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HomeMy WebLinkAbout0064 TROTTERS LANE CAPE COD TOW OF BARNSTABLE INSULATION 2012MAY I PM 2: 08 Ron OWSS YEA K" SP"YR M SUMNOW "n5 QuT mS OVSu-Ro" c"um"5 1-800-696-6611 DIVISjopq Town of Regulatory Services Building Division Address - Address 2 - Date: Dear Building Inspector Please accept this Affidavit as documentation that Cape Cod Insulation,Inca performed& completed the insulation and weatherization work at the property listed below. Cape Cod Insulation did this in accordance to the specifications listed on the building permit application. All work has been inspected by a certified Building Performance Institute (BPI) inspector. All work preformed meets or exceeds Federal & State Requirements. Property Owner Properly Address Village KEfry C001C- 6gT'�+4&/5 L AAA Anl's.415 /V (1S Insulation Installed: Fiberglass Cellulose R-Value Restricted Unrestricted Ceilings (x ) ( ) ( ) ( ) o0 Slopes ( ) ( ) ( ) ) ( ) Floors Walls 7 S' ce y , L H E assi y Jr, esident C e C Ins ation Inc. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map® q Parcel. / Application # 0 D � Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis Ut Project Street Address Village f Owner Cam? Address `!y Telephone--* 0 Permit Request, ` O q-30 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuatio '� Construction Type , m Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family. ;7—Two Family ❑ Multi-Family (# units) _ Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No' Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft:) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing_ new Half: existing rtq.v Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ' ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wo1xisting coal stoyg: ❑ems El No c Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size Barn: �p new�__, size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes Vo If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 1 Telephone Number Address J � � 1.� License#�(�a ~Nidg Home Improvement Contractor# Worker's Compensation # Wa 00616!fQ ALL CONSTRUCTION DEBRIS RESULTING FROM HIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED t MAP/PARCEL NO. ' t 3 • ADDRESS VILLAGE N OWNER DATE OF INSPECTION: . FOUNDATIONS FRAME ,r INSULATION I FIREPLACE ELECTRICAL: ROUGH 'FINAL PLUMBING: ROUGH FINAL . GAS:-•i -- ROUGH FINAL EJNAL BUILDING° DATE CLOSED.OUT ASSOCIATION PLAN NO. } ; _.;; : ����1:i c.����i��tf?1'e.''�r�� ��1 � ,iui•�"�[��� ► '��Ir�.Gc1�'��l 10 Park Plaza - Suiti✓ 5170 Boston, Massadiu.settS 02116 1- orne Improvement Cutracior Reo lStrall0tl. Recaistration: '153567 Type: Private Corporation Expiration: '12/15/20'12 Tlyt• 206.133 L COD INSULATION, INC 1 iL NN"Y CASSIDY 1:.)15 YAhMOUTI-I RD. iTi ANNIS, MA 02601 Upuate Address null I'Ctttl'll CM'd, dark Ire.asun lur Alit . -L Address Renewed I I f{mphi.yinott Lust yard mi'11111rr Allan, .\ tiustnc�.s Regul1ltwa Licu i.,:'fir rC IStratlun N%i!Id lul' :,!t!v iiol':IE.IMPRO�LIVIENI`��It7Tl{tAC�7C�t r,:ruucCG} brlorcthr C.Xpiratiun date. 11'found I'rew'n tu: ;uyistratlon' 1.5:;i6; Type: Uftice of Consumes Affairs and Business Regulation E.xu+r tt!on' 12,15/2012 Private Corporation lU Park !'I;rza-Suite;t7U Bustun,M:k 02 116 :... .....i:NJ. INC ndersec reta ry !ytl Vbu lid ith Isi- It IT +_ i�la.,achux'tt, - Urll:u uurnt ul't'uhlit' 1;thclt A Board of till ildin. Itr 'uLrtiurlN troll .1Uultlartl� Construction SuNervlsor License License: CS 100988 HENRY C ASSIDY 8 SHED ROW WEST YARMOUTH, MA 02b73 11;11/2013 ( uuuuis.i„°a't TrH: 7620 Client#:4597 CCINSUL ACORb ;M CERTIFICATE OF LIABILITY INSURANCE 702J (MMIDD%YIYY)2/20122 tI[![ 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. e certificate holder Is an the po Icy les must be endorsed. ,subject o the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: Margaret Young Rogers&Gray Ins. -So. Dennis PHONE FAX 434 Route 134 JA/C,No Ext1:508-760-4602 --„ _(AlC, No E MAIL ........._.__._ ): 877-816-2156 P.G. Box 1601 ADDREss:youngma@rogersgray.com PRODUCER South Dennis, MA 02660-1601 CUSTOMER ID#: INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A:Peerless Insurance 18333 Cape Cod Insulation Inc 455 Yarmouth Road INSURER B:Ohio Casualty Insurance Company INSURER c:Atlantic Charter Insurance Hyannis,MA 02601 INSURER D:Commerce Insurance Company 34754 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: ,-HIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NO'WI THSTANDING 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. NSR ADDL SUBR POLICY EFF POLICY EXP A GENERAL LIABILITY CBP8263063 04/01/2011 04/01/2012 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES(Ea occurrence) $100,000 CLAIMS-MADE OCCUR .._.__.... _X_ MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GLN'L AGGREGAIE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $2,000,000 PRO- $ D AUTOMOBILE LIABILITY 11 MMBCKVMK 04/01/2011 04/01/2012 COMBINED SINGLE LIMIT $ (Ea accident)4 ANY AUTO 1,000,000 BODILY INJURY (Per person) $ At L OWNED AUTOS BODILY INJURY(Per accident) $ t X SCHEDULED AUTOS PROPERTY DAMAGE $ X HIRED AUTOS accident) X NON-OWNED AUTOS $ B UMBRELLA LIAB X OCCUR 0001254514645 04/01/2011 04/01/2012.EACH OCCURRENCE i$1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $1,000,000 OEUUCTIBLE $ X RETENTION $ 10000 C WORKERS COMPENSATION WCA00525902 06/30/2011 WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N 06/30/2012-X TORY LIMrrS ER ANY PROPRIEI'OR/PARTNER/EXECU'rIVE ��� E.L.EACH ACCIDENT $500,000 OFFICERrMEMBER EXCLUDED? I "J N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE$500,000 If yes,describe under E.L DISEASE-POLICY IT s500.00O DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Workers Comp Information Included Officers or Proprietors CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE f _.. 019RR-2009 ArORr)rOPPORATION All rinhtc rpCprvarl �,. ' 77Jt; i�olr•url;:" •� ,.: ih OI tY�C2ss�ti:!Jcca'cir'� {usrrial A c icl�rl.is ,•''I. .I' 'I' - ti l 1- 600 li :'rI ngfOri Siren! Bo.;:. , AIA 021:1 �:. • ;,�•I:'v )vr,. . !.ss.gov1dIa i l.t I .,' t 1t1L11'Jl?IaS:IfLUII hisui-atice, 13uilders CoiltractoI-sizic,ctt-ic.i.:lrlsi.l'IuIt1hri, Inl(JI'tll;aliort Plt'.t.L';r I'ti.nv I ,lJihi�' r. .•tA)I t,anI::.auorL/tndi:'iduul)' -- - - - . j/ .l tl! till rt,t l7�IC, c lh Lip' prupria(c_bu. ' l [ 1 1 . .. : ._Z_a_-' )=t�� oh t7r<iJt•'�h (rcyuit rJl C. C_..I .Nt.kv C.01.IJ11-111'l11M i (trill cuul.'nJ' 1.L+J:I llmr.) '' h ',: • ::.I the dub t;onlriCl(n's . ";I.. III tllnlctvJ .!r I,zlrtUcl- h:;i;.; .. ;lic iitach..d sher(. ). -� .RrIi.ici dclinl', tJ u J rr. tit:! cJLllJlo`i cc s 111:_ uunU'aitt)rs 5. L. Dr.rnul.(rl:,n tlL Lul c. titLu C.unaGll s and have woikr.Js' t I Y ) L_J Efuildi.ng tlilrhllnu ,•,,,lhcrS i;Qn'i17. u•tsutcucc G c ui� ,, Cot-poralion and its I0.CJ k Iccloc-11 fal.lalls ur nd,ituuus :11), o II(,I(Jl;UVVI'Icl LIl)Mt all Work ofttt';'I:' i;ayc dXCrclsed [llc Ir ' l (,L,.J T�'Ilurll)Illg I'C1.7AlIS ul dilililivus I SC Inghi ci--: nnp p Il' GL O - ;,•,eu ilvu wulkels' cutuln. tioncr l{.Lj Roof rcpairs .•.'•12t lli'r^ lC'llllll CJJ,•� I c I:•. ;•i(q), and)vc have Ito rn1J.I ;r•:s. [No workers' CoilT 0);M-Ince I'Cl1ULrCd.j i,: 'hot I heck,box rl I must aLo lilt out flit.scuioo below liu,.ag Well workers'con7pensauoo policy intoniu,tion. n: whu,uhnul (his mIWdvu rtldtGa(irtg Ihcy arc doing all „,J .—d then hire otaside rontruclors mLls[submil a new alhddvll llldli.uunl;Null �•. :, !,lat Liluek this hua rrlust uuached lut additional shed sho„❑1 th;.name of the sub-conti'aclors and wait vdictl it;r or tint tllu>c.k(Lu(1,5 111'), ;I uic:,oh-rutiOuctute huvc einploye(:s,they must provide ur,; t:orKus'comp.policy nuulber. I ::I err lv hr(' (hu.( is'pr'ovichiLg workers'con1per'isat; r: ir!surance f7r my employees'. t elo Lv is (hu 1.!ulirp 4uu(;,,h si re rl1l_ �� .__ _�.Lll�l1� 7c—e •. :li .;r11. Iti'; 1.Ic il•..i• r a t op). A the lvot'Icer's' compensation policy (Jet'ia!�itloII page (shurvinl, tlic policy uLlnlbur :.Intl (1xpirviull thief.). .. h . .,Gt.LLrG CUV('.lLlhC a.S rr.gL.Lircd LLndcr Section 2, 4P,IGLc. 152 can lead to the iml siI Ott rifrritrnnal t, 'I:I "100 OU clLld/or 0Jnt'-yt:a.1' MyI-IS0ULT)tr1L, as ,,;a civil penalties in L11e fon» of a ST'OI' 1.4'URI` Ulu'F,IN "'I'l a Iluc t 'IU.00 n (Jay against ncc violator. .Be. advised 111-1 .1 copy of ibis statemcoI may bc. foiw uclod to Ow 0t'lu:r..ul :.4.,t:mis of Lim D1A for itnsuraricc covcrdgr. vcritica:,,I.. :Cf (�141fy r.r rr -j-I r. all I Penalties of p,.; -v t.4at the inforinacion pro video! above is rr ce Ur I,/ I:;,r'i e,'i VI '... ,( _. __ _Ste-�_--�s • �__ I ,•,i toe olily. Do rica wrife-irl•(his fired, to be L'(!f(Ic :!Cp by city or town officiaL ! v,vu, 1'erini[iLicense, Whut Icy (r.lrcle DLit): .tI J u( lltcalLh 2. Hwilct(ng Depar[menc 3. cit_, '1„wn Clcrl( 4. CIccLricul lrlspector' S. l'lunlbint, Irlsl ,•. nu Itllrl Phone _ ..,.., 't (ICI 5'(1 tl: C) OWNER AUTHORIZATION FORM I, oxw /,-- boa (Owner's Name) owner of the property located at (Property Address) (Property Address hereby authorize CA CC7 , (Subcontra r) an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform work on my property. Gii II Op 's Signature I Date F IECIE0v E . MAR 2 6 2.012 Town of Barnstable *Permit# Expires 6 months from issue date STAMS Regulatory Services FeeA2,5— MASS. $ Thomas F.Geiler,Director fD Building Division X-PRESS PERMIT Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 NOV ® 9 2006 �/ www.town.bamstable.ma.us O Office: 508-862-4038 'TOWN OF EfARWAM&° EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X--Press Imprint Map/parcel Number �'�Z ��J ) p Property Address 6'4 `�i-o r°r5 La n e . �a rS�O r15 M ► � 15 , M 4 0,26/�D Residential Value of Work$4,7 S 9 ��++ Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address -Jok n �r C 1 (-70 l� 64 -7'rd LerS ►LarC' , A.r5"s M � ) IS . V4 � 6PG4 4 (ALFR1 -"YA4 N TR.) I� Contractor's Name Sep r-S Acan t e �rwi p► oyem can I prjc Telephone Number 4o 7-S-5/ — s74 O a Home Improvement Contractor License#(if applicable) /" T'P'f— 142 6y / Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner have Worker's Compensation Insurance Insurance Company Name Ace' A me.r l [la � V15 Cc.(�Cc�/l:C C� 00 Workman's Comp.Policy# u)L R C 44��4- 0 R D 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) ZRe-side ❑ Replacement Windows. U-Value (maximum.44) "Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. Ho re Improv ent Contractors License is required. SIGNATURE: �S E-Aks A&F-ry I 7-el, 890 93S 5'0a6 Q:Forms:expmtrg Cam- ~ Revise071405 OF� .� Town of Barnstable BAMSTABIA . Regulatory Services Thomas F.Geiler,Director Building Division Tom Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, b�n r• C�y K ,as Owner of the subject property hereby authorize LuLS J V[fe' —6Sea r5 AGF—rU T 1 to act on my behalf, in all matters relative to work authorized by this building permit application for: 94 7m /7-(-r-s ka�OC- . M/.rST s ti'I , 1 Is, MA 69G48 (Address of Job) A C&,oI raC hJGy 91 Signature of Owner Date Toh h 1F - Cc)o Print Name Q:Forms:expmtrg Revise071405 r The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly (A0FR1=D YUyMff0J _Ta• ) n Name (Business/Organization/Individual): seo r S pd�,O ✓Vt ►� VVt Piet I`'/��� %�� �y1C, Address: /004 FLor ,f ja Ce �'r, I PI<tuy City/State/Zip:Lim EL ,EL . 3 YSO Phone #: .407- SS I - 54 O 2 Are you an employer?Check the appropriat:;�I x; Type of project(required): 1.El am a employer with 4. am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7• ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑Roof repairs insurance required.] t employees. [No workers' 13,,2rOther Vj vi,,� 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 their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Ac c A vv1 e —,l C(A y►S t� r� vt�° U p" Policy#or Self-ins.Lic.#: Expiration Date: D4/DI �'2 007 Job Site Address: 94 —rro / l E r✓S Lane _ City/State/Zip:Mot Mfayi Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pain and penalties of perjury that the information provided above is true and correct. Si afore: Z S&0 1� Date: �4vG Phone#• gG 0 ' 7_; S' S O aC �'e�� 60 , 7-53 ' O4 5a Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2.Building Department 3.City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: IM Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 148607 LXPiditon: 10/11/2007 Type: Public Corporation SEARS HOME IMPROVEMENT PRODUCTS INC, ALFRED NYMAN JR. 1-024-F-LeRBA CENTRAC HK Y LONGWOOD, FL 32750 Administrator d/2006 15:02 407-767-8536 PERMITS L.ICENS= DEPT PAGE 03 .Qft CERTIFICATE OF LI BILITY INSUFibANt:E 04/01/2007o3/In LOCKrON CaA1PAMF.I; C6ER ° om WHE Ill IMUQ AS A TER F INFORMATION 6Zb yy �,St>fb�D ONLY MID.C;aNFEF S NO RlGHITB UPON THE CERTIFICATE CHICAGO IL W561 A R.T?i CUCEWM�L1FD NOT YO IIIET p0u EXT$ND OR (312)88g� M I NEURE R8 AFFORDING COVERAGE rNUMAD Sam Hold► s 1062183 n8 ^ FIB dlbls 6aae HOIN IIIFT0TN1D18111 PIOdI1Cis,Ino. a ert tl Can'.Co_ofNaTth America Atln;FM Malegwau t 85-17M 3w 9eYady Rd, TM E7teles,IL eD179 C7 T I{E POLICIES OF INeUMNG.L.IdTED BeLOW HAVE BEEN ISSUED THE INSURED N ww AsiV FOR TIE PM= PE1RrOD INDICATED.NOTV MWATANONO ANY REQNREMEW, TERM OR CONDNTION OF ANY CONTRACT OTMM 000UMW WRTI RI!FECr `0 WHICH THIS CERTIFICATE MAY B9 13811ED oft PC r6RTA1N,THE NWBURANCE AFFpRDW BY THE POLICIES 18ID 11BREIp Ig r?fUL1E0T Ta>ALL T►Q TNtMB,6XCL118pN8 AND CONOmONS OF SUCH o taRe M LET waN 8 utTrIJ01D3 TIOM Osman tmmuTY A oc ° x Cr4LQDlwokLLvwIvw HDO021729383 04/01/2XI6 04/01R1D7 a 1 dCd CUUM Zs IE OOOVA IIEDE7a' ar,a ? Iad T 5.000 000 sET.MALA0GNeFN3ATE f s • L uaafTAl�aL PER F 5 000 000 LufIUTYA TO 1SAM08219953 04/01/2006 NV01120I 60me�I'MOWL ff f1,000.000 N®AUTDaUDAUTOs wwR'LMOsWMW lurT'o8 ���)Y�eTV f X'X=XxX iL/TY sodom Aa - o ONav_ Aa e S.LR.$5,000,000 04MI/M 01101/20(7 �oTTyylN��pp7�A� AUt�6 oN�tlT: OCCUR ❑courts vim NOT APPLICABLE °ACM m s XXX)O= e fAV0WVftTXWAND WLRC4434086D(CA)(D .) 04N1/d006 O�I�01200► X NrG f vt.N7TETrruAt11 Y SCFC44340972(W� Oj 04MI12096 Ori©1200 CnBrr 1 000 WLRC44340859 04/01/2006 0<101200' EL018FJ18E- 1000000 CIT"EXA •POUCYLwrr f A s-LR,S5.000.000 ` varagdncPenTabinty 0//01/1006 dbiD1/200; sJ,R.u.000,oOr1 �C9CTaPTWNN ar 8MM7WNMWATaONrtNeanl;,p0157tttN6lofNs Aoaee N Al w. IM Nyman,Jr.,UaNne NQOCOl253a IoctNcd®1024 PlpTida 61 b.d�d®1024 PlOrldn Cenral parkwrj,1•onowood.FL 32730 W' �'FL 3275I mld Alfr d W.Nyman.!►.,1.It orlse bC1NCIZA9510 22680tl2 na aen HemE IMWroTeIeLYM PToducls EsHmw e TNtE ATat; ;;NNW►OLMM e6 CAMCG6Lm 9EFOR8 TNB gtpoATTON10t g 3 Pa&way p,T"g=411Np INWN"YMLLaN NAVOR TOMAR� OAVS tArRtTT13!•`"'tl^`^"+ ^mil Comm OTC IIOU IR K"M TO"ll IA"JD6*r FAv.YRE To 0o eo AMALL wATTeN+Nt UAea TryOFAw+tameupw TK R MIN III Aobft OR 1NM►I�EAT iTTvs ter_ CORD 25.4(T/87) rm.....,.�....M..-Ya.�...�.�. a""� ~�+•"�e� °�°.waM a�� a„� � OACORD CO1lOWT-10N IBM r 1-us OF V1ny1 1 f NFRC aaarr dp dols.le DOW)l•)-Aueq I VPnI.ANA cjvi!lot i:�A ' l�igots.:Lc"-E 1 AterSnlLop-E NetfonalPanesbotlon 1/g^ �:)as+o I 3.18 Tnr V idr 10 ° aonC01m° No Z�neinAt,e,. >1>;se? I sin vidcio larninrdo With :ciao I Con rciill ml ---- ---.- aa ENEFtG`i F CFO �� U-Fe — Solar Heat Gain Coeffident Faftm•U CO OMW Gmuntfa de Ene*Sola r 1 . 9 �J . 25 Qsa Mi AD01p11�A41"M��/Ay/yL�PERFORMANCE RATINGS Vm7ransmittatice v,jstoh de L=M MAC C • 4 _ • � FJf�pa�91Gr9'�ie 'NRIC lag CIOI QI68a retinF a t e{Ip1�9Ete a0e me dose Ira!ratalrMa o anll In" mt�ate EotynnNntl taro Pond ant d arolaanan d aordltlolr3 rya.c irome m xef�s Rler n lot am piodnd De�Go en4daesaotvamdntnm� a� xeevaa�' __ =————--—•-——• —— oft do t o et renrAm�nb blel dd wmavel0�!a>ampten a n ioa D�oae da o atnbtenfeleay un tenmia do M & to � �vdpe9 usadas por NFliG e>Q detertN radog t701 ' aaa adoauedo P1Ja un use osOsdlbo.��a»eI eap .liFRC rio nrconYanOW N t igks*p� We do� .W4vWJ Qt 0M � OWN iVraxrta De a e{•usa e9raparta asutr•� f,,..,.��--i I rini! et !or MEPGY ^TAP it v ' .n0:^�La! ,:ter•ao-.., v...�!� �� .. ...:.ti.✓N •/VNU•U•r•.YUYV+r• •WrL•L1�0rY• ���/ i �etjl0ni��?) y�}rrltiY xYAM.' Nortp, NI c7entral, slur. 4f�nt^.all "r: ^ -` Atif: p9in r!0/.1a9 1/5^/A-R25 • it• Tggted Size: 4B- m 130" 1m; Refuer2a onlvidr io I.—LB rmnlR-TaS ? — r , n9 64H126.1/11 gO317 Pa Pl►illipa 19 5727069A= Iteep ft bW for IWssU FXH 6Y STi11s rebated Ta Ian mole VW 1nrw.wwgVM-Pv 6umde at etqueto porn paste r glee Pap oonoox m6s aetta de eSla,vblto wrrw.eeetg�totgov i® Sears Sears Hoomeme ImlTlpfl)Vement Products,Inc. Job No.: b2..4 1024 Flortda Can=Parkwsy tl Longwood.FL 32750 Home MllpmvementProdlsts Phone#:161 1-1'11 1g1o\ FEIN 25-in98691 Weather 'M Fiterlor Protsh- System (� � License Nunbara AL 5481•FL CGCO12538:IA 84194; Location:�Os�k� �Xr MA 14M MS 50222;NC d7390 RI 27281-SC 1058.98; TN 231�—TColumbus.GA G170 7:CT HI�.0607669 Siding Sce Name JOMfO �� Krone:Res."A2.8 02546 Bus $1S01Zt;;' Address: City:mpt�S�DfaS nu•C.St; N,)P" zip: o�y8 1/We.the owners of the premises described below,hereinafter referred to as°Purchaser"offer to contract with Sears Home Improvement Products hereinafter referred to as'Contractor",to furnish,deliver,and arrange for installation of all materials necessary to Improve the premises located at: M:10�4 f" -- (Street) (City) (Slow) (ZIP) According to the following Specifications: NOT INCLUDED INCLUDED SPECIFICATIONS PBEB9B9TION: 1. ❑x ❑ Obtain a/necessary permits and insurances. 2. ® ❑ Inspact surfam in work area-reran loose wood,replace rotten surface wood where necessary in work area excluding roof,daddng or rafters,and structural members. 3. ❑ ® Remove Existing siding: Type: 4. ❑ ® Fir out wells On brick,MOM metal or stucoo areas:Location: S. ® ❑ Caulk and seal around all windows&doors in work area as necessary. 6. ❑ Install approved non-oonosive starter strip INSULATION: 7. ® ❑ Install Insulation on llatwall areas to be sided with'3l4- "114-extruded po rene Insuatm. Girds ours CUSTOM TRIM: 8. ® ❑ custom Vyna-Klad aluminum fascia system: br:—S�GRAY 9. I� ❑ ernove an re spore st existing guttering. 10.tr1>r 441oh.7 kcro�itDn7r— t 1 10. ❑ 19 Cover of home with vinyl soffit system,except those areas noted below. Weatherbeater❑Max❑Plus❑Weatrerbeater❑Other (check one)Color:_Patem:_ 11. ❑ $I Custom Vyna-Klad aluminum frieze boards: Location: Color: Size: 12. I ❑ Jump4& vindow trim: Location: Als fOEL_ Color: 13. ❑ Custom wrap windowalails/rtx6lslheaders with Vyro-Klad aluminum: 14. ❑ ® Remove and reinstall existing storm whdows/awni nga/shuters. Color._ 15. ® ❑ Custom wrap door facings with Vyna-Mad aluminum: Location:f-Tto fzy' is. ❑ 9 Custom wrap garage door facings angWdouble with Vyna-Klad aluminum: Color. 17. Remove and reinstal storm doors 18. ® ❑ Deluxe comer posts: Color. C-,u7 19. ❑ Clip locking system: Location: NS NE L SIDING 20. ❑ Install ter 1)Max 8 Plus ElWeatherbeater ❑Other Solid vinyl siding.(check once) TY4 Vertical COLOR: C-C S", PORCH 21. ❑ Porch ceilings: Location: � Color. c g Ste: 22. ❑ ® Porch posts: or: 23. ❑ ® Porch beams Color: CLEAN UP: 24' ❑ Clean up and removal of all lob related debris: 25. ❑ Each job is Over-shipped to amid delays.Remove excess materials and ra-slodk. WARRANTIES: 26. FK1 ❑ Manufacturer's warranty sent upon completion. SPECIAL ITEMS: • A. Work not to be done: NO DRIP EDGE VE D• LIED a- �W Tk — G O SC�Cf�wT All of the above check boxes and this'work not to be done*section have been reviewed and explained to me. IX TIME FOR COMPLETION OF WORK.Contractor shall commence work within approximately twenty(20)days rrum Uri date shown herein and will be substantially completed within forty-five(45)days thereafter unless a different estimated completion date is sham herein. �pproximate starU date is: -3-S 1.01Sc 9Z Approximate completion date is: NOTE:THE WARRANTY PROVISIONS AS STATED ON THE REVERSE HAVE BEEN EXPLAINED AND I/WE UNDERSTAND TH LLY. ADDITIONAL PROVISIONS AND WARRANTIES ARE STATED ON REVERSE AND ARE PART OF THIS CONTRACT. Please read the following bold type and initial corresponding line. Verbal understandings and agreements with representative shall not be binding.All understandings and agreemems MY&It —set nforth In writing In this Contrast. Purchaser initlehe:t��r J The TOTAL PRICE for all labor&Materials(including arty applicable discount)is $�Z.00 Contract Price $ Down Payment $ Balance Payable$ State Sales Tax(_%)$ (if applicable) Tema: Credit = (Subject to the approval of the Credit Department) Total Contract Price $ 1-4-1 QjZ Cash ❑ (Final payment payable to installer upon completion)Funded by: Bank City St.— Acct N 10%Preferred customer Discount(PCD)awarded for arty future Scene Home Inpmvernent Products purchases.Current pricing available for one(1)year. if this Is a credit transaction,the agreement or credit is contained in a separate document which is Incorporated herein by reference and made a part hereof.Uwe the undersigned are hereby authorizing Sears Home Improvement Products toverity and review my/our credit record with an independent credit reporting agency and release them from all liability Incurred from inadvertent omissions or errors. IN WITNESS WHEREOF Purchaser(s)haws hereunto signed their name(s)this-la�day of I>cac _.200�and acknowledge receipt of a We copy of this Contract and unless otherwise specified,it is understood that the owner is ready for this work to begin. THIS MESSAGE APPLIES TO DOOR-TO-DOOR SALES ONLY.You the Purchasers may cancel this transaction any time prior to midnight of the third day after the date of this transaction. See accompanying notice of cancellation form for an explanation of this right. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. stirmire Wbod below acts as receipt met s)recelwed separsie auxvilaeon brma D aY:Repnsantaeue Dale er Date %iola 1 I ctko tni ADCEIt®BY:kamnird sign a lor seue Proozlo,ice. Dean Dike D2So -Rev.07JDe Assessor's map and lot number ....m.�.....`....J....... S ®�! 10C 14 _ 7, 7_ 77 SEPTIC SYSTEM MUST BE • Sewage Permit number ...................... :7�........................... WITINSH IN COMPLIANCE H l�;RTICLE II STATE SANITARY r`n 'ya �QypGTHElO�o Nr�S�TAoB.L`ED T®"�" TOWN OF BAR SASHSTSDI%$ i Yj 9� 9a, 6BUILDING INSPECTOR 0 ypY APPLICATION FOR' ERMIT TO / ..................................... ....... ..............F......� TYPE OF CONSTRUCTION `` ev..................... Ylti....... ........................................................................ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ........ .. .y �Y'Q �f /.(�-�--2� �. .. . ...................... /1 ��,Q yy� (/(�.�..... r����:v/..1�}:..1.1./..�/�................. ............................................. . . .... .... Proposed Use J' l� �7�'n7 j.1,5� �,�'ei <f�`- 0....... ........... ........................ ........... .......... .........7.............. Zoning District ....................Fire District ........C ?� / 5. ?- ...........`.... ........................ Name of Owner ....T .Address �i.0:...���%f.... ....... 1 ../ ll�,ff:.. .... S_ Nameof Builder ................fit .°,✓�.....................................Address .................................................................................... Name of Architect �Vv!'�;. 1� c..........................Address ...dIalk o1. ....:5 .:.. ... �':iP� !...... J ...... .. . .................... Number of Rooms ..............5;K..........................................Foundation .... ...... ... ' ✓''�.N. ` •L 7'yS / Exterior 7�.................................................Roofing l� >G TAe Floors1/.c!YZ� .....................................................Interior ..........1 ..................................................................... Heating .........r!.. ..�J. .....:.....9/.1................................Plumbing .......... ,�¢� 3�5' Fireplace ..............S.7/. /e-:...............................................Approximate Cost . ........ ��. .................................................. Definitive Plan Approved by Planning Board ------�__ -----19-�1__. Area"` ... ......7. Building with Dimensions Diagram of Lot and C.. 9 Fee ........ ................................... SUBJECT TO APPROVAL OF BOARD OF HEALTH �! n .zg � ley I hereby agree to conform to all the Rules and Regulations of the Town Barnstable regarding the above construction. �ame ........ ........ ................... .......�` -.�...�'... A-47-125 Innovative Builders No ,�1'9361•... Permit for ..Dwelling................ ..................................... 7 .......................... Location ........Tr9t..#.4.......TraTtteal.s..L,.a.......... .............................Mars.tons..I L1.1- .................. Owner .....:.nno`native..Ing.............................. Type of Construction ............... .Rgme................ Plot ......A.la7..1•25.... Lot .... ..................... e Permit Granted ....!WY.............:..7.......... O Date of Inspection 19 Date Completed .L.� s 7. ..............19 - � A PERMIT..REFUSED ..................... .......... ....................... 19 0 Approved ................................................ 19 ............................................................................... i yo}zNe'ro TOWN OF BARNSTABLE co S� OFFICE OF y NX3a BOARD OF HEALTH n 39 y\ 397 MAIN STREET HYANNIS, MASS. m6oi To : Building Ins-pector From: Health Depart:lent -- Subject: Test hole and Percolation Test e,- Zinati on o= th soil at (Lo )- (Ad Tess) ( Village) as made on a.nd mound to be (da.tc) suitable for sub-surface se:Vagej at site of test hole. Building Permit will• not. be a?)prok7ed or se:*,a ge pernit issued until Health D::-ar_ment receives ti-m coj')es of plan showing building, seti;��ge systems and all other details li sited in Board of Health instructions to sewage applicants. This ap-proval does not constitute a final decision concerning the installation of a se ge system_ All State and loc`1 use, -i regulations apt Dly to y i r_at _ approval . 6/20/7.5 _ a }—�-- Y/0Z—CT' L/Z�E'Ti 1,;.1C)y4ERS'OrY 1 i . rPo- Igga, a S2O.00 _ a r CERTIFIED PLOT PLAN S1EVI CONSTRUCTION ONLY : � 8 CE F-C7^y TOP OF FOUNDATION IS S3 FEE ' MORE `" IN AOOVE LOW POINT 6F ADJACENT SA JIB iS` ASL M4S vo ROAD. �fia � �� e� .� _50 GATE 7 (0 7y . wv.., SCALE / , ' �r"L 1��':':r)GE ENGINEERING CO.IN •� CLIENT,[ Zd&/;_ I CERTIFY THAT THE /�1L L� I,EGiISTEREO REGISTERED SHOWN ON THIS PLAN IS LOCATI;'D CIVIL lANO J08 N0. !4 ON THE GROUND A8 INDICATED Atig I CONFORMS TO THE ZONING A f ENGINEER SURVEYOR DR.BY= � � NO ,L V19, � 33 K0. MAIN ST 712 MAIN ST. CH.By' E' OF BARNSTABLE MA33. �O. YARMOUTH, MASS. HYANNIS, MASS. SHEET-LOFT 4�Z E Q LAND SURVEv4+ ' -j. - - :-w[+„• - .,.--„-,,.�...•��.y..•. :mow.'.'.! ,� ,-.+M,. f.+. ... .... r 20 FT MIN; { 4" PVC PIPE _ •CLEAN SAND _ CONCRETE MINA PITCH - 7 ,. COVERS 1/8 PER FT CONCRETE A 10 COVER / LIQUID LEVEL - 10 � 1 " CAST �� r O.T _ 2" LAYER I tRIIN PIPE • : OF 1/8"- 3/8" MIN, pIT�._ SEPTIC TANK • • —T- WASHED STONE ' �R F DIST. � � •I• • • • • ^ • +.o e0X • •f EFFECTIVE' ' •• -- 3/4"- 1 1/2"rlt� • • DEPTH • • • . WASHED STONE . • . • off PRECAST SEEPAGE • • • . • . • PIT OR EQUIV. w.. : INVERT ELEVATIONS ) 6 FT DIAL INVERT AT BUILDING FT. 10 FT. DIA. C (SEE. TABULATION) • - INLET SEPTIC , . TANK FT. OUTLET SEPTIC TANK FT. SECT/ON OF. GROUND . ,WATER TABLE ;-� 9L INLET DISTRIBUTION BOX T. `�` - SEWAGE DISPOSAL SYSTEM.' fT DISTRIBUTION BOX FT. s�tolLET SEEPAGE PIT FT. SCALE 114"= 1=0 ' . .y TABULATION"% DESIGN CRITERIA DIMENSION A _—FT. DIMENSION B l FT. NUMBER OF BEDROOMS _ 3 DIMENSION CY FT GARBAGE DISPOSAL UNIT NGYVE TOTAL ESTIMATED FLOW —40 GAL./DAY SOIL LOG SOIL TEST NUOj'AER OF SEEPAGE PITS / ELEVATION PATE OF SOIL TEST Z y %7 SIDE LEACHING PER PIT 188.SS SO. FT { vu BOTTOM LEACHING PER PIT 78•ZLSO. FT, RESULTS WITNESSED BY R•�B. , �M. TOTAL LEACHING AREA Z�7 Sp, FT PERCOLATION RATE T < Z MIN/INCH r RESERVE LEACHING AREA Z-�2-ZSQ. FT. 3Io" st/BsorL rl fir�' "�:1S,Ji Q,�1►� ZN~GQAI/EL �SA/Vt7 �c, r Kaar.f• tiy\ a, PHILIP -TO tTEIFS r�i c EI.�L J1 ,' ! WEINBERG `^ " w. 366,°�� y' s�9•va�.son�iE- - EL.DtiEDGE ENGINEERING CO I 712 MAIN 33 NO. MAIN S ST - - • '•► `' ��:^` Tom` �a�,f ,�, t:- ;; GrE'A!/E_4�- T. . • 'n ° °,`�` -. ` :- --�iv0 vt/AT�R SO. YARIAOUTH, MASS. HYANILIS, 1'v7ASS. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Permit# Health Division �brli � Date Issued l Conservation Division Fee qg,267 , 00 Tax Collector SEPTIC SYSTeM MUST BE Treasurer /1kh INSTALLED IN COMPLIANCE WITH TITLE 5 Planning Dept. - ENVIRONMENTAL CODE AND Date Definitive Plan Approved by Planning Board TOMS IN REOULATi�,iIS: Historic-OKH Preservation/Hyannis Project Street Address :10L"VE-12sV!S �Xl Village \ ��� Owner !GI;MC'S 1\cam\ e_ :A-=� Address S(&w,\Q _ Telephone Permit Request (N�Q. ��'.u/1 1�n Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new ( AS Estimated Project Cost Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family A, Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes p No On Old King's Highway: ❑Yes 16"No Basement Type: V Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing ` new Half: existing ` new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas .0 Oil ❑Electric 13 Other Central Air: ❑Yes ONo Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:Q existing ❑new size Barn:❑existing Xnew size F � Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes XNo If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name aim dl 1� Telephone Number Address a License# i Home Improvement Contractor# I Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO //� n 4 SIGNATURE DATE '= FOR OFFICIAL USE ONLY PERMIT NO, •L a DATE ISSUED ` MAP/PARCEL NO. ADDRESS- VILLAGE OWNER DATE OF INSPECTION: : FOUNDATION (21(-f&!z � FRAME INSULATION C1 - FIREPLACE ELECTRICAL: ROUGH'S 17: FINAL PLUMBING: ROUGH r- FINAL C r` GAS: ROUGH-' FINAL *r i FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. r i CF 1HE Tp� r + The Town of Barnstable iARNSTABM + MASS,' Department of Health Safety and Environmental Services 039. °i-� Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 50&790-6230 Building Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Ud Type of Work: Estimated Cost Address of Work: Owner's Name: Date of Application: I hereby certify that: Registration is not required for the following.reason(s): ❑Work excluded by law ❑Job Under$1,000 AR uilding not owner-occupied wner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date ntractor Name Registration No. p C OR Date Owner's Name q:forms:Affidav j • � TsbladS2.Ib Praaiptfre Psekga for d ne and TwaFamik Residential Batldlap Ifaad Witt!Food Fort MAXIMUM Nmu mtttll wall Flow g� Aim'(K� u-value R.val &v�O' &wdu2 wall Auitm Wad peen &vdual &vatuat SlOI to 6300 Hradnx D*qm DxW Q 127. 0.40 3E 13 19 10 6 Nommi B 120A U2 30 1 19 19 10 6 Nommf S 12•b 030 31 13 19 10 6 B AFUE T im 4U5 33 13 2S WA WA Normd U 15% OA6 33 19 19 10 6 Nomml WA AnM • I�7i 1r.44 �O �� Y IVM •�..- w Isis fug ' 30 19 19 10 - 6 u AFUE X Ir/. an n 13 25 WA WA Nomw T IVA OA2 n 19 25 WA WA Nommi Z IVA 0.42 n 13 19 10 6 90 AFUE AA Ir/. OJD 30 19 19 10 6 W AME i 1. ADDRESS OF PROPERTY: LOA � Ur, vy�az�yr� TVA 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: 4. %GLAZING AREA(#3 DIVIDED BY#2): S. SELECT PACKAGE(Q—AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-for=-f980303a The Commonwealth of Massachusetts _�.: - -'- Department of Industrial Accidents • , _ office offaYesaffatfoos _ — 600.Washington Street Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit _ n I name: location ci hone# I am a homeowner performing all work myself. I am a sole proprietor and have no one worlds in anv capacity /%///%%%%%////%//------ /%O�%%%/%%/%/%/%/%%%/%%%%/////%/% /%%%I%%/%%%%%%//%%O%//%%//////%%%/%%%//////%%%/%%%////%%//%%//////%/////%%%�%/�/%%%/ an employer roviding workers' compensation for my employees working on this job. ;: an v n em . com a it re A i # '> tV ;: CI : > CV 'ol;>. > insurance ❑ I am a sole proprietor,general contractor, or homeowner(cards one)and have hired the contractors listed below who have owin workers' co ensation polices: the fog g .....................mP.................:.::::.:::.:. :. :.... ...:.::::::::.............:. :..::::. :::.::.:.:..............::...:.:::::::::::.:.;:;:.::.;:.;:.::::.::.:.;::.::;:.«;;::><;<:><:::??::<:;:?.;>;;:.>;:.;::>::<<:<: <.: na me,com pany- a sure S ••:`one:# : >`�.�.> � ' .�'><> ;> b Insurancex o ................................ ................................................ ................................................................. ............................................................................................................ ::::::v.iiii:v.::.::•:::.�.<?:•i::v::v.�::{?.iii:bi}iii:???iv::::::::::::r.•.�:::::?:::?!•ii;i{r:.:S�::?:t::::::•+::?:-i}ii?`::^:::.:•:p::t:::iiiii<:ii:<::t::>.L: .......... ......... c anv.nam acite s . d :....................::.:..:::::::::... :::::::..:............:.:::::::....:. :. ................. hone of enrance Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition oterhnioai penalties of a nae up to$1,500.00 and/or one yam'imprisonment as wen as civil penalties in the form of a STOP WORK ORDER and a nne of$100.00 a day against me. I understand that a copy of this AS may be fo ed to the OtHce of Investigations of the DIA for coverage veriScatioa. ' I do hereby fy 0e p penalties perjury that the information provided above is trw.and correct 1q2Signature Rk Date 1; _ . Print name Phone# -�0 L[:I:hec do not write in this area to be completed by city or town ofncial permit/llcense# ❑Bultding Department QLicensing Board diate response is required ❑Selectmen's Office ❑Health Department phone#; _ 0OWer Umsed 9195 PIA) J ESTIMATED PROJECT COST WORKSHEET Value LIVING SPACE square feet X $55/sq. foot= GARAGE (UNFINISHED) square feet X $25/sq. foot= j PORCH square feet X $20/sq. foot= DECK square feet X $15/sq. foot= i OTHER square feet X $??/sq. foot= CO Total Estimated Project Cost g990915b Office: 508-862-4033 Rauh Crosser. Fax: 508-790-6230 Building Comm: SO'MEONVNER LICENSE EXEM TIM Please Print DATE: JOB LOCATION:, „� -`� �X l � �51 l�l/1� Y 1 1\\1� stria village utmmoer L -HOMEOwNW. 0' . V CO more ha=phone 0 work phone s CURRENT MAII.IIJG ADDRESS: In`'\ !/VViUY,'Z,+Wr—, , VIA, 1AA,A7 r citylto" team zap wac The ctareat exemption for 'was cnacried to include ovvtt Zed dwellints of six tints or less and to allow homeowners to engage an iadlAduai for Hire who does not possess a license, that the DEFINMON1 OF HOMEOWNER Person(s)who awns a patzel of Land on which helshe resides ar intends to reside,an which there is,or is imended to be,a one ortwo-family dwelling,amebed or detached structures accessory to such use aadlor farm suncmres. A person who tm=Mcts more thaw am home in atwo-yearperiod shall not be considered a homeowner. Such"homeawnet'shall submit to the Building Official an a form accegrable to the BtaiIdiag Official,that hd4he shall be ottst'ble for aft C-neit W **mTferttted order the Imildins mertttit. (Section 109.1.1) The amdetzigned"homeowner'assumes responsibility for compliancewith the State Building Code and other applicable cadet*bylaws;mks and regulations. The undersigned"homeowner'certifies that he/she uadorsraads the Town of Barnstable Building Degarnaeat minimum ' etuion cedures and requirements and that he/she will comply with said proc and eats . of Apptwai of Building Ol$cW Now Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Consn=tion Control. HOMEOWNER'S F.XEM MON need shall be rsempt from 'the Code states that: "Any homeunvraer Perfosariag vO*for which a building permit"u requthe provisions ofthis section(Section 109.1.1.11= ing of caustr=Cion Supervisors);provided that ofthe homeowner engages a pc=n(s)for Kist:to do such wort thatsuch Homeowner shall Set as sutpervtaor." responsibilities of a supervisor(sec Many homeosYnuxs who use this exemption We ummmthat shay am aguating �° p Appendix Q.Ruin&Regalations for I(ceasing Construction Supervisors-Session 2-15) This lade of awastaess often results in serious problems.panfculasiy whoa the horammer hints unlicensed Persorn. In this case.oar Board c=not pmeecd against the as itwould with a licensed Supervisor. The homeowner acting as Supervisor is Wdmucly mponsibk. uoliansed person eoanauaities require.as put of the permit To unzsa:e that the hom are emmir is fully aw of hislhcr=ponsibilid=many application.that the homeowner ccr*that her'she undeutaads the rMonsibiiities of a Supervisor. On the last page of this issue is a form cw=tiy used by several towns. You may cast to amend and adopt such a formlcatifrcarion for use in your community. Q:FORh1S:E.YEAF�1 �Q/ . > d lea nTa fcr& !Yrl GDX 1yI 12 At" c l I ID. L�'b�� Tll( �IyV✓6ac1 LiN G" pT 6 ea v, Y�1c„r5fio,n GRAVES CONSTRUCTION, INC. 5 STEPPINGSTONE LANE SANDWICH, MASSACHUSETTS 02563 (508) 428.0576 (508) 758-2789 A a S F( �. � . �''j`�j� 1 Luc --� �� � —���-,i 2 ,, ;. S /i ;a. ,� �� � r ��_, ,� !� _ ! � t� _�� r;"' j ��_ �` }�- _ �~ tio� ck�►— Z .- �— --- -- - � — — - - _ I s-•_Y/O.LE'T ICJ0.7o 402t- �5a9�, `r.✓ i� is N'� ` / 71 7y ` j L Z)4 a Op -ytis� r a4ss., FC:ERTIFIED PLOTPLtd ROBERTP:t'I COIMSTt�UCTION OPJLYoucE �-`� �OT7�-,�'S L� ,c ;'0? OF FOUNDATION IS S — FEE IN ; ���� LO«/ POINT OF ADJACENT �!,, s y •.? oa,..� a --;,— °•-_ ,,�a'` . SCALE: ///gip' DATE: 7 / sJ !a 17.ma s' G!S CRri C. r CLIENT�/ I CERTIFY THAT THE = ! RECISTER2D SHOWN ON THIS PLAN I���� � �€CIVIL I IAPJfl J03 PaO.f'/© C"CIVIL EP... '�--�'-Z ON THE GROUND AS INDICATE A �- SURVEY0;3, DR. BY: �_1 i CONFORMS TO THE ZOPJICaG LAWS:, ` 0 ',1AIN ST OF BARNSTABLE MASS, ' 712 MAIN ST Cy. BY: E3E }.'GUTH, b1ASS. HYANNIS MASS. SLEET A Oe 7,6 7 EG. LAF3D SEIRVE7P'C. ' - -- _ Assessor's map-and lot number ....{. /10C _ 7- 7_ 77 1 Sewage Permit number ...:..................... 4-t . , *THE.r t TOWN 'OF BARNSTABLE t. BABHSTLEL 7. ' ;pYa� BUILDING INSPECTOR . c 0wig �' , I u -. 1 w J i L �i e APPLICATION FOR PERMIT TO ............II........-.......................................................................................................� ar TYPE OF CONSTRUCTION ..................v.....`.......................,_ ¢.............................................................................. r .......��rx;:�........ ........19.�. TO THE. INSPECTOR OF BUILDINGS: „ The undersigned hereby applies ,for a" permit according` to the following information: Location ......../ f.. ... ........../.s;;...7......................`Gh-e......................................... ........ ................................... rProposed Use .:......J..i�- )1� ........: a../� ........ t^ �(rit�...... .. .x. 4 ...... .: ........... Zoning District .................................................. ...................Fire District ......1111f�". .......................................................... Name of Owner .... -.. ... ........Address 6d....;51...�0................. ...................... . i Nameof Builder ................G�....✓e.....................................Address ..........:......................................................................... Name of Architect ..�zL ptl.........rrl ..........................Address v i Number of Rooms ..............5/ ..........................................Foundation v2 �X�-� �D� F r� t �i1�(A-fo .......................................................................... AS I� Exterior ..b......:y:.�5.. l r.-...................................................Roofing /G S�t�s1 e FloorsU .............................................................Interior .............n...................................................................... Heating ......... ...........0,./.......................:.....Plumbing ..........(............oa ►... ..............................S ...................... Fireplace �s T. �i/� ...................Approximate Cost O........ C. ........................................ Definitive Plan Approved by Planning Board r_"�_� __----'-_19_� Area .. �% .....`....� . � �} tt i ; Diagram of Lot and Building with Dimensions Fee ` "``. / 0 SUBJECT TO APPROVAL OF BOARD OF HEALTH `IN c r I hereby agree to conform to all the Rules and Regulations of the Town of-,Barnstable-regarding.the above construction. t `Name 7, G- ... ..:.... I c��. A 47-125 Innovative Inc , No ...193b1••• Permit for ...Dwell.i.ng............... ................................ ` ,............................. Location ...Rt'l..4..Txottex...s..La.................... ...................:...Maxs1:ans..Mil. .......................... a, Owner. ....... ............................ Type of Construction ....k-ame........:................. ............................................................... .............. Plot A..4.7.-n123............ Lot .............. ................. Permit Granted ........... ...J,.....Y........ .........19 77 Date of Inspection............ ....................19 Date Completed ....................................19 PERMIT RE USED ...................................... ..................... 19 o d......... ........./. ...�.... ...................... J .... .. ... ...................... ' ........................................ .................................. _ Approved ......................./7 ..................... 19 ............................................................................... . ............................................................................... Property Location: 64 TROTTERS LANE MM MAP ID: 047/125/// Vision ID:3327 Other ID: Bldg#: 1 Card 1 of 1 Print Date:01/10/2000 COMMUCTIONDETAIL - S—TCH _. M _ . Element Cd. Ch- Description Commercial Data Elements . tyle/Type 3 Colonial Element Cd. Ch. Description odel 1 Residential Heat&AC rade C C Frame Type Baths/Plumbing AS tories Stories Occupancy 0Ceiling/Wall BM ooms/Prtns US Exterior Wall 1 4 Wood Shingle /o Common Wall DK 2 1 Clapboard Wall Height Roof Structure 3 able/Hip Roof Cover 3 sph/F GIs/Cmp C0"owOBILE HOME DATA nterior Wall 1 8 Typical 10 Element ode Description Factor nterior Floor l 0 Typical P -"- 2 Floor Adj Unit Location 8 2 eating Fuel 2 Oil Heating Type 9 Typical Number of Units C Type 1 None umber of Levels /o Ownership Bedrooms 3 3 Bedrooms athrooms 5 1/2 Bathrms ? _... COS.TIMARKET VALUATION 1 1 Full+1H Jnadj.Base Rate 8.00 Total Rooms Rooms ize Adj.Factor .11328 rade(Q Index .98 ath Type Adj.Base Rate 2.37 28 Kitchen Style Bldg.Value New 9,288 Year Built 977 ff.Year Built A)1982 rml Physcl Dep 5 uncnl Obslnc con Obslnc MD-USE pecl.Cond.Code ....... _.; pecl Cond 1010 Single Fam 100 veralI%Cond. 85 eprec.Bldg Value 67,400 � � OB OUTB.UILDING& YARD ITEMS(L)/-XF BUILDING EXTRA FEATURES(B). Code Description LB Units Unit Price Yr. Dp Rt %Cnd Apr. Value FPL2 irepl-1/2 Sty B 1 3,200.00 1982 1 100 2,70 BUILDINGSUBr AA-`SUMMARYSECTION'_ Code Description Living Area Gross Area E .Area Unit Cost Unde rec. Value BAS First Floor 672 672 672 52.3 35,19 FUS Upper Story,Finished 700 700 700 52.37 36,65 UBM Basement,Unfinished 0. 672 134 10.44 7,01 WDK Wood Deck 0 80 8 5.24 41 1 7 2 12 1 51 Blde Vah 79,28811 Property Location: 64 TROTTERS LANE MM MAP ID: 047/125/// Vision ID: 3327 Other ID: Bldg#: 1 Card 1 of 1 Print Date:01/10/2000 CURRENT:OWNER: `.' _.TOPO UTILITIES: STRT/ROAD. LOCATION_ .: : _ ____ CURRENT ASSESSMENT ___ _. DWELL,JAMES B&JOSIE evel eptic I Paved Description Code Appraised Value Assessed Value 4 TROTTERS LANE as RES SIDNTL 1010 70,10 70,100801 MARSTONS MILLS,MA 02648 �ublic WateBarnstable.2000'MA SUPPLEMENTALDA'T-A =`ccount# 29739 Plan Ref. Tax Dist. 300 Land Ct# er.Prop. #SR Life Estate VISION DL 1 LOT 4 Notes: DL 2 IS ID: Total 97,00 97,00 _ .;'. RECORD OF.OWNEI2SHIP -BK VO VE. ::SALE DATE:: /u 44:: A RICE:V C' - - - PREVIOUS.fISSESSMENTS HISTOR : ._ ..___:_. _:S LE_P DWELL,JAMES B&JOSIE 10086108 03/15/199 Q I 100,000 Yr. Code I Assessed Value Yr. Code Assessed Value Yr. Code I Assessed Value AUGHN,JOSEPH C&KATHLEEN 4262/099 09/15/1984 Q 1 68,500 1999 1010 26,900 1998 1010 26,90 RARKRADER,ALAN J 2731/ 2 Q 0 1999 1010 66,0001998 1010 66,00 Total. 92,9001 Total., 92,90 Total. 87,700 E.YEMPTIONS_ ._ =__OTHER ASSESSMENTS This signature acknowledges a visit by a Data Collector or Assessor Year' TvvelDescription Amount Code Description Number Amount Comm.Int. APPIZ4ISED VAL UE'SUMMARY Appraised Bldg.Value(Card) 67,400 Appraised XF(B)Value(Bldg) 2,700 Total ) Appraised OB Value ]d 0 NOTES =' (Bldg) 26,900 c _.._ _._ .... :. .: =: _.._ _. __. Special an Value Appraised Land Value d Spe ' Land Total Appraised Card Value 97,00 Total Appraised Parcel Value 97,000 Valuation Method: Cost/Market Valuation et.Total Appraised Parcel Value 97,00 .. _.m _.._ :... =_ BUILDING PERMIT RECORD m . __ .. VISIT/,.CIL9NGE HISTORY _:,.: _ . Permit ID Issue Date Type Description Amount Insp.Date %Comp. Date Comp. Comments Date ID Cd. Purpose/Result B19361 7/1/77 0 1/15/79 100 MM DWELL 6/9/97 JG 00 eas/Listed ................_..._.�....__......._._......_......__..__............._......................_............_................_.__.......__.... - L NDLINE VAIUATIONSECTION _. _._ B# Use Code I Zone D JFrontaee Depth Units Unit Price L Factor S.L C.Factor Nbad. Adf. Notes-AdYS ecidl Pricing Adj. Unit Price Land Value 1 1010 ingle Fam RF 3 1 0.53 AC 145,000.00 1.00 5 1.00 12CC 0.35 SPCL(.53,UIO)Notes:10 1BLD 50,750.00 26,90 Total Land Uni 0.5 Aq Total Land Valu 26,90 02/, 7 PO