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Home My WebLink About0285 SEAPUIT ROAD f . ftNiVERSAL(D U NV-10503 MADE IN USA SUSTAINABLE WL RECy= FORESTRY INITIATIVE M4wio% Certified Fiber sourcing POST-CONSUMER nv sfiprogram org I _ H E AT L 0 K" C)o Company Name CAPE COD INSULATION Phone Number 1-800-696-6611 Keith Dacey& Kyle D. Installation Date 07/15/2020 285 Seapuit Rd. Osterville, MA GE019365 lobsite Address A-Side Lot #'s P3905512220 Permit Number B-Side Lot #'s Attic Roof 7.4 R-49 350 Square Feet 4.5 R-30 230 Square Feet Crawl Space ? Walls 4.5 R-30 350 Square feet www.Demilec.com cBDEMILEC H EAT LO K5 oo Company Name CAPE COD INSULATION Phone Number 1-800-696-6611 03/03/2020 John Legere Installation Date C285_Seapuit_3oa.d'Osteryille� PA86001994 lobsite Address A-Side Lot#'s Permit Number B-Side Lot #'s P3856003320 • . (.�� . .gift@& 3.2 R-21 180 Square Feet Walls 7.4 R-49 450 Square Feet Attic Roof Rim 3.2 R-21 50 Square Feet Crawl 4.5 R-30 160 Square Feet www.Demilec.com c8DE.MlLEC ' Town of Barnstable _ Building wevscaese�; Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be`Kept MASS. Posted Until Final Inspection Has Been Made. , eo tp�o Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit Permit No. B-19-3989 Applicant Name: E J JAXTIMER BUILDER INC. Approvals Date Issued: 12/13/2019 Current Use: Structure Permit Type: Building-Addition/Alteration-Residential Expiration Date: 06/13/2020 Foundation:- Uj Location: 285 A SEAPUIT ROAD,OSTERVILLE Map/Lot: 095-007-001 Zoning District: RF-1 Sheathing: � Owner on Record: REHNERT,GEOFFREY S&LAURA A Contractor Name: E J JAXTIMER BUILDER INC. Framing: 17 Z • Z" Address: C/O AUDAX GROUP Contractor License: 110609 2 BOSTON, MA 02199 Est. Project Cost: $75,000.00 Chimney: Description: additon to office approx 12x5.5 install gase fire place in office Permit Fee: $482.50 addtion to family room 17x5.5. Install 12'bifold door and relocate 2 Insulation: Fee Paid: $482.50 windows in kitchen area. rebuild pergola off family room Date: 12/13/2019 Final: Project Review Req: Plumbing/Gas g/Gas Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: Service: 1.Foundation or Footing 2.Sheathing Inspection Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Building plans are to be available on site Fire Department Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT � [ Application Number....... ............��1_J......r............................. * BARNSTABI " Permit Fee............ MASS. g G••• •` �.eOther Fee........................ 2,639. Total Fee Paid TOWN OF BAR.NSTA13LE J ' Permit Approval by... .....................On...1�1t 3.1.�.`�.... BUILDING PERMIT �j APPLICATION Map........L,,1 . .-.......,...Parcel.....,w...�..D;d ...... Section I — Owners Information and Project Location Project Address _ sea 0 U l�— Village_ t+ Owners Name Owners Legal Address City D Ste'w State Zip Ozk FT Owners Cell# "�— E-mail r-�— Section 2--Structural Use Single/Two Family Dwelling ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet Section 3 —Type of Permit ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment 6 e�p6�System Addition ❑ Retaining wall ❑ Solar SOIL ❑ Renovation © Pool ❑ Insulation Npy 2 5 2019 Other—Specify. - ()VVN Ur t AhNSTABLE Section 4--Detail Cost of Proposed Construction � Square Footage of Project K ST" Age of Structure t3 Dig Safe Numbei >� # Of Bedrooms Existing S Total#Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist Design Last updated: 11/7/2017 Section 5 -Work Description 5. In 2` Y'7 k o A h 0 l 0 a4 W(A v26VX C \LAQ Section 6—Project Specifics Wiring [] Oil Tank Storage ❑''Smoke Detectors I ambing [J Gas ❑ Fire Suppression eating System ❑ Masonry Chimney ❑Add/relocate bedroom Water Supply R'Public ❑ Private Sewage Disposal . ❑ Municipal On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: �VLV- � I am using a crane ❑ Yes No Section 7--Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No ❑ Section S—Zoning Information Zoning District Proposed Use Lot Area Sq.Ft. ' Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) 3 Setbacks Front Yard Required Proposed r-- Rear Yard Required Proposed Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No Last updated: 11/7/2017 Section 9—Construction Supervisor Name EJ 0y flf'IZ l� Telephone Number Ci a� a� State Zip D/ C Address ��s�r�, � � _r____ t3' � �— License Number 03�S License Type �S Expiration Date I ��'o Contractors Email 9 Cell# !; I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 ' CMR the Massachusetts uilding Code. I understand the construction inspection procedures,specific inspections an documentation re uir Barnstable.Attach a copy of your license. Date (11111 l Signature Section 10 —Home r ovement Contractor Name 61�1 JM61-7 Telephone Number ((05� 779 74eq / Address �� —City l State Zip Registration Number Expiration Date I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance_with 780 CMR the Massach Sty uil- '.ding ode. I understand the construction inspection procedures,specific inspections and documentatio wire 0 CMR d the Town of Barnstable.Attach a copy of your H.I.C... Signature Date 11) Il Section 11 —Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection_procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date PLICANT' SIGN.A�T Signature Date 1 11 Print Name Telephone Number E-mail permit to: Last updated: 11/7/2017 Section 12—Department Sign-Offs Health Department ❑ Zoning Board (if required) ❑ Historic District- ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation For commercial work,please take your plans directly to the fire departmentfor approval Section 13 — Owner's Authorization L `S�� , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to.work authorized by this building permit application for: (Address of job) Signature of Owner date Print Name i j Last updated: 11/7/2017 Of�`l 1, NA7iAFSTAB MASK Town of Barnstable _ Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CBn Building Commissioner 200 Main Street, Hyannis,MA 02601 www.towd.barnstable.mams Office.: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder n�Y ,as Owner of the subject,property hereby authorize Wh"I Ail/L�, K 1!2. to act can my behalf, in all matters reladve to work authorized by this building permit application for.: 1 �. � � �� J (Address of Job) 01 V l� $q! nture of Owner. Date KILL - _ — Print Name Il Property owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\users':dccollikiAppData\LucaNlyticrosoli',Winduw4\Tcmporury Internet FilcslCuntem.Outlook,DDV87AAZ\GXPKLSS.doe Revised 072110 ,per The Commonwealth ofMassachusetts \ Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electriciaiis/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): 19-Y 171ne-K QUIL�pgrY` IA16 Address: S l l D<Sal ll 4 -4 City/State/Zip: MA d 0 Phone.#: Are you an employer? Check the appropriate box: Type of project(required): 1.[,I am a employer with 4. ❑ I am a general contractor and I 6 ❑New construction employees(full and/or part-tim.e).* have hired the sub-contractors listed on the-attached sheet. 7...❑Remodeling 2:❑ I am a sole proprietor or partner- These sub-contractors have ship and have no employees 8. -1 Demolition working for me in any capacity. employees and have workers' g ❑Building addition [No workers comp.insurance.$ comp.-insurance 10.11 Electrical repairs or additions required.] 5. [] We are a corporation and its ❑ officers have exercised their 11.❑Plumbing repairs or additions 3. I am a homeowner doing all work myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, 1(4),and or have no 13.❑ Other employees. [No workers' 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. lContractors 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: !"►K�/�� `�`� Policy#or Self-ins. Lic.#: '/" �/ S__ Expiration Date: Job Site Address: S ftOKCity/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 for insurance covers e verification. I do hereby certify under the p d penalties of perjury that the information provided above is true and correct. Si ature: • Date: Phone#: Official use.only. Do not write in this area,to be completed by city or town offtciaL .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#: TE ACC)Ro® CERTIFICATE OF LIABILITY INSURANCE DA01/30/2019Y) 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 have ADDITIONAL INSURED provisions or 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 NAME:CONTACT Erica H.O'Connor HART INSURANCE AGENCY,INC. PHONE 508-759-7326 x205 FAX 508-759-7366 243 MAIN STREET A/C No PO BOX 700 ADDRESS: eoconnor@hartinsuranceagency.com BUZZARDS BAY,MA 025320700 INSURERS AFFORDING COVERAGE NAIC# INSURER A: ARBELLA PROTECTION INS CO 41360 INSURED EJ Jaxtimer Builder, Inc INSURER B 48 Rosary Lane Hyannis,MA 02601 INSURER C INSURER D INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER MM/POLDD/VVVV MM Y EFF POLICY EXP LTR IDD/VYVV LIMITS A V COMMERCIAL GENERAL LIABILITY 8500042039 01/01/2019 01/01/2020 EACH OCCURRENCE $ 1,000,000 �OCCUR DAMAGE TO RENTED CLAIMS-MADE PREMISES Ea occurrence $ 300,000 MED EXP Any one person $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JET LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY 1020011547 01/01/2019 01/01/2020 COMBINED SINGLE LIMIT nil $ 1,000,000 Ea accide ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ A UMBRELLA LIAB OCCUR 4600042040 01/01/2019 01/01/2020 EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED RETENTION$ 10,000 $ A WORKERS COMPENSATION 4220048905 01/01/2019 01/01/2020 STATUTE OERH AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE NI N/A E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION Fax#:(508)775-3344 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Offico of ConsumerAffalfs&Business Regulation Registration valid for individual use only HOME IMPROVEMENT CONTRACTOR TYRI;:Cxroczation before the expiration date. If found return to: RASjsW2t!jM ggRiratirlfl Office of Consumer Affairs and Business Regulation 0609_ 11102/2020 1000 Washington Street-Suite 710 r-. Boston,MA 021 E J JAXTIMER,,SV1 LUERr t�G�fs ERNEST J.JAXTIME C�3 , 48 ROSARY LN 'p; of valid wl ignature HYANNIS,MA 02ti01 Undersecretary Commonv�ealth of Massachusetts I.VDivision of Professional Licensufe Board of Building Regulations and Standards • ConstfV-06n%iopervisor CS-003251 .'pires:01114/2020 ERNEST J JAXTIMER ;'.iw 48 ROSARY LVE 9` HYANNIS MA 028011 Commissioner v 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Waterways Regulation Program X285544 Chapter 91 Waterways License Application - 310 CMR 9.00 Transmittal No. Water-Dependent, Nonwater-Dependent, Amendment G.. Municipal Zoning Certificate Geoffrey S. Rehnert Name of Applicant 285 Seapuit Road Dam Pond Osterville Project street address Waterway Cityrrown Description of use or change in use: Modify existing licensed pier by replacing fixed end with floats and extending 10' as per attached plans and Order of Conditions. i To be completed by municipal clerk or appropriate municipal official: "I hereby certify that the project described above and more fully detailed in the applicant's waterways license application and plans is not in violation of local zoning ordinances and bylaws." ?�Q-t.0 0 1p�� 71��6/ Printed Name of Municipal Official Date Signature of Murfici al Official Title City/Town CH91App.doc-Rev.03/17 Page 6 of 13 r PETITIONER5: ti0 -Z GEOFFREY 5 4 (AURA A REHINERT N C/O AUDAX GROUP BO 101 HUNTINGTON AVE P ND �\J 1305TON, MA 02199 9p DAM 411;v0i POND 6 Fps p;I F�?. m o��r9 60, 6 NORTH yyPP' i1 S,p/T96"�'o BAY MIDDLE Q PCs 9L" '-'O POND 6 O O •T !L � s��`ST LOCUS MAP 5100 29' 1 2"W r o� l 15.98' 5390 28' 50"W G9.04' 690 ° �o 15. SHED bo � �✓LOT 8 ti v N5 10 30' 48"W / 40.00' - w 5270 57' 5211W p rnI5G.09' C v 5130 57' 1 2"W \ i �o 4.00' 0 BARN K) - `��\ LOT G �� - v 0 CABANA �` �� p4�' Z ?° WETLAND n p 1 O o ? N21 ° 02' 48"W - �\ '578°521 2 I STUDIO D o 35,80' 75 , 7E 1 1 270 7°� 2®� 2' 08T N/F 0. CNARLES 7G.33' N \ wLUNGTprVq� MOgp i1- w � OSTERVE 02655 201 TRUST o PP psS !c N57° 0748W rC_ J, 83.00' �� sTEpH Np u' C-)o DOYLE 0 80 160 NO 37559 9 v � Feet PLAN ACCOMPANYING THE PETITION OF GEOFFREY * LAURA REHNERT ' - REV: 0 I/25/2020 5HEET 511EET I Of 4 TO MODIFY AN EX15TING PIER IN THE WATERS OF DAM POND 05TERVILLE, BARN5TABLE COUNTY, MA DATE: 1 2-3- 1 9 SCALE: I "=80' Plan Prepared By Stephen J. Doyle and A5500ate5 P. 0. BOX G2 1 , East Falmouth, MA Telephone: 505/540-2534 A55E55OP5 MAP 95 BLOCK 007 - LOT 00 I Q REFERENCE CERTIFICATE: 1(8494.3 REFERENCE PLANS: 5728-G*57*28-H nO STRUCTURAL DE51GN BY OTHER5� `, Q / MLW = 0.0' �co -0 FLOOD ZONE: AE�X 1 �Pp -5.9 1 1 -6.0 -6.8 LADDEP. �` -5 9 EXISTING FLOAT SIyWIDE ROAD 6.0 EACH SIDE f "" ' 5.5 / �C PAN 5 ONG -5.9 5.9 EX15TING RAMP �dp / ti �k�o �!G Pi'�, moo !o r1' .- 5.5 / /ErrSrrNGDq� o PUBLIC ACCESS STAIRS/I /��<` _ �lYU% `1 rN/'ICFS EACH SIDE EXISTING KAYAK RACK 0 KAYAK ACCESS WALK EXISTING KAYAK PACK c,J / � � / 1 4_ \ / C6AR ///�/// /^///�� 0 20 40 Feet // ` \\/✓""' ��f (li A•li� �w V o 9 : RTEf I JEN� �y v PLAN ACCOMPANYING ThE PETITION OF Dmrt_F y GEOFFREY * LAURA REHNERT NO TO MODIFY AN EX15TING PIER '��%✓� "i�ic�� IN THE WATERS OF Z•3•Zott� DAM POND 05TERVILLE, BARN5TABLE COUNTY, MA SHEET 2 OF 4 DATE: 1 2-3- 1 9 5CALE: I "=20' Plan Prepared By EXISTING PIER LICENSE #25G4 Stephen J. Doyle and A55OClate5 P. 0. BOX G2 1 , East Falmouth, MA Telephone: 508/540-2534 REV: 01/25/2020 A55E55OR5 MAP 95 BLOCK 007 - LOT 001 REFEREKCE CERTIFICATE: 18.4943 O \ REFERENCE PLANS: 5728-G 4.5728-H /I 5TRUCTURAL DE51GN BY OTHERS �QQ o MLW = 0.0' l; 43�00 FLOOD ZONE: AE 4 X5.9 ROP05ED PILE (I I TYP) FA PROP05ED G'x 20'FLOAT N �� -5.9 -6•0 PROPOSED 4'x 18'FLOAT 30` ! �. -5`9 o". 5.5 SNO Wwr ROAD -G.O CC PLAN 08 � „ I 5.9 PROPOSED TIE-OFF PILE5 -5.9 5.2 PROPOSED 3'x 14'RAMP / till �00 5 9 2 NOTE: ALL PILES 5H,ALL BE 1 2"DIA. 3 0 l 0��FR � T�NG p � �; � / l m BXISrNG Cgr IX15TING NP PUBLIC ACCE55 5TAIRS/ �CFS EACH 51DE EX15TING KAYAK RACK '' /Imo( (I If+��(/ KAYAK ACCE55 WALK EXISTING KAYAK PACK LA /"j? 1 0 20 40 /, `\1� I _ 11. �,'P��i1i;�:%;S�4 Feet \ \ �/`) i C��,1ST`� `9 � \V� 0 � ♦ oc �' FO ��o ♦ STEPH- I u, PLAN ACCOMPANYING THE PETITION OF s_ DOYLE NO GEOFFREY * LAURA REHNERT 37-':,59 q� �F TO MODIFY AN EX15TING PIER R y. .. IN THE WATERS OF Z-3-to DAM POND 05TERVILLE, 5ARN5TABLE COUNTY, MA SHEET 3 OF 4 DATE: 1 2-3- 1 9 SCALE: I "=20' PIER MODIFICATION5 Plan Prepared By Stephen J. Doyle and`A550CIate5 P, O. BOX G2 1 , East Falmouth, MA Telephone: 508/540-2534 REV: 0 1/25/2020 23'± PROPOSED FLOAT AND REMOVE EX15TING FIXED PIER PILE LAYOUT PER PLAN VIEW AND PILES I I'± �—FIXED PIER ' I I I TO REMAIN 11 ; I 11 II II II , I I I ------ ---------- MHW= 2.4' 11 11 I MLW = 0.0 - - - --� - - — ; I I PROP05ED RAMP 11 11 11 II II II I ' II II 11 ; ' I 11 11 I SECTIONAL VIEW 0 10 20 Feet SCALE: I" = 10' i��P�GtS I'�H�syc v PLAN ACCOMPANYING THE PETITION OF STEPIIEN� yu,� GEOFFREY * LAU RA REH N ERT c-') DOYI-F TO MODIFY AN EXISTING PIER NO 3,,559 � s i lgOFe� SO�P � IN THE WATERS OF DAM D 05TERVILLE, BARN5TAA5LE COUNTY, MA L . .3.'zoLO DATE: 1 2-3- 1 9. SCALE: I "= 10, Plan Prepared By Stephen J. Doyle and A550clate5 P. 0. Box G2 1 , East Falmouth, MA Telephone: 508/540-2534 REV: 01/25/2020 5HEET 4 Df 4 r LLIMassachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands SE3-5747 WPA Form 5 - Order of Conditions MassDEP File# Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# BARNSTABLE ' City/Town A. General Information (cont.) 6. Property recorded at the Registry of Deeds for(attach additional information if more than one parcel): BARNSTABLE CT#184943, LCP 5728G Lot 6, LCP 5728H,Lot 8 a.County b. Certificate Number(if registered land) c.Book d. Page 7. Dates: 12/17/2019 01/07/2020 02/04/2020 a. Date Notice of Intent Filed b. Date Public Hearing Closed c.Date of Issuance 8. Final Approved Plans and Other Documents (attach additional plan or document references as needed): Revised site plan a. Plan Title Stephen J. Doyle and Associates Stephen J. Doyle P.L.S. b. Prepared By c.Signed and Stamped by 01/25/2020- 1" = 80' d. Final Revision Date e. Scale f.Additional Plan or Document Title g. Date B. Findings 1. Findings pursuant to the Massachusetts Wetlands Protection Act: Following the review of the above-referenced Notice of Intent and based on the information provided in this application and presented at the public hearing, this Commission finds that the areas in which work is proposed is significant to the following interests of the Wetlands Protection Act(the Act). Check all that apply: a. ❑ Public Water Supply b. ® Land Containing Shellfish c. ® Prevention of Pollution d. ❑ Private Water Supply e. ® Fisheries f• ® Protection of Wildlife Habitat g. ❑ Groundwater Supply n."-'®-Storm"Damage Prevention i. ® Flood Control 2. This Commission hereby finds the project, as proposed, is: (check one of the following boxes) Approved subject to: a. ® the following conditions which are necessary in accordance with the performance standards set forth in the wetlands regulations. This Commission orders that all work shall be performed in accordance with the Notice of Intent referenced above, the following General Conditions, and any other special conditions attached to this Order. To the extent that the following conditions modify or differ from the plans, specifications, or other proposals submitted with the Notice of Intent, these conditions shall control. wpaform5.doc• rev.6/1 612 01 5 Page 2 of 12 F LlMassachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands SE3-5747 WPA Form 5 — Order of Conditions MassDEP File# Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# BARNSTABLE City/Town B. Findings (cont.) Denied because: b. ❑ the proposed work cannot be conditioned to meet the performance standards set forth in the wetland regulations. Therefore, work on this project may not go forward unless and until a new Notice of Intent is submitted which provides measures which are adequate to protect the interests of the Act, and a final Order of Conditions is issued. A description of the performance standards which the proposed work cannot meet is attached to this Order. c. ❑ the information submitted by the applicant is not sufficient to describe the site, the work, or the effect of the work on the interests identified in the Wetlands Protection Act. Therefore, work on this project may not go forward unless and until a revised Notice of Intent is submitted which provides sufficient information and includes measures which are adequate to protect the Act's interests, and a final Order of Conditions is issued. A description of the specific information which is lacking and why it is necessary is attached to this Order as per 310 CMR 10.05(6)(c). 3. ❑ Buffer Zone Impacts: Shortest distance between limit of project disturbance and the wetland resource area specified in 310 CMR 10.02(1)(a) a.linear feet Inland Resource Area Impacts: Check all that apply below. (For Approvals Only) Resource Area Proposed Permitted Proposed Permitted Alteration Alteration Replacement Replacement 4. ❑ Bank a. linear feet b.linear feet c. linear feet d.linear feet 5. ❑ Bordering Vegetated Wetland a.square feet b.square feet c.square feet d.square feet 6. ❑ Land Under Waterbodies and a.square feet b.square feet c.square feet d.square feet Waterways e.c/y dredged f.c/y dredged 7. ❑ Bordering Land Subject to Flooding a.square feet b.square feet c.square feet d.square feet Cubic Feet Flood Storage e.cubic feet f.cubic feet g.cubic feet h.cubic feet 8. ❑ Isolated Land Subject to Flooding a.square feet b.square feet Cubic Feet Flood Storage c.cubic feet d.cubic feet e. cubic feet f.cubic feet s. ❑ Riverfront Area a.total sq.feet b.total sq.feet Sq ft within 100 ft c.square feet d.square feet e.square feet f.square feet Sq ft between 100- 200 ft g.square feet h.square feet i.square feet j.square feet wpaform5.doc• rev.6/1612015 Page 3 of 12 LlMassachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands SE3-5747 WPA Form 5 - Order of Conditions MassDEP File# Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# BARNSTABLE City/Town B. Findings (cont.) Coastal Resource Area Impacts: Check all that apply below. (For Approvals Only) Proposed Permitted Proposed Permitted Alteration Alteration Replacement Replacement 10. El Designated Port Areas Indicate size under Land Under the Ocean, below 11. ® Land Under the +/-16.5,10.95 Ocean new b.square feet c.c/y dredged d.c/y dredged 12. ❑ Barrier Beaches Indicate size under Coastal Beaches and/or Coastal Dunes below 13. ® Coastal Beaches cu yd cu yd a. square feet b.square feet c.nourishment d. nourishment 14. ❑ Coastal Dunes cu yd cu yd a. square feet b.square feet c.nourishment d. nourishment 15. ❑ Coastal Banks a. linear feet b.linear feet 16. ❑ Rocky Intertidal Shores a.square feet b.square feet 17. ❑ Salt Marshes a.square feet b.square feet c.square feet d.square feet 18. ❑ Land Under Salt Ponds a.square feet b.square feet c.cty dredged d.c/y dredged 19. ❑ Land Containing Shellfish a.square feet b.square feet c.square feet d.square feet 20. ❑ Fish Runs Indicate size under Coastal Banks, Inland Bank, Land Under the Ocean, and/or inland Land Under Waterbodies and Waterways, above a.c/y dredged b.c/y dredged 21. ® Land Subject to +/-318 new Coastal Storm a.square feet b.square feet Flowage 22. ❑ Riverfront Area a.total sq.feet b.total sq.feet Sq ft within 100 ft c.square feet d.square feet e.square feet f.square feet -Sq ft between 100- 200 ft g.square feet h.square feet i.square feet j.square feet wpaform5.doc• rev.6/16/2015 Page 4 of 12 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands SE3-5747 WPA Form 5 — Order of Conditions MassDEP File# 1 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# BARNSTABLE City/Town B. Findings (cont.) #23. If the 23 ❑ Restoration/Enhancement*: project is for the purpose of restoring or a.square feet of BVW enhancing a b.square feet of salt marsh wetland resource area 24. ❑ Stream Crossing(s): in addition to the square footage that a. number of new stream crossings b.number of replacement stream crossings has been C. General Conditions Under Massachusetts Wetlands Protection Act entered in Section B.5.c (B.B17 c)(Salt or The following conditions are only applicable to Approved projects. Marsh)above, 1. Failure to comply with all conditions stated herein, and with all related statutes and other please enter the additional regulatory measures, shall be deemed cause to revoke or modify this Order. amount here. 2. The Order does not grant any property rights or any exclusive privileges; it does not authorize any injury to private property or invasion of private rights. 3. This Order does not relieve the permittee or any other person of the necessity of complying with all other applicable federal, state, or local statutes, ordinances, bylaws, or regulations. 4. The work authorized hereunder shall be completed within three years from the date of this Order unless either of the following apply: a. The work is a maintenance dredging project as provided for in the Act; or b. The time for completion has been extended to a specified date more than three years, but less than five years, from the date of issuance. If this Order is intended to be valid for more than three years, the extension date and the special circumstances warranting the extended time period are set forth as a special condition in this Order. c. If the work is for a Test Project, this Order of Conditions shall be valid for no more than one year. 5. This Order may be extended by the issuing authority for one or more periods of up to three years each upon application to the issuing authority at least 30 days prior to the expiration date of the Order. An Order of Conditions for a Test Project may be extended for one additional year only upon written application by the applicant, subject to the provisions of 310 CMR 10.05(11)(f). 6. If this Order constitutes an Amended Order of Conditions, this Amended Order of Conditions does not extend the issuance date of the original Final Order of Conditions and the Order will expire on 02/04/2023 unless extended in writing by the Department. 7. Any fill used in connection with this project shall be clean fill. Any fill shall contain no trash, refuse, rubbish, or debris, including but not limited to lumber, bricks, plaster, wire, lath, paper, cardboard, pipe, tires, ashes, refrigerators, motor vehicles, or parts of any of the foregoing. wpaforrn5.doc- rev.6/16/2015 Page 5 of 12 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands SE3-5747 MassDEP File# Ll WPA Form 5 - Order of Conditions Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# BARNSTABLE Cityrrown C. General Conditions Under Massachusetts Wetlands Protection Act 8. This Order is not final until all administrative appeal periods from this Order have elapsed, or if such an appeal has been taken, until all proceedings before the Department have been completed. 9. No work shall be undertaken until the Order has become final and then has been recorded in the Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of the affected property. In the case of recorded land, the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land upon which the proposed work is to be done. In the case of the registered land, the Final Order shall also be noted on the Land Court Certificate of Title of the owner of the land upon which the proposed work is done. The recording information shall be submitted to the Conservation Commission on the form at the end of this Order, which form must be stamped by the Registry of Deeds, prior to the commencement of work. 10. A sign shall be displayed at the site not less then two square feet or more than three square feet in size bearing the words, "Massachusetts Department of Environmental Protection" [or, "MassDEP"] "File Number SE3-5747 " 11. Where the Department of Environmental Protection is requested to issue a Superseding Order, the Conservation Commission shall be a party to all agency proceedings and hearings before MassDEP. 12. Upon completion of the work described herein, the applicant shall submit a Request for Certificate of Compliance (WPA Form 8A) to the Conservation Commission. 13. The work shall conform to the plans and special conditions referenced in this order. 14. Any change to the plans identified in Condition#13 above shall require the applicant to inquire of the Conservation Commission in writing whether the change is significant enough to require the filing of a new Notice of Intent. 15. The Agent or members of the Conservation Commission and the Department of Environmental Protection shall have the right to enter and inspect the area subject to this Order at reasonable hours to evaluate compliance with the conditions stated in this Order, and may require the submittal of any data deemed necessary by the Conservation Commission or Department for that evaluation. 16. This Order of Conditions shall apply to any successor in interest or successor in control of the property subject to this Order and to any contractor or other person performing work conditioned by this Order. wpaform5.doc• rev.6/16/2015 Page 6 of 12 i LlMassachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands SE3-5747 WPA Form 5 — Order of Conditions MassDEP File# Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# BARNSTABLE City/Town C. General Conditions Under Massachusetts Wetlands Protection Act (cont.) 17. Prior to the start of work, and if the project involves work adjacent to a Bordering Vegetated Wetland, the boundary of the wetland in the vicinity of the proposed work area shall be marked by wooden stakes or flagging. Once in place, the wetland boundary markers shall be maintained until a Certificate of Compliance has been issued by the Conservation Commission. 18. All sedimentation barriers shall be maintained in good repair until all disturbed areas have been fully stabilized with vegetation or other means. At no time shall sediments be deposited in a wetland or water body. During construction, the applicant or his/her designee shall inspect the erosion controls on a daily basis and shall remove accumulated sediments as needed. The applicant shall immediately control any erosion problems that occur at the site and shall also immediately notify the Conservation Commission, which reserves the right to require additional erosion and/or damage prevention controls it may deem necessary. Sedimentation barriers shall serve as the limit of work unless another limit of work line has been approved by this Order. 19. The work associated with this Order(the "Project') (1) ❑ is subject to the Massachusetts Stormwater Standards (2) ® is NOT subject to the Massachusetts Stormwater Standards If the work is subject to the Stormwater Standards, then the project is subject to the following conditions: a) All work, including site preparation, land disturbance, construction and redevelopment, shall be implemented in accordance with the construction period pollution prevention and erosion and sedimentation control plan and, if applicable, the Stormwater Pollution Prevention Plan required by the National Pollution Discharge Elimination System Construction General Permit as required by Stormwater Condition 8. Construction period erosion, sedimentation and pollution control measures and best management practices (BMPs) shall remain in place until the site is fully stabilized. b) No stormwater runoff may be discharged to the post-construction stormwater BMPs unless and until a Registered Professional Engineer provides a Certification that: i. all construction period BMPs have been removed or will be removed by a date certain specified in the Certification. For any construction period BMPs intended to be converted to post construction operation for stormwater attenuation, recharge, and/or treatment, the conversion is allowed by the MassDEP Stormwater Handbook BMP specifications and that the BMP has been properly cleaned or prepared for post construction operation, including removal of all construction period sediment trapped in inlet and outlet control structures; ii. as-built final construction BMP plans are included, signed and stamped by a Registered Professional Engineer, certifying the site is fully stabilized; X. any illicit discharges to the stormwater management system have been removed, as per the requirements of Stormwater Standard 10; wpaforrnidoc• rev.6/16/2015 Page 7 of 12 LlMassachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands SE3-5747 WPA Form 5 — Order of Conditions MassDEP File# Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEPTransaction# BARNSTABLE City/Town C. General Conditions Under Massachusetts Wetlands Protection Act (cont.) iv. all post-construction stormwater BMPs are installed in accordance with the plans (including all planting plans) approved by the issuing authority, and have been inspected to ensure that they are not damaged and that they are in proper working condition; v. any vegetation associated with post-construction BMPs is suitably established to withstand erosion. c) The landowner is responsible for BMP maintenance until the issuing authority is notified that another party has legally assumed responsibility for BMP maintenance. Prior to requesting a Certificate of Compliance, or Partial Certificate of Compliance, the responsible party(defined in General Condition 18(e)) shall execute and submit to the issuing authority an Operation and Maintenance Compliance Statement("O&M Statement) for the Stormwater BMPs identifying the party responsible for implementing the stormwater BMP Operation and Maintenance Plan ("O&M Plan") and certifying the following: i.) the 0&M Plan is complete and will be implemented upon receipt of the Certificate of Compliance, and ii.) the future responsible parties shall be notified in writing of their ongoing legal responsibility to operate and maintain the stormwater management BMPs and implement the Stormwater Pollution Prevention Plan. d) Post-construction pollution prevention and source control shall be implemented in accordance with the long-term pollution prevention plan section of the approved Stormwater Report and, if applicable, the Stormwater Pollution Prevention Plan required by the National Pollution Discharge Elimination System Multi-Sector General Permit. e) Unless and until another party accepts responsibility, the landowner, or owner of any drainage easement, assumes responsibility for maintaining each BMP. To overcome this presumption, the landowner of the property must submit to the issuing authority a legally binding agreement of record, acceptable to the issuing authority, evidencing that another entity has accepted responsibility for maintaining the BMP, and that the proposed responsible party shall be treated as a permittee for purposes of implementing the requirements of Conditions 18(f) through 18(k)with respect to that BMP. Any failure of the proposed responsible party to implement the requirements of Conditions 18(f) through 18(k)with respect to that BMP shall be a violation of the Order of Conditions or Certificate of Compliance. In the case of stormwater BMPs that are serving more than one lot, the legally binding agreement shall also identify the lots that will be serviced by the stormwater BMPs. A plan and easement deed that grants the responsible party access to perform the required operation and maintenance must be submitted along with the legally binding agreement. f) The responsible party shall operate and maintain all stormwater BMPs in accordance with the design plans, the O&M Plan, and the requirements of the Massachusetts Stormwater Handbook. wpaform5.doc rev.6/16/2015 Page 8 of 12 LlMassachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands SE3-5747 WPA Form 5 — Order of Conditions MassDEP File# Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# BARNSTABLE Cityrrown C. General Conditions Under Massachusetts Wetlands Protection Act (cont.) g) The responsible party shall: 1. Maintain an operation and maintenance log for the last three (3) consecutive calendar years of inspections, repairs, maintenance and/or replacement of the stormwater management system or any part thereof, and disposal (for disposal the log shall indicate the type of material and the disposal location); 2. Make the maintenance log available to MassDEP and the Conservation Commission ("Commission") upon request; and 3. Allow members and agents of the MassDEP and the Commission to enter and inspect the site to evaluate and ensure that the responsible party is in compliance with the requirements for each BMP established in the 0&M Plan approved by the issuing authority. h) All sediment or other contaminants removed from stormwater BMPs shall be disposed of in accordance with all applicable federal, state, and local laws and regulations. i) Illicit discharges to the stormwater management system as defined in 310 CMR 10.04 are prohibited. j) The stormwater management system approved in the Order of Conditions shall not be changed without the prior written approval of the issuing authority. k) Areas designated as qualifying pervious areas for the purpose of the Low Impact Site Design Credit(as defined in the MassDEP Stormwater Handbook, Volume 3, Chapter 1, Low Impact Development Site Design Credits) shall not be altered without the prior written approval of the issuing authority. 1) Access for maintenance, repair, and/or replacement of BMPs shall not be withheld. Any fencing constructed around stormwater BMPs shall include access gates and shall be at least six inches above grade to allow for wildlife passage. Special Conditions (if you need more space for additional conditions, please attach a text document): 20. For Test Projects subject to 310 CMR 10.05(11), the applicant shall also implement the monitoring plan and the restoration plan submitted with the Notice of Intent. If the conservation commission or Department determines that the Test Project threatens the public health, safety or the environment, the applicant shall implement the removal plan submitted with the Notice of Intent or modify the project as directed by the conservation commission or the Department. wpaform5.doc• rev.6/1612015 Page 9 of 12 i Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands SE3-5747 WPA Form 5 - Order of Conditions MassDEP File# Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 e0EP Transaction# BARNSTABLE City/town D. Findings Under Municipal Wetlands Bylaw or Ordinance 1. Is a municipal wetlands bylaw or ordinance applicable? ® Yes ❑ No 2. The BARNSTABLE hereby finds (check one that applies): Conservation Commission a. ❑ that the proposed work cannot be conditioned to meet the standards set forth in a municipal ordinance or bylaw, specifically: 1. Municipal Ordinance or Bylaw 2. Citation Therefore, work on this project may not go forward unless and until a revised Notice of Intent is submitted which provides measures which are adequate to meet these standards, and a final Order of Conditions is issued. b. ® that the following additional conditions are necessary to comply with a municipal ordinance or bylaw: BARNSTABLE S.237-1 - 1.Municipal Ordinance or Bylaw 237-14 3. The Commission orders that all work shall be performed in accordance with the following conditions and with the Notice of Intent referenced above. To the extent that the following conditions modify or differ from the plans, specifications, or other proposals submitted with the Notice of Intent, the conditions shall control. The special conditions relating to municipal ordinance or bylaw are as follows (if you need more space for additional conditions, attach a text document): See pages 10.1, 10.2 and 10.3. wpaform5.doc- rev.6/16/2015 Page 10 a112 Name: Geoffrey S. and Laura A. Rehnert Approved Plan =Revised site plans dated 1/25/2020(4 sheets) by Stephen J.Doyle,P.L.S. Finding: The Commission found the proposed pier modification represented a substantial expansion,therefor subject to current pier regulations. Special Conditions of Approval I. Preface Caution: Failure to comply with all Conditions of this Order of Conditions may result in serious consequences. Such consequences may include issuance of a Stop Work Order, fine(s),the requirement to remove unpermitted structures, requirement to re-landscape to original condition,the inability to obtain a Certificate of Compliance,and more. The General Conditions of this Order begin on Page 5 and continue through Page 9. The Special Conditions, if necessary,are contained on Pages 10.1, 10.2,etc. All Conditions contained herein require strict compliance. II. Prior to the start of work,the following conditions shall be satisfied: 1. Within one month of receipt of this Order of Conditions,and prior to the commencement of any work approved herein, General Condition Number 9(recording requirement)on Page 6 shall be complied with. 2. It is the responsibility of the applicant, the owner and/or successor(s), and the project contractor,to ensure that.all conditions of this Order are complied with. The applicant shall provide copies of the Order of Conditions and approved plans(and any approved revisions thereof)to project contractors prior to the start of work. Barnstable Conservation Commission Forms A and B shall be completed and returned to the Commission prior to the start of work 3. General Condition No. 10 on Page 6(sign requirement)shall be complied with. 4. The Conservation Commission shall receive written notice one(1)week in advance of the start of work. 5. The Natural Resources Department shall be notified at least twenty-one(21)working days prior to the start of work at the site, to inspect the areas for shellfish. If deemed necessary by the Shellfish Constable, shellfish shall be removed from the work area to a suitable site and/or replanted at the locus following construction. The foregoing measures for shellfish protection shall ensue at the expense of the applicant. III. The following additional conditions shall govern the project once work begins: 6. General Conditions Nos. 13 and 14(changes in plan)on Page 6 shall be complied with. 10.1 7. The Conservation Commission, its employees,and its agents shall have a right of entry to inspect for compliance with the provisions of this Order of Conditions. 8. Unless extended, this permit is valid for three years from the date of issuance. 9. An Amended Order does not change the original date of expiration of this Order of Conditions. 10. CCA-treated piling and structural timber(greater than three (3) inches thick)are allowed. Otherwise,no CCA-treated or creosote-treated materials shall be used. 11. Deck plank spacing shall be at least three-quarters of an inch('/4"). 12. The seasonal floats shall be stored at a suitable upland site. Floats shall not be stored on banks,beaches, marshes or dunes. 13. Permanent piling shall be driven into place. Some initial pilot-hole jetting is allowed. The following special conditions(in italics)shall govern boat use at the approved pier. These conditions shall continue over time. Note: for purposes of this Order of Conditions,the term"pier" shall refer not only to the linear pile-supported structure, but also to any of its components or appendages,such as the float(s), ell, tee, ramp,outhaul piling,etc. 14. No boat shall be used or berthed at the approved pier such that, at any time, less than twelve inches(12') of water resides between the bottom of the boat or the propeller in the full downward position—whichever is lower—and the top of the substrate. 15. A small sign shall be displayed at the end of the pier, facing open water. It shall read SE3-5747; 285 Seapuit Road Limitations: • Props 12"above bottom,all times • Regulator 34 • Bayrunner 550 • Grady White 180 16. Lead piling caps shall not be used. 17. Work on the pier shall ensue mid-tide rising to mid-tide falling,or as otherwise necessary to provide a minimum twelve(12) inch clearance for the work barge above the substrate. 10.2 18. The applicant may maintain, in conformance with the plan of record,the proposed pier and other structures _ given in the Notice of Intent application for the longevity of the Order of Conditions (3 years). Thereafter, maintenance may be extended through any forthcoming Certificate of Compliance. IV. After all work is completed, the following conditions shall be promptly met: 19. At the completion of work, or by the expiration of this Order,the applicant shall request in writing a Certificate of Compliance for the work herein permitted. Barnstable Conservation Commission Form C shall be completed and returned with the request for a Certificate of Compliance Where a project has been completed in accordance with plans stamped by a registered professional engineer,architect, landscape architect or land surveyor,a written statement by such a professional shall be submitted,certifying substantial compliance with the plans,setting forth what deviation(s), if any,exists with the approved plans. This statement, along with Form C,shall accompany the request for a Certificate of Compliance. 10.3 I Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands SE3-5747 WPA Form 5 — Order of Conditions MassDEP File# Ll Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# BARNSTABLE City/Town E. Signatures This Order is valid for three years, unless otherwise specified as a special FEB 0 4 2020 condition pursuant to General Conditions#4, from the date of issuance. 1.Date of Issuance Please indicate the number of members who will sign this form. I This Order must be signed by a majority of the Conservation Commission. 2. Number of Signers The Order must be mailed by certified mail(return receipt requested)or hand delivered to the applicant. A copy also must be mailed or hand delivered at the same time to the appropriate Department of Environmental Protection Regional Office, if not filing electronically, a ro erty owner, if different from applicant. Signatures: _ ❑ by hand delivery on IJ by ertified mail, return receipt requested, on FED C 4 2020 Date Date F. Appeals The applicant, the owner, any person aggrieved by this Order, any owner of land abutting the land subject to this Order, or any ten residents of the city or town in which such land is located, are hereby notified of their right to request the appropriate MassDEP Regional Office to issue a Superseding Order of Conditions. The request must be made by certified mail or hand delivery to the Department, with the appropriate filing fee and a completed Request for Departmental Action Fee Transmittal Form, as provided in 310 CMR 10.03(7)within ten business days from the date of issuance of this Order. A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and to the applicant, if he/she is not the appellant. Any appellants seeking to appeal the Department's Superseding Order associated with this appeal will be required to demonstrate prior participation in the review of this project. Previous participation in the permit proceeding means the submission of written information to the Conservation Commission prior to the close of the public hearing, requesting a Superseding Order, or providing written information to the Department prior to issuance of a Superseding Order. The request shall state clearly and concisely the objections to the Order which is being appealed and how the Order does not contribute to the protection of the interests identified in the Massachusetts Wetlands Protection Act(M.G.L. c. 131, §40), and is inconsistent with the wetlands regulations (310 CMR 10.00). To the extent that the Order is based on a municipal ordinance or bylaw, and not on the Massachusetts Wetlands Protection Act or regulations, the Department has no appellate jurisdiction. wpaform5.doc• rev.6116/2015 Page 11 of 12 I LlMassachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands SE3-5747 WPA. Form 5 — Order of Conditions MassDEP File# Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# BARNSTABLE City/Town G. Recording Information Prior to commencement of work, this Order of Conditions must be recorded in the Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of the affected property. In the case of recorded land, the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land subject to the Order. In the case of registered land, this Order shall also be noted on the Land Court Certificate of Title of the owner of the land subject to the Order of Conditions. The recording information on this page shall be submitted to the Conservation Commission listed below. BARNSTABLE Conservation Commission Detach on dotted line, have stamped by the Registry of Deeds and submit to the Conservation Commission. -------------------------------------------------------------------------------------------------------------- To: BARNSTABLE Conservation Commission Please be advised that the Order of Conditions for the Project at: 285 Seapuit Road, Osterville SE3-5747 Project Location MassDEP File Number Has been recorded at the Registry of Deeds of: County Book Page for: Property Owner and has been noted in the chain of title of the affected property in: Book Page In accordance with the Order of Conditions issued on: Date If recorded land, the instrument number identifying this transaction is: Instrument Number If registered land, the document number identifying this transaction is: Document Number Signature of Applicant wpaform5.doc- rev.6/16/2015 Page 12 of 12 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands SE3-5747 . WPA Form 5 — Order of Conditions MassDEP File# ILI Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# BARNSTABLE Cityrrown G. Recording Information Prior to commencement of work, this Order of Conditions must be recorded in the Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of the affected property. In the case of recorded land, the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land subject to the Order. In the case of registered land, this Order shall also be noted on the Land Court Certificate of Title of the owner.of the land subject to the Order of Conditions. The recording information on this page shall be submitted to the Conservation Commission listed below. BARNSTABLE 'Conservation Commission Detach on dotted line, have stamped by the Registry of Deeds and submit to the Conservation Commission. -------------------------------------------------------------------------------------------------------------- To: BARNSTABLE' Conservation Commission Please be advised that the Order of Conditions for the Project at: 285 Seapuit Road, Osterville SE3-5747 Project Location Mas'DEP File Number Has been recorded at the Registry of Deeds of: County Book Page for: Property Owner and has been noted.in the chain of title of the affected property in: Book Page In accordance with the Order of Conditions issued on: Date If recorded land, the instrument number identifying this transaction is: Instrument Number If registered land, the document number identifying this transaction*is: Document Number Doi=: 1 s 389:999 02-10-202fi 10.-36 PA1►�ISTAptur LAND COURT R" STRY Signature of Applicant wpaform5.doc• rev.6/16/2015 Page 12 of 12 Town of Barnstable Building t Post This Card So That it is Visible From the Street-Approved Plans Must Retained on Job and this'Card Must be Kept `�$ Posted Until Final Inspection Has Been Made. +1659.'' Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit Permit No. B-20-129 Applicant Name: ERNEST J JAXTIMER Approvals Date Issued: 02/20/2020 Current Use: Structure Permit Type: Building-Addition/Alteration-Residential Expiration Date: 08/20/2020 Foundation: Location: 285 A SEAPUIT ROAD,OSTERVILLE Map/Lot: 095-007-001 Zoning District: RF-1 Sheathing: Owner on Record: REHNERT,GEOFFREY S&LAURA A Contractor Name: E J JAXTIMER BUILDER INC. Framing: 1 Address: C/O AUDAX GROUP Contractor License: 110609 BOSTON, MA 02199 - ~ Est. Project Cost: $85,000.00 Chimney: Description: remodel existing guest cabana;add approx+_250 sf addition Permit Fee: $483.50 w/crawl space add full bathroom Reloceate existing kitchennette I Insulation: 0 Fee Paid: $483.50 relocate bedroom, remove existing built in beds r Final: Date: 2/20/2020 Project Review Req: Plumbing/Gas Rough Plumbing: r---— — Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved application and the'approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. 1 I /r Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: Service: 1.Foundation or Footing 2.Sheathing Inspection Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT ��'� Application Number.................................................... Section 5—Detail Cost of Proposed Construction Square Footage of Project -LSD SY yc� .thAl� Age of Structure h' to Z°"V Dig Safe Number # Of Bedrooms Existing Total#Of Bedrooms (proposed) 1 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist Design Section 6—Project Specifics iring ❑ Oil Tank Storage ❑ Smoke Detectors Plumbing 14VI 08i ❑ Gas ❑ Fire Suppression g y . '? El Masonry Chimney Add/relocate bedroom ❑ Heatin S stem i Water Supply ❑ Public Private l Sewage Disposal ❑ Municipal On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway 1 ,�^w�, I Debris Disposal Facility �� Y1 JV �- I am using a crane ❑ Yes �No Section 7 —Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes No ❑ Section 8—Zoning Information Zoning District Proposed Use WS Lot Area Sq. Ft. Total Frontage Percentage of Lot Coverage # of Dwelling Units (on site) �J ' Setbacks Front Yard Required Proposed Rear Yard Required Proposed ti Side Yard Required \S Proposed-- �y Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No i Last updated: 11/15/2018 Application Number......... ... .. umber.......... ... .. ........... BARNSTABLF, IL MM& Permit Fee......... ..............�:.....Other Fee......................... 1639. TotalFee Paid............................................................... ..... TOWN OF BARNST"LE Permit Approval by.........6................. BUILDING PERMIT Map........................................Parcel............................................. ,,APPLICATION Section//1 — Owner's Information and Project 'Location Project Address- _(,-e-cii2L)v�- f=oa,n Village 0,:4ntsk1AA Owners Name 0-U Vx SCANNED U Owners Legal Address rcc 2 11020 City State V1_ zip C)2.&!s `Owners Cell# E-mail Section 2 —Use of Structure Use Group_& ❑ Commercial Structure over 35,000 cubic feet❑ . Commercial Structure under 35,000 cubic feet Single/Two Family Dwelling Section 3 — Type of,Permit ❑ New Construction Move/Relocate E]'Accessory Structure ❑ Change of use El Demq/(entire structure) El Finish Basement El Family/Amnesty ❑ Fire Alarm Rebuild El Deck Apartment ❑ Spri&39L"/ em Addition G DEpr Retaining wall Solar Renovation ❑ Pool El Insulation JA At 2 2 ZOZO Other—Specify TOWN Section 4 - Work Description "11rf1VSTABkE �-e oro V 5-0 it Ach LV�-n P V ko gAv &akpr I T.Fi.qt iinr1.qtPA- 1 111innI R Application Number........................................... Section 9- Construction Supervisor Name Telephone Number Address City State Zip License Number License Type Expiration Date Contractors Email Cell # I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your license. Signature Date .,F Section 10—Home Improvement Contractor Name Telephone Number Address City State Zip Registration Number Expiration Date I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your H.I.C... Signature Date Section 11 —Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT SIGNATURE Signature Date Print Name Telephone Number E-mail permit to: Last undated: 11/15/2018 Section 12 —Department Sign-Offs Health Department ❑ zoning Board(if required) ❑ Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation ❑ For commercial work,please take your plans directly to the fire department for approval Section 13—Owner's Authorization i as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of j ob) Signature of Owner date Print Name Last updated: 11/15/2018 'Ir Section -- Cons'cx letion Supe o Name , r p Telephone Number Lo 7 Q f Address 60 St2A f t� . City State_� --Zip Number License Type �S L Expiration Date I License Num cell# ��77� �� Contractors Email �-` I understand my responsibilities under the rules and regulations corLice h n Constructionp f de s ures,spm�c°fie�o��d 0 CMRtheMassachusetts uildingCode. Iunderstandthe Barnstable.Attach a copy of your license. documentation re air �? Date q 2 1 Signature Section 1Q --dome I.provement Contractor Telephone Number (�5/ 7 7Y " �I Name �► City _ State Zip '0 Address �' /l � 50 -F Registration Number pirationDate I understand my responsibiLties under`the rules and regulations th co� ct danq with �onF�e�o p o et Con�Ga o specific inspections and AMP.the Massach�-� -Sia.e_fi—r;ildmg Code. 1 undc documentatio wire �/ C ClvBt' d the Town of Barnstable.Attach a copy of you YI.I.C... ]crate 1 j Signature Section 11 —Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number . or in I understand my responsibilities under the rules and regulations construction inspe Licensed �on p oceduress specific inspections wand 0 CMR the Massachusetts State Building Code. I understandth documentation required by 780 CMR and the Town of Barnstable. Date Signature FLICANT S"IGNATURE - Date Signature Telephone Number Print Name E-mail permit to: iv1 titnr2✓ v� Last updated: 11/7/2017 neenon 1z--Department Sign* OM � Health Department ❑ Zoning Board (if required) ® • Historic ]district ® Site Plan Review(if required) ❑ Fire Department Conservation For commercial work,please take yourplans directly to the fire departrnentfor approvaL Section 13 — Owner's Authorization I, _ ' , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to.work authorized by this building permit application for: (Address of j ob) Signature of Owner date Print Name I Last updated: 1IM2017 I r Eoj-""AXTIMER %ol 6UILOER + LANDSCAPE60 MILLWORK F NG�EpT. TO Fe 12 2020 �UN 0FBgR �S�Ae�E Licensed Designee 11 Job Location— Property Owner— Applicant— E.J. Jaxtimer Builder, Inc. Licensed Designee —Jeffrey Garran CSL°078442 Commonwealth of Massachusetts Division of Profgssionai Licensure Board of Buitding Regulations and Standards Cons l��t enf *>visor CS=078442 15t, ices; 0911'1l2020 JEFFREY B GARR�11 N 110 SILT Rp�CK RDA J3 "' 6ptNSTaBt_ anA;,La2 Commissioner Applicant - E.J. Jaxtimer License Designee - Jeffrey Garran I. 48 Rosary.Lane,Hyannis,MA 02601 508-771-4498. 508-778-4911 • Fax 508-775-4909 www.jaxtimer.com i Lauzon, Jeffrey From: Lauzon,Jeffrey Sent: Wednesday,January 22, 2020 9:10 AM To: 'TINA@JAXTIMER.COM' Cc: Lauzon,Jeffrey Subject: ViewPermit, Permit No:TB-20-39 Applicant, Please be advised that the above application has been reviewed and the following is noted: 1) Construction supervisor submitted has an expired license. (780 CMR 110.115.2.5) The application is denied pending the submission of a valid construction supervisor license.And, if aggrieved by this notice;you may appeal to the Building Appeals Board within 45 days in accordance with M.G.L. c. 143§ 100. Respectfully, Jeffrey Lauzon Chief Local Inspector (508)862-4034 Jeffrey.la uzon(aD-town.barnstable.ma.us 1 i DATE(MM/DD/YYYY) A�® CERTIFICATE OF LIABILITY INSURANCE F1/07/2020 THI'S 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 have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Erica H.O'Connor HART INSURANCE AGENCY, INC. NAME: PHONE FAX 243 MAIN STREET .C.N PO BOX 700 Aooae eoconnor@hartinsuranceagency.com BUZZARDS BAY,MA 025320700 INSURERS AFFORDING COVERAGE NAIC a INSURER A: ARBELLA PROTECTION INS CO 41360 INSURED EJ Jaxtimer Builder, Inc INSURER B: NORGUARD INSURANCE CO 31470 48 Rosary Lane Hyannis,MA 02601 INSURER C INSURER D INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER MMIDD YYVV MM POLICY EFF POLICY EXP LTR /DD YYYY LIMITS A COMMERCIAL GENERAL LIABILITY 8500042039 01/01/2020 01/01/2021 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE V OCCUR PREMISES Ea occurrence $ 300,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO 2,000,000 JECT � LOC PRODUCTS-COMP/OP AGG $ OTHER: $ A AUTOMOBILE LIABILITY 1020011547 01/01/2020 01/01/2021 COMBINED SINGLE LIMIT $ 1,000,000 Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ A UMBRELLA LIAB OCCUR 4600042040 01/01/2020 01/01/2021 EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 11 DED I NARETENTION$ 10,000 $ B WORKERS COMPENSATION EJWC139902 01/01/2020 01/01/2021 AND EMPLOYERS'LIABILITY STATUTE OERH ANY PROPRIETOR/PARTNER/EXECUTIVE Y N/A E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ SOO,000 If Yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached it more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE PROOF OF INSURANCE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE @ 1988-2015 ACORD CORPORATION.. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 9/27/2019 Assessing As-Built Cards TOWN OF BARNSTABLE LOCATION.2$r/�,/ A SEWAGE H o20/O t/46O VILLAGE al—A,r.+��'� ASSESSOR'S /MAPS&PARCEL 091- CC7war INSTALLER'S NAME&PHONE NO.1 b1�i Lcial�`s��G✓ Y1 ��!Z� (�(i�S7 n of/ �� SEPTIC TANK CAPACITY /3Yi(,i/Lne;Ze, ",01- LEACHING FACILITY:(typed Lir1 (size) 7-2 c,e 8 - NO.OF BEDROOMS OWNER 0.-r1_ PERMIT DATE://-/9-/0 COMPLIANCE DATE: ' Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility f Feet Private Water Supply Well and Leaching Facility Of any wells exist on site or within 200 fret of leaching facility) l Feet Edge of Welland and Leaching Facility Of any wetlands exist within 300 feet of leaching facility) /Oat Feet FURNISHED BY d74bC f C C A7arXt �d0 b ion R6� .ly b � rb'b fb https://townofbarnstable.us/Departments/Assessing/Property_Values/H Mdisplay.asp?mappar=095007001&seq=2 1/2 I The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): E.J. Jaxtimer, Builder, Inc. Address: 48 Rosary Lane City/State/Zip: Hyannis, MA 02601 Phone #: 508-778-4911 Are you an employer? Check the appropriate box: Type of project(required): 1. ✓ I am a employer with 40 4. I am a general contractor and I 6. New construction employees(full and/or part-time).* have hired the sub-contractors 2. 1 am a sole proprietor 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. employees and have workers' 9. Building addition [No workers' comp. insurance comp. insurance.1 required.] 5. We are a corporation and its 10. Electrical repairs or additions 3. 1 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, 51(4),and we have no 13. Other employees. [No workers' 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 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: Norguard Insurance Co. Policy#or Self-ins.Lic.'#: EJWC139902 Expiration Date: 01/01/21 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 for insurance coverage verification. I do hereby certify under the pain a alties of perjury that the information:provided above is true and correct. Signature: Date: Phone#: 508-778-4911 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#: i oFixe rD •..13ARAIMAWL SrAOL£;.' . {,A.6 g , Town of Barnstable ' RFD NIp'1 A• Regulatory Services Thomas F. Geiler.Director Building Division Thomas Perry,CRO Building Commissioner 200 Main Strect, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder �GY '1� , as Owner of the subject,property �1.r . r� hereby authorize '3 TC1�b�M,- 1 C_ to act on my behalf, in all matters relative to work authorized by this building perini.t application for: e." v6 . 2-oa�p eq 02 6 (Ad ress of job) ) Si'01ature of Owner. bate Print Narne If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users'..(iecollik',Appt)atn\Lucal\hticrosoli;Windows\Tcmporury Intend Filci.Content.Outlook',DDV87AAZ\1:XPRESS.doe Revised 072110 Town of Barnstable Building • BARNSTAISI ' Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept MAsa. S Posted Until Final Inspection Has Been Made. Permit =bsa �m Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit No. B-19-3245 Applicant Name: ERNESTJ JAXTIMER Ap provals -Date Issued: 10/16/2019 Current Use: Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 04/16/2020 Foundation: Residential Map/Lot: 095-007-001 Zoning District: RF-1 Sheathing: Location: 285 A SEAPUIT ROAD,OSTERVILLE Contractor Name:" E J JAXTIMER BUILDER INC. Framing: 1 Owner on Record: OCONNELL, ROBERT Contractor License: 110609 � 2 Address: 264 BAY LANE " y Est. Project Cost: $ 100,000.00 Chimney: CENTERVILLE, MA 02632 Permit Fee: $560.00 Description: Interior Remodel of Kitchen/office/dining/laundryand powder Insulation: Fee Paid:' $560.00 rooms new cabinetry and interior finishes. I D Date: �,� 10/16/2019 Final: Project Review Req: INTERIOR ONLY. NO STRUCTURAL WORK. `�' �� Plumbing/Gas Rough Plumbing: i \Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. j All work authorized by this permit shall conform to the approved application and the`approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: Service: 1.Foundation or Footing 2.Sheathing Inspection �-- Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Rough: 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: I } 3 Application Number..... �...... BARNSTAB MASS. Permit Fee.......................................Other Fee ..................... 9 i639. 1��' VN Total Fee Paid......la .... .... .. TOWN OF BARNST�E � cy Permit Approval by........ ...........Om...P..«° ./.i........ BUILDING PERMIT APPLICATION Map......1 ........................Parcel......��..................... Section I — Owners Information and Project Location r� - Project Address a)I Q Village S Owners Name ep r 2v 1n�2 Owners Legal Address City ✓J�� State M nj Zip , Owners Cell# E-mail s Section 2—Structural Use Single/Two Family Dwelling ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet Section 3 —Type of Permit ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure [] Change of use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment +© Sprinkler System ❑ Addition ❑ Retaining wall ❑ Solar XRenovation © Pool ❑ Insulation ! Other—Specify. Section 4'--Detail Cost of Proposed Construction�106 O a o Square Footage of Project t��1� s R�� x �,ZZ1p ► j Age of Structure . Dig Safe Number ]:6p LAJ14 # Of Bedrooms Existing '.' Total#Of Bedrooms (proposed) S r 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Last updated: 11/7/2017 Section 5 - Work Description L'atd A' (6t. Lot U Aq C4 VIa vvvS Section 6—Project Specifics, Wiring [] Oil Tank Storage , . ❑ Smoke Detectors Plumbing Gas _ ❑ Fire Suppression Heating System ❑ Masonry Chimney ❑Add/relocate bedroom Water Supply ❑ Public Private Sewage Disposal ❑ Municipal On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: 0\ I am using a crane ❑ Yes �fNo Section 7--Flood Zone i Flood Zone Designation NIA Within or adjacent to a wetland, coastal bank? Yes No ❑ Section 8 —Zoning Information l Zoning District C Proposed Use Lot Area Sq. Ft. at - x) f Total Frontage Percentage of Lot Coverage �#of Dwelling Units (on site) _ Setbacks Front Yard Required ` Proposed Rear Yard IJ ' Required Proposed T C ' Side Yard Required ~ Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No Last updated: 11/7/2017 Section 9—Construction Supervisor I f Name E J Jx-v-flm &fl Telephone Number L )7 7 L L� p % � Address ` �� Y z Cit3' �� ,� State_` _ Zi License Number License Type Expiration Date i I ;0_)'C Contractors Email Cell# NV)77G I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts wilding Code. I understand the construction inspection procedures,specific inspections and documentation re uir Barnstable.Attach a copy of your license. Date Signature Section 10—Home xiiprovement Contractor Name of- - .I� Telephone Number Address 7 City l State Zip —Atv0/ Registration Number Expiration Date � _ the rules and regulations for Home Improvement Contractors in accordance.with 780 I understand my responsibilities under CMR the Massa ch Sta wilding ode. I understand the construction inspection procedures,specific inspections and documentatio wire 0 CMR d the Town of Barnstable.Attach a copy of your H.I.C... f Signature Date Section 11 —Home Owners License Exemption I Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Constru�c-ion Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection:procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date PLICANT SIGl�ATURE , Signature V Date 2 6 y Print Name .� �•, �1 ,,r Telephone Number E-mail permit to: �I y1 A p �G��Vy e✓ t)''k- Last updated: 11/7/2017 t Section 12—Department Sign-Offs Health Department ❑ Zoning Board (if required) ❑ i Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation ❑ For commercial work,please take your plans directly to the fire department for approval; Section 13 — Owner's Authorization L , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to.work authorized by this building permit application for: (Address of job) Signature of Owner date Print Name , v Last updated: 11/7/2017 i The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations' 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information 'JAY Please Print Legibly Name(Business/Organization/Individual): ri 'dam nmeK QU1zp�1 IA1 G Address: City/State/Zip: "A d&P 0 Phone.#: 0y)792 "y9 Are you an employer? Check the appropriate box: Type of project(required): 4. ❑ I am a general contractor and I 1.�I am a employer with 6. New construction employees(full and/or part-time).* have hired the sub-contractors 2:❑ I am a sole proprietor or'partner-' listed on the attached sheet. 7...❑ Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition and have workers' working for me in any capacity. employees9. ❑Building addition [No workers' comp.insuran_ce comp.insurance.$ "10. Electrical airs or additions required.] 5. ❑ We are a corporation and its ❑ ectr rep 3.❑ 1 am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp.insurance required.] "Any applicant.that checks box#1 must also fill out the section below showing their workers'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. 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. lam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: tva Pc_T,770d AaLo/ Policy#or Self-ins. Lic.#: '/" t7 9' (�.C, Expiration Date: 4/ Job Site Address: C D City/State/Zip: �5 ,9/-1��P hlMtzt ld 0 - 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 tip to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine. of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the"Office of Investigations of the bIA for insurance coverage verification. I do hereby certify under the pa d penalties of perjury that the information provided ab ove isis true and correct Si ature: Date: — Phone# J`Cj gckq 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 hearth 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: f r - .74, -111.111-11AX el.l?114:-1 `"JI.11s mEico of ConsufnerAHairs&Business Regulstlon ®g►stratian valid for individual use only HOBAE IMFROV7=MENT CONTRACTOR before the expiration date. If found return to: Type; _at�xi Office of Consumer Affairs and Business Re4ulatlon ReaistiatGO iratieLn 1000 washinget-Suite 710 11l02I2020 ton 5.7 G609=a;,_ Boston,MA 021 pp E J JAXTIMER:�l71LDER si3G. �Jt . rZNcST J.JaxTlrli� L 49 ROSARY LN �= of vali�i :lgnature HYANNIS.MA 02E6'1 Undersecretary - Casltxsu mffealth U'Mks r-achu5gttS JiYlSios of Prafessiof?ai LkensuTe Board at Building Regulati3ns and Standards �On5?;vs#:LzA`5�yer�eistSr CS-003251tpirs:a1�14;1.02fl ErZNESt JJAxTIMER �. 48 ROSARY LANE '= HYANNIS MA 62601 e CtammSssioner 9/26/2019 Property Print Print this page Owner Information Map/Block/Lot: 095 /007/001 Property Address 285 SEAPUTT ROAD # A Village: Osterville Town Sewer At Address: No GIS Zoning Value: RF-1 Owner Name as of 1/1/18: REHNERT, GEOFFREY S & LAURA A C/O AUDAX GROUP 101 HUNTINGTON AVE BOSTON, MA. 02199 Co-Owner Name Assessed Values Appraised Value Assessed Value Building Value $ 1,625,700 $ 1,625,700 Extra Features $ 194,300 $ 194,300 Outbuildings $ 448,100 $ 448,100 Land Value $ 3,222,800 $ 3,222,800 Totals $ 5,490,900 $ 5,490,900 Past Comparisons 2018 - $ 5,376,500 2017 - $ 5,065,900 2016 - $ 4,760,800 2015 - $ 4,368,400 2014 - $ 4,307,300 2013 - $ 4,230,800 2012 - $ 5,023,300 2011 - $ 4,907,200 2010 - $ 5,504,000 2009 - $ 5,505,500 Tax Information C.O.M.M. FD Tax (Commercial) $ 0 C.O.M.M. FD Tax (Residential) $ 9,773.80 https://townofbarnstable.us/Departments/Assessing/Property_VaIues/print_19.asp?ap=0&searchparcel=095007001&print=true 1/5 9/26/2019 Property Print Community Preservation Act Tax $ 1,564.91 Town Tax (Commercial) $ 0 Town Tax (Residential) $ 52,163.55 $ 63,502.26 Sales History_ Owner: Sale Date Book/Page: Sale Price: REHNERT, GEOFFREY S & LAURA A 2008-01-02 C184943 $1 HUGHES, ARTHUR W III TR 2007-09-05 C184043 $6075000 MILLER, RONALD W & DIANE D TRS 1993-03-15 C129617 $3500000 DEELEY, M & R(LOT 8) 1992-07-27 C127332 $100 DEELEY, MICHAEL &RUTH V 1989-06-15 C117813 $1250000 THOMPSON, MARGARET U 1950-03-03' C11380 $0 Photos _ i rtf0 Sketches This property contains multiple sketches. Please use the navigation below the sketch to browse sketches. https://townofbarnstable.us/Departments/Assessing/Property_Values/print_l 9.asp?ap=0&searchparcel=095007001&print=true 2/5 9/26/2019 Property Print 2R- -74 4 2 :' 8 fp 0 40': 5 TU= . -25 FHS 17 6i As s' .3 BAs 19� fus' GA#I 2 B6 _ Additional Sketches 1 2 Click Here for print version that displays all sketches at once As Built Cards:Click card#to view: Card #1 Card #2 132N Barn-any 2nd story area FPC Open Porch Concrete Floor REF Reference Only BAS First Floor, Living Area FTS Third Story Living Area(Finished) SOL Solarium BMT Basement Area(Unfinished) FUS Second Story Living Area (Finished) SPE Pool Enclosure BRN Barn GAR Garage TQS Three Quarters Story(Finished) CAN Canopy GAZ Gazebo UAT Attic Area(Unfinished) CLIP Loading Platform GRN Greenhouse UHS Half Story(Unfinished) FAT Attic Area(Finished) GXT Garage Extension Front UST Utility Area (Unfinished) FCP Carport KEN Kennel UTQ Three Quarters Story(Unfinished) FEP Enclosed Porch MZ1 Mezzanine, Unfinished UUA Unfinished Utility Attic FHS Half Story(Finished) PRG Pergola UUS Full Upper 2nd Story(Unfinished) FOP Open or Screened in Porch PRT Portico WDK Wood Deck PTO Patio Construction Details Building Details Land Building value $ 1,625,700 Bedrooms 5 Bedrooms USE CODE 1090 Replacement Cost $1,231,261 Bathrooms 5 Full-1 Half Lot Size(Acres) 2.85 Model Residential Total Rooms 12 Rooms Appraised Value $ 3,222,800 Style Cape Cod Heat Fuel Gas Assessed Value $ 3,222,800 1 Grade Luxury Plus Heat Type Hot Water Year Built 1990 AC Type Central https://townofbarnstable.us/Departments/Assessing/Property_Values/print_19.asp?ap=0&searchparcel=095007001&print=true 3/5 9/26/2019 Property Print Effective depreciation 16 Interior Floors HardwoodCarpet Stories 1 Story interior Walls Drywall Living Area sq/ft 6,226 Exterior Walls Wood Shingle Gross Area sq/ft 14,579 Roof Structure Gable/Hip Roof Cover Wood Shingle Outbuildings and Extra Features Code Description Units/SQ ft Appraised Value Assessed Value SPL3 Pool Gunite 1016 $ 56,600 $ 56,600 GAR Attached Garage 936 $ 37,400 $ 37,400 SPH4 Pool Heater 1000+sf pool 1 $4,700 $4,700 SPC1 Pool Cover-Automatic- 1080 $ 16,300 Avg $ 16,300 FGR4 Garage-Excell-Wd 888 $95,800 Shngl $95,800 GEN1 Large Generator 1 $24,000 $24,000 FPLG Gas Fireplace-Direct 1 $ 1,900 $ 1,900 Vent DKHD Dock-Heavy 1 $ 94,300 $94,300 STRS Stairs to Water 16 $900 $900 PRG1 Pergola-Avg 630 $ 6,600 $ 6,600 PHS3 Pool Hs/Good,Fin Int 434 $ 94,000- $ 94,000 WDCK Wood Decking 84 $2,600 $2,600 w/railings PAT Patio-Average 2302 $ 10,200 $ 10,200 PAT Patio-Average 2868 $ 11,400 $ 11,400 FPL2 Fireplace 1.5 stories 2 $ 9,600 $ 9,600 SHD2 Shed w/Elec 255 $6,200 $ 6,200 FOPC Open Prch-roof,ceiling 40 $ 3,200 $3,200 FPLG Gas Fireplace-Direct 1 $2,200 $2,200 Vent BMT Basement-Unfinished 1044 $ 27,300 $27,300 FOPC Open Prch-roof,ceiling 52 $4,600 $4,600 PRGI Pergola-Avg 165 $2,200 $2,200 WDC Wood Deck w/o railings 165 $2,800 $2,800 BFA2 Bsmt Fin-VG- 1348 $ 61,700. $61,700 Partitioned BMT Basement-Unfinished 2602 $46,400 $46,400 https://townofbarnstable.us/Departments/Assessing/Property_Values/print_19.asp?ap=0&searchparcel=095007001&print=true 4/5 9/26/2019 Property Print PATF Flagstone Pavers on 252 $5,400 $ 5,400 conc BMT 1 Basement-Unfinished 434 $ 14,100 $ 14,100 https://townotbarnstable.us/Departments/Assessing/Property_VaIues/print_19.asp?ap=0&search parcel=095007001&print=true 5/5 i oFine ion 11AANSrAALE, '""M. it5g9. Town of Barnstable O M 9 � . ArFAC 11 Regulatory Services .Thomas F.Geiler.Director Building Division Thomas Perry,CHO Building Commissioner 200 t�ain Strect, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder 1, Cj,(.Q� �dh nr-r ,as Owner of the subject:property hereby authorize .6ime/ 2!%JI L to act on mV behalf, in all matters relative to work authorized by this building permit application for: (Address a Job) gav Si gi ature of Owner. Datc Print Name If Property Owner is applying for permit,please complete the flomeowners License Exemption Form on.the reverse side. C:\Users\dccollik%AppDalalLucal\MicrosolY:lAlindows\Temporary Internet Filc$.Corncnt.OWloolc+DDV87AAZ\EXPRESS.due Revised 072110 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # Health Division Date Issued a� Conservation Division Application Fee Planning Dept. Permit Fee 7 5— Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address 9 95 5 � ��- Village Owneroir ffrs. 6 - 144L.e.�z Address 5P_G` poe', 65L--r)J& Telephone 56f9 _qz "//1(a5 L/o t Ict7=1 k)nt>fT_5 i�s� , 5 L c _ Permit Request tLu Ap -L"_ b Sou- - a� �J Sh�� d'vr acce.s 6 -cs. -. Cod � d�w�� -—1 ��. dz��,`�s � o�c� ne�5 u? '�S ul Le .! �csxVEL to , �tx7u-L µ�C�92. WCQGuC c b d� c ��SL' ova l r' 4��T``��j L 6S v V quare feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuatio �� Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family C91, Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes &No On Old King's Highway: ❑Yes O No Basement Type: 41-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 Coun Heat Type and Fuel: was ❑ Oil ❑ Electric ❑ Other za Central Air: aYes ❑ No Fireplaces: Existing New Existing wood/coal stoves ❑Ye; ❑ No Detached garage:6.existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ listing Q";nevS;;size_ Attached garage: I1-existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes Q-No If yes, site plan review# Current Use Proposed Use �s4 APPLICANT TNFORMATION (BUILDER OR HOMEOWNER) Name . �l9cscS��S - LL Telephone Number �� 42 �t.c,5 s �� Address J39 C� *� 9� License r Home Improvement Contractor# Worker's Compensation # 0G Q 0 212 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 1 '3 r FOR OFFICIAL USE ONLY •APPLICATION# DATE ISSUED 5 MAP/PARCEL N0. ti 3 3 i ADDRESS VILLAGE OWNER DATE OF INSPECTION: } FOUNDATION FRAME INSULATION >J t FIREPLACE I't ELECTRICAL: ROUGH FINAL 4 PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING o DATE CLOSED OUT ASSOCIATION PLAN NO. ° Y The Commonwealth 6f Massachusetts Department of Industrial Accidents Office of Investigations + 600 Washington Street Boston,M,4 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Cortractor~,./Electricians/P''Umbers Applicant Information Please Print LejZibi�' Name (Business/Organization/Individual): C.R 1�G • •Address: d Io c.�- City/State/Zip: D t4Q }il`� ,1 I 02 i�SS Phone.#: r � - Z 8"/16 S Are you an employer? Check the appropriate bog: Type of project(required):. 1C�91 am a employer with Zo 4. ❑ I am a general contractor and 1 6 ❑New construction . employees (full and/or.part-time).* have hired the sub-contractors 2.❑ I am a'sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have g• ❑Demolition workingfor me in an capacity. employees and have workers' Y P t5 9. ❑Building addition [No workers' comp. insurance comp, insurance. required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box R 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. lContractors 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. X. Insurance Company Name: cc>c) cG, Policy#or Self-ins.Lic.#: 3,36( ' 6 G Expiration Date: c5 o, lob Site Address: 285 �v_G 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 for insurance covemie verification. I do hereby certify under the pains and penalties of perjury thatthe information provided above is true and correct. Siznaturey''J`'f__ �� .1 --� =— ._ '� 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): .,I.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Client#:646400 2NORRISEB ACORD. CERTIFICATE OF LIABILITY INSURANCE D01 08(MMIDD 3) 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 CONTACT NAME: Dowling&O'Neil PHONE 508 775-1620 FAX Insurance Agency E-1 N Ext. alc No): 5087781218 IL 973 Iyannough Rd., PO Box 1990 ADDRESS: Hyannis,MA 02601 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Acadia Insurance INSURED INSURER B: E.B.Norris&Son.,Inc. 138 Osterville-West Barnstable Road INSURER C Osterville,MA 02655 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL UBR POLICY EFF POLICY EXP LTR INSR WVD POLICY NUMBER MM/DD MMIDD/YYYY LIMBS A GENERAL LIABILITY CPA005234523 5/03/2012 05/03/201 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $'250,000 CLAIMS-MADE 51 OCCUR MED EXP(Any one person) $5 000 PERSONAL&ADV INJURY $1 000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY JEa LOC $ AUTOMOBILE LIABILITY (Ea eBINEDISINGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED td P BODILY INJURY(Per accident) $ AUTOS AUTOS ( ) NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ A WORKERS COMPENSATION AND EMPLOYERS'LIABILITY WCA021246415 5103/2012 05/03/201 X WC STATU- OTH- ANY PROPRIE'TOR/PARTNER/EXECUTIVE Y f N E.L.EACH ACCIDENT $500 OOO OFFICER/MEMBER EXCLUDED? a N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $500 OOO If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT s500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION Town of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S105139/M105138 LS1 ' _ _ t� . :�•l 1.:... �`:t- ' _.:.( °�• '� `1 -,: i•� - - f;: Sf =•'y ��. _ .r _f`��':�'-�-`-•-<.�_�.', I�_�i. -- - --L_-- i �°y -�- Massachusetts- Department of Puhlic Safety Board of Building; Reurulations and Standards Construction Supervisor License License: CS 15851 ,;;CRAIG Ns ASHWORT;H- • 1,38 OS � . T W BARNST A,.. BLE OSTERVILLE MA 0265,-:` { �,� Expiration: 9/2&2013 (bnunissioner, Tr#: 522 I • e -- Office of Consumer Affairs and Bu lness Regulation _ 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 102014 Type: Private Corporation .:u Expiration: 6/30/2014 Tr# 223290 ERNEST B. NORRIS & SON INC Craig Ashworth 138 Osterville W. Barnstable rd. Osterville, MA 02655 `'Update Address and return card.Mark reason for change. Address Renewal Employment Lost Card SCA 1 % 20M-05/11 U/eeo,uauco-cuueull�n.;C�/l`ua�ccc�ccJelLi License or registration valid for individul use only _Office of Consumer Affairs&Business Regulation before the expiration date. If found return to: =-i4OME IMPROVEMENT CONTRACTOR egistration: 102014 Type: Office of Consumer Affairs and Business Regulation - -_r ? ' 10 Park Plaza-Suite 5170 7 xpiration: 6/30/2014: Private Corporatic r. Boston,MA 02116 ERNEST B. NORRIS&SON INC Craig Ashworth 138 Osterville W. Barnstable_rd. g �� •�- 'y`! r � Osterville, MA 02655 Undersecretary N valid without signature I i I t I REScheck Software Version 4.4.0 Compliance Certificate Project Title: Rehnert Basement Remodel Energy Code: 2009 IECC Location: Barnstable,Massachusetts ' Construction Type: Single Family Project Type: Addition/Alteration Heating Degree Days: 6137 Climate Zone: 5 Congtruction Site: Owner/Agent: Designer/Contractor: 285 Seapuit Rd Mr/Mrs Geoffrey Rehnert Jeff Annis Osterville,MA 02655 285 Seapuit Rd Ernest B.Norris&Son,Inc Osterville,MA 02655 138 Osterville/W.Barnstable Rd Osterville,MA 02655 508-428-1165 Compliance:2.9%Better Than Code Maximum UA:35 Your UA:34 The%Better or Worse Than Code index reflects how dose to compliance the house Is based on code trade-oft rules. It DOES NOT provide an estimate of energy use or cost relative to a minimum-code home. AssemblyCont :Gla*zin UA. or or D•• Perimeter �U-Factor Ceiling 1:Flat Ceiling or Scissor Truss — — — — — Exemption:Framing cavity filled with insulation. Wall 1:Wood Frame,16"o.c. — — — — — Exemption:Framing cavity filled with insulation. Door 1:Glass 36 0.340 12 Door 2:Glass 64 0.340 22 Compliance Statement: The proposed building design described here is consistent with the building plans,specifications,and other calculations submitted with the perk application.The proposed building has been designed to meet the 2009 IECC requirements in REScheck Version 4.4.0 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. Name-Title Signature Date r Project Title:Rehnert Basement Remodel Report date:01/15/13 Data filename:S:\Ext Residential Hmbldr\REScheck Files\Rehnert Basement.rck Page 1 of 4 r REScheck Software Version 4.4.0 Inspection Checklist CNJ( . . Ceilings: ❑ Ceiling 1:Flat Ceiling or Scissor Truss Exemption:Framing cavity filled with insulation. Comments: Above-Grade Walls: ❑ Wall 1:Wood Frame,16"o.c. Exemption:Framing cavity filled with insulation. Comments: Doors: ❑ Door 1:Glass,U-factor:0.340 Comments: ❑ Door 2:Glass,U-factor:0.340 Comments: Air Leakage: ❑ Joints(including rim joist junctions),attic access openings,penetrations,and all other such openings in the building envelope that are sources of air leakage are sealed with caulk,gasketed,weatherstripped or otherwise sealed with an air barrier material,suitable film or solid material. ❑ Air barrier and sealing exists on common walls between dwelling units,on exterior walls behind tubs/showers,and in openings between window/doorjambs;and framing. ❑ Recessed lights in the building thermal envelope are 1)type IC rated and ASTM E283 labeled and 2)sealed with a gasket or caulk between the housing and the interior wall or ceiling covering. ❑ Access doors separating conditioned from unconditioned space are weather-stripped and insulated(without insulation compression or damage)to at least the level of insulation on the surrounding surfaces.Where loose fill insulation exists,a baffle or retainer is installed to maintain insulation application. ❑ Wood-burning fireplaces have gasketed doors and outdoor combustion air. Air Sealing and Insulation: ❑ Building envelope air tightness and insulation installation complies by either 1)a post rough-in blower door test result of less than 7 ACH at 33.5 psf OR 2)the following items have been satisfied: (a)Air barbers and thermal barrier.Installed on outside of air-permeable insulation and breaks or joints in the air barrier are filled or repaired. (b)Ceiling/attic:Air barrier in any dropped ceiling/soffit is substantially aligned with insulation and any gaps are sealed. (c)Above-grade walls:Insulation is installed in substantial contact and continuous alignment with the building envelope air barrier. (d)Floors:Air barrier is installed at any exposed edge of insulation. (e)Plumbing and wiring:Insulation is placed between outside and pipes.Batt insulation is cut to fit around wiring and plumbing,or sprayed/blown insulation extends behind piping and wiring. (0 Comers,headers,narrow framing cavities,and rim joists are insulated. (9)Shower/tub on exterior wall:Insulation exists between showers/tubs and exterior wall. Sunrooms: ❑ Sunrooms that are thermally isolated from the building envelope have a maximum fenestration U-factor of 0.50 and the maximum skylight U-factor of 0.75.New windows and doors separating the sunroom from conditioned space meet the building thermal envelope requirements. Materials Identification and Installation: ❑ Materials and equipment are installed in accordance with the manufacturer's installation instructions. Project Title: Rehnert Basement Remodel Report date:01/15/13 Data filename:S:\Ext Residential Hmbldr\REScheck Files\Rehnert Basement.rck Page 2 of 4 r Insulation is installed in substantial contact with the surface being insulated and in a manner that achieves the rated R-value. Ij Materials and equipment are identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided. Insulation R-values and glazing U-factors are dearly marked on the building plans or specifications. Duct Insulation: ❑ Supply ducts in attics are insulated to a minimum of R-8.All other ducts in unconditioned spaces or outside the building envelope are insulated to at least R-6. Duct Construction and Testing: Building framing cavities are not used as supply ducts. Al joints and seams of air ducts,air handlers,fitter boxes,and building cavities used as return ducts are substantially airtight by means of tapes,mastics,liquid sealants,gasketing or other approved closure systems.Tapes,mastics,and fasteners are rated UL 181A or UL 181 B and are labeled according to the duct construction.Metal duct connections with equipment and/or fittings are mechanically fastened.Crimp joints for round metal ducts have a contact lap of at least 1 1/2 inches and are fastened with a minimum of three equally spaced sheet-metal screws. Exceptions: I Joint and seams covered with spray polyurethane foam. Where a partially inaccessible duct connection exists,mechanical fasteners can be equally spaced on the exposed portion of the joint so as to prevent a hinge effect. Continuously welded and locking-type longitudinal joints and seams on ducts operating at less than 2 in.w.g.(500 Pa). Duct tightness test has been performed and meets one of the following test criteria: (1)Postoonstruction leakage to outdoors test:Less than or equal to 8 cfm per 100 ft2 of conditioned floor area. (2)Postconstruction total leakage test(including air handler enclosure):Less than or equal to 12 cfm per 100 ft2 pressure differential of 0.1 inches w.g. (3)Rough-in total leakage test with air handler installed:Less than or equal to 6 cfm per 100 ft2 of conditioned floor area when tested at a pressure differential of 0.1 inches w.g. (4)Rough-in total leakage test without air handler installed:Less than or equal to 4 cfm per 100 ft2 of conditioned floor area. I Heating and Cooling Equipment Sizing: O Additional requirements for equipment sizing are included by an inspection for compliance with the International Residential Code. I] For systems serving multiple dwelling units documentation has been submitted demonstrating compliance with 20091ECC Commercial Building Mechanical and/or Service Water Heating(Sections 503 and 504). Circulating Service Hot Water Systems: ❑ Circulating service hot water pipes are insulated to R-2. O Circulating service hot water systems include an automatic or accessible manual switch to turn off the circulating pump when the system is not in use. Heating and Cooling Piping Insulation: HVAC piping conveying fluids above 105 degrees F or chilled fluids below 55 degrees F are insulated to R-3. Swimming Pools: Heated swimming pools have an on/off heater switch. Pool heaters operating on natural gas or LPG have an electronic pilot light Timer switches on pool heaters and pumps are present. Exceptions: Where public health standards require continuous pump operation. Where pumps operate within solar-and/or waste-heat-recovery systems. Heated swimming pools have a cover on or at the water surface.For pools heated over 90 degrees F(32 degrees C)the cover has a minimum insulation value of R-12. Exceptions: Covers are not required when 60%of the heating energy is from site-recovered energy or solar energy source. Lighting Requirements: A minimum of 50 percent of the lamps in permanently installed lighting fixtures can be categorized as one of the following: (a)Compact fluorescent (b)T-8 or smaller diameter linear fluorescent (c)40 lumens per watt for lamp wattage—15 Project Title: Rehnert Basement Remodel Report date:01/15/13 Data filename:S:\Ext Residential Hmbldr\REScheck Files\Rehnert Basement.rck Page 3 of 4 (d)50 lumens per watt for lamp wattage>15 and—40 (e)60 lumens per watt for lamp wattage-40 Other Requirements: El Snow-and ice-melting systems with energy supplied from the service to a building shall include automatic controls capable of shutting off the system when a)the pavement temperature is above 50 degrees F,b)no precipitation is falling,and c)the outdoor temperature is above 40 degrees F(a manual shutoff control is also permitted to satisfy requirement's'). Certificate: A permanent certificate is provided on or in the electrical distribution panel listing the predominant insulation R-values;window U-factors;type and efficiency of space-conditioning and water heating equipment.The certificate does not cover or obstruct the visibility of the circuit directory label,service disconnect label or other required labels. NOTES TO FIELD:(Building Department Use Only) I Project Title: Rehnert Basement Remodel Report date:01/15/13 Data filename:S:\Ext Residential Hmbldr\REScheck Files\Rehnert Basement.rck Page 4 of 4 2009 IECC Energy Efficiency Certificate Insulation Rating R-Value Ceiling/Roof 0.00 Wall 0.00 Floor/Foundation 0.00 Ductwork(unconditioned spaces): Glass&Door Rating U-Factor SHGC Window Door 0.34 NA Heating&Cooling Heating System: Cooling System: Water Heater: Name: Date: Comments: 01/21/2013 11:25 FAX LAURA REHNERT 2001 Town of Barastabie us e regulatory Services Tbomeg A Gdler,Director Building Division Thomas Perry,CBO Banding COIDFeliilalmer 200 Mid SUWL Hi'aunls.MA 02601 w^wwAo*%;b9ra#9We-m1Lus Fax-, 50"90-6230 (Mm: 508-862-40s8 property owner Mast Complete rand Sign This Section If Using A Builder m Owne z of the subject px()petL7 hereby authoxin �- to act on my behalf, in sU=m n xhtive to woik autho=ed by this budd4 Pe=ix application for: vE L.C. (Addren of job) Date $*M=e of 0W= pziut Nme If Properiy Owdw is applylug for permit,pleme compleu the Homeowners License BxemPtfoa Pbrm on the reverse side. Cs �Mior�nfl�VriudowdlTantFo�+ry'�O°�Fll�Cunteeu0ufloo�B521J�9,0o� Revised Q53012 I0/Z0 39dd SMEN83 LLUGLINST T0180 E10Z/TL/10 • r CIS ILI i 6 • 1 61 :h Wid E Z NVF 001 14NM 40 NrIM01 4 r 3; - I i REScheck Software Version 4.6.2 Compliance Certificate Project New Guest House Energy Code: 2012 IECC Location: Osterville, Massachusetts Construction Type: Single-family Project Type: New Construction Conditioned Floor Area: 1,852 f1:2 Glazing Area 13% Climate Zone: 5 (6137 HDD) Permit Date: Permit Number: Construction Site: Owner/Agent: Designer/Contractor: 285 Seapuit Road Geoffrey& Laura Rehnert EJ Jaxtimer Osterville, MA 02655 101 Huntington Ave EJ Jaxtimer Custom Builder Boston, MA 02199 48 Rosary Lane Hyannis, MA 02601 508-778-4911 Compliance: trade-off Compliance: 2.5%Better Than Code Maximum UA: 360 Your UA: 352 The%Better or Worse Than Code Index reflects how close to compliance the house is based on code trade-off rules. It DOES NOT provide an estimate of energy use or cost relative to a minimum-code home. Envelope Assemblies Gross Area Cavity Cont. Perimeter Ceiling 1: Cathedral Ceiling 1,243 49.0 0.0 0.022 27 Wall 1: Wood Frame, 16"o.c. 2,398 24.0 0.0 0.054 110 Window 1:Vinyl/Fiberglass Frame:Double Pane with Low-E 216 0.290 63 Door 1: Glass 100 0.300 30 Door 2: Solid 50 0.260 13 Floor 1:All-Wood J oist/Tru ss:Over Unconditioned Space 888 30.0 0.0 0.033 29 Floor 2: Slab-On-Grade:Unheated 54 0.0 1.042 56 Insulation depth: 0.0' Basement Wall 1:Wood Frame 394 15.0 0.0 0.052 19 Wall height: 8.0' Depth below grade: 7.0' Insulation depth: 8.0' Door 3: Solid 20 0.180 4 Project Title: New Guest House Report date: 01/06/16 Data filename: \\bruins4\PROFILES\kpresswood\My Documents\Documents\REScheck\# 12602.rck Page 1 of 9 Compliance Statement: The proposed building design described here is consistent with the building plans, specifications,and other calculations submitted with the permit application.The proposed building has been designed to meet the 2012 IECC requirements in ' REScheck Version 4.6.2 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. Keith Presswood VP keith ?�-effwod 01-06-2016 Name-Title Signature Date Project Notes: REScheck by Cape Cod Insulation, Inc. 18 Reardon Circle South Yarmouth, Ma. 02664 800-696-6611 # 12602 Project Title: New Guest House Report date: 01/06/16 Data filename: \\bruins4\PROFILES\kpresswood\My Documents\Documents\REScheck\# 12602.rck Page 2 of 9 -REScheck Software Version 4.6.2 Inspection Checklist Energy Code: 2012 IECC Requirements: 45.0% were addressed directly in the REScheck software Text in the "Comments/Assumptions" column is provided by the user in the REScheck Requirements screen. For each requirement, the user certifies that a code requirement will be met and how that is documented, or that an exception is being claimed. Where compliance is itemized in a separate table, a reference to that table is provided._ Section plans Ver,�f�ed Feld Verified= o # Pre Inspection/Plan Review �omplies� Comments/Assumptions & Req tD' ........ Value Valuez 103 1 ;Construction drawings and ❑Complies ;Requirement will be met. r Tj i /i ri. 103.2 :documentation demonstrate Does Not [PR1]1 energy code compliance for the ❑Not Observable , building envelope. , ii-- �! i/ z ✓� "Ff ❑Not Applicable 103 1 ;Construction drawings and ''� �� °❑Complies 103 2 documentation demonstrate � ��,� ❑Does Not 403.7 ;energy code compliance for , ❑Not Observable [PR3]1 :lighting and mechanical systems g ;Systems serving multiple " ',Ji 'x �` s 'y3 ' ❑Not Applicable ; !dwelling units must demonstrate ;compliance with the IECC r : Commercial Provisions. / i 302 1 Heating and cooling equipment is Heating: Heating: ;❑Complies 403.6.1 1 ;sized per ACCA Manual S based Btu/hr Btu/hr ;❑Does Not [PR2]2 Ion loads calculated per ACCA Cooling: Cooling: g :I Manual J or other methods ;❑Not Observable v ; ; Btu/hr ; Btu/hr ;❑Not Applicable licable lapproved by the code official. i k Additional Comments/Assumptions: 1 High Impact(Tier 1) Ftlz 1Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: New Guest House Report date' 01/06/16 Data filename: \\bruins4\PROFILES\kpresswood\My Documents\Documents\REScheck\# 12602.rck Page 3 of 9 Section ,a -MFUS 'a , PlansUer,�f�ed " 'Reid"Uer�fied ' # Foundation Inspection y.: Ualueix Value .,..:a£:,', ',,;GompUes2 Comments/Assumptions & Req ID ' ul 402.1.1 ;Slab edge insulation R-value. ; R- R- ❑Complies/ ;See the Envelope Assemblies [FO1]1 ; ;table for values. ❑ Unheated ❑ Unheated ❑Does Not ❑ Heated ❑ Heated 'F]Not Observable ❑Not Applicable ; 303.2, ;Slab edge insulation installed per 'r��/ 3�if r � � �q,❑Complies ;Requirement will be met. 402.2.9 manufacturer's instructions. �j i �� ;y�� []Does Not IF021 ❑Not Observable ; � 1��✓, ' I ❑Not Applicable 402.1.1 ;Slab edge insulation ft ft ;❑Complies ;See the Envelope Assemblies (F03]1 ;depth/length. :❑Does Not ;table for values. C� ;❑Not Observable ❑Not Applicable 402.1.1 'Conditioned basement wall R- R- ;❑Complies ;See the Envelope Assemblies [F04]1 iinsulation R-value.Where interior[ R- R- :[]Does Not ;table for values. ;insulation is used,verification ;❑Not Observable ;may need to occur during }Insulation Inspection. Not ;ONotApplicable required in warm-humid locations 'in Climate Zone 3. 303.2 ;Conditioned basement wall y f ' ❑Complies ;Requirement will be met. [F05]1 ;insulation installed per ❑Does Not manufacturer's instructions. , <,' ;,,✓� ❑Not Observable ❑Not Applicable 402.2.8, ;Conditioned basement wall ft ft ;❑Complies ;See the Envelope Assemblies [F06]1 insulation depth of burial or ;❑Does Not ;table for values. distance from top of wall. ❑Not Observable ; ❑Not Applicable 303 2 1 A protective covering is installed �; , y ❑Complies ;Exception: null [FO11]2 - to protect exposed exterior , '3'. yF� ,yr ❑Does Not Insulation and extends a minimum of 6 in. below grade. ❑❑Not Observable Not Applicable " Y j "` r []Complies 403 8 hSnow-and ice-meltingsystem �vs � a � �� [F012]z )controls installed. „ ❑Does Not []Not Observable ; ❑Not Applicable Additional Comments/Assumptions: t. 1 High Impact(Tier 1) ['2]Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: New Guest House Report date: 01/06/16 Data filename: \\bruins4\PROFILES\kpresswood\My Documents\Documents\REScheck\# 12602.rck Page 4 of 9 nM omHE Section x s Plans VerifiedFreld Verified cil � `# Framing/Rough In Inspection complies? Comments/Assumptions &„Re, ID;; s:, ,. ,..: i.r.. Value Valued ,a':s.::>I.. „n„ i,;.,,. ...,,,...,..." 402.1.1, Door%Uyfactor. U U- ,❑Complies :See the Envelope Assemblies 402.3.4 ;❑Does Not ;table for values. [FR1]1 ® :[--]Not Observable ; ;❑Not Applicable 402:1.1, ;Glazing U-factor(a(ea-weighted U- I U- ;❑Complies :See the Envelope Assemblies 402.3.1, .average). ;❑Does•Not ;table for values. 402.3.3. 402.3.6, '❑Not Observable ; 402.5 ❑Not Applicable [FR2]1 3 303.1.3 I U-factors of fenestration products , / / ❑Complies ;Requirement will be met. [FR4]1 ;are determined in accordance ,. % , " '� ❑Does Not .:with the NFRC test procedure or c ,� „ � Not Observable ;taken from the default table. y �" r ❑Not Applicable y W a �/' � r a, ,ry 402.4.1.1 ;Air barrier and thermal barrier / i` r / ❑Complies ;Requirement will be met. [FR23]1 installed per manufacturer's ,/�� , ��/ ❑Does Not instructions. � ? � ❑Not Observable ti; s y;❑Not Applicable 402 4.3 'Fenestration that is not site built ��,,�'��: � y ry ❑Complies ;Requirement will be met. [FR2011 :is listed and labeled as meeting !" 'f yl /� ❑Does Not AAMA/WDMA/CSA 101/l.S.2/A440 j []Not Observable ;or has infiltration rates per NFRC � 1400 that do not exceed code %, r % ;� y� ❑Not Applicable 'limits. YK' 402 4 4 IC-rated recessed lighting fixtures � �y � �r �%�,�� !� ❑Complies ;Requirement will be met. [FR161 sealed at housing/interior finish { ❑Does Not ;and labeled to indicate <_2.0 cfm 81 / , -]Not Observable ; :ileakage at 75 Pa. � r � ❑Not Applicable 403:2.1 ;Supply ducts in attics are R- R- ;❑Complies [FR12]1 insulated to >_R-8.All other ducts '+ R_ R_ ❑Does Not :in unconditioned spaces or ;outside the building envelope are; :❑Not Observable ; :insulated to >_R-6. ;❑Not Applicable 403.2.2 ;All joints and seams of air ducts ' l/ / ❑Complies [FR13]1 :air handlers, and filter boxes area - .,, ;, �, ❑Does Not ; ;sealed. ❑Not Observable ❑Not Applicable ,sue ,�/i 403.2.3 �Building cavities are not used as y �y 3 � �y/ �'�'� '��` ❑Com lies p ;[FR15]3 $'ducts or plenums. ,/ ❑Does Not I ' / h ❑Not Observable ❑Not Applicable: -403 3 `;;I HVAC piping conveying fluids ; R- ; R- ILIComplies [FR17]2 iabove 105 QF or chilled fluids ❑Does Not ;below 55 QF are insulated to>_R- v ;3 ;❑Not Observable ; ; Not Applicable 403.3.1 Protection of insulation on HVAC f / i' ' ° ❑Complies [FR2411 ipiping. '� '� i�iy /X ' .��'❑Does Not r ❑Not Observable'' ElNot Applicable ; 403 4 2 "; Hotwater pipes are insulated to R R- ❑Complies (FR18]2 >R 3. !❑Does Not I t ' ;❑Not Observable ;❑Not Applicable 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: New Guest House Report date: 01/06/16 ' Data filename: \\bruins4\PROFILES\kpresswood\My Documents\Documents\REScheck\# 12602.rck page 5 of 9 s Section Plans Verified Field Verified $ z-pL# Framing/Rough In Inspection Value Value '' tompiies�c ionsvp 403,5 Automatic or gravity dampers are � �/l' �/;" ' ❑Com lies ;Re uirement will be met. [FR19)2 JIM ❑installed on all outdoor air y � � � Does Not 4 intakes and exhausts. " []Not Observable ; ❑Not Applicable Additional Comments/Assumptions: 1 High Impact(Tier 1) 3 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: New Guest House Report date: 01/06/16 Data filename:\\bruins4\PROFILES\kpresswood\My Documents\Documents\REScheck\# 12602.rck Page 6 of 9 Sectian u li xm. # Insulation Ins ection Plans�Verif�ed Field Verified � ( ornplies? z�Coriiments/Assumptions p Value Value i 3'03T11 All installed insulation is labeled ] r ❑Complies ;Requirement will be met. [IN13]z or the installed R-values , '' ❑Does Not provided. []Not Observableoil, ; ❑Not Applicable 402.1.1, ;Floor insulation R-value. R- R- ;❑Complies ;See the Envelope Assemblies 402.2.E ;❑ Wood ❑ Wood :❑Does Not ;table for values. [IN1]1 ❑Steel ❑ Steel ;❑Not Observable ; ® ❑Not Applicable 303.2, ;Floor insulation installed per ❑Complies ;Requirement will be met. 402.2.7 (manufacturer's instructions, and , ❑Does Not [IN2]1 :in substantial contact with the 'underside of the subfloor. []Not Observable �ti�G 9r, ❑Not Applicable 402.1.1, Wall insulation R-value. If this is a R- R- ;❑Complies ;See the Envelope Assemblies '402.2.5, mass wall with at least 1/2 of the ❑ Wood ;❑ Wood ;❑Does Not ;table for values. 402.2.6 'wall insulation on the wall [IN3]1 ;exterior,the exterior insulation Mass ❑ Mass ;❑Not Observable requirement applies(FR10). ❑ Steel ;❑ Steel ;❑Not Applicable 303.2 lWall insulation is installed per ❑Complies ;Requirement will be met. [IN4]1 Imanufacturer's instructions. ❑Does Not 1. ❑Not Observable ❑Not Applicable Additional Comments/Assumptions: i 1 High Impact(Tier 1) 2 d Medium Impact(Tier 2) '13 Low Impact(Tier 3) Project Title: New Guest House Report date: 01/06/16 Data filename: \\bruins4\PROFILES\kpresswood\My Documents\Documents\REScheck\# 12602.rck Page 7 of 9 Section rU „; x Plans Verified Field Verified •� Em k„, 4 Frnaf Inspection.Provisions' , X f Complies? Comments/Assumptions, Value Ivalue " NDM 402.1.1, ;Ceiling insulation R-value. R- R- ;❑Complies :See the Envelope Assemblies 402.2.1, ;❑ Wood ❑ Wood ;[]Does Not ;table for values. 402.2.2, ; ❑ Steel ;❑ Steel :❑Not Observable 402.2.6 ; [FI1]1 ❑Not Applicable 303.1.1.1,;Ceiling insulation installed per f 'X % []Complies ;Requirement will be met. 303.2 manufacturer's instructions. 0Does Not [FI2]1 ;Blown insulation marked every 0 300 ft2. � -:[]Not Observable r ' ❑Not Applicable 402 2 3Vented attics with air permeable " � �'.�; � ,'� . ; ;❑Complies 'Exception: null. y,, ✓�J.�, .rj ,. [FI22]2 * j insulation include baffle adjacent ❑Does Not to soffit and eave vents that extends over insulation. '' ❑Not Observable ', .. y '` �✓o ONot Applicable 402.2.4 ;Attic access hatch and door R- R- ;❑Complies :Requirement will be met. [F1311 insulation >_R-value of the ❑Does Not !adjacent assembly. (� ;❑Not Observable j❑Not Applicable 402.4.1.2 ;Blower door test @ 50 Pa. <=5 ACH 50 = ACH 50 = ;❑Complies 'Requirement will be meta . [FI17]1 lach in Climate Zones 1-2, and ;❑Does Not <=3 ach in Climate Zones 3-8. ;❑Not Observable ;❑Not Applicable i 403.2.2 ;Duct tightness test result of<=4 cfm/100 cfm/100 ;❑Complies [F14]1 ;cfm/100 ft2 across the system or ft2 ftz' :[]Does Not :<=3 cfm/100 ft2 without air ;ONot Observable handler @ 25 Pa. For rough-in ,tests,verification may need to ;❑Not Applicable :occur during Framing Inspection. 403.2.2.1 ;Air handler leakage designated �� '" `"%� �� ❑Com lies [F124]1 ;by manufacturer at<=2%of []Does Not design airflow. r r f []Not Observable ' ❑Not Applicable 40311 'Programmable thermostats °" y�� ❑Complies [FI9]2 installed on forced air furnaces. ` %y x ' y'K3 , ❑Does Not e ❑Not Observable 6 „ ::• ., r !` .;� v J ' G�: ❑Not Applicable 403 1 2 ``"'Heat pump thermostat installed " y f❑Complies [F11012 on heat pumps. xx F �� Ff ❑Does Not []Not Observable ; ❑Not Applicable 403 4 1 `'Circulating service hot water ❑Complies ' [Fill] ysystems have automatic or ODoes Not ,. accessible manual controls, i � -]Not Observable ❑Not Applicable 015 1 "All mechanical ventilation system ,❑Complies i [FI251. jfans not part of tested and listed 1 x ',,}; ❑Does Not r,HVAC equipment meet efficacy ❑Not Observable and airflow limits. ❑Not Applicable 4045 '75%°of lamps in permanent � � 'r ❑Complies [FI6]1 fixtures or 75%of permanent H'❑Does Not � 1> ®- fixtures have high efficacy lamps ❑Not Observable Does not apply to low-voltage , y; ❑Not Applicable lighting.. � ' �� PP• ; 1 High Impact(Tier 1) .,, Medium Impact(Tier 2) 1 3.1 Low Impact(Tier 3) Project Title: New Guest House Report date: 01/06/16 Data filename: \\bruins4\PROFILES\kpresswood\My Documents\Documents\REScheck\# 12602.rck Page 8 of 9 5ectiorr Plans Verified" Field Verified, , ` � n ' # Finalinspeet�on Provisions Value' Value Comphes3 ;] Comments/Assumptions q. ,,< ..,,.. ,: ..-" 4041.1 Fuel gas lighting systems have ❑Complies [FI23]3 no continuous pilot light. ❑Does Not Mu h ❑Not Observable ❑Not Applicable 40.1 3 f "Compliance certificate posted. - ❑Complies ,IFI'7]� r. 3 ❑Does Not . ❑Not Observable ❑Not Applicable 303 3 f,' 'Manufacturer for ? � 1 .` � %fir �." ` acturer manuals �. ,t ,�, , � . �y� t�, ❑Complies [FI18]3a• mechanical and water heating ❑Does Not .'systems have been provided. StJh []Not Observable h ❑Not Applicable Additional Comments/Assumptions: I 1 High Impact(Tier 1) 2;`Medium Impact(Tier 2) ;,3 Low Impact(Tier 3) Project Title: New Guest House Report date: 01/06/16 Data filename: \\bruins4\PROFILES\kpresswood\My Documents\Documents\REScheck\# 12602.rck Page 9 of 9 i c 2012 IECC Energy Efficiency Certificate Insulation Rating R-Value Above-Grade Wall 24.00 Below-Grade Wall 15.00 Floor 30.00 Ceiling / Roof 49.00 Ductwork (unconditioned spaces): Door Rating U-Factor SHGC Window 0.29 Door 0.30 CoolingHeating& Heating System: Cooling System: Water Heater• Name: Date: Comments i r � � 9 DD 3 REScheck Software Version 4.5.0 / Compliance Certificate Project Rehnert-Doll House Energy Code: 2009 IECC Location: Osterville, Massachusetts Construction Type: Single-family Project Type: New Construction Conditioned Floor Area: 271 ft2 Glazing Area 14% Climate Zone: $ Permit Date: Permit Number: Construction Site: Owner/Agent: Designer/Contractor: 285 SEAPUIT ROAD Ivan Bereznicki OSTERVILLE, MA 02655 Ivan Bereznicki Associates, Inc. 9 Wendell Street Cambridge, MA 02138 617-354-5188 ivan@bereznicki.com off* Compliance: 9.0%Better Than Code Maximum UA: 288 Your UA: 262 The%Better or Worse Than Code Index reflects how close to compliance the house is based on code trade-off rules. It DOES NOT provide an estimate of energy use or cost relative to a minimum-code home. Envelope Assemblies Gross Area Cavity Cont. Glazing Assembly or R-Value R-Value or Door UA Perimeter U-Factor Ceiling 1: Cathedral Ceiling 271 32.4 0.0 0.032 9 Wall (North): Wood Frame, 16" D.C. 136 19.2 0.0 0.060 5 Window 1:Wood Frame:Double Pane with Low-E 5 0.320 2 Door 1: Glass 50 0.310 16 Wall (East):Wood Frame, 16"D.C. 164 19.2 0.0 0.060 9 Window 2:Wood Frame:Double Pane with Low-E 11 0.320 4 Wall (South):Wood Frame, 16"D.C. 163 19.2 0.0 0.060 9 Window 3: Wood Frame:Double Pane with Low-E 10 0.280 3 Door 2: Solid 6 0.310 2 Wall (West): Wood Frame, 16"D.C. 166 19.2 0.0 0.060 8 Window 4: Wood Frame:Double Pane with Low-E 10 0.280 3 Door 3: Solid 22 0.310 7 Floor 1: Slab-On-Grade:Heated 271 10.0 0.684 185 Insulation depth: 6.0' Project Title: Rehnert-Doll House Report date: 12/20/1 Data filename: P:\Rehnert- Doll House\REScheck\Rehnert-Doll House (2013.12.23).rck Pagel of 9 r Compliance Statement. The proposed building design describe A here is consistent with the building plans, specifications, and other calculations submitted with the permit application.The propos buildi en-design- to meet the 2009 IECC requirements in REScheck Version 4.5.0 and to comply with the mandatory req rement fisted n the REScheck Inspection Checklist. Name-Title Si§Aatu re Date l Jk-s Project Title: Rehnert-Doll House Report date: 12/20/1 Data filename: P:\Rehnert- Doll House\REScheck\Rehnert-Doll House (2013.12.23).rck Page 2 of 9 i REScheck Software Version 4.5.0 Inspection Checklist Energy Code: 2009 IECC Requirements: 0.0% were addressed directly in the REScheck software Text in the "Comments/Assumptions" column is provided by the user in the REScheck Requirements screen. For each requirement, the user certifies that a code requirement will be met and how that is documented, or that an exception is being claimed. Where compliance is itemized in a separate table, a reference to that table is provided. Section Plans Verified Field Verified # Pre-Inspection/Plan Review Value Value - Complies? Comments/Assumptions & Req.ID 103.2 ;Construction drawings and ❑Complies [PR1]1 !documentation demonstrate ❑Does Not !energy code compliance for the building envelope. ❑Not Observable ❑Not Applicable ; 103.2, ;Construction drawings and ❑Complies ; 403.7 documentation demonstrate ❑Does Not [PR3]1 !energy code compliance for 0 !lighting and mechanical systems. ❑Not Observable ! Systems serving multiple ❑Not Applicable !dwelling units must demonstrate ! icompliance with the commercial Y ;code. 403.6 Heating and cooling equipment is;, Heating: Heating: !❑Complies ; [PR2]2 sized per ACCA Manual S based Btu/hr Btu/hr ;❑Does Not on loads per ACCA Manua!J or ; ! 6i Cooling: Cooling: ❑Not Observable ' other approved methods. Btu/hr Btu/hr �❑Not Applicable ! Additional Comments/Assumptions: 1 JHigh Impact (Tier 1) 12 Medium Impact (Tier 2) 3 Low Impact(Tier 3) Project Title: Rehnert-Doll House Report date: 12/20/1 Data filename: PARehnert- Doll House\REScheck\Rehnert-Doll House (2013.12.23).rck Page 3 of 9 F Section Plans Verified I Field Verified # Foundation Inspection Value Value Complies? Comments/Assumptions & Req.ID 402.1.1 ;Slab edge insulation R-value. ; R- R- ;❑Complies ;See the Envelope Assemblies [FO1]1 ;❑ Unheated ;❑ Unheated ;❑Does Not table for values. ❑ Heated �❑ Heated ;❑Not Observable ❑Not Applicable 303.2, ;Slab edge insulation installed per ❑Complies ; 402.2.8 manufacturer's instructions. ❑Does Not [F02]1 ; '[-]Not Observable ❑Not Applicable ; 402.1.1 ;Slab edge insulation ft ft ;❑Complies ;see the Envelope Assemblies [F03]1 depth/length. ;❑Does Not 1 table for values. ' ;❑Not Observable ' ❑Not Applicable 303.2.1 A protective covering is installed ❑Complies ; [FO11]2 to protect exposed exterior ❑Does Not J insulation and extends a minimum of 6 in. below grade. ❑Not Observable ❑Not Applicable ; 403.8 Snow-and ice-melting system n ❑Complies [FO12]2 controls installed. []Does Not lad ❑Not Observable ❑Not Applicable Additional Comments/Assumptions: 11 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 1 Low Impact(Tier 3) Project Title: Rehnert-Doll House Report date: 12/20/1 Data filename: P:\Rehnert- Doll House\REScheck\Rehnert-Doll House (2013.12.23).rck Page 4 of 9 r Section Plans Verified Field Verified °# Framing/ Rough-In Inspection Value Value Complies? Comments/Assumptions & Req.ID 402.1.1, ;,Door U-factor. U- U- DComplies !See the Envelope Assemblies 402.3.4 :❑Does Not ;table for values. [FR11 ; 1 ,❑Not Observable :,[]Not Applicable 402.1.1, ;GlazingU-factor(area-weighted U- U- ;❑Complies ;See the Envelope Assemblies 402.3.1, average). ❑Does Not ;table for values. 402.3.3, ; 402.5 ; :❑Not Observable [FR2]1 '❑Not Applicable ; 303.1.3 ;U-factors of fenestration products ❑Complies ; [FR4]1 !are determined in accordanceI []Does Not with the NFRC test procedure or ;taken from the default table. ❑Not Observable ! ❑Not Applicable ; 402.3.5 !Sunrooms enclosing conditioned U- U- ;❑Complies [FR8]1 !space have a maximum ! ❑Does Not !fenestration U-factor of 0.50 in (Climate Zones 4-8. New glazing UNot Observable !separating the sunroom from ;❑Not Applicable ; ;conditioned space must meet !code requirements. 402.3.5 ;Sunrooms enclosing conditioned ', U- U- Complies [FR9]1 !space have a maximum skylight UDoes Not !U-factor of 0.75 in Climate Zones 4-8 ; �❑Not Observable ;❑Not Applicable 402.4.4 ;Fenestration that is not site built ❑Complies ; [FR20]1 his listed and labeled as meeting ❑Does Not lAAMA/WDMA/CSA 101/I.S.2/A440 !or has infiltration rates per NFRC ❑Not Observable ; 1400 that do not exceed code ❑Not Applicable limits. 402.4.5 IC-rated recessed lighting fixtures ❑Complies [FR16]2 sealed at housing/interior finish ❑Does Not A and labeled to indicate s2.0 cfm leakage at 75 Pa. -]Not Observable ❑Not Applicable ; 403.2.1 ;Supply ducts in attics are R- ; R- ;❑Complies [FR12]1 insulated to >_R-8.All other ducts R- R- ;❑Does Not :in unconditioned spaces or ' SO ;outside the building envelope are; :❑Not Observable insulated to >_R-6. ;❑Not Applicable ; 403.2.2 ;All joints and seams of air ducts, ❑Complies I [FR13]1 air handlers,filter boxes, and ❑Does Not ;building cavities used as return ;ducts are sealed. ❑Not Observable IONot Applicable ; 403.2.3 Building cavities are not used for ❑Complies ; [FR15]3 supply ducts. ❑Does Not ` []Not Observable ❑Not Applicable 403.3 HVAC piping conveying fluids ; R- R- ;❑Complies [FR17]2 above 105-QF or chilled-fluids — - ---- ❑Does Not below 55 QF are insulated to >_R- 3 ;❑Not Observable ❑Not Applicable 403.4 Circulating service hot water R- R- ;❑Complies [FR18]2 pipes are insulated to R-2. ;❑Does Not J ;❑Not Observable :,[]Not Applicable 11 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 1 Low Impact(Tier 3) Project Title: Rehnert-Doll House Report date: 12/20/1 Data filename: P:\Rehnert- Doll House\REScheck\Rehnert-Doll House (2013.12.23).rck Page 5 of 9 r Section Plans Verified . Field Verified: #_ Framing/ Rough-In Inspection .;t. ." Complies? Comments/Assumptions & fte ID Value Value - 4 403.5 Automatic or gravity dampers are '. ❑Complies ; [FR19]2 installed on all outdoor air r ❑Does Not intakes and exhausts. w ❑Not Observable ; ❑Not Applicable ; Additional Comments/Assumptions: 1 High Impact(Tier 1) 2{ Medium Impact (Tier 2) 3. Low Impact(Tier 3) Project Title: Rehnert-Doll House Report date: 12/20/1 Data filename: P:\Rehnert- Doll House\REScheck\Rehnert-Doll House (2013.12.23).rck Page 6 of 9 r Section Plans Verified Field Verified # Insulation Inspection Value Value Complies? Comments/Assumptions & Req.ID - 303.1 All installed insulation is labeled ❑Complies [IN13]2 or the installed R-values ❑Does Not provided. ❑Not Observable ❑Not Applicable 402.1.1, :Wall insulation R-value. If this is a: R- R- ;❑Complies ;See the Envelope Assemblies 402.2.4, �mass wall with at least 1/z of the ❑ Wood ;❑ Wood ;❑Does Not table for values. 402.2.5 ;wall insulation on the wall ; ❑ Mass ❑ Mass '❑Not Observable ; [IN3]1 exterior,the exterior insulation ❑ Steel ❑ Steel ❑Not Applicable Q :requirement applies. 303.2 ;Wall insulation is installed per ❑Complies [IN4]1 :manufacturer's instructions. ❑Does Not ❑Not Observable []Not Applicable 402.2.11 ISunroom wall insulation has a R- R- ElComplies ; [IN8]1 minimum R-value of R-13. New I :❑Does Not walls separating the sunroom I ;❑Not Observable ,from conditioned space must :meet code requirements. ; ; ;❑Not Applicable 303.2 ISunroom wall insulation installed ❑Complies [IN9]1 :per manufacturer's Instructions. ❑Does Not ❑Not Observable ❑Not Applicable 402.2.11 ;Sunroom ceiling minimum ; R- ; R- ;❑Complies [IN10]1 insulation R-value of R-19 in ;❑Does Not (Climate Zones 1-4, and R-24 in I ❑Not Observable ,Climate Zones 5-8. ❑Not Applicable 303.2 ;Sunroom ceiling insulation is ❑Complies [IN11]1 :installed per manufacturer's ❑Does Not , instructions. ❑Not Observable ❑Not Applicable Additional Comments/Assumptions: 1 I High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 1 Low Impact(Tier 3) Project Title: Rehnert-Doll House Report date: 12/20/1 Data filename: PARehnert- Doll House\REScheck\Rehnert-Doll House (2013.12.23).rck Page 7 of 9 r [=Section Plans VerifiedPio' ld Verified Final Inspection Provisions Value Value Complies? Comments/Assumptions 402.1.1, ;Ceiling insulation R-value.Where ; R- R- ;❑Complies ;See the Envelope assemblies 402.2.1, :> R-30 is required, R-30 can be Wood ;❑ Wood ;❑Does Not table for values. 402.2.2 ;used if insulation is not Steel ❑ Steel [FI1]1 ;compressed at eaves. R-30 may ; ❑Not Observable :be used for 500 ft2 or 20% ;❑Not Applicable ; (whichever is less) where ;sufficient space is not available. ; 303.1.1.1, ;Ceiling insulation installed per ❑Complies 303.2 'manufacturer's instructions. []Does Not [FI2]1 ;Blown insulation marked every 300 ft2. ❑Not Observable ; ❑Not Applicable ; 402.2.3 ;Attic access hatch and door R- R- ;❑Complies [FI3]1 insulation >_R-value of the :0Does Not !adjacent assembly. ;❑Not Observable ❑Not Applicable 402.4.2, ;,Building envelope tightness ACH 50 = ; ACH 50 = ;❑Complies 402.4.2.1 verified by blower door test result! :❑Does Not [FI17]1 of<7 ACH at 50 Pa.This ;requirement may instead be met ; ❑Not Observable ; :via visual inspection, in which ;❑Not Applicable ; case verification may need to !occur during Insulation - !Inspection. 402.4.3 Wood-burning fireplaces have ❑Complies ; [FI8]2 • gasketed doors and outdoor ❑Does Not i combustion air. ❑Not Observable r ❑Not Applicable 403.2.2 I Post construction duct tightness ; cfm ; cfm ;❑Complies ; [FI4]1 !test result of<_8 cfm to outdoors, ! :❑Does Not ;or:512 cfm across systems.Or, !rough-in test result of<_6 cfm ;❑Not Observable ; !across systems or:54 cfm ! ;❑Not Applicable ; !without air handler. Rough-in test !verification may need to occur ! ! ! ! Iduring Framing Inspection. ! 403.1.1 Programmable thermostats ❑Complies [FI9]2 installed on forced air furnaces. ? ❑Does Not ❑Not Observable ' ❑Not Applicable 403.1.2 Heat pump thermostat installed ❑Complies [FI10]2 on heat pumps. ❑Does Not ' ❑Not Observable ❑Not Applicable 403.4 Circulating service hot water [ Complies [FI11]2 systems have automatic or ❑Does Not �• accessible manual controls. ❑Not Observable ; l ❑Not Applicable 403.9.1 Readily accessible switch on ❑Complies ; [FI12]3 heaters for swimming pools. ❑Does Not ONot Observable-; — —-- -- ❑Not Applicable 1403.9.2 Timer switches on pool heaters ❑Complies [FI19]3 and pumps are present. ❑Does Not ' � . ❑Not Observable ❑Not Applicable 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Rehnert-Doll House Report date: 12/20/1 Data filename: P:\Rehnert- Doll House\REScheck\Rehnert-Doll House (2013.12.23).rck Page 8 of 9 i Section Plans Verified Field Verified - »# Final Inspection Provisions Value Value Complies? - Comments/Assumptions Req.I& D 403.9.3 Heated swimming pools have a ❑Complies [F120]3cover. Covers on pools heated ❑Does Not over 90 QF are insulated to R-12. y []Not Observable i ❑Not Applicable ; 404.1 ;50%of lamps in permanent ❑Complies [FI6]1 fixtures are high efficacy lamps. F ❑Does Not ❑Not Observable ❑Not Applicable 401.3 Compliance certificate posted. ❑Complies ; [FI7]2 ❑Does Not g` ❑Not Observable ❑Not Applicable 303.3 Manufacturer manuals for ❑Complies [FI18]3 mechanical and water heating �. ❑Does Not equipment have been provided. ; ❑Not Observable ❑Not Applicable Additional Comments/Assumptions: 1 I High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 1 Low Impact(Tier 3) Project Title: Rehnert-Doll House Report date: 12/20/1 Data filename: P:\Rehnert- Doll House\REScheck\Rehnert-Doll House (2013.12.23).rck Page 9 of 9 I 2009 IECC Energy Efficiency Certificate Wall 19.25 Floor 10.00 Ceiling / Roof 32.38 Ductwork (unconditioned spaces): D.. Window 0.32 Door 0.31 . . Heating System: Cooling System: Water Heater: Name: Date: Comments r- � «r RRIS&SIN Town of Barnstable August 20,2014 Building Commissioner Tom Perry Re:285 Seapuit Road;Osterville Dear Mr.Perry; We would like to request an extension on permit number B 20140247 . Clearing and staking for the proposed building have been started but the excavation and foundation work are not scheduled to start Until September 15'',2014. Please let me know if you have any questions. Sincerely, Jeff Annis,Estimator _� o E.B.No"is&Son Inc. Pb.508428-1165 �' r cz E.jannij@ebnor7is.com a e� p r-- t:� ERNEST B. NORRIS & SON, INC 138 OSTERVILLE-WEST BARNSTABLE ROAD OSTERVILLE, MASSACHUSETTS 02655 TEL: 508-428-1165, FAX: 508-428-1196 � r TOWN OF BARNS'TABLE 201400531 Bu''di BARNBTABI$ * Issue Date: 02/06/14 Permit NABIL 1639. A�� Applicant E.B.NORRIS&SON,INC. Permit Numbe 402 p Proposed Use: SINGLE FAMILY HOME Expiration Da!�: : 08/06/14 Location 285 SEAPUIT ROAD Zoning District RF-1 Permit Type: GARAGE DET I�ENT`IAL Map Parcel 095007001 Permit Fee$ 561.00 Contractor E.B.NORRIS&SON,INC. Village OSTERVILLE App Fee$ 100.00 License Num 102014 Est Construction Cost$ 110,000 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND BUILD NEW I BEDROOM STUDIO W/1 BATHROOM,W/A 4'FROST ALtHIS CARD MUST BE KEPT POSTED UNTIL FINAL FOUNDATION,SLAB ON GRADE I STORY INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: REHNERT,GEOFFREY S&LAURA A BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: C/O AUDAX GROUP INSPECTION HAS BEEN MADE. 101 HUNTINGTON AVE BOSTON,MA 02199 Application Entered by: PR Building Permit Issued By: TFus Pwmr.cowwS'No BIOHr;TQ OCCUPY ANY S RW'T.ALLEY OR S.ID T.OR AN -PAR77HBIt80P,EI M TBMPORARQ Y OR PH1th1AN&(ILY.'FNCROpCHKtHNfS ANPUB WCPROPBRTY;N SPWMCALLYPFiRjWTTQDt�PTDFRfiFISBlIJLDWGGODSMUSTBEi1PPROVEDBY•Tf JUIUSDICT[ON:`::STRi TAR:ALLEY.GRADFSASWHL.ASDEPTHi1NDIOCATIONOFPUBIICSFBwiRsMAY.BB :,:.:... OBPAINED FRQtrf T1S8 DEPATtTAi6MP`OF PUBLIC WORK$ [fFH ISSUANCe OF THIS PErtiym DOB9 NOT RMEMB TIM APPI.IC,&M FROM THB'CONDIIYON3 OF AN APPUCABIE SUBDMSION'. RESTRiC710NS" .... ....::...:..:.: MINIMUM OF FIVE CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: i.FOUNDATION OR FOOTINGS. 2.SHEATHING INSPECTION 3.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 4.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 5.PRIOR TO COVERING STRUCTURAL MEMBERS(FRAME INSPECTION). 6.INSULATION. 7.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.I42A). POST THIS CARD SOTHAT IS VISIBLE FROM THE 'ETSrFRE BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 I 2 2 2 3 1 Heating Inspection Approvals Engineering Dept Fire Dept 2 Board of Health /All -4E�OFtHE�� Town of Barnstable *Permit# Q� Expires 6 months from issue date Regulatory Services (� q Fee MASS, 9 1BARNSTA `0� Richard V.Scali,Director A �TEo��a BuildingDivision JAN 0 6 2017 Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MAMO"�fiO/Yt,� C�� 1'ds r'+� www.town.barnstable.ma.us 1'd t`f C� Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X--Press Imprint Map/parcel Number drJs 00? OO 1 Property Address (A (ED ps 4f t-t t lie me` 0A [Residential Value of Work$r001.f»[7r Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Cj`eO�F �{ a- LA LNG Uk" 2'6+5 OS lie , AAk 8ZCo3� Contractor's Name �, 4A'�j�yYtO✓ (iUj, f Telephone Number Eo j $Wj 4G Home Improvement Contractor License#(if applicable) Email: Q—�X lea (~4 q M n e t Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Re uest(check box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑ Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) Re-side Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors:_qi ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Prope Owner must sign Property Owner Letter of Permission. A c of the Home Improvement Contractors License& Construction Supervisors License is ed. SIGNATURE: Q:\WPFILESTORMS\build' g p SS.doc Revised 061313 "MA'S NsraLL Town of Barnstable RECEIPT ' 200 Main Street, Hyannis MA 02601 508-862-4038 �0 Application for Building Permit Application No: TB-16-3778 Date Recieved: 12/30/2016 Job Location: 285 SEAPUIT ROAD,OSTERVILLE Permit For: Building-Siding/Windows/Roof/Doors Contractor's Name: ERNEST J JAXTIMER State Lic. No: CS-003251 Address: , HYANNIS, MA 02601 Applicant Phone: (508)778-4911 (Home)Owner's Name: REHNERT,GEOFFREY S&LAURA A Phone: (508)771-4498 (Home)Owner's Address: C/O AUDAX GROUP, BOSTON,MA 02199 Work Description: New roof,New siding,New windows(42),New doors(4) Total Value Of Work To Be Performed: $100,000.00 Structure Size: 0.00 Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: EJ Jaxtimer 12/30/2016 (508)778-4911 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost: $100,000.00 Date Paid Amount Paid Check#or CC# Pa Type ype .Total Permit Fee: $510.00 Total Permit Fee Paid: $0.00 THIS IS NOT A PERMIT A`OR"® CERTIFICATE OF LIABILITY INSURANCE DATE /0s o 6 Y' 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 NAME:IcT Erica H.O'Connor HART INSURANCE AGENCY,INC. PHONE 508 759 7326 x205 FAX 508 759 7366 243 MAIN STREET Alc No PO BOX 700 ADDR�: eoconnor@hartinsuranceagency.com BUZZARDS BAY,MA 025320700 INSURERS AFFORDING COVERAGE NAIC# INSURER A: ARBELLA PROTECTION INS CO 41360 INSURED EJ Jaxtimer Builder,Inc INSURER 9: ARBELLA INDEMNITY INSURANCE COMPANY 10017 48 Rosary Lane INSURER C Hyannis,MA 02601 INSURER D: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. � POLICY EFF POLICY TRR TYPE OF INSURANCE INSD Swyn UER POLICY NUMBER MM/DD/YYY MM/DD1 EXP LIMITS A COMMERCIAL GENERALLIABILITY 8500042039 01/01/2016 01/01/2017 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE V OCCUR PREM" ES(Ea RENTED occurrence) $ 300,000 PREMISES MED EXP Any one person $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 JET LOC PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY a OTHER: $ A AUTOMOBILE LIABIM 1020011547 01/01/2016 01/01/2017 COMBINED SINGLE LIMIT $ 1,000,000 Ea accident _ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident A UMBRELLA LIAB OCCUR 4600042040 01/01/2016 01/01/2017 EACH OCCURRENCE $ 5,000,000 EXCESS LIAR CLAIMS-MADE AGGREGATE $ 5,000,000 DED RETENTION$ 10,000 $ B WORKERS COMPENSATION 4220048905 01/01/2016 01/01/2017 NA PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ 500,000 OFFICEWMEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If es,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TOWN OF BARNSTABLE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD I Massachusetts Department of Public Safety �J Board of Building Regulations and Standards License: CS-W3251 Construction Supervisor ERNEST J JAXTIMER 48 ROSARY LANE HYANNIS MA 02601 CA— Expiration: Commissioner 01/14/2018 1 i II r i III Office of Consumer Affairs and Business Regulation 10 Park Plaza- Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Type: Corporation - Registration: 110609 E J Jaxtimer, Builder, Inc. Expiration: 1 1/021201 8 48 Rosary Ln Hyannis, MA 02601 Update Address and return card. Mark reason for change. SCA 1 0 20M-Mil _ p Addreacc fl Renewal 0 Employment ❑Lost Card office of consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only before the expiration date. If found return to: r� r y Type. Corporation Office of Consumer Affalrs and Business Regulation Registration Expiration +y' 110609 11/02/2018 10 Park Plaza-Suite 5170 Boston,MA 16 E J Jaxbmer,Builder,Inc. Ernest Jaxtimer 48 Rosary Ln Hyannis,MA 02601 _ Undersecretary Not valid without signature i .,►nrrsretn,� s ;�`A� Town of Barnstable Regulatory Services Thomas r.Geller,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Strcet, Hyannis,MA 02601 wwv.town.barnstable.ma.us Office: 509-8624038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I. Geoffrey S. Rehnert ,as Owner of the subject property hereby authorize E.J.Jaxtimer Builer, Inc to act on my behalf, in all matters relative to work authorized by this building permit application for: 285 Seapuit Road,Osterville, MA (Address of Job) 12/31/15 S' ature of weer Date Geoffrey S. Rehnert Print Natne If Property owner Is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:1Userst =IllklAppDato%ocaMlicrosof%%VWo%vs%Tempomry Intemet Niles)Content.OadookWDV87AAZYLXPRESS.doe Revised 072110 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map -I Parcel U D I ` { Application # Health Division Date Issued C / l_ Conservation Division �,,. 8UILDING [5 tion Fee d Planning Dept. f BAN 0 g Permit Fee j� �,.. s o Date Definitive Plan Approved by Planning Board 2016 Historic - OKH _ Preservation / Hyannis OF 13AR/VS7-A13LE Project Street Address 2�,S Sf FL Village 0S- _Vyl L4 Owner G Co K G-k )20 d Address 2 cb Telephone Permit Request cc>m N e Li -^3 e ec!rc»M ci (r t'��f aoI ro Y I ST. Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation OO OLD Construction Type_tl, vy_ Lot Size a 4D A _I(P Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ,4No On Old King's Highway: ❑Yes 5 No Basement Type: gFull ❑ Crawl ❑Walkout ❑ Other ~I Basement Finished Area (sq.ft.) 1 5-P Basement Unfinished Area,(sq.ft) 9 ZS Number of Baths: Full: existing O new S9 _ Half: existing c7 new O Number of Bedrooms: _ existing 3 new / Total Room Count (not including baths): existing new First Floor Room Count 2. Heat Type and Fuel: XGas ❑ 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 121�01 If yes, site plan review# Current Use kQ.�, \ ►- cd Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name �� )(� Telephone Number Address LI V-OS A-2U LY License # Cc 3 2- Home Improvement Contractor# 0 CR Email P C7X'k1 ryl (Q)Yr L S �'Lr? Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO Y-YACA(nix�e ✓T DATE SIGNATURE �- b : FOR OFFICIAL USE ONLY • ' 4 APPLICATION# DATE ISSUED I Y MAP/PARCEL NO. - • ` ADDRESS VILLAGE OWNER A' DATE"OF INSPECTION: FOUNDATION FRAME - - i INSULATION FIREPLACE ' i ELECTRICAL: ROUGH FINAL ' PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING ' DATE CLOSED OUT - ASSOCIATION PLAN NO. r -- The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations' 0 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/]Plumbers Applicant Information Please Print]Legibly Name(Business/Organization/Individual): Address: 'r 8 d Sa rq kkt& City/State/Zip: ids Phone.#: Are you an employer?Check the appropriate box: Type of project(required): 1. I am a employer with 4. ❑ I am a general contractor and I \ have hired the sub-contractors 6. ❑New construction employees(full and/or part-time).* 2:❑ I am a sole proprietor or partner-' listed on the-attached sheet. T.KRemodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' 9 ❑Building addition [No workers'comp.-insurance comp.insurance.$ required.] 5. ❑ 'We are a corporation and its '10.❑Electrical repairs or additions ' 3.❑ I am a homeowner doing all work officers have exercised thew 1 i.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant.that checks box#1 must also fill out the section below showing their workers'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. 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: iL A P9 6 DolA / I AIS U E, 6 — Policy#or Self-ins.Lic. M / 0' Expiration Date: - ;�— Job Site Address: Q�Y1 , ekpui o _ City/State/Zip: 04 U'WXT A OILS 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 for insurance coverage verification I do hereby certi the pains and penalties of perjury that the information provide above is true and correct. Siznature: Date: �. Phone#: Official use only. Do not write in this area,to be completed by city or town offcciaL City or Town: Perniit/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#: 04 , a,�' Town of Barnstable o Regulatory Services Thomas F.Geller,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.ba rnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I Geoffrey S. Rehnert ,as Owner of the subject property hereby authorize E.J.Jaxtimer Builer, Inc to act on my behalf, in all matters relative to work authorized by this building permit application for: 285 Seapuit Road,Osterville,MA (Address of Job) 12/31/15 S' ature of wncr Date Geoffrey S. Rehnert Print Name If Property Owner Is applying for permit,please complete the Homeowners License Exemption Dorm on the reverse side. C:\Users%decolllk\AppDataU.ocoM7icroson\windo%vs\Tcmpomry Inteniet Niles\Content.OutlookU)DV87AAZ\13XPRESS.doc Revised 072110 r Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 110609 Type: Private Corporation Expiration: 11/3/2016 . Tr# 258860 E J JAXTIMER, BUILDER, INC. ERNEST JAXTIMER 48 ROSARY LN HYANNIS, MA 02601 Update Address and return card.Mark reason for change. sCA 1 20M-05/11 Address Renewal ❑ Employment Lost Card (92e Wo-7nnzo wacalC/a o1Q41'idsacXajeC6j Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: 110609 Type: Office of Consumer Affairs and Business Regulation --- Expiration: ,11/3/2016 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 E J JAXTIMER,BUILDER,INC... ERNEST JAXTIMER 48 ROSARY LN HYANNIS,MA 02601 Undersecretary o valid without signature .> I Vlassachusetts -Department of Public Safety Board of Building Regulations and Standards Const;•rctior: Supervisor j License: CS-00 51 T�?Ia]T eTi r IJA11I.1?f1E1� j 1H YAND9S KA 01601 - I! II �, Expiration Commissioner ®�1f11�©76 • I f AC4C>R0I`® CERTIFICATE OF LIABILITY INSURANCE DA01/06/2O 6Y) THIS CEFITIFICATE 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 CONTACT Erica H.O'Connor HART INSURANCE AGENCY,INC. NAME: 243 MAIN STREET PHONE0. 508 759 7326 x205 ac No:508 759 7366 PO BOX 700 ADORIess: eoconnor@hartinsuranceagency.com BUZZARDS BAY,MA 025320700 INSURERS AFFORDING COVERAGE NAIC# INSURER A: ARBELLA PROTECTION INS CO 41360 INSURED EJ Jaxtimer Builder,Inc INSURER B: ARBELLA INDEMNITY INSURANCE COMPANY 10017 48 Rosary Lane Hyannis,MA 02601 INSURER C INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR Ty PE OF INSURANCE ADDL SUBR POLPOLICY NUMBER MM ICY EFF POLIO EXP LIMITS LTR A COMMERCIAL GENERAL LIABILITY 8500042039 01/01/2016 01/01/2017 EACH OCCURRENCE $ 1,000,000 DAMAGE To ENTED CLAIMS-MADE ©OCCUR PREM SES JER,occurrence) $ 300,000 , MED EXP(Any oneperson) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY❑PRO ❑LOC PRODUCTS-COMP/OP AGG $ 2,000,000 JECT OTHER: $ A AUTOMOBILE LIABILITY 1020011547 01/01/2016 01/01/2017 COMBINED SINGLELIMIT $ 1,000,000 Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS PROPERTY DAMAGE $ AUTOS NON-OWNED Per accident) $ A UMBRELLA LIAB OCCUR 4600042040 01/01/2016 01/01/2017 EACH OCCURRENCE $ 5,000,000 EXCESS LIAR HCLAIMS-MADE AGGREGATE $ 5,000,000 DED RETENTION$ 10,000 $ B WORKERS COMPENSATION 4220048905 01/01/2016 01/01/2017 STATUTE___ ER AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 500,000 OFFICERIMEMBER EXCLUDED? N N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 It yes,descr be under .0ESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ SOO,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TOWN OF BARNSTABLE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD __ L ,_ .. TOWN OF BARNS-TABLE BUILDING PERMIT APPLICATION � II Map s Parcel 00 �66( Application #�Z?/L[ Health Division Date IssuedZZ. Conservation Division "� Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Addresss Village n:5�XJJv Owner s FLL Address C�b .ho4 . A Telephone �C��y ' Z� (� c% , �06��S S u , d L 4- v Z' Permit Request IbLLU 4 na Square feet: 1 st floor: existing 'proposed .25 2nd floor: existing proposed Total new 25 S Zoning District Flood Plain Groundwater Overlay Project Valuation MD Construction Type Lot Size ae-ye-S Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure FS Historic House: ❑Yes td- o On Old King's Highway: ❑Yes (.No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other o Basement Finished Area (sq.ft.) �— Basement Unfinished Area ME Number of Baths: Full: existing new Half: existing �` Re�iv Number of Bedrooms: existing _new _ Total Room Count (not including baths): existing new First Floor Room Counf" . Heat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑ Other v� 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 9 new size2S-5 Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes CWI-Rlo If yes, site plan review# Current Use Proposed Use Q APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name � Telephone Number � C� Address ��`� ��J��l� �5+��'E' License# gZL " 1 6 0 z(0 5-5 Home Improvement Contractor# 0 Z0� Email 6D e� V-O ZZ S. Co- Worker's Compensation # 3 S 3�- ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATUR DATE FOR OFFICIAL USE ONLY ` APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE r OWNER DATE OF INSPECTION: Fr FOUNDATION �y FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. i The C.'orJn»oumeallh of_fassachusetis —> P Delrnrnnew of bidustrial Accidents l,,;Y?ia• ;;_, Office of Investigations 600 TVashingtorr.S'treet tf;TL Boston,_U-1 02111 ,``• •- /f, tl'►l'11'JJJCr.S.S.g01'�drft 111orhers' Colnpeusation Insurance Affida-tit: Builders;Contractors'Elects-iciaus Pluinbei-s Applicant Information j� Please Print LeQibb, I�culle(B:ts;nes;'Org_ui_a iclIudii-dual): ;� 06 Address: C'.itv/State`Zip: Phone : Are you au emplo-•er^. Clieck the appropriate box: Type of project(required): NE—Tam a employer :ith 70 4. ❑ I aui a geueral coat actor and I r ). •�• ha:•e hued the sub-contractors 6• ❑Ne:':c0nstructtou emplcyees(ful.a end or part-Fine ?.❑ ?am a sole proprietor or partner- ship listed on the attached sheet. ❑Remodeling These sub-contractor-have ship and ha;a nc employees S. ❑Demolition. :z.orkin- for rue in art,•capacity. employees and have v:orkers' 9 ❑Building addition [No workers' comp.insurance comp.insurance.- required.] 5• ❑ le are a corporation and its 10.0 Electrical repairs or additicns 3.❑ I am a hemeoa:ner doing all,cork officers have exercised their 11.❑Plumbing repairs or additions myself. [No corkers' comp. right of exemption per MGL i2.❑Rocfrepairs insurance required.] c. 152: j1(4).and::-e La.:e 110 employees. [Nc workeri' '-3•❑Other comp.insurance required.] anv a ii-,-Xr ihei ineC K> Jti=1 M'11,also fill out the section belon•>Loning their R•OrltErs•COn.••penc3u0n pOUC%1nI0iIL'-fi0n f Homeolrne:s who subunit tiis affidavit indi:atine they are doiae all t,•or:and ti2n L to outside ccntrac;or;mtui sus u;a uElr aff:dacat:ndicatins such. :Coneactors Sn:.t checc:thas pox rust attached a additionsi sheet showiuz the nam2 O_`the sub-contractors and state a:Lether or not those endues hacE emp30VeEs. I:tLE SUb cOntractor:hzve employees,me y must pro:ide the a•oe}ers�comp.policy number. I am all enrplol^er that is-providing n•or•kers'compensation in.snrance for nil'enrplot•ees. Below is the polio'and job site information. _ Insurance Company Name: Policy"or Self-ins.Lccic.r: {��3 �"" Expiration Date.: Job Site Address: O cJ s& P (� S(� e City/State/Zip: 2� Attach a cope-of the workers'compensation policy declaration page(shoeing the policy number and expiration date). Failure to secure coverage as required under Section 25A of NIGL c. 152 can lead to the imposition of criminal penalties of a fine up to S1 500.00 anti.or cue-year imprisonment,as well as civil penalties in the form of a STOP I ORK 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 DL4 for insurance coverage verification. I do hereUt cert ider th�"' of pe,jnrt'tlr he information prodded abot•e is true and correct. �Simiatwe: � i Dater phone=: c�c� • 'i � Official use only. Do not write ill this area,to be completed bt'city or town official. City or Town: Perinit/License 4 Issuing Authority'(circle one): 1.Board of Health 2.Building Department 3.CitylTo«•tr Cleric 4.Electrical Inspector 4.Plumbing Inspector 6.Other Contact Person: Phone 9: 6 Client#:64MOO 21NORRISEB DATE(MM/DD/YYYY) ACORM CERTIFICATE OF LIABILITY INSURANCE 05/13/2013 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: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 endomement(s). PRODUCER CONTACT NAME: Dowling&O'Neil PHONE 508 775-1620 5087781218 (Al c No Ext: A/C No Insurance Agency E-MAIL ADDRESS: 973 lyannough Rd., PO Box 1990 INSURER(S)AFFORDING COVERAGE NAIC# Hyannis,MA 02601 INSURER A:Acadia Insurance INSURED INSURER B: E.B.Norris S Son., Inc. INSURER C 138 Osterville-West Barnstable Road INSURER D: Osterville, MA 02655 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUB POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD MM/DD A GENERAL LIABILITY BINDER359034 5/03/2013 05103/2014 EACH OECCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY PREMISES EaEoc�«TEr nce s250,000 CLAIMS-MADE 5XI OCCUR MED EXP(Any one person) $5 000 PERSONAL BADVINJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY JET LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accdent ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPER TY $DAMAGE t HIRED AUTOS AUTOS Per acciden UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS MADE AGGREGATE $ DED RETENTION$ $ Eg A WORKERS COMPENSATION BINDER359037 5/03/2013 05/03/2014 X WC STATU- OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $500 000 OFFICER/MEMBER EXCLUDED? a N I A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $500 OOO If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT s500,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION Town of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE n 1988-2010 ACORD CORPORATION.All riahts reserved. 1 '• I i Town of Barnstable. Regulatory Services f Thomas F.Geller,Director Building Division — Tom.Perry--Bni IMCommissioner 200 Main Street Hyannis,MA 02601 www.towmbamstable -ma.us Office: 508-862-403 8 Fax: 508-790.6230 Property Owner Most Complete and Sign This Section If Using A Builder I_ 2ft Rehnert ,as Owner of the subject property hereby authorize E.-B.Nc ds&Son,Inc. to act on my behalf, in all matters relative to work authoriied bythis building permit application for: . 285 Seapult Road,Osterville,MA (Address ofJob) 4/8/14 Sipeaure of Owner Date Geoffrey Rehnert Print Name QTORMs:owP1ERPSWSSlorl J ..- 1.:a Massachusetts -Department of Public Safety �- l Board of Building Regulations and Standards • �r' Construction Supcn•isor License: CS-015851 i •'. CRAIG N ASHWOkTH 138 OST W BARNSTABL OSTERVIL,E 1VfA 0 655 / Expiration Commissioner 09/28/2015 . . . 1 - a . 4. I. 1 . • ' T �• l mil'�`-i-:�,,. �`��-�_ �/�!� ��c?�yz?rGl��r?-L��iC.r(,�Gli ��L/d��i�2':1,lGYC��IiGC/1•CJ��1� Ap- Office of Conswl7er Affairs and Business Regulation 10 Park Plaza - Suite 5170 , Boston, Massachusetts 02116 lHom.e Improvement Contractor Registration Registration: 102014 Type: Private Corporation Expiration: 6/30/2014 Tr# 223290 ERNEST B. NORRIS & SON INC Craig Ashworth _ — 138 Osterville W. Barnstable rd. OOsterville, MA 02655 _ Update Address and retw-n card. Mark reason for change. Address J Renewal CI Employment Lost Card SCFl 1 <, _'0M-05/1'1 office u1'Consumer Aft'airs� ISusiucss ltcgul:,liou License or registration valid f0;'individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: •-- . :,_;.1 Office of Consumer Affairs and Business Regulation ==J egistration: 102014 Type: ,; 10 Part: Plaza-Suite 5170 xpiration: 6/30/2014 Private Corporatior Boston,MA 02116 ERNEST B. NORRIS& SON INC Craig Ashworth �P. 138 Osterville W. Barnstable rd. Osterville, MA 02655 / Undersecretary ,�� Notwalid without signature . G TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 05 Parcel ,Application ' v�� Health Division Date Issued 7i Conservation Division P/ Application Fee (00 Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis Project Street Address o2 8 5 �1-'� Village J A P Owner Address y Telephone Z '11�5 C S� '"� -�r'�C o ^� Permit equest BL� a yLp�-JSezr -� �t�c��' s�`� Led Square feet: 1 st floor: existing proposed 2 2nd floor: existing proposed Total new Zoning District Flood Plain \ Groundwater Overlay Project Valuation `W �� Construction Type �S� bore Lot Size = ��5 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: 0 Yes ❑ No Basement Type: 0 Full ❑ Crawl ❑Walkout Cl Other `L6 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.. v CMY � Heat Type and Fuel: Q�Gas ❑ Oil 0 Electric ❑ Other z Central Air: .Yes ❑ No Fireplaces: Existing New t�S Existing wood"' oal stoves❑e ❑ No Detached garage: ❑ existing ❑ new size Pool: ❑ existing ❑ new size _ Barn: ❑e isting 0 newize_ =° cn Attached garage: 0 existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: -+ w rn Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ `1 Commercial ❑Yes ❑ No t,If yes, site plan review# ) Current Use �� CO"`�l fc�A� � Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name C) ` S Telephone Number Address D U lie Cad"License # S t Home Improvement Contractor# 16 2014 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO LZSIGNATURE DATE €: FOR OFFICIAL USE ONLY APPLICATION# z. t - DATE ISSUED MAP/PARCEL NO. GJ j ADDRESS VILLAGE E OWNER r DATE OF INSPECTION: FO.UNDATIONr FRAME ' INSULATION s FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH - FINAL a;. FINAL BUILDING DATE CLOSED OUT a "' ASSOCIATION PLAN NO. � t -� The Commonwealth of-Massachusells = i Deparunettt of Industrial Accidents Off ce. of Investigations' 600 Washington Street Bosion, 314 02111 ivivtr'.INass.jot%lltlt Workers' Cotnpeusatlou Iusurauce Affida\7t: Btilldel•s,iContl•1cto1's Electriciaus Plttinbeli:s Ai plicaut Iuforinatiou Please Print Le(ibl-,- I�a111e B:ts aes;;Orgattiza is a!1ci Q_«lj: (UO v u�t S 4, 6c~° L. T t/LC. iiII I Address: I3 U`� o��i✓ llE �tS� �Jc1vt5��4��c� 2yc:.��) i City/State/Zip: ��k-C (J << 2-G'S 5 Phoiie Y: 0 Are you an employer^. Clieck the appropriate box: Type of project(required): 1.t>_ i ain a employer,. ith � 4• ❑ 1 am a general contractor and I 7 b. El New corn-ar-tiction euhlo�ees(faL and!or pant-time).* ha-..re hued the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. ❑Remodeling ship and have no employees These sub-contractor.:have S. ❑Demolition employees and have.;orl:ers' w=oil ing for me in am-;capacity _ 9. ❑ Building addition [No v,-orkers' comp.insurance comp.insurance.-- required.) 5. ❑ ;%i`e are a corporation and its 10.❑Electrical repairs or additions 3.❑ I ants a homeo;:ner doing all work officers have a%ercised their 1 LE]Plumbing.repairs or additions myself. [No workers' comp. right of exemption per 1\IGL 1' ❑Roof repairs insurance required.]' c. 152, 1(4}, and v:a ha a no employees. [Nc x�:or>ter_' i3.❑ Other comp. insurance required] °Arc appsic t:t ihz--chec�s bo%=1 t t also fill out the sEct on beioxv_L•o-,vise:ne r ivo7l-us'compeLsat on poL='cN infoTn::Um t :omeowners P.-ho sabmit this affidavit indicat'ng they arc doine all;s•or::and theu Lire outside contractors must subnii.a L•EW aff dal t iudicatins such_ •conaactori Siiat chEc'ILfs box mast attacLEG 31 addrtionai Sheet showilig tLE name of the sa L D-cowractoTs and state whEer Or not those endue-hst•E employee-. Iz the sub-conLnctor-have employees,the must provide the workers"comp.police number. I ant ati eutploi•et•that i:spr•ovidiug mor•kets'cotttpetisatioii ittstrratice for►lit'employees•. Belo+r is the policy and job site information. � InsuranceCompany=Name: CL"CG Policy=In or Self-ins. Lic.1: .3 s Expiration Date: I Job Site Address: a v��4 """ CityiStatelZip: �S�er0``` "I k CZ C 5 Q l S 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 tip to S1,500.00 and/or one-year imprisonment,as well as civ-il 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.DLL.for insurance coverage verification. I do Itereby certify under the pains art unl '`s of p 'T ;that the infor►uation provided above is true and correct. xSig=iature: .� Date: I Plicrie=: Official use only. Do not+Trite in this area, to be completed bt'city or•tonnt official. City or Town: Permit/License,14 Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City-;Town Clerk 4.Electrical Inspector -5.Plumbing Inspector -6-0the Contact Person: Phone?i: CI'sent#•: 646400 2NORRISEB DATE(MtVfDDlS'YYl') A- D CEO IFICATE F LIfi ELIT�' H`` URA 05/13/2013 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 CERMFICA.TE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. 110PORTANT: if tha 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 L CONTACT . 1 r. ai! I N6d,1E: Dowling `� O'hi PHD'tE 08 775-1620 FAx 5087781218 Ali:.I•lo.Gal:5 _r nc • Aoenc ----- E-t. s' r r-a q��lya , Uh FE R—" , U FJoX 19 S,0 . i Ivarirlls. MA 0'6`l1 INSUnER(S L._Gic:a<_ �O\'E+',AvE NA.Ii: r Acabia Insurance i 1k51Ir':D � — . .INSURER B: . E. B. I'v�,rrls� Son., Inc. .IN._ ._-------' ------ -- -- ---'----------- — ----'-- -._. ------- . INSURER C: 136 Os.arvliie-West Barnstable Road - -- ---- -- - - - _--- - INSURER D fdlU 02u55 _ --- __ — 0stervi;1e, - ----- —' --- -----— — ----- -- i I INSURER E: _— I • I INSURER F' COVERAGES CE>^.T;FIGATE NUMBER: REVISION NUiViEFR- - _P i�Y THAN- - _IC._. _ ...-.:I-�r..v __f L:i _ :�n:f= ` '�r E - �C,;.•RI- -,c� i t�,..�� _L.1+b _ccE1V!SSL)_J TO THE I,�-_J,. NI I-is .1J= F._ 1= G!_ .,r r -RI"7 D 0 .:ED. PS 'TV''T HS'i AP;�'L.:3 A'iY -,_ _IR_ivIE1�'I, -c i:' GR G�, D!-rION OF A14Y C 1, CT R O:: - - - . _ �` _ O�TRP. O� �=R DG f i Iti I JJf I 1 R_5:- i .O +%H1.. i T1=r:C.'-_ 1r„ . cE IS`_=J DF1 n1... _ :T4,1d, `n_ It: +..=.NCE ,O:.D=D SY THE POLICIES DESCRIBED I:_rt_!. IS , _BJ=d T T_ ,_L T`I_ ._Rfc'- CLLISt•Jid AND C_+I':U:-1U.. O� cJCH POLICIES. LIMITS SHOWN io.AY -IAV1= BEEN REDUCED SY PAID CLAIM..5 IADDL'SUSR' ? f !Y?c OF INSURANCE INSIWViI POLICY NUMBER h'1 Y�(MM,'DDh!`.'YYL LIMITS _ _!(Mf%IDD. (.A GIN=_FAL Lu, BINDER3590-a4 J • 5/03/2013 05/03/2014 E,(-.. -)ccuR-F_I, I S1.0u-3,000 COMMERCIAL GENERAL LIABILITY '-AMAGE TO RtNTED 2«t P.Et.':SES L-occun,.,m:, 510-00Q f MED EXP(Any one person.) ,_5,000 CLAIMS-MADE �OCCUR I I ! PERSONAL&P.DV INJURY ;1;000,000 i ! I i GENERAL AGGREGATE s2.000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS! r 'S I TS-COMP/OP.AG�r , 21000,000 i POLICI'n j R�T �I LOC I a AUTOMOBILE LIABILITY ,COMSINED SINGLE LIMIT I I(Ea accident) S AIJY AUTO ! BODILY INJURY(Per person) I ALL OWNED SCHEDULED I AUTOS ' I AUTOS BODILY INJURY(Per accident) S NON-OWNED oROPEP.TY DAMAGE HIRED AUTOS I I AUTOS . I o g .erzccident) I UMBRELLA LIAB OCCUR EACH OCCURRENCE is EXCESS LIAR CLAIMS-MADE I AGGREGATE S DED RETENTIONS is A WORKERS COMPENSATION BINDER353037 5/03/2013 05/03/2014 X WC STATU- I �OTH-I AND EMPLOYERS'LIABILITY Y/N T ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ® N/A E.L.EACH ACCIDENT $500,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE s500,000 If yes,describe under DESCRIPTION OF OPERATIONS Wow E.L.DISEASE-POLICY LIMIT I s500,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Insurance coverage is limited to the terms, conditions,exclusions,other limitations and'endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered, waived, or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION Town of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 h4ain Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE n 1988-2010 ACORD CORPORATION.All riohts reserved. t Town_of.Barnstable.- --Regulatory-Services .Thomas F.Geller,Director Building Division ---- Tom.Perry—Btdlding_Commissioner 200 Main Street Hyannis,'MA 02601 www.town.bamstable -ma.us Office: 508-862403 8 Fax: 508-790-6230 Property Owner.Must Complete and Sign This Section If Using A Builder I, Geoffry Rehnert ,.as-Owner of,the subject,property hereby authorize E. B.Norris& Son, Inc. to act on my behalf, ,. in all matters relative.to work auth6d*zed�by.this_building..permit..application,for:..- r 285 Seapuit Road, Osterville, MA --(-Addresss-of Job) 12/23/23 Si ature of Owner Date Geoffrey Rehnert Print Name C Q:FORMS:OWNERP[RNSS10K. a 1 Board of EuMna Reyvamns and S._. s (,1HLPUiaiU❑ �iFi(;e'1`•i:n'. License: CS-015851 ` ,`.' y.. CRAIG N ASHN'ORTH 138 OST NV BARDSTABLE OSTERVILLE KA 02655 :_ Commissioner � ; 09/28/2015 I i -, C�� criJ�lcrcl�lcUl� Office of Consumer Affairs and Business Regulation J 0 1. ark Plaza Suite 5.1.70 Boston, Massachusetts 02116 Home Improvement Contractor Registration Reqistration: 102014 Type: Private Corporation Expiration: 6/30/2014 Tr# 223290 ERNEST B. NORRIS & SON INC _` __ — --•--- ---- Craig Ashworth ---- -- ------- 138 Osterville W. Barnstable rd. Osterville, MA 02655 -- - Update Address and return card. Mark reason for change. Address [J Renewal ❑ 'Employment ❑ Lost Card SCA 1 {; ::20M-05/1 I r'.;��r -v+nr urr+rrur.-rr�l�cr'�(rr.lJrrr:irrJr•C/1 ° Office of Consumer Affairs S.' Business Regulation License or registration valid for individul use only before-the expiration date. If found return to: -�.-HOME IMPROVEMENT CONTRACTOR Type: Office of Consumer Affairs and Business Regulation r _) egistration: 102014 yp -EIty 10 Park Plaza-Suite 5170 ,;Expiration: 6/30/2014 Private Corporation Boston,MA 02116 ERNEST B. NORRIS&SON INC Craig Ashworth 138 Osterville W. Barnstable rd. Osterville, MA 02655 Undersecretary �� NotJvalid without signature i AGRI BALANCEO 00 C) CD Company Name CAPE COD INSULATION Phone Number 1-800-696-6611 Jose Espinol Installation Date 06-24-2016 w m V o, M 285 Seapuit Road Party Barn. PA86001543 Jobsite Address A-Side Lot Vs Permit Number B-Side Lot#'s P3037313116 Walls 5 Y2 R-24 750 square feet Attic 9" R-40 1,040 square feet Garage Ceiling Walls Blazelok TBX Attic 23 mils wet 15 mils dry www.Demilec.com . o ' °� EMILEC HEATLOK610.0 Company Name CAPE COD INSULATION Phone Number 1-800-696-6611 Q o _< =� 06-23-2016 Jose Espinal Installation Date o 285 Seapuit Road, Guest House PA86001543 Jobsite Address A-Side Lot#'s P105597716 w Permit Number B-Side Lot #'s m Walls 3" R-22 150 square feet Attic 6%:" R-48 1,200 square feet Crawl Slopes Blazelok TBX Attic 17 mils wet/11 mils dry www.Demilec.com c8DEMILEC EOJJAXTIMERA BUILDER LANDSCAPE MILLWORK May 9,2016 Town of Barnstable. Tom Mcke.an, Director Health Division 200 Main Street Hyannis, MA 02601 Re: Geoff&.Laura Rell-nert 285 Seapuit Road, Osterville Fireplace for Party Barn Dear Tom, The proposed fireplace for this structure:does not haye enough BTUs to heat up the Large space..It is strictly for aesthetic purposes only. This space is not to be used for sleeping quarters. Sincerely EJ Jaxtimer, President 48 Rosary Lane, Hyannis,'MA 02601 r 508-771-4498 , 508-778-4911 e Fax 508-775-4909 www.jaxtimer.com w I Parcel Lookup Page 1 of 1 { \LASS, �^` o�TfO ��yrn� 'rsr a::} T � t� r.r„ ''G't/d//G5,✓�K'C/ tR'/' °F'��.� ;W � 3' - x Logged In As: Tuesday,January 16 2018 Nancy Larned Parcel Lookup Road Lookue Condo Lookup Multiple Address Lookup R2oorts Search Options Search By Street Street# 285 i Street Name seapuit i Village All Villages Search <Prev Next> Page 1 of 1 Rows/Page: 1 o v Parcel Location Owner Village Index Map 285 SEAPUIT ROAD#A- 095-007- Multiple Address REHNERT, GEOFFREY S & OSTVIL 1457 095007001 001 (285 SEAPUIT ROAD Unit B - LAURA A Party Barn) 285 SEAPUIT ROAD #A 095-007- Multiple Address REHNERT, GEOFFREY S & OSTVIL 1457 095007001 001 (285 SEAPUIT ROAD Unit C - LAURA A Guest House) http://issgl2/intranet/propdata/lookup.aspx 1/16/2018 Parcel Detail Page 1 of 15 Logged in As: -Tuesday,lanbary 16 2018 Nancy Larned Parcel Detail Parcel Lookup Parcel Info _................_....._........._._...._._-................ ___._._....._...___._._.._.____..._._ Parcel ID 095-007-001 LLJ Developer Lot LOTS 6&8 Location 285 SEAPUIT ROAD#AI Pri Frontage F145 Sec Road �Q •�m� � Sec Frontage Village Osterville .......__..I Fire District C-O-MM Town sewer exists at this address No .__ I Road index R7 Asbuilt Septic Scan: 095007001_1 Interactive Map 1 - 4 095007001_2 • Owner e-ownerjREHNERT,GEOFFREV I-- C Ownerer Streetl C/O AUDAX GROUP--I Street2 101 HUNTINGTON•AVE city BOSTON « I state,MA_ __ )zip[219_9 country � ) w Land Info _...-........_._....._....._..................................................._.....:...._......................._............__........................................._......-.._.........._...._.............._......................._......._...................._.................................................................._ Acres 2.85 use Multi Hses MDL-01. .,., zoning RF-1. Nghbd WF11 TopographyLevel mV `I Road IUnpaved ._.I Sr<eawwnw xw.mw:rxwsww�smsrwma:w�..w:e utilities!Public Water,Gas,Septicl Location Waterfront,Excel View Construction Info Building 1 of 2 Built1990 ""I truct M S Gable/Hip w Wood Shingle r .. Living 6226 J Roof Wood Shin I AC Central 1 Area�,�ti�«...��« Cover� g Type Y Style Cape Cod wall Drywall Rooms 15 Bedrooms FAS Model Residential I Fl or Hardwood ) Roth Full-1 Half I M Heat Luury Plus , Tpe ofWater I Rms 12 ROORW- I B ti3 Heat 7 '� Found- � stories 11 Story )Gas J Poured Conc. Fuel. anon ,.«� � 6 Grosso Area fl14579 :Building 2 Of 2 _H ,« m�. ... Built2016 SRu0r Gambrel wail;Wood Shingle Ce 'Living1645 _ Roof AC''.., o. .m Area 1645cover Food Shingle. ) Type# ntral Style GambrelI wall IDrywall I .Bed Rooms 13 Bedrooms Model Residential ( Fl of Hardwood I R oms 2 Full-0 Half I Grade[Exceptional'PII TYpe HOt Water Rooms 6 http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=5202 1/16/2018 Parcel Detail Page 2 of 15 Stories Heat g; I Found- 1 3/4 Stories ) Fuel tGas ationGross Poured Conc. � } g � A Area RF4'7-1 ..............................................................................---.................................................................................................. Permit History Issue Date Purpose Permit# Amount Insp Date Comments 12/13/2016 New roof, New siding, 1/6/2017 Sid/Wind/Roof/Door 16-3778 $100,000 12:00:00 New windows (42), New AM doors (4) REMODEL OF EXISTING DETACHED GARAGE 12/13/2016 INTO FINISHED ROOM 3/15/2016 Addn Alt-Res 2016-0122 $100,000 12:00:00, AND AND 7X6 AM BATHROOM ADDITION, NEW WINDOWS, DOORS, SIDING 12/13/2016 CONSTRUCT A NEW 3 2/5/2016 Addn Alt-Res .. 2016-0123 $500,000 12:00:00 BEDROOM 2 BATH AM CARRIAGE HOUSE 1995 SF 9/26/2014. STORAGE SHED 15X17 4/22/2014 Shed 201402394 $35,000 12:00:00 W FROST WALL 15 ND AM 7/7/2015 2/7/2014 Demolish 201400532 .$5,275 12:00:00 DEMO EXIST BARN AM 7/7/2015 PMT EXPIRED. 2 STORY 2/7/2014 Expired 201400533 $322,700 12'00:00 2BDRM 2BTH AM CARETAKERS COTTAGE 7/7/2015 1 BDRM STUDIO W 1 2/6/2014 Out Building 201400531. $110;000 12:00:00 gTH ON SLAB AM REN/REMOD BMT, ADD. BELOW GRADE 10/4/2013 COURTYD, SLIDERS, 1/25/2013 Remodel 201300503 $250,000 12:00:00 DEMO INT EXIST PET; AM NEW WALLS, INSUL, NEW.BTH, MOVE MECHANICAL HIDEAWAY GAS 6/17/2011 FIREPLC IN 12/22/2010 Other 201006728 $4,700 12:00:00 MSTRBDRM-ZERO AM CLEARANCE DIRECT VENT 6/17/2011 16X60 INFINITY POOL & 12/6/2010 Swimming Pool 201006326 $80,000 12:00:00 7X7 SPA W AUTO AM COVER 11/22/2010 Out Building 201006327 $77,400 BLD POOL CABANA http://issgl2/Intranet/propdata/ParcelDetail.aspx?ID=5202 1/16/2018 Parcel Detail Page 3 of 15 6/17/2011 12:00:00 AM 6/17/2011 CONSTRUCT POOL 11/17/2010 Other 201005793 $43,500 12:00:00 RETAIN WALL AM 6/30/2010 BLD RETAINING WLL & 8/6/2009 Out Building 200903647 $0 12:00:00 CABANA AM 1/15/1991 11/1/1989 Dwelling B33333 $350,000 12:00:00 OS 1 STOR AM 1/15/1990 7/1/1989 Demolish B33078 $0 12:00:00 OS DWELL. AM Visit.History'....... _..... . ...__....._.._......_.._... ......_....._.....................__._............ ............................................................ ........................................_........_................... .....__...... Date Who Purpose 3/23/2017 12:00:00 AM Susan Ricci Bldg Permit Completed 8/3/2016 12:00:00 AM Susan Ricci CALL BACK 7/13/2015 12:00:00 AM Susan Ricci CALL BACK 5/19/2015 12:00:00 AM Jeff Rudziak Cycl Insp.Comp 12/17/2014 12:00:00 AM Mike White CALL BACK 7/8/2014 12:00:00 AM Mike White, CALL BACK 12/30/2013,12:00:00 AM Mike White Bldg Permit Completed 10/4/2013 12:00:00 AM Mike White New Construction 6/26/2013 12:00:00 AM Robin Benjamin CALL BACK 4/10/2013 12:00:00 AM Mike White CALL BACK 9/26/2012 12:00:00 AM Nancy Finch In Office Review 6/21/2011 12:00:00 AM Robin Benjamin Bldg Permit Completed 1/18/2011 12:00:00 AM Robin Benjamin In Office Review 3/22/2006 12:00:00 AM Paul Talbot Meas/Est 6/7/2001 12:00:00 AM Paul Talbot. Meas/Listed-Interior Access 2/15/1991 12:00:00 AM ML' Meas/Listed-Interior Access Sales History Line Sale Date Owner Book/Page Sale Price 1 1/2/2008 REHNERT, GEOFFREY S & LAURA A C184943 $1 2 9/5/2007 HUGHES, ARTHUR W III TR C184043 $6,075,000 3 3M5/1993 MILLER, RONALD W& DIANE D TRS C129617 $3,500,000 4 7/27/1992 DEELEY, M & R (LOT 8) C127332 $100 5 6/15/1989 DEELEY, MICHAEL & RUTH V C117813 $1,250,000 6 3/3/1950 THOMPSON, MARGARET.0 C11380 $0 Assessment History Save Building Total Parcel # Year Value XF Value OB Value Land Value Value http://issgl2/intranet/propdata/PareelDetail.aspx?ID=5202 1/16/2018 Parcel Detail Page 4 of 15 1 2018 $1,330,300 $196,200 $457,600 $3,392,400 $5,376,500 2 2017 $1,065,700 $180,600 $427,200 $3,392,400 $5,065,900 3 2016 $808,600 $158,100 $401,700 $3,392,400 $4,760,800 4 2015, $475,100 $166,500 $414,100 $3,312,700 $4,368,400 5 2014 $475,100 $110,700 $408,800 $3,312,700 $4,307,300 6 2013 $447,900 $81,900 $388,300 $3,312,700 $4,230,800 7 2012 $465,000 $80,000 $360,500 $4,117,800 ;$5,023,300 8 2011 $625,600 $6,900 $156,900 $4,117,800 $4,907,200 9 2010 $625,600 $5,600 $166,700 $4,706,100 $5,504,000 10 2009 $1,328,500 $5,700 $350,000 $3,821,300 $5,505,500 11 2008 $1,866,900 $5,700 $350,000 $3,979,900 $6,202,500 13 2007 $1,908,500 $5,700 $350,000 $3,979,900 $6,244,100 14 2006 $1,919,900 $2,900 $395,500 $3,551,000 $5,869,300 15 2005 $1,683,100 $2,800 $396,000 $3,550,700 $5,632,600 16 2004 $1,316,800 $2,800 $521,200 $2,538,000 $4,378,800 17 2003 $914,200 $2,800 $46,300 $1,166,800 $2,130,100 18 2002 $914,200 $2,800 $46,300 $1,166,800 $2,130,100 19 2001 $858,700 $2,800 $21,700 $1,166,800 $2,050,000 20 2000 $701,400 $2,800 $22,100 $920,800 $1,647,100 21 1999 $701,400 $2,800 $18,700 $920,800 $1,643,700 22 1998 $701,400, $2,800 $18,700 $919,900 $1,642,800 23 1997 $634,000 $0 $0 $919,600 $1,571,100 24 1996 $634,000 $0 $0 $919,600 $1,571,100 25 1995 $634,000 $0 $0 $919,600 $1,571,100 26 . 1994 $495,100 $0 $0 $538,700 $1,051,700 27 1993 $495,100. $0 $0 $554,800 $1,067,800 28 1992 $562,400 $0 $0 .$610,400 $1,193,200 29 1991 $0 $0 $0 $1,017,400 $1,033,900 30 1990 $413,000 $0 $0 $1,564,000 $1,984,000 31 1989 $413,000 $0 $0 $1,564,000 $1,984,000 32 1988 $346,000 $0 $0 $608,200 $965,800 33 1987 $346,000 $0 $0 $608,200 $965,800 34 1986 $346,000 $0 $0 $608,200 $965,800 • Photos http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=5202 1/.16/2018 Parcel Detail Page 5 of 15 _ •::� - •.any:. �T g. a € 1 f e. 4>5 http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=52(12 1/16/2018 Parcel Detail Page 6 of 15 nrr� http://issgl2/intranet/propdata/PareelDetail.aspx?ID=5202 1/16/2018 Parcel Detail Page 7 of 15 �A TA . 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