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HomeMy WebLinkAbout0135 WHEELER ROAD a aq r, ..:-'i. �^'^ r� �ti .L..,--...-..�--.....n++P�.r��..•.w w-��.�M � _+.w- .�.,...ra.. _..►�4. - ...+,er.� - `"..d .�..'r."..�:,�..Y.�..."'�_`.:.. "v � ko Town of Barnstable . *Permit# .o Expires 6 monthsfom issue date Regulatory. Services Fee a a . + L1RNSi'ABLE. � . MASS. Thomas F.Geiler,Director (� [ �N���e� ','YN/ Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number II-- Property.Address 5_5 Ukee r ec a d, y ff Residential Value of Work 7� Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address R n�ff_ _U6�t V1 �5 (.,J�1 Pe�.vr 6d � NI�rSkn� �i��5- • . Contractor's Name g:Vl �C C.,i�r� Telephone Number 77 Home Improvement Contractor License#(if applicable) 172 72 Construction Supervisor's License#(if applicable) _ ❑Worlanan's Compensation Insurance X-PRESS .PERM Che one: I am a sole proprietor FEB - 5 2013 ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name TOWN OF BARNSTABLE Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. I Permit Requ (check box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to 5oo 11 I011 �11 ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement on actors License&Construction Supervisors License is required. SIGNATURE: Q:IWPFTLES\.FORMS\buildipg permit forms\E7PRESS.doc 1 I � 1 I The Cammo7m ealth of Massadluseeffs Department oflndushial Accidents Office ire of Inve stigations 6M Washington Street Boston,M4 02111 . j w►c'w.mass gov%dia Workers' Compensation Insurance Affidavit~ BBuilders/Contractors/Electric ans/Ph tubers Applicant Information Please Print L.e blti Name.(BudwmMm mtion&&vidni): fo,+fic6 C i des Address: /2 L 11 h d City/State/Zip: e t1 AIA o � Phone# 77 / 722 oS�2 Are you an employer?Check the appropriate bo; Type of project(required): 4. am a general contractor and i ' 1.El I am a employer with 6. ❑New construction employees{hall and/or par#time}.* have hired the sub-contractors 2.❑ I am a sole propriehoi or partner- lisped on the attached sheet, ?. ❑Remodeling ship and have no employees Theme sub-contractor have g_ ❑Demolition working forme in any capacity. employees and have worms' 9.• ❑Budding addition [NO Workers'comp-insurance comp.insurance I required_] 5. ❑ We are a corporation and its 10.❑Electric repairs or additions 3_❑ I am a home-0wuer doing all work afficeas��exercised� 11_❑Pi g repairs or additions myself [No workers'camp right , exemgind per have n 1 of repairs insurance required.]T c. 152,�1(4),and we have no employees-[No workers' 13.❑Other comp.insurance required.) 'Any app&mt that checks bom Al must also fillow the section below showing their workers'compensation,policy information. I Homeowners who submit this aidsvit imdicsting they are doing all work and then huu outside corxtxactors mast submit anew affidavit indicating such fContracmrs that chpa this boor(must attached an additional she showing the rime of the sub- ton and stare whether or not those entities haee emphryees. If the sub-contmcioa have employees,they oust provide their workers'ramp.policy number - I tun an employers that is providing workers'congmnsadon,insurance for my emplay m& Below is fire pdicy and,job site informaden. Insurance Company Name: Policy A Of Self-iats.Lic.# FxpiratiQn Bate: Job Site Address- City/StatelZip: Attach a copy of the workers'campeusation policy declaration page(showing the policy muzber and expir-ation date). Failure to secure coverage as required under Seetiou 25A of NLGL c- 152 can Seed to the imposition of criminal penalties of a fine up to$1,500.OG and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up t4$250.Q(f a day against the viol-Aar. Be advised that a.copy of this statement may be forwarded to the Office of Investigations of the DIA for insurince coverage vetsfication— ' I dip hemby card snider th ' sand of t the irafonratatiasn provided ebow is true and correct / Date: Z— S' � Phhonee#- 7 Ty 1 Z 2 5 Z ©jcial arse only. Do not}trite in this area,to b cmpWad by city or town of ciaL City or Tom: Per=WUcense At bsuing Authority(circle one): 1.Board.of Health 2.Building Depwt rent 3.City/Town Cleric d.Electrical Inspector 5.Plumbing Inspector 6.Other a------ Phone fl: L� of rosy + BARNSfAHM + . 9� ,�� Town of Barnstable AlE p Ana+" • Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, E0626`i'- kUSV,ir\S ; as Owner of the subject property hereby authorize PA ;ck 01941A to act on my behalf, in all matters relative to work authorized by this building permit application for: 136 Whee-k-er A. Ar-4�,s A'j-XIS ,-A� (Address of Job) • I /5/1 -3 Signature of Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on,the reverse side. n\WPFTI.FCIF(1RMS1ln9ri�na­4 f.. .%CVPnrcc A— 1 .I °FTIiE rqk� Town of Barnstable Regulatory Services BARNSrABI.E, ` Thomas F. Geiler, Director g Buildin Division . Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 , www.town.barnstable.m.a.us Office:. 508-862-403 8 Fax: 508-790-6230 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. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1•.1 -Licensing of construction Supervisors),provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the 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. ACORQ. CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDIYYYY) O1/24/2013 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: ff the certificate holder is an ADDITIONAL INSURED,the poficy(ies)must be endorsed. if SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Joanne Bretton Southeastern Insurance Agency, Inc. P,,,CONeE.: 508-775-5154 a No:508-790-0557 641 Main Street E-MAIL ADDRESS: Hyannis, MA 02601 PRODUCER INSURERS)AFFORDING COVERAGE NAIC INSURED INSURER A: Arbella Mutual Ins CO 17000 All Cape Exterior Remodeling LLC INSURERB: AEIC Insurance INSURER C: 67 SEA STREET APT A4 INSURER0: Hyannis, MA 02601 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 2013 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP LJMITS LTR INSR WVO POLICY NUMBER GENERAL LIABILITY 8SO0041933 0111412013 01N412014 EACH OCCURRENCE $ 1,000,00 DAMAGE X COMMERCIAL GENERAL LIABILITYPREMISESTOR occurrence) $ 100,00( CLAIMS-MADE FK OCCUR MED EXP(Any one person) $ 5,00( A PERSONAL&ADV INJURY $ 1,000,00( GENERAL AGGREGATE $ 2,000,00( GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00 POLICY jE O- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) I$ ANY AUTO BODILY INJURY(Per person) s ALL OWNED AUTOS BODILY INJURY(Per accident),$ SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (Per accident) NON-OWNED AUTOS I$ s UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE I s DEDUCTIBLE I s RETENTION $ $ WORKERS COMPENSATION NKC500789601201 01114J2013 01114/2014 X TORY LIMITS OEa AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVEY/N E.L.EACH ACCIDENT Is 1,000 00 B OFFICER/MEMBER EXCLUDED? N I A (Mandatory In NM) E.L.DISEASE-EA EMPLOYE;$ 1,000,00( If yes,deDESCRIIPTIIOON OF underPERATIONS below OWNER INCLUDEDE.L.DISEASE-POLICY LIMIT 1$ 1,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE di play purposes only 13oanne Bretton ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD ACORQw AGENCY CUSTOMER ID: 1 LOC#: ADDITIONAL REMARKS SCHEDULE Page of ' AGENCY NAMED INSURED Southeastern Insurance Agency, Inc. All Cape Exterior Remodeling LLC ' POLICY NUMBER 67 SEA STREET APT A4 Hyannis, MA102601 CARRIER NAIC CODE ° EFFECTIVE DATE: ADDITIONAL REMARKS s THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: ACORD Certificate of Liability Insurance Garage Liability INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD POLICY NUMBER DATE(MMIDONY) DATE(MMIDWY) LIMITS AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC S AUTO ONLY: AGG S Automobile Liability INSR ADD'L - POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD POLICY NUMBER DATE(MMIDDYY) DATE(MMIDDNY) Excess/Umbrella Liability INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD POLICY NUMBER DATE(MMIDD/YY) DATE(MMlDNM LIMITS S , Other Liability INSR POLICY EFFECTIVE POLICY EXPIRATION LTR ' POLICY NUMBER DATE(MMIDDIYY) DATE(MMIDDIYY) LIMITS � r f ACORD 101(2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Massachusetts -Department of Public Safety U0 WW4 vea&4 ;. Board-of Building Regulations and Standards -. Office onsutnerAfta`rs&B sioe�ssRegulattoa / WOME,IMPROVEMFsNT CQNTRACTOR ' Construction Supervisor Spccialh $: c Registration 172472 ,Type: License: CSSL-105951 .' . 'f� •�.. _%.I 1 N' Expiration: 1/27/�014 Individual j PATRICK CLIFFq'RD ';; P ICK'CLIFFoil 12 BALDWIN RO`AD'�, Dennis MA 02639. - - PATRICK CLIFF�i` = '' .12 BALDWIN RD Expiration DENNIS:MA02638 a p Undersecretary. 06/02/2016 Commissioner m I r � t t CM i License 4 � e F or re . .... .. before the a gistration vajfT � - Office of xp�ration date - Consu se'only " <.;parkplmerAffairo.aza-Suite Boston,llTq 02116 5170gulationTt Not oo . . !t si rw r�oF ti C7 � ro 6S85�TO� n Of Barnstable *Permit#Regulatory Services E�eees6mmnlhs �on,iss r. awaysrtier.e, : ` )9-6 � Thomas F. Geiler, Director Building Division Tom Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www,town,barnstabIa.ma,us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY NO/Yniid withoul Red X-Preys Imprint Map/parcel Number ro,� Property Address j r^ t..i r_r_L -r< r—�, rLjr14 r1 �i WEr,s1. �'� I S /!•�. j�_ 011�aesidential Value of Work ` �" Minimum fee ofS35.00 for-work under S6000.00 Owner's Name & Address R(✓ 6r_r�& 1•h,-, f,<z_ 3 S' w 1. z L r it 62 - r-1 lava S Contractor's Narne_tIr (,,_?O14-U Telephone Number N7 l•L-j� l - Home Improvement Contractor License#(if applicable) � G Construction Supervisor's License#(ifappIicabIa) ❑Workman's Compensation Insurance p % Yr Check one: OCT 2 8 2010 ct ❑ I am a sole proprietor ❑ I am the Homeowner TOWN OF BARNSTABLE M�-rhave Worker's Compensation Insurance Insurance Company Name r`I �)CKin 41►2r— Pec 0,Le.5S - H-5 Workman's Comp,Tolicy# `7t� . Copy of Insurance Compliance Certificate must accompany each permit. Permit Request (check box) ❑ Re-roof(it urricane nailed) (stripping old shingles) All construction debris will be taken to ❑ Re-roof(hurricane nailed)(not.stripping. Going over existing layers of roof) ❑ Re-side vJ #of doors g/lReplacement Windows/doors/sliders. U-Value �?F I (maximum .35) #of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e. Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A cop the Home Improvement Contractors.Lict nse & Construction Supervisors License is u' ad. SIGNATURE: f GI�'ATU � QAWPI-ILESIFORMSWuilding permitformslEXPRESS.doc • f �°—_--6d Office of Investio ations 600 Washing on Street Boston, ALA 02111 www.rnasS-oov/dia 'Workers, Compensation Insurance Affidavit: Bui"lders/Contractors/Electricians/PluDnbers A licant Information Please Priot Legibly aloe (Business/Oreanization'L-IL N W P P 0 Address: 2 b C EDA 2 S T EX 1�l 93a_ �'360 _ �5l City/State-Zip: W 0,5U 2n( . M� 01 '501 Phone r: �l Are vou.an employer' Check the appropriate box: T,"pe of project (required)'. t. .I am a employer x ith '50 r 4. ❑ I arir a general contractor and I 6. [] New construction employees full and/or an time).*" have hired the sub-contractors ( p 7. R Remodeling �.❑ i ;aiu a�Gie prvYi-i�.w; r parner- listed on 'he 2ttached:beet ship and have no employees These-sub-contractors have S. Demolition ❑ working forme in any capacity. workers l comp. insurance. 9, ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its officers have exercised their 10.❑ Electrical repairs or additions required.] 11. Plumbing repairs or addidcns 3.❑ I am a homeov:�er doing all work right of exemption per MGL ❑ g myself. [No workers' comp. c. 152, §1(;4). and we have no 12,❑"Roof repair insurance required.] t employees. [No workers' 13.❑ Other comp. insurance required.] any applicant that checks box=1 must also fill out the section below showing their workers'compensation police information: Homeowners who submit this affid-it indicating-they are doing all wort:and then.hire outside contractors must submit a new affidavit indicating such. " Contractors that check;this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy"inforrnadon. 'am an employer that is providing workers'compensation irsurance for my employees. Below is the polio} and job site 'nformation ;nsurance Comp any l�ame: �{QCkin4i,re Lnsu(GnCe /�Q'nCll - W G 8 l�y S 9 rl L} Expiration Date: .olicy;=.or Self-ins. Lic" ti�: lob Site AddTess: .13 5 U Le t Lr� City/State/Zip: b'Z�L Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section15A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to S1.500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 a dav" against the violator. Be advised that a copy of this statement may be for e arded to the Office of . lnvesti�,ations of the DIA for insurance coverage verification. i I do hereby ceri' un the pains and e altieess perjury that the information provided above is true and correct.. Signature* " IFO& N - P . Date: Phone.: rl. $ 1-q53- (UCv LOtb�r only. Do not write in this area, to be completed by city or town official. n: Permit/License# hority" (circle one): " Health 2.Building Department 3.Cit�•/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector rson: Phone #: — w j CERTIFICATE OF LIABILITY INSURANCE 05/10/2010 M PRODUCER 508.366.6161 FAX 508.366.5202 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Mackintire Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 11 West Main Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Westborough, MA 01581-1931 INSURERS AFFORDING COVERAGE NAIC# INSURED Newpro, Operating LLC INSURERA: Peerless Insurance Co. 24198 26 Cedar St. INSURER B: Woburn, MA 01801 INSURER C: INSURER 0: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR VDO' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE(mmtnnrYYi LIMITS GENERAL LIABILITY BP8588370 (MA POLICY) .12/31/2009 12/31/2010 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY BP OR 8589577 (RI POLICY) 12/31/2009 12/31/2010 OAMAGETENTED $ 300,000 CLAIMS MADE a OCCUR MED EXP(Any one person) $ 15,000 A PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE. S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICYF—j PROJECT F- LOC AUTOMOBILE LIABILITY BA H584174 12/31/2009 12/31/2010 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ 1,000,000 ALL OWNED AUTOS BODILY INJURY X SCHEDULED AUTOS (Per pe(son) - $ A X HIRED ALTOS BODILY INJURY X NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY ALTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY CU 8582578 12/31/2009 12/31/2010 EACH OCCURRENCE_ $ 5,000,000 X OCCUR ❑CLAIMS MADE AGGREGATE $ 5,000,000 A $ OEDUCTIBLE $ X RETENTION $ 10,00 $ WORKERS COMPENSATION AND WC8645074 - MA POLICY 05/01/2010 05/01/2011 WCSTAWITS I I FIR TU- OTH- EMPLOYERS'LIABILITY WC8645974 - RI POLICY 05/01/2010 05/01/2011 E.L.EACH ACCIDENT $ 500,000 A ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYE $ 500,00C . . Ryes,describe under .. .... :.. .... ... .. .... . .... .. . .. .. ...... ... .... .-.. .. SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. To Whom It May Concern AUTHORIZED REPRESENTATIVE Timothy Mo na h ACORD 25(2001/08) ©ACORD CORPORATION 1988 i I ��,r,4ti;rtlrusetts - Delmil"Ic. t Of E'ut.ilic Safety Board of [3uilcli.n;. Rc ulatiorrs �tnd Standa�-c .s cojistruction Supervisor License a '5 License: C 96093 �Mricted to: _ 1'� HOMA PEACOC . JR EEKONK;`.MA 02771 ..Expiration:. 4/8/2012 T r#: 20816 . i 1 i VA SOT'c4 `Pllti OGl JOU. O: T .w�,,,�)z)uj j uo4.uiggsV a.uo puu suollcin�02t �utpjing jo. piu.oa . :cj-1 cu aD 1-punoj jj -ojup .uoijui!.dp �lll a.c�;aq 3 .LTI..tOj p1IuA► 11014u.1-1Sl , . 0,4 Boat-d of I�nilding Rcgula�ions :anc�.St�� �Iai ;3{ ' � niE .[ p.RE3�f Eii�lT•CO �'RA��'O�c Re ' Sa:.ti�on' .146589 . -' xp:i r:at a n '5I:5/2011 Y: ' re: ::Supp{emer,t Card NEWPRO OPERATi:... L:C. TOM PEACOCK 26 CEDAR ST: .1NOBURN) MA 01801 c n`i isli at ' r! From Our Home to Yours... AA Reg#146589 Federal ID#20-2625129 CT°RL►g#0605216WLWOAU RI Reg#26463 Windows,Siding and More 1 ` 2 Corporate Headquarters,26 Cedar St,Woburn,MA,(P)800-342-2211 (F)781-933-9626,www.newpro.com THIS CONTRACT MADE THE 1 dayof q� 2010 between (Home Owners) { (Home Phone) (Bus/Cell{Phone) Of f { \ Jai �.t �% n ,I i",h t % i( i (Address) (City) (State) (Zip) the"Owner" and NEWPRO Operating, LLC, "NEWPRO". The job address is a condominium. NEWPRO hereby agrees that it will for the consideration hereinafter mentioned,furnish all labor and material necessary to install the following described work at the premises located at (Job Address) (E-Mail) for proprietary use only TOTAL Additional Model TOTAL Windows Purchased JNEWPRO Work Number Qty CASH * Window Color Out: i, Sliding Glass Door. PRICE \ �, Capping Color i )(o / Steel Security Door Door Color In: Out: DEPOSIT Model Name Model Numbers) Qty Sidelites WITH Double Hung <t New Construction Unit ORDER y0,-) Picture Window Storm Door j,, I.: t j_ {; 1 BALANCE Casement G , Obscure Glass ;, F,�,;; TOP BOTTOM DUE AT 2 Lite/3 Lite Slider Screens ((i�lALf F'LL INSTALL J IU I Bay/Bow Frame Please Initial: �NEE Roof.' Soffit: Customer understands t OO does not / CASH Garden Window LL�—'J do any painting or staining. (ie:when removing Balance paid to installer ahinstallation '+ Awning or replacing interior stops or trim) �' _!ally Hopper NEWPRO®is not responsible for conditions or Shaped circumstances beyond its control including con- FINANCE Other densation resulting from or due to pre-existing Bank completion form signed at installation GRIDS olonial, SDL Euro conditions. DESCRIBE WORK: L L t} ( r�;r t c ) J.I AI Est. Start Date: �h-) Customer understands this is an"estimated date" ®RE Est. Comp. Date: Initials Customer understands all steel security doors will have a 3/4"aluminum threshold installed over existing threshold. It shall be the obligation of NEWPRO to obtain any and all permits necessary under this agreement,as the Owner's Agent. The Owners who secure their own construction-related permits,or deal with unregistered Contractors will be excluded from the guaranty fund provisions of MGLC,142A. All Home Improvement Contractors and Subcontractors shall be registered by the Director and any inquiries about a Contractor or Subcontractor relating to a registration should be directed to: Director,Home Improvement Contractor Registration,One Ashburton PI,Rooni 1301,Boston,MA 02108,(617)727-8598. If the Owner is obtaining financing by way of a Retail Installment Sales Agreement,such Agreement shall include a time schedule of payments to be made under said contract and the amount of each payment stated in dollars,including all finance charges. The Retail Installment Sales Agreement shall be incorporated herein by reference. If the Owner is obtaining a revolving credit line to pay,in whole or in part,for the contract amount herein,the terms of the revolving line of credit including interest rate and payment terms,shall be clearly set out on the credit application. The portion of the credit application referencing a time schedule of payment,to be made under this contract,and the amount of each payment stated in dollars,including all finance charges,shall be incorporated herein by reference. - NEWPRO represents that it carries Workmen's Compensation and Public Liability Insurance in the amount:of$100,000-$300,000. If the Owner refuses to permit NEWPRO to proceed with the work herein,or in the event of any breach of the Owner of this agreement,for any reason whatsoever shall cause the owner to pay NEWPRO a sum of money equal to thirty-three and one-third percent of the price agregd to be paid,as fixed; f liquidated and ascertained damages,and not as a penalty,without further proof of'loss or damage. NEWPRO shall not be held liable in damages for delays in the performance of this contract due to causes beyond its reasonable control. Owner warrants that he is the owner of the property on which the work is to be performed or that he is otherwise authorized on behalf of the owners to enter into this agreement. This contract represents the entire agreement between Owner and NEWPRO and cannot be changed except in writing signed by both the Owner and NEWPRO. You are entitled to a copy of the Contract at the time you sign. Keep it to protect your legal rights. We, the aforesaid owners, certify that immediately after the signing of the aforesaid agreement, a copy was furnished to us. You may cancel this agreement if it has been signed by a party thereto at a place other than an address of the seller,which may be his main office, or branch thereof, provided you notify seller in writing at his main office or branch by ordinary mail posted, by telegram sent or;by delivery, not later than midnight of the third business day following the signing of this agreement. (Saturday is a legal business day). See the attached notice of cancellation form for an explanation of this right. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. ❑The owner has seen"sample"warranties that will be provided by NEWPRO upon installation. Sample warranties provided to Owner. IN WITNESS WHEREOF,th �S;paZe-hereunto signed their names this ) t day of 9 20 f t j EIN# Signed Markelirlg�2e oA tive-Printed'Name Owner Accept Operating,LLCBy Signed Owner CORPORATE OFFICE WARWICK BRANCH OFFICE 26 Cedar St Woburn,MA 01801 24 Minnesota Ave Warwick,RI 02888 (F)(P)8009 (From NE) (P)800-356-3312(From NE) '. 781-781-93333-0717 (F)401-732-1371 } WHITE: Branch Copy YELLOW: Customer's Copy PINK: File Copy GOLD: Finance Copy Us-15 U - 1 ......._.... .. -- - - -- - E3 HogCIHC i1{CN'1 -EItVATlpri 4/n:F�/d�.l-n- - 1�£A �2 FL��-AT/niJ /AL8��4�-/_.n,r ._ / SN420:J MA 0A?f-ZL1LN�SVIL7786Fi7f/ a oa�wiro rurna /Ot 3 ' k.rD I.EY LON) SOGF r7' VENT AA- TTO 1L ISN Ft L1• OVEa��"COx Pcil II -� /1 LYM G�++Tt Cf♦ SPOU+f J . I A L ?A IL6 +- ,+rAicH srolao r _ FRONT R6a CEDAR ,+ NOTRIM WrNOA.)T _'I - SIhJr7¢1x.c� Fa.oN - IK3Ixy c5oy MATCN rt AMOWra+p..OUE;2'/d'ICox Pu,, Inv 30 JI\ia lX.D" y/ �\ Ix 4..FRIEZF Y'- e�•OC •4 LV L IF RF Q, q I My)LAT 0/,j �'' O 7 ?I \ R3D GLb. R ILVz 3O'ya i3gA 211 WALLY a x y 7v P Pq A � TVC S , N i � a3aI I � aI � � dx Y slavE '+`w "L LV L__. 6WLa.ltn P�6D4 Doat ") / / Iy w at<i0y 8/fe"O!!. `Z U w. ti 7 INT. Allbs/ NEW EN x}7Ry W�E • 7/A7L EX' Lr•JT._ J C aL1�;D \ KN4z6 WAL. - . E-,-"T• CRAWL_ gr.AC45 0'I. 4E, •�r. • IN-7 LCC•A7E: Ex,ST/N Accrjf DOOR. . F12AMIN(n S TO ) /A( ��V� 1 -/'�•/ -. . WINDOW CNEOUL- J r yM G OtNt,t )71 c sova •; ;; 304 yiwx y6NT/N • Hy INS ,J 0r ,2 ' _ v_n+. ---------- 1 I IJ .-sue`—xn__-=v_-av:is � _...__..-._.-�...._-: -- ..�__--_•-__...__._... . •E itJAYIo J- 7(A%f' 'V•-...I.U•. UPIY� F•L��'AT7 D nl • p,y ;I�o�J AA"t�.�-_�.TYLu%_I;�1L..._Slik•77AE67Y . � (/�I�17L_l111�—M' ,� � oruwwcr�urern r�iD�E� cowl yorr. r, vE��r A5PHAIT ACVP Is AN'r61r oft A�".r DH'PCV i. ALVM� GUl"Ii Rey f�,UVlS J �i F2UN( Rto ctDAe :�a''trw.,- y N04el.0 P•to il' c� SNVlie2� o,)n/r OJtfL 1 x FANG/A y- 4 J 2iDGE 1 �A y j--�-- •' 1�Z�L_ ' / . . Ix 4 FRIe2b i- o wL.iG ac �I CO) /v ..G %a VY Q3u CLG. / jt 1141 3U 48 I94d a x 4 7v P PA Tc i 9Tvng j x o\ p dx%SHUE - _ 2�• i 111 T Lab G� LV L_Q�DLf OF dL u�8"s UG• (AT lyAlal11 1 L+ 107. ly, aC�x 3(o• E v�;T/NG .��=u•��-�s.�...,...,,_-n.: I a.. niiGN New iNTny W/tY•}T/NG ......._ i .. � d44.1 / KNtI vAL I i __ ......_.—__..—. ' � ....—_.._JD_0_%• �/ 1'ELI:fn9E tr.y,/Ny.' ncrEyS DGo2' ` �— . _ r.._�.___ WIND o..J jL/16DU[.[.—��,. —____,�,• ..e....rw W ... WC—) v _ �• .Gi.ty/ ��<�� ".�G_._ . F.tto,er, sl ocK A1n.�L-- � JA , L .':�&ck INSPECTION CHECKLIST Itessachusetts Energy Code MAScheck Software version 2.01 'Huskins Job 819272 'DATE: 11-2-1999 81001 e Dept.lf_ We 1 CEILINGS: 11 I 1. R-30.R-30 I Comnents/Locatlon 1 I WALLS: ( ) ) 1. Wood Frame. 16"O.C.. R-13 I Cotments/Location 1 I WINDOWS Alm GLASS DOORS: l ) 1 I. U-value: 0.35 I For windows without labeled V-values. describe features: s Pane$_Frame Type Thermal Break? I ) Yes I J No ' I Comtents/Location I , 1 SKYLIGHTS: [ ) I 1. U-value: 0.26 1 For skylight.without labeled U-valueo. describe features: 1 e Panes_Pretty Type TTsrmal Break? I ) Yee I ) No I Commont./Locetioe 1 I AIR LEAKAGE: [ ) I Joints. penetration, and all other such openings in the building I envelope that are sources of air leakage must be sealed. When 1 installed In the building envelope. recessed lighting fixtures shell meet am of the following requirements: I !. Type IC rated, manufactured with no penetrations between the I inside of the recessed fixture and ceiling cavity and sealed or I aasketed to prevent air leakage into the unconditioned space. 1 2. Type IC rated. In accordance with Standard AM E 283. with no 1 mare than 2.0 etm 10.91/ Lie) air movement from the the I conditioned apace to the tailing cavity. The lighting fixture I shall have been tested at 75'PA or 1.57 lbsift2 pressure 1- difference and shall be labeled. I I VAPOR RETARDER: f ) I Required on the warm-in-winter aide o! all non-vanted framed I ceiling.. wells, and floors. I I MATERIALS IDENTIFICATION: ( 7 I Materials and equipment must be identified so that compliance can I be determined. Manufacturer manuals for all installed heating I and cooling equipment and service water heating equipment must be I provided. Insulation R-values and glazing U-values wat be clearly I marked on the building plans or specifications. i i DUCT INSULATION: I ) i Ducts shall be insulated per Table 14.4.7.1. , I DJCT COASTRUCrION: J ) All acceee:ble Joints. seams. and connections of supply and return i ductwork located outside conditioned spate, including stud bay.or ' I joist covitiesisp....used to transport air. shall be aa.l.d i using mastic and fibrous backing tape installed eccordl ng to the I anufactursr'e installation instructions. Mesh tape may be I oeitted where gaps are lea. than in inch. Duct tape to not I permitted. The HVAC system must provide a meant for balancing I air and water systems. 1 I TEAPERATURP CCfnV S: ( 7 I Tbermostatc are required for each separate HVAC system. A manual I or automatic wane to partially restrict or shut oft the heating I and/or cooling input to each zone or floor shall be provided. 1 I HVAC EQUIPMENT SIZING: [ ) 1 ported output capacity of the heatinVcwling system is 1 not greater then 12$%of the design load as specified I In Sections 700CMR 1310 and Je.1. [ ) I SWIMMING POOLS: I All heated swimming pool.must have an on/off heater switch and J require a cover unless War 20%of the heating energy is item I non-deplatable sources. Pool pump. require a time clock. I ( ) I HVAC PIPING INSULATION: I NVAC piping conveying fluids above 130 F or chilled fluids I bat 55 P must be insulated to the following levels (in.): I I PIPE SIZES (in.) I HEATING SYSTEMS: TEMP IF) 2' RUNOU S 0-l' 1.25-2- 2.5-1" I Lw pressure/temp. 201-250 1.0 1.$ 1.5 2.0 Low temperature 220-200 0.5 1.0 1.0 1.5 1 Steam condensate any ED IA IA 2.0 1 COOLING SYSTEMS: I Chilled water or 10-55 0.5 0.5 0.75 1.0 I refrigerant below 10 1.0 1.0 1.5 1.5 I I ) I CIRCULATING HOT WATER.SYSTEMS: 1 Insulate circulating hot water pipes to the following levels (in.): 1 I PIPE SIZES It..? J NON-CIRCULATING I CIRMILATING MAINS 6 RVNOUTS I HEATED WATER TEND (FJ: RONOUTS 0-1' 1 0-1.25- 1.5-2.0- 2.0-- 1 170-180 0.5 1 1.0 1.5 2.0 J 140-160 0.5 1 0.5 1.0 1.5 I 200-110 0.5 I 0.5 0.5 1.0 1 ---NOTES TO FIELD(Building Department Use Only)------_-__----_-_---- - .... - _....... ---- .... . . The Town of Barnstable �d.ter Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Ralph Crossen Office: 508-790-6227 Building Commissiore- Fax: 508-790-6230 For office use only Permit no. Date______—. AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW _ SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not be done by dour registered dwelling contractors,isr to structures which are adjacent to such residence or building certain exceptions,along with other requirements. Type of Work: ID� f ' o Fl Est. Cost *J >�� ' ►9����� 13Ert.�nl rA�e�-vri�vr huu Sc ��s Address of Work: — �� cS Cl .S Owner's Name A Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): _Work excluded by law Job under SI,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED VE CONTRACTORS FOR APPLICABLE HOME M OR GUARANTY FUND UNDER MGLOVEMENT WORK DO O 1422AA ACCESS TO THE ARBITRATION PR SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: . D D Or ontracto 7 l < g Registration No. Date Cr Lame e4 P l ZZ' �mCp OR n—ner'S Name �. ✓/re &W11,uzarzureaN 0111l&Waellu:�eiz- EPNRTRENT PU0LT` ;NFETY I .vti"n0', TOii ;IIPEt;L!,�OR ..tN7E CS 001454 K??4i'00O ��reTOommoxuxa�e o�,/uamas/euseQd 2stric:ed To: x /-R(kN3 CAPS : I VEM HOME IMPROENT CONTRACTOR T`'` Registr�tion 100140 'E' cl; NEWTOWN R %Pe---PR-I-VATE`CORPORATION r Ez�iratiion 06T23%00 CAPIZZI HOME_IMPROVEMENT, INC _ ��as Capizzi, Sr. ADMINISTRATOR iG45 Newton Rd. Cotuit MA 02635 c- -------- -- ,/�ie -�anr�»a�uuea4/1. o/,,GCcr�::tae�ia�eCld '. DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE Number: Expires: {i :�:i• �.�- �=.. of f Restricted To: 00 4 THOMAS X CAPI2dI JR ;TLC'280 PERCIVAI DR W BARNSTABLE.�MR 02668 - -^ -- '' ✓/e '�o»r�»v�zaeal�/. n%:G �a�aJa.C(J DEPARTMENT OF PUBLIC SAFETY C W'!RUCTION SUPERVISOR LICENSE -` Number: Ezpires: Restricted To: 80 _ FR;OE Ik,L V RASC71Ii� e/y94-,"i060 BOURNE RO PLYMOUT4. MN 0?360 L f Tlie Commonwealth of Massachusetts T _ice Department of lndastrial Accidents ` --� 600 Washington Sired Boston,Mass. 02111 Workers' Comensation Insurance Affidavit ""... name: / oration: vQ - (sap � ^ city � ❑ I am a homeowner performing all work myself. ❑ I am a sole proprietor and have no one worldn in any a acity rl �G�i � r�rrrv: am an employer providing workers'compensation for my employees working on this job. eompnnv name: 0AV.4a HrmE address: Ito#S. Ateui7/dAI . ' :.,. : . .. . .. .. city: 0 nt i r �aG 3S phone•k �OX) Sl tB- 9S1 fi insurance cn. olicv# JC {D G i ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the follo«ing workers' compensation polices: company name- address, :. :;........::.:•.,•.:,..: city phone tY: .... ...... ..... Insurnnce co. .., ... eomnany name: address: dh- phone i�: ::• :.....r1surance CO. .. ollcv!! ...... ......... / / FaIIure to secure coverage as required under Section 25A of MGL 152 can lead to the Imposition of ert minal penalties of a tine up to S1.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a Me of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the OMce of Investigations of the DIA for coverage veriQntion. I do hereby c^ertiffyy under the pawns anddpp�ennalties prrjury that the information provided above is tea, sigaanutC l _- y" — Date 7T7 7 _ Print name rR O) XI CA V. RA S C H_� r i LZ� Phan 0 7artow—n: nly do not write in this area to be completed by city or town aMdal perm"Cense 0 QBuilding Department(]Lictmang Board mediate response is repairedDSdeednm's Otdce —-.❑Health Department n: phone tt; ❑Other ttrwea 9 95 PJAi TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION a �C�Z Parcel Dom SEPTIC SYSTEM MU # Health Division /%-/!e 97l;b INSTALLED IN GOMPLIUMhued t( QQ WITH TITLE 5 -Conservation Division ��� ,^ EP`�`/�1 " ;'ENIT L Cn:9 Fee�•,��1/1.60 •Tax Collector • Treasurer ✓%��-ii���. �-�' //��/���'. Planning Dept. Date Definitive Plan Approved by Planning Board Hi�tnri�OKH H annis Project Street Address _f a.5 VR I) Village Owner Address S4m� -Telephone �, O _ 4,3 qq Permit Request n/D FklR 4-Mt7iO/U 8C'Twf,CA1 �S'A-,2.4ex,6 £ X4&-A1 t�u&45 Tl1IeAf LM66 S 7A(CN J a R •P. R r S UG e ' Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Estimated Project Cost c c,MD Zoning District Flood Plain Groundwater Overlay Construction Type et)1) rJ - Lot Size Grandfathered: O Yes U4o If yes, attach supporting documentation. Cd 1 ate` Dwelling Type: Single Family Gr Two Family O Multi-Family(#units) Age of Existing Structure -2 5-30 �/RS Historic House: ❑Yes t� On Old King's Highway: ❑Yes Blo Basement Type: 3rfu'll ❑Crawl ❑W Ikout ❑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 _9( 4 Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas it O Electric ❑Other 1 . �. Central Air:' ❑Yes W° Fireplaces: Existing New Existing wood/coal stove: ❑Yes Orr Detached garage:01z4Vq O new size Pool:O existing ❑new size Barn:O existing O new size Attached garage:V,existing ❑new size Shed:O existing O new size Other: Zoning Board of Appeals Authorization O Appeal# Recorded❑ Commercial ❑Yes k1 No If yes,site plan review# Current Use Proposed Use 5cy+n� BUILDER INFORMATION Name- JZ�l t6c Telephone Number r-G 618 Address 1614S A)e111`'1*l3eii A_/ J21, License# 0-56 9a 2 S(9 M& 0"3-5 "Home Improvement Contractor# 10(i r)40 Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO , SIGNATURE DATE _ FOR OFFICIAL USE ONLY NO. 4t4 37(,t--� DATE ISSUED MAP/PARCEL NO. ADDRESS "VILLAGE J OWNER ° DATE OF INSPECTION: FOUNDATION FRAME L� ` P66 INSULATION FIREPLACE' 77 ELECTRICAL: ROUGH FINAL ' PLUMBING: s ` ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATIONTLAN NO. ,, M411-29-00 WED 05:38 PM CAPIZZI PRODUCTION FAX:5084202164 PAGE 2 M -h T 7 i� T_qj T.L i ................... M.Asch!mk :Cnf cad b y,.(;ai' :P I VO 5TATU: HUD:; 1,137 V.TcR: j. or Pamily. Detached 1'\*Pl:.: Qcho.,. mc.n_T,I cc rvi L$Tl CC4 DATE: DXTIS OF 'T'i"I'l.F.: Huskins i9b PROJF^T INK.1P.MATION: f /> �'Ind flnu.r COMPAN'i INFORMATIal: Raquirpd LIA .­ 67 Your tNom' z riZ A r C, 0Y Cavity Cont. Gjem.inq,r j PIP t ol T R--V--I I 1j P R—VO I L!9 U—V-D c;E I L,I WS 0.0 10 WALLS; wood Frri,,v-, 16" O.0 0 46 (;LA'Z,J6(;: Wi.ndows nr Doors ....-__..______.._______-_____ COMPLIANCE STATEMPIq I: ')'hp proposed building deuiclo docc.,...ibmA here is cc)nr,i:r,tejjt witil V.)I,:! t)1.jjjelinq plane, specifications. ann' ot.lvar, (:.zticnilati.uns submittnd with the, permit application. Tho propozDd bu.i1cl.ing h,)T been dt-qiqned to meet the re,76rement!3 of tho Energy Cod?. The heoting load tor thi.;F, hoOding, and the cooling ioeid if appropriaie, has beem di!t4rtilihcd w0ing Stanclard Desiym Cmiliti;,li$ fou)'id tbo C:.xla. I'liq HVAC ?6uipTn-?nt s,?1c3(:t0d t(: hq2t or n^ol the shall by no areator than 12S% of tnp desian Joad as soecifir."d ill .. . ................. I MAR-29-00 WED 05:39 PM CAPIZZ1 PRODUCTION rAX:5004202964 PAGE 4 Iat1 cavitie=Tpac-(m,- n od to trans :�l port air. shall 69 sealed using t,iastic and IibroL.a batk.ing capb Dow! atlJpidKq to the manufacturer's inct•.allatia: l:;struct:iono Meah tepa my be omitted where gapf o.re lens thoti 1%8 inch. ;)uct tape 1<; not, 1 por)nitted. 'IT10 tIVAC., system must provide a means for balancing air and w6i,?t cyst +tnS. I •(•ct•Ipxa;r,•t1!rc rrv.1?'1<ULi',: I t I -1'l+erwastats arq required for ranch sepnr<t'e HVAC s;st.em. A 1116UL10-1 or autm t.i.. me.tns to p.ar.t"liy restrict rr shut all the neating and ht' coni.int1 lnpur. to ranch zone or floor s'^all. be provi:Jad. ! i H:'AC Eq!1l`MVff 2I':;:3: oo put c,,noci.ty of the lieu ting-,cooIimg ( "t Ut`8 Wr Man la5X of the d+Agn laid ae specified ( in Sections 780CW 1310 ynd j-4 4 i ! Al! le,:•:➢t,i•<I .03 !wsr. have an wl:A(. K,a*M) switch and I +gq+,;.r,? 0 ci,v+PT +,n.l=:as over 20 e o i the otfor gy is from npn-KNehWe sourws. FaQ pump.4 r"uire a tKe clock., t ( 1 I XVAC FIFIFiC-) '.'tl.`.:ULA.'iION: I liVA(: F:ip, nr ..^r.t ?1,..ids ah;::, 129 r Or ct)1•led fluid's };A,ow :i5 'w nu.;t he insulated to the lolluwing .1ev6.1s (in. !. ' I 2' N.NClllTS 0-1' 1— -i:' ? !+-4 temp. 201-250 1.0 1. , Is 2 J i 1.ow temperature 120--200 DO 1..0 IN 1.5 I Stoaffl condensate any 1..0 .1'.0 l . 2.4 Ch.i.11sd wat»:r ;,t 40'.c,'. J.., 0.5 0.'S i.ti I r^triger,ant below ,.:) 1 1..! l.r a 5 HC)T WAT6:F S`STENS; j Iii"Me rur•uKt.i.ag hoi, water pipes io t7'g following Ievels (in.j: i F.1FS SUES (in. ) tat:)tl-CIRC:11.hTID1G i CIRCULAT`OG MA10S i.;. pt)NOUT" HEATED WAl'':F. TEMP (F) F.Utatlt,!'J'_?. a•'f" ) 0-1 .25" 1.5 (;+ l'rU-1tiU 0.5 ) 1.5 .(+ i -NOTES '11.) F0,13) (Bui ldinp Uepartmsnt Use Uii1:') .-, ---------- ------ --- --- -- ...- ... _-.. ... ... .. ----._...-........ 1 MAR-29-00 WED 05:38 PIM CAPIZZI PRODUC17ION FAX:5084202164 PAGE 3 • MkSehGck 1*0_Sp CTIOtj Fn=l-gy 07,a., MAS-'_'heck Scf tvi:!79 Ver.F im) ;l.V Hurkins "ob .119 2 CE 1.L I MOS J 1� CumwGrt L'�;/T;,c:i WALLS I. V-ood Frame. 16 C). R-I I tfomm"m C-­./t,oca tJ on ............... W It IDQW AND CLASPS PYTI.�� :1 lj-vaiup: O.35 'For wj.r,(lcws d. thout labeled U-valuq.3, dascribe featurEna: zPanar F�P.MA 'lypp h C T.ma.1 iSrezK? t 1 r es l j NO tJr)n. -_­-------------- li-VA ll:C Z 8 For sk.yliqll" withoul! label.,xI U-vAl.ue:,, describe features; ;ihermal isrea ' °trs No AIR LEAKA(.',E j Joints. penetrations. an(j .all stl:h oper-incis in the building envelope that are sources of air lziuco, fir, seal.ecl. When inctallod 'n titj�? building envelope. rqze.vstid lighting fixtures tjjc 1 1. rypE4 7(: with no penc-sr6tion3 between the ins.'tdo of thri rsr,,)."!Pd fixture and ceiling cavity and vn'tilo(l or gasketed tf:l prevent air loakago into the unconditioned space. rated. in accordance w,'ih starmiovd 4STM I' 2(a. with no MZ4 War', r1m L/70 Air movement tr,:,it) the thd :,rimfltionad space to the c9lli!10 'rhe. Li,htinq fixture shell have t,Aqn tested at 75 PA or- 2.57 dilioronco and shell he AabeI96. VAPOR RETARKER: F.eiqu.ir;Fid or, thv� side of all walla. and I MATEFIALS IDENTIFICATION: Materials and equipment must be idt,tttiflrei ,x, that compli.z.Doe can be dotormined. Manufact?jrer manuals for alt installi9d 119,atItig and cooling equipment wid wal r hcer.ing nquipment must be I providod, Insulat.i.on :k-v--.ttuPv and OiMZ.iTC U-ValUQV MUSt N! C10;n.rIV mirknd on the building plans oi- rl-JSULATTON L),­tc sha!I be .!4.4 1 CUMSTRUCTiON: Al, arcessible joints, seams. alld ,:)f stipply and return olltside condlititink;zI stud bays or MAR-29-00 WED 05:38 PM CAPIZZI PRODUCTION FAX:5064202164 PAGE 1 CAPIZZI HOME IMPROVEMENT 1645 Newtown Road, Cotuit, MA 02635 (508) 428-9518 1 (800) 262-5060 Fax: (508) 420-2164 r'AX }}Askk#R#hhRA AA#BRA}AAAA}A11AhARRAAAA RpRRRARk ARARA}AAAN##AhA AAAi AR#BA R�RR RRARRRAARRRA# FAX NUMBER: FftOM:+Y1+CNRrr�- 0'gV 1►`A! .-PRODUC ION OFFICE NUMBER OF PAGES, INCLUDING COVER SHEET; _, �'