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0029 AMANDA COURT
COCA/rim I r c�' a s ' 0 �':'- srtin....;.�:.�-F �.►r+ ------ A �� ��..Y •`µ.me r 14 2019 12:15PM Tupper Construction Co. 15087785010 page 1 (025'ITUPPER CONSTRUCTION CO. , 546A Higgins Crowall Rd,WEST YARMOUTH,MA 02673 PHONE: 509-778-0111 FAX: 5c8-778-5010 EMAIL admin@tuppe=.com Date: �--' ` I l c Town of Barnstable Building Inspector 200 Main Street o Hyannis, MA 02601 (508) 790-6230 fax Re: Insulation Permit at'29 Amanda Court, Cotuit Permit# d I F' 3q31 Issued On ! / 31) :� This affidavit is to certify that all work completed for the above permit application has been inspected by a certified Building Performance Institute (BPI) inspector. All work performed meets or exceeds Federal and State requirements. Sincerely, r' Richard Tupper License # CS-69058 Town of Barnstable Building BAWMASM ; Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept 8 1' .asp. Posted Until Final Inspection Has Been Made. Permit �e " 'Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit No. B-18-3931 Applicant Name: Richard Tupper Approvals Date Issued: 12/03/2018 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 06/03/2019 Foundation: Location: 29 AMANDA COURT,COTUIT Map/Lot: 055-036 Zoning District: RF Sheathing: Owner on Record: MASON, EMANUEL J&SUSAN S Contractor Name: Richard S Tupper Framing: 1 Address: 29 AMANDA COURT Contractor License: CS-069058 2 COTUIT, MA 02635 Est. Project Cost: $985.00 Chimney: Description: Weatherization work Permit Fee: $85.00 Insulation: Project Review Req: Fee Paid: $85.00 Date: 12/3/2018 Final: Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing Rough: 2.Sheathing Inspection _ 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT 0 J— ti 5 OL,"T' ao �/,; -7A D,uo q ?5 .C� 5�X.�. .A- S5 . Av/A ?b, TOWN OF BARNSTABLE Building BAR oFt"E 201504088 NSTABLE, + Issue Date: 07/16/15 Permit E MASS. �Ar16 3.ON Applicant: CON-SERVE ENERGY Permit Number: B 20151875 Proposed Use: SINGLE FAMILY HOME Expiration Date: 01/13/16 Location 29 AMANDA COURT . Zoning District RF Permit Type: RESIDENTIAL INSULATION Map Parcel 055036 Permit Fee$ 35.00 Contractor CON-SERVE ENERGY Village COTUIT App Fee$ 50.00 License Num 171251 Est Construction Cost$ 175 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND WEATHERIZATION THIS CARD MUST BE KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: MASON,EMANUEL J&SUSAN S BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 34 WABAN ROAD INSPECTION HAS BEEN MADE. QUINCY,MA 02169 Application Entered by: JL Building Permit Issued By: THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF,EITHER TII&OPARILY O N . ENCROACHMENTS ON PUBLIC PROPERTY,NO SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAYBE 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 FIVE CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.SHEATHING INSPECTION 3.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 4.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 5.PRIOR TO COVERING STRUCTURAL MEMBERS(FRAME INSPECTION). 6.INSULATION. 7.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORSDSO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). rM BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 2 2 2� 3 1 Heating Inspection Approvals Engineering Dept Fire Dept 2 Board of Health TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map' a» Parcel 63co 7t °x� OF TA®�� Application #C2 IS �0 ~Health Division • 1' 15 0141 Date Issued Conservation Division Application Feet Planning Dept. _,q. 3 - Permit Fee JS -o Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address z..,4L Village t_t�Tv Owner Address 34% Telephone ��Z- ��lo - `S� .�. �, , �...a. oZ (,S Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay ° a Project Valuation -_ Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. "/ Dwelling Type:' Single Family _Ur"" Two Family .❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑ Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: '11%, existing _new Total Room Count (not including baths): existing -4. new First Floor Room Count Heat Type and Fuel: arGas ❑ 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: 0 existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number so+t- %33 Address 3 B �e�:c ♦ 3-a License # x o z- q B 'S•��.� a-M �-- dz��] Home Improvement Contractor# x-A%zs Email Worker's Compensation # t.o ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE i DATE 2!v 1 FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS a VILLAGE ' t OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE r r „ ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH »; FINAL GAS: ROUGH FINAL FINAL BUILDING ' t - ' DATE CLOSED OUT 'fi ASSOCIATION PLAN NO. �` ' 1 Conservision e n e r g y OWNER AUTHORIZATION FORM I, Susan mason owner of property at: 29 Amanda Ct, Cotuit, MA 02635, USA hereby authorize ConserVision Energy, to act on my behalf to obtain a building permit to perform work on my property. V I ' Owner Signature 1 Date 2/27/15 w r Mas$at huse3t .- pa afety ! Board op.13u!jd:ng Regutations and Standarcis n41rucnon. ircm is-,r 5pec6lo n:ense:CSSL-102778Pe'i CONOR D MCI IV 34 SIASCONSE'>I nRfYf� SAGAMORME B91f-Ve&1, 2 or 4 Comnll"loner O&'.1912018 „� *�7/.•n 6�<utn<r iltN�lif/��� 1 �:1 rii�itx•lj,' �.Office of Consumer AfTeirs&Business Regulation License or registration valid for individul use only ME IMPROVEMENT CONTRACTOF before the expiration date. If found return to: Registration: 17t251 type; Office of Consumer Affairs and Business Regulation NV zpiration:. 31112016 Partr ership 10 Park Plaza-Suite 3170 Boston,MA 02116 CON-SERVE ENERGY CONOR MCINERNEY 376 ROUTE 130 SUITE G SANDWICH,MA 02553 llodersec retary Not.valid without signature 1 , PROGRESS REPORT RESPONSIBLE EMPLOYEE NAME TASK k DATE COMPLETE i rscrnr..=n r a I wim Lim r uuL ris anu I Mr-sees 1 U'IL:a 1 r-rn n.utn. IMPORTANT:if the ce cafe holder Is an ADDITIONAL INSURED,the pollcy(les)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. i PRO UCER CONTACT NAME CS&S,NVORKCOMPONE PHONE FAX - A/C,No,Ed: A(C,No PO BOX 946580 EMAIL ADDRESS: Maitland,FL 32784-6680 INSURERS AFFORDING COVERAGE NAIC# 1-877-724-2669 INSURER A: Continental Casualty Company 20443 INSURED INSURER 6: CONSERVISION ENERGY INSURER C. 376 ROUTE 130 INSURER D: 8UjTE C INSURER E: SANDWICH,MA 02563 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED B€LOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDINGANY 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. ow DDL UBR I POLICY EFF POUCY EXP LTR TYPE OF INSURANCE RSR POUCY NUMBED MIDONY) (MMfDDNYI UMRS A GENERAL LIABILITY Y 6011316335 03111/15 03/11/16 EACH OCCURRENCE 11000,000 COMMERCIAL GENERAL LIABILITY v�GEfORENTE� f 900 OOO � � CLAIMSMADE ®OCCUR MED EXP(Any one person) S 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE = 2 000 000 GEN'L AGGREGATE LIMIT APPLES PER: PRODUCTS-CoMP/0P ADo = 2,000,000 POLICY /X LOC A AUTOMOBILE UAeIL ( ITY 6011316331 03111/15 03/11/16 Ea aBmEO SINGLE LIMIT(Ea accident) $ 1,000,000 ANY AUTO BODILYINJURY(Per person) ALL OWNED SCHEDULED BODILY INJURY(Per accident AUTOS AUTOS H NON-OWNED PROPERTY DAMAGEHIRED AUTOS AUTOS (Per accident) $ $ A UMBRELLA LIAR X OCCUR 661131636 03111116 03/11/16 EACH OCCURRENCE 2,000.000 EXCESS aA1MS41ADE AGGREGATE QQQ 000 DEDIXI RETENTION$10,000WORKERS = A 0 LASS IM NY YIN 6011316349 03111/15 03/11/16 X1 TORYUMrrs ER ANY PROPRETORIPARTNERM(ECUTNE DrFICERIMEMBER EXCLUDED? NIA E.L.EACH ACCIDENT : 500,000 (Mandatory to NH) EL DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS blow E.L.DISEASE-POLICY UU[T $ 501),000 OTHER TORY LIMITS I I ER El-EACH ACCIDENT EL.DISEASE-EAEMPLOYEE $ E.L.DISEASE-POUCY LIMIT Certificate Holder is added as an additional insured as provided In the blanket additional Insured endorsement as it pertains to work being performed by named insured underwritten contra INCLUDES PRIMARY AND NON-CONTRIBUTORY CERTIFICATE HOLDER , CANCELLATION Rise Engineering SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE w(TH THE POLICY PROVISIONS. 1341 Elmwood Ave Cranston,RI 02910 AUTHORIZED REPRESENTATIVE ®1988-2010 ACORD CORPORATION.All rights reserved. ACORD 2.(201 Dias) The ACDRD name and logo are registered marks of ACORD _— I 1 The Com nonwealth of Massachaseft Depa ent of Industrial Accidents O ce of Investigations 60 10 Washington Street Boston,MA 02111 www mast gov/dia Workers' Compensation Insurance davit: Builders/Contractors/Electricians/Plumbers Apiplicaut InformsdollPlease Print L Wbty Name(BuswewOrgaaizationl[ndividial): Cons Msion Energy Inc Address: 378 Route 130 City/State/Zip: SAndwich, MA 02563 phone#: 508-833-8384 Are YON as employer?Check the appropriate bo : t-El I am a employer with TYPO of project(required): etrrp y 6 4. ❑ ��Ve a general contractor and I employees(bell and/or part-time).* hired the sub-contractors 6• ❑New construction 12.❑ I am a sole proprietor or partner- Ii rted on the attached sheet. 7. ❑Remodeling ship and have no employees T mse subcontractors have g. ❑Demolition working for me in any capacity. C1 VIOYM and have workers' (No workers'comp. insurance c4 mp.insurance.t 9. ❑Building addition required:] 5. ❑ e are a corporation and its 10.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work o ficers have exercised their m myself.[No workers'comp. ri 11.❑Plumbing repairs or additions t of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§10),and we have no 3a.❑ 1 am a homeowner acting as a ei iplayees.[No worker' 13.©Other Weatherization general ccnmw*w(refer to#4) cd�np.insurance required.] Any gVHc Ot duet chorus box NI mart also till out the teeoion be showinj their."IMIM'oompemattad�!!%iafotmstioa,Homeowerers who submit this affidavit indicating they am doing wort and then hire outride coutrectaA muu rCoatrsctors that chock this box moat attached an sdditioaal shed submit a new affidavit indicating suchl a the rams of the atbeontrsetars and am whether cr not thane etttitia have eetployaea. If the sub ooetrs�tors bars errplayeea,d stint Prod their workers'coov•Qe ftcy number. I am an employer that is prov1d8r9 workm 0 CO nnpt n baur ace for ruts+t info rt rr��ployed� Below Ott the polo'andlob slit Insurance Company Name. CS&S/WORKCOMP NE Policy N or Self-ins.Lic.It: 6011316349 Expiration Data; 3-11-2016 Job Site Address: Z� City/State/Zip: Attach a copy a the workers'compensatlos policy declaration page(showing the Failure to secure covers as Polley number and eipiratlo�date). go required under Section 25 of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to S 1,500.00 and/or one-Year imprisonment:as ell as civil penalties in the form of a STOP WORK ORDER and a fine of up b$230.00 a hey against the violator. Be advised t a copy of this statement may be forwarded to the Office of investigations of the DIA for insurance coverage veriB tion. Ida henbp c under the palm and pentldn of that the ormadots � � prnrJdd ebour is trsrt and cbrn+ct L� - Q Ali Phone#* So g , g3? - £s 9t;Li OOlcla!ask ortlyi Do not wr Ar In this areas,to be co plttad by city or town o,Oleld City or Town: Permit/License a Issuing Authority(circle one): t. Board of Health 2.BaQding Department 3.C1 own Clerk 4.Electrical Inspector S.Plumbing Inspector b.Other Contact Person• Phone lt: i Town of Barnstable Permit# Fapires 6 months from issue Regulatory Services Fee MWvsr.+si.a, 16 9. ��� Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner. 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma us Office: 508-862-403 8 Fax: 508-790-623 0 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY b Not Valid without Red X-Press Imprint Map/parcel Number Property.Address 2� � �� CT �oTt]1T t 7A- _ Residential Value of Work -2.510� Minimum fee of$35.00 for work under$6000.00 Owner's'Name&Addresses-�'!F}��Gz Contractor's Name ,�2�c�f�o..� i �-�E f-���r/��I . Telephone Number -5���70 /zZ/ Home Improvement Contractor License#(if applicable) GS SG /ooSy w w PER 11A IT ESS IY Construction Supervisor's License#(if applicable) rkman's Compensation Insurance AUG 15 2012 Check one:. ❑ I am a sole proprietor ❑ I am the Homeowner TOWN OF BARNSTABLE, ❑ I have Worker's Compensation Insurance Insurance Company Names 1�- 1-0sh/Er5 Work nan's Comp.Policy#. � 'cJv 13. = 4-1 33 Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to. ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) 0 Re-side #of doors placement Windows/doors/sliders.U-Value- (maximum.35)#of windows - ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. . Separate Electrical&Fire Permits required. 'where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: Q:\wPFIiM\FORMS\building permit formsTYPRFSS.doc Revised 053012 The Commonnwah%of Massacharsefts Depwhnenf of lndusoial Accidents Office of Investrgafions 600 Washington Stmet Boston,MA 02111 www m&mgvv1dia Workers-' Compensation Insurance Affidavit Bmiltiers/Contractors/Eled c ans/Ph mbers Applicant Information Please Print I.elt b Name(Busines&0g llndivi da -* 70�re7 Ad&ess: 16 Hor-)ye7g- x2eY - Gity/Statdzip: MYq-- mane#k -Wei Are you an employer?Check the appropriate box: Type of project(required): IaD'l'am a employer with 4. ❑ I am a,,general contractor and I 6_ ❑New construction employees(full andlor -time�me * have hired the sub-conhaetors 2-❑ I am a.sole proprietor cw partner- listed on the attached sheet. 7- ❑Remooleling ship and have no employees These sob-contractors have g_ ❑Demolition we ddng for me in any capacity. employees and have workm' 9_ Building addition [No tvwkus'Comp-invxsmre comp.inmumxp 1 required-] .5- ❑ We are a.corporation and its 10 El Electrical repairs or additions 3.❑ I am homeovxwr doing allwork officers have eserdse'd their ME]Plumbingrepairs or additions myset£[No workers'comp- At of exemption per MGL 12.❑Roof repairs ra insunce i c_152, §1(4�and we have no �") 13.❑Other employees-[No workers comp.insurance required_] 'Any applied Poet chedcs boa#1 mast also fill out the section below shaaingth&wod me w®pe�tinnp�4 m&nnitim 7 Homeowt�s vrbo sab®it this affidavit i�catmg'they ate doing aD waal and then Lint oatd&couttactats mmst mdm a new afdzwt imdxRtmg sack 1CanU1Lctozs that check tltis boat mast attached an arhiitimal sleet shoariag the mama of the mb-dints and:ctme wbedw anot those enmies bane employees. If the sub-con=acts ham employees,they mmst provide their walkers'camp.policy ntnabrr- I am an employer that is proviaW worker'.compensation insurance for my smplo we& Below is tha policy atud job site information. Insurance Company Name: THE �A✓EzE�S. i�uQ.ftc�CE Cohr�X7 Poll 4 or Self ins.Iic.4: 7FJ uf3 --4f 33 PZL} '�'" I► c3` Expiration Date: _ 29 .yvt As�/iA- eT e.Ore/�T Job Site Address CitylStatelZip: 171`71ft--- 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 a 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisoned,as well as civil penalties in the form of a STOP WORX ORDER and a fine of up to$250.00'a day against the violator. Be advised that a copy of this statement maybe f mwarded to the Office of Investigations of the DIA for insurance coverage verification. I+do hereby carhfy/ttndsr thepains andpenaMes ofperjuty that the informafimprovi&dabove is true and torrent Sitmature: / Date: Phone#: S o D,jrciai use only.• Do not write in this.area,to be comptetesd by city or town offic at City or Town: PerudtfLicense 4 Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/rown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone 9: 6 f RARMADM 9 i63q `0� Town of Barnstable �p�FD MAC� Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.ba rnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must . Complete and Sign This Section .If Using A Builder I, (YAA Lk�'� /X,��. , as_Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: Z9 AA A 0 SKA C —1 00-TiJ (Address of Job) PSignature of Late Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the . reverse side. Q:\WPFMEST0RMS\building permit forms\EYPRESS.doc Revised 051811 i NOTICE z NOTICE TO a TO EMPLOYEES 4 EMPLOYEES O,�M Svg The* Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 600 Washington Street, Boston, Massachusetts 02111 617-7274900 — http://www.mass.gov/dia As required by Massachusetts General Law, Chapter 152,Sections 21, 22&30, this will give you notice that I(we) have provided for payment to our injured employees under the above mentioned chapter by insuring with: THE TRAVELERS INSURANCE COMPANIES NAME OF INSURANCE COMPANY P.O. BOX 1450 MIDDLEBORO MA 02344-1450 ' ADDRESS OF INSURANCE COMPANY (7PJU6-4433P24-8-1 1 ) 11 —09-1 1 TO 11 —09-12 POLICY NUMBER EFFECTIVE DATES BRYDEN & SULLIVAN INS AG 88 FALMOUTH ROAD G HYANNIS MA 02601 NAME OF INSURANCE AGENT ADDRESS PHONE# TORRES, ERICSSON DBA 16 HOOVER ROAD ERICSSON HOME IMPROVEMENT o WEST YARMOUTH MA 02673 EMPLOYER ADDRESS EMPLOYER'S WORKERS COMPENSATION OFFICER (IF ANY) DATE MEDICAL TREATMENT The above named insurer is required in cases of personal injuries arising out. of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers' Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services a provided by the treating physician will be paid by the insurer, if the treatment is necessary and reasonably • connected to the work related injury. 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'.,r'C-'3'�ti"q-�, _ r'• o tt. ` • r; ° TWINO4vSTr1 #, 22 2: 9 R I S E Division of Thielsch Engineering,Inc. 2 s2 {L i 1341 Elmwood Avenue ENGINEERING Cranston,Rhode Island 02910 Thursday, August 9, 2012 Town of Barnstable Thomas Perry, CBO 200 Main Street Hyannis, MA 02601 RE: {=-29�Amanda Court;=Cotuit;MA 02.635} Barnstable Building Permit#: 201200983 Dear Mr. Perry, \` This affidavit is to certify that all work completed at 29 Amanda Court; Cotuit, MA 02635, has been inspected by a certified Building Performaance-Institute (BPI) inspector. The following weatherization work was completed;;,most of the contracted measures could not be implemented due to the home being remodeled at the time of installation. ➢ Perform 7 man-hours of air s`l�Yto include all appropriate blower door tests, combustion safety tests and-procedures. ➢ Install 6" R-21 Class'\l Cellulose insulation to 22 square feet of exterior overhang located below a heated floor area, by drilling holes in the ceiling from below. All work performed meets,o exceeds Federal and State Requirements. Sincerely, A Erik J. Nerstheimer; Field Supervisor 9' p RISE Engineering Residential Installations Department RISE Engineering; A Division of Thielsch Engineering 68 CSL 1004591HIC 120979 I 401-784-3700 . 800-422.5365 . Fax 401-784-3710 CASE #: 124515 CHECK #: 0/5705- TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 0:55 _ Parcel 036 "_Application # l: c��3 Health Division Date Issued l Conservation Division Application Fee Planning Dept. -Perrhit Fee. Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis O Project Street Address 29 AMANDA COURT Village COTUIT. Owner SUSAN MASON Address 34 WABAN ROAD Telephone 617-770-0697 QUINCY; MA.. 02169 Permit Request PERFORM AIR SEALING MEASURES: INSULATE HEATING/COOLING DUCTS; INSTALL INSULATED HOSES AND FLAPPER VENTS TO EXHAUST EXISTING BATH FANS; INSULATE BASEMENT DOOR; ETC, SEE .,'COPY OF ATTACHED CONTRACT FOR OWNER AUTHORIZTION. Square feet: 1st floor: existing proposed 2nd floor: existing proposed- Tofal newD Zoning District Flood Plain Groundwater Overlay -' o ca can � . Project Valuation$1954.82 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. fV Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No , Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name RISE Engineering; A Divison of Telephone Number 401-784-3700 EXT kkk 6133 Thielsch Engineering Address 1341 Elmwood Ave, Cranston RI 02910 License # 100459 exp. 3/28/12 Home Improvement Contractor# 120979 exp. 3/25/12 Worker's Compensation # 3730961-01 exp. 1/1/13 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO RI Resource 5ecov,wry' Johns n, RI SIGNATURE DATE _ 7// Erik Nerstheimer for RISE Engineering i FOR OFFICIAL USE ONLY APPLICATION# t DATE ISSUED _ MAP=/PARCEL NO. a ADDRESS VILLAGE OWNER DATE OF INSPECTION: "��FO.UNDATION FRAME { INSULATION" FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL ,4 GAS:H i-;4AR-- -ROUGH ,, :: + ;:r' FINAL fRINAL:13U:ILDING'3 . ? Y :DATE CLOSED OUT z} ASSOCIATION PLAN NO. ,r . The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): RISE ENGINEERING; A DIVISION OF THIELSCH ENGINEERING Address: 1341 ELMWOOD AVENUE City/State/Zip: CRANSTON, RI 02910 Phone#: 401-784-3700 OR. 800-422-5365 Are you an employer?Check the appropriate box: 4. Type of project(required): 1. X❑ I am aeneral contractor and I I am a employer with - ❑ g employees(full and/or part-time).* have hired the sub-contractors 6 El New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance.* 9. Building addition - required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doingall work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13•[XI Other INSULATION comp. insurance required.] *Any applicant that checks box 41 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: THE PRESTON AGENCY, INC. Policy# or Self-ins.Lic. #: 3730961-01 Expiration Date: 01/01/13 Job Site Address: 29 AMANDA COURT City/State/Zip: COTUIT, MA 02635 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 certif n r tl ins a d'penalties ofperjury that the information provided abov is true and correct. Si mature: Date: 'Z ERIK NERSTHEIMER FOR RISE ENGINEERING Phone#: 401-784-3700• EXT. 6133 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#: THIEL-1 OP ID: 27 ACORO" CERTIFICATE OF LIABILITY INSURANCE DATEDIYYYY) 01/11/13112 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 401-886-8000 CONTACT The Preston Agency,Inc. 1350 Division Rd Suite 303 401-885-1700 gHCNE FA Ertl: (A' C.No PO Box 810 E-MAIL East Greenwich,RI 02818-0810 ADDRESS: Judith A.Wright CPCU AAI ARM INSURER(S)AFFORDING COVERAGE NAIC 0 INSURER A:Zurich-American ' INSURED Thielsch Engineering,Inc.Thielsch Group Inc. INSURER e:American Guarantee 8<Liability HI Tech Realty Inc. INSURER c:Twin City Fire-Hartford Attn:Trent Theroux INSURER D:North American Capacity 195 Frances Avenue Cranston,RI 02910 INSURER E INSURER f COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY EFF POLICY EXP LTR POLICY NUMBER MMIDD/YYYY MMIOD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000. A X COMMERCIAL GENERAL LIABILITY X 3730962-01 01/01/12 01/01/1 PR 3 EMISES Ea occurrence $ 300,00 CLAIMS-MADE a OCCUR MED EXP(Any one person) a 5,00 PERSONAL 8 ADV INJURY $ 1,000,00 GENERALAGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00 POLICY FXJ PRO- LOC Emp Ben. b 1,000,00 AUTOMOBILE LIABILITY EOa BIKED SINGLE LIMIT $ 2,000,00 .denA X ANY AUTO 3730963-01 01/01/12 01/01/13 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS AUTOS ( ) NON-OWNED PROPERTY DAMAGE H 1 HIREDAUTOS AUTOS Per accident $ $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 B EXCESS LIAB CLAIMS-MADE AUC-4857188-01 01/01/12 01/01/13 AGGREGATE $ 10,000,000 DED I I RETENTION E $ WORKERS COMPENSATION WC STATU- TH - ANDEMPLOYERS'LIABILITY YIN X T RY LIMIT ER A ANY PROPRIETOR/PARTNER/EXECUTIVE 3730961-01 01/01/12 01/01/13 E.L.EACH ACCIDENT a 1,000,00 OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,00 C Property Section 02UUNHE6930 01/01/12 01/01/13 Property see Belo D Professional Liab DVL000026802 01/01/12 01/01113 Prof Liab 2,000,00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more apace Is required) When required by a written contract. CERTIFICATE HOLDER CANCELLATION TWNHARW SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Building Division ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street AUTHORIZED REPRESENTATIVE Hyannis,MA 02601 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Licensee Details Page 1 of 1 The Official Website of the Executive Office of Public Safety and Security(EOPS) Mass.Gov Home Public Safety Department of Public Safety Licensee Complaints License Type Construction Supervisor License#' 100459 Restriction WS,IC Name Erik Nerstheimer City,State,Zip North Scituate,RI,02857 Expiration Date 3/28/2012 Status Current No complaints found for this Licensee. _ T Back-To Search } Buard u1' U�'ParF►ttrnt r,t . . Construe ¢Btri(tlirr�= Yub",. -. ,. c.ior. Su Rc-.ula[inn.v.:euti.� . '•r«tt Licen Per`"sor SPecia se:.,CS SL 100459 Restricted to: WS Ity license ERIK NERS THEIMER 228 GLEANER C •. NORTH SCIT HAPEL ROAD DATE, RI 7 0285 £ »•,• Expiration: 312812012 rr=' 100459 I http://db.state.ma.us/dps/licdetails.asp?txtSearchLN=CSL100459 4/20/2011 g1t e O ice o onsumer aiVand usiness e u anon g 10 Park Plaza - Suite 5170 Boston, ssachusetts 02116 Home Improve `�ontractor Registration Registration: 120979 m Type: Supplement Card Expiration. 3/25/2012 THIELSCH ENGINEERING M ERIK NERSTHEIMER > 1341 ELMWOOD AVE. CRANSTON, RI 02910 � a 6� Update Address and return card.Mark reason for change. �- Address ❑ Renewal Employment ❑ Lost Card PPS-CAI 0 50M-04/04-G101216 Office of Consumer Affairs&Bu iness Regulation License or registration valid for individut use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: . Office of Consumer Affairs and Business Regulation Registration,';' fjg7g Type: 10 Park Plaza-Suite 5170 Expira012 Supplement Card Boston MA 02116 THIELSCH ENGi ERIK NERSTHErRn _- 1341 ELMWOODVL1 /1 - CRANSTON, RI 029f( ;= Undersecretary Not valid without signature 4 Control No: 3 4 2 4 4 MOWN THE COMMONWEALTH OF MASSACHUSETTS e DEPARTMENT OF LABOR b DIVISION OF OCCUPATIONAL SAFETY w 19 STAMFORD STREET, BOSTON,MASSACHUSETTS 02114 LEAD-SAFE RENOVATION CONTRACTOR LICENSING WAIVER RISE Engineering A Division of Thielsch Engineering, Inc. 1341 Elmwood Avenue Cranston, RI 02910 WAIVER: LW000672 EXPIRES: April 15, 2015 IN ACCORDANCE WITH M.G.L. C. 1 l 1, § 197(B)(b)AND 454 CMR 22.03(3)(b), THIS LEAD-SAFE RENOVATION CONTRACTOR LICENSING WAIVER IS ISSUED BY THE DIV. OF OCCUPATIONAL SAFETY TO THE CONTRACTOR ABOVE FOR THE PURPOSE OF PERFORMING LEAD-SAFE RENOVATION WORK. THIS LEAD-SAFE RENOVATION CONTRACTOR LICENSING WAIVER MUST . BE MAINTAINED BY THE CONTRACTOR IN ACCORDANCE WITH M.G.L. C. 111, § 197B(b)AND 454 CMR 22.04 WHEN PERFORMING LEAD-SAFE RENOVATION WORK. HEATHER E. ROWE,ACTING COMMISSIONER L� Printed on Recycled Paper f RISE ENGINEERING rweral ID$064405629 Rl Contractor Registration No 8186 A division of Thieisch Engineering MA Contractor Registration No 120979 CT C6ntmctor Registration No 620120 ir 1341 Elmwood Avenue,Cranston,R102910 (401)784.3700 FAX(401)784-3710 CONTRACT Page 1 . PROGRAM THIS CONTRACT IS ENTERED INTO BETWEEN RISE CLC-RCS ENGINEERING AND THE CUSTOMER FOR WORK AS ` Ur-A w DEscruBEDsELow CUSTOMER Pylon DATE chord t Susan Mason (617)770-0697 11/22/2011 124515 SERVICE STREET BILLING STREET 29 Amanda Court 34 W"aban Rd SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Cotuit,MA 02635 Quincy,MA 02169 JOB DESCRIPTION Provide labor and materials to seal areas of your home against wasteful,excess air leakage. This work will be performed in concert with the use of special tools and diagnostic tests to assure that your home will be left with a healthful level of air exchange and indoor air quality. Materials to be used to seal your home can include caulks,foams,weatherstripping and other products. Primary areas for sealing include air leakage to attics,basements,attached garages and other unheated areas(windows are not generally addressed.) $1,260.00 RISE Engineering will provide labor and materials to seal heating and/or cooling ducts within designated unheated areas. This work will be performed at the rate of$70 per man per hour,which includes materials. 6 man hours. $420.00 Provide labor and materials to install 2insulated exhaust hoses with gable wall mounted flapper vents to exhaust 2 existing bathroom fan(s). $200.00 Provide labor and materials to insulate the back of the basement door leading to the bulkhead with 2"rigid foam board that meets the sections R-316.5.4 and 316.6 requirements of building code. Seal all edges and seams with FSK tape. $46.00 Provide labor and materials to install 6"R-21 Class 1 Cellulose insulation to 22 square feet of exterior overhang located below a heated floor area,by drilling holes in the overhang from below. Holes drilled will be plugged. Plugs will be scaled with exterior grade spackle and left in a relatively smooth condition.Finish sanding and touch-up priming/painting will be the customer's responsibility. $28.82 RISE Engineering will apply all applicable,eligible incentives to this contract- You will be billed only the Net amount Currently,for eligible measures,the Cape Light Compact offer;75%incentive,not to exceed$2,000 per calender year. -$206.12 RISE Engineering will apply all applicable,eligible incentives to this contract. You will be billed only the Net amount Currently,for air and duet seating measures,the Cape Light CGmpactuffmsa 100%incentive. -$1,680.00 DWE AGREE HER O FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF NOV 2 8 2011 **"Sixty-Eight&701100 Dollars $68.70 UPO FINAL INSPECTION AND APPROVAL BY RUSE ENGINEERING CUSTOMER AGREES TO RENT AMOUNT DUE IN FULL INTEREST OF t%WILL BE CHARGED MONTHLY ON ANY UNP D BALANCE AFTER 30 DAYS.SEE R INFORMATION ON GUARANTEES,RIGHTS OF RECISION,SCHEDULING,AND CONTRACTOR REGISTRATION. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES AUTHORIZED SIGNATURE-RISE ENGINEERING TOIIlER ACCEPTANCE NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE —T ACCEPTANCE OF CONTRACT-THE ABOVE PRICES,SPECIFICATIONS AND CONDITIONS ARE SATISFACTORY TO US AND ARE HEREBY ACCEPTED.YOU ARE AUTHORIZED TO DO THE WORK DAYS. AS SPECIFIED.PAYMENT WALL BE MADE AS OUTLINED ABOVE i ... y ._. ._.�_+ ..- •. ._.r... a. ...�._♦ ..�.r_ .v — ♦ � • ., .. ... ... . ti.r, ..-•� ... � .. -+sue•. 1F TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parce Application`#��� � Health Division Date Issued Conservation Division Application Fee V-) Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Y Historic - OKH Preservation / Hyannis 0 f W Project Street Address Z� �i�,a�l D A- C Village Cif Owner Address Telephone 2- ey f�f�. 2-1 Permit Request 7riz�ea r Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation* �� Construction Type W.4 FA.om Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Numb6,11 Bedrooms: existing —new cr+ Total Rctm Count (not including baths): existing new First FloorRoom Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other ; Central Air: ❑Yes. ❑ No Fireplaces: Existing New Existing wood/coal fove:0 Yes ❑ No o Detached garage: ❑ existing ❑ new size Pool: ❑ existing ❑ new size _ Barn:❑ existng O�ew size_ a 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 S d= Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 2-J_,-_( L AvFAi Telephone Number _5298 FS67373 Address D. �w)C �l License# ap'f 77l Nor&,ce, Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE v �� r FOR OFFICIAL USE ONLY r o - •APPLICATION# !� �. DATE ISSUED MAP/PARCEL NO. r Y; ADDRESS VILLAGE OWNER f A ; DATE OF INSPECTION: f FOUNDATION FRAME INSULATION • FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING Azf l DATE CLOSED OUT ASSOCIATION PLAN NO. i -.Dep of ladustrial A6dJents . Qfflce of Investigations '600 Washington Street Boston,MA 02111 www.mass.gav/dia " Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Aipplicant Information Please Print Le at Name(Busmess/Organization/Individual):. Address: SG �( 4, City/State/Zip: Phone.# Are you an employer?Chec the appropriate.box: •4. �I am a general contractor and I F7. '[:] ject(required).. 1.❑ I am a employer with employees(fall and/or part-time):*. have hired the sub-contractors construction . 2.❑ I am a•sole proprietor or partner- listed on the-attached sheet deling ship and have no employees These sub-contractors have 8. ❑Demolition working for me ia•any capacity. employees and have workers' [No workers'comp.insurance coup.instuance.t" 9. ❑Building addition required.] 5. ❑ We are.a corporation and its. 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing in work officers have exercised their 11.❑Phunb*repairs or additions myself [No Work='comp. right of exemption per MGL insurance required.]t c. 152, §IN, and we have no 12.[]Roof rePai employees. [No workers' 13. Other Pomp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing tireir worker;'compensation policy information. t Homeowners who submit this affidavit indicating lacy am doing all work and then him outside contractors must submit"new affidavit indicating such tConhacton that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities bave employees. If the sub-contractors have employees,they must providt their work='comp.policy number. Iam an employer that isproviding workers'compensation insurance for my employees. Below is.thepolicy and job site information. 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'(shoy"g the policy number and expiration date). Failure- ail u-e•to secure coverage,as required under Section 25A of MGL c. 152 can lead to the imposition of camin.al penalties of a fine up to$1,500.00 and/or one-year imprisomnent, 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 Investi lions of the DIA for insurance covera a verification. I do hereby certify under the pains•and penalties of perjury that the information provided above is true and co•rrect T / Si tore: Data: Phone##: Ov S U ?,?72 [Ofj7cial.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): .Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: .. r hf6miation and-Instructions Messaclmsetts General Laws chapter 152 requires all employers.to provide workers'compensation far their employees. ✓' Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written" An employer is defined as"an individual,partnership,association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee-of an individual,partnersbip,association or other legal entity, employing employees. However,the owner of a dwelling horse 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 tut be.an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to'operate a business or to construct bmldings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required," AdditionaDy,MCI,ohapter 152, §25C(7)states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for.the performance of public-work unttl•acceptable evidence-of eonmAl ace with the insurance requirements of this chapter have been presented'to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to-your situation and,if necessary, supply sub-confiactor(s)name(s),address(es)and phone number(s)along with their certificate(s)of ' insurance. Limited Liability Companies'(LLC) or Limited Liability Partnerships(L.LP)with no employees other than the members or partners, are not required to cant'workers' compensation insurance. If an LLC or LLP.does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confmnation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law-or if you are required to obtain a worlm' i 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 on that the affidavit is complete'and punted legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the pera t/license number which wall be used as a reference number. In addition, an applicant that mast submit nmltiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address"the applicant should write"all-locations in (city-or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related fo any business or commercial venture (Le.a dog license or permit to burn leaves-etc.),said person is NOT requrired 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 Depatrment's address,telephone-and fax number;. • . :�be�on�mo�x�Q�Massaeh�setts Department of Eadustdal Aotidents Office Q.f Investigatia 600 Washingtm Sfta Bost,MA 02111 Tel.##617-727 4900 W 406 or 1,977-MASSAFE Revised 11-22-06 Fax#617-' 7-7749 WMass.gQvJdis i 02/14/2012 15:53 FAX 5086722997 DIAS-INSURANCE 0 001/002 rE CERTIFICATE IS ISSUED AS A Nb4TTER OF I FORIVIATiOM ONLY AND CON NO WGHTg UPON!oRDE E1FICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND EXTEND ORALTER THE COVERAGE AFd E POLICIES BELOW.T HP3 CERTIFICATE OF INSURANCE GOES NOT CONSTITUTE A CON1R�ACT BETWEEN SSUING INSURER A ORIZED REPRESENTATIVE O,Z PRODUCE AND E CERTIFICATE HOLDER,RTANT. Iftl1eCerilAcs�holder qBApp�ONgLINSUREC,te pq y{�)must tf SUBR00ATION IVED. ataatl t b ttfo terms mtrdl6oro of f>b t R tWr poYd■s mar nequlrs snd A stmentent rbrh�doom not conkff b the to holder in Iloj aFem. PRODUCERmwbrasmem Dhm Insum=Apmq Ina Fail Rirsr.MA 02r21 i COMPAMEB�PORDINO Q� INSURED COMPANY A OR�WITE STATE INSURANCE COMPANY. Pddss CombuoNon Inc 14W Wacmftr ft A'321 ' Frsmkygmm,IIAA 01702-OM THG M TO CWPYTMAT THe:POUCIMS OF INBLRGVNCt Uffp 8ftM VA'E WSH PTO THE INBURW NMEDA50VE FOR THB POLICY PERIq KWATEM NUr WrrHerA ANY REOU#63MERr.I P M OR Cif TON OF ANY CONr'RAOr OR OTHER DOCUMENT WRH PMPBCr TO W}QCH THIS OWNCATE MAYOR=UED O:t MAY PERrAK THE BMSURANCE AFFORMO THE POUC85 MWaBW HERON SMICT TO ALL THE Tom.02WrOW AND COM OM OF MZH Pam.UWTe emovm MAY HAW.NM FEW=W PAID MAM. L7R 7MCFMW �dICY t � lA�f W_nW GAW EMPLOMIft e P LIMTTS � mi d n 43VI22 2l20l2D11 PJ2A 12 �Mo r�rs toa�op�a„oy. Aixmlri e t,00 ' U 61AO CERTIFICATE HOUIER dmcELLAIION CAPE CODE REMODELLING LLC amagpmroRTtisaovt raMWGMCa"b a M ATTN;RICHARD AVERY COVATtoN oNne �/1 pA pd ®NACC�DAtK POROX2418 wfrrsns�Pocmra ana MASHPEE MA ONd AtlTtIORII.ED REPR783BMrATNd �VE Town of Barnstable , Regulatory Services r SS Thomas F.Geiler,Director 59. Building Division Tom Perry,Bnilding Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma as Office: 508-862-4038 Fax: 50&790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, Cf SAIJ PrS6 , P as Owner of the subject property _ l Pay hereby authorize a A to act on my behalf, in all matters relative to work authorized by this building permit (Address of Job) **Pool fences and alarms'are the responsibility of the.applicant. Pools are not to be.filled before fence is installed-and pools axe not to be utilized un 4 all final inspections are performed and accepted. Signature of Owner / Signature of Applicant sq,-Sqvi 14 A y Print Name Print Name Da Q:F0RMS:0Vft4 ERMISSI0NP00I S ;1aU0PNItU UU_) . .. � .mil ��"�'•- ! £LQZlSL/L :uol;ejidx3 � 6tb9Z011W'33dHsvw _ me X08 Od 018. t VLM so :asua3n asuaal� 20stnuadnR uogan4suO .P.irpurIS Pur.xui�11r1�i321 Dulplmg Jo P irog �uauilard ngarsxr.1� -►laP'$ ly d 3 tion valid for individul use only ./�lahucae s_ License or registry office of 'ns 4 before the espira6on date. I'.found Busretiness to:Regulation HOME IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business Regul VCGORmjistration: A52049 Type' lop arkrlawk-=Suite 5170. Expiration: 6%2012 Ltd LiabTity CoTPoT Boston,MA 02116 D HONK . RICHARD AVERYi4�; _i . Al 116 ANTLERS SHORE gam= out si atnr �E v Not v. with E.FALMOk1TH,MA 0 � �' Undersecretary , �1 0 • Q 14'•0" G y II •�ti —ridge � II 1,:4"arm"•.+• � � A 8 I i exterior wall 61 'b I �v II G skylight locations TBD I I II •� GARAGE L - = = = _ _ _ - A I II I sunroom roof over I framed on main room I 4 c� - - - - - - - -•- - - - - - - - - - - - below\.. - - - - - - - c— +y/ II II II II DATE .. 02/19/12 DRAWING 0 Copyright 20 'PLAN VIEW NO. Daniel A.Sylv.r ver 1 OFi`2 Chatham Drafting&Design Service ^ $CALE,8/I6,•P•O' Cl PROPOSED SIGHTS FOR A �OO��N SI�DD�I CN- 29 AMANDA CT., COTUIT, MA• SCALE AS NOTED NOTICE ridge exterior wall�l Renovation plans am based on framing details compiled from a cursory survey of the existing structure. y As all existing framing details and/or irregularities can not be ascertained through the survey,some on site adjustments may be necessary as work progresses.It is the owner/contractors responsibility to O Nidentify and effect such adjustments to the plans or structure. existing rafters @ 16"O.C. dbl.exist. hangers ridge y� exist.collar ties �I b new hdr./plate.under exist.rafters(�3 16"O.C. Iz ' I I new dbl.hdrs. RAFTERS(TYPICAL frame box for skylight ^I exist.ceiling joist N petition exterior walls yJ tz �. new hdr./plate existing ceiling joist @ 16"O.C. exterior wall U o dbl.exist. hangers 14'-0" CROSS SECTION (TYPICAL) new hdr./plate.over a F I I NOTE: CEILING JOIST(TYPICAL ALL DIMENSIONS,OPENING SIZES, DATE LOCATIONS AND FRAMING MEMBER 02/19/12 APPROPRIATENESS TO BE VERIFIED BY TYPICAL T A T? OWNERICONTRACTOR PRIOR START DRAWING Copyright 2012 by 1 1 t IC LLJ FRAMING OF PROJECT. NO. Daniel A.Sylver SCALE, 1/4".I'-0" 2 OF 2 Chatham Drafting&Design Service PROPOSED SKYLIGHTS FOR B 29 AMANDA CT., CL/ My. MA. SCALE AS NOTED �I1RESS PERMIT Town of Barnstable *Permit b a �� of TF�T� 012 Expires 6 months from issue date Regulatory Services Fee 1. TO Thomas F. Geiler,Director NSTABLE Building Division Tom Perry, CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town:bamstable.ma.us Office: 508-862-403 8 Fax: 508-790-623 0 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number ` 9 a Property Address _ Z ! J1 �r YnA j-bA �.r,U j [,Residential Value of Work�` DQ Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Contractor's Name Cl Ak-D al+ V Lr Y Telephone Number �56P 9SCJ Home Improvement Contractor License#(if applicable) ,5ze �'( 7-6 .;�4/ Construction Supervisor's License#(if applicable) g 17 7 ❑Workman's Compensation Insurance tt Check one: I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Worlanan's Comp. Policy# Copy of Insurance Compliance Certificate must accompany each permit Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going-over existing layers of roof) ❑ Re-side #of doors 7 (Replacement Windows/doors/sliders. U-Value i (maximum .4-4)#of windows Q— f *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License & Construction Supervisors License is requir.d. [GNATURE: 1WPFILMTORNIMbuildmg permit fnrms\E)TUSS.doc :wised 070110 .. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 600 Washington Street Boston,MA 02111 . www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): . Address: City/State/Zip: / ./L ' 492" Phone.#: <�669 Are you an employer?Check the appropriate_bgx Type of project(required):' 1.❑ I am a employer with .4. I am a general contractor and I employees(full and/or part-time).*. have hired the sub-contractors 6. ❑New construction . 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition workingfor me in an capacity. employees and have workers' y p t3'• 9. ❑Building addition [No workers' comp.insurance comp.insurance.#' required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions q ] 3.❑ I am a homeowner doing all work officers have exercised their l 1.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees.[No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. =Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site.Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page'(showing the policy number and expiration date). Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and a allies of perjury that the information provided above is true and correct» y Signature: Date: 0 l� 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#: U Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person.in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receivei-or trustee-of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced,acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for,the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contiactor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit maybe submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves-etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone-and fax number:. The Commonwealth of Massachusats Department of hadustrial Accidents Office of Investigations 600 Washington* Street Boston,MA 02111 Tel ##617-727-4900 ext 406 or 1-977-MASSAFE Revised 11-22-06 Fax# 617-727-7749 www.ma.ss.gov/dia 02/23/2012 10:30 FAX 5086722937 DIAS-INSURANCE i%11•,. Z 001/001 2/ 21 /2012 4 : 35 : 11 PM 8975 M 02/05 CERTIFICATE OF LIABHATV ITT,DURANCE OZ ;2"' n. Tax: C�XT%ZATD ZV iwotm Ae A, MA771M or i=ronraszow aimw App cowtime ro mxmftts crow Tm cmRrsrxc&m ROLDER. rasa cuomzrzcwm 1: Does .or Arr xwxveLY on ■Et�xv=T =01M I MBED OR ALTER 99G C01'MG9e Arroaaao Hs T= POLYCxEa 50LDV. sere Czz1rxIrxC3Vx OF =N9VAArCE DO"- R02 cavprxlrwm A CONTRACT lNTW'Mw THE IOOV$a 991MM"18). RUTHOM= REV0rJasrrATlva OR VADDUC2M, AIM THff C1A=ffZCAdx ADzama- nwDAr11T: rt tDe cartii Lento holden 1. aq ARDQTSONAL I2972=, tb. 2olloyttea) mumt ba antl0=sed. it auea,DMTIDN xv DAIVBD, mmd3j.at to the Ce�a antl a0e tlattona O•l "m pox lay, OeLtAln poliolod may R.c moo An endaraemeat. A weat.a.nt on lhi. saOCllia.ta derma not muter mlahta tO the eerttf1dAte Ooidea in liw or ■uOt1 endoraamant le). v�l. ..cT Was =asuzaneo ]►venoy Inc 535 Brayton Av=uem wG... ant. wG.Oaf. val7l River, M& 02721 A.I.M. MUtuA1 Insurance Co 337313 Prides Cs[astrsiC'l10a Izlo 1400 Wozca tmr =toad #7321 , 2'ram1agham, 1ai 01702 Bruhn alaao>R mtmam COYiRMC6 Cmf=ffxCAWm BOMBES, REVISION mrmalk: •ea [s m owe Aaeva ■ Na1r_:e:�lOM asr ImODMMEMST, MAE as CMM=a Or An omm=a arRM On ate Wm am.— TOT=m 9533 Cm==rs amr HE xis®as my 1ST1Yr, M iM===A COXIM Mr ate WCZM=U 02=LMW NZ81Nb =a saaoca to ay.aw-=a, NIis.onn AM COMM"" O, on,,jawwmxa. A3OG2D mum cur snr. me 1®voao 1T ram czmm. me rocses noes evna�art WoMm am TWM ar$ar[wo m� L man OGOlA06 • ❑Qa .fm[Ab qv L[A VZi^21 ❑❑:-KA1,11 ❑r9cm a®eb (a.q w s.amu a ❑^ .vim.a a.7v,s • var'L AGamcGia LiM[i aws[u mu Ejramac[ ormWom❑sac FwLwt•. Cde1t/atl • Avzwrmas raaxzrrr Sao[ . ❑— 1•. taaaeacl (__]Q Wa[Awr(m m9mlti aa� Iv nr^wa.l v 131MA6U Aatoa fpemacar.y Orr r.— ❑ a ■ mm..ccA yru oaea[ man xem� a ❑ammo sum ❑ wen.er .aameA[. • ❑]sG0[7'Stst a �>D[a[tJA i • HOSOGIM �OHi'CILa atF im Orr a Z33LLXZLTM �,c AMe.►.maa raa,rn • 1,D OO,00 0 A mzt0 iw:l ❑ exeL 7025460012012 02/20/2012 02/20/2013 W.L. .saaa-C&Xsa t.m. a y,Daa,000 a.a. /ifaam-■►taw®■ a 1,000,000 CAPE COD REMODELING. LLC. RICNARD AVERV P.O. Box 2416 MABNPEE, MA OZ649 CELL: (506) 956-7373 CPpZIFIr_k= HoI2mm CAlQCE=JJaTION WM COD RbZ=LIWG I.GG a® fa ANY OF TW ABOVE DZBCZMMM VOa.==S M CMMC=- OQOae mm ow immm Was i81�Or, omr m V= Iwo D1i,TV1mw MR A�Q wow RQ 93 w3maO LANE aR VOA ar omwxom.e, Cmi lERVILLS, WX 02532 aant loan WWI M.a[i.s 215 3 6'd 09LO 9titi 909 -0�� '6wjepowe�j po0 ede0 -�auois.!wcuu.). £LOZl :uo!lendx3 �� / 6b9Z0`dW'33dHS` V4 g0rz X08 Od Jlb3Ad 1 QayHORI 1LU�B s0 :asua:), asuaoll a0s.n�adn uolg�nd;suo� ur.su)Ilr.l s ►n r► �ru8 LI. -I. rpur.1Sp n,�a ,�ulpl. 8PlIrS a1lynd.4►►luiwwardaa -�13asny�rssr.I.� *c aIA , aaaac�u!vedd. License or registration valid for individul use only ulahoo. ": ! before the expiration date. If found return to: Office�Cons�ume Affairs&Business Reg . HOME IMPROVEMENT CONTRACTOR Type, office of Consumer Affairs and Business Regulation 152049 10 Park Plaza.-Suite 5170. Registration: 4t• , Ltd.Liabil•�ty Corpora 02116 Expiration: :7#26%2012 Boston,MA. CA COD HOMES f21MQ0EC . + =fir , - R,CHARD AVERY,\ = y ANTLERS SHORE ? -f :. 116 ANT Not valid without signatur s.. E.FALMOUTR,MA 0253G UoHersecrefary t .,r �TME Town.of Barnstable Regulatory Services MASS Thomas F.Geiler,Director sbsq. �0 ' Building Division- , Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barmstabie.ma.us Office: 508-862-4038 Fax 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder Zf HArid A-56J ,as Owner of the subject property - j f - l P Pay hereby authorize a' c hA�IJ 1� to act on my behalf, in all matters relative to work authorized by this building permit I'J d�- Cam_ CA ����- , M A . a (Address of job) Pool fences and alarms-are the responsibility of the applicant. Pools are not to be.filled before fence is installed and pools are not to be utilized untA all final inspections are performed and accepted. Signature of Owner / Signature of Applicant ��s�� l�fuSv� i�tC:Y�AtL'C V Print Name Print Name DatL QFORM&OWNERMERMBSIONMOIS 21o. ne Assu-ntt> T.F _ /25 � y O T` PL A Al .� SCA L E 1 4q '. 5E iiVG LOT — AS o2ECOeDED /N ;2EG/STeY OF CO) • � f-�LA•� t3ooK 2 9 Z /�/�fG�E '2 rf TLi'A T 7 A/E ST2vCTU2E 5/--/OWA-1 A-lEeED/v N os�a WAS L O CA TE D O/v..Ty On/ p W H W G �O- .2E6.I-A1\./D SU2VEyO .DATE BAYS1DE SURVE-Y COOP? 89 W/LL0kv Sr YAk-M01:/TNP02T Ma. �L,ycQ�.,, /-/v.ZZ �Fo.eNiE.e�y G.eOwE�t TAYGO� ct�,e.�o.2ATiJ.vJ i y ' c3oL� oN •' /�O 'f 20. oo N a w {V. T.F = L i 3O 2 y PL 0 T--ALA /V _ L 0 C A T/ ON SCALE 1 BE LOT 3,2 _ 68 'y A5 .2ECO,eDED /n/ AEG/SreY L�'� 25' OF DEED5 �8A2/vSTABLE CO� I�LiaN 800.E z 9 Z ""lr.E 2 7 �.zEs�••• r 2�'1CNiNG-• Jr ".1ERF£3y` CE,2T/FY 7-;'-1A7- TAIE ST.eUCTUeE S1-10WA1 /-/ eE0A/ � of�ass�, WAS LOCATED ON THE GROUND c. ti or" _ /5' o li FRAIJK G� ON WHITING /J �v N.. 29869 Q' .2EG.L A ND S U.2VE y0 DATE 9 GlS7�G� l0 do �� BAYSiDE SURVEY CORR SUR 89 W/LL0kV ST. 'IAleMOUTA4P02T MA. .EL.yCQv.� /-/ZZ �FoeM6e" C.eowec.Z-t TgYGOe C2�e�02Aric�v1 TOWN OF BARNSTABLE 2r 81019 Permit No. .----____-- t �, Building.Inspector r , Cash •eo S.39 OCCUPANCY PERMIT Bona _ h A! "No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to SaT1dim J. I ays Address 1; lot j9C) Z9 Ama—rida C.ourt, +Cotmit t Wiring Inspector g i f .. Inspection date Plumbing Inspector , 1 Inspection date Gras Inspector ', /r- t1 Inspection date Ire :Engineering Department—</ � I � a 3 < Inspection date 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. 191 Building Inspector s map and lot number_ -/� ... . ......z ................. 'i THE 4rmit number ...0... ............... .............. SEPTIC SYSTEM MUST INSTALLED IN COMPLI STAMLE. : l4ouse number ...................oZ7............................................... WITH TITLE 5 90 t639- ENVIRONMENTAL CODE MAY TOWN OF B A-R N S rXMIELATIONS BUILDING INSPECTOR 17 70- APPLICATION FOR PERMIT TO,�&/4-; ....qlwi'�4%e..... ...... .............. TYPE OF CONSTRUCTION ...OAQ 6,/......,"X_ 40�4 P............................................I............. ................................. ....................... 7...........I 9da. TO THE-INSPECTOR 6F BUfLDINGS;- The undersigned hereby applies for, a permit according to the following information: Location *%%a........4-R.-WOW....e,061,11?7 ........ ............................................................................. ProposedUse ........................................................................................................................... Zoning District .....leZ.,5 . .......................Fire District ..... ..... Name of Owner ..........--/ ...............Address .16"16 A_41-"joa7� ... "Ile .............................. ...... Name of Builder.��10&.... Ud...................Address .......... Nameof -Architect ...................................................................Address .................................................................................... Number of Rooms ....4 .............Foundation .................. Exierior6K6:.............................................................Roofing .................................................... 4 Floors ... ......................................................Interior ............................................................ --Heoting—._'.X_'//zd.....4115 y......0.//........................................Plumbing ..PeeE/1. Fireplace ......14 rleI4 4... ...................Approximate Cost .................. ........ . ....... Definitive Plan Approved by Planning Board -----------------------------19 Area ..... ...... Diagram of Lot and Building with Dimensions Fee ... a 0 ...................................... SUBJECT TO AP(LIOVAL OF BOARD OF HEALTH rj 'o- 9'< C14.i> I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name . ..................... .. ... . ......... YS, SANDTRA J. ....8.9.2... Permit for ........... Single Family Dwelliag.............. Location Lo.t...#.3.0.1. .2.9 Am I7lCda...Cnurt Cotuit ............................................................................... Owner .......Sandra i ................................ �...................... Type of Construction ...EXAMP.......................... ................................................................ Plot ............................. Lot ................................ Permit Granted .......Ja.nua.ry. ...1.2........19 81 ..... ....... ..... Date of Inspection ................... 19,00 Date Completed ........ 19 ........... ..... MPERMIT REFUSED .......ME. ......Q . ......... 0 t..Iae.. .. . ... ........ .......................... M (r . .. ... ....... . ...... ........... ............... ................................................ Approvedu ..................................... 19 .. .......... . ... ... ....... .............. ........................................ Assessor's map and lot number wage Permit number .6� .............................. . 33AR3ST LE, BUILDING INS.PECTOR TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Zoning District .... 14 Nome of Builder ~ �_-'~�7 ' /�4/��--�r.._-Address'�� a/��/ .....�~-~. ------ '~'_--�--.--'�-----.--------. Nome of Architect ----------------------A66res .............------------------_____. ' Number of Rooms -------------------.Foun6ohon A0'« .. '' ______ ���� Exie,ior� `l������/�--------------------'RooGng .... ��4 Floors ' 4��?l2�----------.--------|n/orior `����'�����!----------__________. Heating ' -���\/--///�------i-----'Mum6nQ '/. ------._--------___.. , \ | Fireplace ...... .---_--ApproximoteCost . ���/�/�_,______,___,_., ` Definitive Plan Approved by Planning Board l9--------. Area ....................................... --'_-------'^ � ^ � Diagram of Lot and Building with Dimensions Foe _____. _______^_' ' � � SUBJECT TO APPROVAL OF BOARD OF HEALTH . ' . � T , ' . ' � ^ / . r- ' «^ li ��� � . � � I hereby agree to conform � ' to all the Rules and Regulations of the Town of Barnstable regarding the above � /�� '���� Name .�..���Z�»-._....�.-.—'_,`�.:,' ....................... / _-'- - - -----_ -- ----- _ - - - HAYS-, SANTNRA (jE5-3 D6 J. No 2.2.8.0.9.... Permit for ...Qrl.Q...5.tQXY......... Sing.1g�JEATail.y .............. ... ...D.W.ell.jag............... Location ....LQt;...)4.3..Q...29..Amanda...Court ...................CQtla.t............................................ Owner ......a4Ad:r.,A...J......Hays....................... Type of Construction .....Fr.am P........................ ........................................... Pilot ............................ Lot ................................ Permit Granted .......January/U.....19 81 ................ Date of Inspection ...................... ..............19 Date Completed .............. ...................19 PERMIT REFUSED ..................... /.............. ... 1.9 I......... 40....... . ........... ... .......... ............................................................ ................... ............................................................................... ............................................................................... Approved ................................................ 119 ............................................................................... ............................. ...............................................