDIYYYYILIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS-MADE F—y-1 OCCUR CBP8263063 04/0112014 04/01/2015 A- TGE I� $ TORENTE 100,00 PREMISES Ea occurrence MED EXP(Any one person) $ 5,000 _ PERSONAL&ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 X POLICY LJ PRO- � LOC _ JECT PRODUCTS•COMP/OP AGG $ 2,000,00 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ _ (Ea accident) B ANY AUTO 14MMBCKVMK 04/01/2014 04/01/2015 BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BODILY INJURY(Per accident) $ 1,000 00 AUTOS AUTOS NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS Per accident $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 1,000,00 C EXCESS LIAB CLAIMS-MADE R/O XONJ453512 04/01/2014 04/01/2015 AGGREGATE $ DED I X I RETENTION$ 10,000 Aggregate $ 1,000,00 WORKERS COMPENSATION AND EMPLOYERS'LIABILITY STATUTE ERH D ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N WCA00525904 06/3012013 06/30/2014 E.L.EACH ACCIDENT $ 1,000,00 OFFICERIMEMBER EXCLUDED? N❑ N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,00 11 pes,descnbe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Workers Compensation includes Officers or Proprietors. Additional Insured status is provided under the General Liability and Auto Liability when required by written contract or agreement with the Certificate Holder. I CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE EVIDENCE OF INSURANCE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved.' ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD t. \ '1k Massachusetts -Depaftrni&,nt of P blic Safety "�gard of Building Regula#nns pnd Standards Construction Supervisor License: CS-100988 HENRY E CASSH11V 8 SHED ROW - s WEST YARMOU M Expiration Commissioner 11/11/2015 IC�771 Office of Consumer Affairs and Buslness Regulation 10 Park Plaza - Suite 5170 §y. Boston, Massactipssetts 02116 Home Improvement Coiritractor Registration Registration: 153567 Type: Private Corporation Expiration: 12/15/2014 Tr# 233831 CAPE COD INSULATION, INC d - HENRY CASSIDY 18 REARDON CIRCLE SO. YARMOUTH, MA 02664 Update Address and return card.Mark reason for change. Address ❑ Renewal ❑ Employment Q Lost Card SCA 1 0 20M-05/11 cJhe WporyruntctwtuecA1b oIQ/&oaachuae , Office of Consumer Affairs&Business Regulation License or registration valid for individul use only VO' OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: gistration: .-t3.567 Type: Office of Consumer Affairs and Business Regulation piration:, .:.12/15I2014 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 CAPE COD INSULATION`�1fe,-,r= _.t..,,. y ,;, HENRY CASSIDY ' Td— 18 REARDON CIRCLE;`. SO.YARMOUTH,MA OAM 5 Undersecretary %Yotvalwitho t nat re OWNER AUTHORIZATION FORM (Owner's Name) owner of the property located at - 5711 AL o-,-1 G-Je (Property Address) ' Property Address) hereby authorize C-010-t"L2 CG`d- 10-Aj (Subcontractor) ' an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform work on my property. Owner's Signature Date �. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map G ZI Parcel 0 6 ' Application # Q6 f tS a Health Division 611 Date Issued l O Conservation Division Application Fee _ d Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis Project Street Address 5 9 e G O 2 & 3 Village kl-vie, n JV Owner Al&i, L . �' �Gr`c5w I�1�'r>r fcr Address e Go— - �6;_A. Telephone Permit Request l o Govi ver't o�_h 6-r•-- pert v an -KP, 15f100r-, /1�0 �l�Il�}/LE FOUT�GE /S C/NG Square feet: 1st floor: existing A/ oposed 2nd floor: existing A�/Aproposed;A To newer Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type eM e-- Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ..if/ Two Family ❑ Multi-Family (# units) Age of Existing Structure ° Historic House: ❑Yes d No On Old King's Highway: ❑Yes &No Basement Type: ❑ Full ❑Crawl ❑Walkout YOther 80 0c"k Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new o�5,CA- Number of Bedrooms: 3 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 C /No Fireplaces: Existing _New Existing wood/coal stove: ❑Yes W(No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: (existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial Ell Yes ❑'No If yes, site plan review # Current Use 140vvIe— Proposed Use 1"'e4 i��-,�"iw( 1—Iov►.� APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ✓`��' �i.�or k,n' Telephone Number Address �� ol n - 0(�a License # C 5 n q Home Improvement Contractor# Vl 0 (O Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE r DATE — O .d 1 n FOR OFFICIAL USE ONLY S APPLICATION# f DATE ISSUED MAP-/PARCEL NO._ ADDRESS VILLAGE OWNER DATE OF INSPECTION: ;FOUNDATION.° j FRAME INSULATION. FIREPLACE a `s ELECTRICAL: ROUGH FINAL ;. F PLUMBING:. ROUGH FINAL GAS'-' ROUGH ; 6 �: FINAL ` s k •:: FINAL BUILDING' :a• n)w y DATE CLOSED OUT ASSOCIATION PLAN NO: The Commonwealth of Massachusetts ' Y Department of Industrial Accidents Office of Investigations 600 Washington Street t Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers' Applicant Information Please Print Legibly Name (Business/Organization/'Individual): // Address: 14g EA " " � �� 01 ff City/State/Zip: Phone #: Are you an employer?-Check the appro ate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and 1 6. ❑ ew construction * have'hired the sub-contractors.. . �inplliyees-(full and/or part-time). - --- -- •----..__.. _....... . _ .. . - 2.LUJ l am a sole proprietor.or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition working for mein any capacity. employees and have workers' 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 1 l.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL- 12.❑ Roof repairs insurance required.) t c. 152, §1(4), and we have no employees, (No workers' 13.❑ Other comp.insurance required.) 'Any applicant that checks box#) must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they arc doing all work and then hire outside contractors must submit a new affidavit indicating such. tContraetors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site informatiorL Insurance Company Name.- Policy# or Self-ins. Lic. #: Expiration Date: Job.Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify t er the pains and penalties of perjury that the information provided above is trice and correct. 1 -- Signature: -at Phone#: LJ Official use only. Do not write in this area, to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector S. Plumbing Inspector 6. Other Contact Person: Phone#: Information and bstructiWas Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees, Pursuant to this statute, an eanployee 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 However the receiver or trustee of ao individual, partnership, associalion or other legal entity,employing employees. owner of a dwelling house haying not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, constniclion 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.' 2- 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) stales "Neither the conunonwea]!h nor any ofiis political subdivisions shall enter into any contract for the performance of public.-work until acceplable evidence of compliance with the insurance requirements of this chapterhave been presented to the contracting authority." Applican is Please fill out.the workers' compensation affidavit completely, by checking the boxes [bat-apply to your situation and, if necessary,supply sub-contractor(s)name(s), addresses)and phone number(s)along with their certificate(s) of insurance, Limited Liability Companies (LLC)or Limited Liability Partnerships(LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. if an LLC or LLP does have employees a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit, The affidavit should be returned to the city or [own that•the application for the pen-nit 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 Dumber listed beloyr..Se!f-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.al 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.permil/license number which will be used as a.refer ence number, In addition,an appl�eani that must submit multiple permiUlicense 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. Anew affdavi l ust be filled put each year. Where a home owner or citizen is obtaining a license or permit not related to any bL1S]neSSnr commercial venture (i.e. a dog license of permit to bum leaves etc.) said person is NOT required to complete this aiFfidavil. The Office of investigations Would J)rno1h-M ki yunrin-a-dva o--)1G d should shave any questions, please do not besitate to give us a call. The Depariment's•address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised el-24-07 www.mass.gov/dia -y4 f. y` G—�O aue¢l G nc"ss'Ke"`u3a'tiu� License or registration valid for individul use only O{Oce�f"Ico�um'r g before the expiration date. If found return to: HOME IMPROVEMENT CONTRACTOR Type• Office of Consumer Affairs and Business Regulation Registration: 159506 10 Park Plaza-Suite 5170 Expiration: 5/2/2012 Individual Boston,MA 02116 B` K RIVER CONSTRUCTION- EDMAR LIMA 193FAWCPTLN HYANNIS, MA 02610 Undersecretary Not valid without signature -�1.trs,ach:�•cit• 'Jclrtrtmcnt of Public SafCtN 9 Board of Buil(lino Rc,rulations and Standards Construction Supervisor License License: CS 103199 Restricted to: 00 1 ~ EDMAR LIMA M 68 ABBOTT ROAD SOUTH YARMOUTH, MA 02664 Expiration: 10/17/2012 (1unn�i..i,nn•r Tr#: 103199 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 07/06/2010 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 endorsement(s). PRODUCER Schlegel & Schlegel Insurance Brokers Inc NAME: PHONE A 34.MAIN STREET (AIE-MAC,ILN0,Eat): (A/C,Not: ADDRESS: CUSTOMER ID N: West Yarmouth, MA 02673 INSURED INSURER(S)AFFORDING COVERAGE I NgICp INSURER ANGM Edmar Lima D.B.A. Blackriver Construction INSURER B GRANITE STATE P.O. Box 1062 INSURER C: I INSURER D: Centerville, MA 02632 INSURER E: ` INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: . THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE. MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Ts LTR TYPE OF INSURANCE NSR 'WVD POLICY NUMBER (MMIDDfYYYY) (MMIDOIYI'YY) - LIMITS GENERAL LIABILITY -" X MPI0785Q 08/31/09 08/31/10 _EACHOCCURRENCE $1,000,000 A X COMMERCIAL GENERAL LIABILITY D-AMAGE-rO'RENTED-- PREMISES(Ea occurrence) $500-,000 CLAIMS-MADE OCCUR MED EXP(Any one person) $5,000 PERSONAL B AOV INJURY $1,000,600 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 - PRODUCTS-COMPIOP AGG $2,0 0 0,0 0 O I POLICY E T LOC 8 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT j ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY(Per person) $ SCHEDULED AUTOS BODILY INJURY(Per accident) S HIREDAUTOS - PROPERTY DAMAGE (Per accident) $ NON-OWNED AUTOS $ $ UMBRELLA LIAB OCCUR _ EACH OCCURRENCE g EXCESS LIAR CLAIMS-MADE DEDUCTIBLE AGGREGATE $ I RETENTION $ WORKERS COMPENSATION $ AND EMPLOYERS'LIABILITY W0007422977, 56/23/2010 O6/23/2011 X WC STATU. OTH. Y I N TORY LIMITS ER B ANY PROPRIETOR/PARTNER/EXECUTIVEEXCLUDED? E.L.EACH ACCIDENT $ 100,000 (mandatory in NH) EXCLUDED9 N/A - (Mandatory in NH) If yes,describe under E.L.DISEASE-EA EMPLOYEE $ 100,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS ILOCATIONS I VEHICLES(Attach ACORD 101;Additional Remarks Schedule,if more space is required) THIS WORKERS COMPENSATION POLICY DOES NOT PROVIDE COVERAGE FOR EDMAR LIMA i i.. I ADDITIONAL INSURED: MILLER STARBUCK CONSTRUCTION INC. CERTIFICATE HOLDER CANCELLATION MILLER STARBUCK CONSTRUCTION INC tiPOh:BOX-. 7252' unlgLvy•}r E rf r".r a ' s �d ;_ a r%s {i�.`'usl SHOULD ANY iOF THEt ABOVE•rDESCRIBEUi^'P 4g,•:�.�rSU�r;i•.'s"¢.rita�,..r:"+�::%^:.��r. c•�.:,r..�s:,:.1�,....,,,..,y, ,s OLICIES- BE,CANCELLED BEFORE 1 �� . ya`: E,: 15`.. 'f.�,�. .prs!n�'{t`(. +.,. t1.•. .S��. *: kcr,,. f f r5r,,: „y:�s� 'THE EXPIRATION +.DATE THEREOF+r FALMOUTH MA �O 5t4?ls `/ e+',tAa"� � 'y ACCO DANCE+WITH THE PLO CY PR V t� �ANO�rI yEl xWILBE / DfiLJVERED IN A' tti .a tT o IsloNs� ~� ,a s € - b8- 99-11 •5 t � r a. at 09 ACORD�C'ORPO TION All r(gtit8'reservec! w ACORD 25 TFie ACORD name and logo are registered marks of ACOF RY ' .�ik�.:_u�4f3ii-c� R a "nfR's7 7 ��77iC yYii awvrr �" �7t'srn,I 3 d 4 Y d:,' �a.�>,�M..a3��-'i �• 4. � ^naS� x i<-"t^a. - 'i�Y.��l�..-�i- 1 1 1 1 I I I rl i I I 1 I I I I I ! �I I I i-I-i l i I ; f-I ! l i I 1 I l I I '• l i j-�-) -�I--!- III JI-I i! { �I I _J_I_I_I_I I �--I!� i 1— rIJ.J_�. U J_ —E_J—: h��l_�_J�� IJ (— -�'-j s--I---�-�;--I ! I I-�_�-�_-�• __ IL ' i !�- - ! - L!_d1____I__I_' __LL. '—L_L --- -1 It ��! .-!�-�;_-• I J-I---I _! .I_ 1. ! h _I_I ! ! ! ! i � i-i-'-�i � -'-1---�-� -�-._?5. �-1-I-� -(-i ' "O O •,...,» �-' � i l i I_'` ' :J !� _i-, I ! �. I i_�I I_;J � I j ! I_I.,i � _! t I I I-I� i I I I -�.._� -� ! .--'---:' --I ! I-J_I �r _ !-• I ! I _— I i I I� �_ I I �!i-f-1--�-Tr-�� ;-r-�f ---� I I '-9-' -j-' 'Lf P 1 I-`! - (�Z�i�,`• �=,.��"`_` �..!-i-�-it j- -i! - I- JL I_! l I h�_Li-l_'-_i_'-__i i___r , tom: -r_,-�_ r'-r-�_ i_i!i�—`—I--;!— --}_—_[!�•—�-- -�{—i 7 I I i�i i-1 I!�_!I I '`I 1_L!�-1 �-� I—r`j�;—'-i j—�--�-•—�—i—i�1�—i-��—_. J. ! L'_ -- �i !_L i Il I —! t 9 � W.01 ,a of a U.TOO 0MT,5 9E9 Fa.9EREq�_��.�� R ME,i 2,002 .a�..3 �,,.t `r[. Laix LL Cites � � r :?...I � J,.... 00 0 UP yy UP— F61 �f LIVING AREA 1403 sQ It f IKE Town of Barnstable Regulatory Services LlE?f6TABL.� v MA% �* Thomas F. Geiler,Director Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.b2rnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property bier Must - Complete and Sign.This Section If Using A Builder I, �� Gl � , as Owner of the subject.pr0perty hereby authorize LAC 6(' �`�P� CON to act on my behalf, La all matters relative to work authorized by this building permit application for. x SL hie �f� (Addziss of Job) �r U ZO/O Signature of Owner Date x Pnat Name If Property Owner is applying for permit please complete.the Homeowners License Exemption Form on the reverse side. Q:FORMS:0 WNERPER-MIS510N Town of Barnstable Regulatory Services Thomas F. Geiler, Director 's¢ ,�� Building Division PrEo�.�a Tom Perry, Building Commissioner 200 Main.-Street,_Hyannis, MA 02601'. Yrmv.town.b.arnstabl e.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOINSOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCAMN: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state, zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor_ DEFINITION OF BOMEOWNER Person(s) wbo owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to- be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constntcts more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws, rules and regulations. The undersigned "homeowner"certifies that,Wshe understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/sbe will comply with said procedures and requirements. Signatiirc of Homcowncr 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 stales that "Any homeowncr performing work for which a building pcmvt is required shall be exempt from the provisions of this sccdon.(Scction 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work that such Homcowncr shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(sec Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness bftcn result 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 licrnscd Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of hisAcT rtsponnbilitics,many communities require,as part of the permit application., that the homeowner certify that he/she understands the responnbilitics of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a fom/certification for use in your community. Q:fomts:homccx cmpt +� Do 166 Q C� 5 ,� Town of Barnstable *Permit# ®�� PER MIT Ezpbes 6monilrsJrom issue date Regulatory Services Fee -4/7 J U N Y. 6 2010 Thomas F.Geiler,Director TOWN OF BARNSTABLE Building Division Tom Perry,CBO, Building Commissioner (III 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EX]pRESS PERMIT APPLICATION - RESIDENTLAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address t ❑ Residential Value of Work 'Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address �� --� 1--��iG/Y Contractor's Name ��` _� Telephone Numbe:ra— -,�—�, yi Home Improvement Contractor License#(if applicable) � " '/".1 — Construction Supervisor's License#(if applicable) _4V ❑Workman's Compensationlnsurance y�r Check one: •l—P ES S PERMIT ❑ I am a sole proprietor ❑ I am the Homeowner J U N 16 2 010 have Worker's Compensation Insurance Insurance Company Nam / � �,�/ TOWN OF BARNSTABLE workman's Comp:Policy# �7�'-� Copy of Insurance Complianee Certificate must be on file. Permit Request(check box) Re-roof(stripping old shingles) All con.--r-tion debris will be taken to !� ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side Windows/doors/sliders. U-Value ❑ Replacement ximum(ma •'4) *where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Pr Owner t sign perty Owner Letter of Permission. of the a Imp ement Contractors License is required. SIGNATUi2E: Q:Forms:exv ntrg i Construction Supervisor Home Improvement. License Number#008267 Contractor Registration#114813 Home Phone#508 420-5131 CELL PHONE#508 280-0802 ESTIMATE JAMES DANFORTH P.O.BOX 973 COTUIT,.MA. 02635 Allen and Teresa Porter 54 Abby Gate Drive Cotuit, MA. 02635 June 5, 2010 Work to be completed on the entire house and garage roofs, as follows. Remove the existing roofing shingles. Install 8" aluminum drip edge at the roof eaves. Install ice and water shield 3ft. up canto the roof, also in all valleys. Install a 151b. felt paper over the remaining roof sheathing from the top of the ice and water shield to the roof peak. Install a 30-year Architectural type roofing shingle using CertainTeed Landmark Woodscapes which are algae resistant shingles. Shingle weight is 259lbs. per square. The wind warranty is 70M.P.H. I will.use CertainTeed starter shingles along the roof eaves and rakes. I will also use CertainTeed shadow ridge for the roof caps, over the ridge vent. This process will increase the wind warranty to 110M.P.H. Install new aluminum vent pipe flashing. Install a ridge vent on.all roof peaks, using Air Vent Shingle Il. House and shrubs to be covered with tarps while work is in.progress. Removal of rubbish. Material and labor $9.380.00 This price includes the building permit. Insurance certificate will be issued prior to the start of the job. There is a 30-year manufactures warranty on the shingles. I will provide a seven year warranty against any roof leaks. All materials are guaranteed to be as specified.All work to be completed in a workmanlike manner according to standards practice.Any alteration or deviation from above specifications involving extra cost will beco e a chafge above the estimate. Our workers are fully covered by Workman's Compensation Insurance. DATE OF ACCEPTANCEh t G CUSTOMER SIGN ATU CONTRACTOR SIGNATUR The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600•Washington Street Boston,MA 02111 .UV. www.mass.gov/dia Workers" Compensation Xnsurance_Affidavit: Builders/Contractors/Electricians/Plumbers A licant Please Print Le bI Information Name(Business/Organization/lndividual): . e -Address:— city/state/zip: Are you employer? Check the appropriate box. -Type of project(required):. 1 employer with have hued the tub-contractors __ 4. ❑ I am a general contractor and I 6 El New construction . . employees(full and/or part time)•'" ' 2.El am a'sole proprietor or partner- listed on the-attached sheet. 7. ❑Remodeling • These sub-contractors have g. ❑Demolition ship and have no employees employees and have workers' working for me in any capacity. 9. []Building addition comp.insurance.# [No workers'comp•insurance 5• ❑ We are a corporation and its 10.0 Electrical repairs or additions required.] officers have exercised their 11.❑Plumbing repairs or additions 1.❑ I am a homeowner doing in work myself: [No workers, camp. right df exemption per MGL 12•❑Roof repairs c. 152, §1(4),and we have no insurance required.]t employees. (N to ees o workers' .•13.❑ Other comp.insurance required.] , *Any applicant Dudchecks box#1 must also fill out the section below showing their workers'comPeasahon Policy information. t Homeowners who subgit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors mat check this box must attached an additional sheet showing the name of the suubc tractors and state Whether or not those entities have employees. It the subcontractors(rave employees,they must providb their workers'eo policynumber. I am an employer That is providing workers'compensation insurance for my employees. Below isihe policy and job site information. �— insurance Company Name: S policy#or Self-ins.Lie.#: Expiration Date: GJob Site Address: - /Statc/Zip: J Attach a copy of the workers' co easation policy declaration page(showing the policy number and expiration date),. Failure,to secure coverage as required under Section 25A of MGL& 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year impnsonL:.A 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 a Ins a cover verification. 16 hereby ce n er the pain and p allies of perjury that the information provided above is true and correct Sitatature: Date — Phone official use only. Do not write In this area,'tb be completed by city or town official City or Town- Permit/License# Issuing Authority(circle one): own Clerk 4. 1..Board of Health 2.Building Department 3.CityPT Electrical Inspector 5.Plumbing Inspector 6.Other ronfact Person:._- Phone#: DAitc(MMIOD/YYYN) CERTIFICATE OF LIABILITY INSURANCE OP ID J° 05 19/10. ' CERTIFIC;ATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS //�t2TIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES i JELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED /REPRESENYATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. Aec NT: I the ce 1 Icate holder is an ADDI AL INS URI he poec licy(ies must be en orse If SUER S AI si jtst t0 the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not co nfar rights to the certificate holder in Ileu of such endorsement(s)- PRODUCER NAME: A/C�NCo.•,l:xll; (AIC,NO)' Child-G-Bnovese Ins, Agency Inc 60 Temple Place ADDRESS: Boston )jA 02111-1306 cus7DMERlou: DpNFO-1 Phone_617-350-5511 Fax:617-350-5522 INSURER(S)AFFORDING COVERAGE tl INSURED INSURERA: COLONY INS CO James Danforth dba INSURER e: TRAVELERS INS. CO. James Danforth Remodeling INSURERC: p,r)- Box 973 — Co-,uit MA 02635 INSURERD: INSURERE: INSURER'F COVERAGES CERTIFICATE NUMBER; REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NO-R/ITHBTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAN OF ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS ANO CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. rEXi- LTR 7.'PE OF INSURANCE IN W'D AU F UI POLICY NUMBER (MM1D0/YYYY) (MMIDD/YYYY) LIMITS EACH OCCURRENCE 5 1 r 000,000 GENERAL LIA'fILJTY A ]{ COMMER'IALGENERALLIABILITY GL3643403 OB/o2/n9 09/o2/xo PREMISES Ea occurrence) $ 50,000 CLA MS-MADE �X OCCUR MED EXP(Any one person) $ 5,000 _ PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE S 2 000 r OOO PRODUCTS-COMP/OPAGG S2,0001000 GEN'L AGGREGATE LIMIT APPLIES PER $ X P CY LJECT LOC COMBINED SINGLE LIMIT $ AUTOMOBILE LIA9(L'ITY Q (EB accident) Aq AUT D �� 3 BODILY INJURY(Par Person) S A09WpEO:AOT05 r BODILY INJURY(Per ecddcnl) S 804ov..ED AUTOS PROPERTY DAMAGE $ (Per accident) I•IIRED At ITO§' g NbN:OW 1EDAUTOS $ LFMQREL.A41AB OCCUR EACH OCCURRENCE S SE LIAR CLAIMS-MADE AGGREGATE S DEDUCT OLE S REYENTION S B WORKERS COMPENSATION 6KUB 7A05108 Oe/2B/09 ae/1e/10 X TORT LIMITS ER AND EMPLOY ER5'LIABILITY Y/N E.L.EACH ACCIDENT S 100,000 ANY PROPRIETORIPARTNER/EX CUTIV I A OFFICEwmo IBER EXCLUDED7 Y G.L.DISEASE-EA EMPLOYEE 5 10 0,00 0 (Mandatory In NH) if yes,deacrlb( under E.L.DISEASE POLICY LIMIT S 500 f 000 DESCRIMOr OF OPERATIONS below E: DESCRIPTION OF CPC-RATIONS/LOCATIONS I VEHICLES (Attach AGORD 101,Additional Remarks Schedule,IF more space Is required) THE WORKE;ZS COMPENSATION POLICY DOSS NOT PROVIDE COVERAGE FOR JAMES DANFORTH. CERTIFICATE•iOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. HT,NRY CHURBUCK AUTHORIZED REPRESENTATIVE 854 MAIN STREET COTUIT MA 02365 z0 OF&ADO� TION. A6ghLs reserved. ACORD 25(20)9/09) The ACORD name and logo are registered marks of ACORD .. 1 • .._,.r—^ay'+s�[rT'�`�_�l'^ •sue —�-----r.--��.?'w.;�''. 77 �- — ✓vim �+ License or registration valid for injlividnl use only r o °Uefore the expiration'date. If found return.to Oft; C nsum ffatrs&Snsinesc t1t�N' °iq: ; :.Office of Consumer Affairs and Business Reguhtiocri = HOME IMPROVEMENT CONTRACTOR' lO:ParkPlaza-S[lite 5170 Registration 'y114813 Try ;,8b04;• t t Eoston,MA 02116 Expiration 10127/2011 type. Individual JAME c D.DANFOf tTN REMO Yl �a ' l a* J,4MES DANFORTI i c� i �r -- �f � 1105 OLD RD y; — -- �, L a s afore of valid i :Undersec re,4t*;A oz A COTUIT; MA02635� _.g. t. ter__? •�,, .,.�,�_.,•._.:_...._:-,. .i. +�. Vlassachusetts- Department of Public SalON Board of Budding Re!gulatiOns and Standards Construction Supervisor License License: CS 8267 Restricted to: 00 JAMES D DANFORTH PO BOX 973 COTUIT, MA 02635 Expiration: 5/20/2012 ('ununissii,ncr Tr#: 26124 06-16-10,13; 15PM; # 1/ 1 coR� CERTIFICATE OF LIABILITY INSURANCE OP ID $C DATE(MMlDD/YYY1� 06/16 10 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. IMPORTA if the certificate holder Is an ADUITIONAL INSURED,the po Icy les must o endorsed. UBR 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 Ilou of such endorsement(s). PRODUCER NAME: Child—Genovese Ins. Agency Inc IA/C.No en): A/c No): 60 Temple Place AADDiDRESS: H09t:On MA 02111--1306 CKULMULK USTOMERIDO: DANFO-1 Phona:617-350-5511 Fax:617-350-5522 INSURER(S)AFFORDING COVERAGE NAIC 0 INSURED INSURER A: COLONY INS CO James Danforth dba INSURER B: TRAVELERS INS. CO. James Danforth Remodeling P.0. Box 973 INSURER C: Cotuit MA 02635 INSURER D: i INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFYTHAT 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, ; EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LI LTR TYPE OP INSURANCE INSR WV0 POLICY NUMBER (MMSEM ) (MM/DDM LIMITS OENERALLIABILITY EACH OCCURRENCE $1 000,000 A X COMMERCIAL GENERAL LIABILITY GL3643403 09/02/09 09/0240 PREMISES Ea occurrence S 50,000 CLAIMS-MADE ❑X OCCUR MED EXP(Any one person) $ 5 000 I PERSONAL&ADV INJURY 5110001000 GENERAL AGGREGATE s2,000,000 bEWL AGGREGATE LIMIT APPLIES PER; PRODUCTS-COMPIOPAGG $2 00O 000 X POLICY jEa7 LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S ANY AUTO (Ea at ddent) BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Par acddant) S SCHEDULED AUTOS PROPERTY DAMAGE HIRED AUTOS (Per accident) $ + NON•OWNED AUTOS $ S UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS. MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ S $ WORKERS COMPENSATION KD$ A 1 08/26/09 00/29/20 TWC LIMITS ER AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERIEXECUTIV YIN E.L.EACH ACCIDENT S100,000 OFFICERIMEMBEREXCwDED4 X 41A (Mandatory M NH) E.L.DISEASE-EA EMPLOYEE 3100,000 It yes deealbe under DESCRIPTION OF OPERATIONS below EL.DISEASE-POLICY LIMIT s 500 000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more apace Is►e ulredl THE WORKERS COMPENSATION POLICY DOES NOT PROVIDE COVERAGE FOR JAMES DANFORTH. a CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ALAN PORTER AUTHORIZED REPRESENTATIVE 54 ABBY GATE DRIVE COTUIT MA 02365 Edte A&4f - 00 D TION. All rights reserved. ACORD 26(2009/09) The ACORD name and logo are registered marks of ACORD .., -ram,.^',; ,�.r. ..-,fi--��, ,..S,r:^.^ti-.-,,�..,;'Y.��.�yrk.`.��.._,+y,,,,v-.r,rr-.17+Y„�. "�'l'ft„'�. 4^ 'GI(,,-_i4rYf'.�.v, ti.fi' .,... .�.•rt �+ � , ..� �•� TOWN OF BARNSTABLE BUILDING DEPARTMENT ssaaar TOWN OFFICE BUILDING rua �g .639. �� HYANNIS, MASS. 02601 MEMO TO: Town Clerk FROM: Building Department DATE: June 22, 1994 ) . An Occupancy Permit has been issued for the building authorized by Building Permit #...3 6 5 01................__......._....................................................._.............. _.__.. issuedto .Lydia...Daress...... ................._.........._........................................................_......._ ...._............r. �.. Please release the performance bond. r • , `j+ f TOWN OF BARNSTABL.E Permit No. ...A.501..... BUILDING DEPARTMENT I ""rT I Cash TOWN OFFICE BUILDING A.a3v X HYANNIS.MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued to LYDIA DARESS Address lot #81 54 Abbey Gate Road, Cotuit USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. May. l6 Iq 94 ... ... .. . .. ... . .... ................. ...... ....fBZ .�h.................... ing Inspector I _ F BUII. PERHIT NO. .�� D�_� �2 - / ASSESSORS PARCEL ISO. .. y CONTINUATION OF ROAD BOND 'The undersigned. oc.-ner/contractor Hereby agree to ma-; n their road bond force until the folloving wort items are co feted to the satis�action or tie 'S.ec::ioa of the Deparrrent of Public war' s- (/ lca_ and seed s:.. oulae_s as soon as wz_ther pe its: v of e: e_r;t- ✓— mac. cn✓ y A `F- -- - - -- S7 /: L7. (G;�� I=;CC:;�:�_ _, name � n 8o z�t 13 Sa Y D Q.Or R CHARD A. r ; BAnTER NO.Z40-W 7-i-,%47- 7;4/,f-: ZOG.4T/OTC/ �oTvIT SHOWN SETBA C/G S'CAL / O vgTE Z- �B•9� ,B A2rJSTq$� �2E'iC/G'� .4rvo /s /✓ar L oc oT q 7-EI� �yiT///�/ T'yE ,B4 XT,E,C 6 it/YE /NC. i2EG/S2S.eEl� %SEO T� OET�,��/NE .L!>T�./�t/�S .4f�i��./C,�{/✓7' . -i TQWN OF BARNSTABLE, MASSACHUSETTS y y BUIL �� " ) A=21-60 ,`: NQ QQ DATE February 23• 19�4- PERMIT NO., -�g501 APPLICANT B'ayside Building Inc. ADDRESS Centerville #005645 (NO.) (STREET) (CONTR'S LICENSEI Build Dwelling1 PERMIT TO ( l l UMBER OF) STORY Single Family DwellinC WELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) Lot #81, 54 Abbe at Rd Cotuit ZONING Kg AT (LOCATION). yg e Road, DISTRICT (NO.) (STREET) BETWEEN AND (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: Sewage #93-619 J3oTld AREA OR VOLUME 1880 sg. ft. ESTIMATED COST $ 1651 000. 00 FEEMIT $ 134.75 (CUBIC/SQUARE FEET) OWNER Lydia Daress en ervl a BUILDING DEPT. ADDRESS BY THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY OR PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP- PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL -APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL OUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MINAL INSPECTION TI TO LATHE FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1� I, z 2 2 . HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT i 12 zl 2 {'� l� 1 3 -�T N -! BOARD OF THE OTHER SITE PLAN REVIEW APPROVAL L ~• - / r� WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT 'N!L L BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE TOR HAS APPROVED THE VARIODUS STAGES OF WORK 15 NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN CONSTRUCTION I PERMIT iS ISSUED AS NOTED ABOVE. NOTIFICATION ZJE516 N -PA-rA 82 l8s' SINGL- FAMILY '-3 $EWwMS "Jo 7o P No 6,AZ5AW--- 6pgvEv, WI IZL .o PAIL 9g `f t=�w 3�c I Io= 330 6PD y� 5EFrI C T41V- 33o�i So J. =495 6PJ o �q 13�i 1000 GAL �J I M EXP -06FMAL PIT U1 6 loon 6AL/2 STrnJE r nab 51DEMLL AWA =IS'S 5F 4"1o�PD, ( °r j0 10, \ vm0m � - 78 SF to -- u`, �3/ t titi Ito \V TA pi TX�LI6W - 5 4 S P¢°pv „ emu)�� _ - - ` -TOTAL RAIL- FIOW = 3306PD : orI UrLws- IF-� — 1-1 �U PE26e> .A nOW WATE -1"N 2-mw oe-LW P�(t1-OF g/RS,: CArul SN y�h q $n514 = r-a-ioo•o \ �o�,� -- --- -- ------------. PETER RICHARD i $ tu►zr>`a QF SUL UVAfd . : flim asoae P o. 29733 f. � ��• fi ��_ \ /ONAL�`` � ! I \o`/\ aXF-o2z) De1v�- T�51' ------------- F�a..L-s ii q.93 rG = Io3 TF=1a4 I i• �02 F'L= I O Z lnA►�1 sueso�[, p vc. $G, Ao I o00 i mi. GAL itb' lol.o 100.0 . iav I y OCK �Iw 4 love S TIG I �' GAL TANE: - N WA696 v � �. �1'oaE � T4AW a-DEW q 2 G 2 U-14 s"L• BE Fi-Zo !-fjV,- =f AP 21 PA¢GEL Loa Z oe QF ?ols� 3 s Put) FESr o /zs/7s . �tzoF1Lr-- CezrtF-+tom Rer PLdN do W, SGc1 Lam: dv DOTE; I I 10, 93 1 CGMT-y 1+IAT NS Fov woATv flowW NEON coA4?.L S WMA -Mf- 5(pEUge Lr S A�JDSu 2%). CV � `TDWN 0F -&Q-4srA�3 5 �a"l-o�d'� u/ t�ttJ Tt�� 'taac V.i 06s . GrzAr f�-ett,1, DA XTE¢ NYE INC. 7AK RAW . (IS Nor BAtip oN AN I p xrorJdL 4 SuaVI dlJv su�v yotzs �TY.vWtE+J'T' L�.,I� c-�,lGt LJ E�zS E t MD 174F OWE ET-S 44ou x) Llor' I3s o 5T1`2�t1 l ,c MAu , U/7&t>. To ESTABU" 4 Paarelzry u ijel ` APPLICAWT; —,aA JOHN W. KENNEY ATTORNEY AT LAW 12 CENTER PLACE 1 550 ROUTE 28 CENTERVILLE.MASSACHUSETTS 02632 TELEPHONE 771-9300 FAX NO.775-6029 AREA CODE 508 November 17, 1993 Joseph Daluz, Building Inspector Town of Barnstable 367 Main Street Hyannis, IMAA 0206.0"1 RE: Lot 81 Abbey Gate King' s Grant Subdivision Cotuit, MA Plan Book 271, Page 56 Dear Mr. Daluz: Please be advised that I have been retained by Bayside Building, Inc. to determine whether the above-referenced lot is a buildable lot under the Town of Barnstable Zoning By-law and Massachusetts General Laws. It is my opinion that Lot 81 located on the corner of Abbey Gate and Oxford Drive in Cotuit, MA as shown on plan of land recorded in Barnstable County Registry of Deeds in Plan Book 271, Page 56 is a buildable lot. In reaching this conclusion, I searched the records at the Barnstable County Registry of Deeds for the ownership of Lot 81 and of each of the contiguous lots. The lots contiguous to Lot 81 are Lots 80, 82A, and 83A. I ran the ownership of these four lots back to the original subdivision plan. The plan was endorsed with the approval of the Town of Barnstable Planning board on November 5, 1973. On June 1, 1973 the entire subdivision was deeded from Raymond D. Crawford to Peter A. Thompson and Dorothy F. Duncklee, Trustees of King' s Grant Trust. On January 31, 1974 the Trustees deeded Lot 82A to March, Inc. This deed was recorded on February 1, 1974 in Book 1999, Page 112. Thereafter, this lot was not owned in common with Lots 80, 81 or 83A. The lot. is currently owned by Elizabeth M. Hines. The deed to Ms. Hines is recorded in Book 5326, Page 156. On October 8, 1976 Dorothy F. Duncklee and Peter A. Thompson as Trustees of King' s Grant Trust deeded Lot 83A to Malcolm 0. Slavin. The deed was recorded on October 8, '1976 in Book 2409, Page 202. Thereafter, this lot was not owned in conjunction with Joseph Daluz, Building Inspector November 17, 1993 Page 2 Lots 80, 81, or 82A. This lot is presently owned by William P. Godley and Barbara J. Godley. The deed to the Godleys is recorded in Book 5529, Page 282. On October 29, 1976 the Trustees deeded Lot 80 to Richard H. Tashjian and Gladys Tashjian. This deed was recorded on October 29, 1976 in Book 2425, Page 149. Since that time this lot has not been owned in conjunction with Lots 81, 82A, or 83A. The current owners of this lot are Frederick E. Palmer and Patricia K. Palmer. The deed to the Palmers is recorded in Book 8160, Page 185. The lot which is the subject of this letter, Lot 81, was deeded by the Trustees to Thomas G. Woo and Victoria L. Woo on August 8, 1980. This deed was recorded on August 8, 1980 in Book 3135, Page 129. Pursuant to the provisions of Massachusetts General Laws Chapter 40A Section 6, this lot was afforded "plan protection" for seven (7 ) years. As indicated above the plan was endorsed and approved on November 5, 1973. The deed to the Woos was dated and recorded August 8, 1980. Therefore, this lot, at the time of its transfer to the Woos had plan protection. Additionally, as stated hereinabove, this lot was not owned in conjunction with any of the contiguous lots after the transfer of Lot 80 on October 29, 1976. Therefore, pursuant to the provisions of Massachusetts General Laws Chapter 40A Section 6, it is my opinion that this lot is a buildable lot. If you need any additional information concerning this matter please do not hesitate to contact me. Vet rulrDyou s, - G . John W. Kenney i j I i EFI E -,FlFIF-I Or I - z Z I I Fl I I�I jllllj ll;j jl Ij� ►�. .o 1p I I i 1. Elf" I fq ,I F3 j• I I I I I I I T Iliil ` 1 � I ! �� III •�' %�.- �I I ell1l I ! • 2Z-O" ; i o_ t °D' to h Ipq � Z m o =!: N o t p AOY o � I 1� m• —� t_J 1 .r 0 0 cH x35. � �I 0' � .I I •� .I I I Z '---- - �ID6SK` - --J i YN I pu.t, f t t• �D • I I I i 1. a I .� a �� --. r Q � nl I I' I � •. ? m ' t�il� • •� � d I. y o a � I �I � . ��Y . i I •- — I. � i I' • i � I �� I Ij w_. N . . 0 L-- - - Q -bra+c/t �ois•r�aa. - �pi _...- , r m C i D b n m N . I .f I O O 1-11 A 4'.4" i 1 9 1 ' � s h D k� 0 p m di m, T rq D S o I'� V 0 d I r r I IIIfn2 GS o• Ql p 8'•o^ � ' 6.'4. I -- --J I II -- - -- - ' D _ Dz �r x th � f i t L . I -�-�,d•s�s., s z Lu J 6� L J LIB ? o i i — • 0 ri p (h 3 A r cc0s oN 4 m� i ?D CD go cyP N z LA D 8.I 4,_6� 0 Z m 8 � I m m c N� �z -non Z �All. J in in `oar No1i��S ��,cA 8 s r.wi b 2 r m �VV/ 3'1"11h'7�31N-3� -°wz.4D —)N14'11ma 3015�,'V9. -eCr Dt xv �D a zG LU - x LO ` U IV r j! '-o to c n� p o . c =4 c o 411� - n� K go Asse so,(s office(1st Floor): X4 02 �@ SEPTIC SYSTEM Assessor's map�Mumber pC�� INSTALLED IN C r A Conservation �1r��-�--� Nov l WITH T Board t Health um3rd floor): ENVIRONMENTA ►�Sewage Permit number Engineering Department(3rd floor): TOW REGU� House number Y1i Definitive Plan Approved by Planning Board _ 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN : OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 1 Proposed Use IV f Zoning District / 1 / Fire District ti Name of Owner Address Name of Builder Address Name of Architect Address Number of Rooms Co Foundation Exterior Roofing Floors Oq,Ve- t / (A Interior 4 � Heating�� %�-/�/ `�/�� Plumbing Fireplace �` Approximate Cost l (o S U v U Area Diagram of Lot and Building with Dimensions ` Fee OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name 7 rr✓ Construction Supervisors License IV 52! / I DARESS, ..LYDIA No 36501 Permit For 112 Story Single Family Dwelling -Location Lot 481 , 54 Abbey Gate Cotuit Owner Lydia, Daress Type of Construction Frame Plot Lot Permit Granted February 23 , 19 94 Date o I�cctio 19 Date Completed 19 fit t a �+ '•O Ifs� `-;,• •