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0036 CLAMSHELL COVE ROAD
/a'� she%/ j G��' � . . Go I/�" ALTERNATIVE , WEATHERIZATION Date Go 3 Town of Barnstable Building Division 200 Main St. :' ;:.;A,c::; �!°::• Hyannis,MA 02601 ; ?; •" The insulation work �" � �,�.•,�_.5�� � =:YYYYYY{(�;yIW '-••. = .. ;,z:•: ::;.;:r>: ;= i 'CMR., ;,1:�•a ':-•�.,;:�•;;:.. .;.. .. �,,_,;�:�, om has been c n completed acco P :�,�:!�'• '.i•::'J:.<�i�;. :.YY.i _.0.,.1 �,v.s .r,_L':.,::i:::�,"•�:., ...i.,- r.:F�{7:: �:•n::Y.i it ,A r J.•�:. \.: ` J l.1•r: ..::n.:.•<:ti•)• ::2'%'i ` ::'.'••;,••.S�'. c-•:{,r":.:•. ,:...r<:`:'?:: .c�✓,•.:`x, othy Ca 7'-*'. 'P J �:?•.;'iF: 1 '`%r�' �"''• ����;f.•. :-:thy- President =k.,�%��,x'•?�;: ' CSL 105454 58 DICKINSON STUE I TALI-KNER,MA 02 121 1 (508)567-4240 I ALTERtdAT1VEWEATHERIZ ON@GMAILCOM ALTER` AT��E WEAT- H-E-R I.Z'AT.(O.N •IG O Date f Town of Barnstable Building.Division 200 Main St. r^ wF.A: Hyannis,MA 02601 � ,.r::,';q::�a; �i_�; ,+•sK,�+;,rr,:., .• ,�,.w/',�;,i- The insulation work at hey, r rny6" `'`� has been com leted.in acc' 80CMR 5�rj' -{r w� .:,y . r Kr 's�iy to �•jp`•:wi�Y,.iY _f�V,'f. Y;(� y�r:�' rl`i < )� ,d'tif'v:-,;.:,I•r."' •!, ;,�!"')-�'''!!`�:; •`r!A;1, :�:`.y;^',.,�„s.i�`'�:4�;_ y'�:•' 'C�. .�C:�`,,.'•'{' as�.p,,.t�"'SO:,•f..:.:, ,y�:��<:'•� O..a�.'�,.+,;:. 'v:> S^'ZYS. :.r ?: f• ':' C, •:'% fy,- �;fi1: rPL- ._ '• 1r;•..',b+� ;'. a.S4.::..i�; f.�:r:y '',y� ?`3 u'•.�.;-� •,i:°� !�•'iv� :'ri-�•�s."',�y.•, ,.:ir'� .15�•,.�ye:r ;�:f.`,51C'4�'.`-'s:' '�•:;��:s°'�f, i�4.ie�xt" .:c.. R•. 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';�4�^ rr 1r��•xa,�� :a ,-�. •ot l a�;:.. a, $,r`ry.,.;�i"it's' .z_.�:'jy(,-��%• 9 L.r',.A��1f' i .� President 'CSL 10545.4 58 DICKINSON STREET I FALL RIVER,MA'02721 (508) 5.67-4240 ALTERNATIVEWEA7t•IERUA,a10N@GM•AI,LCOM TOWN Or BARNSTABLE BUILDING PERMIT APPLICATION , Map Parcel Application #� �- D Health.Division Date Issued. 77 . , Conservation Division BOLD/NG pEP ,. Application Fee Planning Dept. JUL �� Permit Fee •V Date Definitive Plan Approved-by Planning Board T 2016 FBARN Historic- OKH _ Preservation/ Hyannis SrABLE Project S eet Address Aaffi&k A goad Village UI OwnerPMA 1 U�1901 Address S l�tJ Telephone 0g ` -1 - `1 g0 Permit Request IA&HU fl Zi p6n Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation3 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name i U Tele hone Number F 240 ' /' p t S Address 2 L-l� License # 1las�Irl Fa I l 0 ve r, IV A- D Z721 Home Improvement Contractor# / 7W� Email Worker's Compensation # aM2S7-,0 ALL CONSTRUCTION DEBRIS RESULTING F OM THIS PROJECT WILL BE TAKEN TO SIGNATURE 4 DATE FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. 1 � �1. ADDRESS -•-y VILLAGE OWNER DATE OF INSPECTION: ` . FOUNDATION Y ' FRAME E INSULATION I FIREPLACE .ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL s GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. �. Town of Barnstable °4 Regulatory Services " Picbard V.Scali,Director Building Division Tom Perry,Building Commissioner 200 Mam Street,Hyannis,MA 02601 www.town.barnstable-ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, 1 a g l T hI o y t f&g n., ,as Owner of the subject properly hereby authorize WAAZ�M—toact.onrVbehalf, in all matters relative to work authorized by this building permit application for. 3U. s411 C ova IZOPL ( co f-14 i.} K oc pz r 3S (Address of job) *Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature\of Owner Signature of Applicant pq�� C, �oW1PSo� Print Name Print Name �o`d9.�?A16 Date Q:FORMS:O WNERPERMISSIOM10OLS \ The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite.100 Boston,MA 02114-2017 www.massgov/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):ALTERNATIVE WEATHERIZATION, INC. Address:2 LARK ST City/State/Zip:FALL RIVER, MA 02721 Phone#:508-567-4240 Are you an employer?Check the appropriate box: Type of project(required): 1,[E]I am a employer with 6 employees(full and/or part-time).' 7. New construction 2.[:]1 am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity.(No workers'comp.insurance required.) IM-1 am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. Demolition 10 Q Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.Q Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs.or additions 5.0 I 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.: 13.[]Roof repairs 14.D other INSULATION. 6.❑We are a corporation and its officers have exercised their right of exemption per MGL.c. 152,§1(4),and we have no employees.[No workers'comp.insurance required] "Any applicant that checks box#1 must also fill out the section below showing their workers•'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ;Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:STAR INSURANCE COMPANY Policy#or Self-ins.Lic.#:0849257.00 Expiration Date:02/26/2017 Job Site Address: & Omsk � A I City/State/Zip: E /Y_ 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 up to$1;500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify' _ the pain nal s of perjury that the information provided above is true and correct Signature: Date: Phone#:508-56 2..0 Officiat use only. Do not write in this area,to bicompleted 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 ALTEVAEA-01 C ,F TINCATE F LlAMUTY RISMANCE ` 311ma#s T1 ICAM'S AS A MATTER OF MM W!ttX/�t.f olif�Sd![Q�aF!'ESl # PT ttklR�# Y aR AEEGA . Y:A ;.EaM OR At.T'8; .d0-4 EFES EFce 6 frr !s aL floe past be did: if `€i0dt to �a.ems acid eoa oohs ofS poor, l> as Wit. A .oa t�s oesa took o use PRDDVMR NAi� lta h8llason.tnst aaeeAgeacy,Inc. (M)44T46S31 YiJtfatt t12382 •. .. .. aim INSURED a s .Alwaad �e IA on,I= •2!aeA,§bvd D FDA:EE1PBEr �2721 Q E: tSAMER F: cokqmGw TO-CakTfy THAT T K POLXM:.E . . BELOIrV:HAVE BEEN:M 19D TO Tii�It f <�7�1E POLICY�aD MIDtCAT�. Dtf)TtiR [3iSTANDlNG AtdY TEi�i!1 COND1Ti0lt.QF ANY CONTRACTORO tNhT ;€i =1W.CZ:ngs C8MF�►TE MkY•SSE•tS AMD OR MAY,, THE AFFOMM BY THE PCi iqt�. EXGCEiStt lS•AiiFT G F€JOPiS OF`.StJCl.P0110Ei S. fS -MAY K6S B�k'#iEGl3CED•BY PAtD LTR TYPE.GF;B A 'NUM" 1.ms cdolEAwti GSUA c Uoa. m EACKO 5 CLNMS•MADE' OCCUR S MEDiEXP -0OSDe $ PERSONAL8Afl1YNAM S GEN'L AGGREGATE LIMIT APPLIES PER GENERALAGORM43S $ Pouaf a LCC /� 5 �� S At�TOYO�EEUADQM LMT ANY AUTO 'S0b0*?-ftg7RY•(PetPPl—j 'S ALL OVOW ASCU= BODILY INJURY(Pw4=idgnv S WED HIRED AU OS AUf _ S $ UMBRELI ALL48 OCCUR EACH OCR_4 S OCCESSUAB CLAIMS-MADE AGGREGATE S DED. RETENTION S S AND F7Y YIN wx ftadgmq 00 02MAMS 02r2$l2 7 A ANY:. ❑N/A EL.EACH ACCIDENT $ EL DISEASE-EA' ..Bmo S lo Me D TION�FOPERATIONSb8bN .. DE8CW=10E0PERX=NSIL0CATVAMVffAM-(At 101. RmaadsS�A�de,mtYbsa�elndNmoeaEpipist CERYII:ICATENOWER CAI g&6&TION SHO"ANY OF 7•t!E A8ME DETCMM POLN*S M B E. THE E)C4@�3t01i' DA3E' F, �13�fi .�.. IN Natlonal CW d ACCORWAFEUMiii.POL PRE 46 Sf Nam:Mk 01561 AMORMEMPRESENTAIM O'I98.8.2E314 Af.ORD C d• ACORD:�.t2014i01j The ACM no e and Ingo are m&gft!e4 mft of AGGRO Office of Consumer Affairs and Business Regulation r_f 10 Park Plaza --Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 175683 Type: Corporation Expiration: 5/29/2017 Tr# 265489 ALTERNATIVE WEATHERIZATION, INC- TIMOTHY CABRAL 2 LARK ST �' ----- -- FALL RIVER, MA 02721 ---- -- - -- - ---- Update Address and return card.Mark reason for change. Address i- Renewal i- Employment - Lost Card sc'; 0 20ki-05/1I -- — — �— '6rrntPit. tucttl1,V' Office of Consumer Affairs&Business Regulation License or registration valid for individul use only - "DOME IMPROVEMENT CONTRACTOR before the expiration date. 1f found return to: 2egistration: 175683 Type: Office of Consumer Affairs and Business Regulation H Expiration:,; .5129F2f 7 Corporation 10 Park Plaza-Suite 5170 > Boston,MA 02116 ALTERNATIVE WEATI1ERUZ0$3 44 INC. TIMOTHY CABRAL 2 LARK ST ,�t. �>-�• :,_ FALL RIVER,MA 02721 Undersecretary 1 / ; o valid wit ut signatu J .. k 'r. J y ConNiftsiWUN �f Town of Barnstable *Permit# ra` Expires 6 months from issue d Regulatory Services Fee m 1, -- BARNSrABIA MASS. Richard V.Scali,Director 1639. rF0 MA'S Building Division . Tom Perry,CBO,Building Commissioner Mtn 200 Main Street,Hyannis,MA 02601 MoV www.town.barnstable.ma.us TQIn. �4 2014 Office: 508-862-4038 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ON?111 c ( Not Valid without Red X-Press Imprint S4` Map/parcel Number o oG "o o y Property Address 36 C i'AYY)SNeL(_ COUe- 9- C'I C yT U ` k VResidential Value of Work$ _` y 75 00 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address ` 4 U L 1�) � P "t LL 12b ik6 TC12 /k)5 0_7 R 3 r) Contractor's Name cJ fit✓r Telephone Number 4 q 3 14 CIO Home Improvement Contractor License#(if applicable) NlA Email: Construction Supervisor's License#(if applicable) PIA ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ® I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to i3QcffWe4Z& OGS POSA1.. ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ® Re-side © Replacement Windows door sliders.U-Value (maximum.35)#of windows #of doors: �. ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is require SIGNATURE. QAWPFILESTORMS\building permit formskEXPRESS.doc Revised 061313 r s� C`t�mrrxans�eat �of�assaeTtrrs�s Dep=hnmt of hu?ks&ud Accident Offwe oflnvesA..adons 600 Wayh-&igfon,Vreet Bostoq,,MA 02111, wn'ltmass-gowdia '-v:rket-s' ComperisatioxtIusurance davit:$uildeis/Contra:ctors/EIectriciansMumbers pUcant Iuform,afion Please Print r ejxibly Name ct�oan: �Au 3 �C�-Y✓1 Pso� AddreZ36 C L AYYA Cz114 e Ll- C aAJe, R`� City//tat /z�: Cot t W1 A c�26'� 5 o 5 3 / 9 A,re you an.employer?Check the appropriate box: Type of g o ject C_ tn , tT�al contractor and I project(r�e�:: l_El I am a employer with 4 ❑ I am 6- ❑New construaftoa eropIoyees(full andlorpart-time).* have hired the sub-cantraccf m. 2_❑ I a,r,a sole proprietor or partner- listed on the atta6ed sheet; 7- ❑Remodeling ship and have no employees These sub-contractors have g- ❑Demolitcoa working forme in any capacity- employes and have workers' g_ ❑Building addition [ comp-i%=anc I�o wo±Irers' c4nhp:mmtranre e:I 5_❑ We are a corporation and its 10_C]Electrical repairs or additions ',r�slnir ] . officers have exercised their 14_. Plumbing airs or additions 3.'�I atn a.homeotz:n�doing alI vaorlti g� nrysel€ [No uuorb�ss'comp- right of e�empfiaiiper IvfGL 12-❑Roof repairs: aalsItIr nreregM red-I I c_152, §1(4} and wehnnano employees [No workers' 13_❑O.tfter comp_inset-nce mquired.j 'Any sgplicmttextchehs box Cwnstalsofillotxt the section below sh�their®oskers'compensadoupQULTiufone t Hnmecwnc s n-hn submit ffiis�dxvII inmrsti�g mey aze rnimg::IT ttmic a�thea hixug oatlride coatxacmrs umst snbe4rt s air s.�dsrit- .�r=c;,,v.surFL tCbnt:+cmrs Sh.'tt Cb_^ck tb i s boa mmrt 7 adied an at3diUnnsI sheet sbovring the nsm_of the Salo-O(�micl i xnd Stabs whPtler ac=t these maitles have EmpIQyees_ If th e mb<ontixctots hz a empIopZes,the},must pnndde i s mor3ess'cons-poHu number- if ar�art e.:rtpIvyer rhrct i�przrtddirr�r.►ror�ers'corrzperrsrli�.tr iresztrartce for m}enzp£o}:ee�. 3�eZotF is t3te jwlic}acid job sift irifotmafian. • Insurance CompamfName: Policy 4 or Self-ins-Lic- ExpiratiotLDate: Job Situ Address: cityrtstatelzip: Attach a copy of the markers'compensation poling declaration page(showing the policy nuruber a-ad expsation date). Failure to secore coverage as requiredunder Sectioa 25_4 of MGL c. 152 can lead to the imposition ofcriminal pesmtfies of a fine up to$1,50D_QD andlor om—tyeariagrisonment as well.as civil peualfies in fhe form of a STOP WORK ORDEP-and a fine of'up.to!�250.00 a.day ag rest the violator_ Be advised that a cry of this statement maybe forwarded bathe Office of Inrestigatioas of fhe DIA€or insurance coverage verification_ I dri eby crxti reorder tks pqns and penal es ofpedat y thatfhe uiforrrearti¢n prcnii&d abase is bus and correct Simatuz : _ Date: tt 14 201q //_P b �8 `F 3 I 'f �� ell, ©ff ciat use-aril,}. Da.a t write in flits area,fa bs camped by city ar toam officiaL Cite or Town: rm-a itlLicense# L-- i-g-Au-th Ority(OTCIe•:o Re),; I.Board,of$ezTtfr 2.Bu dingIIepartimeuf I Citt'rawn Clerk 4_EIectricallasgector S.P u:mlung LL3pPctor 6.Other coatrcct Person. Phone 9-- 6 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto this stabzte,an ernployee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written-" An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer;or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also si tts that"every state or Iocal licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonweal for an.y applicant who has not produced acceptable evidence of compliance Mth 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 penormance of public work until acceptable evidence of compliance vri'u'r 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 yrur situlati on and,i.f necessary,supply sub-contractors)narne(s), address(es) and phone n= rbe.T(s)along with their cero".Ec ie(s) of insurance. Limited Liability Compa-ies(-LLC) or Limited Liability Parti:iers)ups(L.LP)with no employees other than the members or partners,are not rbgi-1 red to carry workers' compensation i;1sli amce_ Han LLC or LLP does have employees, a policy is required, Be advised hat this affidavit maybe sitbr itted to the Deparbment of Industrial Accidents for confirmation of iL,-qnencz coverage. Also be sure to sign and date the affidavit 'I1re of davit should be returned to the city or town that the application for the permit or license is being requested,not the Deparanent 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 he number listed below. Self insured companies sn.ould enter their self-insurance license number ou.the appropriate lme. City or Town Officials Please be.size that:the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fi11 out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/lc-ease number which-,,Ube used as a reference number. In addition,an applcant that must submit multiple permit/hcense 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"ail 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 he applicant as proof that a valid affidavit is on file for future permits or licenses. Anew anfidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT requied to complete this affidav~it The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a czll_ The Department's address,telephone and tax number. The Comman •ealth of l Iassachuce s Department of Indust W A.ccident_s Gff Qe Of IuVeStigafit&ns 600 Washington Stre.-et Boston_MA 02111 7,IL A 617 727-4}QO w 406 or 1- i 4 SAFE Revised 4-24-07 Fax 617-727-77A'a <r Town of Barnstable Regulatory Services t - 9anxivsrwsteKAM g* Richard V.Scali,Director �1Dr16 .39.�A Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) ''Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date Q TORM S:O WNERPERMISSIONPOOLS Town of Barnstable Regulatory Services ��of TOiryy Richard V.Scali,Director °^ Building Division Tom Perry,Building Commissioner 1619- ��� 200 Main Street, Hyannis,MA 02601 CFO MA't A www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION DATE: Please Print i ��p �V pp rr�� ((�� JOB LOCATION: C L hmsw� cDoe P—D C DTU 1 7-- number � strut village "HOMEOWNER":� U1- `�-}�YVtPSy'Vl � 11g3 )qgo name e A, home phone# ^ work phone# CURRENT MAILING ADDRES (�S: 1 1 V L(3AS' A)T � (L L a J city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. U DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling, attached or detached structures accessory to such use and/or farm-structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. _ 2Theunigned'I owner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection re and that he/she will comply with said procedures and requirements. Signature of Homeowner ;Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,RuIes &Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems, particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit fonns\HXPRESS'.doc Revised 061313 °F r Town.of Barnstable Permit# Expires 6 months fro . ' ue date Regulatory Services Fee BAIMSTABIZ v� ass.1e39. e� Richard V.Scali,Director filly� ATFD��a � - - -- __-=-��rd=i7►g�3vi=si-on . Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY DV e r9O15 Not Valid without Red X-Press Imprint Map/parcel Number `- ce-�V, Property Address , CLANSWeLL e0vf- � . ®Residential Value of Work$ 5©� Minimum fee of$35.00 for work under$6000.00 -Owner's Name&Address PAU L 'T\4c)wp5 0,tJ C( 1 piC A S PT }-1\1_,(-. Nt> C 4 L°-STeV_ r)T ©r?q 3 o Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Email: _ Construction Supervisor's License#(if applicable) rcn .❑Workman's Compensation Insurance 1 i; 28 Check one: ` ❑ I am a sole proprietor I am the Homeowner ���NSTABL' ❑ I have Worker's Compensation Insurance TOVYN OF Insurance Company Name Workman's Comp. Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑ Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side Replacement Windows/doors/sliders. U-Value _(maximum.35)#of windows WI tj o u SPO S #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 061313' Tha C`amynaniwa i qf-Uassachrmeffs Department of huLqs&itr1 Accidents 60,0 Wa5*iNgtOM-StreelBoston,MA 02MI, W Ft"19 r.7n asm goi-Mi1� ',orders' CompensationInsi=nceAffidavit:Builders/,antr-actorslE.ecfricians/PTumbers Applicant Iufarmation Please Print Legibly Aid,,-,,-- 3 ra C LQ� N S a-fo C,t302 P City/�tafx-JZip= UTUITvmA 1443 jqqD Are you an employer?Check the appropriate box: r T ct ( 4_ ❑ Ii ary a,geoezal contractor and I �of�o'�e ����- 1.❑ I am a employer with 6_ ❑New canstrucGoa eniployees{fall andlor pant-time}* have hired the sub-coniracf m- listed on the attached sheet; 7- ❑Ran dehag 2_El I ezn a sole piaprietor or partner- ��sub-contractors have sb n and bade no employees g- ❑Demolition -zrorki ng for ma in any cape �r_ct emplo}e�and have workers' 1 g_ ❑Building additionWo•-, fn�ranr rorkers' comp_ e comp_msurassce 1 5_❑ We am a corporation audits 10 0 Electrical repairs or additions officers have exercised their lip_.❑Plambi additions3.�I am a homernfin�doing all work- >;repairs or addition myself [No work-rs'comp- right of ex�empfionper MGL 12.El RDof repass iSimn-a=e required]t c_ 152, §1(4�and we hsve no employees.[Na wDricers' 13_.❑other comp_msnxance required.- 'Any snnr:c�zit dixt cbed:s boa 191 mast slso MI.ozrt the sectioa below shawhxg mew xoiRen'CompeensRdou pair aa:R]nm-6azi- l HomeownE:s xw submit dvs sffidx inr'Kcstk9 they are&mg wR rrudc sad t3ien hire outride coatracmrs psi submit a new zi5dnft mdies a;sarFL rciuntoiccmrs gist 6-ck this bwc must sttac}ted wit addict ns xad state xhet e[ocnn.i ttmse? hies 1ixm aamlayec-s_ iifthe srk{oatmactnts tree einpI gees,tfiey nnot pnr iue tt-� woriess'comp-policy number X am art HeLow is thep4&cy and job sift informa69 rL Lns�ce CompamyName: Policy N or Self ins_Lic-�F- Expiration Date: Job Site Address: Cib'J'Slafe nap= Attaciz a copy of the Ts-orkers'compensation polity dedarstiou page(shovrin;the policy rramber• aid expiration date). Failure to secure coverage as regaired under Section 25 k of MGL c 152 can lead to the imposition of criminal penalfies of a fine up to$1,500.da andlor one-year impriso»ty as well as civil penalties in the fog.of a STOP WORK ORDER and a fine of up.to S250_00 a.day against the violator_ Be advised that a copy of this stet maybe forwarded to toe Office of Itnregtigations of the DIA for insin-ance,coverage verification. I drr{Fcrr e c re.rcdL-r tks pans ndpsnaf#iss ofp uiy fftetiLis irr_ornzafian prmaclkd moue is true and correct �n PL 41 Date.: �1�7 I� 2-0 Phone A: 44 3 R C) 0fFizaL use o,tj y}. 2L47 trot writs in this area,to be c mpleted by city or town o ciaL City-or Town: PerruitlLicense# Issuing Authority(circle one): 1.Board of Hez th Buffdiq;Departraent 3.CitO-Town Clerk 4_Electrical inspector S.Plumbing inspector .6.Other Co ntsxct Per von. Phone#: 6 I Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees_ Pursuantto this statute, an eriployee is defined as"___every person in the service of another under any contract of hire, express or implied, oral or written_" An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer;or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the - dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or Iocal 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 an.y 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 compb.apce vith the insurance requirements of this chapter have been presented to the contracting authority_" Applicants Please fill out the workers' compensation arndavit completely,by checkip or the boxes that apply to your situa on and,i.f necessary,supply sub-contractors)name(s), address(es)and phone number(s)along with their cerinc aic(s) of insurance. Limited Liability Companies(LLC) or Limited Liability PairtDerships(I_.LP)veitn no employees other than the members or partners,are not required to carry workers' compensation insa ante_ If an LLC or LLP does have employees, a policy is required_ Be advised that this affidavit may be submitted to the Depaitment of industrial Accidents for confirmation of insi_r-ance coverage. Also be sure to sign and date the af5da•c t_ '11ae a. davit sboul_d 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 lFw 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&e appropriate line. City or Town OJTacials j Please be sure that the affidavit is cemplete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition. an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information (if necessary) and under"Job Site Address"the applicant should write"all locations in _(city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. Anew affidavit must be filled out each year_Where a home owner or citizeu is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this afiidav t_ The Office of Investigations would lice to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call_ The Department's address,telephone and fix number: Thb Comma iw-W h of lviassachuse-its Depaxtmt-t Qf Iiidustdal Accidfeats GfftQe Qfluyl�stgat%ans 600 Washingtaa S'1Te�t Boston_NTA 02111 T d,-Al 617 727-49-OU w 4€16 or 1-&7 IvL4SSA_FE Revised 4-24-07 Fax# 617-727-" l49 w�P�.�tas�govl�a Town of Barnstable t Regulatory Services v I Eg Richard V.Scali,Director 'OrEo_39. Building Division Tom-P-er-ry—Building-Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 _ Fax: 508-790-6230 = Property Owner Must Complete and Sign This Section If Us ina A Builder as er of the subject property hereby authorize to act on my behalf, in all matters relative to work authorize bythis ding permit application for. (Address f Job 'Pool fences and alarms ar the responsib' ' of the applicant. Pools are not to be filled or u ' ' d before fence is ' talled and all final inspections are perfo ed..aad accepted. Signature of Owner Signature of Applicant Print Name Print Name Date Q TORMS:O WNERPERMISSIONPOOLS Town of Barnstable Regulatory Services Hof rutty Richard V.Scali,Director P Building Division • MASS. Tom Perry,Building Commissioner 1639- ��� 200 Main Street, Hyannis,MA 02601 ATFO MAt A www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: 3 C, C L A VI S�4 6L.(- C©K-W,.JVLZ) C O TO�d number street village "HOI,,ffiOWNEW': Pj)U!-. 11V 0M PS Tq �0 6 q55 -303 U R j 3 74 3 B 2 bd name ry n home phone# work phone# CURRENT MAII,ING ADDRESS: _y Q 1-- E'its y4 l L(- _ q 3 o city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is,or is intended to be, a one or two- family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner" shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance A ith the State Building Code and other applicable codes, bylaws,rules and regulations. _ The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection eproiqedures and requir�and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules &Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems, particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the Iast page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. QAWPFILES\FORMS\building permit fomis\EXPRESS.doc Revised 061313 i 104219 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map- O "' Parcel bOT Application 4:�? 6 Health Division Date Issued 14ot ho Conservation Division Application F69/ Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board ,v Historic - OKH. Preservation/ Hyannis Project Street Address 36 Clam Shell Cove Road ? Village Cotuit Owner Paul R Thompson Address _36 Clam Shell Cove Road Telephone 508-428-5417 �r Permit Request air sealing, install 600sg ft of R-38 to open attic space, 2 insulated ehaust hoses, 20sg ft of R-13 to wall Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 1999.00 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. V� - Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) - 1 Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes,-. No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other =i v Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) v Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name RTSF. Engineering Telephone Number 401-784-3700 ext 150 Address 1341 Elmwood AVe, Cranston, RI 02910 License # i QQ! J Home Improvement Contractor# 120979 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO RI Resource Recovery SIGNATURE DATE 1/19/10 FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ` ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION r • FRAME INSULATION � FIREPLACE `•K ELECTRICAL: ROUGH FINAL f PLUMBING: ROUGH FINAL GAS: ROUGH FINAL - - FINAL BUILDING i f DATE,CLOSED OUT ASSOCIATION PLAN NO. . The Commonwealth of Massachusetts I Department of I ndtastrisal Accidents Office of Investigations, ations, 600 Washington Street Boston, IA 02111 v �w>�v>w.rvatass.gov/dita WOrke>rs' Compensaflon insurance Affridavit: Bu➢lders/Cont rac to➢°s/]E➢tectt➢-➢c➢ans/IP lumbe➢-s Mficantt Information Please Print L,egibl y Name (Business/Organization/Individual): RISE Engineering; A Division of Thielsch Engineering Address: 1341 Elmwood Avenue City/State/Zip: Cranston, RI - 02910 Phone #: 401-784-3700 or 1-800-422-5365 Are you an employer?Check the appropriate box: Type of project(required): 1.0 1 am a employer.with 4. ❑ I am a general contractor and I 5. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 1 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL I LEI Plumbing repairs or additions myself..[No workers' comp. c. 152, §1(4),and we have no 12.0 Roof repairs insurance required.] t employees. [No workers' 13.Dx Other Insulation comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. — J 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 sheetshowing the name of the sub-contractors and their workers'comp.policy information. I area an employes that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: The Preston Agency Policy#or Self-ins.Lic. #: WC2—Zl l-259874-0/19 Expiration Date: 04/01/ 10 _ Job Site Address: `1 � Sh �Y�i City/State/Zip: l _ 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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi un .. r the ins an penalties of perjury that the information provided above is true and correct. Signature: u�^` �—" Date: ,q/ID Erik Nerstheimer for RISE Engineering Phone#: 401-784-3700 or 1-800-422-5365 Ext. 133 Official use only. Do not write in this area, to be completed by city or town official .City or Town: Permit/License# Issuing Authority*(circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: i RISE ENGINEERING Federal ID#05-0405629 RI Contractor Registration No 8186 A division of Thielsch Engineering MA Contractor Registration No 120979 T 7- CT Contractor Registration No 620120 1341 Elmwood Avenue,Cranston,RI 02910 (401)784-3700 FAX(401)784-3710 CONTRACT Page 1 RI S E THIS CONTRACT IS ENTERED INTO BETWEEN RISE ENGINEERING AND THE CUSTOMER FOR WORK AS E NC 1 N EE RI NG DESCRIBED BELOW CUSTOMER PHONE DATE Client# Paul B Thompson (508)428-5417 11/12/2009 104219 SERVICE STREET BILLING STREET 36 Clam Shell Cove Road P O Box 532 SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Cotuit,MA 02635 Cotuit,MA 02635 JOB DESCRIPTION RISE Engineering will provide labor and materials to install 280 square feet of R-19 faced fiberglass insulation to the basement ceiling.Owner will apply some type of ceiling cover ie..bead board $308.00 RISE Engineering will apply all applicable,eligible incentives to this contract. You will be billed only the Net amount. Currently,for eligible measures,the Cape Light Compact offers 75%incentive,not to exceed$2,000 per calander year. -$231.00 WE AGREE HEREBY TO FURNISH SERVICES•COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***Seventy-Seven&00/100 Dollars $77.00 UPON FINAL INSPECTION AND APPROVAL BY RISE ENGINEERING.CUSTOMER AGREES TO REMIT AMOUNT DUE IN FULL.INTEREST OF 1%WILL BE CHARGED MONTHLY ON ANY UNPAID BALANCE AFTER 90 DA SEE REVERSE FOR IMPORTANT INFORMATION ON GUARANTEES,RIGHTS OF RECISION,SCHEDULING,AND CONTRACTOR REGISTRATION. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES IZEVI.A INEERING CUSTOMER ACCEPTANCELt NOTE:THISDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE I I I I ACCEPTANCE OF CONTRACT-THE ABOVE PRICES,SPECIFICATIONS AND CONDITIONS ARE �.7 SATISFACTORY TO US AND ARE HEREBY ACCEPTED.YOU ARE AUTHORIZED TO 00 THE WORK DAYS, AS SPECIFIED.PAYMENT WILL BE MADE AS OUTLINED ABOVE RISE ENGINEERING Federal ID#05-0405629 } RI Contractor Registration No 8186 A division of Thielseh Engineering MA Contractor Registration No 120979 CT Contractor Registration No 620120 1341 Elmwood Avenue,Cranston,RI 02910 401 784-3700 FAX 401 784-3710 CONTRACT Page 1 RI S E THIS CONTRACT IS ENTERED INTO BETWEEN RISE ENGINEERING AND THE CUSTOMER FOR WORK AS ENGINEERING DESCRIBED BELOW CUSTOMER PHONE DATE Client# Paul Thompson (508)428-5417 11/12/2009 104219 SERVICE STREET BILLING STREET 36 Clam Shell Cove Road P O Box 532 SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Cotuit,MA 02635 Cotuit,MA 02635 JOB DESCRIPTION RISE Engineering will provide labor and materials to seal areas ofyour home against wasteful,excess air leakage. This work will be performed in concert with the use of special tools and diagnostic tests to assure that your home will be left with a healthful level of air exchange and indoor air quality.Materials to be used to seal your home can include caulks,foams,weatherstripping and other products. Primary areas for sealing include air leakage to attics,basements and other unheated areas(windows are not generally addressed.) This work will be performed at the rate of$66 per man per hour,which includes materials and testing. 16 man hours. $1,056.00 RISE Engineering will provide labor and materials to install a I I"layer of R-38 Class 1 Cellulose added to 600 square feet of open attic space. $720.00 RISE Engineering will provide labor and materials to install 2insulated exhaust hose w\roof mounted flapper vent to exhaust existing bathroom fan(s). $200.00 RISE Engineering will provide labor and materials to install R-13 faced fiberglass to 20 square feet of wall. Insulation will be fastened in place. $23.00 RISE Engineering will apply all applicable,eligible incentives to this contract. You will be billed only the Net amount. Currently,for eligible measures,the Cape Light Compact offers 75%incentive,not to exceed$2,000 per calander year. -$1,499.20 • j WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***Four Hundred Ninety-Nine& 80/100 Dollars $499.80 UPON FINAL INSPECTION AND APPROVAL BY RISE ENGINEERING.CUSTOMER AGREES TO REMIT AMOUNT DUE IN FULL.INTEREST OF 1%WILL BE CHARGED MONTHLY ON ANY UNPAID BALANCE AFTER 30 DAYS.SEE REVERSE FOR IMPORTANT INFORMATION ON GUARANTEES,RIGHTS OF RECISION,SCHEDULING,AND CONTRACTOR REGISTRATION. DO NOT SIGN THIS CONTRACT IF THERE AR LANK SPACES �j') UTH/ONTRACT E E ENGINEERING CUS MER ACCEPTANCE 14( ` I/�jy,V,^1 NOTE: MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE ACCEPTANCE OF CONTRACT-THE ABOVE PRICES,SPECIFICATIONS AND CONDITIONS ARE SATISFACTORY TO US AND ARE HEREBY ACCEPTED.YOU ARE AUTHORIZED TO 00 THE WORK DAYS. AS SPECIFIED.PAYMENT WILL BE MADE AS OUTLINED ABOVE AC'®i�D CERTIFICATE OF LIABILITY INSURANCE OP ID MR DATE(MMIDD/YYW) THIEL-1 11 05 09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIO The Preston Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1350 Division Rd Suite 303 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR PO Box 810 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW East Greenwich RI 02818-0810 Phone: 401-886-8000 Fax:401-885-1700 INSURERS AFFORDWC%uvsRAGE NAIC# INSURED INSURER'- aartford Underwriters Ins. Cc Thielsch Engineering, Inc ER B: Hartford Casualty Insurance Co Thielsch Group Inc.Hi Tech Realty Inc. INSURERC: Liberty Mutual Insurance Group 195 Frances Avenue INSURERD: North American Capacity Cranston RI 02910 INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INbKLTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MLICY NUDD EFFECTIVE DATE MMIDD O LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY 02UUNTD5678 04/01/09 04/01/10 PREMISES Eaoccurence $ 300,000 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 $2,0 0 0,0 0 0 POLICY g JECOT LOC Erap Ben. 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 B X ANY AUTO 02UENTD4850 04/01/09 04/01/10 (Ea accident) ALL OWNED AUTOS BODILY INJURY SCHEDULEDAUTOS (Per person) $ HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 10,000,000 B X OCCUR CLAIMSMADE 02XHLTUF6573 04/01/09 04/01/10 AGGREGATE $ 10,000,000 $ FDEDUCTIBLE $ RETENTION $10,0 0 0 $ WORKERS COMPENSATION AND X TORY LIMITS ER C EMPLOYERS'LIABILITY WC2-Zll-259874-019 04/01/09 04/01/10 E.L.EACH ACCIDENT $ 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 500,000 If as,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT 1$5 0 0,0 0 0 OTHER D Professional Liab DVL000025902 04/13/09 04/01/10 Prof Liab 2,000,000 A Leased/Rented Eqp 02UUNTD5678 04/01/09 04/01/10 Equipment 100,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION TOWN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Town of Barnstable NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Building Division IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 200 Main Street Hyannis MA 02601 REPRESENTATIVES. AUTHORIZED EPRES ACORD 25(2001/08) ©ACORD CORPORATION 1 i rage 1 oI 1 The Official Website of the Executive Office of Public Safety and Security(EOPS) Mass.Gov Home rublic Safety Department of Public Safety Licensee Complaints License Type Construction Supervisor License# 100459 Restriction WS,IC Name Erik Nerstheimer City, State,Zip North Scituate, RI,02857 Expiration Date 3/28/2012 Status Current No complaints found for this Licensee. Back To Search Board of BuiIdin;Regulations and Sta.iidaril's Li.Cense or registration vafid for individul use only i HOME IMPROVEMENT CONTRACTORI. before.the expiration date. If found return to: Registration:. 12097g Board of Building Regulations and Standards EzF.ati:o_n 3_25/2010 i. One Ashburton Place Rm]301 Typ F0:p"p`lement Card r^�' ii st ,Ufa.OZI,O$ _ -; -HIELSCH ENGI t.-1- !LNG fir :RIK NERSTHEINIER=;-':= � 341 ELMW00D•AV,E . :RANSTON, RI 02910 Not valid lid without signFrt;7e hrtp://db.state-ma-us/dps/licdetails.asp?txtSearchLN=CSL100459 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION i- Map �o Parcel SE Permit# � SEPTIC SYSTEti1 MUSS' Permit Health Division iD-- 9-Tr INSTALLED IN COMPLIAN e Issued WITH TITLE 5 Conservation .� e Dili I ENVIRONg14tNTAL C®DE Tax Collector . Fee ' ,TOWN REGULAT9(:9\6S: TT Treasurers Planning Dept. Date Definitive Plan Approved by Planning Board Historicl-OKH Preservation/Hyannis Project Street Address .110 1!f&J015 ell e_'luz , Village �1149 r� Owner Y• g-/'ty S. eyd/ 7_' ajw45:1)A/ Address S, He_ Telephone 6Z.2 ✓r I7 Permit Request ILYe4 Z'e Pd, 512AloP,04 4 Square feet: 1st floor:existing 2 proposed?8'� 2nd floor: existing proposed Total new Estimated Project Cost 12-01Aell Zoning District Flood Plain Groundwater Overlay Construction Type t,JAor7 F rlP Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. IN Dwelling Type: Single Family 14 Two'Family ❑ Multi-Family(#units) Age of Existing Structure 3,0 Lm5 Historic House: ❑Yes J,No On Old King's Highway: ❑Yes No Basement Type: ❑Full ❑Crawl ❑Walkout •❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other 1J 0 A)42, Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size. Pool:❑existing' ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial -❑Yes J No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name ild ¢� �d/fie /9A � �,Telephone Number , 0 9 7 7 Address License# jJL�r U/l�{>, Home Improvement Contractor# i //, 1 Worker's Compensation# 0<!f, 3 � — 9� 7 a ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TOQrrls ��I�oG� iI� SIGNATURE DA �Veasi� c FOR OFFICIAL USE ONLY *PEP' 4-3�MP�FjtIT NO. - DATE ISSUED MAP/PARCEL NO41 i ADDRESS VILLAGE ' OWNER -; DATE OF INSPECTIbN: r ' FOUNDATION �_'• ' FRAME INSULATION, !-=.', FIREPLACE ~ ,, ELECTRICAL. rZROUGH FINAL ' PLUMBING: M ROUGH FINAL GAS: ROUGH FINAL , FINAL BUILDING L " `' 6A + ' q 4 DATE CLOSED OUT, ASSOCIATIO.N'PLAN NO. ' q i r ,l j EXISTING HOUSE 101-0" i EXISTING AJNROOM REBUILT i EXISTING DECK REBUILT - 28'-0" �r MR AND MRS.PALL THOMPSON 36 CLAMSMRL COVE RD. i. COIUIT,MA. I J ❑ ❑ L CEp S CR El El III L Mot MA MRS.PAM THOWSON 36 CIAMSFRl COVE RD. COTUIT,MA. (� ve^-ram ia9198 A3 i U SI/ A( a MR MID MS.PAUL THOMPSON 36 OLAhSHELL COVE RD. COTUR,MA. Pit. ila^-�-o^ 0,9198 6.2 Cf 2X4 WALL 2XlO JO 4X4 P.T. POSE �swm�ounmrw. MR AND hWS.PAUL THOMPSON 36 CLAMSI¢LL COVE RD. COTUIT,MA. ve^-lea' 1W9198 09 } of ��..�'-t. it;s 7.s''�.j.=_-p'✓ yf..�i'P��/..t Ey�,�,',a�•,.,:.•(p4E� . p k re.s�.�TOOf1V/1lOxIL LaQw �/,�^"" \ HOME IMPROlkk'T_:.CONTRACTOR f . `Registration �120111 ra4�s��� ' + 3�T pe ,INDIVIDUAL % � " la.v 4 :7R Fsb rt t at, ��,PLAUL F ,CAPRWN IO f, 15 STERLING RD � � s�"Est#' (� - •�'"��.e�- �}t�NNIS MA 02601 y.�� '���`�'-" ADMI-M OR S a�yt rY a��FY.¢k i4 vwS�4 ti r '��'� "a;F,� '�, t� ��Q.� i}v �q'�'^�:fir.7 N�• - . • �• fie-�jomvrna�uae� °�,_/���ivaeC/a DEPARTMENT OF PUBLIC SAFETY t CONSTRUCTLON.SUPERVISOR LICENSE NumbeT7 = tExpires: 'I ted Istc ; PAU F ':CRP.RIOo r M,rt ,ed 15 RAILWAV LUFFS HYANNIS, MA 02681 STANDARD LEGEND 6R ale ll�l�a IOPY�d/Ntly ® wLEmelsE EulYaT O OEOWWKILIEB - cO EcffalEuslE i':?�9 Ol0Yl0a YulSFN' I CID m11iEEEUb1� - t '' curse AYEA 4 mum � F�mvE1TATs WOES _ acolmo IATe/mIl mommum 1 -- 2 Po01 WI00111 LINE lOT0am100011I1E F+ 90THWATION i i .� •-- STW WALL H1[E I ETAINe6 ETY1 tA SMI(EJIACE STONE AEIIY ie SMWA146 POOL .�. 10101/OEQ - - - - - - - - - O. lUIDOIOS/sIXXTUIES 1 , pIM OOa/POi/am " - 0 ASYSSOR'SAw BOONOAIT o 1 e WK• . IMENYB - - - - ' ' ' • , O EWE O ROM . so • SIDWWm ' ` ' X S , ' 1 ' 1 ' - . • EWE a ma O Iert O egV01 1 � / SITE MAP 1 T.O.B.eE061A1e1C INfOlYAT10Y SISTEAIS UNIT - 1 SCALE:in feet MAP 6 0 .. 30_..- 60 1 INCH—60 FEET52 a # 41 s , 1 / 116V+rr - 1 , 1 I 1 101E WlEIIDaILiBAC WIliYKwccm�0166 � Il11®1lWlY1�S 1AFT1EN01 WN IOfQtll4 e1K/V HYiO�L�lIe10a�B1Y IA1 NMI , tlYili�illlYM1INf.OlY9IM1 Y/. ®1{oN®IOM1R®f�NYSIfO � . � MAP b � �r1all•_Ic.1�lINrIN�mN/w®N " 1— A - � / LLYENIpNNIIIN. . tw ' - The Town of Barnstable �$ Department of Senith Safety and &Viroamental Services Building Division 367 Main Sheet,Hyaaais MA M601 Cron= Off= 308-790-6227 g Ccmmisr:. Fax: 308-790-Q30 For office use only Permit as Oate AFTMAVIT SOME zwROVEMENT,CONTRAGTORZAW SUPPLEMENT TO PERMIT APPLICATION ' , moderni=dDI. MCI. t I4ZA tzquires that the "reconstruction+ stterssfons, rmtn►atioa. reps conversion. improvement; removal. demolition. or constratxion of an addition to say pre-ezistiag owner occupied building containing at least one but not more than four dwelitag emits or to :fractures which are adja cent to such rrsideaee or building be done by registered contractors. with certain czccption&along with other requirements 'I'ypa of Wont: '_r- �- Addren of Work: Owner's Name �Lyl/ ,� A k/ Date of Permit Appiladon: /D/ 0 I hereby certify that: Registration is not required for the following renson(s): Work ezcladed by law ,lob under SIAM wilding not ownerweeapied —Owner puffing own permit Notice is hereby given that: OWN PERMIT OR DEALING WTtH I3r1REGZSIERED OWMM PULLING TWM R1 _ CONTRACTORS FOR PROGn At4 OR GGUARAMM FUND UNDER MGL 142A AC WORK DO NOT HAVE CESS TO TM•� SIG,.IID UNDER MALE OF PERIURY I hereby nnniy for a permit as the agent of the owner: Date Contracmr Name Begcnasfoa Na J ' OR ownerrs Name Bate i =-= The Commonwealth of Massachusetts Department of Industrial Accidents &Wee 911AY85908055 600 Washington Street Boston,Mass. 02111 Workers' Co m ensation Insurance davit . name• f'/ r�_ S+- ��--. �,4-U � �''11��n �.��ad� location. city �,�7J/�% phone# �g-�5�1.7 ❑ I am a homeowner performing all work myself. ❑ I am a sole etor and have no one woridn in ca achy I am an employer providing workers'compensation for my employees working on this job. :y > « "' ars...: < Win ,.. ,.p,. :o>:::;.>::.�:::.:>;::::.�:::::::.;.; ._ _ .. .. ':i:3ii>i;;;::;;i5;r:i4;;ii `;:k:;i::::;E`:f ...... .........:::::::%;:i:i3i%: ..... .. :: :: :::::::i::i:::::>:: 5<:i:::::: :::::::i::::: :::ii�::.:.`ii:::'::::`:::i::::::::;:;:;;;:;:;':::::2t;::j :::::%`:j::i':::i:"'': :; i i::::i ?.'...>..::::,:: 22: ::'; :::::...... ..... 51: r .:.: #. .. phone# xX :4i:�?::: :::::::::::::....................................... :•............................................................................................................................................................ ................................... _::.�:::: :•.�::::::::. ......••...••......••...••......•• :•::::::: iiii:iiiiiiiiiiiiiii'r:i:: :v.•y:: t:3:::.ii:tii:i}iii::::::•+y: {y(WY iitiff`:if,:;%:;%Jinn?ii?•:.ii: :i''''.9J:: ::::!5;is::j:{:::::::t:i:'i:t:i::i:'':::i::ii'::i:':::i:J:}}iJiii:•4::i:: {i::i::i::?:::%:5: :.:n �::::':F v:is:..::':::.�: ::::::::v::::::v::v::::v.�:::: ...... ...:..:....:..:..:..:..:•.i'•::... •. :•: :•:•. ::.. i ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractairs listed below who have thefollowing workers'..compensation polices:....:.:::.:::::..:::::::::.::.::::.::..::::::::::::::.:.:::::.:;:..::.::::.:::::::::::::::::::::.::::::::::::::::::::::.:::::::::::::.,..::::•.,�,..,..::::>;:: COmD ::::::::::: :;::;;.:;•.;::: �•. tt?> XX .......... t�dtess...::..... X. ..::.....:::.. . :.rcx•.:•.. . r.•.,. ................. ::::#•>:::::::i:•:......::::::::.�:.�:.:::::::•.�::::•....mot::::::::•:n::::::.::. ...:::::r::•::•:.;:;.; ;:;.:.;:i.;::.;:;t;i.:.;::::.:.:::::t:.:::.:;;:.:;.;:.;:.;:.::.::.::.;:.:;><:.;:..;.:.;:.;:.;;:.;:.;::.;:;.;:;.::;;;.::::.::.:;.;:::::. one . . .�.4 :..?:i:cr::••:•a.. ........................................................................................... ..............: :::::.:..:::.�:::::::::.�:::.::::.�::.�:::.�:::::::.:; :.;;:.; y:::.::::::::::::::.::::.::.:..:::::::::::::::.::::::::::::::::.::::::::.............................................................................. .............. ................................................. ...................................::::::::::::::::::::::::::::::::.�:::::::::::::::::::::._:::..:::::::::::::::•:::•::::.::::::.::::::::::::::.:::::::::::.+.•:%:.......:..tr........... ...:::::.y. ::::.:.:.::::::::.....................................................................................r't::::• : ,:::•.�::::......::......::........ ...................::::.:::•:.:::..................................................::..:.:._.�.�:::::::: t.;r:tttt•»::::•::::;::•>:::•>:•::::::•:... ..:'::.:,:::::::::..::.:.::•:.:::::•.;::::::.:;:n:;:::.::::: :.:'<: ::;+:•::::..;:.;•..;:::::t•:r:'::J::;::;a:;::::i:;S....i. ;:•:3 ..................................:•::.....:............:............:..:.:......................::.::...... ,•.:.�::.:•:t•::•:•;:.........:........::.: ...a:t:is<: <.:�»::.�::.�:;�:;::»>:::»:;.>::::•:�.....::.�:::::: ..,::>.. ::•r::......i.............:.......... ::.t:•::::::::::.t„.,a;is<;A;:•::^ air:3.ua�.•....,2•r; I(niiireace:ca........................................................................ :::::•:: ........::::.::::.:::::::::::.:::.::.:::•::•:::::::•::::::•:::...............::.....................:.:........::::::::: .;;:.;:.;:.:•;:•:;;t;?.:::> ::>;:....:?..........:.;:.;:.;:.;::•;;:•;:•: z>z:>::>::>:<:s»::;:::>:::;<.:•;:.>;:.;;:t•;:.:t:;:•:,.:t.::.::tt•::•:;•;::;:•;:i.;:;.;:•>;:;::«J:.;:.:.;:...;:.:;.;;:.;:.:?.;:.:.:...-:.;:•;:•;:•;;:•;::;::::;:-::;:.:.;:.;; :;;:tttt•;:•>:.>;;:;.:;:t.> L'muasai�name:............:........................:...................... -.-. ....................................... . .............:: T . , i ,., ...V.::.........>:T:•:•:::::::. :%::J%%:r:r:%`::: : vT::•:x::::n•::. ::w:....,, ....:....... ............. v::::.�:::v:::'. :i•:}..::....::: ..... :::•.: :v:::::::::::::.�::::.:::::::::..:.:.. At [8SS .>:`vY.J:>.'>.^:'.<>.•:i:t•i}:ivi:t{i:j:i %:; %::%::4:•it ii%??':'i:i:•ii: ........::::::: b ...« M .•4S:. <::;::%J::::X. ;:i::::: �> ;:%;:y'i:•':�:F::::�� :� ''::':3i:%::�;:2�r:riii:�::::?iii:�i::;%:::;:%�v:;: �.•. '�:>:<:::<:::�:::;:;:;::?;�;.`•?:::r•;::::•:::::;t.;;;:;.;;:.:.s;:.»:.;;;:.:<:>::>:�»»::::>::::::>:::>::::::<::::<:::::>:`?t%%%:?::Si::;:::<:>:::5:.:;.:.::.:.:i.:;:.>::.: Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a Sae up to$1,00.00 andlor one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a Ste of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the OSlee of Investigations of the DIA for coverage verification I do hereby c under the pains and penalties of perjury that the information provided above is&w mid coned Date 16o 9, , e signature / �1 �7 - Print names !J / � Phone# Z 7�� 5l'7 .. official me only . do not write in this area to be completed by city or town official city or town: permitilice nse# ❑Building Department ❑Ucensing Board ❑checkitL�ia<e response b required ❑SeLsrfmen's Office QHealth Department contact person: phone#; - ❑Other <�Assessor's map-and lot number ... :,h...................... IRE 0 Aso, jewag�'e Permit number ..........................................I...............k-j EARNSTABLL House number ...........................................................I............ MAOL 1639- TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...:................ ......M.C.19 .........l lfit............................................... 77 TYPE OF CONSTRUCTION .............................................. .rlt.................................. ........................................... 19............ ................................... TO THE INSPECTOR OF BUILDINGS: The undersigned .hereby applies for a permit according to the following informationp - C-0 I...-r �9/ , 0 Location .................. ......*;."********............ .................6 7...4.............................. ProposedUse ............ ...... . ........................................................................................................................ Zoning District ................42 ............................................Fire District ........ ............................................. Name of Owner ... P.,07......Address 5�141.t77.. 'T. )/.,,,PD.IJ.....R.4 Name �f Builder P.A.I.d<Y:S.A ok.7..............Address ........... Nameof Architect ...................................................................Address ................................................................................ Number of Rooms ............../........................ Foundation ........-r-:XA S!q.............................................. Exterior ....................................................................................Roofing .................................................................................... Floors ....... ....................................................................Interior ..................................................................................... Heating ....................................................................................Plumbing ................ ....... Fireplace ..................................................................................Approximate Cost ..... ..9�0....................................................... Definitive Plan Approved by Planning Board ----------------------------- Area .......................................... Diagram of Lot and Building with Dimensions Fee .............15.,AD..................... ...... .. SUBJECT TO APPROVAL OF BOARD OF HEALTH • /-(0y OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ....... ........................................................ 0 7 Construction Supervisor's License ................................. -t-,T-HOMPSON, PAUL 25096 ENCLOSE PORCH No .....9........... Permit for .................................... Single Family... g.............. ............... ................ Location ...3.6...Cl.ams.he.1.1...P.oi.h.t...Roa.d. . .. ..... ....... .... .. .. .. .... .. .. ....... .. Cotuit . ............................................................................... Owner ..Pau.1...T.....ho........mps.on.............................. ....... .. .. ..... Frame Type of Construction ...........;.............................. ................................................................................ Plot ............................ Lot ................................ May 23, 33 Permit Granted ..........................................19 r. Date of Inspection ......................... 19 Dcfe Completed ..... ..................19 Assessor's map and lot number ... ./................... l YYY '3•� `. �OF THE Q Sew a Permit number — :......:< Z 33AMSTODLE. i Housenumber ......................................................................... 26 RFD MPY a� TOWN` OF BARNSTABLE _ i U I BUILDING INSPECTOR APPLICATION FOR PERMIT TO ................... �..�.� ....... .I ...................................... i TYPE OF CONSTRUCTION ..........................................'"' .Y a. ......,..........:........................................... �/�.�J .................. 19 7. TO THE INSPECTOR OF BUILDINGS: / I The undersigned hereby applies for a permit according to the following information: Location ` Proposed Use ..e. ! ' ice ...... ' t� .......... ^.. i Zoning District .......... I. ............................................Fire District .......<.:. a ,. > Name of Owner ....... ..0 .!....:.....1.�. e!�.:.•�. .. .......Address �.. �� ?.- ...:`....... :........:.'../..rij.......���. Name of Builder -�.`.�b.... 1 ' / ' 3` S �'!`:?..............Address . �- � ................ .................................................................................... Nameof Architect ..................................................................Address ......................................................J...................... Numberof Rooms ............/...................................................Foundation .......... s,S/� � ................. .. �cs�. Exterior ..............................................\....................................Roofing .............................................................i...................... Floors .........I1. .:..i............. ............Interior ............... !.may ......................................... ................. Heating .......... . ...................................................................Plumbing .............. . .............................................................. Fireplace .....................:.............................................................Approximate Cost .... j..!'� .................................................. Definitive Plan Approved by Planning Board ----_------_------_-----------19________. Area .......................................... Diagram of Lot and Building with Dimensions Fee �.F SUBJECT TO APPROVAL OF BOARD OF _HEALTH P C . k r' I 1 � • OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS ' I hereby agree to conform to all the Rules and Regulations of the Town of Barnstabre regarding the above construction. Name . =1/,f� ......................................................... t / Construction Supervisor's License Y.... �� THOMPSON, PAUL A=6-8 2-5096 ENCLOSE PORCH No ....V........... Permit for .................................... ........Sin, le...Family...D.W eL�l ing............. ovL Location ....3.6...Cl.ams.he.1.1...Pert...R.oa.d . .. ..... ....... .... .. .. ............. .. .... .. Cotuit .. ............................................................................... Paul Thompson Owner ................................................................... Type of Construction ..Frame ...................I..................... .................................................................. ............. Plot .............................' Lot ................................ May 23, 83 Permit Granted ........................................19 Date of Inspection .....................19 Date Completed ......................................19 l� �C�� _ `3- la 7 �Assessor's map and lot number ..... ..... .........��....'.�! ' // ' a SEPTIC SYSTEM MUST BE 7P, ;;'!STALLED IN COMPLIANCE - ..�. . . . ( ...�77. WITH AR-fiCLE II STATE �- Sew`�ge JPermit number :,,. < r SAS:ITCHY CODE AND TOWN TOWN OF BARI i� �.TAr LE f= *'THE T� .1, a I BAHH9TOIILB;• "6 9ae� BUILDING INSPECTOR �. t7Yf►Y 4 i �,4 /? n_ APPLICATION FORkPERMIT TO ........... C.....�. .......... ....:........!�......... ................................... C-4 TYPE OF CONSTRUCTION ............... .^/ �4................................................................................................. .. .......... .. ..Y..................19,n. .y TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit)according to the following information: Location 3� C. � ..... A�e 1� aer) ProposedUse .....ie0111)7..1z.X ......�I z.....................................................................................................I......................... S IF- Zoning District ......................Fire District ........ ..d �V.e!...� Nameof Owner 'TA.�o.ns........►�Y....0..� .....................Address ..................................................................................... Name of Builder .. .P. ...... '� �e !�.Y�. .A.�e ...........Address .......... 4./..0 I.�................................................ Nameof Architect ..................................................................Address .............n...................................................................... Numberof Rooms .........../.....................................................Foundation ...../. .7.1�� ................................................... Exierior ...................��.,.!�................................................Roofing ..........MS/2 h.G..Z ............................................. � Floors .Interior o..!4................................................. V � � Heating ...... ..... ...(.r.Y....................................Plumbing .................................................................................. Fireplace .............. .r .S.........................................................Approximate Cost ........... Definitive Plan Approved by Planning Board -----------_______-----------19________ . Area b.f�.' ............................ Diagram of Lot and Building with Dimensions g 9 Fee ..0....................................... SUBJECT TO APPROVAL OF BOARD OF HEALTH Mew o I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ..J ... .............. = Wood, James 6 8 ' . . Permit for . ����m�..�..�ao�l ` ' ad ' — �. ��sO�. ............dn&�C.414�y. 'Location .36... Road . - . . ...............Cmxat................................ ' ' . ` 8vvna, ............................................ . , Type Aconotruction YQ.94.ATAgq�—'�---.. — ` �'��'--..;�.---�----------. ------. ' ` ^ Pkot -----.---- �o ___�6______ ` . . . ' Permit ^ noa6 h . ----.lq 77 ' ( � ]Date of inspection 5X�i Dote Completed .� ..���-----lg /- . . � . ' v PERMIT REFUSED . ------------.'.-------. l� . . , . . /--------------------------� ' , �-------..�.'----------------. . / ^ . '—'---~---r—'^-------`—~^~~-- � . F--------- .................................................. 'App,oved _— ....................................... 19 ' � ---------------.----..--..--..� , . -------------------^-----^— | ' | Assessor's map and lot number ..... ...... .1...:!'! _ ....../ ,A Eiji/.. � Sewage Permit number ........:�..!. � TOWN OF BARNSTABLE BASBSTODLt. S ~ "b q �e0� BUILDING INSPECTOR �o way a' '�!`"APPLICATION FOR';PERMIT TO p. ...........::................................................................................................................ y TYPE OF CONSTRUCTION ��'✓cZ a� ............. `. ................................................................................................. r ................................................19....... } TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit)according to the following information: Location ...... 6...... . :./r:{.......... the/ �..................................................................................................................... ProposedUse ..... .................................................................................................. ZoningDistrict ...... ......................................................Fire District ........ ......... .......................................... ce i 7- Name of Owner �:?.:r..�..r�:'. ice' !► ..........Address ......................... ......................................................... .........................:.................. Name of Builder ... ........1 -'`.•....... =. /p Address .......... u � h,...... .................... ......... ........................................................... Nameof Architect ..................................................................Address .............7....................:.................................................. Numberof Rooms .................................................................Foundation ..........?.:.;?............................................................... vt/Q ...... .............................................Roofing s ,,� 7G Exterior ..................................... ....:.............. ., ........................................ y %r ON Floors V - .......................:..............................................................Interior ............Y."'W..?................................................................ Heating .:.. ,•V.. .......'....�.....t.....................................Plumbing ......,........................................................................... Fireplace .............��' .............................................Approximate Cost ................................................... Definitive Plan Approved by Planning Board ---------------_---------------19________. Area ...................................... � a .Diagram of Lot and Building with Dimensions Fee .....�. SUBJECT TO APPROVAL OF BOARD OF HEALTH r i � 1 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ..............7...1;/..? . i.....�--� ...............y. Wood, James 6-8 r No ...1°JRQ9 Permit for addition - famly . ................... ....raaan.........siloigltr... amily...dllin&........ Location .36....Cl,a=lle. row ,. ...........C:atui°t...................................................... ° i Owner .....James..W.0.0I....... ................................ Type of Construction ....... oo.d..f rA;A*............ ............................ ......... .................................... Plot ............................ Lot ................................ o Permit Granted .......Niarch...15.. ............1977 - e - } 1 Date-of Inspection ...................... .............19 x Date Completed ......................................19 PERMIT REFU/SED 19 ............... ....... ....... ................................... . .......................... .... e ...................................... I3Approved ................................................ 19 s ............................................................................