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HomeMy WebLinkAbout0059 SEAPUIT ROAD S9 S��P� ��- �'��� �� t .�� �� �� r 4 f �of4llz rl CAPEC66" INSULATIO%N �JP ,N 15 74b, ®®® EISER OEASS SEAMESSS SPYAITOAM SUSPENDED DA1TS OUTTSSS EA INSUt10N "11005 _ 1-800-696-661-11 V I" Town of Barnstable Regulatory Services Building Division 200 Main St Hyannis, MA 02601 Date: i�fll Dear Building Inspector Please accept this Affidavit as documentation that Cape Cod Insulation, Inc. performed & completed the insulation and weatherization work at the property listed below. Cape Cod Insulation did this in accordance to the specifications listed on the building permit application. All work has been inspected by a certified Building Performance Institute (BPI) inspector. All work preformed meets or exceeds Federal & State Requirements. Property Owner Property Address Village Devoi Os�e/-L)I y P Insulation Installed: Fiberglass Cellulose R-Value Restricted Unrestricted Ceilings ( ) ( k ) CLI P V Ct1t'l-- Slopes ( ) ( ) P ) Floors ( ) ( ) ( ) ( ) ( ) Walls ( ) ( ) ( ) ( ) ( ) AV 4.1,-(vM d Sincerely He yWidsident Cape c. 2� APPROVEDi-�y-9� TOWN OF BARN,STABLE ❑ GAS Cta'WIRING ❑ PLUMBING C] BUILDING TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map l Parcel ` / 001 Application # aa/ 6 S-13 SC) Health Division Date Issued If ? 12- Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board p' Historic - OKH Preservation/ Hyannis V Project Street Address Village Owner -)2,,- ✓— ,le JaLe Address Telephone Permit Request f� 94 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation J24a,d, d Construction Type Xa,&,11W71_D6"*' Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family .El' Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes 0'No On Old King's Highway: ❑Yes 8-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: 0 Gas ❑ Oil ❑ Electric ❑ Other `Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No N :Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ e sting ❑ new s ze_ garage: 9 9 Attached ara e: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other. Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ CIO rr Commercial 0 Yes ❑ No If yes, site plan review # 34. Coo Current Use Proposed Use - APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ll/&—.fg,, Zz7,- J/ Telephone Number �- Address Z? ,���1/Zc�'i��i Z21A License #�/ f:p � GALA/ o Home Improvement Contractor# 1&:YL3-2 Z Worker's Compensation #` 4�&,!!*1_2J_59e1 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE I FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED f MAP/PARCEL NO. _ ADDRESS VILLAGE s . OWNER x? DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE " ELECTRICAL: ROUGH 'FINAL ` PLUMBING: ROUGH FINAL ' ti GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT' ASSOCIATION PLAN NO. % - OWNER AUTHORIZATION FORM (Owner's Name) owner of the property located at (Pr perty Address) (Property Address) r hereby authorize Qj (Su ctor) an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform work on my property. Owner's Signature Date l 1 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Reqistration: 153567 Type: Private Corporation - Expiration: 12/15/2012 Tr# 206433 CAPE COD INSULATION, INC HENRY CASSIDY 455 YARMOUTH RD. __._------------..---------�.--.. ... . HYANNIS; MA 02601 Update Address and return card. Mark reason for cluulgc. Address �j Itenewal I Lnal.aloyanent - ) Lost Card �P3•lAl 0 50PIW404•G101216 (11'lire� ua kuuacr Affairs�l./uus nc's.Regul�•atioaa License or registration valid for individu! HOME P '6V�1PiftWf"f"6iIfZiXt�`t!f5 /zrweCCi before the expiration date. If found rctw n to: t_ Registration: 153567 Type: Office of Consumer Affairs and Business Regulation Park Plaza-Suite 5170 Expiration: 12/15/2012 Private Corporation 10 Boston,MA 02116 P ; OD INSULATION; INC HENRY CASSIDY 455 YARMOUTH RD.. HYANNIS,MA 02601 Undersecretary t alid ith t si to arhusetts-Dellartnletll of Public ti:lfet% Board of Building Regulations anti stallllal'lIS 4onstruction Supervisor License License: CS 100988 HENRY CASSIDY 8 SHED ROW WEST�ARMOUTH, MA 02673 Expiration: 11/11/2013 (uuuuivi„n.•a Tr#: 7620 I 4 zvIi rlVI No. 1605 P. 1 Client#:4597 CCINSUL ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDOIYYYY) THIS CERTIFICATE IS ISSUED AS A MATTER 07/02/2012 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 cerllHcatla holder ie an ADDITIONAL INSURED.the policy(ies)most be endorsed.If SUBROGATION IS WAIVED,Subject to the terms and condlllons of the policy,certain policies tray ruqulyd an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsemenl(s). PRODUCER Co ACT Rogers&Gray Ins. -So.Dennis NAME: Mat' aret Yowl PHONE508-760-4602 434 Route 134INC.NNa Exl: a/c Na: 077.816.2156 E-MAIL --- South DBnnis, MA 02660-16U1 5011 398-7900 INSURERI9)AFFORDINO COVERAGE NAIL N INSURERA:Peerless Insurance 16333 INSURED Gape Cod Insulation(no INsuRERa:Evanston Insurance Company -� 455 Yarmouth Road INSURERC:Atlantic Charter Insurance - IfyaruTis,MA 02601 INSURERD:Commerce Insurance Company 34754 INSURER E _ ENSURER F: COVERAGES CERTIFICATE NUMBER: _T REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED IJELOW 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 AFFOPDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVEE BEEN REDUCED BY PAID CLAIMS. SRK TYPE OF INSURANCE ADDL SUB POLICY EFF POLICY E1( POLICY NUMBER IMMIDDIYYYYJ JMMIDWYYYYJLIMITS A GENERAL LIABILITY CBP8263063 4/01/2012 04/01/2013 EACH OCCURRENCE $1 000000 X COMMERCIAL GENERAL LIABILITY pq�q Er PRl:MI�ES anccu,-_ 0 rcnm $100 000 CLAIMS-MADE EX OCCUR MEO EXP(Anyone pefeon) $5 000 PERSONAL&AOV INJURY $1 UODUU0- GENERAL A13GREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS•COMPIOP AGG s2,000,000 POLICY M PRO LOC p AUTOMUe1LELIAHILIT'Y 12MMBCKVMK 4/0112012 04/01/201" COMBINED SINGLE LIMIT {!a a[cidenl 1 00U 000 ANY AUTO BODILY INJURY(Pm pc.on) $ 4LiAB CHEDULED _- UTO$ BODILY INJURY(Par auu:Uanl) S XNUN-OWNED PROPERTY AM UTOS S S l3 XOCCUR XONJ453512 4101/2012 04/01/201 EACH OCCURRENCE! $1 QUO OOO CLAIMS-MADE AGGREGATE $1 UUU UV() OEU X RETENTION 10000 $ JIN KERy COMPl:NSAT{ON VUCAU0525yU2 6/30/2012 06/30/201 X WCSTATU- Ol-li. ' EMPLOYPIR ANY ERS'LIgAaBINLITY Y J N J3_ CER)MEMBOEfI EXGUOI�XECUTIVE� NIA E.L.EACH ACCIDkN1' 1 OOO UOO datary in NH) 7.deac6badnde,. E.L DISEASE-EA ENiPLOYEE $100'0 000 CRIPTION OF OPERATIONS bcla'u _ E.L.DISEASE-POLICY LIMIT $1 0UU UOU DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES(Attach ACORb idi.Addbfoo"I Ranmrks Schedwe,If more 6Ppcs is requd'ed) "Workers Comp Information"' Included Officers or Proprietors i Certificate Holder is included as an additional insured under General Liability when required by written contract or agreement. CERTIFICATE HOLDER CANCELLATION Cape Cod lnsulation,lne SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL be DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE - ®188 -2010 ACORD CORPORATION,All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo aro roglslered marks of ACORD IFS83840/M83848 MEY The Common w, ,dih of Massachuseits Departmemol industrial Accidents W Office-e, .q Mvestigattons M. 600 14 4 ish ington Street hose, AIA 02111 pl(Ause Print Legibly L 31 -72 5 P110110: -51 C Arc)k)(1 an unl)l0YClr? C-Iiieck, t1kc upprolwiate box; Type of project (1-CilUiriAl): I 1 4. D I am a .A contractor and I have 6. New C01IS11-LIC60111 clllpluyccs (full and/or hired ill,- id- ojaractors listed on 7. E] Reinudeling the atta-Iicd F1 S. DCnloti[ii)n I ilill l)V0PritL0r or parcnership Thesesili..".-Ifiractors have dill(have: no ctriployees working for employer,:iio have workers' comp. 9. Building addih011 me in any capacity. (No workers' insuralic".1 10, cucctcicZti rcimirs or addiliulls C01111)HIS1,11,1111CC l'CCjUi1-C(l.j 5. E] We are:i joi-mion and its 11. PlUJ1lb1n8 t'e()W'L'S Of ilddiliolls officers ii:i%;-exercised their right of E" S lloilleowner doing Lill work exempism 11,-f MGL c. 152§(4),and 12. Roof repairs myself l N11 workc-i-s' corill). we havc II,- -mployees. [No worker,' 13. Other i1)SUf.`llK'C C0111P. lll.'J.l:ilWC LF. "Y-1j)1)1l1dl11 111JI ChC&S l)0X It I MUSt also fill out the section below show,,,iiwir workers'compensation policy inforniation. I ikmw­,lwls who Subillit this itffiduyit indicating they are doing all wo,l,,Dili lieu 11jfC OUISido conutictors must submit u now Liffiduvit inklicatiiig such. Puud lcnti thal chcck this box 111LISt attach an additional sheet showing il-w.w, of the sub-contractors and state whether or not Illose entities have ellitfloy".r.s 11 4I.Q wb hay';ClnPl0y,;r.,;, they must proyidc their workers'coitq, J­h,) Ifullibcr. laill un employer that is pro vielitig workers'compensation ii,s,w,ineefor my employees.Below is the policy atul job site - histuamt-- (.'ompany Narrte: 62 vt,��C— A 43 A Policy it All .Sell'-ills. Lic. It: 612CA 00A� ExpirationDate: At)!)Site Address: city/State/Zip: Allach a cupy of the workers' coinpensilition policy declaration pag,(si...tying the policy number and expiration date). Valluic to y;C111-C cuvoragr as VCqUifCCl Under Section 25A of MGL C. 15.' lCild to thc imposition of ctiniiiial fienaltics of a fine up to 1 500-00 mltvul 011c'-Mll 1111prisull(liC11t,as well its civil penalties in the form of a STOP jkK ORDER and a fine Of Lip to$250.00 a day agaiust(lie violator.11c'.;iklvised 01.1t J CVJ)y OfthiS SAULCIIJCJIC ljjzt e forwarded to the Office of lnvesti�.,(i......„I the DIA for insurance coverage verification. 1 do:here c if outlet tithe 11,pt.ris arulpenallies qj'per itri that the information provided above is true and correct. 0 DaLe: 17 Clficiid li.)c wily. L)Q nut )VI-ite in this area, to be couspieted I.-f-rap orlowt official # Issuing:Authority (circle 011c): L Huard of health 2. Builtlijig Departiiient 3.GI /Tw i-i Clerk 4,Electrical JllSJ)CCt0F S.PIUMbilig 11)Sl)CCl0l* 0.Other Colitact .........— phone#: 000 000 >oa- p a 1 Engineering Dept. (3rd floor) Map. cel Permit# 2, y0 V ~ House �— Dat Issued 3 Board of Health(3rd floor)(8:15 -9:30/ 1:00-4:30) M sO Conservation'Office(4th floor)(8:30- 9:30/1:00-2:00) S P 'M WtT BE Planning Dept.(1st floor/School Admin. Bldg.) jW5 AfVC� Definitive Plan Approved by Plannin Board 19 E AND KpeA90✓cL iy o� /LNS TOWN OF BARN - Building Permit A plication Project Street Addr s L0 ) ��e.e Village — Owner S Address �3 J ✓E rn a Telephone �5ep- Z9 7 Permit Request NLO AJ U First Floor 1 700 square feet Second Floor c)0 square feet Construction Type 113600 f(LAtyl C—_ Estimated Project Cost $ _225, 000 Zoning District 2 F — i Flood Plain K) Water Protection �J T) Lot Size 7 2!y Grandfathered fdYes ❑No Dwelling Type: Single Family X Two Family ❑ Multi-Family(#units) Age of Existing Structure I n ✓`I(% Historic House ❑Yes 0�io On Old King's Highway (IYes kNo Basement Type: Full ❑Crawl ❑Walkout ❑Other _ Basement Finished Area(sq.ft.) NI n Basement Unfinished Area(sq.ft)Jn Number of Baths: Full: Existing New Half: Existing New QO KID, No.of Bedrooms: Existing New ° Total Room Count(not including baths): Existing New �_First Floor Room Count Heat Type and Fuel: �j Gas ❑Oil ❑Electric ❑Other Central Air '4Yes ' ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes 't�No Garage: ❑Detached(size) i Other Detached Structures: ❑Pool(size) r- f Attached(size) ❑Barn(size) �❑\None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# - Current Use Proposed Use Qt I (� Builder Information ro ^ p Naamme V0 I l D DE ` u l ] Q Ck� Telephone Number J�C`�9 4 2-8 Address 2 PLZ; cam_ Cc�V� License# hz= Home Improvement Contractor# Worker's Compensation#TTj HAQTFa2A 7 WZV t'►1D NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE7'�;�"/= DATE ] BUILDING PERMIT DENIED FOR THE FOLL WING REASON(S) C` h FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE a e OWNER a DATE OF INSPECTION: ' FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING- r,i C'OROM FINAL GASt- FINAL FINAL BUILI Nft- �r a DATE CLOSi ASSOCIATIO�P�4N i jI S EA Pv IT Qo da 139•18 i r 11 7P sit jr BF-I 17 ��+� � 228.38 • .� :- w 13 Ere 7 X F,C "� .Coc,aTro.y OST.Ert 4-4.6 s�iow.v �.eEav cos-rvL ys oa E id • i 5'97 7`•.�/E S'/OE.0/.C/� A.A/O SETB.4 ,t�E4 U�.2E�1EN7"s o.�" TNT'.�-o wit/ac'• Bq�NJT�eL�' Aic/O �/S NOr Lor �KA x7;9.-C¢ O��SET.r'.Sya`✓./S�;lov�a N,07- 8X-- USED 70 l�.F. rFP�/i.Ci� .LC�T G�it/�s <IO�L/CANT BiGpUCAU ,4 Off' /UC t ri EA P� IT 13q 18 Go.S3 goo't `µOF iki "0qlCHA 22B 3B ' A. -� /3 sazTFR a - Vo 24048 MAP /�8 Jac 12.d �PAar. tAlpTF { CE eT P L0G47/OXJ OST'E/Z✓/LLE _ ',�/OWN h�E,QEO.�/ COS-1f�L YS W/Thy SCA Z-G— ��� gyp' . 0.47^E /O /.</2--- A//4:P SETBACK AAl/ .2E�"E.2E�t/CE- ,�EQ Ui.2E�-JE•�/T.s o.�" TNT' To w�V aF 64 2&)s T,d RL.L= - Akio /S Alor LOT' OATE:_ 97��� �lV d. ,B✓�XTE.0¢�VYE ///G. `TiS//S P.L.�J�//S i!/aT B,GSEO a.</QW AEG/STE.2E1� l��O SLJ.el�6Ya� D�•SSET.S Syo�,�/.1/ S,�ULIJ it/OT g� A�i�� /CA/t/7' Q /000,6AU TOWN OF BARNSTABLE E CERTIFICATE OF OCCUPANCY PARCEL .ID 000 000 100. GEOBASE ID i ADDRESS' 59 SFAPUIT ROAD PHONE �?�teJJill� ZIP - r LOT 6; BLOCK �• LOT SIZE DBA -� ' DEVELOPMENT DISTRICT.- PERMIT 60626 DESCRIPTION SINGLE FAMILY DWELLING (PMT.#25404) PERMIT TYPE BCOO TITLE CERTIFICATE OF OCCUPANCY CONTRACTORS: Department of Health, Safety ARCHITECTS: i and Environmental Services TOTAL FEES: BOND $.00 Ox tME i ( CONSTRUCTION COSTS $.00 756 CERTIFICATE' OF OCCUPANCY f : BARNSTABLE, +' MASS. �._ 1639.. I BUILDI oD I; ON I DATE ISSUED 05/11/199r3 EXPIRATION DATE BY I , I `GOWN ,OF BARNSTABLE r- ":>� BUILDITNG PERMIT. PARCEL ID 000 000 100 GEOBASE ID ADDRESS 59 SRAPUIT :ROAD C (si�Y (L C MA; Gil' LOT 6 BLOCK LOT SIZE DBA DEVELOPMENT DISTRIN ^� PEE'jM,TT 25404 DESCRIPTION NEW 3 BDRM HOME -SEW.PT.09'4-463 PERMIT TYPE BUILD TITLE NEW RESIDENTIAL SLDG PMT CONTRACTORS: BI LODEAU BUILDERS, . TNC. .. Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: $852.50 NE BOND $-00 OxT CONSTRUCTION COSTS $275,000.00 101 SINGLE FAM 'HOME DETACHED 1. PRI'VATF P. * BARNSTABM • MASS. OWNER 039• ADDRESS ED MI`►I BUILDING,DIVISION BY/ DATE ISSUED 09,/03J1997 EXPIRATION DATE '" ✓ THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OFTHIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS, HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ELECTRICAL,PLUMBING AND MECH- 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. ANICAL INSTALLATIONS. 4.FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS a I 1 1 1 1 440 -., -1,eit Ig 9 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 -1� LY"'1 BOARD OF HEALTH OTHER: SITE PLAN REVIEW APPROVAL WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC-. MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION.yy __ // NOTED ABOVE. TION. ,,� � i t BUILDING PERMIT C IC ►� N A 2- PROVED TOWN OF BARNSTABLE -R GAS -E.wiR. NG ",a],Ptw-61N G El-�M_-DI N , APPROVED � TOWN OF Ba AB E ING PLUMB .p DEPARTMENT,OP PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE Number: ". :. Expires: Restricted To: f00 1 e; ,PETER J BILODEAU 237 PRINCE AVE MARSTON HILLS, MA 02648 V l,J�' .. 'g M Y - �T. S -r tic{` ,. The Cuntmunurcultlt of:ltuscuchusctts %r►s ��_ Department Of fltdZIS-Waal Accidents :=1�i;:i• i��' 61111 1114.01 nqtun Strect 'A• Boston.A ays. 02111 , Workers' Compensation Insurance Affidavit A El :tot infnrntatinn• _ _ Please PRINT:Ierjv (L)LEAJ UI cin (�� I `l ��— rn i"T nht,nc e -1;2P--) 2q7 g j I am a homeowner performing all work mvself• M I am a sole proprietor and have no one work-in, in any capacity I am an employer providing workers' compensation for my employees working on this job. f I I► I t- nhnne If• 'A?C) /q 7-8 incurniice co. T I 'gr1 nnliry 0• -7 VJ 7i V M [1 I am a sole proprietor. beneral contractor, or homeowner(circle orre) and have hired the contractors listed below who have the following workers compensation polices: cnmminv name! I r :Iddrect• Jam, Clft•• '/ phone�' Incl(rinrr Cn. / n11c1'0 rnmPanqv n t c• .iddresc- phone It• nsurance co nolicy>! lttach additi 'n21 sheet if neesiarvr •• ^••i•� -•+_ — _ __•rr_ �+._ ....r..�rs '+ ailurc Ill secure ctleerace as required under tieetion 3A of AIGL 153 can lead to the imposition of criminal penalties of aline up to SI500.U0 andiur nc y cars'imprisonment as%VC11:13 cit•il penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day al;ainst me. 1 understand that a opt of this-statement mac be furn•ardcd to the Office of Investigations of the DIA for coverage verification. do herchr�crrix•-tin%•r/rc n.Its'Fr ii penalties ojperjurr Ilia'the iajormadon prot7ded above is true and correct. ^nature/Js( V N Date 7 — 97 ._.. � _ � � wog 'Tint name „ n6r Phone* 42— L9 7 official use univ do not write in this area to be completed by city or town official cin•or town: permit/license# ntluildin0 Department ❑Liecnsin0 Board C . check if immediate response is required C3Seleetmen's Office CItlealth Department contact person: phone it: nOther i. Information and Instructions , 1 Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' cvmprnsaticm for employees. As quoted from the "law . an employee is defined as every person in the service of another under anr contaac o`f Hire, express or implied. oral or written. An cmplt rcr is defined as an individual. partnership. association. corporation or other legal entity. or any two or : the forcaoin�g cngaged in a joint enterprise.and including the legal representatives of a deceased employer. or-the receiver or trustee of an individual . partnership. association or other legal entity, employing employees. Howeve 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 cmplot►s persons to do maintenance , construction or repair work on such divellirr� or oat the _grounds or building appurtenant thereto shall not because of such employment be deemed to be an empb MGL chanter 152 section 25 also states that even- state or local licensing agcnc}•sirall withhold the issuance o. renewal of a license or permit to operate a business or to construct buildings in the commontrenith 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 clrapt been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation ai supplying company names. address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sibs and date flee afCdati►it. Tire 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 reeu: to obtain a workers* compensation policy. please call the Department at the number listed below. City or 'rowns ' Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottor, tite affidavit for you to fill out in the event the Office of Investi,,ations has to contact you regarding the applicant. I be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be return, the Department by mail or FAX unless other arrangements have been made. i The Office of Investi=ations would like to thank you in advance for you cooperation and should you have any quest 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 M` Office of Investigations 600 NA'ashington Street Boston,Ma. 02111 fax #: (617) 727-7749 Phone #: (617) 727-4900 ext. 406, 409 or:375 _ - -......I . . . .. . . . .. .... . . z. Av& ill 17 77.og6 lZF-t 14P 3O40 Aw Iles Pu. 12d (PW) SEq Pu R- 44. �. Gc•$g So.00 �38.12 U� -4# 1 � N �' r _ `-38 i n SG 0 . . '-- '3} . / r/ / .. STEPNEN ALLYN WILSON ca 216 M a ,� I � . WT I i L-4- L 1, .I 7t �I - El i 'J - — ;�i':;I•:Li:.; � � it I I y ! I e -- --_-- O . :ire 5aonu ;� U `@ m cam m 3 M � - 1l —i—:1 h 11 r • F � —11 1,� q�- b 77 �1 ,�, 1 T? �1 17-1 rd«a:o _ —17 re --1 1 I = I 1 I � 3 -- _ I —�rER '51 l.0 r.)S A C A m I • I 1 PZ' Yr ' 1 Ilk O 7 o �..a.. of 10• �•O-- l O• �.. — Db DV 1• •p I i p ' I t i • I: O t.'O� gyp.. -.p•p. 1b _ j •. ._.. .._ .__ .. _. ....��_ 10.0. gyp. a n0. i so'a wo• 1 i PSt'R_81LO1�SOV '+_'" l3 0 A C IC m w ti o I I . I � To s • L 44,0, ' I . e'o �o-b• roo•' leo• c•o. `� S7orteSE e~ j 1 I je L•r.0. wwn. A\w > — J I s.0 4 — i '0 I• L oil F /, • • i b i � r i I R7,' s0• r° •O.� S ip F I o i i 1 y/e'L•.Ira- i OY n 3 w � 10. v � 1 40• i � 0 r � .v C o i 1 I — o ?_._._. I _ mo- so• °a I. E a MM BILOnEAU F `� ?S(B� a m o i I 0 s r - K - i r ^ o I I �p a iE I � I BSr.vpOM, - I , - OO i . INII I. E3 _ .._ .. 0 o 0 i i a ' I PETER 611A�E�tl1 •> Q� a �� . M. C e•a . < 6 9 03� I gTV r. VT •I 7Ar +'i/ ra w�.n +��o•h•s+w♦ ; - I zi b5. I fs F i s a a Al - J • I - i PETER 151LOT)t7Su- --"' $ 40 i. 3 a _W'IV -44 • a.:� 7 4Y1- F F - -• r D 9'.0' ST1PS A 7 � IL•O O z I A a I 3 i o 0 I J Y C O • G i O a < � O c r ; . o n I � n c I 0 � T . n<yY a C m a < O cM � ? 3 �. P � b " '0 TMl�V micpomcleap CNI C= VERTICAL GRID D . E . FILTERS a P Micro-Clearis ahigh-perform - a } t ': ance filter series that provides superior water clarity, efficient t flow and large cleaning capacity for pools of all types and sizes. Gil o Micro-Clear filter tanks are now C:N _M molded from PermaGlass XL," Q a glass reinforced copolymer, P providing the ultimate in strength, durability, and long life. Micro-Clear r7 filters also combine high technology features with a is "service-ease" •. design for depend- able operation and Hot � low maintenance. I � Plus, Micro-Clear filters are avail- able with the unique SP-74ODE Selecta-Flo control valve, the only filter control valve designed specifically for D.E. filters. For the quality conscious pool owner, Micro-Clear filters are an unparalleled filtration value'. i 13 DE-6000 Micro-Clear Vertical Grid D.E. filter with optional SP-740DESelecta-Flo"'"4-position control valve. Featuring PermaGlass',ft-- N� Filter Tank Material i o HAYWARD Hydrogen,Oxygen and Hayward. The elements of clear waterTM M po- IearTM Vertical Grid D . E . Filters Automatic Air Relief purges any trapped air during filter operation. • Screenless design eliminates clogging. Integral Lift Handles and Uniform Low Profile Tank Base NSF® make removal of grid nest fast and simple. High-Strength Filter Tank molded of PermaGlass Xr provides extra durability for dependable,corrosion-free performance. High Impact Grid Elements designed for up-flow filtration and top-down backwashing for maximum efficiency. Heavy-Duty Tamper-Proof Bolted Center Flange Clamp ' securely fastens tank top and bottom together.Allows quick access to st all internal components without disturbing piping or connections. Union Locknuts make disassembly and reassembly of filter from piping fast and easy. I yd Noryl®Bulkhead Fittings for extra strength and heat resistance. - Inlet Diffuser Elbow distributes flow of incoming unfiltered water s upward and evenly to all filter elements.Parabolic tank base design r provides for even distribution of D.E.to grids. Full-Size 11/2"Integral Drain provides fast, 100%clean out and easier flushing of tank. Convenient Valve and Plumbing Options allow for customized control.2"internal piping and plumbing for maximum flow performance. i t r rV11117i I � • FILTER TYPE: Vertical Grid Diatomite:24,36,48,60 ft? FILTER TANK: Injection molded PermaGlass XL11 FILTER ELEMENTS: Monofilament polypropylene cover fitted over 8 curved, high-impact grids j CONTROL VALVE: 1%z"or 2"6-Position Vari-Flolm 2"4-Position Selecta-Flo!l 2"2-Position slide valve.May also be plumbed singularly or in series , with quick-connect union couplings Mess valve). PERFORMANCE RANGE: %z TO 3 HP(30 to 120 GPM) DIMENSIONS: DE-2400—31'i"H x 23"W(800 mm x 584 mm) DE-3600—36W H x 23"W(927 mm x 584 mm) DE-4800—4N"H x 23"W(1080 mm x 584 mm) DE-6000—48V'H x 23"W(1232 mm x 584 mm) Above dimensions are for filter only.Overall width with slide valve is 30"(762 mm); overall width with either 4-or 6-position multiport valve is 33'(838 mm) MODEL EFFECTIVE DESIGN TURNOVER(GALS.) NUMBER FILTRATION AREA FLOW RATE 8 Hr. 10 Hr. DE-2400 24 ftZ 48 GPM 23,040 28,800 DE-3600 36 ftZ 72 GPM 34,560 43,200 Plumbing Versatility.Select from a wide array of valve options for customized control of your DE-4800 48 ftZ 96 GPM* 46,080 57,600 filtration system,including Hayward's 2,2-position DE-6000 60 ftZ 120 GPM* 57,600 72,000 slide valve. 'Determined by pump size and piping system hydraulics. 2'piping is recommended for flow rates of 90 GPM or more. Flow rates above 120 GPM are not usually required for residential pools. HAYWARD POOL PRODUCTS, INC. • Hayward Pool Products,Inc. , Hayward Pool Products,Inc. Hayward Pool Products Canada Hayward S.A. 900 Fairmount Avenue 2875 Pomona Boulevard 2880 Plymouth Drive Zone Industrielle de Jumet Elizabeth,NJ 07207 Pomona,CA 91768 Oakville,Ontario L6H 51`14 B-6040 Charleroi,Belgium 8-95 ©1996 Hayward Printed in U.S.A. I CkWE i a . . °: The Town of Barnstable BARMAIM Department of Health Safety and Environmental Services P Building Division ; 367 Main Street,Hyannis MA 02601 Ralph Crossen Office: 508-790-6227 Building Commissioner_ Fax: 508-790-6230 For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, :. conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not 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:-�i a ► �� �`' Est.Cost �,t 6nn ti Address of Work: Owner's Name � Qe ° �eo f,\I Date of Permit Application: — I hereby certify that: Registration is not required for the following reason(s): ! Work excluded by law Job under$1,000. Building not owner-occupied 1 Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED ME VE CONTRACTORS FOR APPLICABLE PPLI PROGRAM OR GURARANTY FUND UNDER MGLO 142OVEMzNT WORK DO NT A ACCESS TO THE ARBITRATION SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. f 8 Registration No. Date Contractor Name OR i Date Owner's Name The Commonwealth of Massachusetts Department of Industrial Accidents '�. ' • _--�,�} 0llllcs iJ/ommst/�s�lfi�t 600 Washington Street ✓-�� �' '�� Boston 'Mass. 02111 -" Workers' Compensation Insurance Affidavit -71 Applicant informations t }..: ;.♦ name location: U t 1 phonc y I am a homeowner performing all N'ork myself. I am a sole proprietor and ha%e no one �%orking in any capacity - I am an employer pros iding workefs' compensation for my employees working on this job. company name: Sc ,e'ae address: �cX '� 5- L city: I 11S l�►��5 phone#:_- insurance co IV t�UT 1` I S f l (j policy# N C o 2•� J-6 6 _'^ ❑ I am a sole proprietor. general contractor. or homeowner(circle one) and have hired the contractors listed below Who have the follow in,- workers* compensation polices: company nam • IMF; address* citn': phone#: insurance co noliev# company name: citx. phone No AolioY# insurance co Failure to secure coverage as required under Section 25A of MGL IS2 no lead to the imposidoo of crimisal penalties of a dot up to S1.S00.00 and/or one years'imprisonment as well as civil penalties in.the form of a STOP WORK ORDER soda floe of S190.00 a day agsiost me. I understand that s copy of this statement may be forwarded to the Office of investigations of the DIA for coverage verification. /do hereby cerrif}•under rha pains and penalties o/perjury that the information provided above is true and conem Signature Ct) " — Date Print name A 1 c ► Sc 1P-a(zrk Phone 11 �l oMcial use only do not write in This area to be completed by city or town oMcisl Jrd city or town: _ _ permitAiceose N nBuilding DoUceusiug O check ifimmediste response is required C]Scicctmeo'QHealth De c,eontact person: phone N•_ _ nOtbcr i :'1�7Mt-'Vi•r...•1:5 �.�:fS.':A.�: i�!•�`IQ.•tG:."t 't"' .... .. .. '1'•" � f s. ONE INPROVEMENT 60NTRA�TO ✓ 1 .A80}StfiSt10A�116666 ,- q' �r 9� ' p ape INDIVIDUAL `. ', xPl'att oon 0/05/98 , R 4i1; 1t:ti 'd... t �•61^.. �A•rt. 'Yf n•v ' ' �IARREN F SCHERER . ;,' �y•� INIRREN ��SCtIERER�� .: ARINER tIR ,y MA;02635 � %:�:��:b••''•,:L�:4�i:'.sg.�s.tlr�ld'A,r�__:l��yj/./�,tius`°"'°i/,�'�'�_/ Cgs ' ✓lte -VOyI OWNERS COPY b MODEL: Grecian -RAWINGS APPROVED AS NOTED. SIZE: 18'6" x 36'6" 8' Deep TY :.JBJECT TO CHANCE WITH WEIGHT: - F 'OVISIONS OF AL WOES AND GALLONS: I 1 = I SQ. FT. OF SURFACE ON BOTTOM 1; LAWS. DATE: February, 1981 , I ADWICH WSMION KEPT. - 1- I 9' i i I 5. NSPI TYPE it 1 1 ' I I I 1J 147' — --I 1a I SLET wstr / SnIMMEN 9' g' 9 NSPI TYPE I I t I I I m 1 m I I I L 1 J r— a'6" 1 D' MODEL: Grecian WILI r I ,•.[rL) eOU PO measuremenrs art nontontal SIZE: 16'6" x 35'6" 8' Deep ' ar•o bnMnea olmensOns 1 - -� v WEIGHT: GALLONS: B' ems— e 1 SQ. FT. SURFACE OF BOTTOM: DATE: February, 1981 r NSPI TYPE II i-- e MODEL: Grecian —� SIZE: 20'6" x 40'6" 8' Deep '4- ------------ - 12• WRIGHT: GALLONS: SQ. FT. SURFACE OF BOTTOM: DATE: February, 1981 q'�.� ono I�fi� Engineering Dept. (3rd floor) Map Parcel Permit# ,� d !� 01 House# �`6 Date Issued "2(' Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) 161- Fee �,��. 9 0 Conservation Office(4th floor)(8:30- 9:30/1:00-2:00) 01SYST_ ItEM MUST BE Qlain �8L:;uiniDeot.(1st floor/Sc6W n,�.. W &W ) INSTALLED IN C _ CE WITH TI 19�19Ii3CNNo'EN MA ,11 `r is a Lag ks B I EO MPS�`� TOWN OF BARNSTABLE rl Building Permit Application Project Street Address 2/- S EA PJ 1\ go Village (�- �& Owner �@'CGt2_ 13 i Lo n e A Address Telephone Permit Request wt wt wt,i v�, G F6o( ,4-- DeC =�CJ Q_l�V Iy 1 Il�Cs9 G� t© X 1-2 GA Z,5�- o onl n E �G7q First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No 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 No. of Bedrooms: Existing New 6� ,0 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 Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) to X 33 ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name Sl"ae_e � S Telephone Number 4 2(3 Address {�fQ `'� C License# d G4 2 3 a Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE l BUILDING PERMIT DENIED FOR THE FOLLOWING RE ON(S)