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0242 WINDING COVE ROAD
,�'�._,.. �--� r�..---��,�.r...-` � .� r� r'^'1 _. _ - ..._�f.�..��..,na.�..u-,�p.a.rAwu,.c�um.iwi...s,.w..w..w.a.q.e�.e....<...w�.�.�. ..�.....,..�....�.w...,...,... -=— ,- �t�n..c�eseaui l " TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map U� T Parcel I I Application #C-,) Health Division Date Issued Conservation Division Application FeeeeJ Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project`Stre'et^Address 25!2 Ow ner/70/ l/1/r-�✓�/ iT�/���/ I"Aci°dress � li1/,✓rr�in��- y'� �2Gf Telephone Permit Request VL nntk Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑ Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil` ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization Cl Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION _ �(BUIL�DE�R-OR HOMEOWNER) itNa e=` e7rctft2f Telephone Number' d es.s ?`' ,,b�e�In prov ment Contractor# l`1-530 Email ' Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO NATURDATE � x ' FOR OFFICIAL USE ONLY s, r APPLICATION# DATE•ISSUED MAP/PARCEL NO. 1, ` ADDRESS VILLAGE , OWNER ' DATE OF INSPECTION: FOUNDATION (3�Scw�y �S�i:�-EE:�" ! I✓,tjca;-,� !: FRAME 71/9 INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL s . FINAL BUILDING 166 DATE CLOSED OUT , ASSOCIATION PLAN NO. .y o t Massachusefits - Delgartment, cif Public Safety t ' . -Board of Building kegufations and- Standards Construction Supervisor �f License: CS-070"085 LEIF E BOTTCHf; 825 CEDAR. STRKE .' y West Barnstable TVIA 026"'6 c� .,Jy �• ' ' '�' `` Expiration • Commissioner r 08/30/201 5 0n rest �i cted Buid s rfan use groupwhichg contain less than 35 000 cubic feet 991M of enclosed space. Failure to possess a current edition of the Massachusetts State BuildingCode is cause forrevocat�ion of this license. 6 For DPS Licensing information visit: www.Mass.Gov/DPS f �TMETti Town of Barnstable .� Regulatory Services y' nu+,& �` Richard V.Scali,Director 163q. .0 �0.59 Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.townbarnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize s„� /�®Trl'/��,� to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) ""Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence-is installed and all final inspections are performed and accepted. Signs of Owner Signs o plicant . Print Name Print Name G �ZZ45� Date QTORM&OVJNERPERMISSIONPOOLS Town of Barnstable Regulatory Services P��THE Tp�y Richard V.ScaIi,Director Building Division RnRNRI`ART.R « Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 QED MAt a www town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCAT101,1: number street village "HOMEOWNER": name home.phone# work phone# CURRENT MAMING ADDRESS: city/town state rip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of sic 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 buildingpermit (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 j (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. Q:IWPFI!_ESWORMS\buiilding permit forms\EXPRESS.doc Revised 061313 �TME r Town of Barnstable 0 Regulatory Services + BARNSTABM MASS. g Richard V. Scali, Director �p z6gq. �0 tEo 39. 6. Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601. www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 NOTICE TO THE BUILDING DIVISION OF WITHDRAWAL OF LICENSED CONSTRUCTION SUPERVISOR FROM PROJECT 6-Va()LJWD2 I, /�_�i r/icQ/�rr/ ems ruc ion up OLCJ(�� # , hereby certify that I am no longer the Construction Supervisor listed on the application for the project under construction as authorized by building permit #eb/Jb S , issued to (property address) 2 y,2 � sT�iY'S i�'/%LLSon , 2011; . I also certify that on NIA , 201 , I notified the property owner,that the project under construction must cease until a successor licensed Construction Supervisor, is submitted on the records of the Building Division. G L ER DATE q/forms/newcontr reference R-5 780 CMR rev:040414 i �oFt�E Town Of Barnstable Regulatory ServicesHMMSTABM . Richard V. ScaIi, Director �p i639• �® pEn�aat�. Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma'.us Office: 508-862-4038 Fax: 508-790-6230 . a NOTICE TO THE BUILDING DIVISION OF LICENSED CONSTRUCTION SUPERVISOR ASSUMPTION OF RESPONSIBILITY Construction Supervisor License # 65—0?f00 ,hereby certify that I have assumed responsibility for the project under construction, as authorized by building permit#.It�5n M�-[ , issued to (property address) o� o� VO1 v-y—� COJ Q eGCACA on I U 201 S I The following dqcuments are attached: copy of my Massachusetts State Construction Supervisor's license or Homeowner's License Exemption form (if applicable) copy of my Home Improvement Contractor registration(if applicable) Commonwealth of Massachusetts Workers' Compensation Insurance Affidavit. Road Bond (if applicable) LI NSE HOLDER DATE q/forms/newcontrb rev:040414 • fs�c�s.rr�c�.g-a�ia - . CQM2i Ins rrznMAjHdaziL- d;rsfQM���„� - • ��'ac Pig Frin�� �Cd Ll1 �C� �'YJ� ate; L plltl 47 -��Z `z' C2— - Are}tea an amployar7 Chrc g bG= Type of P70ject -k I a=a eaxplog€r 4_'❑ I aQ � *+r�$I New El��,.,,,,7�,,�,� -❑ I—a=a sole grog6ar o rY"•,a• mEr-/ I3.4ir-d o4 i�E dtffd.S�L� 7- ❑�.r.`T b ship znd bare m employees nH=sab-ao%d=dug 1�-ve $- ❑ Ong dnrme m my mpacily. wmp �andhave wo�xs' � i cvmg fiL9 -d= co g- ❑ $zdddian ° I 5_ e ace a caLparzdic;maad ifs I0-n kcal npa!"x addh inns ❑ f ama ImMBwwnM dcrinb 4wad- °�� '=` '„-Tyea ILL Pinmbmg�ga�rs ar adcRk�s ngsr" [No'tea'=MP- gerE'fQ L20 Rmofrepai8 Wince ;, j i c_157,§1(4} an3.-vm ham aD • emglnpees.j1�Ta�t�t�x` L��Other - c�p_tM�MT3iM4j #�eaarnesvdso�r„�r;,t� Y=�rT g i&eaEtMcM rmst sabmasa zf�d�itmma s� ��s•H�.�dL�rYt�ibmcm�tstls�rd,a-��;��,,,i�•,dh�Fth�a�of8=ester-rm3sb�•crLrm�ocrmz•fl�FFv� eax�sIoyas_Ift�t m5 cah.�eT±�meg�t gm�*idEc '�P-P �b2 Hirai an B Ivyet ca sxofutt LM=aTa=,V•for Iffy ea7Inysss SeTgtr is fhep� m�d3oh sda Aiitzch a:copy of the Rurlaxe m ap=atina paRLy deczatioa pzge-(mil;tIMI6FL-`Y xcmaiser a}sd boa a-te): Faiia�fA secure cue�s wader Secfm>z�A of 2�L c I52�u]eari to iire imposi�aa al pes�afEies of$ fiaE np t��LSDU(3D andlQr�yearimp as t�eII as az�I ge�i�m frle�.of a S�C71'A�OR�{IgD�and a fi�G of up.fg�5Q_E7Q a day a�ffie vi9laf>:,t_ lie a�vzsed�a cagy ccFffsis s�e�mag be wed tu'fize Uf�re of InresEg�ions of�e I371�€x+„�„�co�ge - lr c�a. Qer�ffP:rruirr ar a u�vrracdiisa prauufe�ahs�e a•�•ua rmd caFFarf 6jL-LaI E:Ta zt* Dc not w iltr i a ffaa area,fa Be caaigie� by c�,or txm affidTJ Cify or Tow T�oxsc Fs�.g��uritg{mr.7e one: . • - . L Ba m-a ofH= lx I ug �I{Rfd£awa O=k 4-EI=hiea h=p=tor 5_Pfamdamg wr -6L.Cqhcr i • _..._..._.._.._.........-•- �� License or registration valid for individul use only �� {jamin%ftWa r b'96,ness '-_ anon. i before the expiration date. If found return to: iSf onsumer airs Office � Office of Consumer Affairs and Business Regulation — —_ HOME IMPROVEMENT CONTRACTOR Type: 10 Park Plaza-Suite 5170 Registration: y111950 Corporation I Boston,MA 02116 Expiration: �1`I812017 I ;= = : C.O;N: RACTOR INC. L"t TTCHER HOME=IMF :_ T� " LEIF OCHE of valid without signature 825 CEDAR ST Undersecretary W.BARNSTABLE, L 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 0 5"7 Parcel ® Application #-.^L--"� Health Division Date Issued (lam (0 Conservation Division Application Fe b Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis �Proje Villag ee EOwne V lo— An_ / �/ �iT,�otyi�/ Address Telepph�oone----�,5'®8 Permit Request Z'x /D Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay (Pr_oject Valuati /'FOOD Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. ' c Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King v ighway:- ❑Yes> ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft)' , Number of Baths: Full: existing new Half: existing G new Number of Bedrooms: existing 4 new I r- Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT I -T-10, (BUILDER O HOMEOWNER) me Te p o e Number Address Yf AJ License # 'ga.y ''S Za/G/N 5 Home Improvement Contractor# r. Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE-, / �� FOR OFFICIAL USE ONLY APPLICATION# , DATE ISSUED ; MAP/PARCEL NO. ADDRESS VILLAGE 'r. OWNER' ` DATE OF INSPECTION: i FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH ! FINAL PLUMBING: ROUGH FINAL - GAS: ROUGH FINAL FINAL BUILDING , DATE CLOSED OUT - r . I ASSOCIATION PLAN NO. 9,' r q ' u Gc9 C� 07— ti i , C O 7T . . E C'•E_",(P T/F-Y Th/E _rs ✓�.� l y,;r, b'::' ''l Ab�/l� O C / /+ yr 6 d !� Y *..,•']'� pt /` ./L: r '';' >C;%1. ^/ /`•Y/C�✓f',..y.4... A , 'Aw TJy/S Jo�,c7N /S �'.S' /T �'�/��-� ,cy�� TJ•!.9 T /T CON�"OiPJ'►'1S TO ZO/V//�/ O'QT'—`.'�!rC%•�: W:;/•�<:��' SC.gL E•' /••- ;/E.d'' Dept of'1ndwh idAcddezfs Office o.flmesff9afi02u .600#rimh6vtua Street BasAMH4 02rrr ' WWW-M=9VV1,za Workers Co.=Pcmaiion Inmw=ce A Udavit:BtuldetdContrac orsMect icians/PhmaLbers Applicant Information Please Print Name /20>/ Gay/Sta�: r prys LG• Phomt: Are pot[an employer?Check&e appropriate botL ' Type of protect(required):1.ElI am a eoiployrr wig 4- ❑I am a g=,-d cmhaactcr and I ao P*=(M and/or part tom)-* have hand 6• ❑NcW camshvditto 2.Q I am a sole proprietor or pmtnrr- listed m Vie atftucbed sheet 7. ❑Reozodding s*and have no eogloyces TELCM snb�ao¢hactnrs have 8. [�DemnLtion wozid33g for me ii<Bay capacay employers and have wmk=- [No vad=-�•iy ap ce comp.in�nrr t 9• ❑BmZding addition e�] 5. We are a cmparafum andii 'I0.❑Electricalrepaim or additions 3. I am ahorat owner doing all work offic=have mummsed lh= ILQ Phrabmgrepaim or addifions myself [No wa&me cam. of czmop*m per MGL 11E]Roof repairs bsorance regmited.]t c•M§I(41 and we have no employees.[No wmioms' 13.E]offer camp-insomna mqaim&j *Any apPlieaat that ch bmc#l=Mt also Mottthc-tioabriawshowingtbcswad='mmpmsatioaPolicynfo u2sun t Hhmeawne6 wbo snhmittHs affidw&mdiratmg the}'z=doing air wmk and thm Las unbar; a nmst snbm$anew zmdavk kdu-.dingbvch_ kknilmdr-s thatehxkfib box mmst attached an addhimnl sbedtshowmgthe anme of tht mb-m�and shot whc6cr or notjbose edif=Lope employes Ifthe sub-CmduLdoa h"C emP1q9c:cz.ffmY=Rst 1uVdc th=wmioa'e=P-policy met I am an en ph yer•that it providing workers'comperuatim i re for my unTroye= Bdow fr the poL7 and job site � ixformatian, _ . Immnmm Company Name: Policy#or Self-ins.Lie.#: Fa�aatiamDafz: lob Sift Addiims-- CSiy/Stafel7ap: Aftarh a copy of the workers'mmptnsatinn policy declaration Page(showing the policy i mmber and ezpirafron dam). Failure to secore coverage as requaed ender Sectim25A ofMGL o.152 can lead to the imposition of Final peaalfies of a f=UP to$1,500.00 and/or one-year imprisonment;as won as civil peoahh s in the fnuu of a STOP WORIK ORDER and a fine of up to$250-00 a day against the violator. Be advised that a copy of this statzmeot may be filtwmded to the Office of hlvmlgations of the DU fro fi manse covmmge ymM=16M Ida hereby crl fify '/ p07 My the Ile uzformcrtfoa provided above a tare soft rct Pbnn,e#: ,� D� G/o?�� /e�5 �S� • D aI use only. Do not vrite ht this area to be completed by�or tm u offn*L City or Town: Permits a ens:e Zssomg Au&orifp(Cade one): L Board of Health 2 BmldmgDepazimet[t 3.CitpfTawn Clerk 4,Elecfzirsl&4ector 5.P ti Office hzathinglnspector Contact:Person: Phone Information and Instructions ' Massa Gc=ral Laws chapter 152 rePzs all employers to provide We lk=l campeosation for feu•=3pIoyees. Pmrsnaat to this statute,as empkgl w is defined as=every pesos in&o service of anothcc under any dart of hoe, corpuses or miplied,anal or written." An.emp&yff is deed as"Em.fi rvid a1,partnership,assod diom,cmporaiia n.or offs=legal m tf,or any two or move of the foregoing caged.in a joint mtec�and iT,r-b mg fhe legal repSese teives of a deceased employer,or the receiver or ftustee of an mdividnal,parIncdhip,association or other Iegal entity',employing employees. However fhe owner of a dwelling house having not maze fhan free apm tmeafs and who resides therein,ar the occupant of the: - dwelling house of anofer who employs persons to do mair¢eoanc-,construction or repair wmk on such dwelling house or on the grotmds or baud fit apptafeoant fhereb shall not because of sash emplopmea t be deemed to be an employer." MM chapter 152,§25C(6)also states that"every sbrL-or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the concmommalth for any applicantwho has not produced acceptable evidence of cdmpliance wn the insurance,coverage required-" Additionally,MCA,chapter 152, §25CC7)stains"Neither the nwealth.nor any of its political subdivisions shall _ ender into any cautract for the performance ofpublic wazkuohl acceptable evidence of ca mpliance Y&h the iosu:r .=-. regBa entente of this cizrhave been prPseotexin th ie contracting audhorhy." Appb=xts Please f l o-u± the wodaris'compensation affidavit caropletcly,by chug&e bates that apply to your sitnation and,if necessary,supply sub-contrachor(s)name(s). address(es)andphone mmiber(s)alongwiththeir certificate(s)of insurance. Limited Liabfltty Companies(LLC)or Limed Liabi-ity Parmersbips(LLP)withno employers other than the members or partners,are not regmred to miry wm3=-e compensation insuranm If an LLC or LLP does have employees,apolicy is requfted. Be advised that this affidaykmaybe mhm ttnd to the Department of Industrial Accidents fur cc)nf mmatinn ofinsmanc,e coverage. Also be sure to sign and date the affidavit The affidavit should be rmEnmed to the city or town that the application for the permit or license is being regneshd,not the Deparlmerlt of Indnstrial Accideofs. Sbouldyou have any guestions regarding the law or if you are regafizd to obtain a workers' comp policy,please call the Department at ibe mtmber listed below. Self-hsored companies should eater heir self-iosaz nce license number on the appropriadm line. City or Town Officials t Please be sore�the affidavit is complete and printed legibly. The Depm t has pro4ided a space at tits bottom of the affidavit for you to M out in the event the Office of Investigaficros has to contact you regarding the applicant i Please be sure to fill in the pcn�/ cease manber which will be used as a rferenco number. In addition,an applicant that mast submit multiple peonit/Iiceose applitstioms in any given year,need only submit one affidavit indicating current policy information(if necessary)and tmder'2ob Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that bus been officially stamped ormarktd.by the city or town maybe provided to the applicant as prof that a valid affidavit is on fle for future pe®iits or licanses. A new affidavit must be filled oitt each year.Where a home owner or citizen is obtaining a license or p itnot-rc1dzd to airy business cr co=crc:ial venfnm (Le. a dog license or peon$to bum leaves etc.)said person is NOT req¢hed to complete this affidavit The Office of Investigations would Ike to thank you in advance fin'your cooperation and should you have any questions, please do not hesitate to give us a call The Department's address,telephone and Ax number. The COMM¢uwesltk of MassachuseM Department afY&stddActwidmta tM=ox1UVesti&U0= 64-Wigton Sty BastitA MA 02111 Ted.,9 617 727-4900 eat 4-06 or 1--M MA.SSAM Revised 4-24-07 FAQ#617-727 7749 ww mas 9QgAHa l o`PPIl ot-i5arnsta.me Regulatory Services ° Richard P.Scan,Director Buildinig bivWon n�►BUSS.S. • Tom Perry,Building Commissioner �.m� 200 Main Street Hyannis,MA 02601 www Wwn_barastable ma.us Office: 568-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE E 3MOnON DATE S JOB LOCATIort���6� Gr/iivi�i�v�,- zL number sfzsst VMW Hot,�owNEx: l�/ �Tt/w.�✓ S D�4�2 na=T - home phone tt wor]c phone err CURRENT MAHJNG ADDRESS: eity/amn stake up 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. DEFZNMON 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 ofBamstable Building DepartmentmmimUma inspection procedures an rE_qiii?=en that he/she will comply with said procedures and.requirements. SignatEc dmcecownd Approval of Binding Official Note: Three-family dwellings containing 35,000 cilbic feet or larger wM be required to comply with the State Building Code Section 127.0 Cansftuction Control HDAE&OWNMIS ESEIY=ON TTie 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.Ll-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 a unaware that they are assuming the responsibilities of a supervisor xe (see Appendix 0,Roles&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often resalts 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: Q:IWPFI EMFJY SNbdc mg permit hnnslEXPRESS doc Revised 061313 oTME Town of Barnstable ' Regulatory Services WAMt�► Richard V.Scab,Dhwtor 0 cud►` Building Division Tom Perry,Bmlding Commissioner 200 Main St=t;Hyannis,MA 02601 www.town.b arnstablema.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property, herebyauthouze to act on my behalf, in all matters relative to work authorized bythis building permit application for. (Address of Job) Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are perfon=d and accepted. Signat xe of Owner Signature of Applicant Print Name Print Name Date Q:MRMS:0WNE ER=SMJeoors • i i Vr e A.OS�'T i LLI LL- c' `F _ �0 �y 1 � -7- fV r_.Al j ,Vv J 07 r�dal A�TrrL ��. �II�■1111■■1�■■11�■■11�111�I ■1■■�■1■■ ■1■�■1■■�■1■��■11 111�■111�■■1�■■11�■■Il�li�ii �II�■111�■■1�i■11�■■11�I11�I TY , 0 vented ridge cap architechural shingles � to match existing MAIN HOUSE EX S CJ MASTER BEDRO M 'i 9 O white cedar shingles I`' T o match existing —6Fb4 BIG, � LITHWIN RESIDENTS WALK IN CLOSET 242 WINDING COVE RD. NEW FINISH ELEVATION FRONT MARSTON MILLS,MA SCALE 1/4 IN.=1 FOOT roof pitch t "1 2X12 ridge pfates lag bolted to main ?+g , 5/8"plywood sheathing house w/3/8"x5" joist hangers 'a e 16"o/c propervent o Hurricane ties from all rafters to wall plates 2x6x34"heads vented drip edge doi i le 6 to )late Y4 In.cda ply w0A= - MAIN HOUSE alo/art MASTER BEDROO �1/2"sheathing epml m,. d.W.2.12 I,W.r Ilt In G&I 1.9 antlior S•IR In Vt In I",bte fnnI ' ' n.m.r to p.el 4R8 pmt -GR{tBE.- Sonotube S'mnaete colurm/post form �. 2x6 u wall "o/ Ins to /r-21 sul n. concrete fwtng end B•24 blgfoW foodng form column/post R-30 Insulation 2"x10"joist 16 o/c 2x10 joist plate lag bolted to main "�4x6 postw/ house w/3/8"x5" 6F2A simpsen strong tie post anchor 16"o/c 2x10 joist hangers typical 4, 4 1 E 8'13n LITHWIN RESIDENTS WALK IN CLOSET 242 WINDING COVE RD. NEW FRAMING ELEVATION FRONT MARSTON MILLS,MA SCALE 1/4 IN.=1 FOOT 12 roof pitch 2 ridge �9 , —5/8"plywood sheathing 49 Insulation w/propery Hurricane ties from all r, rafters to wall plates vented drip edge dou bIE 2x6 top pIE e �1/2"sheathing Ln 2 3 stud va1116 0/ I ulate r-21 ih ulation. 2"x1 "Joist 1 o/c — 6 R f t B — Sonotube B'mnaete mlum tpost forth ,'•. .�' .�• concrete foc{Jng 944 Oigfoot fwdng LITHWIN RESIDENTS WALK IN CLOSET 242 WINDING COVE RD. NEW FRAMING ELEVATION SIDE MARSTON MILLS,MA SCALE 1/4 IN.=1 FOOT 20 8 EXISTING MAIN HOUSE MASTER BEDROOM passage to walk in close pplate lagged 6"o/a/4 3/8"x5"bolts 2x8 raft 16"o/c \J1 h rican ties II raft s to alls 1 t] a LITHWIN RESIDENTS WALK IN CLOSET 242 WINDING COVE RD NEW FRAMING ROOF LAYOUT VIEW MARSTON MILLS,MA SCALE 1/4 IN.=1 FOOT 70 81 E F- EXISTING MAIN HOUSE MASTER BEDROOM passage to walk in closet 2X plate ag bol I ed to 11 o/ 2X10 ist h gers, 'cal 2X10 DIST, 6"0 ado ble 2x 0 outs Jeplat ootings E 10'0" LITHWIN RESIDENTS WALK IN CLOSET 242 WINDING COVE RD NEW FRAMING LAYOUT VIEW MARSTON MILLS,MA SCALE 1/4 IN.=1 FOOT I i i I I i Mckechnie, Robert To: rlithwin@verizon.net Subject: Application for Permit-Closet Addition Good Morning Roy, Here is the short list that we discussed: elan shows concrete footings and piers. Your contractor may suggest sonotubes with big feet. This would be acceptable. The sono tubes are commonly used because they are easier to install. ,12<. The plans do not reflect the current requirements of the energy code (2012 IECC). The current requirements are: Q R-30 in floors (ok on plan) R-20 in walls (may require 2x6 wall construction) R-49 in ceilings (R-38 shown on plan) A corrected copy of the plan is required (just one). VA copy of the plot plan was not provided. Please show the addition location on this plan and the approximate set Vf!/backs. loll` 'This information needs to be received before a permit can be issued. f Thank you. Robert McKechnie Local Inspector Building Department Town of Barnstable 200 Main Street Hyannis, MA 02601 508-862-4033 1 Town of Barnstable Regulatory Services + BAMSfABM v MAW. Thomas F. Geiler,Director �'ArFo,39..�a`0 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 PLAN REVIEW 3 0 1/1 Owner: r!t 7'WW1 t/ Map/Parcel: 0 S-7 O t�/ Project Address o?1/2 iViNr/6 Co, Builder: /k/h .� The following items were noted on reviewing: /�/�V//YLGGI!'1 so No TGC�ES �Q "/iy �O i(/s 7itcL�T�cxJ o E-S /�a z� �LD cc1 ff.�-�G/I�i[IZ_E /REScei/�Ti u//2F T : it'3o- coot oR BPS - o9cGou�� 8y T.f�s C'cr7�-E-_ 3 110C,07AI /P 0 pi Reviewed by: /2rz---�/�Z-/- Date: Q:Forms:Plnrvw consarvWon 11/14/14 Thomas Perry, CBO Town of Barnstable Building Division 200 Main St Hyannis, MA 02601 RE: Insulation Permits Hear Mr. Perry, This affidavit is to certify that all work completed for insulation work at 242 Winding Cove Road (application#201309037) has been inspected by a certified Building Performance Institute(BPI) Inspector. All work performed meets or exceeds Federal and State requirements. Sincerely, C� Conor McInerney ConserVision Energy C Q: 'T1 co i W 376 ROUTE 130,SUITE C SANDWICH,MA 02563 508-833-8384 WWW.CONSERVTODAY.COM f 'C `_ = RUCTION CO. - . id ptial and Commercial,Builder' 1+A....I .,. TION SPECIALIST d14 MCCARTHYC M WWW r October 21, 2014 C3. o CM Town of Barnstable Thomas Perry CBO Building Commissioner 200 Main Stret M Hyannis, MA 02601 cT RE: Insulation Permits Dear Mr. Perry, This affidavit is to certify that all work completed for permit application#201406298 at 242 WINDING COVE ROAD has been inspected by a certified Building Performance Institute(BPI) inspector.All work performed meets or exceed Federal and State requirements Sincerely, G d� Michael McCarthy McCarthy Construction je I -, AkrRUCTION CCARTHY COO esid '"fiat and Commercial Builder, TA aI ��IZATION SPECIALIST e QuALrr [d3r0 October 21, 2014 Town of Barnstable Thomas Perry CBO Building Commissioner 200 Main Stret Hyannis, MA 02601 RE: Insulation Permits 4 Dear Mr. Perry, 1-3 This affidavit is to certify that all work completed for permit application#0 at 242 WINDING COVE ROAD `�'� has been inspected by a certified Building Performance Institute(BPI) inspector.All work pferformed`� meets or exceed Federal and State requirements CN Sincerely, Michael McCarthy McCarthy Construction TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Applications V Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address day,p— Village k— )VIs Owner �°Y L..I�w.� Address S: r L Telephone Permit Request 4- ►y Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Isci Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King'sWhway: q,Yes,� NoBasement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other I o Basement Finished Area(sq.ft.) Basement Unfinished Area (sq-f)e `� Number of Baths: Full: existing new Half: existing net L Number of Bedrooms: existing _new .� Total Room Count (not including baths): existing new First Floor Room CountP Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes 0 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 _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Mike McCarthy ConStrigetoan Telephone Number PO Box 52 Address WPC* DennisTA4A 02670 License # Cell (508) 280-6964 GSL 58633 �C. ,—69393 Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 4t, ` FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. <'- ADDRESS VILLAGE OWNER s� DATE OF INSPECTION: - FRAME INSULATION FIREPLACE r .ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL 'i r GAS: ROUGH FINAL FINAL BUILDING= s DATE CLOSED OUT f ASSOCIATION PLAN NO. i 's OWNER AUTHORIZATION FORM I, v (OwneVs Name) owner of the property located at (Property Addre s) nn (Property Addre s) hereby authorize (Subcontractor) \j an authorized subcontractor for RISE Engineering,to act on my behalf to obtain a building permit and to perform work on my property. Owne s Signat • X z Date I Massachusetts -Department of Public Safety Board of Building Regulations and Standards _ - Cm1xh•urtil�n Supersi�ur License: CS-058633 MICHAEL J MCCARTHY PO BOX 52 W DENNIS MA 6267; I A - Expiration Commissioner 04/10/2016 MOM wammio/�Ct7a 0/� �j?7/c/Alejeff's _— Office of Consumer Affairs and Business Regulation -- 10 Park Plaza - Suite 5170 j Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 169393 Type: Individual Expiration: 6/16/2015 Trek 238121 MICHAEL MCCARTHY MICHAEL MCCARTHY P.O. BOX 52 WEST DENNIS MA 02670 / Update Address and return-card.Mark reason for change. SCA 1 G 20M•05/11 %/ ElAddress Renewal 0 'Employment 0 Lost Card The Commonwealth of Massachusetts Department oflndustria/Accidents Office of Investigations 600 Washington Street Boston,MA 02111 wwlp.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Blectricians/Plumbers Applicant Information Please Print Le ' I Mike c arthy Construction Name(Business/Organization/Individual): PO Bog 52 Address: West Dennis, AIA 02670 City/State/Zip: CS1 phMQ3 HIC-169393 Are u an employer?Check the appropriate box: Type of project(required): 1.&I am a employer with 4. El am a general contractor and I �—# have hired the sub-contractors 6. ❑Now construction employees(Rrll and/or part-time). 2.❑ I am a sole propridtor or partner- listed on the attached sheet:; 7• ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity, workers'comp.insurance. 9. ❑Building addition (No workers'comp.insurance 5. ❑ We are a corporation and Its 10.[1 Electrical repairs or additions required.] officers have exeroised their 3.❑ I am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself.(No workers'comp. a 152,§1(4),'and we have no 12.❑R °f repairs Insurance required.]t employees.[No workt:rs' 13. er comp.insurance required] *Any applicant that eheclns box#1 must also till cut the sexton blow showtog their workeW compensation poiley bdbrmadon. t Homeowners T4W submit this Affidavit indicating dsey arc doing all work and then hire outside contractors most submit a dew afd"Indicating suck lContract m that check this box must attached an additiand sheet showing the name cf the subcontractors and their workers'comp.policy lydiOrmadox lam an employer Oiat Is providing workers'compensation Insurance for#q employees Below Is the policy and job site Information. �+ Insurance Company Name: A• •n• ���w-� Policy#or Self-ins.Lic.#: VWL 1GO (.so�1G�6" �°i`�� Expiration Date: Job Site Address: e.I2 I,.s..��., Gly- City/StEmalp: 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 ofMGL c.152 can lead to the imposition ofcriminaI penalties of a fine up to$1,500.00 and/or one-year Imprisomnen%as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cer7 N e pa a enaltkes ofperfury that the lr{/ormadon provided above Is true and correct S Phone#: Qjflcial use on Cy. Do not wrlle In this area,to be coiVIated by city or town ofj klaL '1 City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector j 6.Other Contact Person: Phone#: r• ACOORV CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) , ti 07/10/2014 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: It the certificate holder Is an ADDITIONAL INSURED,the policy(les)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 01962-001 RRI€/►CT Bryden&Sullivan Ins Agcy of Dennis Inc j}E1Q Ext: (508)398-6060 ,No.: (508)394-2267 PO Box 1497 �"S{ ss: So Dennis,MA 02660 RE8W AEE0RQKQ-Q0Y0AG.E ALCM sAIRER A. A.I.M.Mutual Insurance Company 26168 _ INSURED INSURER 0 Michael McCarthy Construction Inc NSIJRER G _ P 0 Box 52 West Dennis,MA 02670 S gURERE COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO W1•IICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE I SK POLICY NUMBER MM/DD LIMITS GENERAL LIABILITY EACH OCCURRENCE i COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTEDvrencel i CLAIMS-MADE f7 OCCUR MED EXP(Any one person) i PERSONAL 8 ADV INJURY i GENERAL AGGREGATE i GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG i --�OLICY I UEC —�OC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT i ANY AUTO BODILY INJURY(Per person) i ALL OW SCHEDULED BODILY INJURY(Per accident) i AUTONED S AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE i AUTOS i UMBRELLA LIAR OCCUR EACH OCCURRENCE i EXCESS LIAB CLAIMS MADE AGGREGATE i DED RETENTION i i pAND PERMPLOilETfols�' TME�r X ARMS O - A OFFICEWMEMBER EXCLUDED?ECUTIVE YNIA VWC-100-6017656-2014A 7/17/2014 7/17/2015 E.L.EACH ACCIDENT i 500,000.00 (HMaggnesdaat�toyyryy�In NH) a� E.L.DISEASE-EA EMPLOYEE i 500,000.00 DESCRIPTION OPERATIONS below E.L.DISEASE-POLICY LIMIT i 500,000.00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,H more space Is required) Workers Compensation Coverage applies to MA employees only. CERTIFICATE HOLDER CANCELLATION Thielsch Engineering 195 Francis Avenue SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cranston,RI 02910 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map-` 13 Parcel Application # l Health Division-`-' Date Issued �. Conservation.Division _ i Application Fee S Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address wlj.2_ Village Owner �� L�htiw�-, Address s,•,.� Telephone Permit.Request Square feet:z 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation '`' Construction Type .Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family P/ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑ Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new .... ......... Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Roosp Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric O Other J`7 Central Air: ❑Yes ❑ No: Fireplaces: Existing New Existing wood/c,al stove: ❑Ye ❑ No r Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ e.fisting ❑lpew ize_, ► Attached garage. ❑ existing ❑ new size _Shed. ❑ existing ❑ new size _ Other: + � ,r 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 Mike McCarthy C'nnstruction Telephone Number PO Box 52 Address West Dennis, M_A_ 07-670 License # Cell (508) 280-6964 C-SL 58633 191C =6939.3 Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE y///I FOR OFFICIAL USE ONLY APRLICATION# DATE ISSUED ' MAP/PARCEL NO. ADDRESS VILLAGE OWNER f DATE OF INSPECTION: � FOUNDATION E FRAME r INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING E, DATE CLOSED OUT ASSOCIATION PLAN NO. f AC R o CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYI) 10/1612013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).' PRODUCER 01962-001 !CONTACT Bryden&Sullivan Ins Agcy of Dennis Inc HENNo.ExtZ: (508)398-6060 — — -__ !�N_No.A(508)394-2267 PO Box 1497 E So Dennis,MA 02660 I A MAILDDRESS: -_-_---__- _- • INSURERLS)AFFORDIbJG COVERAGE-,--_-,_--,-- NAICj/ ---_ Mutual Insurance Company 33758 INSURED i INNS_UR€LB_-------------...------------------Michael McCarthy Construction Inc I INSURER C West Dennis,Dennis,MA 02670 INSURER LLN$URER EE- -_---------- --'-- -- �I i COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEWISSUED 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 CONDIMCNS OF SUCH POLICIES.LIMITS SHOIA'N MAY HAVE BEEN REDUCED BY PAID CLAWS. INSR ADDLTUBR'-- -- -'-------T POLICY EFF POLICY EXP----"—- -'---- -' ---- - ' LTR' TYPE OF INSURANCE I INSR I WVD I POLICY NUMBER )(MMIDD/YYW) (MM/DD/YYYY LIMITS �GENERAL LIABILITY �----------_-_----- --I- I EACH OCCURRENCE $ `.COMMERCIAL GENERAL LIABILITY l DAMAGE TO RENTED -$'--'---'----- ' `-- -� ! I I i PREMISE,S�aoccurrence)--i..--------.... I CLAIMS-MADE I OCCUR 1 1 I' I MED EXP(Any one person) $ I PERSONAL&ADV INJURY $ j GENERAL AGGREGATE $ - ,GEN'L AGGREGATE LIMIT APPLIES PER: ; ! I PRODUCTS-COMP/OP AGG !$ RO- - - - i_ POLICY :......_JECT LOC __ -/ ...... - - --- ! I COMBINED SINGLE LIMIT i AUTOMOBILE LIABILITY i 1 { �$ . ANY AUTO i I I BODILY INJURY(Per person) '$ ALL OWNED I SCHEDULED { I r AUTOS AUTOS I I I BODILY INJURY(Per accident);$ I NON-OWNED I I I PROPERTY DAMAGE -; -•-• - -----"__..._. HIRED AUTOS i AUTOS i L� er accLn� $ F- I "- -- ----- --- ----"- ! °$ UMBRELLA LIAB :OCCUR I j EACH OCCURRENCE F$ j EXCESS LIAB ? i CLAIMS MADE ! i AGGREGATE I$ DED j RETENTION $ I I I $ I - -- - - - -'j �n/C gTA7� � 10TH-. A pRKERS CpMPENSATION i i I X TORY LIMITS i ER AND EMPLOYERS'LIABILITY L_�._--.-. —.-__--__... AI ANyy PR��ppRI�ET'�ppR/PARTNER/EXECUTNE Y N ' I ! I E.L.EACH ACCIDENT I$. 500,000.00 oFFICER/MEMBEREXCLUDED? ( Y I N/A i VWC-100-6017656-2013A 1 7/17/2013 7/17/2014 r------- -----'-------- j(Mandadton,In NH)) t--� I I I !(E.L.DISEASE-EA EMPLOYEE I$ 500,000.00 D99 115TM OF 9PERATIONS below I I _ - - -_ - I F L.DISEASE_POLICY LIMIT $ 500,000.00 _ ...._.. -..�..._. ._ ... _...... - ---- - I I ! DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) I CERTIFICATE HOLDER CANCELLATION I TOWN OF SANDWICH Attention:BLDG DEPT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TOWN HALL ANNEX THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Sandwich,MA 02563 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE �C' fiu \ ©1988-2010 ACORD CORPORATION.All rights reserved. i Business Regulation Office of Consumer Affairs and 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement C6ntractor Registration C O A -= - - Registration: 169393 0 3 t �- �� to9 m d r� = Type: Individual 0 ° `" Expiration: 6/16/2015 Tr# 238121 N 0 s MICHAEL MCCARTHY MIMI! MICHAEL MCCARTHY _N �`�— in P.O. BOX 52 •,. � � 4w -4 % y WEST DENNIS, MA 02670 = }>�` ,.6 M 'Update Address and return card.Mark reason for change. 0 o j �4��> Address Renewal ❑ Employment Lost Card '•110 l\�� f7 SCA 1 0 20M•05/11 • a (921e zmzazzcuealG/ License or registration valid for individul use only (n v Office of Consumer Affairs&Busibess Regulation x �'~ "`" m OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: 'r` ::<.; ;;. — Office of Consumer Affairs and Business Regulation a cn o egistration: /1'69393 Type: a) q'4 G m 10 Park Plaza,-Suite 5170 a is .., a u xpiration:rw6/1662015, Individual Boston,MA 02116 MICHAEL MCCARTHY MICHAEL MCCARTH:Y,=E?�����- 6 RANGLEY LN. \ SOUTH DENNIS, MA 02660:I"� Undersecretary Not valid without signature f IL OWNER AUTHORIZATION FORM (OwneYs Name) owner of the property located at 01 d- vJ Ib� �2 6 C-- (Property Addre ) (Property,Addre s) herebyauthorize 1 ' \ C , (Subcontractor) an authorized subcontractor for RISE Engineering,to act on my behalf to obtain a building permit and to perform work on my property. Owne Signat . x 2 2 �L Date The.Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations ' 600 Washington Street Boston,MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/EIectricians/Plumbers Applicant Information . Please Print Legibly Mike McCarthy Construction Name(Business/Organization/tndMdual): PO Deo e7 Address: West Dennis, MA 02670 e - City/State/Zip: CSL-58633phJMV-169393 A7aIm an employer?Check the appropriate box:, Type of project(required): 1. a employer with_�_ 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- wed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g• ❑Demolition workingfor me in an aci employees and have workers' Y capacity. �• comp.tnctrran�,$ 9. ❑Building addition [No workers'Comp.insurance p 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.] *Auy.applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit tins affidavit indicating they are doing all work and then hue outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of 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 insurance coverage verification. I do hereby certify u e and penalties ofpm*g that the information provided above is true and correct Signature: Date: Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for thew employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in'a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual;partnersjhip;;assoc, _ or other legal entity,employing employees. However the owner of a dwelling house having not more than three.apartments and who resides therein,or the occupant of the dwelling house of another who employs persons.to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant,thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below._ Self-insured companies should enter their self-insurance license number on the appropriate line.' City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (Le.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions.- please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Iuvestr`gations 600 Washington Street. ' Boston,MA 02111 i Tel,#617=727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#617-727-7749. wwwmass.gov/dia TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Ma o _.t Parcel o�� `� licat on #- 6 p pp Health'Division Date Issued Z Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address 7-IA Z- ._,, ..,a Villages Owner Address Telephone s d-% - N :o%a > �.. . ....s. Permit Request .�.. �.i.1-r W d,�. L a.� .c1.� Z„ ?Vy y .b o ,�.� k►.>fit.-..�a...� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new. Zoning District Flood Plain Groundwater Overlay '. so Project Valuatio k Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure V5 Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑ Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq C Z Number of Baths: Full: existing z new Half: existing neW,, Number of Bedrooms: Z existing —new CD v Total Room Count (not including baths): existing new First Floor Roorn Count Heat Type and Fuel: ❑ Gas Oil ❑ Electric ❑ Other C= Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/c al stover Yes❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number —o% - %33- $3 'a 4 Address License # o 2.,1- B ap Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE Iz FOR OFFICIAL USE ONLY -, APPLICATION# e DATEISSUED MAP/PARCEL NO. ADDRESS VILLAGE. OWNER t DATE OF INSPECTION: " FRAME -. - - - - - - INSULATION FIREPLACE ELECTRICAL. . ROUGH FINAL . t PLUMBING: ROUGH FINAL: GAS: _ ROUGH FINAL FINAL BUILDING DATE CLOSED OUT t ASSOCIATION PLAN NO. ayJ y The Commonwealth of Massachusetts print Form.., Department of Industrial Accidents Office of Investigations 1 Congress Street,Suite 100 Boston,MA 021.14-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Busin..ess/Organization/individual):Con-Serve.Energy,Inc .dba ConserVision Energy Address:376 Route 130 City/State/Zip:Sandwich, Ma 02563 Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.❑✓ 1 am a employer with 8 4• ❑ 1 am a general contractor and.C 6. [],New construction employees(full and/or part-time).* have hired the sub-contractors 2.El I am a sole proprietor or partner- listed on.the attached sheet. 7. ❑ Remodeling These sub-contractors have ship and have no employees. 8. ❑Demolition working for me in any capacity. employees and have workers' 9. [] Building addition [No workers'comp.insurance comp•insurance.- required.] S. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 1 LEI Plumbing repairs or additions myself.[No workers'comp. right of exemption per MGL 1.2•❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees.[No workers' 13.❑✓ Other Weatherization 2013 comp,insurance required.] •Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. [Contractors that check this box must attached an additional sheet showing the[tame of the subcontractors and.state'whether or not those entities have employees. tf the subcontractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance.Company Name:Selective Insurance Co.:of the SouthEast Policy#or Self--ins.Lic.#:WC7956539 Expiration Date:3/14/2014, Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.60 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification.. I do hereby cerd under the pains and penalties ofperjury that the information provided above is true and correct; Signature- - - Date 3. 2 2013 Phone#:508-833-8384 Official use only. Do not write in this area,to be completed by city or town offieiaL City or Town: Permit/,License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.Citylfown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: CSSL-102778 DONOR D MCINERNEY 30 SIASCONSE-T DRIVE SAGAMORE BEACH MA 02562' 08/.19/2014 Office 6(ito ins'umer Affays&Busmcss Rigulatton` HOME IMPROVEMENT CONTRACTOR Registration;; 17.12514 Type: Expiration: 3/1i2014 Partnership. CON-SERVE-ENERGY COIdOR MCINERNEY 376 ROUTE 130'8111TE C y ;�z SANDWICH,'MA 02563 - Uodersecrtfory I License or regisiration val dtfofindividul use only, before-the expiration date:`If found return to: .Office of Consumer.Affairs'and,Business Regtilafion, 10i Park Plaza-Suite 51,70 Boston,-M'A,02116 Not valid without signature: 1. PA 151AIM, A 'suss save � ' PERMIT AUTHOWATION FORM owner of the property located at; (Owner's Name,printed) (Property Street Address) (Citylrown) hereby authorize the Mass Save Home Energy Services Program assigned Participating Contractor listed below to act on my behalf and obtain a building permit to perform insulation and/or weatherization work on my property. Owner's Anatirre e / Date FOR CSG OFFICE USE ONLY Conservation Services Group has assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: Participating Contractor Date Rev.12132011 �i CONTRACTOR WORK ORDE1 k-_Y atlon 3Ces 4roup --aaWkshbMton St.Suite 3000 Printed: 11/18/201 trough,MA 01581 Work Order Id: S77356P82223C33 tractor information 'Custbm9-0ite Details-, r 4, ConserVision Energy Roy Lithwin Email: rlithwin@verizon.net Phone(Eve): 508-428.1258 376 Route 130 242 Winding Cove Rd t Sandwich,MA 02563 Marstons Mills,MA 02648-1824 Phone(Day): ID: S00002177356 Total Installed Measures Location Description Quantity Unit$ Total$ Living Space Door:Thermal Barrier Polyiso 2"(Attic) 1 $74.31 $74.31 Living Space Door:Thermal Barrier Polyiso 2"(Attic) 1 $74.31 $74.31 Living Space Door:Thermal Barrier Polyiso 2"(Attic) 1 $74.31 $74.31 Living Space Install 2"Thermal Barrier Polyiso On Kneewall 251 $4.02 $1,009.02 Installed Measures Total $1,231.95 I Payments Incentive Payments Weatherization Incentive $923.96 .Total Incentive Payments $923.96 Customer Share - Total Customer Share $307.99 Less Deposit Of $107.99 Customer Share Balance(Due Contractor) $200.00 t Conservation Services Group-50 Washington Street Suite 3000-Westborough,MA 01581 -(508)836-9500 i CONSENE-01 MVAUGHAN AC�RIO' - IIAN,DD„ M CERTIFICATE OF LIABILITY INSURANCE DATE 3/28/2013 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: H the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the Polley,certain policies may require an endorsement A statement on this certificate does not confer rights to the certiffeate holder In lieu of such endorsement a PRODUCER ''NAME:- Strategic Business Unit - Rogers&Gray Ins.-Dennis Branch . PR 43(RID 134 a r,1 608 388-7880 Re: 877 816-2166 South Dennis,MA 02660 E-NAMADDRESS: -.. - IN3 AFFORLNNG COVERAGE wuC r.. . INSURERA:SelectlVe Ins.Co.of the Southeast INSURED - - INSURER B: .. .. Con-Serve Energy,Inc. INSURERC: dba ConserVlalon Energy $07 Main St w3uREao: Hyannis.MA 028M INSURERE. INSURER F' COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INWRANCE 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. Lm TYPE OF L-90-VAMM 2M RID POLICYRUMBER. POLIMEW POUCIVI - - llMtlS oENERALLGEWIY EACHOCCURRENCE. S 1;000.0 A X comUERCIILGENERALLAwm 52011299 311412M3 3H412014 pMuSE,1,w n S 100,021 CLAIMS41ADE a OCCUR MEDEXP0MawpersxQ 3 10,00 .- PERSONAL&IDVINJURY S.. ._. 1,000,000 GENERALAGGREQATE $ 3.000,00 . GEWLAGGRMATE LOUT APPLIES PER PRODUCTS-CoMPIDPAW $ 3,000,00 AUMOMEWIBURY R E. . 1 - - ANYAUTO- .BODILY INJURY(Perpmon) $ - ALLOLLO AUTOS KNEO SCHEDULED A BODILY INJURY(Per,oddmu) S NONOVNED HWEDAUTOS AUTOS P R 3 S UVEREAAAllllH OCCUR ... EACH OCCURRENCE- _ 3 W EXCE33 8 CLAIM AGGREGATE S DIED RETI3 WORKERS OM PENSATIGN - - _ - AlU- OTH• TORY LMIT ER A ANY AIrDEMPLOYe- EXCLUDED? UDE E© NIA Y)N C7956639 3/14/201 E.L.3 3114/2014 EACHAC=ENT $ 600, � OfifCER&EJ�tJ�lJ10ED9 PI+ In MR) E.L.DISEASE-EAEMPLOYE .3 600,00 11 de,OAEe under . I. OFOPERATIONSbdow E.LDISEASE-POLIC LIMB 3 600,0 I DESCRIPTION OF ODERAMM I LOWIDNa I VElif%ES(AWeb ACORD 1101,A Mond Rmmft Sd*&*f moo opts-O r,adnd) EXCLUDED OFFICERS UNDER WORKERS COMPENSATION:CONOR&COURTNEY MCWERNEY"NOTE THAT BLANKET ADDITIONAL INSURED COVERAGE APPLIES TO THE COMMERCIAL GENERAL LIABILITY(IF A WRITTEN CONTRACT IS IN PLACE). CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Rise Engineering ACCORDANCE MTN THE POLICY PROVISIONS. 1341 Elmwood Ave. Cranston,RI 02910 - - AUTeOMMOREPRESENTATME . 019811-2010 ACORD CORPORATION. All rights reserved. ACORD 26(2010105) The.ACORD name and logo are registered marks of ACORD I Town of Barnstable �FtME Tqy� Regulatory Services TOWN OF BARNSTABLt Thomas F.Geiler,Director B^MSTABMAM'� ' Building Division 2�9 OCT -2 PM 3 43 i639. `�� Tom Perry,Building Commissioner FD MA p 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us DIVISION Office: 508-862-4038 Fax: 508-790-6230 PERMIT# 97 - FEE: $ SHED REGISTRATION 120 square feet or less Location of shed(address) Village Property owner's name Telephone number Size of Shed Map/Parcel# Sienature Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? Conservation Commission(signature is required) Sign off hours for Conservation 8:00-9:30&3:30-4:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A -PLOT PLAN Q-forms-shedreg REV:042506 I LOT 28 v 7, LUT .a'O �o LOCA7 /N .�.. ;: ,�.• .Bh�:�'/�'..aTi9.QL.�--ems=�1r�' r EL7 FO.e "s CE,P T/F'Y T,�/E .�"aci�rt,�%.��"; s��•,�w�r o�v C�liq.�..��"�.' .d��.�"�'�'�,����'�7"�st.�.giVO 7,4,/,q C�N�OiPMS TOSC"946 ' ��"�' .�c C"• ./.9fh�$� •`�- ��� � Cq.oE' �`� /SL.9Np S' Sv ✓E Y/ L sor's map and lot number ....`5...........:........... THE r0 `` SEPTIC SYSTEM MUST �` � �♦ '9ewage' Permit number ..............I.�� �..... INSTALLED IN COMPLIA li BAWSTADLE• i House number ......... `......' .a 2"1.. WITH TITLE � 9 MA6a � .................................. ENVIRONMENTAL �.p y. CODE �p G j �� E�������E��A� �®i/'E �i�Di�,�NPYOr\�0 ' TOWN OF BARNSTA�BLE* �r, BUILDING INSPECTOR APPLICATION FOR PERMIT TO ....... .!� �.L. i 5.!.`.'.! (. ...................� `..`. �\1....... TYPEOF CONSTRUCTION ...........�.............................:!!� �............................................................................. ..........................��'tl..�.L.......19....r TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .. G. ..... .?.N..1�.P.I ��....�.U.l) ...��� .2s.� U/ ............... ?� .�--.�....................... ...... .. .....j. 1a� �.. ...(.. ......:-��...�.w�.. �.. ........�..c�.�..1.1.►. . ............................................................................Proposed Use ....... S �/ Zoning District ....................................................................:...Fire District .. ..S 1 ,r L/ ,,l.(.� Name of Owner �..�� .!.. ? ....).1..0..�.✓S=tE sZ.�.:.......Address , U.....Ij�¢�.�.!! ... �r... .... ... ..57 ,!1 .R.,T 1 e-\ �hcd_lf s...U:... .�-L-r.N�� •C��..��.. ►.....az�Name of Builder ...... .... 1... ress ..... ... ............... ..... .... Name of Architect ... Q..�^..�--.I...j.�..............................Address .... 4.5... ✓4....... ..I11...,........... .......... . I _ 11 Number of Rooms ............................... ( Foundation .. ...... �..C r C .� LJ/........CC7 1 r �.f ....�. .1. ......... J G �!� (CJ�Cn304CJ S ( ...Roofing r ) Exterior ........... ........�...... ..........................•.�.�.��... .....�................ ........................................................... Floors ....................................................Interior ...... K.............................................. Heatingss ( Q C�t•r _ g �1:..... ..... ........................................................Plumbin .............�... -5..................................... Fireplace ....................................................................Approximate. Cost ....kp. Q P.!2 '..P.C].............................. Definitive Plan Approved by Planning Board ------------------------------19---------• Area ........ 9...... ....... Diagram of Lot and Building with Dimensions Fee J SUBJECT TO APPROVAL OF BOARD OF HEALTH 91. V OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS 1 hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ... •.... � ' A 11.�.11. ..J.�.:.......... Construction Supervisor's License .....V.0 "�....✓..� ROEMER, HFIR4A ...2739.8... Permit for ................ !Sin( le Family..p�4j�5 5................. . ........................ Location ... I....242 Winding Cove Rpa(�, ........................................ ...................Mars.tons...Mills.............................. Owner ......Hele.....na..Roemer........................................ ............. Type of Construction Zr�PW. ............................... .................................................... ........................... Plot ............................ Lot ................................ January 85 Permit Granted ............ .-ry 7 j - .......................19 Date of Inspection . .......— ........ ........19 k- Date Completed 0,la _ 4S 7 - 1 - Assessor's map and lot number ............................................ - OFTHETD _, 1 sewage Permit number ............... !3 7.�......_ ...... ..................... h Z 3AHH9TLELE, i House number """a r.. .....:..:!.. ......::................................... 9 t6 �O 39• �0 i p YFY 6,• TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...... e ...-.P............... Gl ..... ................................� I I .Lc . � TYPEOF CONSTRUCTION j�O 0 .CCn .............................................................................. .............. ................................... ..........................�.Z�.?.Z........19�. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....... (. .Uf.... ...........1M�$c �Z... arks 1M U !--.5........................ Proposed Use ....>S.!.vt C',j.. .................C��v�!!..s..�.1/........��..�t.),C..�.�.!.!�. .......................... )SI2 � V �fJL�C ZoningDistrict ........................................................................Fire District .............................................................................. Name of Owner 2 ( f..?/iG, 1 <"f•,?/vtS...i .,........Address �1�U � .... .. , �....K.:..f/,. .....j.......... ............-... ,... . ............. �( r' 6Z / C� lc�:� 0Z63 Name of Builder �.Ii•(n•�I,rr.S U n�C•1�Ll,NC�7ka. ddress ......... �_. !> . <...... ......:........ Name of Architect �G..�^..�-..� � Address �� S...� �v't �C�h..11.................................. ......... Number of Rooms ................. / S Foundation .. ...... .0 U..C.�..� , e �/.��....... d.1..I ( S ............ ......... .�. ...� �l � f �I Exterior .......:....t................... .:..:.......................�".�.K: ..........Roofing ......................C........................................................... Floors ..................:.................................Interior ...:... .... ...._......... ...:.................I............................. Heating ..� ..................Plumbing �'?............:..... Fireplace ...............Approximate. Cost .... .............................. Definitive Plan Approved by Planning Board -----------_---__-_-----------19--------. Area ...... ....................... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH Ole 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. ( t I Name ....�... I1A.......( .....4'ati.! .... . .1...G ........... v2 �J I Construction Supervisor's License .....�. ....J..... ....... ROEMER, HELENA . A=57-41- 27398 V'- story No.................. Permit for .................................... ........Singlp—Family..Welling...................... Location JPt..29.e.....2.42..Wkldjng..Covp,...Road .............DAU itQm..DIU15............................... Owner .... ................................. Type of Construction ..Fj:ame............................ ............................................................................... Plot ............................ Lot................................. Permit Granted ...��U.a.ry.. ........... ./1Y 85 Date of Inspection .................................. .19 Date Completed ......................................19 TOWN OF BARNSTABLE 27398 Permit No. ------------- `3 Building Inspector V,ux,u i Cash -------------___--- °"°''� OCCUPANCY PERMIT Bond --- Issued to Helena Roemer Address lot #29 242 Winding Cove Road, Marstons Milks Wiring Inspector f� �A Inspection date -- `� f Plumbing Inspecto a Inspection date Gas Inspector v 1� �` l Inspection date Engineering Department $��t fl���i�/Al/�r Inspection date -/'q' Board of Health �> � ,r��_.�.0 / Inspection dater _ 7- 8 THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. ��6 �� .�...� . ....................................... Building Inspector f. JOSEPH P. Pt%LUz - 4TELEPHONE, 775-1120 Rid/ding Comminioner - EXT. 107 . TOWN OF BARNSTABLE BUILDING INSPECTOR TOWN OFFICE BUILDING HYANNIS, MASS. 02601 ' I MEMO TO: Town Clerk , `r FROM: B`/d j?artment ; .DATE: An Occupancy Permit has been issued forth;,,b ilding thorized by ; Building Permit # r/�` issued to ' Please release the performance bond. IS - � � � � •=O;f .2.2_,.;�L�`s,r _ . zoo • - , . .� .. IZ1� '3 _ �rg h .• - . _ .LOT gip•.' . ,c-o rIP3C39ARD "6�'. _OFFRRR.a1 . L O CA47-E40 /A/ • /��tC1�SfE ����j�� .o�PEA:57RE0 FO.Q . S CE"RT/FY' 7NE ic"ljr✓i4/,C�.'f�' °; t ' O^/ �'�iti�i .�+ e� 6 z�/�.�✓./o7,z TS .9NQ CONFORMS TO 2ON/N 0�7TE.`,L3, «2�'J. � ,pEG�/L..�T •.y i �` '''� C.4.�E f� /SL F�NO S S!/.P✓E Y/�/G z06�y � ,.w�.. fi�P.L-S. x. TE•57T/C.rE T - Mf7.SS. y. ALGER & SCHILLING ATTORNEYS AT LAW 886 MAIN STREET 7 P. O. BOX 449 OSTERVILLE. MASS. 02655-0063 JOHN R. ALGER TELEPHONE 428-8594 THEODORE A. SCHILLING AREA CODE 617 R December 10, 1984 Mr. Joseph Daluz Building Commissioner _ Town of Barnstable 367 Main Street Hyannis, MA. 02601 Re: Lot 29, Winding Cove Road, Marstons Mills Dear Joe: Charles Wellington asked me to write this letter to you concerriing. the above captioned property. I represent his father, Roger Wellington, who purchased this lot in April of this year -from Mostafa Shahroozi. Mostafa Shahroozi purchased the lot on November 2, 1979. by a deed from Mohammed Hussein Shahroozi. Mohammed Shahroozi purchased the lot from Osterville Enterprises, Inc. on October 10, 1978. Osterville Enterprises, Inc. purchased the, lot on October 3, 1978 from New England Investors, Inc. None of the. above mentioned owners, based on my examination of title, owned any other land adjoining this land and; therefore, since the zoning changed on' November. 5, 1978.and the lot was then held in separate ownership, it is my belief that our zoning by-laws allow this lot to remain buildable unless adjoining land is purchased. Roger Wellington sold this lot to Helena Roemer on November 20, 1984 and I do not believe that she owns any adjoining land. Therefore, it is my opinion that you can issue a zoning permit for this parcel since it is a valid lot. If you have any questions, please do not he 'tate �o ac me. Ver tr o s TAS/dsd