Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0056 WHITE MOSS DRIVE
, i r 031 O�94 , n „ i 0 , � e u 8 i r , 0 tO, r a n" o ' y Q I O r n „ „ x o , n n „ m Y � „ i Town of Barnstable *Permit Regulatory Servicese 6 months rom issue LMnas Richard V.Scali,Director Building Division Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-623 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY 1( n1,ANot Valid without Red X-Press Imprint Map/parcel Number 11 "l V�Y 1 W Y�' Property Address (P Ld ozc I1115S l,-,)2 4 M jjf2-S j bbf ff Alit esidential Value of Work$ ` 041 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Contractor's Name 1 4L ?4W1V' Telephone Number 37" (6%3 Home Improvement Contractor License#(if applicable) N q?S Z- Email: Construction Supervisor's License#(if applicable) om orkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ Larn the Homeowner I have Worker's Compensation Insurance Insurance Company Name C C�-rl► ()N 1D�`W$T Z-X �� Workman's Comp.Policy# U 17 - 9 S-7 7 69 — ( f W %jY(17 Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑, ,�roof(hurricane nailed)(not stripping. Going over existing layers of roof) L\.I Ke-side EDAeplacement Windows/doors/sliders.U-Value 32 (maximum.32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: QAWPFILESTORMS\building permit forms\EXPRESS.doc 06/20/16 f RANNEY + PO Box 816 TIRININGTON Marstons Mills,MA 02648 Tel 508.428.7147 info@thecapecodcarpenters.com Fax 508.428.7167 RENOVATIONS•ADDITIONS•CUSTOM HOMES TheCapeCodCarpentersxom October 25, 2016 ESTIMATE Site: 56 White Moss Drive, Marstons Mills; Janice Kinder& James Crockett; 508-274-8760; 508-428-7822; jan.ce.kjn.der@comcast,,net Remove and replace cedar shingle siding on back& right of house, including right side of back dormer and on back of g4rage, covering approximately 750 sf Work to include: • File for building permit including inspections .........................................................$ 150.00 • Supply dumpster for construction waste removal ................................................... $ 500.00 • Set up staging ............................................................................ ....... ...... $ 250.00 • Remove existing siding; dispose of waste; install clear white cedar squared& rebutted shingles siding using stainless nails including Tyvek waterproofing, approx. 750 square feet; ......................... $ 7,000.00 TOTAL LABOR & MATERIALS $7,900.00 Initial deposit requested to schedule work $ 3;950.00✓ Due upon completion $ 3,950.00 Please noW our standard contract: f • This estimate is valid for 30 days. No additional wok is included in this estimate unless described in writing. • Deposits and payments are not refundable unless otherwise noted. Contractor is not responsible for any damage to lawn or plantings around demolition area. • Contractor is not responsible for any damage to interior furnishings that may need to be moved to complete work. All construction waste and replaced items(including windows,doors&appliances)will be considered disposable unless other indicated by property owner. • Property owner is responsible for all costs associated with hazardous materiels,lead,mercury storm water pollution discharge or costs associated with American Disabilities Act requirements if necessary. • Any repair,moving or installation of alarm system is the responsibility of the property owner. • Customer is to supply all paint if any is being used(unless otherwise specified) • Property Owner agrees that Ranney&Rimington Custom Builders may display a small sign on the property during the duration of the wok and one month after completion. • Property Owner is responsible for any and all engineering,site plan.Conservation,Zoning,and/or Historical costs necessary in association with obtaining any necessary permits unless otherwise noted. 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 Place,Pm 1301,Boston,MA 02108 • The property owner has three-day cancellation rights of this contract under M.G.L.c.93,48;M.G.L c.140D,10 or M.G.L.c.255D,14 as applicable.After 3 days all deposit and special order payments are non- refundable. • All warranties and property owner's rights are under the provisions of 780 CMR 110.6 and M.G.L.c.142A Any alteration or deviation from above specifications involving extra costs will become an extra charge over and above the estimate at$75.00 per hour plus materials. if cost of materials and labor changes,this estimate may increase no more than 15% • It is the obligation of the home improvement contractor to obtain any and all necessary construction-related permits;in the event that the property owner secures their own construction-related permits or deals with unregistered contractors they will be excluded from the guaranty fund provisions of M.G.L.c.142A. Work will begin no later than six months from the issuance of any necessary permits and will be completed no later than two years from the issuance of necessary permits. • Property Owner's failure to make payments for wok duly performed may result in a lien against the homeowner's property.Owner is responsible for any legal fees and court costs Ranney At Rimington may incur to collect the monies due on this estimate.The contractor and the property owner hereby mutually agree in advance that in the event the contractor has a dispute concerning this estimate,the contractor may submit such dispute to a private arbitration service which has been approved by the secretary of the office of consumer affairs and business regulations and the consumer shall be required t9 submit to such arbitration as provided in M.G.L.e.142A. DO NOT SIGN THIS CONTRACT IF YOU HAVE NOT READ IT OR IF THERE ARE ANY BLANK SPACES Y � 10/25/16 for Ranney&Rimington Custom Builders Date (jope�ywner Date Home Improvement Contractor Registration#144752 GX .l *a I R HAW RANNEY+RIMINGTON CUSTOM BUILDERS Proud Member of National Association of Home Builders•Home Builders Association of Massachusetts•Home Builders&Remodelers Association of Cape Cod•Better Business Bureau I �e�Cnnz�rra{zryeal/�a.G%G�aJ:r(c�rrJpl�3 Office of Consurner Affairs Business Regulation g� HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only - 8 .Type: LLC before the expiration date. R found return to: t`;>Regisfration iration Office of Consumer Affairs and Business Regulation 7.52 11/01/2018 10 Park Plaza-Suite 51T0 Boston,MA 02116 Ranney+Rimi-'g09,511 Building, LLC ? Alexander Ran 157 Thankful Laie..Y Cotuft,MA 02635`r :` Undersecretary Not valid without signature CERTIFICATE OF LIABILITY INSURANCE DATE(NIMl12ni fi M. FICATE 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 IMPORTANT:if the certificate holder Is an ADDITIONAL INSURED,the pollcy(ies)must be endorsed. if SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require and endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsements. PRODUCER CONTACT NAME: ROGERS 8L GRAY INS AGCY PHONE FAX 434 RTE 134 (A/C,No,Ext): (AIC,No): E-MAIL SOUTH DENNIS,MA 02660 ADDRESS: 2342X INSURER(S)AFFORDING COVERAGE NAIC III INSURED INSURER A. HARTFORD UNDERWRITERS INSURANCE COMPANY RANNEY&RIMINGTON CUSTOM BUILDING LLC INSURER B: INSURER C: INSURER D: PO BOX 816 INSURERE: iMARSTONS MILLS,MA 02648 INSURER F: ' COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: HIS 13 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH R€9PECT TO WHICH THIS CERTIFICATE MAy BE 13SUE0 OR MAY PERTAIN.THE IN 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. WSR ADD SUB POLICY EFF DATE POLICY EXP DATE LTR TYPE OF INSURANCE L R POLICY NUMBER (MMIDDIYYYY) (MMWDIYYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ CLAIMS MADE OCCUR. REMISES(Ea occurrence) ED EXP(Anyone person) $ ERSONAL 8 ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: ENERAL AGGREGATE $ POLICY PROJECT❑LOC RODUCTS-COMPIOP AGG $ AUTOMOBILE LIABILITY COMBINED SINGLE $ ANY AUTO LIMIT(Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Per person) HIREDAUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) UMBRELLA LIAS OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ A WORKERS COMPENSATION AND X NC STATUTORY OTHER EMPLOYERS LIABILITY Y/N UB-9F857789-16 08/06/2016 08/06=17 LIMITS ANY PROPERITOR/PARTNERIEXECUTIVE y� OFFICEWMEMBER EXCLUDED? N/A E.L.EACH ACCIDENT $ 100,000 (Mandatary In NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describeDESCRIPTION OF OPERATIONS below under DESCRIPTIONE.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIRESTMCTIONS/SPECIAL ITEMS THIS REPLACES ANY PRIOR C13RTMCATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE THE INSUREDS MA WORKERS COMPENSATIOMPOLICY AND TIS LIMITED OTHER STATES ENDORSEMENT AUTHORIZES THE PAYMENT OF BENEFITS FOR CLAIMS MADE BY THE TNSURED'S MA EMPLOYEES IN STATES OTHER THAN MA NO AUTHORIZATION IS GIVEN TO PAY CLAIMS FOR BENEFITS IN STATES OTHER THAN MAW THE INSURED HIRES,OR HAS HIRED EMPLOYEES OUTSIDE OF MA THIS POIJCY DOES NOT PROVIDE COVERAGE FOR ANY STATE OTHER THAN MA. 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 PROVISIO".,ice AUTHORIZED REPRESENTATIVE � J ACORD 25(2010105) The ACORD name.and logo are registered marks of ACORD 1988-2010 ACORD CORPIONATIM A11W§fits reserved. Massachusetts Department of Public Safety ' Board of Building Regulations and Standards License: CS-088595 Construction Supervisor ALEXANDER M RANNEY 239 SCUDDER AVENUE HYANNIS MA 02601 r CA— Expiration: Commissioner 04/16/2018 Construction Supervisor Restricted to: Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(991 cubic meters)of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code Is cause for revocation of this license. DPS Licensing information visit: WWW.MASS.GOV/DPs a s TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION : O l5 Ct 1 (f Map Parcel b� Application # Health Division Date Issued b_3 Conservation Division Application Fee` Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/Hyannis Project Street Address t Village ✓'C ic O°, S - Owner JQt 1-" of i— Oc &,e Address Telephone �Q a Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new `Zoning District Flood Plain Groundwater Overlay Project Valuation L Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) o -- � ti Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's H ttay- El Ps Wlo Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other `?A Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) w Number of Baths: Full: existing new Half: existing new� � ' w Number of Bedrooms: existing _new cao v r„ Total Room Count (not including bath:3): existing- new First Floor Room Count .................... Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Stied: ❑ 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 !' �Tdephone,Number J t Address &--- T L-ic_ense# 4Z, 144f-Home.Improvement.Contractor#--/ � Worker's Compensation #47,f % r3 -D/- 6)-3 ALLCONSTRUCTION DEBRIS RESULTING;FROM THIS PROJECT_WILLBE TAKEN TO fir- �//a'!�i°� SI_GNATURE ~DATE�� --5, —y. !fit FOR OFFICIAL USE ONLY APPLICATION"# " DATE ISSUED MAP/PARCEL NO.- ADDRESS VILLAGE OWNER • DATE OF INSPECTION: r. .. FOUNDATION., FRAME r f INSULATION 'r c . FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL - GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT 1 ASSOCIATION PLAN NO. ' t y The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington,street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): �IUC� t��i AX-1 Address: Pt,) City/State/Zip: PS �/ �' !j ^ Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4.%o 1 am a general contractor and I' 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. Ej Remodeling ship and have no employees These sub-contractors have g. Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp.insurance comp.insurance.# required.] 5. We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees.[No workers' 13.❑Other comp.insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'corrrpensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors roust submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. / 11"'44KI1,61 Insurance Company Name: /v e� , Policy#or Self-ins.Lic.#: �f�� I�3 Expiration Date: L Job Site Address: City/State/Zip: 6 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date), Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA fo ' surance coverage veri atio . I do hereby certify er e n and pen f er' a information provided abov is tru and correct. Si nature: _._- _-..._-- Date: Phone#: ! 2 -- Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Boa»d of health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: MAY-7-2013, 04:40 FROM:MRHONEY 7815458974 TO:17746786008 P.1/2 8203e8 AC RO O• ` CERTIFICATE OF LIABILITY INSURANCE 0ai:s°oi�'' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER,THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEpp77VELY AMEND EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. OR PRODUCER,AND THE CERTIFICATE HOLDER, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTgAC7 BETWEEN THE ISSUING IN$URER(S),AUTHORIZED REPRESENTATIVE IMPORTANT:11 the o01MRICete hpldEr Is an ADDITIONAL INSURED,the Pollcy(lee)must tat+endorsed-If SUBROGATION IS WAIVFD,sub)eet to the Imme end conditlone Of the POIIOY,Certain Pollcles may retlulre an ende,smnant. A statement on thb derURPyte dove not adnfer r{ghts to Old cgrllflrale holder c Ilqu of auoh a do+eertlerrns PRODUCER CONTACT NAME: Applied Riak =nmrance gerviCes, Xna, PHONC - FA 1.0825 OldWil Rd (Arc,No,.Ed). (877)234-4420 (1.%.No)• (877)234-4421 o,ttaba, w 68154 E-MAIL ADDRESS: PR(10UCER (877)134-4420 CUSTOMFR100 INSURER(S)AFFORDINO COVERAGE NAIL• INGURCO iLb= 0►' >3rothere Casststl,etion,• lw. 1N3Uf46HA: CQntinentrl snacalnity Co. 28358 l dba 1'T - hOmIly M;Othem C=Mt Cucbim. INSURER 8; 44 Allen pl INSURER C; Scituara, VIA 02066-1302 INSURER D; -- CTL 1273 727210 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS 18 TO CCRTIFY THAT THE POLICIES OFF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PEFIOD INDICATED. NOTWITHSTANrnNG ANY REOUincmENT,TERM OR CONDITION OF ANY CONTnACT OR OTIICR DOCUMIiNT WITI{RESPECT TO WNICH 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 SEEN REDUCED BY PAID CLAIMS. N-a ADOI.$UPR POLICY EFF POLICY EXP LTR HOP INSURANCE INBR WVD POLICY NUMBER MMIO YY LIMITS GENERAL WIBILRY COMMERCVIL GENERAL LIABILITY EACH OCCURRENCE Ll El DAMAGE TO RENTED CLAIMS rREMISES oaaulmwo $ MADE OCCUq MED EXP Ww ano -1`114 NA A ADV INJURY $ GEN'LAGGREGATE LUIIITAPPUES PER; GENtcRALAQQREQATE s - PRooLim-COMPIOr`ACO $ POLICY PROJECT 1.00 AUTOMOBILE LIA0IUTY ❑ANYAUYO COMBINED 810LE LIMIT «e.;del0 ALL OWNED AUTOS BODILY INJURY ow nan SCHEDULEDAUTOSI MILY INJURY KcWwl i HIRED AUTOS PROPERTY DAMAGE A NON-OWNED AUTOS $ S UMBRELLA LIARJ OCCUR + t JLCM CCOURRENCE EXCESS LIAR CLAIMS-MADE �" ❑ AOOREOATE $ DEDUCTIBLE RETENTION $ wookcR8 COMPENSATION jr JWC STATIC" p AND EMPLOYERS'UAaIUTY Y/FTO .LIMA �CUTIVE(OFFICER ME I8HR N/A ❑ 2 ACN A�{DENT $ 10 0 0 0 0 611CLU,ED? CCC-���...III 6-B37537-01-03 (Mandatory In NH) E-LDISEASE-FAEMPLOYEE $ 100,000 If yes desanps under SPECIAL PROVISIONS bmi" E.L DISEASf_'•POLICY LeaT $ 5 0 D 000. DEMAIPTION OF OPERATIONS/LOCArONS/VBHICLCS(Adeah Apgre 101,Addltlonal RemarW 8ch9ft%II mono apace to mqulmd) CFA IFICATE HOLD15A CANCELLATION 1= Oa18tl't UOQ, mC. SHOULD ANY OF YHEASOVE De5CRWZD POLICIES BE CANCELLED BEFORE THE 44 AUm 81 O-XPIRA71ON DATE THEREOF.NO'nCE WILL BE DELIVERED 1N ACCORDANCE WITN &Atuatts, OR 02066-3302 THE POLICY PROVISIONS. AUTHORIZED RHPRPSHNfATIVE At txL7 PL�Dj6CC DmmapA>~ e 17837,1,8 AC046 a This ACORD narns and logo am regleterad auks of ACORO 01988 Z008 ACORD CORPORATION Aq rlgtgs raRYod i �lze License or registration valid for.individul use only Office of Consumer Affairs&Business Regulation - before the expiration date. If found return to: OME iMPROVF�VIENT CONTRACTOR Office of Consumer Affairs and Business Regulation Registration�aW�88 Type: 10 Park Plaza-Suite 5170 P!f? ? 13 Supplement C d Boston,MA 02116 FH:kiC ROBERT ABBO'ft ";;i'�".t"�` 136 TURNPIKE Rd-$W`QQ. SOUTH BOROUGH,`Nf c"Q�p 2 Not v d withois ignat e Undersecretary i i t f { �.7-2013 04:41 FROM:MAHONEY 7815458974 TO:17746786008 P.2/2 g y i 21amrrnrtrreuietrc�.l�i,n,��(laaar�ca�var 0 r of Consumer Affairs&Busifiess Rogulatio i OME PROVEMENT CONTRACTO j ogietra n. .1.09304 Type: pirstfon.-• /y�p/2p.14. lndivldual JAMES MAHONEY JAMES MAHONEY SCITUATE A 02066 Under • eU,ry i Massachusetts-Department of Public Safety Board of Building Regulations and Standards Con,,tructiUp SuPcn iwr- L-icense:LI."49242 JAMBS D MAJ16P1EY;'-- 44 N Z Scituste MA�r2 " i !. O ,Lw . f`'ts►�� Expiration Commissioner 02f0712014 Ie ?37b- YHwy. � �bbW71 e • OA I e e t �i 0-1 `Use- I . I STORE COPY INSTALLATION SERVICES CUSTOMER CONTRACT TOVIN OF BARNSTABLE € LOWE'S OF WAREHAM, MA, STORE#2376 STORE PHONE: (77 - 900 2421 CRANBERRY HWY, STE. 100 SALESPERSON: _ f : 59 AREHAM, MA 02571-0000 SALESPERSON ID: 1219649 Document Print Date p3/27/2013 This is only a Quote for the merchandise and services printed below. This becomes an agreement upon payment and issuance ora Lowe's receipt, upon which the entire agreement, including the specifically completed pages of this document,the Terms and Conditions included with this document,the applicable portion(s)of Lowe's receipt,and any other addenda or attachments hereto,shall be referred to herein as this"Contract."PLEASE READ THIS ENTIRE DOCUMENT,INCLUDING THE"TERMS AND CONDITIONS."BEFORE SIGNING. Lowe's Registration or Contractor License Number/Lowe's Contractor Name Lowe's Home Centers, Inc.'s MA HIC NO.: 148688 Lowe's Home Centers, Inc.'s FEIN:56-0748358 Customer Name Home Phone SOLD JAMES CROCKETT 508-246-1963 Customer Address Other Phone TO 56 WHITE MOSS DR City State/Province Zip/Postal Code MARSTONS MILLS MA 02648 i PROJECT SUMMARY Category Comments/Scope of Work Amount Addendum Reference Barcode PROJECT SELLING Granite Countertop- Fabricated by $ 1663.85 376625733 - CAB/C-TOP Discover Marble&Granite INST. - JAMES' BATH 'ALL NEW WALL PLATES, 376630840 - FIN. ELECT. PROJECT SELLING SWITCHES, AND GFCI'S ARE TO BE $ 1231.94 INST. - JAMES' BATH BISQUE COLOR' PROJECT SELLING No Comments $ 1948.30 376632439 - FIN. PLUMB. INST. - JAMES' BATH PROJECT SELLING No Comments $ 1019.97 376626364 - FLOORING INST. - JAMES' BATH PROJECT SELLING No Comments $ 1897.67 374241613 - GEN.SERV. Store 2376 Project Summary for JAMES CROCKETT Page 1 of 7 STORE COPY INST. - JAME'S BATH Includes removal of wall paper border; Priming & painting closet back wall and 376631834 - PAINT/MILL. PROJECT SELLING walls,ceiling, trim in bathroom; Both $ 1119.30 INST. - JAMES' BATH sides of new door; Client to supply all primer and paint PROJECT SELLING Move outlet and new GFI $ 600.30 376631339 - RO. ELECT. INST. - JAMES BATH PROJECT SELLING No Comments $ 900.45 376632606 - RO. PLUMB. INT. - JAMES BATH Materials Price $ 2722.8 Note: Please see Contract Addenda for a more detailed merchandise and installation description. Labor Charges $ 7658.93 Detail Deduction -$ 0.01 PHOTO RELEASE: Customer grants to Lowe's and Lowe's employees the right to take photographs of all work performed at the Premisis related to this Con- tract, and irrevocably grants to Lowe's all right, title and interest in and to the photographs for use in all markets and media, worldwide, in perpetuity. Customer authorizes Lowe's to copyright, use and publish the photographs in print and/or electronically, and agrees that Lowe's may use such photographs for any lawful purpose, including, but not limited to, marketing, advertising, publicity, illustration, training and Web content. By initialing here, Customer agrees to the forego- ing. [Customer to initial to the left]. Additional Specifications: Federal law requires Lowe's to provide you with the pamphlet Renovate Right: Important Lead Hazard Information for Families, Child Care Providers and Schools. By signing this Contract, Customer acknowledges having received a copy of this pamphlet before work began informing Customer of the potential risk of the lead hazard exposure from renovation activity to be performed in Customer's dwelling unit. TOTAL CHARGES OF ALL MERCHANDISE AND SERVICES where applicable SUB-TOTAL $10381.7 *TAX $ 0.0 DELIVERY $ 65.0 ORDER TOTAL $ 10446.7 BALANCE DUE Store 2376 Project Summary for JAMES CROCKETT Page 2 of 7 STOROPY 74 ff Work is to commence upon res nay a availia ilt f Contractor and/or any special order or custom made Good(s)which is anticipated to be [fill in date].Es- timated completion date is� A, date]. Said estimated substantial completion date is not of the essence. A statement of any contingencies that would materially change said estimated substantial completion date is as fol- lows: (if applicable,insert a statement of such contingencies). NOTICE TO CUSTOMER All items listed in this contract and specification sheet(s)are to be installed under conditions agreed upon at time of purchase and at the price appearing on this contract form.This assumes sound ex- isting substructures,superstructure and points of attachments. Extra labor or material incident to installation necessitated by defective substructures,superstructure,points of attachment,or the moving of fixtures or appliances to be billed at extra cost to customer. IF THE CONTRACT TOTAL IS$1 000 00 OR LESS Customer must paa, in n full COMPLETE THIS SECTION ONLY WHEN THE CONTRACT TOTAL EXCEEDS$1,000.00: Customer to Pay in Full;OR L]Customer to use the following payment schedule: (1)Deposit$ to be paid upon signing contract. Deposit should be 1/3 the total contract price;and (2)Payment of$ to be paid anytime after this Contract is signed and before commencement of installation,I/We authorize Lowe's to do one of the following(check appropriate box be- low): L]Charge my/our credit card for the amount of the payment indicated above anytime after the date this Contract is signed;or [�Deposit my/our check for the amount of the payment indicated above anytime after the date this Contract is signed;and (3)Final payment of$100.00 to be paid upon completion of the installation and both parties'satisfaction. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES AND UNTIL YOU HAVE READ THE TERMS AND CONDITIONS CONTAINED IN THIS CONTRACT AND WHICH FOLLOW THE SIGNATURE PAGE(s).BY SIGNING BELOW,YOU ARE ACKNOWLEDGING THAT YOU HAVE READ,UNDERSTAND AND AGREE TO THE TERMS AND CONDITIONS SET FORTH IN THIS CONTRACT.YOU ARE ENTITLED TO A COPY OF THIS CONTRACT AT THE TIME OF SIGNATURE. NOTICE REGARDING ARBITRATION AGREEMENT FOR CLAIMS COVERED BY M G L c 142A f LOWE'S.AND OWNER H,E�REBY MUTUALLY/AGREE IN ADVANCE THAT IN THE EVENT LOWE'S HAS A DISPUTE CONCERNING THIS CONTRACT, THAT LOWE'S MAY SUBMIT SUCH DIS- PUTE T(ZrA PRIVATE ARBITRATION SERVICE WHICH HAS BEEN APPROVED BY THE SECRETARY OF THE EXECUTIVE OFFICE OF CONSUMER AFFAIRS AND BUSINESS REGULATIONS AND THE OWNER SHALI�,BE REQUI ED TO SUBMIT TO SUCH ARB RATIO S PROVIDED IN M.G.L.c.142A. \ ` By: Date: tee' i Date: O n r7 f Store 2376 Project Summary for JAMES CROCKETT Page 3 of 7 STORE COPY By: Date: Co-Owner or Witness ,• 9 � THE SIGNATURES OF T FePAR, IES ABOVE APPLY ONLY TO THE AGREEMENT OF THE PARTIES TO ALTERNATIVE DISPUTE SOL O INITIATED BY OWE'S PURSUANT T c.142A,THE OWNER X'Y BE/P ITPf D TO INITIATE AL ERNA VE D R aQkUIIQN EVtN WHERE THE SECTIONABOVE S NOT SEPERATELY SIGNED BY THE PARTIES. le WITNESS OUR'HAND(S)a 'tl SEAL-(Sj BELOW THIS DAY OF Lowe's.,Ho ee Cente/rs„Inc: j (Seal) >Owne (Seal) Print Name Mtn 6�l/ �►Print Name. Address: 9 `-!7 �-4A .S ���t4,( Co-Owner or Witness: (Seal) CITYP4�6c qt State!' '4— Zipa?Vt Print Name: Customer acknowledges receipt of a true copy which was completely filled in prior to Customer's execution hereof.You the customer may cancel this transaction at any time prior to midnight on the third business day after the date of this transaction.See the attached Notice of Right to Cancel for an explanation of this right. Store 2376 Project Summary for JAMES CROCKETT Page 4 of 7 — 992 z Fi, 53" 264"— 1 19 -/ 4" 16"— 508" 184"— 148' � CD � =1� - N _ \` ..m . . i o 00 Y , w 21 4 i N J' 4 N) O = 'la do OD N 00 CIO M i EP tv NJ TRIM AND INSTALL 2 - (WBEP) 444" 20.0 , ON BACK-SIDE WALLS OF 4 TRASH AREA TO CLEAT 16" 18" 33z" A -31" V TOP AND FINISH OFF. 'MAKE SURE FINISH EDGE '-174"- - 474 """` " FACES OUTWARD.` 34" 657" JANICE'S BATHROOM All dimensions-size designations given are This is an original design-and must not be Designed: 3/22/2013 subject to verification on job site and released or copied unless applicable fee Printed: 3/22/2013 adjustment to fit job conditions. has been paid or job order placed. 3� 7Crockettbath.kit All Drawing#: 1 AMR 1p IIIH Note:This drawing is an artistic Designed: 3/22/2013 interpretation of the general appearance of Printed: 3/22/2013 the design. It is not meant to be an exact . rendition. f1� 2\k3 3 7Crockettbath.kit An Drawine#: ] 934 3" 384 V 37 4 11 17 2" - 1 1-2"- —36"-- 448,E O O I diW - = UF3 (: .7 NCN cal --'------' ' TOILET-1 0)�r 1 .' 841 AS VSDB3634-HL I = _ ! !N O coA 3T' ! �!N 0) / M M / �p tWMWMWM_ NZ i 00 p 6OR KBATH A!w O 0 co _ ...:..:::..:. . ;,..: 29,-6' 29,-6' 348" JAMES BATHROOM 588" All dimensions_size designations given are This is'an original design and must not be Designed: 3/22/2013 subject to verification on job site and released or copied unless applicable fee Printed: 3/22/2013 adjustment to fit job conditions. has been paid or job order placed. 7 7Crockettbath2-kit All Drawine#: 1 o ' o 0 o 0 0 Note:This drawing is an artistic Designed: 3/22/2013 interpretation of the general appearance of Printed: 3/22/2013 the design. It is not meant to be an exact rendition. ,N3 31 7Crockettbath2.kit All Drawing#: 1 i pF11HE Tp Town of Barnstable *Permit# p Expires 6 months from issue.da e ~' Regulatory Services Fee' BARNSTABM MASS 9cb , ; � Thomas F.Geiler,Director AtfD PAA�A . Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 I www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY INot Valid without Red Y Press Imprint Map/parcel Number Property Address r Di 5 ( , L ❑Residential Value of Work 07%,�:7t2 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address _ 1 a W.,.- Contractor's Name ,l1LU_ t, rv.n Lrr,�t;t�yy�z;� Telephone Number _1509-5157' F7757 Home Improvement Contractor License#(if applicable) 110O 5SS? Construction Supervisor's License#(if applicable) 5- 7 ❑Workman's Compensation Insurance X PRESS PERMIT Check one: NOV 2 0 2�12 El am a sole proprietor ❑ I am the Homeowner N I have Worker's Compensation Insurance TOWN OF BARiVSTABLE Insurance Company Name /U(a�; Workman's Comp. Policy# W COS 97 R 2 0 Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof.(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side #of doors Q Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows *Where required: Issuance of this permit does not exempt compliance with otlier town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: C:\Users\decollik\AppData\Local\Microsoft\Wuidows\Temporary Internet Files\Content.Outlook\DDV87AAZ\EXPRESS.doc . Revised 072110 f f 7—sac huset& t DIwime wof iiar�a�����,4c;tae��a�s Office Of Invesfig MIMS 600 PYsIii�3 gar:5 . iat Iat JM. os € .ei . 11),17 Are �Gu as empia Check th appi6priate b " a .❑. s a € With4.: I am ctt aid T offfi } ❑ I a WIe Propfietor Of.. er - iste the aftcbiiidsheet. i 0 Rem odd m :a c ha .me ia? Y se ra. eontractr_rw have . ❑I ea fx� t1,1011ung.for Me* asp any c sit t. . e rta3` �an6.have.�V,,sagas' as ss eri p.iEa E�sre cam.iEs �e ET aefdi€i t sae _ ❑ �e Em a earpmatim and its 10_❑Elm-trice€repE: ad nts s ;.❑ a a homeowue.r& � cfficei:�ha.,e ex sa1j th&r �� ❑Pitsg rep.aim r�acsas:. _ asr Ys i rig #of exeMPMm- p ❑RY3ca�.aars . empl uyees. o%,xkets' 113 0 Winer -::*Azv-&qPhEsnk tEia3,ehes°3osF EtEasi aloe fIl £!3�stogy Eie4ac �}s,ui��Y �usets'eompet4s policy £Q4 Ct S.iIIb17TFi S 3 3d'H.C3L 3Ilf L8LFB lt[f�F84ea�i.; : - g .ate doing s�[was .ez7a 3t a7 2 u'322tTi�Yr;tY t5Rst.s¢�iK s 3iFLt affidasEi iuffi—,stiMg i t.Fl.°awl stars£fis : C the 3sox>rst stis� sm sddilisrea€. tm �tFsv t£� �ziir c as tFatw*s and sta3rhaL OF:n7t EFZo 2�SFrss.� 9 5^ :3€t3 suFl-eun a s 9sv �g%+ads,3Fiea n rc'�tayside heir Wakm,v5MI, icy'"Umber. t$�Yxa ts'Protiding»u�giSRrs''r.�r ��s�rtz�tx��zs�a�rtsrx��a�.Y Ott*�rYap�rt�z�r� I3e :F�F�i� � }ft sty �g✓=,,�ns ��Cs �/lA Q2byfS Much c copy o€the Comgeitsatia$p�Iary deck ration page€shen-ing ate i 3'tF ua era Y Bpi r tmtc a gar€to secure cown.pa%required un t•Secifim"25A of-MGL c.. 152 lead to,ffie eitso:i of CramsraQl e�ttf a �� :i well 1s rivii paialfics�a the f ofg!S'OP IVORA RDE-It i,ed a of up �2� .ti . .fi y'agaEM€:. Y © gar_ .Be sni t Ehat a.Culp esf thi:_,staltmieat s ded to the.office IRx-esfigat€s cif die.M far, si c cm-erase vffif irahou. dm 283PE° Lsi"tF �'nil dor the � �:x m.,0s.a,�Pga fEtr�'�Fntat t3Y�prE�vr�sExr�t�an��As��e�g���a��'i�.��a�•u�ar���rr�r�'' tore: tsar _.: wso ply.P saz r t�EaE; #�az eraa t?Ya �E�`. - � -ow to"waE G1t .®€ i :.... :. Pit/7se K Issuing Auihc ,.(circ e,au:): . LP6.aA of Realms 2;: €rung:Department 3.Cats$"tt x 1•.&, �.��etti�Eti.�i t�� �.�ht���g Met set° C40,tact Peso: hoses 9.- 6 The ion--Monwear',k Of��assachusetts Department of Industrial Accidents Qj'T'ee of Investigations 600 WashingXt it street Boston;iv4 02111 �• tvwr.ras gjokem ov�da' pensationInsuranceA'fidav!t:BuUde_s/C-ontractors/Electrieiea Pnsr/iPnitu Im,eb e'brlsA licant Infformation mB sPlea�fa ( usinesslorganization/individuai): Addr Itate/Zss: - _ f City/S � iP•A41o.&.,...r��,r ' Are yo,, an employer?Che6 the appropriate box.: 1•❑ I am a employer with 4. !_— 1 am a�e;;erai ! Type of project(required): employee (full and/or part-time).* b contractor and i ! 2 l a sole proprietor orhave hired the sub-contractors i 6- ❑New construction shi and have no employees partner- listed on the attache;sheet.t ; ?- ❑Remodeling wo kin These sub-contractors have ?g for me in any capacit y. workers'comp.insurance. i 8" El Demolition [N o workers COMP- re trod j Insurance 5• ❑ We are a core°ration and its j�(! 9. ❑Building addition 3 ❑ ' a homeowner doing all work right Of have exercised their I j 10.0 Electrical r` I epairs or additions myself[No workers'comp, gl:of exemption per MGL i 1 l.�Plumbing repairs or additions Msi ncc required.]t °2, ' 4A% and we have no i j i2.j�goof repairs erreloyees.LNo workers' *Any apptic�rtt that the cOmP iPSL"ance required] '3�Other checks box t must atso fill out the section beaow showing the;workers compensaCon ' f Homeowner who submit this affidavit¢tdipti --------- 'Cont. ractors that check this box must u'they are doingall. Policy information work zrc tie.^.hire outside contractors must submit a new affidavit indicating such, attached as additional sheet showing the name ofe sub-contractors and their workers' I am an a plover drat is proWdin x'or?rers'compensator,insurar-ce for ; w�rplo,e gyp'Policy information informal g } es. Below is o the p 'and_ob site Insurance Company Name: Policy#or Self-ins.Lie. Job Site Address: Expiration Date: Attach a copy of the workers'compensation o'tic dec[arati :City/Sate/Zip: t I5 A OkY p Y on page is€:o.r.ng the policy number and expiration date}. Failure to secure coverage as required under Section 25 a ° �rCI, fine up to$II,500.00 and/or one-year imprisonment,as yell as civil entities in the c.I5?,can lead to he mposition of criminal penalties of a of up to$250.00 a day against the violator- Be advised that a c°. + a O1P1 of a STOP WORK ORDER and a fine Investigations of the DLg f ?Y Of'-his Stat.,ment may be forwarded to the Office of or insurance coverage verification. I do hereby certe under the pants and pe�;es ofPe'I✓ry Mat the infor nation provided above is true and correct r, ilate: Phone#: t;r, � �� �>-7 5— OfftcZal i e or:1y. Do not write it this area,to be conipieted by cu+,or torn offciaL City or Town: Issuing I ?ermit/f,icense?r g Authority(circle one}: 1.Board of Health 2.Building Department 3.Ci ji own Clem .Electrical rsaector S.PiumbirtgInspector' 6.Other Contact Berson: Phone r: i _= Office of Consumer Affairs&c Business Regulation r 1 License or registration valid for individul use only 1OME IMPROVEMFNT CONTRACTOR I before the expiration date. If found return to: I �* f Office of Consumer Affairs and Business Regulation Registration:a1.18588 Type 10 Park Plaza-Suite 5170 ZExpiration: 10/ 812013 Supplement'aid Boston,MA 02116 LOWE'S HOMES,CENTERS IN-' '` AMBER DRAHT { ' 4, ,. . "; C?' tdt_ , 136 TURNPIKE RD:SUITEJ00;/ SOUTH BOROUGH,IV-K 1772 Undersecretary of alid without signature v ' ' a Offrce.of r� is oa�zTruT /��r �� � 4s zt, nsumc Afrii K d "t� ° ��-,�. rYIEIMPROVEMEIV7 � 4 .,, �e .'`. ;�^ .a.. +' �VRYk �istration: COPlTF4CTf}r. �� + yc, a , r 1�t,k Aeon valid for individul u 4t a' rPiration: 168027 F .x �*� � CA s , se only" #lon date if found return to x 12/7/2012 `DBA', �r ,r + ; ti er Affairs•and Business Regltl►tion. I`DIET!i KENDALL r'CNNETs. ?'J,yr}T` I' :t .q a a )•, 6 yt H a KEh�Lr � ��'�jijY{,cr_ "€� �� •-•�� „�,���y� < f t�, ELDEN PL. /aIRYP,�TeN M.A 02 .�r 7 y �5 ♦3l w�l�i, f `• �•,t�� � � �� }4��`,� �{mod.' 4 -,.f ="r i.,r' - i `r. s• x y ti, 17ndersccr �} A Yr as fir' * R �xidt� Uwrtiloutl Qltat :. .see Ule ,. t �ias�,f�lur,il{:_ fj�.l,artnu'11t of Public . tftt� lirr.tl rl r)t•fitrit+Iirr+�. � ,, + - I/Iat1On.l':Intl k ati - <:c,lstrt;vtiaz� - t.ttitaartd� r Supervisor License l.;r;ense.: GS 75153 KENNETH D KENDALL 5 WEEDEN.PLACE Y •• + FAIRHAVEN, MA 62719 ' . Expiration: - Trfr: SME fn. r ► ► r + BARNWABLE, "`"SS. Town of Barnstable 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 IP�VY\E S r a,4=E , as Owner of the subject property hereby authorize I-ljw . 5 � alu ( 4 44`4 .Lv. to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) �I . Si ture of Owner ljfate q�(No7S Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\decollik\AppData\Local\Microsoli\Windows\Temporary Inlemet Filcs\Content.Outlook\DDV87AAZ\EXPRESS.doc Revised 072110 i tawas-2376-bsb*Offin U21 CmbeM Hwy.Wk W Ll ' WWvhm,Ma 02371 a7 A�4a 9�4 TN' QF BARNSTABLE OW FRIEDLINE&CARTER ADJUSTMENT, INC. 436 Main Street, P. O. 1 Q,x 33& 11 AN 9: 4 b Hyannis, Massachusetts 0260.1 Tel. (508) 771-3232 FAX (508) 790-2344- ai�J SION TO: (Building Commissioner or Inspector of Buildings ( ) Board of Health or Board of Selectmen O Fire Department TOWN OF Barnstable TOWN`HALL Hyannis, MA RE: Insured: KINDER, Janice& CROCKETT, James Property Address: 56 White Moss Drive Marstons Mills, MA Policy Number: HOM00356581 Type of Loss: Lightning Date of Loss: 6/9/2011 File#: 113027 Claim has been made involving loss,'damage or destruction of the above captioned property, which may either exceed $1,000.00 or cause Mass. General Laws, Chapter 143, Section 6 to be applicable. If any notice under MGL, Ch. 139, Sec. 3B is appropriate, please direct it to the attention of this writer and include a reference to the captioned. insured, location, policy number, date of loss and file number. On this date, I caused copies of this notice.to be sent to the persons named above at the addresses indicated above by First Class Mail T. W. MCMAHON Adjuster 7/7/2011 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map o3 Parcel ��-00� ��� D Permit# c /Health Division "<�� /�' 1 Date Issued conservation Division .3 le Olt_ *ee �s �. d �/Tax Collector EPTIC SYSTEM MUST�Treasurer . -1 NSTALLED IN COMPLIANCE WITH TITLE 5 ENVIR®NM'ENTAL CODE AND D TOWN REGULATIDiVS Historic-0 _ eserva ion yanrns roject Street Address �^ V�1 t-� ITC M OS S P,t u E Village Ar�S i_Q N M I L LS Owner gA L V AT (2_t__T ko Address 5_0, N ;�L MASS �Q� M Telephone (5 8 aj 4 (D - 712S Permit Request eZZ Square feet: 1 st floor: existing propos 2nd floor: existing proposed Total new N a I 9�4) Estimated Project Cost 0Q Zoning District Flood Plain` Groundwater Overlay Construction Type _Vdaa� Lot Size - '� �C , Grandfathered: ❑Yes O No If yes,attach supporting documentation. Dwelling Type: Single Family�l �Jvy�o,Family ❑ Multi-Family(#units) Age of Existing Structure t' d Historic House: 0 Yes --W No On Old King's Highway: 0 Yes No Basement Types®Full ' ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 768 Number of Baths: Full:existing Z new A/ A Half:existing (0 new N A Number of Bedrooms: existing - new A Total Room Count(not including baths): existing new First Floor Room Count 3 Heat Type and Fuer---O Gas ❑Oil 0 Electric ❑Other Central Air: ❑Yes No Fireplaces: Existing I New X Existing wood/coal stove: ❑Ye��No Detached garage:❑existing 0 new size Pool:0 existing ❑new size Barn:0 existing ❑new size Attached gara§G-W existing 0 new size d Shed:0 existing ❑new size Other: C k C Zoning Board of Ap Is Authorization ❑ Appeal# Recorded ElCommercial ❑Yes ❑ If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name Telephone Number Address License# Home Improvement Contractor# . Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY � 1 PERMIT NO. DATE ISSUED n 'MAP/PARCEL NO. ADDRESS VILLAGE OWNER. Lam DATE OF INSPECTION: 4t FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL r � 1 GAS: ROUGH :v a FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. ' BA 9TABM Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building'Commissione: Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal, demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building,be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: Co E�) C.0 io�9 OF -0 K Estimated Cost ZO G ."Address of Work: 14 1T t �U�S ..CJ 2 ly C� . ��P1�i�,hid H t LLS-N A Owner's Name: t— A�o q E C{��►� Rate of Application: ��4Q Cf-i 1 1 I gg g I hereby certify that: Registration is not required for the following ieason(s): Work excluded by law blob Under$1,000 Bur ing not owner-occupied weer pulling own permit I 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 Name Registration No. R 4-a CV4 IL riq — ✓✓✓ Date Owner's Name q:forms:Affidav - - The Commonwealth of Massachusetts = = Department of Industrial Accidents ONC.0 otlayesOnfons 600 Washington Street Boston,Mass. 02111 V Workers' Com ensation Insurance Affidavit L'14ame: 74l_V A-Ty Wa-cation J'7(u� F-[ / S f) l V city FRS v N� M ILLS one �Q� 4Za - /123 j I am a homeowner performing all work mvseif. ❑ I am a sole proprietor and have no one workin in any capacity IN ❑ I am an employ ding workers' compensation for my employees working on this job. com nnv name: \ address: city: phone#• insurance co. pnlicv# ❑ I am a sole propriet , general contractor, or omeowner(circle one)and have hired the contractors listed below who have the folloning workers' c pensation polices: com anv name: address: city: phone#- insornnce cn. o tcv .. :.:.,::.........:::.:.....:.... tom anv name: <::<:.;::.:.::•: address: city- phone#� insurance co. 20 CV Fafiure to secure coverage as required under Section 25A of MGL 152 can lead to the Imposition of criminai penalties of a fine 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 fine 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 verification. 1 do hereby c y r an n: iA�ofperjury that the information provided above U'istruue and correct �+�Signature Date RCW V 197 1 _ Print name � L✓4 CA fqv o Phone# 4zo -7)z3 official use only do not write in this area to be completed by city or town official city or town: permit/license# QBuilding Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other (revues W95 P1A) 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 contr.:= 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 receive:c: trustee of an individual, partnership, association or other legal entity, employing'einployees. 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 renews: 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. 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. 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 returned io the Department by mail or FAX unless other arrangements have bees made. The Office of 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. The Department's address;'telephone and fax number- The Commonwealth Of Massachusetts ' Department of Industrial Accidents Ofnce of Imrestlgauans 600 Washington Street Boston; Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 eat. 406, 409 or 375 ' o Department of Health Safety and Environmental Services Building Division R&WgrABLL 367 Main Street,Hyannis MA 02601 MASS i659. Eo Moil�' Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner HOMEOWNER LICENSE EXEMPTION Please Print DATE:M4JRC 4 /B LOCATION: 5 (O W 14) / C � 1 0.SS � ]Z1 V(✓ ��� �r 7ZS ;trytjS t_111 LL-S V Z6�q �mber reet /� village "HOMEOWNER":"" 'L 0,4To —, ICH..-stP '7 Zy '��2 3 &2-_3 Z1-� name home phone# work phone# CURRENT MAILING ADDRESS:S;A1 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 pEocedures and requirements and that he/she will comply with said procedures and re e 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 to amend and adopt such a form/certification for use in your community. QYORMSIXEN PT r2r,77,4&L 3G GP�� sP �- /q3 4q i. Z3 7)Ap j,O5CD ✓ ECK I h \4 ^' v k5 tu V IL o lc Lo 2- CERTIFIED PLOT PLAN LOCATION 8�..... BL <�1/�xs7FwS /'IiLLs� SCALE . .-30.�... DATE '`>4Y?o 1998 PLAN REFERENCE .8C!NG LoT`S 37p 7-s I CERTIFY THAT THE L'Q!ST7,UG !Pkvlr�/.VG SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON AND THAT IT CONFORMS TO THE SETBACK REQUIREMENTS OF THE TOWN OF ���vS �'��?•g.. . . . .WHEN 'CONSTRUCTED'. . DATE �.A�. Zj REGISTERED LAND SURV OR 12"diameter concrete column 12' 10 48"below grade 12" 2»x 10"rim joist ~4' o.c. / 4' steps(3 stringers) FRAMR4G PLAT FOR concrete pad a/ at base BACKYARD DEC �► AT 12» 56 WHITE MOSS DRIVE � 12"tread approx. . a columns T'rise approx. WSTONS MILLS doubled rim joist 8' o.c. � _ � ..�...:..+........*...».►....*....... 2"x 8" &2"x 10"�� 16„ all beams st�rim joist s bolted to Scale: 1/4"=1' O.C. 2"x 8"x10, doubled 2 x 12 s ? All lumber to be pressured treated. joists Ii overlapped March 12, 1999 10"diameter columns 14' h concrete column 1 7'_o.c. 48"below grade �---- 1 18' r. 3'9"o.c. I~� 8'beam (see other steps underground sewerage line for detail) 2"x 6"x 15'9" 2' 6" decking future sight N 3'9"o.c. 5, bulkhead of hot tub { basement —� 4' steps 1 - center of column f 18"from house slider door window 16' 12" Existing House 2" x 6"top rail RAILING & BENCH DETAIL FOR BACKYARD DECK AT 56 WHITE MOSS DRIVE, MARSTONS ME LLS f#rtrt#f##ff##rt###rt#rtf#rt#trtff►>rtrt##t##f Scale: 1/2"=1' All lumber to be pressured treated. 2"x 10" rim joist .March 12, 1999 1 3 1/2"to 4" spacing 4" x 4".post bolted P g P 1 3/4"balusters between balusters to rim joist 2"x 6"top rail 2" x 6"back and seat Bench to be placed along southeast side of deck. Railing to place along 0 remainder of deck. 2"x 6"braces 4"x 4"post 2"x 10" rim joi t 2"x.6"brace LUMBER LIST FOR BACKYARD DECK AT 56 WHITE MOSS-DIVE, SIZE LOCATION QUANITY MARSTONS MELLS 2" x 12" x 16' "A" & `B" beams 4 Scale: 1/2"=1' 2" x 12" x IT (2) @"D" beam 3 All lumber to be pressured treated. (1) @"IT' beam March 12 1999 2" x 12" x 8' "C beam 2 ' 2" x 10" x 14' 'F" rim face 1 2" x 10" x 12' "G" rim face 1 see large framing plan.for 2" x 10" x 10' "E" rim face 2 corresponding letters- 2" x 10" x 8' "J" rim face 1 2" x 8" x 14' "N"joist 1 2" x 8" x 10' (22) @"K"joist 24 (2) @"L"joist 2" x8" x8' "M"joist 1 10" diameter X 4" concrete tube 11 12" diameter X 4" concrete tube 1 `Bigfoot tube footing 12 various hardware including: post bases,.framing anchors, bolts, deck screws& nails 12" diameter concrete column 12' 48"below grade 12" R 2"x 10"rim joist ~4' o.c. / C I 4' steps(3 stringers)` FR-ANffNG PLAN FOR + concrete pad at base BACKYARD DECK AT 12" 56 WHITE MOSS DIVE, 12"tread approx. u 7"rise approx. WSTONS MELLS H columns doubled rim joist 8 O.C. � _ »*»r»»»r»****r»»»»»»**»r»#*******»»»» 2"x 8"&2"x 10' all beams / steps bolted to Scale: 1/4 —»_ 1 �� O.C. 2"x 8"xl0' doubled 2"x 12"s nrn?01 st .c. All lumber to be pressured treated. joists n 10"diameter overlapped March 12, 1999 columns 14, r concrete column 48"below grade 7 O.C. ' 18' 3'9"o.c. underground sewerage line 8'beam —► (see other steps I 1 for detail) 2"x 6"x 15'9" * ' 2' 6" decking I ;future sight of hot tub ' basement N 3 9 o.c. 5' bulkhead 4' steps 1 1 center of column f 18"from house slider door window 16' 12" Existing House 2" x 6"top rail RAILING & BENCH DETAIL FOR BACKYARD DECK AT 56 WHITE MOSS DRIVE, MARSTONS MILLS Scale: 1/2"=1' All lumber to be pressured treated. 2"x 10" rim joist March 12, 1999 3 1/2"to 4" spacing 4" x 4"post bolted 1 3/4"balusters between balusters to rim joist 2"x 6"top rail O 2"x 6"back and seat Bench to be placed along southeast side of deck. Railing to place along Oremainder of deck. .. o 2"x 6"braces 4"x 4"post 2"x 10"rim joi t 2"x 6"brace LUMBER LIST FOR BACKYARD DEeK AT 56 WHITE MOSS- , SIZE LOCATION QUANITY MARSTONS MILS 2" x 12" x 16' "A" & "B" beams 4 Scale: 1/2"=1' 2" x 12" x 12' (2) @"D" beam 3 All lumber to be pressured treated. (1) @ "H" beam March 12 1999 2" x 12" x 8' "C" beam 2 ' 2" x IT x 14' 'F" rim face 1 2" x 10" x 12' "G" rim face 1 see large framing plan for 2" x 10" x 10' "E" rim face 2 corresponding letters- 2" x 10" x 8' "T' rim face 1 2" x 8" x 14' "N 'joist 1 2" x 8" x 10' (22) @"K"joist 24 (2) @"L"joist 2" x8" x8' "M"joist 1 10" diameter X 4" concrete tube 11 12" diameter X 4" concrete tube 1 "Bigfoot" tube footing 12 various hardware including: post bases, framing anchors, bolts, deck screws& nails 1.2 Board of Health (3rd floor): Sewage Permit number 11AUSTABLE. NAM Engineering-Department (3rd,, floor): 1639- TOWN OF BARNSTABLE RUILDI G , INSPECTOR ..... ) - -) eUl_r�cf APPLICATION FOR �PERMIT TO 7 ............................................... J*'*'** J. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit, according to t;---following info-rma-t-ion: V .... ............ . . '�)"'__� -1 ProposedUse ...Sizvc .[e......T�� .......(.1 . ............................................................. ............................................ _ r.....................................Fire District ................. Exlerior ...W//C..... 0. .. ..1'e5....��klcp. �Roofing SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS ! | hereby agree to conform to all the Rube and Regulations oftne Town of Barnstable 'construction. ' ` Nome � ____. � / Construction Supervisor's License ^�.—�, -- ' _ J GREENBRIER CORP. A=03 -004-031-005-012 no oo� No ....3.Q4.22 Permit for ...,1? Story Single Family Dwelling........... Location .....Lot #,5,...,,,56..White Moss Dr. Marstons Mills ............................................................................... Owner .....Greenbrier..,Corp...................... Type of Construction .......F'.r.? Pt ..................... .......................................................... ................ Plot ............................ Lot ................................ z Permit Granted ......Feb:ruary 6.......1.9 87 Date of Inspection ....................................19 Date Completed .........................:............19 A - AW3 r. , 43,540 SF 150'FIE 91 N rA Ck c 3o�/S1/S sE7/jAcK3 , 7 �IE/1SSurcClb La It I o -f Z� 3 6' �9.o dog j I93 ,�9 Z ► :� r �c z � •Y � n• � 4� h M M �y40, y CA Zy.o w e 10 /Y 6 y°3 2-'0 9- �,•� i VL 07 0 I CERTIFY THAT THE SHOWN ON THIS PLAN. IS w of LOCATED•ON THE GROUND AS INDICATED �� ROBINW. s� AM LCOX <: No.31341 0@ DATE REGISTERED LAN D S^AVEYOR ;. . LEVY a ELDREDGE ASSOCIATES,INC. CLIENTS %. �+ERTIFfrlu PLOT PI AN ENGINEERS - LANDSCAPE ARCHITECTS JOB N0, PLANNERS— LAND SURVEYORS �oT S 4tIN/�E Mo'.t eI1/Z c� ' DR. BY�,� :� IN <s 889 WEST MAIN STREET CHKD.BY,_,",.,,,,.._ 4 BAR- sr�?t��.�, r,,lA CENTE61LLE, MA. 02632 SHEET.J,.,OFZ.., SCA141 �.�0.,�.... DATES410s Assessor's offioe (1st floor)- ,� ,( �. THE sor's map•and lot number .fT�!!!..�....3/.�..�....°� ��"�S �a �Q••°� rO�o Asses Sewa of Health (3rd floor): SEPTIC SYSTEM MUST �` g Board �....1- l�...ge Permit number .................. i_.. INSTALLED IN COMPLIA ."a 9TLDLE, i Engineering Department (3rd floor): S� GJS f � House number ........................................................................ WITH TITLE 5 o raY a�0 APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 -P.M.' only MWIRONMENTAL CODE TOWN PROA A9 TOWN OF BARNSTABLE BUI• IDIG .I SPECTOR f r APPLICATION FOR PERMIT TO7s ,� �LC,4.r.........,_/�-�.1.Cal... ..... : ............................ TYPE OF CONSTRUCTION ....... ............. ............................. t ...........................V-7............19... TO THE INSPECTOR OF BUILDINGS: i The undersigned hereby applies for a permit according to tbg following infor •on: • Location ......�0..�..#..�:;._...... ..... t.. e ��.�... .-.:.`'��..�............ .G��+rS'....�L.S. .......... ................... C f f Proposed Use ..:.,JC.vI. . ..4..�...... G'�✓Y�1.. .. ................ Zoning District ...................... �,. ..:..................................Fire District ..e//y � ./.CI ..J�//�:.'.! Name of Owner ..... !T .e/�1. ..[^.� .... r....Address Name of Builder .... ...Address ....... , ... Nameof Architect ..................................................................Address ..........................................................:......................... GNumber of Rooms ....................................... . ............Foundation C� Exterior ....... Floors ./.{� .... .�..... ........ .Cr.. �. :...Interior ..... �.e.... 'Q. K....................................... Heating . ................ ...... . ............Plumbing ... "J� "\..5.. .Fireplace ..................................................................................Approximate Cost ..........1... ? ...Q.Q. ......................... . Definitive Plan Approved by Planning Board .l_(/►1 --------i_7_,_-___19_Q__(O . ` / Area ......1..�.�jo................ Z Diagram of Lot and Building with Dimensions .` Fee ................../................:.......... SUBJECT TO APPROVAL OF BOARD OF HEALTH � Z ` X Z-4 c� tAD l0� 3 � - OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town'of Barnstable regarding the above construction. Name .....1. .. ... .. . Construction Supervisor's License O�/. ... ...... GREENBRIER CORP. P No . 3 ``..... Permit for ....................................r` �` Single Family Dwelling .......................................................................... Location ...?.....ot fit. .,......5�...Y�ihL :e..-MO.-S£...Dr ive 1Zar8'i-c)ns l�iills Owner Greenbrier..Coro. ......L.................... Type of Construction ....�.rume Plot ............................ Lot ................................ Permit Granted February 6 , 19 87 , Date of Inspection .....................................19 Date Completed ...........................................19 r A,O� f_7YtIA- =iN�Q` �� v/ �r �/ /� !_ rwn��dT/� eel s 1,1,4 i 2:k -T �iSi�Ntl�lr' 74 1 10 obi Sd�E � ZX�2 o Al0212 � �!Z/O.b,cy o � �.8 ✓`GP/'3�i?/s I � �/yI/�✓�lo ��s'��N� /-7vlly 410E �"��Ifelw is ,n:�Plvl- s-rwA4f 4 iN D�✓E �..�i,�DT �z) �IlaA 0r looFxool. 1 « y.7 = zywFr