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Home My WebLink About0045 WHEELER ROAD kb4e ale, o 1 jl 'y i � II ti Town of-Barnstable B`Ulldln s , r c.s 54ir: fa 3 1+t' �i b ':Retained�or J'ob',and this Cacd`Musti`:be:,'Ke t :�, .1. tipstfiis;(ard 5ahat iXkls V�srtil ;From he 5trget .:Approved Plans Must e p. ' ,•,r •.�A1�N3[A81L �: ..�. ... .. .r °d. '�'t 1 s,''J ' w5+f• :i�. _ :trr.• -•r ... ,., i:... . Posted Until FinaIIns' ectwn Has;Been°Made `r fr,= �,. '='�_ = r' f # p 1639 u . s: t.„ _ 6 � .. _ er n 'W ert�fi t k�ec an ;is;Re utred;spchButicim shall NoLbe:Occupied:�ntNAM il.a;F�na1 Inspection?has'been here a _c7q .., up. .GY. .q. g t r,;.,s Applicant Name: DANIEL JOYCE CONSTRUCTION Approvals Permit No. B-174475-;`' - pP Date Issued: 08/10/2017 Current Use: r�• Structure Permit Type:. Building''-'Alteration INTERIOR Work Only- Expiration Dater 's'02/10/2018 Foundation:; .__....... ........ Residential Map/Lot: 104-007 aY Zoning District: RF Sheathing: Location: 45 WHEELER ROAD,MARSTONS MILLS Contractor Name: DANIEL JOYCE Framing: 1 � x Owner on Record: JOYCE,CHRISTOPHER J&ALISON T CONSTRUCTION 2 Address: 45 WHEELER ROAD - - ---Contractor License: 158158 Chimney: MARSTONS MILLS, MA 02648 ,� Est. Proiect Cost: $0.00 Description: Add Bar Sink to Basement Remodel ;' Permit Fee: $85.00 Insulation: Project Review Req: Add Bar Sink to Basement Remodel Y Fee Paid: $85.00 Final: Date:`' 8/10/2017 Plumbing/Gas _ ) f; ., Rough Plumbing: Final Plumbing: i Building Official This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within siii months after issuance.This Gas: All work authorized by this permit shall conform to the approved application and the'approved construction documents for which this permit has been granted. Final Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open:for public inspection for the entire duration of the work until the completion of the same. } - "- % Electrical r Service: The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: �'r Rough: 1.Foundation or Footing - - - - — - 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) ; Low Voltage Final: b.Insulation 7.Final Inspection before Occupancy . . Health :. V$here applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. ,'. Work shall. the Inspector,has approved the various stages of construction. ` Final:.. Fire Department r "Persorixcontracting with-Lin registe,red-ContractomAo.not have access to fhe-guaranty`fund„ (as set forth;in MGL c.142A). Final: Building plans are to be available on site - M.Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 91� p =� V5 ~ Ma 1 y I p Par ce Application # I Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee 65 V Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address ,Village ' Z S ee.��r a' Owner r^ d o `P _. i� Address Telephone > 0 Permit Request Ad d A > 14 0 8 4l�1?/7a eh f 0 Square feet: 1 st floor: eP ., isting proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Gonstriction Type BUILDING (KEPT. Lot Size Grandfathered:. ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# unisl)�� o 2011 Age of Existing Structure Historic House: ❑Yes 'No OVOn Old Kings HighLway: ❑YesANo Basement Type: Y Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) J4 d`_o Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new 0 Number of Bedrooms: existing _new _ Total Room Count (not including baths): existing new '3 First Floor Room Count Heat Type and Fuel: [ Gas ❑Oil ❑ Electric ❑ Other Central Air: Yes ❑ No Fireplaces: Existing / New Existing wood/coal stove: ❑Yes �rNo Detached garage: ❑ existing ❑ new size_Pool: Coexisting ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage:Xexisting ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name t'-� 1 ® C Telephone Number —7 7 '� Address I V flyLA Y<4 1 J License # 0 5. Home Improvement Contractor# Email U (e ��CC S I e Worker's Compensation # !� ' Itn �P 3 0y �7 I 4 ALL CONSTRU TI N DEBRIS SULTING Fq&PTHIS PROJECT WILL BE TAKEN TO 1b 'C((2faA—_ v. SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. -� ADDRESS VILLAGE F _a OWNER I' DATE OF INSPECTION: FOUNDATION CK ` FRAME INSULATION c r FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING r F DATE CLOSED OUT ASSOCIATION PLAN NO. The Commomveah*ofl rdtusetls. 3�e�aatirre�sgqt crf�rTr�drrstrial�xcc�.�derrts 600 F3'ashhWion Street Basttin,ALI 02.Ul t•VFV1'ILT11LtSSzgaY�l�1a Wcw1mrs' .Campensx6mTnsn-mceAffidavit:Builder-dCucfracturs/Mectdcians(Flun3hers APpUcantTmfwmafiqn ��. PleasePrint Name�� . Cj C A l&ess.- 4 U CitWSta Phanc-t'4,--* -77 Aree u an emplayer?Cir ckthe appr6priate boor ' Type of pro] (r��d)= L am a employes� / 4. ❑I am a general contr$chsr-and I (ll mployees(fish and br pait4 ime,)* lime lured fhe sub-contractors 6_ Ides oomst iott 2,❑I am a sole os or _ listed on the.attached sheet. 7- KRemodeliug These sub-contractors have sltrp and have no employees - S_,❑Demolition -waddng firsts is any capacity. employees a-ad have wod ers' [No VuPdOeas' camp_irlsix rn a comp.ineaiMace# 9. ❑Budding addition required.] 5_ ❑ Weareacorporatimandits lak❑Rlprk;ralr�L%oradd�ians 3_❑ I am homeamw doing all wodc offmam have exerr iced their 1L❑Fir mbmgrepaim or additions. sel€No was'comp- Tight of esempfion per MGL c.152, I and we have no L❑Roof repairs inctriamrer�d�1 � (� • employees-[NO woslvess' 13.❑Other cozp-==seance req e&] •may app&a Hut che�boz it—st dm M out the swdm bdmvshnmag&eu walere co ewsstiaupeHcg i�acma`a= *�l,ffo�evamQrs�sabot iris nag tbv_y�e�aia�alFwa�aid tip 1�auts;de ca�c�samst submit a new��t iedics�no sacb_ 'AtffZ9LtOS•f£17ttr11w+tW b=m¢sttttacbea=sddiri—lsheetshovdngtilz—oflbesub-ccm=wAD SsmdstyeVr}led"ar=fbaseeatidnbrm -49DYEES Ifthes3b-can±MCtM1=eemp10seE%1fiey=M1tpms1&theu srorkea'namp.PGRUUMBEL I gin Qni eutpIal�er t7irrtis prouirlinig n�nrlceis'campertsrdfart irisrarai3ce�'or m}'emplo3�ees $efoty is Yltapaficy arrd job site informatbiL r Insaance Company wane: .Poficy 4 or Self-i s_I_ic_,,�- Ao -S- rmpintionDate: / v Job%teAddress= Q - (.�i9 ter- Ciig/StatetT.tg: Attach a copy of the u;orkere coaapensationpoRcy-dect-umfion page(shouing the policy number and expiration date). / Faihire to secure coverage as requirednuder Section 25A of MGL c. 152 can lead to the imposiuoa of criminal penalties of a fine up to$L50M amVIor one-yearimprisonmenk as well as cif penalties is tine form of a ST(yP WORK OBDEKand a fine of up to$MOO a day against the violator. Be ad-irised tliat a copy of this statement.maybe fkwarded to,tine Office of In-esfigatinns.of the DI&for ims+wa,n¢coverage vrriffcafom 'Ido keriry car* tha mid ialfirsafperjurytTu ttJns informa#fanprinidedaboI h tars grid arrreecct Si___ Date: osxat�.rr� Phone i� I t)fficid use ari£y. Da not smite in tfds axed to be ct zg6ted by city artnnm n rcfaL CA'y or Town.: PertmtUceme g Issdg Auf1writy(earls one): L Board of M218 2.Ekm'[Tmg Department 3.flty/Town Clerk 4 Electrical Inspector S.Phrmbing Inspector 6.Other Conbet Person: Dhow 'oriniation and lastruefions hEmsach l Laws. I52 regmres all emplay=to provide w03300'=mprosaian for f beir effipIoyees. ee is defined m.. every person m I ie service of anatjirs ender auy content#of Iiae, Pm 7aamtto this stat afl- e$pr=err irnpli ed,'oral or wry." amoCia on,corporation or other legal cry,or a¢y two or more An.�Fay�is defined as an mdiQidIIa1,partn�.sb�, es�-aiives of a deceased employer,or theof the foregoing m a joint a use,and malndmg Elie legal=pees receiver or trastee of an fibavidnA partnership,association or o$her Iegal entity,mgLjYmg�joY�- However the owner of a dwellinghowu ha hagnot more tbm three apartments and-who resides ,or the occopm t ofthe- dw ffi g house of another who csaploys Persons to do maintmancq conch uctian or repair wort-oa such dweIImg house or on the glomods or bm- mg appvrCE tTjerefn shallnotbw=o ofsnch employmedbe deemedto be an employe" GL d3ap §25C(6)also sfaiEs liiat¢every sf c r to cal IirP�agency shaII witTihold hie issuance er M r fir ISL, renewal of a'acensa or permit to operate a bnsmess or to construct bmldings is the COmmou�Yealth for any applicantvzho has aotprod-ac-aced acceptable evidence of cumplianm Wia the msurance_covexage requiredf Addffionally,Md chapter-152,§25C(n stars fileithm the - ,or gay ofits political snbdxvisions shall ear inin any contract for the peafmmance ofpublio work until acceptable evidence of compliancewith$he insm�cce. of this cater have I;e=p=CMtE-d to ffiC CQnftRCCM9.MnaDZty." Applicaai=s Please faoiof the woias'compensation azfidavit completely,by .g the boxes$ apply to your sitnati on erect, if necessary,ropPfY nd phoner¢rmber(s)along wrihthercetdlcarte(s)of auies or LimitedLiabMty Partaesships(Clip)withno empIoyeas other than the =sramzce. Limifedl-ia]?iliiY Cam (�-� members or partners,are not rimed to cagy worTose�P=satian insurance. If an LLC or I I does hate employees,apolicy is . Be advised this affidayrf maybe snbmi�d to the Department of Indrmftial d date�[e Accidents for confmmnnad of i1yQaCdace coveragm Also be sure to sign an ai�davit T1ae affidavit should bereimmed to ffie city or town that the application for the permit or license is being reclnestr aotthaDepa:rme�f of In I�4scidemis. n=Hyou ha vo any T=ftons regEr g ffie Iaw or ifyon ate=pared to obtain a wodcers' pensationpolicLpimsecallthmDepartmeutattbennmberHs�fedbeIoW �ed - self-inscnmpaniessbonld�tettheir cc� self-insorance license numIxx on the appmp�afE line. city or Town Ofacials Please be sore that tho affidavit is campIet,audpri edlegiibly. 'Ihe Department has provided a space at ffie bolt= outo fill out in.tho event the Office oflnvm-ftl �s has to cor actYon:reg=ding the applicant of the affidavit for y Please b e sure fD fill in the peamii'lIice�ase cumber�t*hich will be used as a recce m�bcr.�ad�•O�� g cat that mast submit multiple pe`m&Hc�se appht d ions in Haygivesi yew,need only snhmit one affidavit _t policy mfom2ation(if n=essary)and under"fob 5Jte m&ess�°fie applic should wLde"all locations in to lie or town)."A copy of the-afidavit ibat has been offidaIly stamped.or mazked by the city or tnvm may prov ided applicant as proof that a valid affidavit is on file for futrre'permifs or Iicense�s. A new affidavit mirst be filled out earth year.Wheae a home owner or citizPaa is obtaining a license or peonit not rs7ated to any bttsincss or commercial vee (ie.a dog license or permit to bum leaves etc-)said person is NOT named to��this affidavit would HIM to thank you a adrx=for yom coopm-d ion and sbovld �� you have mry gII , The Office of Inyes'tiga�s please do nothesitatr to g Va a caIl. The DeR rtmm es address,telephone and fax= bee: . �a�artiiE of Massachmss-� �4� n Shceet Ta:#617-T27-4900 eat4.06 w 1477-16ASSAFE Fax#617` 27 774 Keviscd424-07 p Wx i Sinks v Sinks/Entertainment/Elkay Lustertone Stainless Steel 15" x 15" x 6-1/8", Single Bowl Top Mount Bar Sink Image May Not Reflect Selected Options e -rn31� of Elkay Lustertone Stainless Steel 15" x 15" x 6-1/8", Single Bowl Top Mount Bar Sink BLR1560 ATE(MWODNYYY) ACoR& CERTIFICATE `OE. LIABILITY INSURANCE D 12/12/2016 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 CT Atlantic Insurance Group Agency Inc NAME: Berkley Assigned Risk Services PHONE 530 Adams St A/C.No.Ed):(800)634A589 FAX No.: (866)215-8118 ADDRESS: PolicyServices@berkleyrisk.com Milton MA 02186 INSURERS AFFORDING COVERAGE NAIC N INSURER A: Acadia Insurance Co 31325 INSURED Daniel Joyce INSURER B: DANIEL JOYCE CONSTRUCTION INSURERC: PO Box 117 INSURER D: INSURER E: West Hyannisport MA 02672 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. lNbR TYPE OF INSURANCE POLICY NUMBER EXPLIMITS LTR INSR WVD MM/DD/YYYY MM/DD/YYYY GENERAL LIABILITY AUTOMOBILE LIABILITY $ WORKERS COMPENSATION Y/N X TrORYTLIMITS ❑0 H AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y❑ E.L EACH ACCIDENT $ 100000.00 A OFFICE/MEMBER EXCLUDED? N/A ❑ MAARP300574 12/1/2016 12/1/2017 (Mandatory In NH)If yes,describe under E.L.DISEASE-EA EMPLOYEE $ 100000.00 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500000.00 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,it more space is required) Election Category Election Status Name Issue State: All Entities/Insureds: Sole Proprietor Exclude Daniel Joyce MA Daniel Joyce CERTIFICATE HOLDER CANCELLATION Town Of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis MA 02601 AUTHORIZED REPRESENTATIVE ` I I ACORD 25(2010/05) BRAC3139 r Massachusetts Department of Public Safety <� Board of Building Regulations and Standards License: CS-102512 € Construction Supervisor DANIEL J JOYCE,JR, 1 PO BOX 117 WEST HYANNISPORT MA 02672 =' �r��ti�fi' i:�r�•- Expiration: Commissioner 12/13/2018 �� c�//re rAari��iarrcuea/!�o��iaa�cc�icae/lo _ Office of ConsumerAffairs&Business"Regulation License or registration valid for individul use.only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:- �{ Registration: :.:158158 Type: Office of Consumer Affairs and Business Regulation Expiration r°.1-2/1�7/2017 DBA 10 Park Plaza-Suite 5170 Boston,MA 02116 DANIEL JOYCE CONSTRl1CTION DANIEL JOYCE 14 DOLPHIN LN. HYANNIS,MA 02601 ;Undersecretary Not alid it ut si nature NOTES v ;7 41f1 I I � I I I i • i I I I ! Proposed New Walls I 0 TV Area � iFe a e,iti, =*v cai i_es e�aztiz�!bared Mechanical Bathroom I rePartyo 1ay,elar.'> pi� In;.and,sio!!mi i Proposed New Walls becofti,re�rayceo,ordeioRddiho'utranen consent o o}ce lorw,,00g,Inc. i �CF 2866 Door O Un° finished Area 2866 Door I I arSrn � 50 Cased cn I Foundation Window Opening I 3066 Door •° °w� Add (2) 18" x 12" Office Area i Cy QjOy I I Jo c Londsca inyr inc, co 0 Nurs'cns Hills,MA G2648 Q) it ��0 S0 wwo.jo cela scapin g-4?Oi ' O rr..joicemntlscaeing.con FOUNDATION ! _AY^UT PLAN j *Insulate wal_Is with R- 19 Fiberglass Insulation I \-JuYCE *Drop ceiling in _fi-njished areas 7' above finished floors RESIDENCE i 45 wheeler Rd Marstons Mills, MA 02648 I• 0 4 a 12 feet 19 Ol-3d0-15 Ia�^ S.Aal*.onen SCALE:1/4•= -0' ammo �! a� Ol T /27/17 F — ury cn • 1 r i t i 4 � f Ir C 4T r SU"D'JVGI) AUS 4401� T®wry OF RAPfAlS-r 68 Flint Street, Marstons"Mills, MA02648 'ABLE TEL: 508-428-4772 f•AX: 508-428-4707 www joyeclandscapingx mi August 3,2017 Town of Barnstable Building Division 200 Main Street Hyannis, MA 02601 Attn:Building Commissioner Jeff Lauzon As per your request this letter will serve as affirmation that my personal residence at 45 Wheeler Road,Marston Mills construction of a family recreation and playroom is not going to be used for additional bedrooms. Thankin/you advance, Ch stopce i o f 9 Berautifut properties Be iti Mere... s t o TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Q— ec� Map Parcel Application # . _ _ 7C Health Division Date Issued Conservation Division Application Fee Planning Dept.' Permit Fee �. Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis Project Street Address -e e Village A Owner C�T✓ Pr T- 0yrr Address Telephone o �— 0 51"1? e 4 Permit Request J A ( S 0 0 A l�1 n� S e ^1 C`l ✓/� p oi /h T L/ � -ec�.��✓cam j /'� v✓�t Square feet: 1 st floor:: existi proposed 2nd floor: existing proposed Total new Zoning District /\ Flood Plain Groundwater Overlay Project Valuation 0 000 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ) No On Old King's Highway: ❑Yes,,(PrNo Basement Type: YFull ❑ Crawl ❑Walkout ❑Other Basement Finished Area (sq.ft.)I+T��S dt�s Basement Unfinished Area(sq.ft)__ I f Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing Q new Total Room Count (not including baths): existing new 3 First Floor Room Count Heat Type and Fuel: Gas ❑ Oil ❑ Electric ❑ Other �'' Central Air: ` Yes ❑ No Fireplaces: Existing / New O Existin°g`wood/coal stove: ❑Yes No 30 � ,q Detached garage: ❑ existing ❑ new size_Pool:9 existing ❑ new size_'�:a,Barn: ❑ existing ❑ new size_ Attached garage:Xexisting ❑ new size _Shed: ❑ existing ❑ new size _ Other:• b '<. Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ - Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION j (BUILDER OR HOMEOWNER) 4 Name /� �I(� clOYCIF Telephone Number Address P 6 d-,)( / l 5 License # 16 �— �/ ` f r�� ►s v�� "l 4— 0 b Home Improvement Contractor# /S U Email I loycr ,,, �'�Clr[ e�Worker's Compensation #M 4-40 300�_7 ALL CONSTRUCTION DEBRIS RESULTING FROM HIS PROJECT WILL BE TAKEN TO SIGNATURE DATE ` FOR OFFICIAL USE ONLY APPLICATION # r _-�4JATE ISSUED MAP/PARCEL NO. =� ADDRESS VILLAGE OWNER, DATE OF INSPECTION: 'FOUNDATION s 7:. FRAME INSULATION _ FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH i FINAL GAS: ROUGH FINAL FINAL BUILDING [r ' r DATE CLOSED OUT r ASSOCIATION PLAN NO. r 1 . .v ' Town of Barnstable Regulatory Services Richard V.Scab,Director. 16"3 *`� Building Division Paul Roma;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 Pr TO�Icr_, as Owner r of the subject prop erty4j- hereby authorize ® cc: to act on my behalf, in all matters relative to work authorized by this building permit application for. 4ers (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or.utilized before fence is installed and all final . inspections are performed and accepte . z�- S' oP'wn Signature oiVAp#cl � vcr Print Name Print Name Date r Q:FORMS:OWNERPERMISSIONPOOIS Town of Barnstable Regulatory Services Richard V.Scali, Director Building Division ARC Paul Roma,Building Commissioner i6s9� a.� 200 Main Street, Hyannis,MA 02601 p www.town.barnstable.ma.as Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING:ADDRESS: cltyhDwn state zip code The current exemption for"homeowners"was extended to include owner-occupied dwelling of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be-considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. - — - - - - Signature of Homeowner Approval of Building Official Note: Tbree-family dwellings containing 35,000 cubic feet or larger will be required to comply with the i State Building Code Section'127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required . shall be exempt from the-provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. - To ensure that the homeowner is fully aware of his/her responsibilities,many communities require, as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. The Camm vweafth efA&nadi Department uf1udzsbidAcddmts OJTWC of 600 FYI Shwd Boston,d-A f12HI • t'vrv�umar�gv��e�ra . Wurltil & CampeniafianImmn-mc$ f*dz"L Bm11eFS/C4Mb=W 'c kja1�t ers AmiRcant Please Frm Nam - f G Apt= cityrstatm (-- Y<WSP,9 /►1 o�67Phone-i'k- 7 7c,(-- e)-3 � —O-: :�O Are you an employer?the the apirepriate bay Type of project(required): sat a employer vi 4_ ❑I am a general coatmaur sad I • earpSa�rees(full arr&foc part-tme)-* have Irired tlse su#r-cow 6_ El New cons 2.❑ I am a sale psoplietar arp utuer- listed entire atbthed sheet 7.,(Remde&g ship and have no I�� These sub-cauhacts have 8. ❑Demolition waridng forme in any capacity. errloyeess and have worms' INo n-t�'eonzp.imsueaace comp_k�,�.2 9. addition mpire&] 5. We are a corporatiaa and its 1d❑EI�1 repaim or ad&hons 3.ElII,a�m�7f abaam eomer doing all wmk Officers have wed their 1 L 0 Plumbsagrepaim or adchfioms � END workers'O=P- right of per MG 1?❑Roofrgxim m,n==e required_]1 c.M JIM andwebave no I3.O fltfies �ay�-[No � canes msmaace required.] #AuyaPF thatcheds box Rmostelan:fMo=theswd=belowshaoiagthe¢vm&es'aaapeesatiaapn&cgi c� f�GIDeC�nelS Wlra SII�Ft L3bS a{iidae ig they YIf ¢g WC¢3:sad�hFxe aatsid�eamact SIIbm]t a netvat&da�it mdi �rx -C=ftaMaffMat dhecf tlift bme mast suit Ma adelit; shad sbmdng theaame of de sab-co sari state vhef m or not 8mse emrties have -mPlcyees.7fthesvbc adocska--ggafes,B2er giatide&& VEMP.FolkFMMMber lam all uasnranw for uT emp&t�wm Berow is the po •icy and jab site Issnranse CompaapNM= Paficy-,',c r Self-isrs_Tic-;9- M tit 1'" 00 S7 Fspimtiaa Date= / 7 Joh Site Address C41S Atach a copy of the workers'compensationpolicg declaration page(showing the policy atmber sad espiratioa date}. Faih me to seeum coverage as required ender Section:25A o€MC$.c.1572 can kad to ffie imposition of cArniaal penaifaes of a fine up to$1,500 DD anaor ane-yearsmpFisoumenk as Wr 11 as civil penalties st the faaa of a STOP WORK{}BDERand a fime of up to$250-W a clap against ffie violainn Be advised tint a cry of this statement pray,he forwarded tulle Of flee of lavestsgations ofthe DIA far hm=w coverage vedficaditm_ lido herghy sdar-tJte psrraIties a, perlcctl'fhattlte it b2 rwa€ivaprovi&d abors is fts aunt correct �-- 3� Phone -7 L 3 OFkid we anlj. Do sat twits in dib areo,fo be cmnp ete+d by city artaatvu aft City or Taws: PeTHIft'iff,icence# L=ing Auflmm*y(Carle one): L Board of Heal& 17 Ring Dqm masat 3.ctyfrawn Gird; 4.Eleetriml Iuspeetar S.Plneaidng Emspedmr 6.Other Contact Person: Phow P- 6 luformation and Inst"nCtionS / Mgc rhcPt Ge=zzl LaEm ffieptrr 152 Ieqmcm aU=:PIoYCM ID F T IF,WMI=& p�to.this sfatoiu,as�loyr�is defined.ss.�.�va'p p�sr�nm ffie service of�othrr oadPs any co�xact offalr., - egrass or napliut oral orvuftt:� An�Tvyer n d:£ned as�an m fvi$uaI,parta��," "r'y=PWAf=or o�IePI ems- of e�Y�� of the fia•eg�g��in:a Joint and mclnd fmg bo legal Feprese�es of a deceased eorpla,Anmyes$e rerei4�or trustees of m dal,P associai-or of m Iegal e�y,employing Flo - hm=h=ngnotmorethanthroeaPMttr ead�vhoresides ni,orfheoccogautofthe - ownea of a.dweIlmg air work.on such dwell�.goy hoe"use dw Mug house of des who employs persons to do ms�ca on or mP an l �s �g aPpmteaautffimretn shaUmtbww=of such employmmtbe deemedtD be empl MC3L chapter 152,§25CC6)also stdns that"every state or local��a agency shall witi�b old ffie ss. cE ar renewal of a ficease or permit to operate a bm-mess or to construct budmgs is the commonwealffi for nay 2pplic2nf.?Yho hms not produced acceptable.eYideae=of cdnrpBmm with tb�m�»�covexage required." Add�onaIIY.M _Chapt=ISZ,§25C.(7)sib�`Ieiihec the nor�y ofifa po isMl sabdxvisions sbaII enf�r info any contract for the:perfimnaw�d ofpvblio wmkuabI acceptable evidence of coui Hmcew&L$ie iasm1mce._ req==erts of this chapter have been PTeS ed to ffie r�rrfi•��a 3 Applicants Please fill o� tba wolk='compeasabon affidavit comtpl�ty,by g boxes that apply to your siination.md,if nme=zrL supply s)nmme(s), addresses)and phone m=ber(s)along with.their=tfr (s)of msuramce. Limited Liability Compar i (LLC)or I,>mifedLiabffity-PmtamxbiPs.(LU)w&no mnPloyees offiM fig fiIe members or pis,are not reqad fn cry wo6=e ea3pens3hnn hn=mlc, - If an LI.0 or LLP does have employees,a policy is - Be advisedthattbis of daykmaybe salted fn the Department of Industrial. Accidenjs for con£mmadm offinance coved Also be sure to sign and datethe affidavit Tho affidavit should be returned to the city or town that the appfir fion for the pennrt or hoense is being 'not the Department of bAastaal A=dmlm nouldyou have any Tmstons regmragffie Jaw or zfyou a=rmpmr-d to obtain a wobcers' CZM3pP„&3'ion,pohep,PleasecaUthaDepartmentatfirennmb=lis-tndbelow. Self-msoredooupanicsshvnldentertheir self-basma„cp licensees oniiie - City or Town Officials t Please be sure fhat the affidavit is camplefa and primed legibly. The Depmtmeaof has provided a space at.the botipm of the�fidavitfor youtri IM ant in eves the Office has to��tyouregmdmgthe aPPhcant Please be sm-e to fill in tiie pem�liceasc mm3ber which w�I be Lsed as a ce nvmbcr In add ion,�applicant that mzzst submit mule pe�crose Epplk2 i=in en any giv year;need only sabmit one affidavit indicating ur coant policy mfozmatioa Cif nxessary)and undrs"Job�Address"fhe applicant should�'aII IocabOns m (may or- ffim town):'A copy of the.affidavit fiiat has been oy stamped or madced by the city or town may be provided in applicant as.proof tbat a valid affidavit is on f ac for fain=peirm$s or licenses A new wrist b yew'Wham a home owner or citizea is obtaining a license or peun.¢not xrlatrd�any (ie_a dog license or pem3h to bozo leaves eta.)said person.is NOT required to Clete this affidavit The-Office of Inv wouldlilmin thaokyou im advance foryour eooperahan and shovldyouhave any guesirous, plrsse do not hesitate to givm vs a caI- The DeREFt f's address,telegbane and fax n mmber y - Commonwe&j*of Massachns Depzmmt Gff Yb A nt% ice Of IJIMS06ktio= -Tel..#6I7-72M m t 4-06 ar I-a77MA SAFE Fax 617` 27'749 B.cv cd 4-24-07 gt a Y .i ATE ACC>0 CERTIFICATE OF LIABILITY INSURANCE D ,2„2,20,6 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 CONTACTBerkley Assigned Risk Services Atlantic Insurance Group Agency Inc NAME: y 9 530 Adams St ac.No.Ed):(800)634A589 ac.No.: (866)215-8118 ADDRESS: PolicyServices@berkleyrisk.com Milton MA 02186 INSURERS AFFORDING COVERAGE NAIC p INSURER A: Acadia InSUranCe Co 31325 INSURED Daniel Joyce INSURER B: DANIEL JOYCE CONSTRUCTION INSURERC: PO BOX 117 INSURER D: INSURER E: West HyannisDort MA 02672 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. POLICY EFF PO �xp LTR INSS TYPE OF INSURANCE INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS GENERAL LIABILITY AUTOMOBILE LIABILITY $ WORKERS COMPENSATION WC STATU- ❑OTH- AND EMPLOYERS'LIABILITY Y/N X TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE ] E.L EACH ACCIDENT $ 100000.00 A OFFICE/MEMBER EXCLUDED? N/A MAARP300574 12/1/2016 12/1/2017 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 100000.00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500000.00 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,11 more space is required) Election Category Election Status Name Issue State: All Entities/Insureds: Sole Proprietor Exclude Daniel Joyce MA Daniel Joyce CERTIFICATE HOLDER CANCELLATION Town Of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis MA 02601 AUTHORIZED REPRESENTATIVE 2J� i ACORD 25(2010/05) BRAC3139 �r ` a Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-102512 Construction Supervisor DANIEL J JOYCE,JR T y ' PO BOX 117 WEST HYANNISPORT MA 02672 rri�{i' 11?��-- Expiration: `Commissioher 12/13/2018 . �e epaoirr�iaarecvealC/o�C�/jlaaaric%ccdeCG _ Office of Consumer.Affairs&Business'Regulation License or registration valid for individul use only kq-,'.,HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: :: 58158 Type: Office of Consumer Affairs and Business Regulation Expiration;..°12%:17/2017 DBA 10 Park Plaza-Suite 5170 Boston,MA 02116 DANIEL JOYCE CONSTRUCTION'; DANIEL JOYCE , 14 DOLPHIN LN. - �.:c�•-y_ti.,:,.� HYANNIS,MA 02601 Undersecretary Not alid it. ut si nature I NOTES ., JAN 3 0 2017 O c '77 i' BUJ TV Areo Proposed New Walls �. me` ats de4p,and seas ee6 M ttw* Mechanical Bathroom Proposed New Walls e°'e �t"�" aAdt + , consent of � &* Inc 2866 Door Un fin.ish ed Area 2866 Doo r ` 50 Cased Foundation Window Opening 3066 Door Add (2) 18 x 12" Office Area — L Qj Joyce landscaping, Inc, 68 FUnt Street \ Marston ME%MA 02648 { .�� ... 50e-428-4772 50-428-4107 - - _ - - vn joycelaMscaphXon F❑UNDATI❑N LAYOUT PLAN *Insulate wells with R- 1 9 *'Fibergloss. Insulation J❑YCE *Drop ceiling ,in finished areas . 7' above finished floors RESIDENCE 45 Wheeler Rd Marstons Mills, MA 02648 1'=4' �a 0 4 8 12 feet S.Aaltonen 01-380-15 If amn rt a¢r i¢ SCALE:1/4'=r-0^ aR 01/27/17 rrt v ien 1 I pfite e MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY MA.DATE 2--. PERMIT# J v JOB SITE ADDRESS ell/e, ,� .{y OWNER'S NAME POWNER ADDRESS TEL FAX TYPE OR OCCUPANCY TYPE COMMERCIAL® EDUCATIONAL RESIDENTIAL ' PRINT NEW: RENOVATION: REPLACEMENT: PLANS SUBMITTED: YES❑ NOO CLEARLY ❑ [ [� - 'FIXTURES Z FLOOR- BSM 1 2 3 4 5 5 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE — DEDICATED SPECIAL WASTE SYSTEM — DEDICATED GAS/OIUSAND SYSTEM �^ — DEDICATED GREASE SYSTEM o —� DEDICATED GRAY WATER SYSTEM — I DEDICATED WATER RECYCLE SYSTEM — DISHWASHER DRINIQNG FOUNTAIN FOOD DISPOSER — r— FLOOR/AREA DRAIN INTERCEPTOR INTERIO — IQTCHEN SINK �'— LAVATORY ROOF DRAIN SHOWER STALL I SERVICE/MOP SINK ® ' Lr TOILET URINAL ') WASHING MACHINE CONNECTION r� I WATER HEATER ALL TYPES7 WATER PIPING OTHER INSURANCE COVERAGE: ' I have a current liabilityinsurance policy or its substantial equivalent which meets the requirements of MGL Ch.142 yES NO Uj Q> IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOWco �V LIABILITY INSURANCE POLICY OTHER TYPE OF INDEMNITY® BOND ❑ Z m OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chaff 14�theo Massachusetts General Laws,and,that my signature on this permit application waives this requirement. = ALA_ Z CHECK ONE ONLY: OSER ® A NT SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true a accurate to the best of my knowledge and that all piumbing work and installations performed under the permit issued for this application will be In co pf n wit II P rtinent provision of the Massachusetts State Plumbing Code and Chap r 142 of the General Laws. . PLUMBER'S NAME �') � � �'' LICENSE# jj SIGNATURE MPEX Jp® CORPORATIONE]#=PARTNERSHIP®# LLC0# COMPANY NAME Jar ^> 1`�1J\ j ADDRESS CfiY ✓�y� �� G L STATE ZJP �Z TEL �� FAX CE11 l7 S�y I . EMAIL J �, `� ��, C�✓l'1 Y l�" V t��n 1 v l J i I I i I �""� l I i I J TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION It's Parcel Map- ApplicatiQh # LA t, Date Issued Health-Division Conservation Division Application Planning,Dept. .'Permit Fee Date Definitive,Plan Approved by Planning Board Historic - OKH Preservation Hyannis Project Street Address q5, I'A 4g k L: PZ Village Owner C, &'& Address e a IF, Telephone Permit Request 1, 1 -1, Z_x(AhJVZ�4 k4olyt Ad4.,4�ov i. r Square feet: 1 st floor: existing—2-i4roposed A63 2nd floor: existing proposed Total new 1-5-3 Z6-ning District Flood Plain Groundwater Overlay Project Valuation elyocao-'l- Cor!:struction Type 1,/N L6.t Size 06 14 COX Grandfathered: El Yes' Ll No If yes, attach supporting do o ZE%tion. Dwelling Type: Single Family Two Family Q Multi-Family (# units) Age of Existing Structure a_ Historic House: Q Yes 3<o On Old King's Highway: UYes KO Basement Type: alrull Q Crawl Q Walkout Q Other 1-0 Basement Finished Area (sqft), Basement Unfinished Area (sq.ft) / 4169 m ON Number of Baths: Full: existing. new Half: existing new Number of Bedrooms: existing -Onew Total Room Count (not,, not including baths): existing 53 new First Floor Room Count Heat Type and Fuel: *15as 'Ll Oil Q Electric C3 Other Central Air: 5KYes L3 No Fireplaces: Existing_ New 0 Existing wood/coal stove: D Yes 3wo Detached garage: El existing 0 new size Pool: Ll existing El new size Barn: D'existing 0 new size— Attached garage: Vexisting El new size Shed: Eirexisting Q new size / Other: Zoning Board of Appeals Authorization Q Appeal # Recorded U Commercial 0 Yes CZo If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name �6 1Z Telephone Number g ;20 Address 090 License # 7 3 7 9 ma , 6a&57, Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO 7bt,&V-ZW,,d.4q1 SIGNATURE DATE 62 Ll z FOR OFFICIAL USE ONLY APPLICATION# ` r DATE ISSUED MAP%PARCEL NO. y q ADDRESS VILLAGE , tr OWNER. r J DATE OF INSPECTION: ; r FOUNDATION FRAME C) e> cA— q 7 0 INSULATION" 9t bLo it FIREPLACE ELECTRICAL: ROUGH FINAL i PLUMBING: ROUGH FINAL , D GAS: ROUGH FINAL ' y , , FINAL BUILDING DATE CLOSED OUT ' ASSOCIATION PLAN NO. r i �TM�r Town of Barnstable Regulatory Services ass . Thomas F. Geder, Director Building Division . Thomas Perry, CBO, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnsta b 1e.ma.us 'Office: 508-862-4038 Fax: 508-790-6230 PLAN REVEEW Owner: Map/Parcel: 7 . D O Project Address YS' � C /� Builder: �S • /LC vLt The following items were noted on reviewing: • ,Q/��'fi T L l7�l°GfI"N �/� �0 6 Gt�- — N� G�J Reviewed by: �JL Date: l O Q:Forms:Pinrvw I , The Commonwealth of Massachusetts Department oflndustrial 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 Le 'bl Narne(Business/Organization/Individual): S Address: rjlbJ!`t &0 ��iw�rt yi 1 , � 0al032 City/State/Zip: R.yi Ot Yywt 2 3L Phone.#: Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. I am a general contractor and I . employees (full and/or part-.time).** have hired the sub-contractors 6. ❑New construction 2. listed on the attached sheet T. 0 Remodeling I am asolt;proprietor or'partber- ship and have no employees These sub-contractors have g. -0 Demolition working for me in any capacity. employees and have workers' 9 Building addition [No workers'•comp.-insurance comp. insurance.$ S We are a corporation and its 10.❑Electrical repairs or additions . required.] � - ' 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp.insurance required.l "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. ZContactors that check this box must attached an additional sheet showing the name of the sub-contactors and state whether or not those entities have employees. 1f the sub-contractors have employees,they must providt:their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my.employees Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic,M Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of crimiri4i penalties of a fins;tip to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine. of up to$250.00 a day against the violator. 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 certr nder the pains nd penalties of perjury that the information provided above is true and correct. Signature: p Date: Phone#: Q y a 0- o 00 Official use.only. Do not write in this area, to be completed by city or town offcciaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of health '2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Information and Ins tu.ctions 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 ore than three apartments and who resides therein,or the occupant of the owner of a dwelling house having not m dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not 'produced-acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7) states`Neither the commonwealth nor any of its political subdivisions shall . enter into any contract for,the performance of public work until acceptable evidence of compliance vzth the insurance requirements of this chapter have been presented to the contracting authority.' Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractors)name(s),.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 j 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 bas provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address" the applicant should write"all locations in (city or town).".A copy of the affidavit.that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related fo 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 COrt.IRlonwealth of Massachusetts }department of ladustrial Accidents Office of Investigatlans. 600 Washington Street Boston, MA 02111 Tel..#617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 11-22-06 www.mass.gov/dia ENERGY CONSERVATION APPLICATION FORM FOR ENERGY EFFICICIENCY FOR ONE,, AND TWO-FAMILY DETACHED RESIDENTIAL-CONSTRUCTION (780 CMR 61.00) Applicant Name: �61-e L Site Address: Pr;", Town: �Ali/5 Applicant Phone: $0 y'20--o$s Applicant Signature: Date of Application: p NEW CONSTRUCTION: ehoose ONE of the followin two'o tions 780 CMR.TABLE 6107.1 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA FOR NEW ONE- AND TWO-FAMILY BUILDINGS MA�ClMt1M •MINIMUM ' Ceiling or Basement Slab QOption 1: Fenestration exposed Wall Floor Perimeter AFUE U-factor floors R-Value R-Value R-Value wall R-Value HSPF SEE] • R-Value and Depth National Appliancc-Energy 3 5 R-3 8 R-19 R�19 R-10 R-10, Conservation Act(NAECA)of 4 ft • 1987 as amendod,minimums or cattr as applicable i Note: This form is not required if you choose either of the two versions of REScheck as listed below. Option 2: RES check Version 4.1.2 or later variant software analysis must be completed 780 CMR 6107.3.2 REScheck—Web which can be accessed at http //www.energycodes.goy/rescheck/ ADDZ� ONS:O E2 ALT RAT)ONS.TO EXISTING BTJLLDINGS.OV R'5 FEARS OLD* *buildings under 5 years old must use option#1 or#2 in New Construction section above. Complete the following formula to determine the %o of glazing: (a) Gross Wall & Ceiling Area equals Formula: (100 x b_ a) 6(p SF 100 x 2* % of glazing (b) Glazing area equals ZK SF b a If glazing is<-40%.u.9e the chart beloW. If lazing is > 40 % rocee.'d to "SLTNROOM" section 780 CMLR TABLE 6101.3 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA ADDITIONS TO EXISTING LOW-RISE RESIDENTIAL BUILDINGS MAXIMUM MINDA M Ceiling and Slab Perimeter Fenestration -wall Floor Basement Wall R-Value U-factor Exposed floors _ R-value R-Value -V ue and Depth .3 R-3 7 a . R-13 R-19 R-10 R-10, 4 feet a R-30 ceiling insulation may be its in place o if th nsulati achieves the full R-value over the entire ceiling area(i.e.not compressed over exterior walls, and includinv anv access openings). ' SUNROOM—An addition or alteration to an existing building/dwelling unit where the total glazing area of said addition exceeds 40% of the combined gross wall and ceiling area of the addition. Note: Owner to fill out Consumer Information Form found in Appendix 120.P Check Compliance Number of Stories(a roof which exceeds 8 in 12 slope shall be considered a story) :5 12:12 1.3 FRAMING CONNECTIONS 2.1 FOUNDATION | | �2 AmcnumAuExuruuwua//"N � �� / 5/8^Anchor 8uks4nbeddadcv5/8~ �Proprietary k4achan�a|Anchor uoana8ernadvnin concrete V Bo�S �n -gene�| --.-----------..�ab|a4)----.....�----.. Bolt �nmand�o�tcfp��-----^---- u ---.--------'. /& " - .~ ` Bolt Embedment-concrete........................ ................(Fig ...... ............. ................. ... Bolt Embedment-masonry..........................................(Fig, ----�---.«-«----. » .= /" � Plate VVmshoc.-.------------------'(Rg5�---------------.�3rx3^x�� 3' FLOORS FLOO� Floor-framing --.-------�(Par78OC/WRChaph�r55).�N46- . � ' �� 12' - � A�Q0) . � Maximum Floor Dimension ----'---.�---'----� "~��' - --_- FuURm�h�VVoU Studs at�- ~ F�urOp�nngsbsoU�on �cmEx�horVVoUU��L---.g��-------� Mbximum Floor Joist Setbacks � �d SuppordnQLoodbaahngVVaftcvShoanxaU-----.(`�7).............,------------.`___ Maximum Cantilevered Floor Joists -� �d Su LoodboadngVVaUs'orShoanxaU-----.(=�8 `�__ F|oo�Bn*c�gat�nd�o|b----.-------------V-m»/ ^`^""� F�orS Typo ........................................................(per'8"^°" Chapter 55/'-y0'---.6.P---' ---- | FbmrShoaU�ngTh�knass --------------.:-' ---' F�orSheoU�ngFa�e�ng---------------.�-- 2).��_dneUn�d_��_� edgo/ ��n8n� | 4.1 WALLS ' Wall Height ' 1U' ' i and � LoadbeahngwaKo---.--'------------ � Non'LoedbeohngwoUs----�-----------' and Ta�e5)-----. . . --------' nndTa�e5)------�/�_m.�24'n.c � ,,="�"^"" -'-----'--_--_---.�` - 7�O)----------''��-'��'� -d ,,..11~..� Offsets -_-----�� ` �2 ��E��LLS` Wood Studs �~ �� h�. Loadbeahng�a||a . -----------------(Table 5)------- ��^ --+_ -|- .---------------��bk�5)-------��.2x�__'--_ft__-�. �a�oEndYVaVOmcmg � /�� Full --------------.��g1ug-------,---^^��-----,---. ' - --- � '7F� 11) � ��VW3 VVSP.4�cF�n Leng�----'��--------- (Fig --'----------''____ 'G -- VVS n��used)-':---- i1� -------------'--_ft> C.9VV 'Gypsum l uou�ling Length(if*Laha�|B��o�� O ��o�c ' U=� 11�------------------.`_� � � --- � with 4bb�k� ��4�topodngin end��iorbnso bays _��_ � or1 x3o�|�gfuningobips �� 1G^spacing min. x g Double Top Plate ft AH,C Guide to Wood Cou.stntctiou hi Hid•% 14, 11d Ai-eas: I10 mpit I-Virid Zone r Massachusetts Checklist for Compliance (780 Ci,IRS301.2.1.1)' Loadbearing Wall Connections Lateral(no. of 16d common nails).......................'.........(Tables 7)..................................................... Non-Loadbearing Wall Connections Lateral(no.of 16d common nails)................................(Table 8)................:...................................... Load Bearing Wall Openings (record largest opening but check all openings for compliance to Table 9) Header Spans ........................................................(Table 9)................................... 2 ft_)5�in. 5 11' Sill Plate.Spans ........................................................(Table 9)....................................2,.ft__f�cin.511, Full Height Studs (no. of studs)....................................(Table 9)......................................................I Non-Load Bearing Wall Openings (record largest opening but check all openings for com,P}lance to Table 9) HeaderSpans.............................................................(Table 9)...............................`..I ft_Jn. 5 12' l/ Sill Plate Spans.... ..................:....................................(Table 9)..............................0. ft in.5 12" Full Height Studs(no. of studs)....................................(fable 9)...................................('�....... ..... Exterior Wall Sheathing to Resist Uplift and Shear Simultaneously Minimum Building Dimension, W z Nominal Height of Tallest.Opening .................................. .._5 6'8" 9 Type (note ) G� � i Sheathing T e.............................................. 4 .....�/.?:............. ....�........��P-�*.Cv,.� . Edge Nail Spacing................:........................(Table 10 or note 4if less)......................:._(� in. Field Nail Spacing...........:..............................(Table 10).........................................•.......f�in. Shear Connection (no. of 16d common nails)(Table 10)...............:......................................._ Percent Full-Height Sheathing Table 10 .................................................... 5%Additional Sheathing for Wall with Opening> 6'8"(Design Concepts).................... o� Maximum Building Dimension, L Nominal Height of Tallest Opening2........................................................................._5 6'8" SheathingType............................. ................(note 4)................. ....................... Edge Nail Spacing...................:.....................(Table 11 or note 4 if less)........................ in. Field Nail Spacing.......................................:..(Table 11)................,...:............................ in. � Shear Connection(no.of 16d common nails)(Table 11)................... ..........:.........:.............. Percent Full-Height Sheathing ° 5 Additional Sheathing for Wall with'Opening> 6'8"(Design Concepts).................... Wall Cladding Ratedfor Wind Speed?.............................................................. .......................:..........:................ 5.1 ROOFS Roof framing member spans checked?.............:..........(For Rafters use 4WC Span Tool,see BBRS Website) i Roof Overhang ..(Figure 19) ft:5 smaller of 2'or U3 Truss or Rafter Connections at Loadbearing Walls Proprietary Connectors / Uplift................................................(Table 12)............................................U= pif ✓ Lateral.............................................(Table 12).............................................L= plf Shear............................:............ (Table 12)............................................S= pff Ridge Strap Connections, if collar ties not used per page 21... (fable 13)............... = plf Gable Rake Oudooker..........................................(Figure 20) ....... ft 5 smaller of 2 or U2 Truss or Rafter Connections at Non-Loadbearing Walls Proprietary Connectors / Uplift. ...............................................(Table 14)...........................7................U= lb. Lateral (no. of 16d common nails)...(Table 14)............................ .......L= . lb. Roof Sheathing Type...................` . ....................(per 780 CMR Chapters 58 and 59 Roof Sheathing Thickness.............1<v...............:..... ................................ in.Z 7/16"WSP Roof Sheathing Fastening............................................(Table 2).:................ Q.. ................. Notes: `✓ 1. , This checklist shall be met in its entirety, excluding the specific exception noted in 2, to comply with the requirements of 780 CMR-5301.2.1.1 Item 1. If the checklist is met in its entirety then the following metal straps and hold downs are.not required per the WFCM 110 mph Gui a. Steel Straps per Figure 5 b. 26 Gage Straps per Figure 11 c. Uplift Straps per Figure 14 d. All Straps per Figure 17 e. Comer Stud Hold Downs per Figure 18a and Figure 18b 2. Exception:Opening heights of up to 8 ft. shall be permitted when 5% is added to the percent full-height sheathing requirements shown in Tables 10 and 11. 3. The bottom sill plate in exterior walls shall be a minimum 2 in. nominal thickness pressure treated#2-grade. l , I ��►+e,q,, Town of Barnstable Regulatory Services. $"R AS& Thomas F.Geiler,Director 019. ► Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize ("'f'U to act on my behalf, T in all matters relative to work authorized by this building permit application for. I (Address of Jo ) J / Signature of r Date Print Name If Property Owner is applying for permit please complete the . Homeowners License Exemption Form on the reverse side. Q:FORMS:O W N E RP E RM IS S I ON Town of Barnstable o Regulatory Services tMa , ; Thomas F.Geiler,Director 94i 9. Building Division ATEn µpi a Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 T HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is,or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. x. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0'Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be"exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. Irf this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORM S\homeexempt.DOC 1 " IVlassachusctts - Department of Public S:ifcty Board of Building Regulations and Standards Construction Supervisor License License: CS 57394 Restrictedto: 1G r� a ROBERT G 'WALSH 71 WALNUT ST ' MARSTONS MILLS, MA 02648 Expiration: 6/2/2011 ----(commissioner ---' Tr#: 16666 . ' .C� �ie �a�ninxauueall/ a�„/�,00ae�iueeQ2 "i \ Board of Building Regulations and Standards I _ 1 HOME IMPROVEMENT CONTRACTOR Registry on\141991 Z Expiation_3/2010 Tr# 264420 �r I=� ' HARBORSIDE REMODELING- �- `,� s� r ' ROBERT WALSH,< - i 250 CAPTAIN CROSBY ROAD CENTERVILLE,MA 0202 Administrator ' ... I . . . _ . . .1 t. '` i I. I �� I� �._.. ... . . . � ,..J r - . , � � <, , . LOT E Ngg463 p� 1 Sf. A.M. 10417 LOT D ! AREA = 89,355fS.F. �� CB .01 Y h 2 ti 1, O qq o �,`)YYY BU N' 16 O' ; `1 O LOT C O' ti - CB lZ � rP NOTE.- ' r� SUESKETCH IS NOT TO SCALE cl) �O , s- s 6�rav(d /A/0'� 0 FLOOD ZONE "c"_ FO UNDA TION CERTIFICATION RES ZONE.• 'RF" TO WN.'MARSTONS MILLS SCALE.'1"=80 PL.REF 240 41 ELEV NIA I CERTIFY THAT THE ABOVE YANKEE SURVEY CONSULTANTS FO UNDA TION IS LOCATED ON P. 0. BOX 265 THE GROUND AS SHOWN, AND �y. UNIT 1, 40B INDUSTRY ROAD ITS POSITION��_____ � , •CONFORM TO THE ZONING LAW MARSTONS MILLS, MASS. 02648 SETBACK REQUIREMENTS OF No,3ZXB TEL: 428—0055 _EARN"T�AB _ c:;r.R FAX 420-5553 � ts,� SOB PA UL A. MERITHEW DATE IZ�09�2002 NUMBER 52834FND I ,Z U ON 0 Gob 0 AM C ' '"`� I � r X v TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map f Parcel 60 Permit# .,5 7 1-/0 Health Division `- l 2�'O) Date Issued Conservation Division Fee ):�'6 Tax Collector SCr ISEPTIC SYSTEM ',MUST E"r Treasurer ( Y-- r r 17.001 INSTALLED IN COMPLIAf`%,,� M Planning Dept. WITH TITLE 5 ENVIRO'MMENTAL COZ^ ,t: Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address Village Owner Address qS l_,J1n Q uR '. Pp Telephone -�C '�k20J Permit Request QCy3+ kCb Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoao �' Valuation � 0 ' Zoning District Flood Plain Groundwater Overlay Construction Type 95�k-t-� � Lot Size OCR.3J� Grandfatliered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes�O No On Old King's Highway: ❑Yes No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count. Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes, ❑No Detached garage:❑existing ❑new size Pool:❑existing�Q new sizeO(&B Barn:❑existing ❑new size' Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ } Commercial ❑Yes"`� No If yes, site plan review# Current Use Proposed Use R-�''Cc� -,�(3,jV ,, BUILDER INFORMATION Name\�Nc "r , POGO 6 G 1jR CL\;R Telephone Number SOb-3q�'j�� 1 Address N\ �> On0-�r QpQ-j—I lb License# Home Improvement Contractor# k?,2vll(-p Worker's Compensation# WC 13 o')%bo9d ALL CONSTRUCTION DEBRIS RESULTINGARTHIS PROJECT WILL BE TAKEN TO " ,-,SIGNATURE DATE N,1S1e1 FOR OFFICIAL USE ONLY s, PERMIT NO. 'DATE'ISSUED MAP/PARCEL NO. E ADDRESS VILLAGE OWNER. d DATE OF INSPECTION: FOUNDATION -FRAME INSULATION FIREPLACE 3. ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents Oflxce ot/aVest/oogolgs 600 Washington Street ' Boston,Mass. 02111 Workers'. Compensation Insurance Affidavit name: RED location phone#H4x)—q vx� city ❑ I am a homeowner performing all work myself. ❑ I am a sole rietor and have no one workin in aav achy , ��p0//, � ��dm workin on thisjob.workers co ensauoa for my .:.:::::...:::g »:<:::>::::::<:;:>:>::::::::>::>::::::>:<::::::»:<:>:::::» an em lover XX Si OA m vn trD p dt'e Q. litm ::. . ... . }}::: .>;::.:;>:>;:::;:::.:is.:z::;>;::;i:-;:.;}i:•::•i:;:;;:::•�-;:`:�;`.;:. '.::.:.:• :..�:s;i:;:}:.:�::•:::::::::::::::::::::::::}i:.;::}'::::�:::::;.::�:.:.�.�:...,::;.::: tv .. .:... ❑ I am a sole proprietor,general contractor, or homeowner(circle one)and have hued the contractors listed below who have ' lion polices: workers' suss ........ w P w,.r::::w,•::w...,:::.::: win �mP ::::..........::.:..... the following :.........:.............:::.:..::::::::::::. .....::.::::::::......... ..:::...::.::::::........:::.::::::::::..:::::::.........:::.:::::::::......::::::::.:.:......::.::.:.......:.:::::... ame: ;.: ... ... ............... ....................:.:.....:::•:.:.�0}}}}i}}:�}}}}:a};}}::•}:: �:::nvv::.v::::::::::r...w:v: :........................... ...:.:.:..i:-:}::i::::+v:;i::i:•i}:;•}}}:}:i::i:S•i............::w::::::.�.�:::::::::::.}:•}}:.}}};ii:•}}:;?•>:•:v}::<•:�}:;;•::::i:.:fir:^ii:isi:?::::i:::i?t;.{:iyv>.>}:;i:y;i i `v}:i::}.............................................................. ,i:..:;. .....::•}:is:w:::::::::•.................•• .............:::................. .. ..... . .............. ....:�:•:::::v::::w:;:;:::.::•.�:v:.�::v.�:::v4::::::•:'` .......::::::::....:::::}•w•::wvr::;;:..:..:.�...r:; ,::x,:.. ::::}:;•a a•1•:::r:rry.,...ar a :w,n..'^•.:....•:;?•:. E`"...... ... ...........................::::.�::::::::•:::::::::.::}:•:i}}}':•:}}'•:;'.., ..............: .,..,....h:..,?r:......., .r/....,r.•nvv..p}}iakv..n w 4..:Y?.`:•i:?^:ii}: .... ...... ...... ....... ...........................:::•:r.............:.:..w.::..}3h,................ ............i•\a}:?•SAr::x:.,.w•..........x x., ... ..... ...... ...... .............r. .....w.rw w,• S}w ............ :. ... :.::::::::.�:.........w• + }:«::;.}:;.:;.:;;.}>:;.;::.;:....:'.:. tee: ...... ..::..:. .::..:::::::.............:.:................ ,............................................................................:::.................. .. ....... ....... .......... ............ .......w .......:.::............ ,?T.,•r....w.a:xr:,v.v:?•i}:a•::•::::v:.::.... ................ ..............:•::w:v, .................. v:::.v::{?.,.fin,.:•{, ..K...:}v:.• ..:... ............... ............ ...... ......n,...Y.....:r... r........ r...,r...........r.,::: ,........fin.......:•: x::;•:;......h�a::.v.,...... ....:......... .................:.....:::: ......;:...........:..:::::::::::::....::::......:..:...;?,.,..:.;;;:::.::::;:is>;}';•::•:-.::.}'•:<-}:.,-:: a di£res .:.:::....:........... M. .............>s:i«<: ............::::...X. ....:.:..:::<.}::. ... ::::::::::::::::::::::::::::::::::::::::::...... .................:.:::............... li ' {i�rt yiii:;:'i:jjj}:!v�ii O j/ e as under Section ISA o[MGL 152 can lead to the tmpos�an of afadml penaltlea o[a 6ae up to SI�00.00 and/or Faffme to secure coverage required one yam,bsrprisotrment as wed as duff penalties is the form ota SPOP WORK ORDER and a 6ne of 5100.00 a day ageia�t me. I tmderstmd Ebat a copy of this Statement may be forwarded to the Once of Inv atlgations of the DIA for coverage verfIIation: 1 do hereby certify under the penalties of perjuq that the information prowl above. &w.and coned ' • Date �� S'`C� Signature Print name d� Phone# ofaciai we only do not write in this area to be completed by city or town off3dal perudtNcense 0 ❑Budding Dept dty or town• ❑Licensing Board ❑SdectmeWs Office check if immediate response is required ❑Health Department f ❑Other contact person phone i!; - (levied 9195 PJA" Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workerof an mpensther nd naor weir Mas person in the service employees. As quoted from the "law", an employee is defined as every Of hire, express or implied, oral or written. of An employer is defined as an individual, partnership, association, corporation or other legal entity, or any twoogre er the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased emp over, o r the 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, orcehoccupantdlling e o� h°n the grounds c another who employs persons to do maintenance, construction or repair work on building appurtenant thereto shall not because of such employment be deemed to be an employer. ev MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuanceonwealth for any a ant wh h, of a license or permit to operate a business or to construct buildings in the coverage d. Additionallypneitherche not produced acceptable evidence of compliance with the insurance� a for the performance of public work until commonwealth nor any of its political subdivisions shall eater into any P of this chapter have been presented to the,ontractmg acceptable evidence of compliance with the insurance requirements authority. / /j Applicants ' compensation affidavit completely,by.checking the box that applies to your situation and Please fill in the workers comp with a certificate of insurance as all affidavits may be SUpply�g company names, address and phone numbers along a Also be sure to sign and the Department of Industrial Accidents for c°mfirmatian of insurance coverage. submitted to or town that the application for the permit or license is date the affidavit. The affidavit should be returned dents. Should Y�have any questions regarding the"]aw"or if yc being requestd, not the Department of Industrial Acci are required to obtain a workers' compensation policy,Please call the Department at the number listed below. City or Towns bl ' The D provided a space at the bottom of t Please be sure that the affidavit is complete and printedlegi y. Department has prov the applicant- pie affidavit for you to fill out in the event the Office of Investigations has to contact you regarding apP ermitllicense number which will be use ann d as a reference number. The affidavits may be ree3 t" be sure to fill'in the p � the Department by rid or FAX unless other arrang® have been made. e Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. Th please do not hesitate to give us a call. 10 The Department's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Office of lavesugadons 600 Washington Street Boston, Ma. 02111 I fax#: (617) 727-7749 phone #: (617) 727-4900 eat. 406, 409 or 375 Of THE Tp� The Town of Barnstable &UtNSTABLE. ' MAS& g Regulatory Services c9.3 Aim Thomas F. Geiler, Director, Building Division Peter F. DiMatteo, Building Commissioner 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. DateA� 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. Type of Work:ps"��2 \�1g�� ` l'-J1M�� Estimated Cost v 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 []Building not owner-occupied ❑Owner 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 Contractor ame Registration No. OR Date Owner's Name q:forms:Affidav:rev-070601 • r i RESIDENTIAL: SHEDS - POOLS-DECKS-OPEN PORCHES- GAZEBOS DETACHED GARAGES FEE VALUE WORKSHEET ACCESSORY STRUCTURES >120 sq.ft.(Sheds,detached garages,gazebos,etc.) >120 sf-500 sf $35.00 $ >500 sf-750 sf 50.00 $ >750 sf- 1000 sf 75.00 $ >1000 sf- 1500 sf 100.00 $ >1500 sf—USE NEW BUILDING PERMIT APPLICATION DECKS x$30.00= $ (Number) PORCHES x$30.00= $ (Number) IN GROUND SWIMMING POOL $60.00 ABOVE GROUND SWIMMING POOL $25.00 $ RELOCATION/MOVING $150.00 $ (Plus above fee if applicable) PERMIT FEE $ Q:forms:dkcost eff:082301 oard of Building Regulations and Standards One Ashburton Place - Room 1301 Boston , Massachusetts 02108 Home Improvement Contractor Registration Registration: 132476 Expiration: 02/13/2003: � (�� Type: Individual HOME IMPROVEMENT CONTRACTOR Registration: 132476 TIMOTHY RICE Expiration: 02/13/2003 TIMOTHY RICE Type: Individual 197-8 RT . 6A DENNIS MA 02638 TIMOTHY RICE '��JIIiOTHY RICE 7-8 RT. 6A ADMIMSTMMR DENNIS MA 02638 1 BOARD OF BUILDING REGULATIONS `. License: CONSTRUCTION SUPERVISOR sl Number: CS 077899 Expires: 08/28/2004 Tr.no: 77899 Restricted To: 00 TIMOTHY P RICE ��,��u✓ 197 B RT 6A DENNIS, MA 02638 Administrator l . t •.f 1cp0mCleap'm n. VERTICAL GRID D . E . FILTERS a ' P Micro-Clear is a high-perform- r7 ' ance filter series that provides superior water clarity, efficient flow and large cleaning capacity for pools of all types and sizes. � Micro-Clear filter tanks are now , molded from PermaGlass XLT' s a glass reinforced copolymer, rL+s q' i4 °--_ ---_-- providing the ultimate in strength, �} s durability, and long life. Micro-Clear Gv1i filters also combine high technology features with a OD "service-ease" I` 40$a/ly design for ' dependable operation an � d low maintenance. Plus, Micro-Clear filters are avail- able with the unique SP-740DE Selecta-Flo control valve, the only filter control valve designed specifically for D.E. filters. 11 i For the quality conscious pool owner, Micro-Clear filters are an - %- unparalleled filtration value. 0 DE-6000 Micro-Clear Vertical Grid D.E. filter with optional •, SP-740DE Selecta-Flolm 4-position control valve. , I� �.............. , - Featuring _�_— PermaGlass>_ � i, Filter Tank Material .N • O 0 HAYWARDR Hydrogen,Oxygen and Hayward. The elements of clear water m IV po-Cleap" Vertical Grid D . E . Filters Automatic Air Relief purges any trapped air during filter operation. • Screenless design eliminates clogging. NJ f® Integral Lift Handles and Uniform Low Profile Tank Base make removal of grid nest fast and simple. High-Strength Filter Tank molded of PermaGlass Xr provides extra durability for dependable,corrosion-free performance. _ High Impact Grid Elements designed for up-flow filtration and top-down backwashing for maximum efficiency. i Heavy-Duty Tamper-Proof Bolted Center Flange Clamp ' securely fastens tank top and bottom together.Allows quick access to all internal components without disturbing piping or connections. Union Locknuts make disassembly and reassembly of filter from �d piping fast and easy. Noryl®Bulkhead Fittings for extra strength and heat resistance. Inlet Diffuser Elbow distributes flow of incoming unfiltered water upward and evenly to all filter elements. Parabolic tank base design l provides for even distribution of D.E..to grids. M1 Full-Size 11/2"Integral Drain provides fast, 100%clean out and easier f flushing of tank. Convenient Valve and Plumbing Options allow for customized control.2"internal piping and plumbing for maximum flow performance. r • r r r l • FILTER TYPE: Vertical Grid Diatomite:24,36,48,60 ft2(2.23,3.35,4.46,5.58M2). FILTER TANK: Injection molded PermaGlass XLT°" FILTER ELEMENTS: Monofilament polypropylene cover fitted over 8 curved, a high-impact grids CONTROL VALVE: 1%2"or 2"6-Position Vari-FW12"4-Position Selecta-Flolm 2"2-Position slide valve.May also be plumbed singularly or in series with quick-connect union couplings(less valve). PERFORMANCE RANGE: %2 TO 3 HP(30 to 120 GPM) DIMENSIONS: DE-2400—31 W'H x 23"W(800 mm x 584 mm) DE-3600—36W H x 23"W(927 mm x 584 mm) DE-4800—42W H x 23"W(1080 mm x 584 mm) DE-6000—48W H x 23"W(1232 mm x 584 mm) Above dimensions are for filter only.Overall width with slide valve is 30'(762 mm); overall width with either 4-or 6-position multiport valve is 33'(838 mm( Model Effective Design Turnover Filtration Area Flow Rate 8 Hours 10 Hours Number ft' m' GPM LPM gallon kilo liter gallon kilo liter DE-2400 24 2.23 48 182 23,040 87 28,800 109 Plumbing Versatility.Select from a wide array DE-3600 36 3.35 72 273 34,560 131 43,200 164 of valve options for customized control of your DE-4800 48 4.46 96 363 46,080 174 57,600 218 filtration system,including Hayward's 2;'2-position DE-6000 60 5.58 1 120 454 57,600 218 1 72,000 273 slide valve. "Determined by pump size and piping system hydraulics. 2'piping is recommended for flow rates of 90 GPM or more. Flow rates above 120 GPM are not usually required for residential pools. HAYW RD POOL, PRODUCTS INC. Hayward Pool Products,Inc. Hayward Pool Products,Inc. Hayward Pool Products Canada Hayward S.A. 0 900 Fairmount Avenue 2875 Pomona Boulevard 2880 Plymouth Drive Zone Industrielle de Jumet Elizabeth,NJ 07207 Pomona,CA 91768 Oakville,Ontario L6H 5R4 B-6040 Charleroi,Belgium 8-97 ©1997 Hayward Printed in U.S.A. �V1 OF J14 structural Designve� / )�•.��' SS only when inGl.all ti-I�:l in 1� HY st T !] ric t Accoldanca vritlh 3 T. �y In<tt Uf�If:nC R G, Manul ecrilrrr'Fr P.E. Il Cure T.VJaIY•o,. No. 31376 .' J . COPING LAYOUT ppnum /2' SIT"6� be ' Z. `\b 7' /z' n' 21 �. 36 PANEL LAYOUT ,k11tApIUS oonum 8 8 8 —• 8' tra9 \ � t Ae FR 8r6rr 8 6' X•:e.ence 6' 9.6 �? — /S'b" _ 6'6"—�s-1Ir6"_ 3' 1 lul Pool Pool DEWL A arovu TO w Lk"% ONh4 OR olllll Area Capacity ao A.Wl uamw rr 6 ya 23r!=00 • Sp.FL Gallons 14 W M Amm /oarl+eu rna tuu nva ,ww eMI . tmiotn tarwsnale�t/ata I THIS BROCHURE IS FOR ILLUSTRATIVE PURPOSES ONLY AW tThee%w a ulachrdmakea "'• / EDITION POOLS onty those representations which we stated M Its written warranty.My other represerhlationt,stalemenl4 d conbaob Blade by the dealer ender the ponbeotpr to the Nslpner . regarding arty materials produced by the Ina fadhrd c ane atbibutaWe to the dealer and/ar the canba %or only The dealer d oo"Won who Sans d hslaas your pod Is an Independent contractor and not an ya'..a•.Ir agent or employee of manulacMer.The ocnabuc0on methods lff strafed we auggesltons and apply r n 1°°1U1 KAAoo MR only to normal ground conoi0on4 There may be additional preceutlons and/or met oda of constnrctbrc tS' 18' X 36' RECTANGLE Tlx responsibility Is the contrwtd4 r'pf0Y1"a day'N1ane u 2' RADIUS CORNERS % WVAtaIm sous . SCALE: NONE 1991 RC 1 1 J ZA ;- (-'a-'I o ^ _ -r--.-•>-tiro. ..__ --��..-.,_,.�..• _ J� `1�� t 'C}UQ o sep !J o�S-e 90 W / LA 'D c.e To / j00 co be 6'j u Ow NcA I �0R\NmNs ra 01 pL :..0 R APR PT r o ----- .�'o..ti ''' ./ 20.0• �.v ? 9.S' 4.of HOUSE ROp.V ti.. s3Gl p 34.0' c e, 14.0' j �7 Fes.:• \ O 6 Q o2,0 180, 00 1;.. It 0 �� # 7! ✓ 7::• O 9B ^ C s It 39 C... '1V #is ' a It 7p W o � 0 Jr 29 tzl , 34 Fw o na F P A V E �l 49 o a � ce CZ ,__c rn %D® o \x rn b Y- TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Nn 10 Map A Parcel �6— = SEPTIC SYSTEM MUST Gpe mit# INSTALLED INt� PL� A Health Division — 3 A WITH��TL9�" Daate Issued � W Conservation Divisiont S, �1� �� 9�u dY �' �9" �NAR®NMIwNTAL GNP 13 �� 1 �l Tax Collector Treasurer `~ /�bie� �4E1iVl Cam' Planning Pt. i De `� Date Definitive Plan Approved by Planning oard —�.7_ y AUG 16 20�01�l?OJc 0'� �Q = !mac P� � ! 1, F�ifY!Ii7aRm Historic-OKH Preservation/Hyannis /Ols..-� ^•f3'Y:__ Project Street Addres 45 �1ee(�' i,�D Village 1— M-P, Owner VM Q 2QtAQQT Address t0q NII�t4 AVE Telephone (P,,w I ^ DGTYq41..LVl MA Permit Request kA,2 10 l 1, lAL l)Ok:►.X`iic_ �� i�(2 (L &U ,_ 2 '/2 . �� L o Square feet: 1st floor: existing proposed •2nd floor: existing _ proposed Total new LL ,,tt N (O. �w oo Valuation Zoning District Flood Plain Groundwater Overlay Construction Type G _ �ft51l7fr,�Q►/�C.. Lot Size T � -��.4- S CA-. � S•F. ! Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family 0/ Two Family ❑ Multi-Family(#units) ' Age of Existing Structure Historic House: ❑Yes ff/No On Old King's Highway: ❑Yes VNo Basement Type: W Full ❑Crawl O Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) O�-IQ 2— 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 rJ Heat Type and Fuel: J Gas ❑Oil ❑ Electric ❑Other Ce:4-tral Air: 3/Yes ❑No Fireplaces: Existing New I Existing wood/coal stove: ❑Yes 8 No Detached garage:O existing ❑/new size `Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:O existing new size X 30 Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ,,O//Yes 0Ao If yes, site plan review# --Current Use YwAar 4ANn_ Proposed Use - uqa,-P- EN&A girn6l reoci-, I BUILDER INFORMATION Name L Telephone Number %- ) j33 Address •0 . y License# � MA— Home Improvement Contractor# Worker's Compensation# WC1-51 5 _ ?Z zl$-oil ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO � ��AC d II SIGNATURE DATE �,�f `r FOR OFFICIAL USE ONLY DATE ISSUED rr45. I' MAP/PARCEL,NO: ADDRESS VILLAGE OWNER .y-•"- ', ..: . - .. � ' -. .._. DATE OF INSPECTION`: FOUNDATION FRAME •- .. INSULATION* FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL - - i GAS: ROUGH FINAL _ FINAL BUILDING B FZ�iVL uJ 7[llr��3 ' DATE CLOSED OUT w ; ASSOCIATION PLAN NO. - - 7 TOWN OF BARNSTABLE CERTIFICATE OF OCCUPANCY PARCEL ID 104 007 GEOBASE ID 5260 ADDRESS 45 WHEELER ROAD PHONE MARSTONS MILLS ZIP - i LOT BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT CO i PERMIT 71599 DESCRIPTION CERTIFICATE OF OCCUPANCY 055404 PERMI TYPE BCOO TITLE CERTIFICATE OF OCCUPANCY i CONTRACTORS: PAUL R PACELLA Departmentof ARCHITECTS: TOTAL FEES: Regulatory Services BOND $.00 �TNE CONSTRUCTION COSTS $.00 756 CERTIFICATE OF OCCUPANCY 1 PRIVATE • BARNS1'ABLE, • MASS. 1639. BU D G D ION BY ( I DATE ISSUED 09/17/2003 EXPIRATION DATE i 1 TOWN OF BARNSTABLE CERTIFICATE OF OCCUPANCY PARCEL ID 104 007 GEOBASE ID 5260 ADDRESS 45 WHEELER ROAD z PHONE MARSTONS MILLS ZIP - r LOT BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT CO PERMIT 71599 DESCRIPTION CERTIFICATE OF OCCUPANCY 055404 PERMIT TYPE BC00 TITLE CERTIFICATE OF OCCUPANCY CONTRACTORS: PAUL R PACELLA Department of i I• ARCHITECTS: Regulatory Services TOTAL FEES: I' BOND $.00 CONSTRUCTION COSTS $.00 756 CERTIFICATE OF OCCUPANCY 1 PRIVATE * BAMSTABLE, • I� w i639• RFD MAC°i :� a BUILDING D IONi BY DATE ISSUED 09/17/2003 EXPIRATION DATE i THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- j CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR j ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL-CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND j �' THIS CARD KEPT POSTED UNTIL FINAL INSPECTION WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU PERMITS ARE REQUIRED FORELECTRICAL,PLUMBING AND MECH- „ (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. 3''INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4.FINAL INSPECTION BEFORE OCCUPANCY. VISIBLEPOST THIS CARD SO IT IS BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 2 2 2 i 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 BOARD OF HEALTH OTHER: SITE PLAN REVIEW APPROVAL WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. I II . 1 I I I I II TOWN M tARNSTABLE BUILDING PERMI , - PARCtL ID 104 007 GEOBAS` R:-I'D 5260 ADDRESS 45 WHEELER ROAD ! PHONE �;:r',''• MARSTONS MILLS ":•,4 ZIP LOT BLOCK LOT SIZE I DBA `DEVELOPMENT DISTRICT GO,r_rw i PERMIT 55404, • :DESCRIPTION 4 BED SINGLE FAMILY DWELLING PERMIT TYPE BUILD TITLE NEW RESIDENTIAL BLDG_ PMT CONTRACTORS: PAUL R PACELLA ARCHITECTS: Department of Health, Safety 1 ( and Environmental Services TOTAL FEES: $1,458. 13 � BOND ---- •'-$.00 tlCONSTRUCTIQN COSTS $426,616.00 101 SINGLE FAM HOME DETACHED 1 ' PRIVATE P'.Q' E_ ` HARNSTAB • c s ! MASS, !I _ k BUILDING D VBY I I DATE ISSUED 11/O1/2001 EXPIRATION DATE I�l THI-)`PERMIT.CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED'PLANS MUST BE RETAINED ON'JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS'CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR'' 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL,PLUMBING AND MECH- (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. ' 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4,FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLEFROU STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 0;vn 2 2 �c� 2 / s 1 HK#rING INSPECTION APPROVALS EN I EE G PARTMENT 2 ARD OF HEALTH T' - _��j 3v o? awi-S6 OTHER: SITE PLAN RVIEW APPR VAL I i WORK SHALL,NOT PROCEED,UNTIL PERMIT WILL BECqME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS'ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. _ - NOTED•ABOVE.2 emu'` TION. I1I I . ` I I I I I I II I I ' I r G LOT E Ng34s3 p 1 A.Af. 10417 LOT D AREA = 89,355fS.F. � ca i 1 .01 s43g6?p Q) 4.2 O a4 0 4"ICY/ Q LOT C •O' NOTE.• SUESKETCH IS NOT TO SCALE k o I 0 �• I FLOOD ZONE "c"_ FO UNDA TION CERTIFICATION RES ZONE.. "RF" TO AN-MARSTONS MILLS SCALE'1"=80 PL.REF. 240 41 ELEV N/A I CERTIFY THAT THE ABOVE YANKEE SURVEY CONSULTANTS FO UNDA TION IS L 0 CA TED ON Of P. 0. BOX 265 THE GROUND AS SHOWN, AND PAl�i, ya UNIT 1, 40B INDUSTRY ROAD ITS POSITIO DES D _____ MARSTONS MILLS, MASS. 02648 CONFORM TO THE ZONING LAW l�o HE'vvv a. SETBACK REQUIREMENTS OF No, � TEL: 428-0055 BARNSTAB E_ ,�, > . FAX 420-5553 — �� — __ JOB PAUL A. MERITHEW DATE. IZI09�?002 NUMBER52834FND OPINE► '� The Town of Barnstable BARNSTABLE, M.SS. Department of Health Safety and Environmental Services - 9 MA m 1639. �e "rEo Mn+° Building Division 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection A3 Location -eP- e r R-A . Permit Number S 5 `I 0 y � Owner � �� i ►ll.�►•hov.� Builder f a�.� � etc. �. Ocz One notice to remain on job site, one notice on file in Building Department. The following items need correcting: 1 l y 1 '\a N i C. a ' \)L V\N- S TU �I\t U k Ts 2 0- o 6-t 5'f i n © ► n-zt ew r (-S be S CCU tee' -Pn 4 v! 5'F i n. J a a.v r11e•C� Please call: 508-862-4038 for re-inspection. Inspected by ' Date 7!�6 UPDATE PERMIT RECORDS : ADD CHANGE DELETE PRINT FEES HELP END CHANGE RECORDS IN PERMIT TABLE PENTAMATION----------------------------------------------------------- 09/17/03 PERMIT NO. 71600 PARCEL ID 104 007 45 WHEELER ROAD PERMIT TYPE BCOO CERTIFICATE OF OCCUPANCY DESCRIPTION CERTIFICATE OF COMPLETION #57404 STATUS C COMPLETED APPLICATION DATE 09/17/2003 DATE ISSUED 09/17/2003 EXPIRATION DATE DATE COMPLETED MASTER PERMIT VARIANCE VALUATION 0 . 00 BOND 0 . 00 CONSTRUCTION TYPE GROUP TYPE CONTRACTORS 077899 ANCHOR DESIGN AND POOL CORP. ARCHITECTS/ ENGINEERS/OTHERS ENTER Y IF ALL ARE CORRECT OR N TO REENTER LEAVE BLANK FOR NON-PROPERTY RELATED PERMIT. CTRL-I FOR HELP. I MARSTONS MILLS ASSESSORS MAP 104 LOT E NOTE ARCHITECT FOUNDATION PLAN DIFFERS PLAN REF• 240/41 _ FROM THE DIMENSIONS SHOWN ZONING "RF" Of-volt, RACE C °� �� FLOOD ZONE.• "C" LANE C COMMUNITY PANEL# 'r 250001 0015 C ` LOCU DATED.• 8/19/85 0 VERLA Y DISTRICT "CP" C� ,yyST/C po t. �•s v ..:...:...:......... ti j i � � ? :;<:.. ti ..... . . ......... .. LOCUS MAP ....... oo , �g 9 LOT D ' ! C AREA = 89,355+S. F. o 0° o� gBENCHMARK ti iTOP OF CB. loo �`. — _ _ l I7LEV.= 100.O'(ASSUMED) � � � :�0 <;. ors• , l , �., � LOT C -'- S;r`?;r 3� j 9� 2 C RPGE PROPOSED SITE AND SEWAGE PLAN �6 OF LAND AS/LOT 12 LOCA TED A T 45 WHEELER ROAD MARSTONS MILLS, MASS. �� a �d ��BRUCE PREPARED FORNuFlpmy `��' A. NO 74D � � TOWN WATER DA VID D U�VIONT � ��GI �� 104 ` _ ! % :' AS/LOT 105 s �� CB AUGUST 12, 2001 ��`�,f11 A�� ,r ��G H SE BENCHMARK 56 ` GRAPHIC SCALE �4 `�� '''' / TOP OF C.B..:., YANKEE SURVEY CONSULTANTS 40 0 20 40 e0 160 ELEV.= 100.GI'(ASSUMED) UNIT 4 40B INDUSTRY ROAD P.0. BOX 265 MARSTONS MILLS, MASS. 02648 P TEL• (508)428-0055 FAX (508)420-5553 ( IN FEET ) y P4� E�� J# 52834 1 inch = 40 ft. `�'" 1 EL. = 103 _ 20, MIN. TOP OF FOUNDATION 10' MIN. CONCRETE COVERS 4" SCHEDULE 40 P. VC. MIN. PITCH 118 PER FT. 102 2"LA YER OF CONCRETE COVER 118"-1/2" fl~ MAX /�" MAX , , / / , / / , EL=101 WASHED S719NE usez Zs", 2 SEWER /NVERT MID. HOUSE) PVC SCH. 40 RISERS LINES EL._ 1_0.5 PI7rH 1/4" PER FT. RISER 312�"MIN ND UNITS FLOW LINE EL. =98 0 INVERT (NORTH END) 11101, N 14" �2.0' 0 0 0 0 0 0 0 o a ED 0 0 EL.=_99 GAS INVERT INVERT S" SUMP LEVEL o 00 0 0 0 0 0 0 o a o 0 0 INVERT BAFFLB EL — 98.5 INVERT o —95.5 EL.= 9_8. 75 EL.__ 9_8.25 EL.=98__ 4 4' f f INVERT (7V BE PLACED ON FIRM BASE) DISTRIBUTION EL.=_97.5_ MArHANICALLY COMPACTED OR B~ OF S70NE BOX 42' X 12.8' TRENCH FORMATION � h __j5QQ__GALLONS 70 BE WATER TESTED SEPTIC TANK PLACE ON 6" STONE 3/4~ 71'J 1- 2~ SOIL ABSORPTION DOUBLE WASHED 7t'JNE SYSTEM (SAS) BOTTOM OF TEST HOLE OR USGS PROBABLE WATER TABLE ELEV. = 86 _ NO OBSERVED WATER TABLE (8108101) ELEV.= 86 PROFILE OF OBSERVATION HOLE I ELEV.=_9�'__ PERCOLATION RATE <2 MIN INCH AT 66 INC OBSERVATION HOLE 2 ELEV= 100' SEWAGE D I S P 0 S A L SYSTEM DEPTH HORI TEXTURE COLOR OTHER DEPTH HORI TEXTURE COLOR OTHER NOT TO SCALE 0_3" 0 ORGANIC 0-3" 0 ORGANIC 3"-8" A SANDY LOAM 10YR 4/2 3"-8" A SANDY LOAM 10YR 4/2 8"„30" B LOAMY SAND 10YR 5/6 8"-30" B LOAMY SAND • 10YR 5/6 30 —5 C 1 SILT LOAM 10YR 8/3 30"-5' C 1 SILT LOAM 10YR 8/3 GENERAL NOTES 5'—9' CZ MED.' SAND 10YR 5/6 5 9' C2 MED. SAND I DYR 5/6 AND COBBLES , , GRAV6'L AND COBBLES GRAVEL 9'-13' C3 MED. AND CO 2.5 YR 8/4 9 —12 C3 MED. SAND 2.5 YR 8/4 1) ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. NO ,WATER ENCOUNTERED ® 13' NO WATER ENCOUNTERED ® 12' TITLE 5 AND THE TOWN OF _BARNSTABLE____ RULES AND REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. SOIL TEST 2) ONE CO VER ON SEPTIC TANK SHALL BE BROUGHT TO 810812001 WITHIN 6" OF FINISHED GRADE" OTHERS WITHIN 12" DATE OF SOIL TEST SOIL TEST DONE BY BRUCE G. MURPHY, R.S. 3) ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF WITNESSED BY: . GLENN HARRINGTON WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN DRIVES5 FT OF PARKING USED UNDER OR WITHIN 5 FT OF DRIVES OR PARKING AREAS.E P# 10024 DESIGN CALCULATIONS.' 4) ANY MASONARY UNITS USED TO BRING COVERS TO GRADE SHALL NUMBER OF BEDROOMS . . . . . . . . 4 BE MORTERED IN PLACE. NOTE GARBAGE DISPOSAL . . . . . . . . . NO 5) NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH TOTAL ESTIMATED FLOW DEEDED OR ZONING REGULATIONS. 0WNER/APPLICANT IS TO INSTALL FOUR (4) ACME 110 CAL/BR./DAY x _4_— BR.) 440 CAL/DAY OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. 500 GALLON LEACHING CHAMBERS REQUIRED SEPTIC TANK CAPACITY 1500 CAL 6) UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCA VA TION CONTRACTOR 4 FEET OF DOUBLE WASHED STONE REQUIRED IS TO CALL "DIG— SAFE" AT 1-800-322-4844 AT LEAST 72 HOURS' SIDES AND ENDS SOIL CLASSIFICATION . . . . . . . . PRIOR TO COMMENCING WORK ON SITE. 12.8' X 42' X 2"EFF DEPTH DESIGN PERCOLATION RATE � 2 MIN./IN. 7) CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS EFFLUENT LOADING RATE . 74 GAL/DAY/S.F. SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. 5' STRIPOUT.'AROUND LEACHING LEACHING CAPACITY (AREA X RATE) 549 CAL/DAY 8) PARCEL IS IN FLOOD ZONE___"C"____. TO APPROXIAMIFLY 5' BELOW GRADE RESERVE LEACHING CAPACITY . . . 549 GAL/DAY TO MED. SAND & CRA VE'L SOILS (42 X 12.8 X . 74)+(42t42t12.8t12.8 X . 74 X 2) 9) LOT IS SHOWN ON ASSESSORS MAP .10-4_ AS PARCEL _7 _. REPLACE WITH CLEAN SAND TOWN TO INSPECT O VERDIG PRIOR TO BACKFILLING SHEET, 2 OF 2 JOB NUMBER___52894 ("f'O�'�' The Town of Barnstable BARNSTABLE, • Department of Health Safety and Environmental Services .MASS. t639• prEDM►'�� Building Division 367 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection Location Permit Number 5�— fUL4 � n— Owner Builder T. One notice to remain on job site, one notice on file in Building Department. The following items need correcting: R l�v D t r-. r L 6n y; A"-av- u- Roo(Z- Please call: 508-862-4038 for re-inspection. Inspected by Date "( �'✓ a�/ E��° The Town of Barnstable BARE. Department of Health Safety and Environmental Services MASS. 0p +079. �0 Building Division 367 Main Street,Hyannis, MA 02601 Office: 508-8624038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection �61 L/t'-� Location Permit Number W Owner �S Builder �. One notice to remain on job site, one notice on file in Building Department. The following items need correcting: -� �-�; ►�, - �2- 24- 3 0 FL..►sue I-u ti 4 S�G�. G L & 6n 1N�rk 1 Please call: 508-862-4038 for re-inspection. Inspected by �� Date _ I y Affidavit of Substantial Financial Interest I, ' �v�� of on oath depose and state as follows: 1. I'am an applicant for a building permit for the rope_._Located at Map 1C�y , Parcel The address of the property is r� Gy �e/P_� /a�cc� /Yl�r,�s j?�Ils 2. 1 have legal or equitable interest in the real property which is the subject of the building permit application which is identified in paragraph 1 above. 3. Within in the last twelve months from today's date, which is 1f S'o2�� , the following individuals or entities have had a 1% or greater legal or equitable interest in the real property which is the subject of the building permit application which is identified in paragraph 1 above: Name Address 4. Within the last twelve months, from today's date, which is �f S'� / , I have had a 1% or greater legal or equitable interest in the following properties which have been the subject of a building permit application: Map/Parcel Address /a L/ 0a 5. Within this calendar year, I have submitted building permit applications for property in which I have a 1% or greater legal or equitable interest. 6. Within the last ten days, I have submitted © building permit applications for property in which I have a 1% or greater legal or equitable interest. 7. Within this month, I have submitted O building permit applications for property in which I have a 1% legal or equitable interest. 8., Within this month, I.have received building permits for property in which I have a 1% legal or equitable interest. Signed under the pains and penalties of perjury,'this / day of Olcl ; 200_. 2001-0050/afn 1 Q/LOTTERY/AFFIDAVIT RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE 5 New Buildings, Additions $50.00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET LIVING SPACE qsquare feet x$96/sq. foot plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE _square feet x$64/sq. foot= x.0031= plus from below(if applicable) ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-S e as new building permit: square feet x$96/sq. foot= x.0031= STAND ALONE PERMITS m Open Porch �x$30.00= + (number) 4WD l 30- Deck G,Mx$30.00= (number) �j 0 o Fireplace/Chimney (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25•00 Relocation/Moving $150.00 (plus above if applicable) O .1� Permit Fee proicost ,� v•. ...�� r .. ... is The Town of Barnstable P,OF THE rqs� BARNSTABLE. Department of Health Safety and.Environmental Services 9 MASS. 0 �679• �0 P�FOMP Building Division 367 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 PLAN REVIEW Owner: 3D(�`Q. y ).UIN1g Map/Parcel: Project Address: �.7 �.1 e rO1- Builder: I � e , The following items were noted on reviewing: t (IJ,t Y)A CR o S Reviewed by: Date q:building:forms:review M CMR Appends J Table J=Ib(continued) prescriptive Packages for One and Two-Family Residential Buildings Hated with Fossil Fuels MAXIMUM MINIMUM Glazing Glazing Ceiling Wall Floor Basement Slab Hearing/Cooling Am'(%) U-valuer It-value R value' R-valud Wall panneta EquipmentE�acncY' Package R value° 1t value' 5"I to 6500 Hatinq Degree Days' - - 12% 0.40 38 13 19 10 6 Normal i.. _ -- -- R 12'% 0:52` _--'30` ------19 19--- —10,_' - _.--6 Normal .� S 12% 0.50 38 13 19 10 .6 85 AFUE T 15% 036 38 13 ZS N/A N/A ------------ Normal U 15% 0.46 38 19 19 10 6 Normal V 15'/e 0.44 38 13 25 WA WA 85 AFUE W 15% 0.52 30 19 19 10 6 85 AFUE X 19% 0.32 38 13 23 WA WA Normal Y 18% 0.42 38 19 25 WA WA Normal Z 18% 0.42 38 13 19 10 6 90 AFUE AA 19% 0.50 30 19 19 10 6 90 AFUE 1. ADDRESS OF PROPERTY: / . klt4rcy,� 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: `T WA • 5 3. SQUARE FOOTAGE OF ALL GLAZING: / 'S "• 4. %GLAZING AREA(#3 DIVIDED BY#2): 5. 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: 1 4-forms-f980303a STANDARD FORM From the Ofte ppoh ipURCMSE AND SAP.AGRO MEW 1170gRt.te.M132hy Inc. Hyan -iis —mA 02601 17 This �t� 1-day of 2-- q 001 PARTIES Thomas E. and Roberta A. Cxypoliscki 'of 130 Greeley Avenue, AND � *,r. L1.2672 lESS�S West iiiydnnxsp.,�r.,, •�•'� hereUefter celWd the SELLER,agte®a to SELL and David S. Dumont-l;of 67 Willow Avenue,MR bi) Hyannis, MA 02601 he,-dne,a Called rile BUYER or PURCHASER,agrees to 13UY,uPw the terms hereinafter set forth, ftfdIowingdesctibed premises:A certain parcel of Land known as 45 Wheeler Road, Marstons Mills, Mh 02648 and more fully 2. DESCRIPTION described at the Barnstable County Registry Of Deeds, (0in and brotude Book 1534 Page 314. tom nif nvi me) 3. 6UIWl14GS Included In the sale as a parr of said premises are the buildings,$tr.' - .and imprtrremertie new STRUCTUF2-S, thereon. ad" side IMPROVEMENTS, MFG FIXTURES (M in or delete) fertaea. gates, tt 9es,shrubs,plants Said premises are to be conveyed by a good and sufWard quitdalm deed runfll $to the BUYER, 4. TITLE DEED or to the nominee designated by the BUYER by written notice to the SELLER at Ieast seven (M IN days before the deed is to b ver e delted as herein provided,and said dead shah lnduda two by specdre awyey a good and dear record and marketable title thereto,free from enc umtxanoss,exoW dons, ease r►e�ts (a} Provisions of exisiontj.buiidlr� and zoning.laws. dons, easements, O .. ----_-- wa one in par (a) Such tives for the then current yeer is are not due and payable on the date of the delivery of wa4s not included in(b), leases, mu such de : of and deed; for municipal b9tterments assessed after the date of this agreement: other lions, other encum (d) Any hmnce5, end make pro- (e) Easements,restrictions and reservations of record,if any,so low 88 tie same do not PrQ vision to Protect hibit or materfaiiy interfere with fiv CvReM us""sand iXem°eft: SELLER oagainst l�s as •(f) br"chcovenants In leases, whom necessary. 5. PLANS If said deed refers to a plan necessary to be recorded ttmewith the.SELLER"I deliver such plan with the deed in form adequate for recording or registration. ' 8. REGISTERED In addition to the foreOng,if the title to said Orerrtises is r+eg0atetred, sale!deed shell ba lr:form TIi?E suffidentt to enl�tae the BUYER to a Certificate of Title of said prt3m(ses,.and the,SEI.{FR shall deliver with said deed all instruments. If any,necessary to enable the BUYER to ottin such Certificate of Title. 7. PURCHASE PRICE The agar*purchase price for said premises Is Two hundred sixteen thousand ( );spy is and xx 100 dollars,of which e -to -out the amounts if $ 19, 00 0.0 0 have been paid as a deposit this day and desired $ 1,000.00 paid as deposit July 10, 2001 $ 196, 000.00 are to be paid at the time of delivery of-the deed In cash,or by certifled,cashier's,treasurer's or bank check(s). S 216,000.00 TOTAL COPYRIGHT®1979,19M,19M.198T,iM,1991 AU rt".reswww. T.Na.twrn.may not ba coaled or mpmdu000 in vrl�Ote GREATER AOSTON REAL ESTATE BOARD ar in part In any manner wtwteoewr wUwut ft peon awrbes wrlW Flew.19N Forth No.RA151 consent or the areatot aoston Row Eawo Boom. Cvwv 5,0 -- --•- . A. M.on the 17th day of Such deed is to be delivered St. 11 o dock 8. TIME FOR 2001 , the gaLriastable PERFORMANCE; Augua t is that time is of t!to esaerto9� DF-;LIVERY OF ante otherwise flgroed upon IFt vyttbng. � $8r DEED(FA in) bpi g. the Gems POSSE5310N AND Full possession of said premises all tartants and O=Pards, Opt as heratn provided,is CONDITION OF to be delivered at the time of the delivery of the deed,said fascia two and in violation of said PREMISE. . gortditSorr a$tfsfr r• are,reasonable icomply�� Gf�'aFf I mto the de♦it►Eay qK reletred to in dau�� {etteth a flat of buiMing arxi mmngg laws.and(c) writer said pngmrses prior s this dausne e ffach r��any) 4 hereof. The BUYER shah be ertdtied to fe�onalM complies with the term deed in or,w to determine wttettw ttte c oildiiban thereof of the iB. EXTENSION YO if the gELL�R shall be unable to gi�►e title or to make cortveyence,or to deliver possessiondo not PERFECT TITLE premises,all as herein sopulated,yr.I•.at.thhe-tlme of the detnrety of the deed the promises1►.._foilttwith OR conform with the proviSions hereof,then any ss hereto sshall�nse and this agreement et ll be void PREMISES refunded and all other obliggations of the parties h+x use reasonable CONFORM without recourse to the parties hereto, unless the SELLER as rov�ded herein,or to make ttte said etforts to remove any defects in true,or to deliver po P the SELLER shall t3 (Change pew Of ise�s conform to thepfevasion&hereof,as the may�.in which e+rer+t $ (fe2y/r8(n. pyyMten notice thereof t0 ttte BUYcii nt t;r.~,w""`Xa ft.time for perfprtltan04 ilfil9Uf1d8r calerland tt1Bf®tlQaft days— the time for performance hereof shall be extended for a period of thirty remove fede 1? FAI�RE TO If at the expiration of the extended time the SELLER shaft have failed so,to 08 tttetein anyagreed, In d Olt title. axe the prernl .conform,as the rates may be, botaer,f a.Mortgage on PERFECT TITLE deliver imssess on,or d of this reernent or arty emsnislOn thereof, OR MAKE any time during tt period it the insurance proceeds.if any.to be used for suet putpoe�,then f the PREMISES said premises sty refuse r parties hereto. CONFORM,etc. an hereto matt minas and th s agreenentalshall be d without recourse ito the p Other ea r�orra o parfi" 4 .. r.. end®d time for performance,to i2. gUYER's The BUYER shall have the electiER on,at either n delivff O't O alid oom�in their then condtiM and to Pay ELECTION TO accept such title as I without deduction,in W*M��SELLER Shall cones �, ACCEPT TITLE therefore ini0*event of such conveyance In d with ttte pnovism"of this cause,if the Said shalt have been 4amagad by fire or casualty insured against,then the SI~LLER shall,unless tpromises he SELLER has previously restored the premises to their former condition,either (a) pay over or assign to the BUYER•on delivery of the deed,all amounts fcco-cir+". or recoverable on account of such insurance,less any amounts reasonably expended by the SELLER for any partial restoration,or proceeds or a ps' (b) if a holder of a mortgage on said premises shall not permit the inwranoe p be so _ thereof to be used to restore the s premises purchase I n dcition°r ry of the deed,equal assigned',give to the-S' R i r n or re'.Y . . .. to said amounts so recovered or recoverable and retained by the holder or ins s9id rrt0j1lage- less any amounts reasonably expended by the SELLER for any partial restoration- The The apes of a deed by the BUYER or his nominee 8t8 the�l be «•dawned to be 13. _ACCEPTANCE . OF uE a fsl a. s and di�+,arge of every agreement and obllgation exoapt such as are,by the terms hereof,to be performed after the delnr6ry of said deed. 14. USE OF To enable the SELLER to make conveyance as hereln provided,the SELLER may,at the time of MONEY TO dWivey of the deed,use the purchase--money or any portion thereof to deaf the title of any or all CLEAR TITLE encumbrances or interests,provided that all instruments so procured are recorded simultaneously with the delivery otsaid de ed. 1 S• INSURANCE Until the delivery of the deed,the SELLER shall maintain insurance on said premises as foiiows: 'insert amount Type of insurance Amount of Coverage (6ist fldd4'tonal tivpes of)nsursrica (a)Fire and Extended Coverage "$ "mad) mounis es (b) . 16. ADJUSTMENTS op mod,waterer use ctharges,e�pty;lcwgeeeri>eagtf (W operaov ex. ltjt*X*3bWMW,and taxes for the them current Sol peAS'es, br arrY, or year: shall be apportioned ,as of the day of performance of this attach schedule) agreement and the net amount thereof shall be added to or deducted from,as the case may be,the purchase pdee payable by the BUYER at the time of delivery of the deed. Copyright O 1979,1984.1988,1987,19$$,1991(treater Boston Rea!E Board. AR rights reserved. Pwe 2 , 17. AOJU$TMENT' If the amount of said tt�is not known at the time of the delivery of the deed,they shall be OF UNA9SESSED apportioned on the basis of the taxes assessed for the preceding fiscal year,with a reapportionment AND as apart as the new tax rate and valuation can be asoartalned-,and,if the tenses which are to be ABATED TASKS apportioned tot t same shall be apporbrtionedmount of such beetween the pa prov Was to ided that neither party shall be obligated to institute or prosecute proceedings for an abatement unless herein otherwise aSNe� 18. BROKER's FEE A Broker's fee for professional services of $16,000.00 (fig in fee wim is due irratt the SELLER 10 u aa-ne S E. illurp-hY, ii n c. to be shared. equall dolreramount or with BK Real Estate to be paid only upon sucessful completion penoenfage;also of sale and recorded. name of Brokerage the Broker(s)herein, frmr(a)) 19. BROKER(S) The Brokers)named herein James E. Murphy, Inc. , BK Read. Estate WARRANTY warrant($)that the Broker(s)is(are)duly licensed as such by the Commonwealth of Massachusetts. (IV in name} 20. DEPOSIT All deposits made hereunder shall be held in escrow by Yames E. Murphy, Inc. (lid in name) as escrow agent subject to the terms of this agreement and shell be duly a000urded for at the time for perfonrnartoe of this went. In the event of any disagreement between the parties,the escrow agent may retain+all Qeposits made under this egreemenil pending Instillations mutually given in writing bythe SELLER aDd the BUYER. Repo. it to be held �.n a non-interest bearing account. 21, BUYER's If the BUYER shall fail to fulfill the BUYER'S agreements herein, all deposits made hereunder by the DEFAULT; BUYER shalt be retained by the SELLtl as-iiqucdatad damages::r..emd Within thirty s after Me DAMAGES time for performance of this agreement or any extension heroof,the SELLER otherwise notifies the BIKER In writing. 22. RELEASE BY The SELLERS spouse hereby agrees to join in said deed and to release and convey all statutory and HUSBAND OR other rights and Interests in said premises. WIFE 23. BROKER AS The Broker(s)named herein join(s)in this agreement and becomes)a party hereto,Insofar as any PARTY provisions of this agreement expressllyy apply to the Broker(s),and to any amendments or modificatlons of such proviems to wtach the Broker(s)agrees)in writing. 24. LIABILITY OF If the SELLER or BUYER eorsmutes this agreement in a representative or 6dudacity,only the TRUSTEE, principal or the estate represented shall be bound,and neither the SELLER or Sim,so executing, SHAREHOLDER, nor any shareholder or beneficiary of any trust,shalt be personally liable for any obligation,express or BENEFICIARY,etc. implied,hereunder, 25. WARRANTIES AND The BUYER ackrmwledges that the BUYER has not been Influenced to enter Into this transaction nor REPRESENTA- has he relied upon any warranties or representations not set forth or ino morated in this agreement or TIONS previously made in writinngg except for the following additional waranties and representations.If any, (fi#in);If none, made by either the SELLER or the Broker(s): None state "node"irany Wed, indicate by whom each war- am or ropresan- taW was made 26. MORTGAGE In order to help finance the soquisition of said premises.the BUYER shall apply for a.aonve0tional NTING&N.'CY bank or s3'; r inoiitu3l:rural mortgage!^an of$ 151,200:.4 n at pr astirrg CLAUSE rates,terms and conditions. If despite the BUYER's diligent efforts a 0grnmitment for such loan (orryt if not cannot be obtained on or before August: 3 , 2001 the BUYER may terminate j proyided for this agreement by written notice to the SELLER and/or the Broker($),as agents)for the SELLER, In Offer to prior to the expiration of such time,whereupon any payments made under this agreement shall be Purchase) forthwith refunded and all other oblipabons of the parties hereto shall cease and this agreement shall be void without repoume to the parties hereto. In no event will the BUYER be doomed to haveF trite-- diligent efforts to obtain such commitment unless the BUYER submits a complete mortgagee loan application conforming to the foregoing provisions on or before July 14 , 2001 , Copyright* 1979,1984,ION,7BWT.im,IM Greaw Boston Rftl east@ Board. Ali rights rese,ved. PM4 3 27. CONSTRUCTION This im tlment,wwouted in muttipie rpunterft,is to be construed as a Massaohuaetie contract,is OF AGREEMENT to take efted as a soled Instrument, sets forth the entire Contract between the Parties,is binding upon and enures to the benefit of the parties hereto and their respectiv®heirs,devisees,00cxltors, administrators, successors and assigns, and may be cancelled,mOdifled Of amended onlY by a written Instrument executed by both the SELLER and the BUYER. if two or more peirswe are named herein as BUYER their obligations hereunder shall be joint and several. The capd d marginal notes are used orgy as a matter of convenwace and are not to be aonsldered a part of this agreement or to be used in deWmIfung the Intent of the parties to It_ 28, LEAD PAINT s LAW 29. SMOKIi DETECTORS 30. ADDITIONAL The initialed riders, If any,attached hereto,are Inoorporated herein by raferance. PROVISIONS ConLingent on satisfactory perk test to be •done at BUYER's expense. FOR RESIDENTIAL PROPERTY CONSTRUCTED PRIOR TO 1978.BUYER.MUST ALSO HAVE SIGNED LEAD PAINT`PROPERTY TRANSFER NOTIFICATION CERTIFICATION' NOTICE: This is a legal cumerrt that Cr Wading obligations. if not understood,consult an attorney. . � r SELLER(or spouse) omas E. Cxypoliski ELLER Roe a A. Cxypoliski � $•{ IIYEE2 David S. Dumont BUYER Tai payer ID/ i "IR es E. Murphy, I SK Re l Esrete Copyright® 197"9,1984,1986,IN!,100,1W t3MOW Boston Resat Eatete hoard. All rights=wvW. Pegs 4 I I I ADO E1WUM A. 31_ All notices required or permitted to be given hereunder shall be in writing and delivered by hand or mailed postage prepaid,by registered or certified mail,or by facsimile In case of Seller to: Thomas E.Cxypoliski and Roberta A.Cxpoliski 130 Greeley Avenue West Hyannisport,MA 02612 With a copy to; James E.Murphy,Inc, 1170 Rte. 132 Hyannis,MA 02601 fax,(508)771-1717 In case of Buyer to: David S.Dumont 67 Willow Avenue Hyannis,MA 02601 With a copy to: Steven J.Pizxuti,Esquire 336 South Street Hyannis,MA 02601 fax:(508)790-0072 or in the case of either party to such other addresses as shall be designated by written notice given in such manner to the other party. Mailed notice shall be deemed given upon deposit in the United States Postal Service so long as notice is faxed to the representative stated above, or if given by hand, at the time of delivery or receipt. 32. Buyer and the Buyer's agent shall have rights of access to the Premises prior to the time specified for delivery of the Sellers deed for the purposes of inspecting and conducting engineering and other tests. 33. Any title or practice matter arising under or relating to this Agreement which is the subject of a . title or practice standard of the Massachusetts Conveyancers Association at the time of delivery of the deed contemplated hereunder shall be governed by such title or practice standard,as the case may be,to the extent applicable. 34. As pan of an along with the real property referenced in or described in this Purchase and Sale Agreement, the Sellers also agree to transfer and assign the following property interests included in the purchase price: (a) all plans relating to the lot conveyed and any subdivision thereof, all construction and/or renovation plans and specifications,if any, relating to the land,structure and all guarantees and warranties, fi any,by and rights against,third parties with respect to any and all borings,soil tests, percolation tests and other tests and reports with respect to the Premises,and; (b) all permits,certificates,variances, consents and approvals, if any, pertaining to the land, structure,or any personal property thereon. All of the above(a) and(b) shall be deemed for all purposes of this Agreement, to be an essential 'pant of the Premises. L i 35. it is understood and agreed by the parties that the Prerhim shall not be in conformity with the title provision of this Agreement unless: (a) all buildings,structures and improvements, including, but not limited to, any driveways, parking areas, landscape areas and garages, and all means of access to the premises, shall be located completely within the boundary lines of said Premises and shall not encroach upon or under the property of any other person or entity;and (b) No building, structure or improvement of any kind belonging to any other person or entity shall encroach upon or under said Premises;and (e) The premises abut a public way duly laid out or abut a private way with access to such a public way accepted as such by the town or city within which the Premises is located. 36. Sellers represent,covenant and warrant to and agree with Buyers as follows- (a) Sellers have the legal right, power and authority to enter into this Agreement and to perform all of its obligations hereunder, (b) There are no tenancies,occupancies,or licenses in or to the Premises; (e) Sellers have not commenced nor have Sellers received notice of the commencement of any proceeding which would affect the present zoning classification of the Premises. Sellers will not initiate any such proceedings and will promptly notify Buyers if Sellers receive notice of any such proceeding commenced by third parties; A No work has been done on the Premises which could give rise to any liens under Massachusetts General Laws,Chapter 254 and no contracts are outstanding or in effect with respect to the doing of any such work; (e) There is,to the best of Sellers' knowledge and belief,no notice,suit,order,_decree,claim, writ, injunction or judgment relating to material violations of any laws, ordinances, codes, regulations or other requirements.with respect to the Premises (or any portion thereof) in, of or by any court or governmental authority having jurisdiction over the Premises; Sellers' warranties and representations trade in sub-paragraphs (a)-(e) above shall be a condition of Buyers' obligation to close under this Agreement that all of said warranties and representations are true, both as of the date hereof and as of the closing. 37. The parties hereto acknowledge that they have been offered the opportunity to confer with qualified legal counsel of their own choosing and at their own expense prior to the signing of this agr•eemetlt, 38. The closing as set forth in Paragraph (8) of this Agreement may, at Buyer's election and with reasonable notice to Seller, be performed at Buyers' attorney's office, so long as said office is within the county in which the property is located. The seller's proceeds paid in accordance with Paragraph(7)mar tG� be paid by . certified lheQky� 39, Notwithstanding anything contained in this Agreement to the contra end except as otherwise 0 g Y S � contrary eP prohibited by law, if the Buyer shall fail to fulfill the Buyer's obligations set forth in this Agreement,then all deposits made hereunder by the Buyer shall be retained by the Seller as liquidated damages,which shall be the Setter's sole remedy at taw and equity. 40. Paragraptf(10)of this Agreement shall be replaced in its entirety with the following: l If the Seiler shall be curable to give title or to make conveyance, or to deliver possession of the Premises,all as herein stipulated,or if at the time of the delivery of the deed,the Premises do not' conform with the provisions hereof, then the Seller shall use reasonable efforts to remove any defects in title,or to deliver possession as provided herein,or to make the said Premises conform to the provisions hereof, as the case may be, in which event, the Seller shall give writt ly Flvti.z thereof to the Buyer at or before the time for performance hereunder,and thereupon,the time for performance hereof shall be extended for a period of thirty days. In the event,however,that such extension adversely affects Buyer's mortgage financing commitment terms,Buyer shall have the alec•,ior. to temainate this Agtermcnt and any payments made hereunder shall be forthwith refunded. 41. In the event that the provisions of this Addendum and the provisions of the attached Agreement are in conflict,the provisions of this Addendum shall govern. 42. This sale is subject to and contingent upon the Buyer determining that the property is buildable in accordance with all governmental laws and regulations for a residence with garages of the Buyers design- In the event that the Buyer determines that the property is not so buildable,then the Buyer may trrminatc this agreement and all deposits shall be forthwith refunded without recourse against either party. EXECUTED this th"t72Q&q day of Suly 2001. Bityerd — �� Seller r 1 Seller JUL-10-2001 11 ;07 AM JAMES E MURPHY I14C 5087751717 P. 02 ;•d r,uMen��llrr�aui*tiuuw o�1P�r GoRwRe+1eN,LONG►earl 1e1 •-I elll;�1Z.;44 1 ffii 314 22915 1, J0W f:. BARNARD, JR•, of 496 Starboard Lane. ,I sktitltitttal�lt8 • Barnstable (0stervL1140, Barnstable cla", ?rin Married y I oc coal da14tlos ppoll and In lull condderaticn of s15 000 00 grants to 'CtiOt�lA.4 E. OXYF'OL18KY and Nf3B1ER'I'A 1. OXYPOLISKI, husband and ! wife,ea tenants by the entirety, both of foe Chequaquet Way, Barnstable (Centerville), said Barnstable County, wild gulttlatw eaumants I • ij the land in Barnstable (Marstons Mills), Barnstable County, MassachusettsIN , N1 bounded and described am follotV ,•�I (Ok,air,iat,anJ.nunl6naM,,if..t) _ SOUTHEASTERLY by Wheeler Road as shown an hereinafter mentioned �. i lan, one hundred severity-six and 50/100 (176.50) feet; ll . SOUTHWESTERLY by Lot C as shown on said plan, five hundred five (5o5) feet, more or lose; NORTHWESTERLY by land now or foravxrly of first Nationil Honk of Yarmouth as shown on said plan, one hundred seventy-six and 5/10 (176.5) feet, more or less; and' NORTHEASTERLY by Lot E as shown on said plan, five hundred nine ! (509) feet, more or less, Containing 89,400 square feet, more or less, and being shown as :I LOT D on plan entitled "Plan of Land in Marstons Mills Barnstable ITsa. Par John E. Barnard, Jr. Scale: 1 in. = 100 Ft. Date: July 20, 1970 Charles N. Savery Inc. Registered Engineers Surveyors Hyannis South Yarmouth," which said plan is duly filed with Barnstable County Regtatry of Deeds in Plan Book 240, Page 41. �I Together with a right of way over Wheeler Road as shown on said plan i•' ' to and from said Lot 4 and Race Lane, in common with others who are now or may hereafter be entitled thereto, and so much of said lot as by i.mplicati.on of law'lioa within thn limitrl of 5111 Road is subject j; to the rights of others in and over the same. 1 I� The above described premises are conveyed subject to the restrictions as contained in a deed from Halen W. MacLellan to John E. Barnard, Jr. and Grace Elizabeth Barnard dated April- 13, 1953, duly recorded with d; said Deeds in Book 839, Page 161. The above described premisea are also conveyed subject to an easement l" to the Cape & Vineyard Electric Company at al duly recorded with said Deeds in Book 994, Page 407. There is conveyed as appurtenant to the said Lot D a right of way in common with others who are now or may hereafter be entitled thereto over a 40 foot way as shown on a plan recorded in Book 209, Page 91, r to and from Wheeler Road and North Cotuit Pond. Being a portion of the premises conveyed to me by deed of Grace Elise- ' I bath Barnard dated November 29, 1966. duly recorded with spice Deeds in Book 1357, Page 413. rn ('nl : �':1`I `i•,i_(;! '.�':'!+' IU• Ili . Ch 1 . - 9 t KE�'MAP fc4". //N.a♦000/T. /y/� F/IfST NAT/ONAL BANK Oi YARMO!/TN a , a r� SYMVIO AL • - rYSt - �J A►rr: /40'Y 1 /76.s' /ga r J Q •° 10 low 047 orr. St.-too10.i ,. aO7ootsi 'fivaa e9,600r 6B1400Y:.s Wi` h bpi � y In y h e .. • Ui ev � . � ,per. �•, o i s�.sis/Si.94 A•I/9.30 +o.�0 8ii►'�►'ii�w '• �A7 ' /76.So t A • ov - ?•�.ros � � ,Q.84Bo.00 g S i ` •r•/of7s ��A./rl00 ,roloo� /BO.oO /76.s0 _ • a o:•w 6//•s6 /q'DAO = R•/vso.00 •�- `yJ�EELER �i N b W/LFR/D �YHEELER' SR. SET AL/., 77?L/STE?ES B&OWWA4"/iLAMjmQ sOARO AOPWVAL R6✓/SEO .I4/G. S, /970, •.rosw TM 5Uq&MVrSj*m CONtwOA.uw j g PLAN OF L4/V40 .10 IN � M�iv' as= BARNSTAes�E 'HAss AUG 1719 roR ✓OHN E. BARNA RO, ✓R. NO7-e. d TM/d PLAN /J A S!/OD/V/S/ON OF LOr cvscm--o o1, OvAes AJ .J/VDWY ON oLAiv OF LA/VO OF ✓OI/N an 4 ✓Ado GNTd: ✓!/LY ?O,/y70 ,r,. ,.' OAR/VARO, ✓q., PAT,F0 A/i4V.s7-c-O /962, , �� urEo LO. KCLL000, C/V/L KNQ/IV!'iR. _', C�a�.Gpf A.m CHARLE.S oOV. SA✓ERY INC. •ice •o •-(I �NOINILrs 8�/IrYIrO�I: NYAA/N/J ramrAe Y.fmowoG/TN �Ng 70/35 2 The Commonwealth of Massachusetts •....: — Department of Industrial Accidents Office offn�estigatinns 600 Washington Street Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit XT aw name: location: ///►� , hone c❑ I am a ho owner performing all work elf. I am a sole r rietor and have no one workin in�' ate ' ob. ///// /// acit//%%%////////%/////%%///%%//%%/%//%///////%////%/%/%//%%%/%//%%//////////////////%////%///�%%%/�/%//, Orkin on this j to ees g ::.::::::::::::.... ::::::::;:::: %//// for em Y n P :::.;:.:::::::;::::::::::::::::.:::. ensatlo my em to n co a :. a d s 0w who ed b el insurance rieto general contractor, r homeowner(circle one)and have hired the contractors I am a sole prop have Otte n work ..compensation ...... the foll .:::::;:.:.:::::. s a m oma address _ 7..�.:::::. ... ::::.i:::::.i::v::.ii:::.::.i:v. ..i::::::•i:w::::::•.::. i:• :::.i ::::y;;:::::i :: i:v:::•Yi:^: :'. :i�i:. .::.......... ho :. ... ::v:::is i:''i:•::::: ....... ..::::..::.i�ii:ii:i::iiiiiiiii:ii:iii:::::::vv:Jii1:L::ii::}ii:':i:::ijL::iii:i:;??;:;.':��::?•�'� .:::::::::�:::i::::i��::...?.'.:::�•:'':j:::iii J:: y>}::i:}:: :<:':'.ii:.::.+i:'.::i•:'i::::.ii::"::::. .:.. ::• •: ...:. ' . ... ........::.::'::::'::..iiii:•i:iiiF::i•:�:v:v:iiiiiiii:<'Y:i:•:i.:i::ii:i:?i:'i:::i:•iiiiii':':bi:!!..;ii::: :i .ii:::•i.: .:}:M,�:i: : :: .i•:^.. .::•i L:::......:::: i::.i:':is i::::::ii:ii:::.i:':i:''::.i:'isvi:'::.i:•:i::•i:'::.i:•i:+:i::::.i:'i:•::•:::.i:•i:•i::.:i•i:•:i''::. ::::•::.i:v'<•::'.. ::. :: :i::.. ...... ins can ce.. ................... ........................ m a n .:: ::::::.::::::::.::::.:::::::.::::: .::::.:......... ;e `ddr •a ......:..:........ 'e li r 0 tuIIrance CO:<`>;«:::s>:; >:<;:::::: imposition of crhninal penalties of a fine np to 1 00 and/ Fypnn W secure coverage as required under Section 25A of MGL 152 can lead to the hnp and a fine of 3100.00 a day against me. I mtderstsad that a one yam,imprisonment as well as civil penalties in the form of a S pof the DIAWORKOfor coverage verification- copy of this statement may be forwarded to the Office of Investigations under the and penalties ojperjury that the information provided above is trr�and correct I do hereby Yy Date Qk& p ( 1 Signature Phone#�z � — print name L oMclal use only do not write in this area to be completed by city or town official QBfiding Depwtmmt permit/license t# Licensing Board city or town: ❑Selectmen's Office use is required ❑Health Department O checkitimmediate respo - ❑others phone tt; contact person: Ull 0,,,d 9195 PJA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", 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 eriiployees.'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 section 25 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,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 in the workers' compensation affidavit completely,-by checking the box that applies,to your situation and supplying company names,address and phone numbers along with a certificate of insurance as all affidavits 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.' Sl oiild you have any questions regarding the'law'or if you are required to obtain a woikers' compensation policy,please call the Department at the number listed below. City or.Towns 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. The affidavits may be.returi d to the Department by mail or FAX unless other arrangements have been made. The Office.i f Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. VON The Depaitnient's address,telephone and fax number: ti The Commonwealth Of Massachusetts Department of Industrial Accidents Me of ImlesugauOns 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 1 phone#: (617) 727-4900 ext. 406, 409 or 375" r r .. TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA HOME OFFICE HARTFORD, CT License and/or Permit Bond Bond No. 103300907 KNOW ALL MEN BY THESE PRESENTS: That we, Bay Colony Systems Inc, P. O. Box 1907, Sandwich, Ma. 02563 (hereinafter called Principal ) , as Principal and Travelers Casualty and Surety Company of America , a corporation organized and doing business under and by virtue of the laws of the State of Connecticut, and duly licensed for the purpose of making, guaranteeing or becoming sole surety upon bonds or undertakings required or authorized by the laws of the State of Connecticut, (hereinafter called Surety) , as Surety, are held and firmly bound unto Hereina One Thousand and 00/100-------------------- Dollars ($ 1, 000. 00 lawful money of the United States of America , for the payment of which, well and truly, to be made, we hereby bind ourselves and each of our successors and assigns, jointly and severally, firmly by these presents. THE CONDITIONS OF THIS OBLIGATION ARE SUCH THAT, WHEREAS, the Principal is desirous of obtaining a permit under Zoning Section 1269 of the Town of Barnstable to build a structure on LOT D #56 Wheeler Road Marstons Mills, Ma. NOW THEREFORE, if the said Principal shall faithfully observe and keep each and all of the agreements, stipulations, conditions, specifications and provisions by the said Principal to be kept and performed, contained in said permit issued to the said principal, according to the full extent and spirit of said permit and the ordinances of the said Obligee now relating, or that may relate thereto and shall indemnify and save harmless the said Obligee from all liabilities, loss and expense whatsoever which the said Obligee may incur and suffer arising out of the issuance of such permit, and shall make no default therein; then this obligation shall be null and void; otherwise it shall be and remain in full force and effect. IN WITNESS WHEREOF, said Principal and said Surety have caused these Presents to be duly signed and sealed this loth day of August 2001 Principa Travelers Casualty and Surety Company of America urety _ � torney in-fact Rosalie B, Swift IN WITNESS WHEREOF, TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA has caused this instrument to be signed by its Senior Vice President, and its corporate seal to be hereto affixed this 2nd day of February, 1998. I 'ND SURET`c TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA STATE OF CONNECTICUT }SS. Hartford 7 i u HARtfORD, COUNTY OF HARTFORD CONK. By— George W. Thompson Senior Vice President On this 2nd day of February, 1998, before me personally came GEORGE W. THOMPSON to me known, who, being by me duly swom, did depose and say: that he/she is Senior Vice President of TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, the corporation described in and which executed the above instrument; that he/she knows the seal of said corporation;that the seal affixed to the said instrument is such corporate seal;'and that he/she executed the said instrument on behalf of the corporation by authority of his/her office under the Standing Resolutions thereof. My commission expires June 30, 2001 Notary Public Marie C. Tetreault CERTIFICATE I, the undersigned, Assistant Secretary of TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, a stock corporation of the State of Connecticut, DO HEREBY CERTIFY that the foregoing and attached Power of Attorney and Certificate of Authority remains in full force and has not been revoked; and furthermore, that the Standing Resolutions of the Board of Directors, as set forth in the Certificate of Authority, are now in force. Signed and Sealed at the Home Office of the Company, in the City of Hartford, State of Connecticut. Dated this loth day of August TV 2001 ��,ND SUgEE` �y �q s + HARTFORD, CONN. i W e By.., Rose Gonsoulin Assistant Secretary S-2435(7-95) .. TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA Hartford,Connecticut 06183-9062 POWER OF ATTORNEY AND CERTIFICATE OF AUTHORITY OF ATTORNEY(S)4N-FACT KNOW ALL MEN BY THESE PRESENTS, THAT TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, a corporation duly organized under the laws of the State of Connecticut, and having its principal office in the City of Hartford, County of Hartford, State of Connecticut, hath made, constituted and appointed, and does by these presents make, constitute and appoint Noel J. Almeida, Fred W. Fay, Kenneth R. Forster or Rosalie B. Swift "* of Sandwich, MA, its true and lawful Attomey(s)-in-Fact, with full power and authority hereby conferred to sign, execute and acknowledge, at any place within the United States, or, if the following line be filled in, within the area there designated , the following instrument(s): by his/her sole signature and act, any and all bonds, recognizances, contracts of indemnity, and other writings obligatory in the nature of a bond, recognizance, or conditional undertaking and any and all consents incident thereto not exceeding the sum of TWO HUNDRED FIFTY THOUSAND($250,000.00) DOLLARS per bond" and to bind TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, thereby as fully and to the same extent as if the same were signed by the duly authorized officers of TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, and all the acts of said Attomey(s)4n-Fact, pursuant to the authority herein given, are hereby ratified and confirmed. This appointment is made under and by authority of the following Standing Resolutions of said Company, which Resolutions are now in full force and effect: VOTED: That each of the following officers: Chairman, Vice Chairman, President, Any Executive Vice President, Any Group Executive, Any Senior Vice President, Any Vice President, Any Assistant Vice President, Any Secretary, Any Assistant Secretary, may from time to time appoint Resident Vice Presidents, Resident Assistant Secretaries, Attomeys-in- Fact, and Agents to act for and on behalf of the Company and may give any such appointee such authority as his certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds, recognizances, contracts of indemnity, and other writings obligatory in the nature of a bond, recognizance, .or conditional undertaking, and any of said officers or the Board of Directors may at any time remove any such appointee and revoke the power and authority given him or her. VOTED: That any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or conditional undertaking shall be valid and binding upon the Company when (a) signed by the Chairman, the Vice Chairman, the President, an Executive Vice President, a Group Executive, a Senior Vice President, a Vice President, an Assistant Vice President or by a Resident Vice President, pursuant to the power prescribed in the certificate of authority of such Resident Vice President, and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary or by a Resident Assistant Secretary, pursuant to the power prescribed in the certificate of authority of such Resident Assistant Secretary; or (b) duly executed (under seal, if required) by one or more Attomeys-in-Fact pursuant to the power prescribed in his or their certificate or certificates of authority. This Power of Attorney and Certificate of Authority is signed and sealed by facsimile under and by authority of the following Standing Resolution voted by the Board of Directors of TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, which Resolution is now in full force and effect: VOTED: That the signature of each of the following officers: Chairman, Vice Chairman, President, Any Executive Vice President, Any Group Executive, Any Senior Vice President, Any Vice President, Any Assistant Vice President, Any Secretary, Any Assistant Secretary, and the seal of the Company may be affixed by facsimile to any power of attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attomeys-in-Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such power of attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding upon the Company in the future with respect to any bond or undertaking to which it is attached. 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