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Home My WebLink About0010 CAP'N CARLETON'S RD / O - 'n C�,��--� _�«. Otr Application number..R.—tq........................ Date Issued....................�.. .......... ......... ....... MASg t63 Building Inspectors Initials......... ....... .... ............. Map/Parcel........ ......... .... .. ...... MIAMI T- IJAKIVS I-ABLIE 1 G� P TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: Nokls, o,4 dU14/B STREET VILLAGE Owner's N S/ ame: -A e- 171 Phone Number---V 0 ly /3l�YI -115 Email Address: Cell Phone Number Project cost $ OW 0 Check one Residential J54 Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: 4xt,�A- o d Date: TYPE OF WORK E-1 Siding ED Windows (no header change)# F-1 Insulation/Weatherization El Doors (no header change) # Commercial Doors require an inspector's review- 1Z Roof(not applying more than 1 layer of shingles) Construction Debris will be going to Y,,f&,WeC, 7'-4 k CONTRACTOR'S INFORMATION Contractor's name:?.ed eZI-Z El A.I. ff Q- Home Improvement Contractors Registration(if applicable) # /o ,3 7 / 4/ (attach copy) Construction Supervisor's License# 7 (attach copy) Email of Contractor C C-Om Phone number re 7? ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER ....................................................... � *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides? Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Check one: this event is a: for profit non-profit event °k 2 Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am--9:30 am or 3:30 pm-4;30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT'S SIGNATURE Signature - Date All permit applications are subject to a building official's approval prior to issuance. The Commonwealth of Massachusetts Department of1'ndustrialAccidents . I Congress Street,Suite 100 Boston,MA 02.7..14-20I7 www Ynass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORIT Y, Applicant Information Please fript Legibly Name (Business/Organization/Individual):T'CLU_A .-F -i C-)VLF Address: j City/State/Zip: Phone#: Are you an/employer?Check the a,•propriate box: project(=eq_:uired,):� Type of 1.©�m a employer with LL—emnloyees(full and/or part-tune).`f` 7. New construction 2,Fj I am a sole proprietor or partnership and have no employees workitig for me ian 3. Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.❑i am a homeowner doing all work myself.[No workers'comp.insurance required,]t IO❑Building addition z,❑1 am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole I Ln Electrical repairs or additions proprietors with no employees. 12.E]Plumbing repairs or additions 6. 1 am a general contractor and I have hired the sub-contractors listed on the attached sheet. These sub-contractors have employees and have workers'comp.insurance.t 13. Roof repairs6.Q we are a corporation and its officers have exercised their right of exemption per MOL c. 14 they op 152,§1(4),and we have no employees.[No workers'comp.insurance required.] r *Any applicant that checks box',I must also fill out the section below showing their workers'compensation policy information. 'Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors trust 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. t I aiii au employer that is pr•ovidiiig war"keys'conipeiisatiori iiisitrance for my eitiployees. Below is the policy and job site itiformation. Insurance Company Name: i Policy#or Self-ins.Lic.-M: w C 6 3 L S 3%� 6 L �0 a2U Expiration Date: Job Site Address: !b ��--� /k) e-CUV I-e�r)S City/State/Zip: jv LT 1AA- 0_2,k,3,5_ Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c,'I52,§25A is a criminal violation•punishable by a fine tip to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification.` I rlo hereby certix under the pains anal penalties oj'perjuiy that the inforination provided above is true and correct. Signature: /� ( % �G � Date: t r Phone'1- J�t/a —�I2' - rl Official use only. Do not write in this area, to be completer)by city or town official. City or Town: Permit/License Issuing Authority(circle one): 1. Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person:. Phone : i The Commonwealth of Massachusetts Department oflndustrialAccidents 1 Congress Street, Suite 100 Boston,MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information / Please Print Legibly Name (Business/Organization/Individual): Address: (C ) 1 P X 1 Aj S City/State/Zip: MA 0265Sphone#: Are you an employer?Check the a ropriate box: Type of project(required): 1.AV a employer with / employees(full and/or part-tune).' 7. New construction 2. 1 am a sole proprietor or partnership and have no employees working for the in g. Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3. 1 am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10 E]Building addition 4 f❑I am a homeowner and will be hiring contractors to conduct all work on my property. 1 will ensure that all contractors either have workers'compensation insurance or are sole 11. Electrical repairs or additions proprietors with no employees. 12. Plumbing repairs or additions 5.F�I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.Q Roof repairs These sub-contractors have employees and have workers'comp.insuranceJ _ /� 6.Q We are a corporation and its officers have exercised their right of exemption per MGL c. I ther /?z`l/t('op 152,§1(4),and we have no employees.(No worker'comp.insurance required.] *Any applicant that checks box KI must also fill out the section below showing their workers'compensation policy information. 'Homeowners who submit this affidavit indicating they are doing all work and then hue 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 whetter or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I arc an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: G /�L` %L/ �i y/�� C)A C l� Policy#or Self-ins.Lic.#: W C 5 3 f S 3 D to Ur —7O b�0 Expiration Date: all 0 I Job Site Address: i C F� ZI�C�Q��r//�s' e07,t`, rM f -eP G3,5 j /�� City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine tip to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. { I t10 hereby certi raider the pains and penalties of perju►y that the information provided above is true and correct. Si nature: aS.5 6e Date: /'r Phone#: 50C —of 2 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#: R I I 01/08/2019-Hicinbothem Residence-Proposal(cont.) PPPW— SONS,INC. Project: John Hicinbothem-Hicinbothem Residence - 10 Captain Carltons Road — Cotuit,MA 02635 (508)314-0892 i l :�_:::'_�_:^:`•fir: "a- �.. I Terms and Conditions Mark your selections,sign and return to contract. Payment schedule-1/3 due with signed contract, 1/3 due when job is half done,1/3 due upon completion. No deposit required on jobs under$3,000 Credit Card payments over$3,000.00 subject to 2%convenience fee. Price valid for 30 days unless otherwise noted: 1 hereby authorize the following items Payment due upon receipt of invoice. Thank you for your business! R IN 0 800.00 B.PREFERRED ROOFING:$17,250,00 WATER SEAL CHIMNEY:$750.00 Amount Signature ate i o Paul]Cazeault&Sons Roofing-P:508-428-1177-F-508-420-4555 Cleon Theodorides-P:(508)428-1177 -cazeaultroofing.com 1031 Main St Osterville,MA 02655-1537 4 4. • A6�Z CERTIFICATE IFICATE OF UGL-"aMILI 11 13NSURtiANCE DATE(MM/DD1YYYY) �. 11/07/2018 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 endorseinent(s). PRODUCER CONTACT NAME: Linda Sullivan DOWLING & O'NEIL INSURANCE AGENCY PHONE E t 508 775-1620 1FAX IA AC, C No: E-MAIL ADDRESS: Sullivan@doins.com 973 IYANNOUGH RD INSURER(S)AFFORDING COVERAGE NAIC# HYANNIS MA 02601 INSURERA: LMI INS CORP 33600 INSURED INSURER B: PAUL J CAZEAUL T&SONS INC INSURERC: INSURER D: 1031 MAIN ST INSURER E: OSTERVILLE MA 02655 INSURERF: COVERAGES CERTIFICATE NUMBER: 334821 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCEINSD POLICY NUMBER ,POLICY MMIDD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES Ea occurrence S MED EXP(Any one person) $ N/A PERSONAL R ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: PRO GENERAL AGGREGATE $ POLICY JECT [71LOC PRODUCTS-COMP/OP AGG S OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED (AUTOS AUTOS INJURY N/A BODILY Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS per accident $ UMBRELLA LIAB OCCUR I EACH OCCURRENCE S EXCESS LIAR CLAIMS-MADE N/A AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION Y.I STATUTE EORH AND EMPLOYERS'LIABILITY Y I N ANYPROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 A OFFICER/MEMBER EXCLUDED? I NIA N/A N/A WC531S386670028 08/10/2018 08/10/2019 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 N/A DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. 'This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date Of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/lwd/workers-compensation/investigations/. 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. AUTHORIZED REPRESENTATIVE Daniel M.Crooly,CPCU,Vice President—Residual Market—WCRIBMA @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD t l oot 0 1 'o 'ii l= :2' +7PI:'�l;.a��; ''{f �� !;iri• r...��. iO3i �ai115•ir_._ .:ai:,=riiii , i, -t" :�a'�: _ -. _._._ ;,c . ,; ; :iir- LCa i'IOR�:,.Pc�teisraiidtl�e�sx�r•e ��►;�Sry ?r��l�rsrisrar of StrildingRegutatinos and StMim,ft RUSSE L CA2EA� y 2071 MAIN S'iA � Vt Commissioner - 7n Y` Ol;I{;a,, Of' ('.','0nSurrvc.:;r E-aaa,{S 2nw1 Bulsiniess a ]n1.J- , UC1S't0,'], � 8I.s:: 1Cr 3L 15C-tr:S iD. "a0m.-', )n?. rovemel-1?:411(ln':y'a'C O y' i i Lj�SSi%tii0 1 Type: Co~Porabon Regisira'ion: '10371 PAUL 3.CA?EAUL i u SONS, INC. E"pira'ion: 07/08/2020 '1031 MAIN STREET OS T ERVILLE, MA 02655 ...._._.._....._..e.1.suaaIe Aid ss. inej e a.irr i Ga.,d. -.•Y.- j f.:/f-rtf,� ©F ice of consume.Ava;r Business Regulation s IrJV1E flill?-111-1 OVEM DI i Cory--MACT�t P Regist-ation VaNd for'i idividual use on?lt TYPE,�Coraoration befase ifle expir_lon-tote. 11 sound vefulm-b:i: c ;^_•aaiscra C zi�� ti=Uisa��on 1,;;: ..e of Ger,,samer AWairs and i;.ssin2ss RLguiallon , 07/08/2020 1000iPdasningfon Steal-Suit 710 PAUL.1_CA%EJLi=__� ais l�sic. Boston,itilA 021'l l F'USSELLCA7EAUL�Tc — '1031 i�j]AIN S I RECT. OSIEP.VILLE,NIA OZo55` `J— �` 1fr �lo'`s vafld vv*U la VL9�l?'i:�;ice Undersecretary o l.'Stu 3 itiik 1180 l;i 698-556 Nt,erl..5fla:(50 ) 1177128-1 T?e. f?s, !KiJ'J 'e,:-eT: ;z,9. ... ..7 ra•;1i !l4'1 ,7 F 497 This Forrrii t n- ff I(!yf)s5 g a Roofer I i (print) A D l� Y� � -finer A as i0io 1'h of the sukieorl proowly hereby autho rizes Paw i, �'azeault Sofa��;�ofsr�� ;t~>?�a �-- - to act on my behalf, Ith all enatterrs relative to work authorized by this bu l��9ng permit application for: A ddress of Job ,/D CA /070!�11,V C14 �� t�C. Co/o 17- pa-635' Signature of Darner - MailingAddress of Owner_/p � ylir ems's, d �-r, 3 -�s— Telephone # - D � '/ '�' D -100 92— Date 1 cF Please return this form to Paul J. Cazeault Roofing along with your signed contract. It is needed for us to obtain the building permit required by your town to complete your roofing project fax#508-420-4555 office@cazeault.com HICINBOTHEM 7025277413 p.2 j JOHN R. HICINBOTHEM 10 CAPTAIN CARLTONS ROAD COTU IT, MA 02635 CELL P1101NE: 1,08-314-0892 EMAIL: JIIICI\QOrlr'�-AOL.COM -e 00 May 8, 2014 Jessica Rapp Grassetti, President Barnstable Town Council Thomas K. Lynch, Barnstable Town Manager Ruth Well, Esq., Barnstable Town Attorney Thomas Perry, Barnstable Building Commissioner Re: 91 Captain Carltons Road., Cotuit Ladies and Gentlemen: I am unable to attend Friday's meeting with the Board of Directors of Landfall Association, and l wanted to express my concern about the appalling situation at subject premises. It is most disturbing that a member of the medical profession.and a member of the association would flagrantly violate applicable law and association covenants by conducting a commercial enterprise for his own personal gain. This enterprise is not only illegal but poses a threat to the personal safety and well being of the community, and residents relv on Town officials to keep them safe. While it is frustrating that not much progress has been made in terminating this enterprise in over a year, it is heartening that the Bureau of Substance Abuse has prohibited treatment sessions at the residence and that To«vri officials will meet with the association's directors tomorrow. My hope is that the meeting will be productive and result in a game plan for bringing this matter to a successful conclusion. In this regard, I offer the following thoughts for the meeting. • identify violations of state and local laws and regulations that are allegedly violated and. determine if there is any disagreement between Town officials and the directors regarding same_ Identify the association's covenants that are allegedly violated. Determine what actions Town officials might take to address these violations, including those which do not involve litigation, e.c. revoking certificate of occupancy and approaching the medical licensure board. a Determine what actions the association might take to address these violations and verify that any required procedural steps required by the by-laws have been taken. ® Develop a game plan of next steps for Town officials and the association. Thank-you for your cooperation and assistance in this important matter. Very truly yours, /n l _ TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map—a, Parcel C Application # o7Q a 1a q9-- Health Division Date Issued Z Conservation Division Application Fee S� Planning Dept. Permit Fee i !3 . Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis `Project Street Address 10 A P 'Al 6 A R 16-tot/ 'S OA 0 Village C04vi Owner f1� L 1 Al D�"j'l�}� J O N N AA/D Shc�e%Address �� EA90u� �/BUJ RU 1Na}y l!��p Af Telephone Permit Request R e mo d-i I 4-we ex ii n h y 6J'Ql S — cull xiir?e Af rw 6,o rli,sr 0 Je(PHP 0OrI 1�50 11 13A-T# - Amw gix4w X iuwti el Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District 9 G Flood Plain Nu Groundwater Overlay Al0 Project Valuation 30i oty, Ud Construction Type IV669 Lot Size U+ 9 6.0 V Q Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family CY Two Family ❑ Multi-Family (# units) Age of Existing Structure iI Historic House: ElYes ElNo On Old King's Highway: ❑Yes ❑ No O Basement Type: All 0 Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new d Half: existing I new Number of Bedrooms: existing 10 new Total Room Count (not including baths): existing 60 new First Floor Room Count Heat Type and Fuel: ❑/Gas ❑ Oil ❑ Electric ❑ Other Central_, ir: ❑Yes ❑ No Fireplaces: Existing P New Existing wood/coal stave: LLYes ❑ No ,� o Detached garage: ❑ existing ❑ new size— ❑ existing ❑ new size _ Barnf existing❑ Hera size_ co Attached garage: J existing ❑ new size _Shed: ❑ existing ❑ new size _ Other.:) -In d 0- Zoning Board of Appeals Authorization ❑ Appeal # Recorded 0 c Commercial ❑Yes ON& If yes, site plan review# o Current Use I?15 0 e4-ri AI 11W Id f 4M '1 y Proposed Use /4 r+ftj y 00 M APPLICANT INFORMATION (BUILDER OR HOMEOWNER) , Name G�1Z� hUJi�A hyj, Telephone Number 1�011F Address 16 of Nx W-f ewa/ R e License # 7 y4 y o (UJ Co-N41 MA Home Improvement Contractor# f 00 7 0 Worker's Compensation # W 13 6 9.a1 321 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO U#ji(a ?VAJf,& fAWN ul4k /14A SIGNATURE DATE FOR OFFICIAL USE ONLY t 'APPLICATION# • DATE ISSUED =' - MAP/PARCEL N0. - ADDRESS VILLAGE _ OWNER DATE OF INSPECTION: 17 \' FOUNDATION FRAME r� INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL ` PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT 4 ASSOCIATION PLAN NO. i The Commonwealth of Massachusetts Department of Industrial Accidents - Off-ice 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): C AP 1 2_Z_i 14 6 rAC- :rrn pp., e ye 1na1y T T_A� c Address: I e vv4-c;�::� p 6+ `'f' ' City/State/Zip: � �"V r ° fl'1;°� �'�� Phone #: .�Gj� �� lS� Are you an employer? Check the appropriate box: Type of project(required): 1.[2 I am a employer with 4. ❑ I am a general contractor and 1 6. ❑ New construction employees(full and/or part-time).* have hired the sub-contractors 2.ElI am a sole proprietor or partner- listed on the attached sheet. 7. Q, Remodeling a,6.9ThU ship and have no employees These sub-contractors have g, ❑ Demolition working for me in any capacity. employees and have workers' 9 ❑ Building addition [No workers' comp: insurance comp. insurance.$ required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.El am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §l(4),and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#1 mul 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: .14 5j 0 r fl��E� rp�e �v' rNduR'JNE Policy# or Self-ins.Lic.#: "G O 1 3e 'R a 1 3 ;J Expiration Date: Job Site Address: 1 0 C4 er, (4ile 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 ci.•il 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 unde he ' ns andpenalties ofperjury that the information provided above is true and correct. Si ature: 7 Date: U 310i1At7oz Phon6#: °� c19 Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/Lic6nse# 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#: Client#:47298 CAPIHOM ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 12/28/2011 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 Karen A Walther,CISR Rogers&Gray Ins.-So.Dennis NAME:PHONE 508.760.4630 FAx 877.816.2156 AIC No Ext: ,A No 434 Route 134 E-MAIL South Dennis,MA 02660-1601 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# 508 398-7980 INSURER A:Nationalrang Grange Insurance Co. INSURED CapIZZI Home Improvement,Inc. INSURER B:Associated Employers Insurance INSURER c:CNA Insurance Companies Capizzi Enterprises,Inc. 1645 Newtown Road INSURER D: INSURERS: Cotuit,MA 02635 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 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. ' INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MMIDD MM/DD/YYYY A GENERAL LIABILITY MPB1075H 6/08/2011 06/08/201 'EACH OCCURRENCE $1 OOO 000 X COMMERCIAL GENERAL LIABILITY PREMISES(ERENTED hnce) $500 000 CLAIMS-MADE FXI OCCUR MED EXP(Any one person) $1.0 000 PERSONAL&ADV INJURY $1 000,000 GENERAL AGGREGATE . $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: G PRODUCTS-COMP/OP AGG $2,000,000 POLICY jEO- LOC $ COMBINED SINGLE LIMIT A AUTOMOBILE LIABILITY M1 M28044 6/08/2011 06/08/201 Ea accident g500,000 ANY AUIF BODILY INJURY(Per person) $ ALL OWNED Ix SCHEDULED BODILY INJURY(Per accident)' $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE HIRED.AUTOS AUTOS Per accid $ $ A X UMBRELLA LIAB X OCCUR CUB1076H 6/08/2011 66/08/2012 EACH OCCURRENCE s5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $5 000 000 DED I X RETENTION$$10 000 - $ - B WORKERS COMPENSATION .QQ1.30221321 12/25/2011 12/25/201 X WC STATU- OTH- AND EMPLOYERS'LIABiUTY TORY LIMITS Ea— ANY PROPRIETOR/PARTNER/EXECUTIVE Y/NE.L. $1 OOO OOO OFFICER/MEMBER EXCLUDED? � N I A EL.EACH ACCIDENT (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1 000 000 If yes,describe under DESCRIPTION OF OPERATIONS below - E.L.DISEASE-POLICY LIMIT $1,000,000 C Surety Bond 70011667 11/28/2011 11128/2012 $25,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) - Carpentry. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE ©198 -2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S75543/M75539 KW ' •' ✓iza-raamvrzeyu�ea�lla d /f�.'ateaefarseG1L Office of Consumer Affairs&Business Regulation Licensee or registration Valid for iudii?3dul use only -� OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration p 7r�p Type• Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Expira `'ram �. Supplement Card Boston,AfA 02116 CAPIZZI HOI:41EA, l +j4C. : - a GAIRY GUSTAFSO�V COlvlf,IMIA 02636 Undersecretary o d without signature �� 41<ts�<tcbuutt� - t?cXt tittrtrnt Of Public S<t€eta i 7 Board of Building Rc=,ttl:tt'st:n. :und Standards' Construction►Supervisor License License: CS 74640 GARY GUSTAFSON 8 SNORT WAY SANDWICH, MA 02563 3 Eipiratioss: t912912012 Tr.- 7058 x v L s Page 7 of 7 CAPIZZI HOME IMPROVEMENT INC. SPECIFICATIONS AND ESTIMATES STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT OWN THE PROPERTY LOCATED AT l 0 C A 9 iN CAk I-e— Teti j-� IN of v MASSACHUSETTS. i I HAVE AUTHORIZED CAPIZZI HOME IMPROVEMENT TO ACT AS MY AGENT TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. I GIVE MY PERMISSION TO LESSEE TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. SIGNATURE OF OWNER: �z/2 </z oar / ell OWNER'S ADDRESS: OWNER'S TELEPHONE: LESSEE'S SIGNATURE: LESSEE'S ADDRESS: LESSEE'S TELEPHONE: APLLICANT'S SIGNATURE: APPLICANT'S ADDRESS: 1645 Newtown Rd., Cotuit,MA 02635 APPLICANT'S TELEPHONE: 508-428-95188 RESPONSIBLE OFFICER: 641%y b UJTi Al exI RESPONSIBLE OFFICER ADDRESS: RESPONSIBLE OFFICER TELEPHONE: PERMT Town of Barnstable. Permit# • `a:� Regulatory Services �Fe'e� ls�remissrredate • BEAM F s 9� 6 f•`e�' BARNSTABLE Thomas F. Geiler,Director Building Division Tom Perry,CBO,.Building Commissioner 200 Main-Street,Hyannis,MA 02601 www.to wn.b arras tabl e.ma,us` Office: 508-862-4038 EXPRESS PERMIT A,PpLICATION - RESIDENTIAL Ojvj.,yax: 508-790-6230 Not Valid without Red X-Press Imprint Map/parcel Number g� C I?roperty•Ad'dress Residential Value of Work_ 17t s-, t`Z Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address i zel Contractor's Name Telephone.Niimber —7*7-/ . 7g- t"�P1 Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner �. I have Worker's Compensation Insurance Insurance Company Name_ 17�C4^&� workman's Comp.Policy# A)(L Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side �J,[) Replacement Windows/doors/sliders. U-Value #of doors (maximum.44)#of windows 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License& Construction Supervisors License is required. SIGNATURE; - The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations _ 600 Washington Street Boston,MA 02111 www.mass.gov/dia Worker's compensation Inset Cur Affidavit:Builders/ContractorsoectridansOwnbers Applicant Information Pie ase Print Legibly Name(Business/Organization/individual): i S , l cityistalerLip:_fNr7JCC + rn IT P.J 7 phone, T / Are You 8n employer?Check the appropriate bos: 1.❑ I am a employer with 4,4 1 am a Type of project(��): employes(full and/or s general O0 and I have 0. New construction P��)• hired sal-oontr�aas listed an ❑ 2. the attached abea.$ 7. I am a sole proprietor or partnership These have g' ❑Demolition and have no employees working for employees and have workers'comp. 9. Building addition me in any sty.[No workers' insurance.$ em�in-required.] 5. We are a corporation and its 10.❑I$erxric�l 1tp8ii3 or additions 3.❑ I am a homeowner doing all weak officers have exerdsed the¢fight of 11• Pkmbing repairs or additions myself[No workers' m perMGL a I52§(4),and 12. Roof repairs insurance required.]t we have no employees.[No workers- 13.❑Other camP•insurance requited.] °A=Y aPp> t mat checks boa#1 mast also su oat me section below showing mere wows' policy intasmetioa ,t Homeowners who sabr itt this affidavit-,Ncaft M are doing aD work and the=hue wade mnaaeomfs tinter submit a aw affidavit iadaarmg sort sub contracta¢s have boa most attarL en sflf&tiozrel abeet stwwrog de name of fhb nab-oonnae�am SUM wbemer or not dose a nfi-bave emplaym,H employees,dmY mast provide rhea wortas'camp•policy®tuber• to foyer drat w prov1&W workers'co» ton uamwtee for mg employees,Below is the paltry andjob sere Imsmuce Company Name: Policy#or Self-ins..Lic.#�� /��{(�J�� Expiration Date Job Site Address:/��l r1 J�i/i.ln C_0 r l e--I'(�'l'e r�.�� t� Attacht Dopy the rage as n ply Page(Jowbg the pof&9 tmmb®'and ezphvd n date).Fa>7me m setme coverage as regttcedfmda section 25A afMGL c,152 can lead m the impose ad cmmiW p of afm cep to$1,5M.00 and/or My Wit,as wen as civil peaaltres in the farm of a STOP WORK ORDER sad a fie of cep m=%00 a day against me violator.Be advised that a Dopy of this stattemrat may be forwarded m the Office of Investigations of the"TA for insaraox coverage va ficaace. I do cv*uadw&e pa* and peaaMw of pwfiwY drat the wornwtion above is rue and eormet. Signme at : Date. Phone#: — Qgrdd use only.Do nerd write is dds area,to be Completed by day or town o8ieial City or Town: /le# Issaing Aud m*(curie am): L Board of Heatlh 2.Bniidimig Dgrartment 3.City/I'own Clerk 4.Ekcbical Iaspedw 5.Plumbing Inspector 6.Other Contest Person: Phone# �W6 APO r M C learv. Cl ok VIP— eau4�a�;ze-- MZ.oLje•S 010s. cla 11 L'P fii d8e Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: '` Office of Consumer Affairs and Business Regulation t Registratior}_ 8688 10 Park Plaza-.Suite 5170 [' Expiraia }# 011 Boston MA 02116 7yPg= Sfertiefit Card [ LOWE'S HOMESCR1#�7C'. t JAYMI RODRIGUfrZ_r - t 136 TURNPIKE RD`;:SQFFE--,100 g SOUTH BOROUGH,+iVIA 0.1 Undersecretary Net-valid without signature t L C. L E. t L . L E I [ ' l • t C L. i . r C L [ C i • v MI ion License or registration valid for individul use onIv �-010E UVIF ROVEMENT CON—RA-TOR before the expiration date. If found return to: Reoistr tion: 1 CC,02 Type: Office Of Consumer Affairs and Business Regulation Expira, .2!7/2012 DBA 10 Park Plaza-Suite 5170 V, Boston,NIA 02116 5 V; HAVEN, Nr 0 2 Not valid without signature 4: i4 s - at Ptjjjji. Et s, i;,fe t is a C3 75153 KENNETH D KENDALL 5 ViCEDEN PLACE FAIRHAVEN, MA M1 9 Expiratic 1 1/12/2613 Ti#: 9095 The Commonwealth of Massachusetts Department.of llndiistrial Accidents Office.of investigations d00 Washington Street Boston, NL4 02111 m4ss.gov/dia. Workers' Compensation Insurance Affidavit: Build ers/Contractors/Electricians/Pl umbers Applicant Information Please Print Lezibly Name (Businessrganzation/Individual): � /O i ` � troP1�,1P l Address: aC-o— City/State/Zip: Phone#:_._ �C�B �a��91� 7[3E ou an employer?Check the appropriate box: I am a employer with. 4. [] 1 am a general contractor and I Type of project(required): employees (full and/or part-time).* have hired the sub-contractors 6. ❑New.construction am a sole proprietorof partner- listed on theattached sheet.. 7, Remodelinghip and have no employees These sub-contractors have working for me inany capacity. employees and have workers' 8' ❑DemolitionNo workers' comp, insurance comp,insurance.t 9. ❑.Building additionequired.] ; 5..E] We are a corporation and its 10.❑Electrical repairs or additior.am a homeowner doing all work 'off cershaveexercised their:self. 11:❑Plumbing repairs or addition y [No workers' comp, right of exemption per MGL surance required:] t C. 152,.§l(4);and we have no 12.Q Roof repairs employees. No workers' 13.Q Other comp,insurance required.) 'Any applicant that checks box fll must also fill out the section below showing thcit workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and there hire outside contractors must submit a new affidavit indicating such. tContradtors 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: am an employer that is providing workers'com information pensation insurance for my employees. Below is the policy and job site 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 fin( 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 thepains andpenalties ofperjury that the informationprovided above is true and correc4 Sip-nature: Date: Phone#: Official Ilse Only. Do not write in this area, to be completed by city or town offrchrl City or Town: Permit/License# Issuing Authority.(circle one): I.Board of Health 2.Building Department 3. CityMWn Clerk 4. Electrical Inspector 5. Plumbing Inspector - ._.6. Other 1 STORE COPY INSTALLATION SERVICES CUSTOMER CONTRACT- MWORK- INT/EXT/PATIO DOOR LOWE'S OF WAREHAM, MA, STORE#2376 STORE PHONE: (774)678-6000 421 CRANBERRY HWY, STE. 100 SALESPERSON: ROBERT SHURTLEFF AREHAM, MA 02571-0000 SALESPERSON ID: 1410318 I Document Print Date: 04/04/2011 This is only a Quote for the merchandise and services printed below.This becomes an agreement upon payment and issuance of a Lowe's receipt,u agree- ment, including the specifically completed pages of this document, the Terms and Conditions included with this document the applicable portion(s) of Lowe's receipt, and any other addenda or attachments hereto, shall be referred to herein as this'Contract." p upon which the entire DOCUMENT INci UpING Tug "TERMc ANn CONDITIONS to npp 12RE aIr•uuuG FLowe's Registration or Contractor License Number/Lowe's Contractor Name we's-Home-Centers Inc-Home - A'HIC NO:: 1486 9 Lowe s Home Centers, Inc.s FEIN: 56-0748358 ----_..____—.-___._.._._ .... .._.-.-- Customer Name S JOHN HICINBOTHEM Home Phone O Customer Address 508-314-0893 10 CAPTAIN CARLETON'S RD. Other Phone L city D COTUIT State/Province Zip/Postal Code MA 02635 Installation,Address T 10 CAPTAIN CARLETON'S RD. O Installation City Installation State/Province COTUIT MA Installation Zip/Postal Code 02635 MERCHANDISE AND INSTALLATION SUMMARY MERCHANDISE SUMMARY 30820 :26SE.8 : STK : 2X6X8 TOP CHOICE KD WHITEWOOD :2X6X8 TOP CHOICE KD WHITEWOOD : CANFOR WOOD PRODUCTS MARKETING -QTY 2 238345 : 2827-8: STK : 3/4X5.5X8 RF EMBOSD PVC TRM BOARD : 3/4X5.5X8 RF EMBOSD PVC TRM BOARD : ROYAL MOULDINGS LIMITED-QTY 5 320717 : F51 SK V PLY 505 605 : STK : BB ENTRY KNB PLYMOUTH (14660) : SECUREKEY POLISHED BRASS RESIDENTIAL ENTRY DOOR KNOB: SCHLAGE LOCK COMPANY-QTY 1 320802 : F60SK V PLY 619:.STK :SN HANDLESET KNOB PLY/PLY(133459 : SECUREKEY SATIN NICKEL RESIDENTIAL ENTRY DOOR KNOB WITH DEADBOLT: SCHLAGE LOCK COMPANY-QTY 1 39683 : PRODUCTCODE : SOS : SOS RB COMMODITY FBRGLS-DORFAB TC : ENTRY/EXTERIOR SINGLE UNIT, 6 PANEL: DOOR FABRICATION SER- VICES, INC-QTY 1 $tore 2376 Project No. 322128468 for JOHN HICINBOTHEM Page 1 of 8 STORE COPY 76804 : S296-SINGLE DOOR : SOS : SOS THERMA TRU SMOOTH STAR : S296 SINGLE DOOR : REEB MILLWORK OF NEW ENGLAND-QTY 1 Materials Price $ 1066.1 INSTALLATION DESCRIPTION Stock or SOS : SOS Door Type : Exterior Select Location : Front Door Select New Door: Single Pre-hung Number of Doors to Install : 1 Side Lights or Transoms : No Hardwood (Mahogany or Oak) Door: No Hidden Damage Description : None Number of additionial...holes_bored_for-accessories-:-None---.-...---._...--- ._..._..._.._._ ...... _.___ ___..__....._....._..---...._...... install-SpecPalized ICA-6r�ise"Hardwa�e�:��No"�� - Install Storm Door: No Lead Safe Practices : No Stock or SOS : SOS Door Type : Exterior Select Location : Back Door Select New Door: Single Pre-hung Number of Doors to Install : 1 Side Lights or Transoms : No Hardwood(Mahogany or Oak) Door: No Hidden Damage Description : None Number of additional holes bored for accessories : None Install Specialized Mortise Hardware : No Install Storm Door: No Lead Safe Practices : No Total Linear Feet of Custom Trim to be Installed : 0 Deliver Door: Yes Customer Understands Scope of the Project: Yes Permit Required : Yes Who Will Obtain Permit : Lowe's Permit Fee : No Additional Miles Traveled over 20: 10 Bring Up To Code Description : None Local Disposal Fee: None Describe Other Work Needed : None Comments: No Comment Labor Charges $ 734.0 Detail Deduction -$ 35.0 Additional Specifications: Notation: Lowe's will not make structural modifications, paint or stain or remove/reinstall security system equipment. Customer is responsible to advise if prop- erty is governed by Historic District Regulations. Additional Specifications: The Environmental Protection Agency (EPA) has requested that Lowe's notify installation customers that a lead based paint hazard may exist in dwellings built prior to 1978. See pamphlet EPA 747-K-99-001 for details. Store 2376 Project No. 322128468 for JOHN HICINBOTHEM Page 2 of 8 STORE COPY TOTAL CHARGES OF ALL MERCHANDISE AND SERVICES where applicable SUB-TOTAL $1765.14 *TAX $ 0.04 DELIVERY $ 0.04 ORDER TOTAL $1765.1 BALANCE DUE ........... ........... II Work is to commence upon reasonable availablity of Contractor which is anticipated to b [fill in date]. Estimated completion date is QS- Z I [fill in date]. NOTICE TO CUSTOMER All items listed in this contract and specification sheet(s) are to be installed under conditions agreed upon at time of purchase and at the price appearing on this contract form. This assumes sound existing substructures, superstructure and points of attachments. Extra labor or material incident to installation necessitated by defective substructures, superstructure, points of attachment, or the moving of fixtures or appliances to be billed at extra cost to custom- er. IF THE CONTRACT TOTAL IS11-000,00 OR LESS Customer must pgyj_n full, CDAELETE THIS S CTION ONLY WHEN THE CONTRACT TOTAL EXCEEDSIUMM. m6ustomer to Pay in Full; OR LJ Customer to use the following payment schedule: (1) Deposit$_to be paid upon signing contract. Deposit should be 1/3 the total contract price; and (2) Payment Of$_to be paid anytime after this Contract is signed and before commencement of installation, I/We-authorize Lowe's to do one of the following(check appropriate box below): Charge my/our credit card for the amount of the payment indicated above anytime after the date this Contract is signed; or J Deposit my/our check for the amount of the payment indicated above anytime after the date this Contract is signed; and (3) Final payment of$100.00 to be paid upon completion of the installation and both parties'satisfaction. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES AND UNTIL YOU HAVE READ THE TERMS AND_CONDITIONS CON- Store 2376 Project No. 322128468 for JOHN HICINBOTHEM Page 3 of 8 STORE COPY TAINED IN THIS CONTRACT AND WHICH FOLLOW THE SIGNATURE PAGE(s). BY SIGNING BELOW, YOU ARE ACKNOWLEDGING THAT YOU HAVE READ, UNDERSTAND AND AGREE TO THE TERMS AND CONDITIONS SET FORTH IN THIS CONTRACT. YOU ARE ENTITLED TO A COPY OF THIS CONTRACT AT THE TIME OF SIGNATURE. NOTICE REGARDING ARBITRATION AGREEMENT FOR CLAIMS COVERED BY M.G.L. c 142A LOWE'S ANDFRBI ETION EBY MUTUALLY AGREE IN ADVANCE THAT IN THE EVENT LOWE'S HAS A DISPUTE CONCERNING THIS CON- TRACT, THAT SU IT SUCH DISPUTE TO A PRIVATE ARBITRATION SERVICE WHICH HAS BEEN APPROVED BY THE SECRET- s�iY OF THE FFIC OF CONSUMER AFFAIRS AND BUSINESS REGULATIONS AND THE OWNER SHALL BE REQUIRED TO SUB- SUCH AS P IDED IN M.G.L. c.142A. f /� BY' -- Date: `i C .....-- o e' en By: L' Date: '7'l r- By: Date: Spouse THE SIGNATURES OF THE PARTIES ABOVE APPLY ONLY TO THE AGREEMENT OF THE PARTIES TO ALTERNATIVE DISPUTE RESOLUTION INITIATED BY LOWE'S PURSUANT TO M.G.L. c 142A THE OWNER MAY BE PERMITTED TO INITIATE ALTERNATIVE DISPUTE RESOLUTION EVEN WHEREE SECTION ABOVE IS NOT-SEPERATELYI BY THE PARTIES, WITNESS OUR HAN S)A D SEAL(S) BE W THIS_O�DAY OF L we's Home Centers In By: (Seal) Print e: ! 9 Address (Seal) Fwner City State/Province Zip/Postal Code Print Name Co-owner or Witness (Seal) Store 2376 Project No. 322128468 for JOHN HICINBOTHEM Page 4 of 8 Insulation Certificate l0 I IV 1�� Number and St eet City &Gep County, Subdivision Lot Number Permit Number Description of Installation ROOF (� Product /"��cE2 Lot Number Thickness (inches) Thermal Resistance (R-Value) 4: Psg CEILING Product Lot Number Thickness (inches) Thermal Resistance (R-Value) Loose Fill Type Brand Name Contractor's minimum installed wight/fl2 lb Minimum thickness inches Manufacturer's installed weight per square foot to achieve Thermal Resistance (R-Value) EXTERIOR WAL Product 101 �l Lot Number. Thickness (inches) ,].; Thermal Resistance (R-Value) zo RAISED FLOOR Product Lot Number Thickness (inches) Thermal Resistance (R-Value) SLAB FLOOR Product Lot Number Thickness (inches) Thermal Resistance (R-Value) Width (inches) FOUNDATION WALL Product Lot Number ` Thickness (inches) Thermal Resistance (R-Value) Declaration I hereby certify that the above insulation was installed in the building at the above location in conformance with the current Building Energy Efficiency Standards. f- 2i Gener I Contractor(Builder) License Number Si natur and Ti .. Date Sub-ab ctor(Ins ion I Her) Lice se Number 01 ✓v LID 20l o Sig a and/Titl IQ Itate I V w' / l✓/T' `Fy�YfIF1ED pLra,_Q A is a BioBased®Insulation Certified Dealer 0B/OBA✓EO � Revised August 2008 mp} lNSL/LAT/ON®,0? A4gED FOAM IN9V� {{j 1 I I tNE Town of Barnstable BARNSTABLE, � Regulatory Services MASS. Building Division !FD MPS m 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 ✓' Fax: 508-790-6230 Inspection Correction Notice Type of Inspection Location /D YA**N ��4%'�F1'vtiS � Permit Number �n (7 Owner Builder14-"71`y�l r ; { One notice to remain on job site, one notice on file in Building Department. The following items need correcting: d J o(� W kf- n L C.V 1XJG- S Y �O i J Please call: 508-862-463.8 for re-inspection Inspected by�cTa� Date �/0 A- (.O T TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ! � -75 Map �. Parcel Application # Health'Division Date Issued O Conservation Division Application Fq Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis Project Street Address l �� (h C G�.ir'2- � n S. Village d Owner �'t7 Y 1 rl �'e ` d � � C 1 CL Ar 192 4 A 4s�s. 4- c+0 ri �s Telephone D8 ~7919 7 Y1 Permit Request a-.kd +7• r `� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 000 Construction Type Lot Size es Grandfathered: ❑Yes ,o If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes N&o On Old King's Highway: ❑Yes VeNo Basement Type: ❑ Full ❑ Crawl Walkout ❑ Other Basement Finished Area (sq.ft.) l Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing Z 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 0 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 a APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name t<� �cZJ S'� T-� 6 P1 Telephone Number d �Z �f Address tense # 7514 �y rCiio) LZ4 kvnt __I�h ;erQV_e-MMf Home Improvement Contractor# /0 0 7� y tZf1.L� Worker's Compensation # 4V X/ Za-V ALL CONSTRUCTION DEBRIS R LILTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY PLICATION# DATE ISSUED _ MAP/PARCEL N0. ADDRESS VILLAGE -OWNER DATE OF INSPECTION: FOUNDATION ��r` FRAME S�P 9/6/lu�ca.�cyv�D �/O tf�o�ta- , INSULATION FIREPLACE16 -+ ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL y FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO:.�- ` r Toma- of Barnstable ' Regulatory SerACe5 sragc Thomas F. Geiler, Director �,�� Building Division rya Thomas Perry, CBO, Building Coxumissioner 200 Main street, Hya ix s,MA 02601 WWIV.town.bamsta ble.ma.us Fax: 508-790-6230 r 'Office( 508-862-4038 PLAN RE VIE W Owncr: C J/16 0�/e%L`_ Map/Parcel Project Address /O' r r'l� o/�S Builder: C The following iter as were noted on reviewing: Wt>Ajel L ex-p • z Fn �iuGi�cr��-- �L G � J�LE • � �r/S �a Reewed by: Date: �0 Y'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): . no e /K t h fi Address: ,�j IV-�W r,. R0 CL k - City/State/Zip: Phone.#: CY Are you an employer? Check the appropriate box: Type of project(required):. 1. a employer with t 4. Q I am a general contractor and I * have hired the sub-contractors 6. ew construction employees(full and/or art-time). ❑ I n a sole proprietor or partner- _ listed on the'attached sheet. 7.)�kemodeling ship and have no employees -`These sub-contractors have g, ❑Demolition working for me in any capacity. =employees:and have workers' 9. ❑Building addition [No workers' comp. insurance comp. insurance.$ required.] 5. ❑ We are a corporation and its, 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their M❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs c. 152 1(4), and we have no i insurance required.] t , employees. [No workers' er :.comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing Peir 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. n/ t Insurance Company Name:_ /v 1�4�-� V A)1:2. Policy#or Self-ins. Lic.#:—A) 32- Expiration Date: ?�J� //� / 2 / Job Site Address: I DCk� � `'P 7�l�J.S' City/State/Zip: f jl/ 6�J S 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of — Investigations of the DIA for insuranP6 coverage verification. I-do her-eby c-ertify ands he a' s-and enalties af-per-juiyLthat-the-infor-mation-prgvid above-is-true-and-corr-ect.Signature: Date: J — Phone#: Official use only. Do not write in this area,to be completed by city or town official, City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3:City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector .6.Other Contact Person: Phone#: _..................... Office of Consumer Affairs&B siness Regulation License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 100740 Type: Office of Consumer Affairs and Business Regulation Expiration: =fi62372012 Private Corporation 10 Park Plaza-Suite 5170 F _ Boston,MA 02116 CA I Z Z I HOME I�.p-F-__(kV:7 C. Thomas Capizzi,yr = 1645 Newton Rd. iA = _E ;" g Cotuit, MA 02635 Undersecretary y ry Not valid�ou �sgate ' >Ttt ..i�tttt.st:tts- Dupa'rilnint of Public Safeli + � Btr�:rd r;-t's;rrilcli,�% d'�i:��?i.latiijrr� �Irs1 �%:Lti[iili•ff:'� Construction Supervisor License License: CS 74640 Re.stri.cted to; 00 ''a-t `s` �}Ala GARY G,U$TAFSON 8 SHORT.VVAY SANDWI.C '"� e sf EA irzai0q: 11/29/2010 MILT Tr#: 7755 ti Client#:47298 CAPIHOM ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE TEIMM2010 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 NAME:CONTACT Karen A Walther,CISR Rogers&Gray Ins.-So.Dennis PHONE 508-760-4630 508-258-2230 434 Route 134 r-M No Ext: ac,No AJL ADDRESS: waltherka@rogersgray.com P.O.Box 1601 CUSTOMER ID#: South Dennis,MA 02660-1601 INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A:National Grange Insurance Co. Capiui Home Improvement,Inc. INSURERB:ACE Property&Casualty Ins.Co Capiui Enterprises,Inc. 1645 Newtown Road INSURER C: Cotuit,MA 02635 INSURERD: 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 kDDL=1 POLICY EFF POLICY EXP LTR TYPE OF INSURANCE NSR POLICY NUMBER MM/DDNYYY) (MMIDDIYYM LIMITS A GENERAL LIABILITY MPB1075H 06/08/2010 06/08/2011 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence s500,000 CLAIMS-MADE �OCCUR MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY I JECT —1 PRO- F LOC $ A AUTOMOBILE LIABILITY M1 M28044 06/08/2010 06/08/2011 COBIKEaccident)SINGLE LIMIT $500 000 ANY AUTO (EaBODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ X SCHEDULEDAUTOS PROPERTY DAMAGE $ X HIRED AUTOS (Per accident) X NON-OWNED AUTOS Uninsured $250000/500000 Underinsured $250000/500000 A X UMBRELLA LIAB X OCCUR CUB1076H 06/08/2010 06/08/2011 EACH OCCURRENCE_ s5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DEDUCTIBLE $ X RETENTION $ 10000 F $ B WORKERS COMPENSATION NWCC45843208 12/25/2009 12/25/2010 X JWWLAas OTH- AND EMPLOYERS'LIABILITYER ANY PROPRIETOR/PARTNER/EXECUTIVEY/N E.L.EACH ACCIDENT $1,000,000 ❑N N/A OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If s,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Carpentry CERTIFICATE HOLDER CANCELLATION 10 Days for Non-Payment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE ©198 -2009 ACORD CORPORATION.All rights reserved. ACORD 25(2009/09) 1 of 1 The ACORD name and logo are registered marks of ACORD #S52549/M52541 KW Page 7 of 7 i CAPIZZI HOME IMPROVEMENT INC. STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT I, D i. OWN THE PROPERTY LOCATED AT to e� IN C'0 ±U' 'r ,MASSACHUSETTS.T 3 I HAVE AUTHORIZED CAPIZZI HOME IMPROVEMENT TO ACT AS MY AGENT TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CUR,THE MASSACHUSETTS STATE BUILDING CODE. I GIVE MY PERMISSION TO LESSEE TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR,THE MASSACHUSETTS STATE BUILDING CODE. �C SIGNATURE OF OWNER: -, OWNER'S ADDRESS: OWNER'S TELEPHONE: LESSEE'S SIGNATURE: LESSEE'S ADDRESS: LESSEE'S TELEPHONE: APLLICANT'S SIGNATURE: APPLICANT'S ADDRESS: 1645 Newtown Rd., Cotuit,MA 02635 i APPLICANT'S TELEPHONE: 508-428-9518 RESPONSIBLE OFFICER: RESPONSIBLE OFFICER ADDRESS: RESPONSIBLE OFFICER TELEPHONE: J> 0 PROP. 14'0 4' ADDI8cp TION -. PROP. 20xl4' r' TANK DECK Q9 O EX. s DWELLING . 06 6g. O 9 0 MBLU 38-51 y <�� 10 CAP'N CARLETON'S ROAD , %p �o� COTUI T, MA PQ� P6. LOT AREA 23,844 SF EX. DWELLING AREA— 1914 SF 'Q EX. LOT COVERAGE= &OX PROP. LOT COVERAGE= 10.0.E '9Q L_39.27 SEPTIC FROM ASSUILT ON FlLE AT THE TOWN HEALTH DEPARTMENT CER TIFIED PL 0 T PLAN HICINBOTHEM RESIDENCE I CERTIFY THAT THE IMPROVEMENTS SHOWN P�,l� OF A(4 Ss9 10 CAP'N CARLETON'S ROAD HAVE BEEN LOCATED WITH AN INSTRUMENT ��`` cyG COTUIT, MA o s DRAWN: RBS SURVEY. ROBE DATE: J"-- 8, 2010 JOB #: E00883 SYKES . y SCALE:1"=30' DWG. CPP No. 35418 EASTBOUND T LAND SURVEYING, INC. P.O. BOX 442 ROBB SYKES, P.LS. DA TE FORESIDALE, MA 02644 REScheck Software Version 4.3.1 Compliance Certificate Project Title: Hiconbothem Energy Code: 2009 IECC Location: Cotuit,Massachusetts Construction Type: Single Family Project Type: Addition/Alteration Heating Degree Days: 6137 Climate Zone: 5 Construction Site: Owner/Agent: Designer/Contractor: 10 Cap'n Carleton's rd Cotuit,MA Compliance:Passes Compliance:7.3%Better Than Code Maximum UA:55 Your UA:51 The%Better or Worse Than Code index reflects how close to compliance the house is based on code trade-off rules. It DOES NOT provide an estimate of energy use or cost relative to a minimum-code home. Gross Cavity Cont. Glazing ILIA Assembly Area or R-Value R-Value or Door Perimeter U-Factor Ceiling 1:Cathedral Ceiling(no attic) 210 38.0 0.0 6 Wall 1:Wood Frame, 16"D.C. 252 15.0 0.0 12 Window 1:Vinyl Frame:Triple Pane with Low-E 56 0.270 15 Door 1:Glass 39 0.300 12 Floor 1:All-Wood Joist/Truss:Over Unconditioned Space 196 30.0 0.0 6 Compliance Statement: The proposed building design described here is consistent with the building plans,specifications,and other calculations submitted with the permit application.The proposed building has been d signed to meet the 2009 IECC requirements in REScheck Version 4.3.1 and to comply with the mandatory requirements listed in RE eck Inspection Checklist. ski) , �� -/ ame-Title Signatur Date Project Title: Hiconbothem Report date: 07/15/10 Data filename:C:\Documents and Settings\Admin\My Documents\REScheck\Hicombothem.rck Page 1 of 4 l REScheck Software Version 4.3.1 Inspection Checklist Ceilings: ❑ Ceiling 1:Cathedral Ceiling(no attic),R-38.0 cavity insulation Comments: Above-Grade Walls: ❑ Wall 1:Wood Frame,16"o.c.,R-15.0 cavity insulation Comments: Windows: ❑ Window 1:Vinyl Frame:Triple Pane with Low-E,U-factor:0.270 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: Doors: ❑ Door 1:Glass,U-factor:0.300 Comments: Floors: ❑ Floor 1:All-Wood Joist/Truss:Over Unconditioned Space,R-30.0 cavity insulation Comments: Floor insulation is installed in permanent contact with the underside of the subfloor decking. Air Leakage: ❑ Joints(including rim joist junctions),attic access openings,penetrations,and all other such openings in the building envelope that are sources of air leakage are sealed with caulk,gasketed,weatherstripped or otherwise sealed with an air barrier material,suitable film or solid material. ❑ Air barrier and sealing exists on common walls between dwelling units,on exterior walls behind tubs/showers,and in openings between window/door jambs and framing. ❑ Recessed lights in the building thermal envelope are 1)type IC rated and ASTM E283 labeled and 2)sealed with a gasket or caulk between the housing and the interior wall or ceiling covering. ❑ Access doors separating conditioned from unconditioned space are weather-stripped and insulated(without insulation compression or damage)to at least the level of insulation on the surrounding surfaces.Where loose fill insulation exists,a baffle or retainer is installed to maintain insulation application. ❑ Wood-burning fireplaces have gasketed doors and outdoor combustion air. Air Sealing and Insulation: ❑ Building envelope air tightness and insulation installation complies by either 1)a post rough-in blower door test result of less than 7 ACH at 33.5 psf OR 2)the following items have been satisfied: (a)Air barriers and thermal barrier:Installed on outside of air-permeable insulation and breaks or joints in the air barrier are filled or repaired. (b)Ceiling/attic:Air barrier in any dropped ceiling/soffit is substantially aligned with insulation and any gaps are sealed. (c)Above-grade walls:Insulation is installed in substantial contact and continuous alignment with the building envelope air barrier. (d)Floors:Air barrier is installed at any exposed edge of insulation. (e)Plumbing and wiring:Insulation is placed between outside and pipes.Batt insulation is cut to fit around wiring and plumbing,or sprayed/blown insulation extends behind piping and wiring. M Corners,headers,narrow framing cavities,and rim joists are insulated. (9)Shower/tub on exterior wall:Insulation exists between showers/tubs and exterior wall. Sunrooms: Project Title: Hiconbothem Report date: 07/15/10 Data filename:C:\Documents and Settings\Admin\My Documents\REScheck\Hicombothem.rck Page 2 of 4 r o Sunrooms that are thermally isolated from the building envelope have a maximum fenestration U-factor of 0.50 and the maximum skylight U-factor of 0.75.New windows and doors separating the sunroom from conditioned space meet the building thermal envelope requirements. I Vapor Retarder: Cj Vapor retarder is installed on the warm-in-winter side of all non-vented framed ceilings,walls,and floors;or it has been determined that moisture or its freezing will not damage the materials;or other approved means to avoid condensation are provided. Comments: Materials Identification and Installation: Materials and equipment are installed in accordance with the manufacturer's installation instructions. Insulation is installed in substantial contact with the surface being insulated and in a manner that achieves the rated R-value. Materials and equipment are identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided. Insulation R-values and glazing U-factors are clearly marked on the building plans or specifications. Duct Insulation: Supply ducts in attics are insulated to a minimum of R-8.All other ducts in unconditioned spaces or outside the building envelope are insulated to at least R-6. Duct Construction and Testing: ❑ Building framing cavities are not used as supply ducts. All joints and seams of air ducts,air handlers,filter boxes,and building cavities used as return ducts are substantially airtight by means of tapes,mastics,liquid sealants,gasketing or other approved closure systems.Tapes,mastics,and fasteners are rated UL 181A or UL 181 B and are labeled according to the duct construction.Metal duct connections with equipment and/or fittings are mechanically fastened.Crimp joints for round metal ducts have a contact lap of at least 1 1/2 inches and are fastened with a minimum of three equally spaced sheet-metal screws. Exceptions: Joint and seams covered with spray polyurethane foam. Where a partially inaccessible duct connection exists,mechanical fasteners can be equally spaced on the exposed portion of the joint so as to prevent a hinge effect. Continuously welded and locking-type longitudinal joints and seams on ducts operating at less than 2 in.w.g.(500 Pa). ❑ Duct tightness test has been performed and meets one of the following test criteria: (1)Postconstruction leakage to outdoors test:Less than or equal to 8 cfm per 100 ft2 of conditioned floor area. (2)Postconstruction total leakage test(including air handler enclosure):Less than or equal to 12 cfm per 100 ft2 pressure differential of 0.1 inches w.g. (3)Rough-in total leakage test with air handler installed:Less than or equal to 6 cfm per 100 ft2 of conditioned floor area when tested at a pressure differential of 0.1 inches w.g. (4)Rough-in total leakage test without air handler installed:Less than or equal to 4 cfm per 100 ft2 of conditioned floor area. Heating and Cooling Equipment Sizing: 0 Additional requirements for equipment sizing are included by an inspection for compliance with the International Residential Code. For systems serving multiple dwelling units documentation has been submitted demonstrating compliance with 2009 IECC Commercial Building Mechanical and/or Service Water Heating(Sections 503 and 504). Circulating Service Hot Water Systems: ❑ Circulating service hot water pipes are insulated to R-2. ❑ Circulating service hot water systems include an automatic or accessible manual switch to turn off the circulating pump when the system is not in use. Heating and Cooling Piping Insulation: l] HVAC piping conveying fluids above 105 degrees F or chilled fluids below 55 degrees F are insulated to R-3. Swimming Pools: l] Heated swimming pools have an on/off heater switch. Cj Pool heaters operating on natural gas or LPG have an electronic pilot light. Timer switches on pool heaters and pumps are present. Exceptions: Where public health standards require continuous pump operation. Where pumps operate within solar-and/or waste-heat-recovery systems. Project Title: Hiconbothem Report date: 07/15/10 Data filename:C:\Documents and Settings\Admin\My Documents\REScheck\Hicombothem.rck Page 3 of 4 r� Heated swimming pools have a cover on or at the water surface.For pools heated over 90 degrees F(32 degrees C)the cover has a minimum insulation value of R-12. Exceptions: Covers are not required when 60%of the heating energy is from site-recovered energy or solar energy source. Lighting Requirements: A minimum of 50 percent of the lamps in permanently installed lighting fixtures can be categorized as one of the following: (a)Compact fluorescent (b)T-8 or smaller diameter linear fluorescent (c)40 lumens per watt for lamp wattage—15 (d)50 lumens per watt for lamp wattage>15 and—40 (e)60 lumens per watt for lamp wattage>40 Other Requirements: Snow-and ice-melting systems with energy supplied from the service to a building shall include automatic controls capable of shutting off the system when a)the pavement temperature is above 50 degrees F,b)no precipitation is falling,and c)the outdoor temperature is above 40 degrees F(a manual shutoff control is also permitted to satisfy requirement's'). Certificate: ❑ A permanent certificate is provided on or in the electrical distribution panel listing the predominant insulation R-values;window U-factors;type and efficiency of space-conditioning and water heating equipment.The certificate does not cover or obstruct the visibility of the circuit directory label,service disconnect label or other required labels. NOTES TO FIELD:(Building Department Use Only) Project Title: Hiconbothem Report date: 07/15/10 Data filename:C:\Documents and Settings\Admin\My Documents\REScheck\Hicombothem.rck Page 4 of 4 20091ECC Energy Efficiency Certificate Insulation . Ceiling/Roof 38.00 Wall 15.00 Floor/Foundation 30.00 Ductwork(unconditioned spaces): Glass&Door Rating U-Factor SHGC Window 0.27 Door 0.30 NA CoolingHeating& Heating System: Cooling System: Water Heater: Name: Date: Comments: 14 oFT KKErqs, Town of Barnstable *Permit# b Expires 6 months from issue date • Regulatory Services Fee EMWSUBLE, v MASS. Thomas F.Geiler,Director �p s639. �� rFo 3. Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 f EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY p Not Valid without Red g Press Imprint Map/parcel Number O &D �— Property Address— .1�1a CA-�o r I desidential Value of Work y� 00, Owner's Name&Address �� t 5V)i elm- 0 0- t n b O o &p firms n Cri•to n Contractor's Name �� - 4 I T l Y)�1(-t)�/�ef)-FTelephone Number 5!06-115-- 1 1-7 a Home Improvement Contractor License#(if applicable) : O 5 couco Construction Supervisor's License#(if applicable) q -s ❑Workman's Compensation Insurance -P E S P R T Check one: AUG 2��7 WIn❑ I am a sole proprietoram the Homeowner haveWorker'sCompensationInsurance TOWN OF BARNSTABLE Insurance Company Name �' `�-�/1Sl}�fgn��' cq Workman's Comp.Policy Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to YRe-side e-roof(not stripping. Going over existing layers of roof) ' Replacement Windows. U-Value (maximum.44) *where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Pro er must sign Property Owner Letter of Permission. provemeut Contractors License is required. Signature Q:Forms:expmtrg — - 1 �Cp E fpk� Town. of Barnstable Regulatory Services 's 13AMsWt4 Thomas F.Geller,Director Building Division - Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508 790-6230 Property Owner Must Complete and Sign This Section If Using A Builder 5 (k `�IG1V1 .;as..0=. er.,ofthe.subjectproperty- ..._..._. .: hereby authorize9mY\"C-. 0 .. :r to.Sct on ny..b.ehal . T— in all matters relative to work authoiized•by.this building.pe=oit•appkationtfor. ( ess.o o s4aztvte of Owner Date Friat Name 8 HOMEOWNER: DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES I authorize Sprinkle Home Improvement to act on my behalf in all matters relative to the work to be performed on this job (i.e. permits, applications etc.) if necessary. a. 4vnZer Lsignature Ton ractor Signatu a 1) .-y 7 Date Date 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/Contr �tors/Electricians/Plumbers A hcant Information s Please Print Legibly Name (Business/Organization/tndividual): t'�(11�-� �0✓Yti�. .�- �(o U "(' Address: a� �aM�� City/State/Zip: .. �Ca dNh�S MPr Phone#: 5 o S -115 -' 111.$r Type of project(required): AVeu an employer?.Check the'appropriate boa: 4. (] 1 am a general contractor and I 6. New construction 1. am a employer with�_* have hired the sub-contractors �—,/ employees(full and/or part-time). listed on the attached sheet t 7• hd Remodeling•"` 2.❑ I am a sole proprietor or partner- Demolition ship and have no employees These sub-contractors have 8• ❑ . working for mein any capacity. workers' comp.insurance. 9. ❑ Building addition [No.workers' comp. insurance 5• ❑ We area corporation and its 10.❑ Electrical repairs or additions officers have exercised their required,] oright of exemption per MGL 11.❑ Plumbing repairs or additions 3.❑ I am a homeowner doing all work myself.[No workers' comp. �c. 152,§Y(4),and we have no l2.❑ Roof repairs employees. [No workers' insurance required.]t . 13.❑ Other camp.insurance required.]. •Any applicant that checb.box#1 must also fill out the section below showing their workers'compensation policy information: t Homeowners who_submitthis affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit in ic rng such tContraectors that check this box must attached an additional sheet showing.the name of the sub-contractors and their workers'comp.Policy I am an employtiOn- er that isproviding workers'compensation insurance for my employees. Below is thepoliey andjob site information. nn ,, -�-�" Insurance Cotapany Name: Ce Policy#or Self-ins.Lie..M U 0 LA Cl 0 I a 061 Expiration Date: 5 Job Site Address: City/StatelZip: 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 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 e pain enalues of perjury thht the information provided above is true and correct: Signature: - Date: Phone# �(� 115' Official use only. Do not write in this area,to be completed by city.or town of kiai City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2..Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. efined as"...every person in the service of another under any contract of hire, Pursuant to this statute, an employee is d express or implied,oral or written." an An employer is defined as"an individual;partnership, association,corpo eti6ii&gi.ser legal deceased emplo Or yer,orb re tWO of the foregoing engaged in-a joint enterprise,and including the leg eP to employees. However the receiver or trustee of an individual,partnership,association or other legal entity,ephp ying owner of a dwelling house having not more than three apartments and who r si n Q therein,Work on such dwelling house dwelling house of another r the occupant of 6e who employs persons to do maintenance,co . or el the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold,the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not.produced acceptable evidence-of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence.of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary;supply sub-contractors)name(s),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 maybe submitted-to the Department of Industrial Accidents.for confirmation ofinsurance 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 appropriatelline.. . City or Town Officials Please be sure that the affidavit is complete and printed legr'bly. 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 appl icant Please be sure'to fill in the permittlicense 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..Anew'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 a'hd should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts . Department of Industrial.Accidents Office of Investigations 600-Washington Street Boston,MA 02111. 'Tel. #617-727-4900 ext 406 or 1-,877-MASSAFE Fax#-617-727-7749 Revised 5-261!05 wwwmi ass.gov/dia xe _am4nowwe� 0/1�� f� Board of Building Regulations and Standards - ; HOME IMPROVEMENT CONTRACTOR _ - Registration: 103757 I Expiration 7/9/2008 I Type Pnyate Corporation SPRINKLE HOME}IMPROVEMENT,,.;INC. Brad Sprinkle 199 Barnstable Rd. = Hyannis, MA 02601 Deputy Administrator f � J � --��e -U�r�iriaaiu�sea`�. a�✓��aa:lar�uiaeC� �� ' BOARD OF BUILDING-REGULATIONS f License: CONSTRUCTION SUPERVISOR ! i " V � Nurn* CS 006643 } 'y E 8/1955 Bi°rthdate 10/0 # , :Expires 10/O8/2007 Tr. no: 66:38.0 a 3Construction -CS, =Y,� Restricted 00 ' BRAD K SPRINKLE 190 LOTHROPS LANE:-. w�'= W BARNSTABLE, MA'-02668 Commissioner CERTIFICATE,OF IINSU' ANCE. ISSUE DATE 05/21/2007 L � _ PRODUCER ^ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND Brycderi &Sullivan his Agency CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE Inc DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 35 Falmouth Road - — ---------'------_.----.--._.._....--- Hyannis,MA 02601 COMPANIES AFFORDING COVERAGE — INSURED— Sprinkle Home Improvement Inc 199 Barnstable-Road COMPANY A A.I.M. Mutual Insurance Co LETTER Hyannis,MA 02601 I/'z,,' S. COVERAGE '['HIS IS TO CERTIFY THATTHE 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. TYPE OF INSURANCE POLICYUNIRER POLICYEFFECTIVE POLICY EX N RATION LIMITS CO TYPE N DATE(MM/DD/YY) DATE(MMIDD/1'Y) G I.NE.RAL LIABILITY GENERAL AGGREGATE $ PRODUCTS-COMP/OP AGG. $ _ COMMERCIAL G FNERAL LIABILITY PERSONAL fi ADV.INJURY $ L =CLAIMS MADEDOCCUR EACH OCCURRENCE r—I OWNER'S C CONTRACTOR'S PROT. FIRE DAMAGE(Anyonc lire) I_1 MED.L•XPFNSE(Anyonepemon) AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT MANYAUTO BODILY INJURY ALL OWNED AUTOS (Pcr person) SCIIEDULEDAUTOS -- _•------- ------------ HIRED AUTOS BODILY INJURY GARAGE;LIABILITY PROPERTY DAMAGE $ EXCESS LIABILITY EACH OCCURRL•NCF -UMBRELLA FORM AGGREGATE_ i OTHER THAN UMDRiLLA FORM —_ 'w�' '-' �' r _ ;_ WORKERS COMPENSATION AND STATUTORY LIMITS OTHER EMPLOYERS LIABILITY X _.-- -- ---- THE PROPRIETOR/ EL EACH ACCIDENT S 500,000 A PARN CRMrXECUTIVE oFFICIERS ARE: 7004943012007 05/13/2007 05/13/2008 EL DISL-'ASE--POLICY LIMIT S 500,000 XJ INCI. I EXCL EL DISEASE--EACH 500,000 L•MPLOYEL• roNln9lsN'I;S/ULSCIiII'TION OF OPERATIONS OR LOCATIONS: . h CERIIFICA'1'C1101'DL'Rn"N t` �grr rCANGCILA'I'10� % : . �6., i >li � SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE BRAD SPRINKLE j' IIEREOF,TFIE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 WRITfEN NOTICE.TU'I'FIE Cf.RI'IFIC.4TIa HOLDER NAMED TO THE LEFT,BUT FAILURE TO MAI1,SUCH NOTICE SHALL IMPOSE NO OBLIGATION R LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. 199 13AIINSTABLE ROAD HYANNIS, MA 02601 AUTHORIZED REPRESENTATIVE I IrngineeringDept. (3rd floor) Map &3 O Parcel . Qsl Permit# vt�p v�Tjl - House# `/f .8 - Date Iss ed — Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) Fee Conservation Office(4th floor)(8:30- 9:30/1:00 2:00) Planning Dept. (1st floor/SchoolAdmin. Bldg.) dInc, Definitive Plan Approved by Planning Board 19 _ e; ' W BA RNSTABLE. ` ' MASS. ' / �FD TOWN OF BARNSTABLE ,�'� ,a,q. , ` ABuildin Permit Application Project Street Address Village Owner Address .Telephone t i Permit Request A-W-Nuff kPbAaA5 'First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ .Ono Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No 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 No. of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name Telephone Number 4 Address License# Home Improvement Contractor# Worker's Compensation#,Sly)0 17l10� i`c�� NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE a��/9`7 BUILDING PERMIT DENIED FOR E FOLLOWI G REASON(S) f FOR OFFICIAL USE ONLY _ PERMIT NO. Z- • k DATE ISSUED !' MAP/PARCEL NO: `\' - \ ADDRESS VILLAGE OWNER P DATE OF•INSPECTION: - - FOUNDATION • FRAME . r. INSULATION i FIREPLACE ELECTRICAL: ROUGH FINAL \ PLUMBING: ROUGH ` FINAL - GAS: ROUGH FINAL , ,FINAL BUILDING b�1TE CLOSED OUT ASSOCIATION PLAN NO. r 2 DEPARTMENT OF PUBLIC SAFETY ONE ASIMUR%N,.PLACE, RM- 1301 OCT 3 1995 BOS_ __ L-,,02108-1618 F . ,F-,Ur-1ON SUPERVISOR LICENSE Q Expires: Birth - c.-;')6325 10/20/1997 10 2 To: 00 -.,,,ZEAU—" Detach bottom, fold sign on !-U1.'--f2 ST back, and laminate license card. I.'T !-!.A. 02655 Keep top for receipt and change of address notification. Restricted To: 00 23407 00 - lone xp rEs: Z4,thdate: IA - Masonry only N!i@/19q7 19!nI1959 !-I - I & 2 Fazilly Hoies Failure to possess a current editior. of th; Nassachusetts State BuiildiDq Code ti is cause for revocation of this license. HOME IMPR.Q-VE,.0"9N—..- Board of B(j ff-4f f.' Y One-A$R, U—I'm Bos Xg -IOME IMPROVEMENT. !C�QN-T- RArT., -,`e9istration �ype PARTNERSHIP ONTRACTOR 714 PAUL J . CA .EASJ INF, SHIP J;+ Paul J . Caz6a u-'-1'*t'-'!- :09/98 22 Giddiaiid� P.— ;--- Orleans MA, -026531' -A SONS ROOFI Qault 4 w a Rd"' nx 278 -02653- COMMONWEALTH OF MASSACHUSETTS DATE(hIM/DD/YY) ACJRD,. CERTIFICATE OF LIABILITY INSU:RANC As.LJ. 2 08/06/97 I PRODUCED THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CE 'TIFICATE Drake, Swan & Crocker HOLDER.THIS CERTIFICATE DOES NOT AMEND EXTEND OR 14 Lot's Hollow Rd. ,PO Box 429 ALTER THE COVERAGE AFFORDED BY THE POI ICIES BELOW. Orleans MA 02653-0429 COMPANIES AFFORDING COVEF 4GE David D Rust COMPANY :Ph_„cNL. 508-255-3212 Fax No. A Assurance Co. of Americ< 'INSURED ----_. -----•-- ••----- --- COMPANY -- •---. -- --- B Credit General Insuranc( Co. i Paul J. Cazeault etal DBA Paul COMPANY Ij. Cazeault & Sons Roofing C F O Box 2781 COMPANY ------- ---- ---- ----- Orleans MA 02653 D CC 1EP..^,ES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE I OLICY PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT •0 WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL• HE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION L IITS LTR DATE(MM/DD/YY) DATE(MM/DDIYY) GENERAL LIABILITY GENERAL AGGREGATE $ 1000000 I n X "I?AMERCIALGENERALLIABILITY CFP25552812 05/01/97 05/01/98 PRODUCTS-COMP/OP, G $ 1000000 i CLAIMS MADE t X1 OCCUR PERSONAL&ADV INJUF. - $ 500000- I •'NNER'SB CONTRACTOR'S PROT EACH OCCURRENCE $ 500000 _ - --- FIRE DAMAGE(Anyone b •) $ 50000 - MEDEXP(Anyonepersoi $ 10000 A-UTCAOBILE LIABILITY COMBINED SINGLE LIMI- $ 'IY A:)Tt.-, I --------'--- ------ L OAI14ED AUTOS - T BODILY INJURY- - $ -- ,GHEDULED AUTOS (Per person) -9RED AUTOS BODILY INJURY - DN•O`NNED AUTOS (Per accident) - - ------ PROPERTY DAMAGE $ GAR;,GE LIABILITY AUTO ONLY-EA ACCIDE ( I$ ':Y AUTO OTHER THAN AUTO ONL EACH ACCIG; 1T 5 EY,CFSS LIABILITY EACH OCCURRENCE $ %1GRELLA FORM AGGREGATE $ 'HER THAN UMBRELLA FORM $ WC STATU• `h' IT OR�:ERS COMPENSATION AND � �-J------�- - C:7.1P'DYERS'LIABILITY EL EACH ACCIDENT $ 100000 - TIRE I'ROPRIE'rOR/ B PART'IERS/'EXECUTIVE R INCL SWC17005900 08/09/97 08/09/98 EL DISEASE•P _---r•: $ 500000 — OFFICERS ARE: EXCL EL DISEASE-EAEMPLO :E $ 100000 OTHER i DEf'^,IF':^'I OF OPERATIONSILOCATIONSNEHICLESISPECIAL ITEMS Roofing CERTIFICATE HOLDER - ;..:CANCEL CATION PEACOCI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANC LLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL E:OEAVOR 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 ON TjiE COMPANY,ITS AGENTS OR 5EPRESENTATIVES. • AUTHORIZE ATIVE r ACORD 25-S(1/95) ©ACORD CORPORATION 1988 I 4 � ' The Commonwealth of Alassachusctts De aritnent a Industrial Accidents P Office811=90920tts 600 N ashin,tiut Street Busto►:, A1aas. 02111 Workers' Compensation Insurance Affidavit slot ion � --s•--•.....��..,....-.---.;,,,,�,._.,......;.,.,,._..�-.,..,__.....-____._ _.-- nplic nforrnat � i'lease PRINT le�tbly !1 y�-I---./' `1 /�/�ly�.A name* /C�Nl I)/C G ill (AKA) A V locations 16 ��/ � /aL/1 /l�L/A Ci N, �� [ l - phones! M 1 am a homeowner performing all work myself. M I am a sole proprietor and have no one working in any capacity ..:.t>...._,..�..-.,•, ; iw�.:r'P_'+ _..•.L'�l•R.m,�,, _ .n'„` '"�.. ..-....---'-�•��.'�.�-_-''...r-�•^4'1--",'^.Y*t�_ rt�-� '.r. ��:_.T..�� `�I am an em lover providing workers' compensation-for my employees work-ing on this job. conmanv name �1 �VC� address: city: /1�1/ 1,77/GCS /�f� ��D phone#: insurance co. /T 1 am a sole proprietor, general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: company n•tmc• address: city: phone M insurance co. policy# r7 .F;;,•r;T'-;R. „• �ilr�{' �N�l Llaf'L . -�'j�C"'L�L.1_G ' .-. ,n:rs:�:•+..::T�+•o�.�^�,r,•s^�:�1!s.Y,•'K �'rT'_rl '�'7�f�/nf3a:'•. 'C." i��.'T4T..".`9.;6Y.•� company name: 'tdd ress' city': phone#: insurance co. policy,# :At add!tionaI'shcef if tit_r!_3—r-1--% _wit r;' a rr �•r� :z:r °� _ �' Failure to sccurt:coverage as required under Section:SA of MCL 152 can lead to the imposition of criminal penalties of it fine up to SI.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP 1VORK ORDER and a tine of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. 1 do herehr cerrift'under the pains and penalties of perjuq'that the information provided above is true and/correct. Si_naturc 0 aj, Date ( —� Print name Phone# _ .' official use only do not write in this area to be completed by city or town official city or tp,*%•n: permit/license# riBuilding Department C]Ucensing[Board 0 check if immediate response is required ❑Selectmen's Office C3Iiealth Department contact person: phone#; MOthcr (wised i,"*11lA) Assessor's map and lot number .. ..�?�� ,., .......... FTNer Sewage Permit number' . :.�.r................. . �......... BARNSTABLE. i Housenumber ........................................................ .......... rasa 900�YAY.a`�0� ' TOWN OF BARNSTAELE BUILDING IAS P E C T 0 R APPLICATION FOR PERMIT TO ... �jL'. .....d11. (,1-... ..... ....................... TYPE OF CONSTRUCTION .CSit ...... .. ..�� .. . • .y!'L. .................. ....a.?........ �9. '1.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...pyLt�.. -�l,,.Q.IL...ax... .....! ..f 'POD.,...... ( ....... . . ............... . Oer/ Proposed Use . ................................... ZoningDistrict ........................................................................Fire District .............................................................................. �� 1 Name of Owner .vl.ftltr�rt/.7........AR1S.�...........................Address ...... . ... ....��... ...... ........................................... 1 Name of Builder . ................Address ....:��I...L2 .o�v ...�"�.;.. .... ... .. . L« Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ..................................Foundation ....................................... Exierior ....................................................................................Roofing ..4.,ka... ..... ....................................... Floors .1.................................................................................Interior ..................................................................................... Heating 1�tt?1A ......................... .................Plumbing ....... 4Lz—AtX............................................................ ........................ . >�v Fireplace ....IaAa-,.¢.....................................................................Approximate Cost .��A.e..................................... .............. ....... i Definitive Plan Approved by Planning Board -----------_------_-----------19_______. Area .......................... Diagram of Lot and Building with Dimensions Fee — - SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. / Name .!'....4 ..ma, ..`... . .......................... PAIlISI, \/I0CE0T ' No Permit permh for .....E.NCLOSIC----. ,____.. ]« Location — . ..I��di---- ...................qptoit___.___________.. . _ - ~, Owner . 'PaKioi.......................... , - ~, Typeuf Construction ...FlZaMe-----'---. -------------------------- . no�Pkz �� ` --------- —`----.��-_--. ' ~9 Permit Granted ................................S teo��ez '7. lg 8I k^ ' --.. Date |n - lg / .r�..~. ---------^�—' . ' Dote Completed ---- — ............ . . .` ^. . . . . PERMIT REFUSED ' ^ ~ ' . ^ . '—^---'------^---------'' ` � ' ----------------.--`.-.--.---. ` ' ' ' '' —....----.--------------.. — ' —. ~--------------..---.—..��--... ^ ' ' ---~.—.—.~--..._.—...--.---.---.— ~ . ` ^ - ' . Approved ---------------- lg ' ^ , -------'------------^--~—'^—' ^ . ----------..—.--------~.---.�� ~ � -�..�.v= Assessor's map and lot number ...... ,�... ... ......... TH E ET�� , Sewage Permit number ..... ........................../...,.,,..�/.G -7.• • ( • Z BAHB STABLE , i 4House number ......................:........................ ......... vo 1639. � pq' i639• CEO NAj a. �Y TOWN �, OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ... r� �Q.....!n�... I`��-..:SL9/ln ,� ... i��P,O fl c. �• ............................ TYPE OF CONSTRUCTION ../.tt +�..0 .....el.;t &s,.A... ?'?! !a !�<. �. cctn. ,...... �!, a a: en- ........... -,. 7 .19. r. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....��rl�-. �. ...{? ....C.I.tt"I.. ......... r�.... <+ ... ..�.!(�.. ...o Proposed Use ...5'rn..,P. n..... CA......... ......:,► a.;a.p :. .. :........................................................................................ ZoningDistrict ............................................................... .Fire District ............................................... :............... ZN`q��m ame of Owner ..Vt•n,��..P...a�(.�......!.�.R•lC.r'.......................::..Address .....(-�4'�i � 0 TLLr�t •....:.................................. t: A JlA.,�i I l! -/ r /L1�.�C.�.Qst..f.:2�...............:. ..o i .�'.F ;!.. ...,1�!?�•..,e of Builder .................... Address ....:�r'1...�.!►..�..�:z..... �.....�f....;..�?::......... ..::. . . Name`�of Architect .................................................................�Address ..........................................................;......................... F1.oundation Number o Rooms ....... ...................................................: ndation ...............................................: ........................11 .. Exterior .................................. • .Roofing �Y� �. �5—)r i� Floors .../.....:...................................... ....................... ".Interior ............... ........................... .................. Heating..:...:...P....................�.:�"............................... ........?Plumbing ...A..�.. n. v:........'.::.................. \....... Fireplace ..:..!..: . ..............................:......................................Approximate Cost ...........// )oay....... ............................... Definitive Plan Approved by Planning Board _____________________ 19_ . Area � .5.`.?.G...� Diagram of Lot and Building with Dimensions '"` Fee � . ` SUBJECT TO APPROVAL OF BOARD OF HEALTH G t r(• ` y 4 � Y'r .b. .�t• 4 {t I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .............::. 23430 ENCLOSE DECK Capt. Carlton Road Location ......t.....-...................-..........-----. -'---.----..C..��gg,t-----------. ' ' Ovvne, -.. ....�arioi________. ] ' ' ��-- ---....�.. Type of Construction. .....EKAMe.-------.. ................................................ ----------' ! � Plot ............................ Lot.---------- | � - � ^ Permit Granted `S el-7.�--]9 81 � Date of Inspection ---------.....-..lQ ` � uon» Completed . � � ' � PlL1ZT ' � 7 ---. lA ^ � . � --------.---. --~----- . � . � ^-._- -.-..^' -------.` [^�� ---''"��'``* --- .. � � ----^---~-^----'^-~^-'—^----'' ' ' Approved --'------------- lg / . � | ' ' � -------..-..-------------.---.. | -----'`-`---~^---------'--~-' . . � Assessor s -map"'and lot number ...............:...........?. ..�..,� `TNE T S,gwage Permit number �. :'.✓.e��.•......G: /..�... EARNSTABLL House number' .......................::................................................. *� 'rb 9 a• TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .. :..........................................0 . . . TYPE OF CONSTRUCTION . " '/�! '�...' t ............... .. . . ..... ................................................................................3 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: t. Location ....�U....... �....1 A.... ......... .................. ................... /1............... ................................... i, Proposed Use ..( ....... ...... ..'... .... .7.. . 7 � Zoning District � .......................................Fire District .. t Name of Owner (/,I/�rl�t/1/ / ��15..�.............Address .........................!/�/,,,,,,�................................. e Name of Builder �!. �......./V�.... `..............................:Address .. U// `...... �............ . ..... 4 Name of Architect ... .......................Address Number of Rooms / l��. �/�/� ....../............�............................................Foundation .. ....... ......1. .�... ..�G:`�Y...... !% .J...�../� f / / .....Roofing .................. .:..... ......................................................... Exterior .L � ................. ........................................ Floors . � X 19 / ✓'��''/�� erior ....... ...............U.................. ............`. ........ ................................... .. .......... . Heating ...... ................................................Plumbing I Fireplace ....... .......................................................rApproximate. Cost ..... /✓.. ..�..................... .... Definitive Plan Approved by Planning Board -----------_______-----------19_______. Area ........ ............. s. Diagram of Lot and Building with Dimensions Fee z- SUBJECT TO APPROVAL OF BOARD OF HEALTH E n r " {5 " 1. 1:. f' i {1 . I 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. / ' G�� ' _ Name ... ........ ............ Una/ 9/�S Construction Supervisor's License ..................................... i PARISI, VINCENT A=38-51 25195 Addition . No .................. Permit for .................................... .........Single...Family..Dwelling................... .. . ..... .... .. .... Location jP...!�. tain Carleton Road ............................................... Cotuit ........................................................................... Parisi Ow' ner .......yinc.ent... .................... Type of Construction ......Frame. ........................ .. .... ............................................................................ Plot ............................ Lot ................................ Permit Granted ....June 15..............19 83 ..................... Date of Inspection......................................19 Date Completed .......*.................................19 Assessors map and lot numb r .. . ................. Sewage Permit number Z BARNSTA.BLB i House number .... �+ �Fa YPY a� TOWN OFI jBARNSTABLE BUKDING " .INSPECTOR APPLICATION FOR PERMIT TO ..G� !..\... TYPE OF CONSTRUCTION .......! ��C... .. ?''L....................................................... ................................. { ........... /.....:..:....... �9 3 TO THE INSPECTOR ,OF BUILDINGS: _ The undersigned hereby applies for a permit according to the following information: Location- ....... .... ... ............ ...�.:.... ......................................... ............... Proposed Use .. ..... .....�.7.. .J ...... ............ ZoningDistrict ..... . ......... ........... .... .........................Fire District ............. .......... ....................................... .. ......... 5Name of Owner 111, !C)l � ..... S .............Address ......... , .......A ... .............. ...... .......Name of Builder All. ..........Address ...�� Nameof Architect ...�1..........................................Address ...............................................................:.:.................. Number of Rooms ...... .........................................................Foundation ../ .......lL� ............................-' ~E� �� .. ......... Exterior .L(%l3�9�i.... Roofing .......... .. .. ............................ . Floors. �.X..I. ....../ .//�. '.........:.. ........ . Interior .... ............................ .... ............ Heating ...... ......................................... . .. Plumbing i ` L _ Fireplace .......�-......................................................Approximate. Cost ................................. . .. ............ Definitive Plan Approved by Planning Board -----------_______-----------19_______. Area ........c�.7; P. ... ........... Diagram of Lot and Building with Dimensions Fee CID ........... ...................... SUBJECT TO APPROVAL OF BOARD OF HEALTH � d OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the;Ton of Barnstable regar ing the above construction. Name . . .... .... ....... ........................ . Construction Supervisor's License .................................... PARISI, VINCENT �No 25195 Addition .5... Permit for .................................... SiRgjq...FaTijy Dwelling................ 10 C.2k4FE& Carietonj,.2�ad location ........................... Cotuit ............................................................................... OwnerVincent Parisi .................................................................. Type of Construction .....F........ram...e .. ........................ ................................................................................ Plot ............................ Lot ................................ Permit Granted .....J.uae....L5.................19 83 Date of Inspection? 97.......................19 Date Completed ............... .........19 i-• r � �rr-�±�'�' ,_..,r_... _-...{�«�•--.*-�.•..�.,�...--..,.T...;..,r.=M i'+ �.'- -••-_ _QT^T-rw+�-- ---r—-1'�'•-rr•---� i.r-;2'�7cj t cam'--- hI r CCI.� Aoolrlol ' V Till LOT r A 1ON - 14 -' �' 'ti • '•"- .. " . ,: •Q •V' �y �,J°"` t�Fr�'��`�n/ •i1:� .. COY-.7'+"4.�a��" :Y all 7. V w_ is^ '•'Y�^� .. 'r • ^ 'tom +' ��i tf:. •�.� � t• : ,J•��..:•• •l,i i? �.' ,G•r :MORTGAGE �t_;. F. ,-f'•,w� «.� -- SH � -YLDT" PL A N.=PR E-PAgED F'OR =:+ .}" c 'CHARL.ES �� .LINCtjtN � - ..- ,• LOCATE ATs Y - `' �`,i`•''j,��.�`. ��' r +�' . Yno�o CAP'NLE `� s R S CA �. 1 �O' >apT£: _ a` . 1' :1 f , .. _ • • ter• •� t •'•' . .. - .y THIS PLAN HAS BEEN PREPAREL FOR "MORTGAGE POR'POSES ONLYAMD IS NOT'THE RESULT:OFAN DNS "is*' R'VEt .T+e,- y LINES SHOWN HEREON SHOUL-DNOTBE USED TOfSTABLISH PROPERTY 1:1NE,S OR BE•USED F60 .`fl11!$`tEjUG7lflDj;P1URj�OS $,�p + r ' ��. •- �. e' ,. . �i w. •� • .._'fie+ ' I CERTIFY THAT THE BUILDING 1� LOCATED ONTt1E G3i0U11ID AS DEP1C -TiiJ. `LOCATt0k;5 "e A?r,E' APPLICABLE ZONINGORDINANCE D EXCEPT•AS SHOWN .0'-POSSt81f YONl1+t0•N;Ots4�iQN;�TH>~``$UILr�Iq�a WITHINff HE FLOOD - HvA?I R. A All-Ill -t .+tI F:- •Q I .�H S:F-.OM.�. • +�;-'I »�_�. •_'rt+ « •1 Z ;.., \- . �jf I•r�:.•�?....`s:N .1• yC.�J's�.y '�!1•S`' REF' .PLAN BOOK-.#�AGE.t-.[.' h^ Zg :. ,}.� b/..� Sk ASSOC DEED Boat ..PAGE —� � - REGISTRY--OF- OEDS, �_ `� T WAR"-ASS' TOWN OF BARNSTABLE permit No. 2 2 8 2 3 Building Inspector A Cash _-- 639. OCCUPANCY. PERMIT - X ",t-�I b A Bond "No building nor structure shall be erectedrand 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 Donald P. Higgins Address Wareham - #10 Captain Carletons Road Cat-13if- Wiring Inspector - / G/Grfs. Inspection date Plumbing Ihsp ctorl �f, Inspection date Gas Inspector C, ,s-^ Inspection date P -Engineering Department OJVLA�a_ ' Inspection date S / /�a 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. Kv Building Inspector i F-249 r� NOT --I'' t=OR L07 -DtM�--N 510N5 -5EE 5u�to► vIS1 O►�! P1_fiN DATE+� 7- 18- �3 f 3Y CHAiM=5 n 5AV C-P, (, IN(-, 5VRV"Og5 -L C PLA r4 3 4 6 4 2 or- 4- LOT 32 40, ' S 51 -15'- 20" W _ C.5. w, d/h .8G' fnd no' LoT 3 op'. 5 3' Q N -7 I' } �.a 44.E, N Z OLI Q 6� 3G.0 �.o' i a.o NEW FOUNloKf ION �q � LOT 3� O g Q Q (n , ,t ' irl C.8 w. d/h �' J. 9�� 170 - Q 4�'- 14'- 11" W v o CAP' N CAR LETOW5 ROAO s T)LOT PLAN OF- UOT 31 I GFRT(FY THAT THE •FouNOA-riot.I PRG-PARD FOR 5140\VN 15 LOCATED ON THE GRouH0 A`DUEPIGTF-IJ ANo THAT ►T'5 HIE- D GON 5T KU GT ► o N LOAF,T' O N 15 11-A CoN FORM AM6 MTH EX1 5TN G SE-T fbACK IRE-Q- CAP M GARNET o t- S ROAO UiRC—fA&HTS OF THE- TOWN OF- BARN 5TAbLE7, MA5t) 6AR N 5T A ELF Z o f�l F5<-LAu/. �/ % 5CALG ► z 40' BAN 20981 'l f�A 6HAQLE 5 L. RowUEY & A54 G(,l ATE 5 REG. LANo SuPve- ¢¢oR 61 VI E NGINI` >_P\5 & 5URV Yarc'5 - Z-�� \VEST_ \VAR�NAt_ _ M/ASS•- pAT� i Assessor's. ma and.lot number Q�OF THE t0`♦ SEPTIC Sewage Permit number .... . ................ C SYSTEM MUST c� INSTALLED IN COMPLIA � 9HBSTODLE, • , °House number .....................................!................. WITH TITLE 5 9oc ' X"&t639 ENVIRONMENTAL CODE A TOWN OF BARNS ffLURTIONS BUILDING ANSPECTOR APPLICATION FOR ,PERMIT TO ....: -Phu"... ........................................................ TYPE OF CONSTRUCTION ...61C9 . . ................................................................................... ......../..`...... .../..., ................19. TO THE'INSPECTOR OF BUILDINGS: r The undersigned hereby applies for a permit according to the following information: Jj3l Location ... . ............. . ............ ............................................................ Proposed Use ......�.. .... ............. .............. Zoning District .�....~.......................................................Fire District ....... . ............ .......................... Name of OwnerO.OA19L. ... ...1.. `.��/..! .........Address X �/I/��'1..........i J/ .......yo3............ .�.......... Nameof Builder ....................................................................Address .................................................................................... Nameof Architect ..........:.!.Y. ...............................................Address ..................................................................................... 0 Number of Rooms ........ .................................:....................Foundation ....... 6 ................................................ + Exierior .�X !�... ............................................Roofing .......... ... ... .... ....... a ........................ Floors .............................Interior Heating - ......................................................Plumbing ..C ...... ./.r ?% "�-�' r Fireplace ..................................................Approximate Cost y 0 OD . . .............................................. Definitive Plan Approved by Planning Board ----- --------------19--------• Area ...../... ./..! ...� Diagram of Lot and Building with Dimensions Fee Q 7.^ SUBJECT TO APPROVAL OF BOARD OF HEALTH Nip k1V �a 1 I hereby agree to conform to all the Rules and Regulations of the Tow of Barnstable regarding the above construction. � � � Name ...................................... . ............................... L Higgins, Donald P.. st- si Cotuit In Or 0 '--'^^^^^^^~'--''—`^`'^^^^^^^-^^^^^^~`^^ � � � --------'------------^'—^—~—' ' _ __ _ � Assessor's mop and lot number -� ..................... ...........-` ^' | ' � Sewage Permit'number ....................;................................... | � House number '�p� .............................................................. t639- r��-��T�J �� T�� -� �7 TOWN� �� |� ��]� BARNS TABLE �� BUILDING � NN N N �� 0 �� N �� p �� / ��0N00-0NN �� N �� =��N� � NN �� , APPLICATION FOR PERMIT TO ..........'-. ------�..--�..f".�'1'�----..--..-..-.----.----- TYPE OF CONSTRUCTION ....................... ............... , �/ � .........�--._.^-------,l9........ � TO THE INSPECTOR OF BUILDINGS: | The undersigned hereby applies for o permit according to the following information: ' Location ---'----,.-..---_� '--'_.2---._^.'�u--------.�'�..---------.---.--.----., ' ^ Proposed Use ---�..�------.�.....`^-----.^'`,�--.'------------------.--------------. Zoning District ---.!------.-----.-------'Rvo District ---/�-...L--------.---------- | ' ^ � Nome of Owner Add ' ' '.-------------'--------. ,�» -----.-.--------------. � Nome of Builder ----------------------'A66res .................................. Nome of Architect -----.----------------.A66ress ---------------------------- .~ ^� ^ Number of Rooms ---,------------------'Foun6ot�n --------.'.---------------__ . . ' .. ' . Eme,ior .....^' ............ �-.��*�..................................................Roofing --.`�� ^'� / .................................................. ` ` Floors -----�.^..�,--------------------,.|nnahor -�-�/'��-.��...,----------_-_____. . . Heating ----.----------------------'F1um6ing -_ ............................................ / Fireplace --'�------------------------Appnoximone Cos t ................ Definitive Plan 6v Planning Board ^ lV----. Area -'^--`��--�.�. i . . ' � ..� ` --' Diagram of Lot and Building with Dimensions Fee _______________ SUBJECT TO APPROVAL OF BOARD OF HEALTH ^ , - / ^ ' ; � | hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. / ^ � Nome ................................... ..-��-------.-'_, / `�� ^/ | i ^^ . ' ' =g----^ Dona^ ^ . No.---23823 Permit —T l/2 � � �----. . � � � single family dwelling ` ------------.�------e------. ^ � � 10 Cant Carletcoza Road � Location ---.�.��—�--------------.. . � Cobuit ----'----^-----------------' ' ~ Donald P, ' Owner ---------.-n�.......--------. ^ � , . frame Type of Construction -------------- � � Plot ' 81 rc,�v �,onu�, VJ�anu�a ~~'~ ' ~r--- � Dote Completed � | | � . | � / PE IT RE FUSED / Y . ----- 19 "�� . -----.^=="^,�°�.�—.,^��^�m^—:�.-----.. � ` ^—.---.—~...----------.------- � � ' .-----..--.-----....------..~—~. ' ^ � ' —~------.—.....---,---.~.--..—.~ ` �---------------- lA Approved . ' ^ --------~.------------....—.-- � � ------------------~.—.—.—~.,. . � i Af . c LO TO o'"I, Oi BAR,,' ABL `° 4) ca O U j EI > O cn a) 2� r;J� - P-4 3: ?7 � ' o � � oLs co = `Z � 1 DIVIS 0i'i N 7 CL O () U I all trim,casings,rake,fascia and soffit to be pre-primed pine to match existing match existing pitch c CD match existing(asphalt)roof shingles a 15#felt 0 _n a v 2x10 rafters @ 16"oc r 2x6 ceiling joists ai 1/2"CDX ply. o 0 R-38 insulation N .032 alum.gutters and downspouts cont.soffit vent 1I1 ® f� Certainteed solid vinyl siding over Amowrap d 0 2x4s @ 16"oc _ 1/2"C DX ply. O R-13 insulation M c n CC a) 2x10s @ 16"oc .v N R-19 insulation _ 0 L) N y � y o p C oU C p Existing > < Proposed Addition Date: ! 6-8-2010 Foundation Plan/ Deck Framing Plan Revisions: 6-18-2010 6-25-2010 6-29-2010 IMPORTANT 7-2-2010 ANY CONSTRUCTION THAT INCREASES LIVING SPACE BEYOND 1200 SQ. FT. PER LEVEL MAY REQUIRE THE Note:These plans are for the sole purpose and I INSTALLATION OF ADDITIONAL SMOKE DETECTORS. use of Capizzi Home Improvement and are not 4 to be distributed or used for construction other NOTE: A SEPARATE PERMIT IS REQUIRED FOR THE than by Capizzi Home Improvemen INSTALLATION OF SMOKE DETECTORS-THE ' : ' PERMIT 2QEa.NOT SATISFY THIS REQUIREMENT. { c `o v 0) CO CD 0 U a E N o E ass CC", � Cn match ex. O Z rn as _ � CO U pitch ® ® ® N e N 7 V U 0 LLLJ FM c n CO 0 <— Proposed Addition _ Proposed Addition m ai Right Side Elevation Rear Elevation - E m t M � � C � O U R N'yNy f� ffl U t _ �U 0 � p0 C L O ® ® ® ® � Date: 6-8-2010 s I Revisions- t 6-18-2010 6-25-2010 < Proposed.Addition 6-29-2010 (beyond) Left Side Elevation Note .Tf e§�eplan&are:for the sole purpose and use of.Capizzi.Home:_fmprovement and are not to-be,-:distributed.orused'for construction other tharrby`.C.apizzi%FCorrte k.nprovement. 44'-5" •- c Cpri�t��ovs 'S 1'�/.sx7%+ i-w 2=011 2650DII 20500H 26500H 2O H 265WH 2GSWH 2GSODH 265M11 I x& FW-&+S �. -------------- Use 6new" AeU0/L E�o Q�STGsIPS 1 toy i �o moF P s Tb co.'-nNrX-T ry USE St.v%p5av 20' ,N ' N . AC /q raves P8br A^, I piss to 16'-10" 13'-101/2" U G6M �"i! PoSZS 8 " p$a%xiruns U -v Porch $ Dining RoomDECK n I 1p{a�WOOd Ca��alc. C S M11Ne x2o FYa�++ Fly+^ 1 p la�e3• o _ V too o j 1 - C S-RO, IiW 2411 O' step u ! . ' w� u a rn #-dt AWO 15 ►nLabX ' d, °`'p % Sim .� - I coca 5 a�d h@GY'bay t itla�1 u —1 i ' oit (existing slider) remove double-hung s u U door opening to AWLY• I 3,-f 1" b I slap I i remain as is ~ I I island I I (remove door) 1 I'llazy as range _ — L — — — — — — — 1 N nder cab. � icrowave — Kitchen i o� ss9c I t �� MARK A. yc ` susan co I Mom` NZ{� s trash bin { y LEE M/0 NAL ss �� 66 1�r -� Family Room Widttc.IY I 6'-0"wide cased opening Date Date new opening to be positioned 6-8-3 for 2 4"depth @ tower cabinets 20'-9" Revi 6-18 6-25 6-29 7-2-9 i First Floor Plan Note:These plans are for the sole purpose and use of Capizzi Home Improvement and are not to be distributed or used for construction other I than by Capizzi Home Improvement: C tf) 0 C O U O � � m 4 � NE 20 0ZWCo 10" dia. sonotubes w�l8" �°T CU enclose perimeter of porch and y @ 4'-0" below grade ,N r new dining room with cement , �, � o board with stucco finish c, 8" 6 8 + 20' C I _ _ „ .. zit. d 'W Joe, o 4 x6 P.T. post r " dia. gfoot .- 1 a r no s @ 4'-0' 3 belo gra I existing structure at porch I I (to be converted to `= 3-season room) to remain Ave —av - I I o P.T..,2-xes @ 16" O.C. j `° N -C-0 l f4� sP o a V ON c s U N (V U �w. Z Tiw,lec.•loK. n� � �0 (Existing Foundation) c o N OF Atg J 7 MARK A. Date: 6-8-2010 ,o . 39068 ' ��`` Foundation Plan/ Deck Framing Revisions: Plan ass/O��AL ENG\ 6-18-2010 6-25-2010 6-29-2010 •�p,N�Pio410m 7-2-2010 Note:These plans are for the sole purpose and use of Capizzi Home Improvement and are not 3 to be distributed or used for construction other than by Capizzi Home Improvement.