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0055 STONE BRIDGE LANE
�`,- Cf�� �t riC� c �.. y L- _ - - __ - � . n - --- - - :w�� ALTERNATIVE WEATHERIZATION TOWN OF RAANAK�� 7019 ME 26 PM 1= 35 DIVISION Date: Town of Barnstable 200 Main St. Hyannis,MA 02601 Re:Permit# Villa e: �4 / g The insulation/weatherization work at � (./L has.been completed in accordance with 78.00MR: Regards; Timothy Cabral, President CSL-105454 58 DICKINSON STREET I FALL RIVER,MA 02721 I (508) 567-4240 I ALTER NATIVEWEATHERIZATION@GMAIL.COM Town of Barnstable Building Post This Card So That it is Visible From the Street Approved Plans Must be Retained on Job and this:is Card Must be Kept v M039.AE& Posted Until Final Inspection Has Been Made.. * Permitc�Mvt° Where a Certificate of Occupancy,is Required,such Building shall Not be Occupied until"a Final,lnspection has been made. Permit No. B-19-4094 Applicant Name: ALTERNATIVE WEATHERIZATION INC. Approvals Date Issued: 12/06/2019 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 06/06/2020 Foundation: Location: 55 STONE BRIDGE LANE, MARSTONS MILLS Map/Lot: 125-006-007 Zoning District: RF Sheathing: Owner on Record: DEWITT,JOHN L& ROCHE, PATRICIA M Contractor Name: ALTERNATIVE WEATHERIZATION Framing: 1 INC. Address: 55 STONE BRIDGE LN 2 Contractor License: 175683 MARSTONS MILLS, MA 02648 Chimney: Description: insulation/weatherization Est. Project Cost: $3,273.00 Permit Fee: $85.00 Insulation: Project Review Req: Fee Paid: $85.00 Final: Date: 12/6/2019 Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: F: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Rough Gas: 4 All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Final Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. - - ._w_ t Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work:; r Rough: 1.Foundation or Footing ' -- 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Application number J....l... ....vo� Date Issued...........Lz ITiP.Ai............................... BUILDING DEPT KAM Building Inspect rs Initials..... DEC s 20,9 a`� ... ......... ... _....... � Map/parcel.................................�..�.�.�.. TOWN OF BARNSCAi3LE *W-` awr TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDO W S/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY L'NFORMATION Address of Project: Q66 I r NUMBER STREE VILW-J��b Owner's Name: �Q,TI I�Cilh�e_ '� Phone Number Email Address:JQJTrUQ4 J P- ('&T4LV,6 f,rut-Cell Phone Number r-� I Project cost$ 3�'�` Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize ,// -61 axe to make application for a building permit in accordance with 78 MR J� Owner Signature: Date: TYPE OF WORK E-1 Siding E-1 Windows(no header change)# o Insulation/Weatherization 0 Doors (no header change)# Commercial Doors require an inspector's review 0 Roof(not applying more than 1 layer of shingles) Construction Debris will be going to CONTRACTOR'S INFORMATION Contractor's name lT ff-a/!�-h W e- Wi&Ww7 Home Improvement Contractors Registration(if applicable)# /���0 �3 (attach copy) Construction Supervisor's License# /UJ ysy (attach copy) @Cap/• W Email of Contractor Q.A Phone number 4 U f-5107 WY0 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. I APPLICATION NUMBER F` *For Tents Only* Date Tent(s)"will$e erected Removed on number of tents total Does the'Ant 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 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 APP IC 'S SIGNATURE Signature (/ Date / r All permit applications are subject to a building official's approval prior to issuance. Permit Authorization mass save Form SWAMxowvwh onvfw *ncy Site ID: 3889654 Customer: Patricia DeWitt l , 11 v '` �' V"`1 ,owner of the property located at: (ClwnePs Name,printed) 55 Stone Bridge Lane Marstons Mills, MA 02648 (Property Street Address) (City) hereby authorize the Mass Save Home Energy Services Program assign d Participating Contractor listed below to act on my behalf and obtain a building permit t erfor n cation and weatherization work on my property. Owner's Signature: I Date: 9 —) �—� 1 000000000000000000000000000000000000000000000000000000000000000000ao0 FOR OFFICE USE ONLY We have assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: AlAe=&LL W UgLri ZZAE M 14 C— Participating Contractor Date Name: RISE Engineering Phone: 401-784-3700 Email: Page 1 of 1 For Office Use Only Rev.102015 The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street, Suite 100 Boston,MA 02114-2017 www mass.gov/dia «'orkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Annlicant Information Please Prini Legibly Name (Business/Organization/Individual):ALTERNATIVE WEATHERIZATION, INC.' Address:2 LARK STREET City/State/Zip:FALL RIVER, MA 02721 Phone#:508-567-4240 Are you an employer?Check the appropriate box: Type of project(required): l.❑✓ I am a employer with 16 employees(full and/or part-time)." 7. New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. 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 4.[]l am a homeowner and will be hiring contractors to conduct all work on my property. I will 10❑Building addition ensure that all contractors either have workers'compensation insurance or are sole I LM Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.[3 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 6.M We are a corporation and its officers have exercised their right of exemption per MGL c. 14.[D Other INSULATION 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:LIBERTY MUTUAL INSURANCE Policy#or Self-ins.Lic.#:XWO58867158 Expiration Date:06/07/2020 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 MGL c. 152, §25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under a sand alti s of e ury that the information provided above is true and correct Signature: Date: Phone#:508-567-4240 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#: � �' GATE(MMIDD/YYYY) ,4oRa CERTIFICATE OF LIABILITY INSURANCEF��' 05/24/19 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 have ADDITIONAL INSURED provisions or 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 UUNIAtel NAME: Anthony F.Cordeiro Insurance Agency a/c No Ell: 508-677-0407 A/C No): 508-677-0409 171 Pleasant Street Fall River,MA 02721 ADDRESS: HSouza@Cordeirolnsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Liberty Mutual INSURED INSURER B: Ohio Security Alternative Weatherization INSURERC: Ohio Casualty 2 Lark St INSURER D: Fall River,MA 02721 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. ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDDIYYYY LICY EFF MM/DD/YYYY LIMITS x COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RLNTFU CLAIMS-MADE FRI OCCUR PREMISES Ea occurrence $ 300,000 MED EXP(Any oneperson) $ 15,000 A Y Y BKS58867158 06/07/19 06/07/20 PERSONAL a ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO- ❑ JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 HOTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident 1,000,000 ANY AUTO BODILY INJURY(Per person) $ B OWNED X SCHEDULED Y BAS58867158 06/07/19 06/07/20 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS x HIRED x NON-OWNED PROPERTY DAMAGE. $ AUTOS ONLY AUTOS ONLY Per adent x UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB CLAIMS-MADE Y Y US058867158 06/07/19 06/07/20 AGGREGATE $ 1,000,000 DED I I RETENTIONS S WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE I I ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 C OFFICER/MEMBER EXCLUDED? N/A XWO58867158 06/07/19 06/07/20 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Action Inc and NGRID,USA,its direct and indirect parents,subsidiaries and affiliatesshall be named as Additional Insured on commercial General Liability and Automobile Liability polcies. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN NGRID USA ACCORDANCE WITH THE POLICY PROVISIONS. 40 Sylvan Road Waltham,MA 02451 AUTHORIZED REPRESENT 110 ©19. -2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 3 Comtnonweattfi of Massachusetts Division of Professional Licensure Board.of Building Regulaitions'and Standards , Cans r rvisor CS-105454 _. ' 1pires:05/0W2021 TtMOTH'Y OA)i r 58=KiNSON SIRE i FALL_RIVER i1t'0273 y /. - Commissioner Office of Consumer Affairs and Business Regulation 1000 Washington Street- Suite 710 Boston, Massachusetts 02118 Home Improvement %ptractor Registration Type: Corporation ALTERNATIVE WEATHERIZATION,INC. Registration: 175683 2 LARK ST +� W Expiration: 05/28/2021 FALL RIVER,MA 62721 I w nJ�M Sy8 `� Update Address and Return Card. SCA 1.0 2OM-05/17 Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE.Coraoration before the expiration date. If found return to: e i f tld j Exairation Office of Consumer Affairs and Business Regulation 75683 05/28/2021 1000 Washingtoawithou r,' .ERI. ' ' ton,MA 021 ALTERNATIVE�WEATt�ERLZi9.ON,INC. TIMOTHY CAL3RA 2 LARK ST �-� FALL RIVER,MA 02721- Undersecretary U ivy Ot Vture • s . Y c TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 1IS' Parcel ON -0V Application # c2v O.S of Health Division Date Issued Conservation Division Application Fe '--11q&- Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis ' Project Street Address �S S4-0he_ f�6A L-4-r-, Village Owner k1j � -r�U. `1���i�'�" Address Telephone I i / rro Permit Request �w `a1- 71d �( r b l�ro� s a cco� '' U � e C� i i t� ,S " S ,�C-=S do 5elcol - `1 c yS hL P(or Square feet: 1 st floor: existing T)Zproposed / 2nd floor: existing �UUproposed Total new Zoning District r Flood Plain >J 0 Groundwater Overlay ' O Project Valuation 11 ow Construction Type Lot Size 0A Grandfathered: ❑Yes dkrNo 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: kFull ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) �j Number of Baths: Full: existing Z new Half: existing new — Number of Bedrooms: existing new Total Room Count (not including baths): existing S new .S First Floor Room Count 3 Heat Type and Fuel: Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes . [ No Fireplaces: Existing i 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 L,,,N,Az,-w Proposed Use R"S,�-�-u. APPLICANT INFORMATION _ (BUILDER OR HOMEOWNER) Name �+� ��� __ _ C�Jb Telephone Number 701"��� Address 4� aLicense #_0711(p;SL OZ4 �110 pill Home Improvement Contractor# Email rW r I•C-0h\ Worker's Compensation # wcc.s�so�pf�gzpj,� ALL CONSTR pCT N DEBRIS RES,,LTING FROM THIS PROJECT WILL BETAKEN TO (SIGNATURE DATE i FOR OFFICIAL USE ONLY APPLICATION# t ' DATE ISSUED x MAP/PARCEL N0. y ADDRESS VILLAGE OWNER T• DATE OF INSPECTION: FOUNDATION sll;D FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL r PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ' f4 CAL, ra FINAL BUILDING K°°�K I. 4_ DATE CLOSED OUT ,17 ASSOCIATION PLAN NO. ,; 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): ���� �t tj kk Address: Z_ (2bUi City/State/Zi `t�, , S S Phone#: Are you an employer?Check the approp ' ee bog: Type of project(required): 1. I am a employer with ( 4 l I am a general contractor and I employees(full and/or part-time).* have hired the sub contractors 6. New construction 2. I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have g. Demolition working for me in any capacity. employees and have workers' 9. Building addition [No workers' comp.insurance comp.insurance. required.] 5. We are a corporation and its 10. Electrical repairs or additions 3. I am a homeowner doing all work officers have exercised their 11. Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12. Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13. Other comp.insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ;Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. 1 Insurance Company Name: AS5CcA tk A Policy#or Self ins. Lic.#: dJ L�S O©mod/D/ C{ZO��_ Expiration Date: f's Job Site Address: `j,� �i n 9� Ge ��r t� City/State/Zip: /►144'joB S hJA, ##4 OL648 Attach a copy of th orkers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure co Tage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,5.00.0 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 clay 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 certi ii ins and penalties of perjury that the information provided above is true and correct 'Signature: i Date: S LoIS Phone#: 7-7'1 _ Sid 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#: �TME Town of Barnstable _ Regulatory Services - II �L& Richard V.Scali,Interim Director Building Division A 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 �y��1\ ���` S to act on my behalf, in all matters relative to work authorized by this building permit 5:S S tw PSCII e (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fen is installed and all final inspections are performed and accepte ignature of Owner ignature o pphcant . L ,a,' — (� �5 GroJy Print Name Print Name Date QTORMS:OWNERPERMISSIONPOOIS 10/13 � Ll Massachusetts -Department of Rublic Safety Board of Building Regulations and Standards Construction Supen-isur 1 &2 Family j r License: CSFA-071165 CHARLES R CRO*O — 45 HATHAWAY RD k1 q'R i O.STERV LLE NfA 02655,r( i / Expiration Commissioner 12/20/2015 ^� �e�panvnzoozraea/,l�o�C�/�iia�crcluaelta Office of Consumer Affairs&Business Regulation - ME IMPROVEMENT CONTRACTOR 1 _ egistration: � 38 Type: xpiratiori: "5C2 Corporation DUNHILL COMPANIES;LTsD_ —t CHARLES CROVO 45 HATHAWAY RD OSTERVILLE,MA 02655 Undersecretary License or registration valid for individul use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,MA 0 Not valid without signature Client#:15284 2DUNHILLCO ACORa CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 09/11/2015 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 Dowling&O'Neil Insurance Ag PHONEFA 973 lyannough Rd,PO Box 1990 Mai Erd:508 775-1620 AIC No: 5087781218 Hyannis, MA 02601 ADDRESS: INSURERS)AFFORDING COVERAGE NAIC 9 508 775-1620 INSURER A:AmTrust E&S Insurance Service INSURED INSURER B:Associated Employers Insurance Dunhill Companies LTD PO Box 381 INSURER C Osterville,MA 02655 INSURER D: 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 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. LTR TYPE OF INSURANCE NSR WVO POLICY NUMBER POLICY EFF POLICY EXP LIMITS A GENERAL LIABILITY BINDER398174 8/21/2015 08/21/2016 EACH OCCURRENCE $1 000 000 PXBVVP MMERCIAL GENERAL LIABILITY DMA T RENTED P EMI S E.MD.) occu D. $5O 000 CLAIMS-MADE OCCUR MED EXP(Any one person) $5 000 D Ded:1,000 PERSONAL&ADV INJURY $1 0009000 GENERAL AGGREGATE s2,000,000 GEN'LA GGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $1 000,000 POLICY PRO-a LOG $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per aaddent UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION WCC50050101882015A 7/15/2015 07/15✓201 X WC sTAMI OTH- ANDEMPLOYERS'UABILRY Y/N ANY PROPRIETOR/PARTNERIEXECUTIVE E.L.EACH ACCIDENT $500 OOO OFFICER/MEMBEREXCLUDED? a N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $500 000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMB 1 s500.000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION John DeWitt SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 55 Stonebridge Lane ACCORDANCE WITH THE POLICY PROVISIONS. Marstons Mills,MA 02648 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S157506/M157505 LS1 ACC MEP CERTIFICATE OF LIABILITY INSURANCE °Aosilo2015�"' 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 HART INSURANCE AGENCY,INC. NAME: 243 MAIN STREET PHONE FAX AIC,No): PO BOX 700 ADDRESS: BUZZARDS BAY,MA 025320700 INsu S AFFORDING COVERAGE NAIC a INSURERA: ARBELLA PROTECTION INS CO 41360 INSURED Christopher J Rodrickdba Northern INSURER B: Atlantic Plumbing&Heating INSURER c 26 Aug ustus Way Middleborough,MA 02W INSURER D: 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. �TTR R TYPE OF INSURANCE ��SUR POLICY NUMBER M/DD/YYYY M/DD POLICY EFF POLICY EXP LIMITS A GENERAL LIABILITY 8500048570 10107/2014 101 2015 EACH OCCURRENCE $ 1,000,000 N7:1 MERCIAL GENERAL LIABILITY DAMAGE TO RENTED 50 000 PREMISES Ea omurence $ CLA.1MS4 ADE �OCCUR MED EXP An one person) $ 5.O PERSONAL&ADV INJURY $ 1'mo,ow GENERAL AGGREGATE $ 2,0W,0W GENL AGGREGATE LIMIT APPLES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY 7PRO- LOC $ AUTOMOBILE LIABILITY COEa aaidenMBPED SINGLE LIMIT t ANY AUTO BODILY NARY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY PLURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Per accident) $ UMBRELLAUAB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y I N TORY LIMITS ANY PROPRIETOWPARTNER/E)ECUTNE EL.EACH ACCIDENT $ OFFICEWMEMBEREWxUDED? El NIA (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ R yes,describe under DESCRIPTION OF OPERATIONS below EL.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONSI VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) CERTIFICATE HOLDER CANCELLATION Fax#.(508)428-0453 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE DUNHILL COMPANIES,LTD THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 776 MAIN STREET ACCORDANCE WITH THE POLICY PROVISIONS. OSTERVILLE,MA 02655 AUTHORIZED REPRESENTATIVE C 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 26(2010106) The ACORD name and logo are registered narks of ACORD r BUZZA-1 OP ID:JA A�oRn• CERTIFICATE OF LIABILITY INSURANCE DATE 0911 0120 1�Y1f) 09/10/2015 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 endorsemen s. PRODUCER CONTACT Marchionne Insurance Agency PHONE FAX 11 Independence Ave. c o Ext: A/c No: Quincy,MA 02169- E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A:Scottsdale Insurance Co INSURED Buzzards Bay Electric Co INSURER B:Liberty Mutual Insurance Co. c/o Stanley Andrews 201 Head of the Bay Road INSURER C: Buzzards Bay,MA 02632 INSURER D: 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. ILTR NSR ADDL SUBN TYPE OF INSURANCE POLICY NUMBER MMI DI EFF MM/DD POLICY E Y LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY CPS2112460 04104/2016 04/04/2016 PREMISES Ea occurrence $ 50,00 CLAIMS-MADE 7 OCCUR MED EXP(Any one person) $ 6,00 PERSONAL BADVINJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00 POLICY JFCTPRO LOC1 $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNEDPROPERTY DAMAGE $ HIRED AUTOS AUTOS PER ACCIDENT) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X WC STATU- OH- AND EMPLOYERS'LIABILITY TORY LIMITS ER Y I N B ANY PROPRIETOR/PARTNER/EXECUTIVE C231S390071015 04/03/2016 04/03/2016 E.L.EACH ACCIDENT $ 600,00 OFFICERIMEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 600,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 600,00 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION DUNH001 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN DUNHILL COMPANIES ACCORDANCE WITH THE POLICY PROVISIONS. 182 OSTERVILLE W. BARNSTABLE RD AUTHORIZED REPRESENTATIVE Osterville, MA 0265504- ©19885010 ACORD CORPORATION. All rights reserved. ACORD 26(2010105) The ACORD name and logo are registered marks of ACORD 1 _ o rC_ _ ;�- Ise ( h ,� L���� y ,, � , o„ Sr.� z ;, . _ - ., —__.� �i �'� `_...__-._� `l�11 �"u7 ��~� •�.. • � �.� �. '.- -- ---- ---- Q i � �I QQ i r . _. ' � .,4 Y P TOWN QE BARNSTABLE 7`1r PM 3- 4 � o 4-4 i v i i /h�fiyt I J i I i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map /625— Par0 ©0 7 Application # Health Division_� --/ - Date Issued 10 1 t Conservation Division Application Fee *�5p Planning Dept. Permit Fee d ( • 93 Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis Project Street Address 5_6 <Sl0ll Village ?YY—SW ' /9F2/CL S Owners/aY4- Address cI' i�lC Telephone Permit Request 20 Anabl U z 2 /% / YD�/(O�/ tf'/ ��5� /VAele" 4. Vr1_ Square feet: 1 st floor: existing proposed/7/W 2nd floor: existing proposed Ao/ To al new Zoning District /9,CJ Flood Plain ,,0*10 Groundwater Overlay A10 Project Valuation J Construction Type Lot Size D,Y 196�g Grandfathered: ❑Yes quo If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure O Historic House: ❑Yes ❑�f� On Old King's Highway: ❑Yes awo Basement Type: Dull ❑ Crawl ❑Walkout ❑ Other �- Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) � Number of Baths: Full: existing_ new Half: existing n� c eyti,- 0 p Number of Bedrooms: existing _new o Z Total Room Count (not including baths): existing knew First Floor Rc,!V Count Heat Type and Fuel: 5Y6as ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes [moo Fireplaces: Existing / New Existing wood/c al stover YAM-No. cm Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn:'❑ ex ting ❑mew Mze_ o� Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes U o If yes, site plan review # Current Use Proposed Use ep�/,Ae9 5'27/19C, APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name A UiY117G (fdJl7A22V2 e,. Telephone Number J � '�2�r 92 2 y Address (5/�,_ License # �! Home Improvement Contractor# Gl� Worker's Compensation # ALL CONSTRU 71 /7DIFRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATUR DATE i� �y FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED 't MAP/PARCEL NO. h `f ADDRESS VILLAGE •t OWNER ' DATE OF INSPECTION: FOUNDATION `FRAME 0 K Ij- 0 8 INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL = GAS: ROUGH `FINAL FINAL BUILDING 2. 3 c Z74 A l DATE CLOSED OUT a`G';'4 ON V9' ?� f: ASSOCIATION PLAN NO. :" „I h 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 Leelbly Name(Business/Organization/Individual): . Address• City/State/Zip: 6 ,- 62.46 Pfione.#: Are you an employer? Check.the appropriate b z: :Type of project(required):. 1.❑ I am a employer with 4. a general contractor and I 6. ❑New construction . .-employees (full and/oi part-time).* - have hired the stib�ontractors 2.❑ I am a'sole proprietor or partner- listed on the'aitached sheet 7. ❑Remodeling ship and have no employees These sub-contractors have g, Demolition working for mein any capacity. employees and have workers' �. 9. ❑Building addition [No workers' comp,insurance comp.insurance. 5. 0 We area corporation and its 10.0 Electrical repairs or additions _. required] officers have exercised their 11. Plumb repairs or additions 3.0 I am i homeowner-doing all work 0 myself [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.❑ Other comp.insurance required.] . *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation.policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.. $Contractors that check this box.must attached an additional sheet showing the name of the sub-contractom and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. L Insurance Company Name: 3`tom( s "`' �� c JR atAJ k— Policy#or Self-ins.Lic.#: d l .��1 L Z.O ( Z Expiration Date: i Job Site Address: J�a.rs •✓�"(9�� City/State/Zip: QJ � Attach a copy of the workers'compensation policy declaration page'(show ng 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 a ainst the violator. Be advised that a copy-of this statement may be forwarded to the Office of Investi aiions of thr.XYA for I-DEirmce coverage vegigcattM I do hereby c der ns• aloes of erjury that the information provided above is true and correct Si atur . Date: /C-> Phone#: e.� 2-2-2- Official use only. Do not write in this area, to be completed by city-or town off ciaL City or,Town: Permit/License# Issuing Authority(circle one): J.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to.this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more _of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the _ receiver or trustee•of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the 'dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to-operate a business or to construct buildings in the commonwealth for any applicant. who.has not produeed.acceptable evidence of compliance with ihe.insurance coverage required." Additionally,MGL chapter 152,§25C()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 vidth the insmnince 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-contCactor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies.(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials. Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"alllocations in (city or town)."A copy of the af'idavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves-etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone-and fax number: The f ommQnwWth of M=caGY.1l2wds DepaitmMt of lafttaal Aceid(Mts Office of byesti t ms 60.0 Washington Sbr- a Boston, MA 02111 'del.#617-7-27-4900 ext 406 or 1,-M IMASSAFE Revised 11-22-06 Fax#617=727.7749 www.inass.gov/dia Client#: 15284 2DUNHILLCO 'ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 10/11/2012 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 CONTACY Dowling&O'Neil NAME:PHONE 508 775-1620 Insurance Agency E-MAIL ac No: 5087781218 973 lyannough Rd., PO Box 1990 ADDRESS: Hyannis,MA 02601 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:AmTrust E&S Insurance Service INSURED INSURER B:Associated Employers Insurance Dunhill Companies LTD INSURERC: 776 Main Street Osterville,MA 02655 INSURERD: rINSURER 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 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. LTSRR TYPE OF INSURANCE IANDSRL WVD POLICY NUMBER MM/LDIDY EFF MMIDDY YYY LIMITS A GENERAL LIABILITY NES100415800 8/21/2012 08/2112013 EACH OCCURRENCE $1 OOO OOO JX COMMERCIAL GENERAL LIABILITY PREMISES aENTEDnce $50 000 LAIMS-MADE aOCCUR MED EXP(Any one person) $5 OOO BI/PDDed:1,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $1,000,000 POLICY JEa LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PeOPERTnDAMAGE $ HIRED AUTOS AUTOS UMBRELLA LI1B OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ B WORKERS COMPENSATION WCC501088012012 D711512012 07/15/2013 X WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $500 OOO OFFICERIMEMBER EXCLUDED? a N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $500 OOO If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT s500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) Charles Crovo is excluded from the workers compensation policy. Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION John DeWitt SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 55 Stonebridge Lane ACCORDANCE WITH THE POLICY PROVISIONS. Marstons Mills,MA 02648 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S101915/M101914 LS1 CERTIFICATE OF LIABILITY INSURANCE DATE!MMDDI 02-08-201012 THIS CERTIFICATEIS 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 SUBROGATIONIS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: PAYCHEX INSURANCE AGENCY INC PHONE I FA 210705 P: ( ) - F: (888) 443-6112 (A/CL-MAINoExtl: (IAlC,No): (888)443-611 PO BOX 33015 ADDRESS: SAN ANTONI O TX 78265 CUSTOMER ID K: INSURER(S)AFFORDING COVERAGE I NAIC k INSURED INSURER A: Twin City Fire Ins Co j HULTEN INC INSURER B: I 2 MAGNOLIA RD. ## B INSURER C: YARMOUTH PORT MA 02675 INSURER D: INSURER E: I INSURER F: I 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 REGUIREMENT, TERIA OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO RICH 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. ILTR TYPE OF INSURANCE I'INSR WVDI POLICY NUMBER i(MM/OD/YEXP YYY) (MMEFF PCIDD/YYYY) j LIMITS GENERAL C LIABILITY i f I LEACH OCCURRENCE I $ COMMERCIAL GENERAL LIABILITY I i PREMISES (Ea occurrence) I $ LI CLAIMS-MADE I OCCUR i I MED EXP(Any one person) I $ f PERSONAL&ADV INJURY $ !I GENERAL AGGREGATE j $ GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG I $ POLICY I—�PRO-JE T ��LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO fEa accident) I i BODILY Y INJURY(Per person) I $ ALL OWNED AUTOS If"—( BODILY INJURY(Per accident) $SCHEDULED AUTOS PROPERTY DAMAGE �I HIRED AUTOS (Per accident) I $ NON-OWNED AUTOS I i I ( $ IS UMBRELLA LIAB U OCCUR I I EACH OCCURRENCE S EXCESS LIAB I CLAIMS-MADE AGGREGATE $ U DEDUCTIBLE $ I �RETENTION $ I $ I WORKERS COMPENSATION WC STATU- I IOTH- AND EMPLOYERS'UACIIJ Y Y!N I I I I X I TORY LIMITS 1 ER I ANY PROPRIETORIPARTNER/EXECUTIVE— I I $ 100, 000 A OFFICER/MEMBER EXCLUDED/ u N/A E.L.EACH ACCIDENT (Mandatory in N 76 WEG TQ32 95 If yes,describe under 02/21/2012 02/21/20131 E.L.DISEASE-EA EMPLOYEd $ 100, 000 DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT I S 500, 000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedtde,if more space is required) Those usual to the Insured' s Operations . CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE Dunhill Company DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, 776 Main St . AUTHORIZEQ R PRESENTATIVE Osterville, MA 02655 �� CtL� ..� 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD m '- �Istssaehusetts-Del►:u1huent r►t'Public :Cat'etv a. Bnarcl of Building, Construction Supervisor►Ucensei►►d.►►dti One- and Two-family Dwellings License: CS 71165 CHARLES R CROVO.' 45 HATHAWAY RD OSTERVILLE;MA 02655 " I Expiration: 12/20/2013 ('ummisainncr Trm": 5542 License or registration valid for individul use only ;cc�� ✓fae T�amrna�zcuecr�l�r _p�f ; � -found return fo:' —� Office of Consumer Affairs&Business Regulation before the expiration date. If Regulation �J HOME IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business Reg — 10 Park Plaza-Suite 5170 Registration: -�=1.40459 Type: 2116 Expiration: 461,2A%2013 Individual Boston,N CH LES R CRO.VO"=`-: ?i- CHARLES CROVEt.=�- '= 776 MAIN STREET'+.':., valid without signature OSTERVILLE,MA 02655, -.-'.':• Undersecretary DUNHILL COMPANIES, LTD Proposal October 1,2012 Mr. and Mrs. Dewitt 55 Stone Bridge Lane Marstons Mills, MA Re: 55 Stone Bridge Lane Marstons Mills, MA The below proposal is to construct the new kitchen to 55 Stone Bridge Lane Marstons Mills, MA. The below price includes: i Demolition • Remove mull window • Remove double hung window:and reframe opening • Demo file floor • Remove bath door and frame:and sheet rock and compound • Demo kitchen Installation • Install 3 and %4 inch white oak floor throughout the kitchen and dining area. Floor to be stained to match a sample board of"Gunstock"pre-finish. • Install 30 degree angle bay window and trim. Window to be Andersen 400 Series Narrowline • Install new taller casement window over the sink. Window to be Andersen 400 Series Narrowline • Install casement and trim for bay window L • Install kitchen cabinets purchased by homeowner through Fairview Millwork • Install subway tile. Tile and installation materials to be provided by the homeowner • Remove door to the basement and install new solid core six panel smooth door with a cat door to be provided by the homeowner. Door hardware to be satin nickel hinges and levers • Remove door to right front bedroom and install new solid core six panel smooth door. Door hardware to be satin nickel hinges and levers • Replace pull hardware on pocket door going into the bathroom • New can lights are to be "old work" style. The trim bezel is to be a brushed metal look. A$300 allowance for under cabinets lighting material to be chosen by the home owner labor is included:in base price. Home owner to supply bezels and bulbs for three existing cans located in the family room labor included in base price • Patch holes in ceiling from electrical cans being moved • Paint kitchen walls and ceiling and trim-- Painting to include one coat of primer and two coats of finish paint. Ceilings to receive flat latex, eggshell latex on walls and oil satin on trim, based on one interior trim color throughout_. Based on Benjamin Moore or Shermin Williams paint selections. • Paint bathroom walls-- Painting to include one coat of primer and two coats of finish paint. Eggshell latex on walls. Based on Benjamin Moore or Shermin Williams paint selections. • Price does not include: Architect fees to include landscape design or field supervision Landscape or hardscape to include driveways, irrigation,walkways, or lawn areas, Interior decorator package Removal of asbestos or unknown underground storage tanks if found Moving or Reconfiguring Existing Septic System Changes in Project Scope: Any deviations from these specifications or plans involving extra charges must be agreed upon in writing between the contracting parties and payment is expected upon an invoice being submitted. All change orders will be billed at cost plus 15% GENERAL CONDITIONS: Permits by Dunhill Companies All removal of construction debris, Dunhill Companies responsibility All power and water to be supplied by homeowner All material is guaranteed to be as specified, and the above work to be completed in a substantial workmanlike manner in compliance with local building codes for a sum of: ($19,985.00) Respectfully su tt Charles R C vo 1� Dunhill Co p es/ Signatur6: Date: l Z The above prices and conditions are satisfactory and are hereby accepted. You are—'-- authorized to do the work as specified. ACCEPTANCE OF PROPOSAL: ZSignature: Z J ,� ��1 Date: Q C� , ' , ��y e N y N ( - TOYIN.OF BARN.STAB1 i 125 1" � U —2o —401-� 12 T, 2 906 43Ia' 18" e 24" 30"- - 5" Oil r: o �rdPLA�'� 4, �rvt,: s.��r�t;�otr .. • Z31-E ?�9 JAB VI 830-L W2130-L ' ' i�:1>:: ::;::; W2130-R CW2430-R Dou '1'9 5 E� n ' ._... .0._�-��- D................. .t FB WO CA) ; ' ONTO t tH v Q O r-n 1 � � • v"� � to� � O :� 3•.: ;. y a too)"d a T N t 7 u tJ1(p � 1 0 - CL 0i N oo A Ir�1 07 OD y: W R �ww�lxf 1, 2 t :3. (D - {r: 7 _ N N N 7 a. -i � � p cD Tp 1 � t • .`G 0 "+ ' •I 7 p (a-AD, , ... ` F 0o $ �' y�s T L"9 2 �I 1 l 2 N .o $ c iN FrI.L� Shf�fi' �! aryN Q GNU PO i VI o n) m ' 0 a CD / ........... a...................................... ...._...;............__...� .. m v E A Affimm! P Or—Vc"M -Dooe - moo ra A-c 5'1d692ib8 C tFA,vGE USG „s9— -----_„ S-rA t Aj Do Lo i i►+e r �,�F.� � ToWn of Barn *Permit# i �pP O{y�p ,y•: •, :. Expires 6 mgnths from is ue date -._.:. Fee . �:...:-....._. .Regul-atory Services Thomas:F.Geiler,Director - 161 • CFO Mt►��� ��.BARN..:5 1<F :...Building Division' --Tom Perry, Building Commissioner .. • •.200 Main•Street,- Hyannis,MA 02601--•-••• �u_ • Office: 508-862-4038 Fax:'508-790-6230' . .. - . . .:�:-::�:::.:.•:;-.•-.:.:_•::�.;: �,.::: •••-.... . .... PERMIT. pUCA7'I.ON RESIDENTIAL ONLY. Not Valid without Red X-Press Imprint Map/parcel Number f ZS-- 0 0(v*0 Property Address `Residential Value of Work �,Zdd0 l Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address L S, Contractor's Name �'r�C 1 Off' r-A).TC—rLP/��r Telephone Number Home impr ovement Contractor License#(if applicable) . � Z 3 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 �� Workman's Comp.Policy Copy of Insurance Compliance Certificate must be on file. 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) Q Re-side 2 Replacement Windows. U-Value ,l (maxim •44) �'i D C�'S department regulations,i.e,Historic,Conservation,etc. *Where required: Issuance of this permit does not exempt compliance with other town ep ***Note: Property Owner must sign Property Owner Letter of Permission. Home Improvement Contractors License is required. Signature QTorms:expmtrg Revise063004 • 71. "�"� °�`�i4d� 6 License or re istration valid for individul use only Office of Consumer Affairs&B siness.Regulation g Y HOME IMPROVEMENT CONTRACTOR before the expiration date. If.found return to: Registration:,eV3358 Type: Office of Consumer Affairs and Business Regulation Expiration: �7/8/�ZQ12 Ltd Liability Corpo& 10 Park Plaza-Suite 5170 —_—Ewa Boston,MA 02116 TCAWIDE ENTEc2 RICHARD CAPE i 4507'R'RTE 28 COTUIT,'MA 02635 ^y Unae�secretary t valid wit tsignature t MV assachusctts- D-e.pru-trimit of Puhlic Saret., Board of BuilAin Rel-ulations and Standards Construction Supervisor License License: CS 89273 Restrictecfao;;, i)o,.. ,r RICHARD" `-:CAPE S. M ; A uv. 1;W.HITMAR`RD COTUIT;;MA'0263'.5 Expiration: 11/27/2011 V ('omni.issinni i 3rt.: 9638 ' EIG -Fax Server 5/10/2010 3 : 08 : 38 PM PAGE 2/003 Fax Server AICORD. CERTIFICATE OF LIABILITY INSURANCE -705/10/2010 PRODUCER (800)666-0200 FAX (781)Z61-1111 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION tern Insurance Group LLC - Main ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Accord Park Drive HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Unit Bl Norwell., MA OZO61 ' INSURERS AFFORDING COVERAGE NAIC# INSURED CAPEWIDE ENTERPRISES LLC ANDr INSURER A- Selective Insurance Co of SC 19259 JP MACOMBER & SON INSURER B: ACE USA PO BOX 763 INSURER C: CENTERVILLE, N.A. 02632-0763 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERl D•,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 gONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED.BY PAID CLAIMS. INSR DD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POL ICY EXPIRMIDATION LIMITS GENERAL LIABILITY S 19Z9637 04/30/2010 04/30/2011 EACH OCCURRENCE $ 1,000,0001 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100 1 O CLAIMSMADE D OCCUR MED EXP(Any one person) $ 5.00 A X PERSONAL BAOVINJURY $ 11000,00 GENERAL AGGREGATE $ 2,000,000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS.COMP/OP AGG $ 2,000,00 POLICY FXJ PEC LOC AUTOMOBILE LIABILITY A 9092960 04/20/2010 04/20/2011 COMBINEDSINGLELIMIT $ ANY AUTO (Ea accident) 11000,000 ALL OWNED AUTOS BODILY INJURY X SCHEDULED AUTOS (Per person) $ A X HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY•EAACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY S 1929637 04/30/2010 04/30/2011 EACH OCCURRENCE $ 51000,000 X OCCUR CLAIMS MADE AGGREGATE $ 5,000,000 A $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND C4628477A 04/14/2010 04/14/2011 X To�Y L MITS °EH EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $ 500,000 B ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L.DISEASE•EA EMPLOYE9$ 500,000 If yes,describe under SPECIAL PROVISIONS beIcw E.L.DISEASE•POLICY LIMIT 1$ 500,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS vidence of Insurance CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL —rO#)L) Q_DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ��- -- onald Cleaves/SEW2 C ACORD 25(2001108) ©ACORD CORPORATION 1988 The CONIn10AWealth Of Massachusetts �,^ k. P'.:i"'. .7q^,�'"y- Departnsent ojlridasfrj4,Ac•cldents y OAiee ojlnvestlgadons ». 600 Wa hington Street Boston,MA 02111 � �..r.� wwwaxass gov/dla Worken' Compen�adou�Io'snrance�,Af ldsvit::Builders/Coutractor�s/Electriclan�/Plumbers � :z��n>pUcsntIoformados'`�y'�;:'�."' - . • , . . . Please Print Lettibly Nattie"(Bu:inesf%Organiiatioivtndividual): e. 0 �y 'Addresa:r�. X �7(0 3 GtY/StatelZip: G2•y,.t✓c. .y�V( p�gZphone#:,�5 dZ8 -eyI — .1ie yooIn' employer?Cheek tti appropriats'bos Type of projiet(regtttred l am a eatployer,with Vs 4'0 1 sire's general contractor and l v e to ces till!and/or tune .: ` havehited`the lub-contiactora 6 ❑New conapvcdon (� Pam- ) 2.❑ 1 am a sole pwineto:or partner- listed on the attached sheet. 7. 0 Remodeling.- ,�, ship and have no employees These sub-coatractoraahave 8: (]Demo4tJ wor6ns for rr a ii any capacity. "` —employees and have workers'_ 9..; [No workers'comp. insurance comp. insurance.$ 0 Buildi4 addition ;. ,, 5.,0,We are s corporstion and its 10.0 Electrical repairs or additions 3.❑aI:am s liotrteoaRter doing all.work otEcers tiave exercised$bell :- 1 l.❑PlutttbtoR repan or additions Rmyself,[No.workers'comp. nght:of exemption per MOL insurance required:j t c. 152,4 12.0 Roof repaid¢1(4),and we have no . z, employeesr'[No workers' 13. Other _I&E.P Gib - ,r `CO .nlauranCC •MY,=?pPNc !jt st chaks boil A!t,mwt atw:flq out the seceion below horin�thek wortien'eo "" f Homeowners who�ubmi thiar"a8ldavit mdicatin ' � Y mtamiaties. _ ,t �. a!� duin5 aq wort.eud'llrn hds auuido contntctote rnuet,tubrtiit a iiaw�altidivii indicatieN=akh tContraetoe that eheck this boa must etdched ai iddittdtia!riteetihowdtil the ease ofthi subcon&wton and soft whe' -ornot Chow eetides_havt cnVloyeea!aifdwvjb•ccetacton have maul i a^PbYK+.dwY` Pam'dt ttieb wvrloen'conk:poNry numbs.; #; I'em'ow=employer'Aat Is provtding workers'compensation bsatrr+sacti joi'niy esrptoyees Silica 4 tAe" awd o1't!h lejorwiallo� /1 � p°�S M, .. �. Insurance Company;Name: 8: � w�;�- PoUcy'q Expiration `Jo6 Site Address ' 57OUG&4ZC� 12) ";f, s CityiStite/Zip: /- -5-7Onx.Q/�ILcS /ljg- Attach a eopy,of the workers'eompenis,.on Polley dceliiratlon a e sahowle the_ s.. p, g j , , .g po&T nuinbet'r and eipiistion date). Failurcdo secure coverage as-required under,Section 25A of MGL c..152 can lead to the imposition of criminal penalties of a fine;up to 11i500.00 and/or,one-year imprisonment,as-well as civil penalties in the.form ota STOP WORK ORDER .and a fine of up to$2SO.00 a day against the:violator. •Be advised thatra copy of this-statement may be'forwarded ioihe OtTice of Investiaadotu of the.DlA,for insurance coverage"veriRcation. Qo'heiiA"earl! wnQer rAt ilea°aed 'lira/Meg o e w ihei tAs le o"i o1/ o provtded idove It-we and cot lice$. . . . xC•rx.•. .ram... - Phone �b' 4-Z� 42ZS ,— Offlelel use.,n ite o not wr in i " arts,to be comp de or to wsi of)?clo4 City or Town: w r• 'Pernilt/Llcense 0 Issuing Authority(circle one): a 1. Board of Health 1. Building Department 3.City/Town Clerk 4. Electrical Inspector S. Plumbing Inspector 6.Other Contact Person: Phone M: Capewide . . ENTERPRISES, LLC J.P.MACOMBER& SON Post Office Box 763 MAY 259 201 0 Centerville,MA 02632 PROPOSAL SUBMITTED TO: WORK TO BE PERFORMED AT: NAME: John DeWitt ADDRESS: Same as Opposite ADDRESS: 55 Stonebridge Rd Marstons Mills,-MA 02648 PHONE: 508-420-1815 Capewide Enterprises, LLC proposes to furnish all materials and labor necessary to complete work at the subject property at 55 Stonebridge. • Will remove existing trim and slider • Will complete all flashing and weather stripping • • Will install new Pella (designer series)sliding glass door • Will complete all trim work required for installation The material is guaranteed to be as specified, and the above work.to be performed in accordance with the drawings and'specifications submitted for above work and completed in a substantial workmanlike manner. NOTE - This proposal may be withdrawn by us if not accepted within 30 days. Any alteration or deviation from above specifications involving extra cost will be executed only upon written order, and will become an extra charge over and above the estimate; payment for the extra is due in full before 0—,e-chrge made aA11Et `' agreements contingent upon strikes, accidents,,,ory delays _beyond�zeur teoir trol `C��'R�e n er�pr�ses:t is not responsible for driveway damage due to the weigl r affegxuip rient/machinery. ACCEPTANCE OF PROPOSAL The above prices,specifications and conditions are satisfactory and aneftreby accep ed. You are authorized to do the work as specified. Payments will be made as outlineq, pooye V x Customers .n i`Ta� }�.���.ch�..�'tj,� v r.�u.^"fi*c a��x2 �Ic�✓.Q\�s�'"c�t �-"°�' i t ,y,< zr .5 '3 °•�• 'a.ti i .,-r1 . /. � �.d.�y{S� r ! e _ Date �� SignaltUre,41, yw � � � Kai nd r u�thczriedG�ewade�EnterprisesRepresentative �° s . to s 3 w - { a. < r . *",p 41 e. 4, di-a 9 j Y, ` •,y'i. iszl�AYfiy;ay„r - .sf�"'•..ir4`s .Ij T\!tV(, r1S` +f • J F✓f < 3 T��s 7�fi: t Y!' o �v7 ''ZF e `aR'r �.✓r �,e`I+} t.-.��+. f;F, +a `M . Phone: 508.428.4028 Fax: 508.428.3928 Rich@CapewideEnterprises.com s,:iSa'v;i:spy� ''� ' �- ._... •t ' ,�� ;.-,,.,ta' ,. Joao@CapewideEnterprises.coin iM a www.CapewideEnterprises.com I We Town of Barnstable *Permit# Expires 6 months from issue date Regulatory Services Fee Thomas F.Geiler,Director ®�° � �" ' Building Division SEP .l 6 2009 Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA.02601 TOWN OF gARR1ST,qFXE www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid►vithout Red X-Press Imprint Map/parcel Number Property Address SS S C l C- LVIn/1. / [Residential Value of Work 'C0b ' U Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address S�`� V3 C�A) I 1 r �S S 10 A-J 3 tj t( QG C L (1- AJ G-. Contractor's Name C ��`j ly3 C'" ( C,`-OA t Telephone Number' 5. `7 C) f� Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) z BNorkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner [( I have Worker's Compensation Insurance Insurance Company Name A C u S'� Workman's Comp.Policy# 2— Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ® Re-roof(stripping old shingles) All construction debris will be taken to (—A ❑Re-roof(not stripping. Going over existing layers of roof) Re-side Replacement Windows/doors/sliders. U-Value -�j (maximum.44) *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 is required. SIGNATURE: Q:Forms:expmtrg Revise061306 L i The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations" d 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): L 0 P W l O C-" Cam' C c1,(P/(� •Address: S O C City/State/Zip: C 0 f y rry9" Phone.#: S60 Are you an employer?Check the"appropriate box: "Type of project(required):. 1.' I am a employer with k S 4. ❑ I am a general contractor and I * have hired the sub-contractors 6• ❑New construction . employees(full and/or part-time). 2.El am a'sole proprietor or partner- listed on the"aitached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, []Demolition working forme in any capacity., employees and have workers' 9. ❑Building addition [No workers' comp.insurance comp.insurance. $ 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions required] � • 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.M Roof repairs " insurance required.] t c. 152,§1(4),and we have no employees. LI`T to ees o workers' 13. Other too lr — S t A comp.insurance required.] NCB *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. 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.polidy 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: (��^J s U A- `�ri CC Policy#or Self-ins.Lic.#: e—`t� E `C �� Expiration Date: 0 Job Site Address: S ol"c 811_U0,CC"- City/State/Zip: I i 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 th IA for insurance coverage verification. I do hereby certi under the ins�and penalties of perjury that the information provided above is ue an correct. Si ature: Date: /� Phone#: C) 0_f ca use only. Do not write in this area, tb be completed-by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): A.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver nr trustee-of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling-house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to'operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance,coverage required." Additionally,MGL ohapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for,the performance of public work until-acceptable evidence.of compliance with the insurance requirements of this chapter have been presented'to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contiactor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies'(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit: The affidavit should be returned to the city or town that the application for the permit.or license is being requested,not the Department of Industrial Accidents.- Should you have any questions regarding the law or.if you are required to obtain a workers.' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their Self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete'and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"an-locations in (city:or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as.proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related io any business or commercial venture (i.e,a dog license or permit to bum leaves-etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions please do not hesitate t6 give us a call. The Department's address,telephone-and fax number: The Commonwealth of Massachusetts Departmemt of kndustrlal Accidents Office of Investigations 600 Washington Street Boston,MA Q2111 Tel.#617-727-490.0 ext 406 or 1-977-1\IIASSAFE Fax##617-727-7749 Revised 11-22-06 www,mass.gav/dia 09/14/2009 11:02 15087599100 ONSET COMPUTER CORP PAGE 02/02 �. Town of Barnstable. Regulatory Services $ saute Thomas P.Goiter,Director Building W-Asion Tom Perry, Bui1d(ng ConwWssioner 200 Main strew; Hyannis,MA 02601 www.town.barnstabte,ma.us Fax: 5U8-790-.6230 Q$ce: 508.862-4038 property owner Must Complete and Sign This Section If Using A.Builder as Owner of the subject property s - hereby authorize C w,G�Ql�Fr 3e S L_C, to act oia my behalf, in all mratt=relative to work authorized by-this building permit,applicatwn for. . _ (Addms9 0t j0 ) 1 9 I� 2P�Qj9 S'0=e Owner Date a Print Name Q:Fow�ts;a�viap.Iu'�ItMTssYota Z00/Zao[A HQIAHdV3 R76V9i:V?Q5 Xdg 99:60 B00?/V[/60 DATE(MM/DD/YYYY) ACORN, CERTIFICATE OF LIABILITY INSURANCE 0411512009 PRODUCER (800)782-0251 FAX (781)261-2099 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Eastern Insurance Group LLC - Commercial ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 77 Accord Park. Drive HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Unit Bl Norwell'. MA 02061 INSURERS AFFORDING COVERAGE NAIC# INSURED Capewide Enterprises LLC INSURER A: Hanover Insurance Co. 22292 PO BOX 763 INSURER B: ACE USA Centerville, MA 02632. INSURER C: INSURER D: 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. INSR ADD'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY LBN5336555 0413012009 0413012010 EACH OCCURRENCE $ 1,000,0061 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 300,001 CLAIMS MADE �OCCUR MED EXP(Any one person) $ 10,00 A PERSONAL&ADV INJURY $ 1,000,00( GENERAL AGGREGATE $ 2,000,001 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00( POLICYF_j JE OT LOC AUTOMOBILE LIABILITY TBD AUTO 0412012009 0412012010 COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) 11000,006 ALL OWNED AUTOS BODILY INJURY X SCHEDULEDAUTOS (Per person) $ A X HIRED AUTOS BODILY INJURY X NON-OWNEDAUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) �,• GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY UHN5336545 0412012009 0412012010 EACH OCCURRENCE $ 2,000,OO OCCUR a CLAIMS MADE AGGREGATE $ A ,000,000 $ 2,000,00 DEDUCTIBLE $ X RETENTION $ 101 00 $ WORKERS COMPENSATION AND C45761472 0411412009 0411412010 WC STLIMITS I I ER ATU-7 OTH- EMPLOYERS'LABILITY u E.L.EACH ACCIDENT $ 500,00( B ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYE $ 500,0O If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,00 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Evidence of Insurance. CE T FICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING.INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 4. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE' Ronald Cleaves/KC1. ACORD 25'(2001/08) ©ACORD CORPORATION 1988 Board of Building'Regulatioiis and Standards Construction Supervisor License License: CS 89273 Expiration: 11/2712009 . Tr# 11090 Restriction: 00 RICHARD M CAPEN 122 WHITMAR RD �"l �j— COTUIT, MA 02635 Commissioner , ✓die �ornnrrearzu�et�/a o�,.�l'laaaac�euae�la �Z \ Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 143358 Expiration: 7/8/2010 Tr# 272627 Type: Ud;l.iability Corpor CAPEWIDE ENTERPRISES L.L.C. RICHARD CAPEN 4507 R RTE 28 � ----. -COTUIT,_MA.02635_-____. 00-35,000 cf enclosed space lA-Masonry only 1G- 1-2 Family Homes Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. License or registration valid for individul use only before the expiration date. If found return to: Board of Building Regulations and Standards One Ashburton Place Rm 1301 Boston,Ma.02108 tYalid without ignature d�� �e�-.���s SS S�an� Bi~ta � �� . m� �a�/ao� a� 1���s i } t �k TOWN OF BARNSTABLE Permit No. ..33821 BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash 7 .Yl 6j9 X. \ .. HYANNIS.MASS.02601 Bond ..... .. CERTIFICATE OF USE AND OCCUPANCY Issued to Capricorn Realty Trust Address Lot #5, 55 Stone Bridge Lane Marstons Mills, Mass. USE GROUP FIRE GRADING OCCUPANCY LOAD K THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND.IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. July 26, 90 �G ,.. Building Inspector TOWN OF BARNSTABLE BUILDING DEPARTMENT ! asaa�r�m _ TOWN OFFICE BUILDING rua HYANNIS, MASS. 02601 MEMO TO: Town Clerk r FROM: Building Department DATE: _ 761 An Occupancy Permit has been issued for the building authorized by Building Permit #. .. .......�5 ........ ...... .............................................. .... _..........�..._ ....__...... ...�� issuedto ........./ � I............ . ..... ,.. ........ �..� ... _. ..._�_. __ Please release the performance bond. TOWN,OR BARNSTABLE, MASSACHUSETTS ' ti-125-, 006=001.0.02 DATE June: 21, 19 90 NQ ~ 33821� PERMIT NO._ 'APPLICANT Franco R. Er Dev. Co. ADDRESS_ 765 Fa1mOLlth Road, Hyannis #00U989. - (N0.) (STREET) (CONTR'S LICENSE) A' PERMIT TO,•"' Build Dwelling (—!-I STORY Single Family Dwellin�WEBL�RN OF G UNITS ° ."(TYPE OF IMPROVEMENT) NO. (PROPOSED USE) "Lot #5, 55. Stone Bridge. Lane, Marstons Mil ls ^ zoNIrIG. (AT,'(LO¢ATIONI.R DISTRICT- RF +•. (NO.) (STREET) �- 4AND ?' (CROSS.STREET)• (CROSS,ST REE7) LOT SUBDIVISION; LOT BLOCK SIZE. BUILDINGa1SfT0,BE FT. WIDE BY FT. LONG BY FT. IN.HEIGHT AND SHALL CONFORM IN CONSTRUCTION • "; -;TO TYPEa' USE GROUP BASEMENT WALLS OR FOUNDATION* I '> (TYPE)} M , ga #8•REARK$ -' 9-155 .. .. c f Bond (AREA OR+ AOO S ft• A OO VOLUME y Q� 'ESTIMATED COST 40/.�00.,0'� FEEMIT 64• �'+ Y '(CVBIC%SOUARE FEET) _ x- - :y owNER ,`Capricorn Realty Trust t;; 6S_`Falmou / Hyannis Road HT c"1'nnis BUILDING`DEPT. ADDRESS BY IS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING AND "A 1. FOUNDTION OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIREO,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MINAL INSPECTION TI TO BEFORE FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 Aze U61, INS . 1 �sc.4�o-n.a� Q �ww�,owvt 2 - L 'P I g- 2 7 LA 3 JA S HEATING INSPECTION APPROVALS ENGINEERIN EPARTMENT 1 OTHER 2 aJBOARD OF HEALTH t� 2 �l 7- X6*419x.`.L WORK SHALL NOT PROCEED UNTIL THE INSPEC• PERMIT W!L L BECOME NULL AND VOID IF CON S T RU CT,I ON INSPECTIONS INDICATED ON THIS CARD CAN 8E TOR HAS APPROVED THE VARIODUS STAGES OF WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE CONSTRUCTION. ARRANGED FOR BY TELEPHONE OR WRITTEN PERMIT IS ISSUED AS NOTED ABOVE. NOTIFICATION. t _ i \ om �0 Apr hti �B(o.4•f I .Q / t Sr.. 5--i7-90 INITIAL ISSUE k54.4 THIS PLAN IS NEITHER INTENDED NO DATE DESCRIPTION IBYI FOR, NOR SHALL IT BE USED FOR u�Lr ...iiti7D 4ria�Y — Lor S MORTGAGE LOAN PURPOSES. / Srr��vE �RrX LauF �TRE�vr3R�ER L�✓�C,oOMENT�D� SCALE: / 40 JOB NO. /50¢ I CERTIFY THAT THE FOUNDATION SHOWN ON THIS PLAN IS LOCATED �� PAUL A. v ON THE GROUN DICAT LEVY No. 10617 a G1 Q LEVY, IDROGE & TAM ASSOCIATES INC. t �t�..' DATE REGI T ED LAND SURVEYO .? T%^e;� 7F`% �� � t Qffi 889 WEST MAIN 8TR Xr CENTERVII.I� UA 028:L' w �j C3 n P1Rlun IF I I Lv1. i t - gj4TH • .. ._..._. 1-- t�l�ulaC�— � kITC•NEN_ i._. i gc ooh Nf LL- GLN N `7 SC*" 1.•41✓L1 •PIPO"Do' DP•wM Br �(/ o•lf r7/ .�Q PfrSEO 4•'= I'_ O, WE GRUN?RIER f i I I CORPORMON I /avP..m MW�f 1 10 ram,EYu o.•.nwD I.D.�610 (SW 77..3616 1 oK 1nAssess$ offioe Ost floor): '��� THE �/� •/ .Assessor's rrnap and lot number �5.. 114 „oDoz� U Board of Health (3rd floor): q SEPTIC E®N C NIPI. Sewage Permit number �< `�L �+ INSTALLED •11TLE 5 g .... .. ..... . �.. 1 Z BAH3971►DLE. Engineering Department (3rd floor): ............. 5..,, � ?..:. y ENVIRONMENTAL COD WY9. House number .......................... TOWN aEGULA TION APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00•2:00'P.M.'only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...G411.str.Vj.qt;,,, •.,sngle,. family dwelling TYPEOF CONSTRUCTION ......W.O.Q.d...tXame.................................................................................................:... Mdreh 25 89 TO THE INSPECTOR OF BUILDINGS: , The undersigned hereby applies for a permit according to the following information: Location Lot #5 Stone Bridge Lane Marstons Mills ProposedUse ......................................................:...................................................................................................................... Zoning District ..........ILI................. Fire District ..Q.enrvl,le/Os r teville Name of Owner Ca.P;;i.QQKXI.,• ............Address ...7.6.S...i 1MQ.Vt.h...Rd.,....UY4 Ais,,•............... Name of Builder .... ra.nc.Q...R-E.,...PeV.,.G.Q...T.nQ......Address .7.6.5...FAIMQ.uth... .....�.......:.. Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ..........$iX.................................................Foundation ..... ...G.,................................................................ Exierior C,.a.Pb.Qar.d...and/.Qr...5hi ngles....................Roofing ...X�,hPalt...sbingle.$....................................... Floors ......car.Pet.................................................................Interior ...p eetrock ............................................................. Heating ....Gas,- .-.W.A........... .............Plumbing ...TWQ-CoP.Per.................................................... Fireplace .....Ye.5...................................... ........Approximate Cost ........$4 0...0 0.0 ....0.0..-... ..................Cj.............. Definitive Plan Approved by Planning Board __:___ Z 3__-_______. _ � . Areo �� ......._... .... .......................... Diagram of Lot and Building with Dimensions Fee / SUBJECT TO APPROVAL OF BOARD OF HEALTH 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. Nam ...... ..... . .... .%.�.�... ! ... Construction Supervisor's License .... 0 0 9,8 9................. CAPRICORN REALTY TRUST 14o ...3;3,821.. Permit for ...1.z... t6?.1;y............ SM ��....Sing1e. Fam..... ............ Location .Lot... ......... `....S.t.QXIQ...J3.X'.3.g.e Lane L • ......................... Owner .... apricorn Realty, Trust,,,, Type of-Construction FX,E:IMQ.......................... ........ .............................................................. :a Plot .......... .................. Lot ................................ Permit Granted .....June•,.2,1.,•,,,,,,,,,,,•,19 90 .......//.....................19Date of Inspection .......' Date ompleted ...........19 Assessor's offioe (1st floor):` { / ' �� ` \u �/6 Assessor's map'and lot number ..../.. J�.l....����6:, 6/41 �TNETod♦� Board of Health (3rd floor):h Sewa a Permit number 1 J( .,!I+. .........................�.. . :... ± r g .. VVV + Z BABS9LL31LE. i Engineering Department (3rd floor):,. N o• House number ° ). ; SAS,,,,, / �?!„ ° 3 �e ..... �£0 MIR d' APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00•2:00 P.M. only TOWN OF BARNSTABLE BUILDING INSPECTORrfl APPLICATION FOR PERMIT TO ...construct„a...single familv,••dwellinq y- TYPE OF CONSTRUCTION ......W.nnd...f.name..................................................................................................... ................ i' ...2`-?.i.19...87 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location Lot #G Stone Bridge Lane Marstons Mills ............ ...................................................... ProposedUse ............................................................................................................................................................................. 1 R.F. Centerville Osterville Zoning District ........................................................................Fire District ............................... ............................................. Ca ricorn Re alt Trust 765 Falmouth Rd H annis Name of Owner ......P................................Y...........................Address ...........................................r......Y..............-.s............. Name of Builder .... ranco,.,R.E......Dev,..C.o.jnc.....Address 765„Falmouth„Rd,,.,Hvann s,, MA.......... t` 'Name of Architect ..................................................................Address .................................................................................... Number of Rooms ..........SX.................................................Foundation ....P...C.?................................................................ _ xlerior Clapboardand/or.,shingles:.:.................Roofing ...4shPalt...shiagles,,, Floors ......carp.....et .Interior ...sheetrock ....... ............................................................... . .......................................................................... Heating ....GdS—F.W.A.. p ....................................................Plumbing ...Two-Coper..................�. Fireplace ....Ye.S......................................................................Approximate Cost ........$40.a.000-.00.................... :.......... :: Definitive Plan Approved by Planning Board _______-//_/2_3__._______19_ �. Area .......................................... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH 41 i. n 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. c Construction Supervisor's License 00.0989 . CAPRICORN REALTY .0 /02 j ooG • 607 No .33821... Permit for .... .....Story Single Family Dwelling Location ..Lot #5, 55 Stone .Bridge Lane Marstons Mills ............................................................................... Owner Capricorn Realty Trust ........................................................ Type of Construction ,.Frame .... . ............. ............. ............................................................................... Plot ............................ Lot ................................ Permit Granted ....June 21 , 19 90 Date of Inspection ....................................19 Date Completed ......................................19 C,oi 9 ea A PERIP'liI� COMPLETED 1111 9a v 6 , I+• IL. LEACHING PIT DETAIL REVISIONS: .: DETAIL.. 1000 GALLON DISTRIBUTION BOX DETAIL: C G �A: SEPTIC TANK -�- SOIL TEST PIT DATA: VO CATIES yNDIc1►TEs NOT TO SC L iiOT TO SCALE - •.. NQ tATE r PERC. OBSERVED NOT TO SCALE �► E 41ROUNDWATER /cv a rJ i11►NMOLE UOVER 4bw C SEED L SEPTIC TANK SMALL BE STEEL 4. INLET AND OUTLET TEES TO 8E CAST IRON OR NO. OF OUTLETS. OR t VEMENT NOTES: _ Z I SROUBHT TO F NW ORAOE ! I" •. REINFORCED CONCRETE. 'TCHEQ 40 PVC. TEES TO %E CENTERED UNDER TP TP TP NOTES! DTP 'MANHOLE LOVER • / }� 2. SEPTIC TANK TO WITHSTAND LOADING ,_ r---�-1---� // .-ORD.£L._ GRD. EL. L DMt BOX TO WITHSTAND H-fO LOADING 21 II CO3 :ORD. EL. M NT•bR S OR 1QiRD L. .e0_ UNLESS UNDER PAVE E tvE j 1 UNLESS UNDER PAVEMENTS DRIVES ORFILL OW. 3 W E . E •40W. EL. GW. EL TRAVELED WAYS.WHEREIN H-20 LOADING Ep ! ,... �i L !�-�O� _ :AW L• - t TRAVELED WAYS WHEREIN 1111140 LOADING �� :Y - PRECAST • SMALL APPLY. ;. p 1 1 SHALL APPLY. ...•; :: .. .•. • • •,• _ • - , TO/� SL/8 3. ALL PIPE CONNECTIONS AND CONCRETE �a1w+oL[ xn i 5 1 ' DIST. ...•.._.... •. . ' ' - CONSTRUCTION TO BE WATERTIGHT. snoeT to[ Mw[ 1 BOK 2. PROVDE INLET TEE OR BAFFLE WHERE SLOPE OF o PVC INLET PIPE- o o v v » a o o is INLET PIPE EXCEEDS 0.08 FT./FT OR IN e _ - 1 i PUMPED SYSTEM. d a L---r o 1N0TEt _ GENERAL NOTES: 1 u cow" 3. FIRST TWO FEET OF PIPE OUT OF DIET. � I OO O GALLON LEACHING PIT , Zf PERG $ -6 ,. BOX TO BE LAID LEVEL. �b o n o a t� c WITHSTAND H40 LOADING ` �' , PLAN VIEW o coo UNDER L THIS PLAN tS FOR DESIGN AND 3 _. / :-•:••• .•.!•.•_. ;. y N. UNLESS U • ' - C- CONSTRUCTION OF THE SEWAGE PRECAST I, REMOVEABLE r• • A4VEMF.NT,DRlVr, vR nOMAL OaTt u[r[L UOVER �•, 3✓4 To I-- o n o a o .a. o o c • . TRAVELED WAY WHEREIN DISPOSAL FACILITY ONLY ; DOUBLE 'LEACHING ,PIT -moo H-20 LOADING �::ALLAND . :` ` I •COAR..S� ----I r I O11 _ �5.671 2. ALL CONSTRUCTION METHODS _L 11 >fIfASHEO - APPLY. MATERIALS SHALL-CONFORM TO AUIsS. t I4 ao �9Al'o RAVI<L v v PROVIDE :.;- :•;: :.: ..•» ::»�:.-.....:�'.- o +v o a ono ' t \ INUT T[[ M►A HT - - (no Ii+n*isl , D.E.Q.E. :TlTLE 'S AND LOCAL:BOARD SotitE /itlE 1 _ ., o 0 o ct o 0 0 0 0 1 11 JOINTS trp) .t OF HEALTH 12E8ULATIONS _ 1 — PRECAST e� 4'.O•MM. OYTL[T .5-8 _ J'_1l![[ °y r?: O : _ _a ; t �• o o n o 0 o v p 3. ALL PIPES LOCATED UNDER PAVEMENT 1 SEPTIC 1 L}I-loll LgIJ10 tf[ITN Ti[ 4" INLET 1 �� .:) \ \ d MOT[-tt _ — - l �'- N .�r r ,�. OR TRAVELED WAY SHALL DE /KED/U/Vf t 1 : LI1 I 4 OUTLET a •. ,. SCHEDULE 40 OR EQUAL. I Tel I t s •. sL ---�.� ::•L--------J , 1 1 4. ALL UNSUITABLE MATERAL (TOPSOIL, L_________ __ __ - - ___.! ;� T' �.• - Z F OIA. 2 SUBSOIL, CLAY) ENCOUNTERED BELOW 54AZ0 teoTTor oM L[V[L 1TaeL[ eeasc 4,:0 a-� o �LEVELST7►BIF IOTTOM ONI OIA. BEE REMOVED INVERT OFOR A F THE LDISTANCEACH E OF PLAN VIEW CROSS-SECTION VIEW CROSS-SECTION `_ > SASE 10'• AROUND .AND REPLACED WITH CROSS-SECTION CLEAN COARSE SAND. ' !: l o wA7"�� S� DATE: DATE:. DATE: DATE: :. 5-31=88 INVERT ELEVATIONS: TEST BY: TEST BY: TEST $: ` TEST BY: AA INVERT AT $UILDING loZ-2a-2a . STLPHEN H S .. . m. .., , ` ` INVERT AT SEPTIC TANK(in) 300 WITNESSED BY. WITNESSED BY: WrrHESSED BY. WITNESSED BY. JERRY DUNNING INVERT AT SEP o IC TANK(Out) �' PERC. RATE: PERC. RATE: PERC.AA t E: PERC. RATE: ` INVERT AT DIST. BOX(in) < 3 MINJINCH MIN./INCH 'MINJINCH MINJINCH INVERT AT -DIST. BOX(out) :#. INVERT AT LEACHING PITS DATUM �. D � BOTTOM OF LEACHING PIT 55":60 Al / U.S.G.S. MAXIMUM GROUND VERTICAL DATUM: N.G.V.D. WATER ELEVATION • 00� OBSERVED GROUNDWATER BENCH MARK USED: T.- �' , i ELEVATION M28RA DISK M.H.B. ROUE 28 EL. 61 .76 N G.V.D. O ,• L �• 38 � . T Z O N E D : R.F pie/✓p r SE��YBACKS ( OPEN SPACE) : . FRONT : 30, t l�l 4= 45.93E - SIDE . . . 15 � � � REAR. 15 I 64 DESI , � I GN CRITERIA. = 6Z �... ' I7.3 j -. 9(o _ S. F I DESIGN FLOW: ti w Lc)-r' G� t i 0. 40 ± A C . _ I 3 BEDROOMS AT 110 :• _ . GP.B./D a+30 GP.D. ITZNOTES I 1 NO GARBAGE GRINDER • , L c,T � -� t 23 I The BSC Group ' 1 . FOR PROPERTY LINE INFORMATION, SEE PLAN I � � t •' � ., _ � I REQUIRED SEPTIC TANK. RECORDED AT THE BARNSTa�3LE REGISTRY OF DEEDS. cA ` . PLAN BOOK 447 PAGE 44. 330 X 150 % = 45 GAL. 2 THE TOPOGRAPHIC INFORMATION SHOWN WAS I / P/2�p�5 �. '�[22� d SEPTIC TANK PROVIDED: = 1000 GAL. OBTAINED BY AN ON THE GROUND SURVEY. 44 ¢ � �_��_ � M 2 MI �J SIZE OF LEACHING FACLrT1Y REQUIRED: Cape Cod Survey Consultants r i 3. UNDERGROUND UTILITIES WERE COMPILED FROM AVAILABLE DELL//«'� t t 3 OE3X3N PERC.RATE: MINJINCH ; ' RECORDED PLANS OF UTILITY COMPANIES AND PUBLIC AGENCIES QV ?;O•F •P 3236MainStreet AND ARE APPROXIMATE ONLY. BEFORE CONSTRUCTION CALL �� 0 q� `� \ c, .pN�x , Route6A 'DIG SAFE' 1-800-322-4844- h 5' t _ 330 G. P. D. CAPACITY BamstableVllageMA "�- /006 Vic. 02630 ! 'l. rC ?FINK t 617 tf� �33 �_♦ SIZE PROJECT TITLE: 'Peep x DiA. E OF LEACHING FACLTTY PROVIDED. EL=io3.tv ` W/Z' sTn�E W DEEP X 6' DIAM. PIT W/2' .'TONE - �N.,�4 :�.�- _ SEWAGE DISPOSAL - .• � '► �: � S_IDEWALL 178 S F X 2-0 = 3.a6 G.P.D. . I SYSTEM DESIGN w BOTTOM 79 S F X 0.83= G5 G•PD• OF �_. i ---- TOTAL: 257 S.F. 2I pySH OF MA �i ss , v,, ... ,.. G.P.D. LOT 5 �� 9c /90. oo - , •- • STO B. NE BRIDGE LN. 4 2 L'�G:P.D. > 330 G. I? D. O K , RENWICK G� —— , . CHAPMAN v ' A� p�No. 27654�0Or �� �Z \ t 1 N LOCUS PLAN. Ilr 208t" O�FSS/STE NG 1 MARSTONS MILLS M •.. oNn�E U PE�I SPREE \ /�. DATE PROFESSIONAL NGINEER - CIVIL Loeu .� Jlyr .�1.!'.L �.� 45. ;. y PREPARED FOR: �SIW t1At1-- +1 NICH OLAS - FRANCO � . POOP Of C. o FRANK WHITING y ePP 07 DATE: DUNE 13 1988 . . o 4 do tl COMP./DESIGN: S.A.A. L.N No. 29869 �, IST� � CHECK: C.F.W. /pL. .c PLAN VIEW l DRAWN: T.A.M. of D TE- PROFESSIONAL LAN SURVEYOR SCALE: 1 = 20 �o ` ` FIELD: R.E.G./T.A.W. V , k FILE NO: 0 10 20 40 60 FEET DWG.NO: 133E;_ SHEET JOB NO: 3.3047.0 I OF