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HomeMy WebLinkAbout0094 WATERFIELD ROAD u 94 WATERFIELD 7RD Fa Town of Barnstable Bung Post t ildi ng .exivsrweu Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on'Job and this Card Must be Kept`. M^ Posted Until Final Inspection Has`Been Made. , 63 ''� Where a Certificate of-0ccupancy is Required,such.Building shell Not'be Occupied until.a Fine)Inspection has been made.~,., Permit Permit No. B-18-876 Applicant Name: James Curley Approvals Date Issued: 03/30/2018 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 09/30/2018 Foundation: Location: 94 WATERFIELD ROAD,OSTERVILLE Map/Lot: 119-024 _ Zoning District: RC Sheathing: Owner on Record: TOLAND,THOMAS J&DENISE V Contractor Name: JJAMES P CURLEY Framing: 1 R Address: 105 BRIDLE LANE Contractor License: CSS�L-099138 2 LOWER GWYNEDD, PA 19002 �� Est. Project Cost: $7,000.00 Chimney: Description: Strip and re-roof approximately 15 square of asphalt roof shingles. Permit Fee: $35.70 1 Insulation: Fee Paid: $35.70 Project Review Req: Date: � 3/30/2018 Final: Plumbing/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. Rough Gas: All work authorized by this permit shall conform to the approved application and thekapproved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Final Gas: 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 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.The Minimum of Five Call Inspections Required for All Construction Work: Rough: 1.Foundation or Footing. ---- -�-'"x 2.Sheathing Inspection Final: 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 Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health 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. 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 - i t �; __ ..4 i f w �-' -�. >-� R Town of Barnstable ermit: U-S(Q Regulatory Services ate: oF�"E Richard V. Scali,Interim Director A Building Division Fee: EAMS ABM ' Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 �Fo �A www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 TOWN OF BARNSTABLE SOLID FUEL STOVE PERMIT Owner. m `t Do h I S e- !-Ian �Phone: c2 l c� - :Z -1/l9--7U 0 3 � o ��r •..� d Install at: q � J �l ��j Village P V`(1 ' o Map/Parcel: o 2`4 Date: Stove A. New/Used �? B. Type: Radiant/Circulating C. Manufacturer: Lab.No. �n D. Model No.: Chimne A. New" (If existing,please note date of last cleaning B. Flue Size C. Are other appliances attached to Flue? h D. Pre-fab Type and Manufacturer c-r"Pn pn t 60-�'-4 hQ 5"- Fn Cnr'Q- �a S37 E. Masonry: Lined/Unlined Hearth - n A. Materials: 81 t S rat, 5 _ -6y` PICX>n B. Sub Floor Construction: Installer Y'eCeiv&y yu-\c�ze� kom e -c-5om e Tit' v��%r( l�hPjj^��U2V' c�SeC) Name: Address: Phone: Location of Installation: H.I.0 Registration# Construction Supervisor# OR check i,-*� Homeowner Installing, no license required LICENSED INSTALLERS SIGN h ep APPLICANTS SIGN TUBE: APPROVED BY: Please make checks payable to the Town of Barnstable *This constitutes an official stove permit after inspection,photographed, and approved by the Building Inspector Q:forms:stove Rev 11/4/13 27w€ownrom of Massat.:husef Depart; t a,f Iiudks&i-d Accidents - OBtce ofiitigations 600 Washington Street Roston,MA 02 wnwanass:goldia W rke& CampensationInsuranceAffiidavit:Bui]ders/Cantmctors/Eiectrician&Oumbers rant Information —7� Ptease Print Legibly (Sosme�ldrgrmization/tn3ivi�al7: ry) g� (I J P rrl I`je 1 I Address-. City/Statae ap: Phone g: Are you an employer?Check the appropriate box: Type of project(required): L❑ I am a employer with 4. ❑ I aorta gew al contractor and I e ployees{full and/or part-time)_ * have>riredthe sub=contxactozs 6_ []New won 2_❑ I am a sole propzietor orpartner- listed on the attached sheet" 7- ❑Remodeling ship and have no employees employees ees andz have have g- ❑Demolition working forme in any capacity_ Ply and have wot9cers' ❑Building addition [No worm c- s'comp_iusm e comp_insurranc # 10_ Electrical r or additions 5. ❑ We are a corporation and its ❑ �g 3_ I am a homt u�ntrr doing all wt officers have exercised their 11_0 Plumbing repairs or additions myself [No work='comp_ right.of e2w lion per MGL 12-01Zoof repairs / insurance required_]F c_152,§I(4),and we halm no employees-[No workers' 13..2 Other��1 QQd;STO I�Pi comp-insurance requireti-1 *Any spplicat that checksbox Kmost also fill out the section below showing iiheirwoikea'cotape=16oupoaTiuf+ *^ 13nmeawners Who submit this affidavit ia&=ting they are doing eII worTc and then hire outside coot rKtors most submit a new affidavit iss�rstina such tCoat=actors that check this box-mast attached as addidoosl sheet showing the ns me of the sorb•-cmafracton sod state whether ocnot those entities have easpkuves. if tha sub-contractors have employees,they must provide t3leir warkers'comp.policy amnber. lam arz empInyer That is prmidarg tt�orkers'cortgmnsation insurance for my emplayees. Beloty is Ste policy and job site infbrmaA-01L Insurance CompanyName: Policy#or Self-ins.I.ic-4: Fxptsation.Date: Job Site Addresr City/State/ : 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 cw 152 can lead to the imposition o f criminal penalties of a fine up to S1,500.0d and/or one-year imprisonment,as well as civil penalties in the foam 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 Iuvestigations of ffie DIA for insurance coverage Gerfficatwn- I do llereby fy Under tha trs and natiies ofpedwy that the informationprmided above fs true and correct Date Phone#: J / o fl cial use only. Do Trot write in f ds area,to be campieted by city or town officinL City or Town: PermitUcense# Issuing AwLthority(circle one): 1.Board of Health.2.Budding Department 3..CiVrown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Coact Person: Phone 9: 6 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. P rsuant•to this statute,an employee is defined as"_..every person in the service of another under any contract of hire, express or implied, oral or written_" An employer is de£med as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer;or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction,or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or Iocal licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance.coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certincaic(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees;a policy is required_ Be advised that this affidavit maybe submitted to the Department of Industrial Accidents for confirmation of incttrance coverage. Also be sure to sign and date the affidavit The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' . compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate lime. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permittlicense applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under',job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file fur future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would Bice to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of M&-.sachusett s Dspa-dmant of Tndustdal Accidents Offim of kvestigatiGn; 600 Wa,shmgtaa Strut Boston,MA 02111 Tel.#f 17-727-4900 W 406 or 1-97MEA-SSAFB Fax# 617-727-7749 Revised 4-24-07 V'WW.mass-govldia Q. ho is re onsible for making application for th ermlt?� - --� Application for a permit is required to be made by'the owner or lessee or their agent of the building (e.g.; the HIC registrant). if application is made other than by_the owner, written authorization of the owner must accompany the application. Such written authorization shall be signed by the owner and shall include a statement of ownership and shall identify the owner's authorized agent, or shall'grant permission to-the lessee to apply for the permit. The full names and addresses of the owner, lessee, applicant and the.responsible officers, if the owner or lessee is a corporate body, shall be stated in the application. Please note: It is the responsibility of the registered HIC to obtain all . permits necessary for work covered by the Home Improvement . Contractor Registration Law, M.G.L. c 142A. An owner who secures his or her own permits for such shall be excluded from the guaranty fund provisions as defined in M.G.L. c. 142A.. Back to Top Q. My contractor told me I need to obtain the ermits f m construction. Ma I obtain the relevant ermits_f_ro �My local building department or is the contrracto rn (required to:do that? --- :-----r While you may certainly obtain your own permits, be aware that if you do, You will fall into a homeowner exemption that will disqualify you from being eligible to receive recourse through M.G.L c. 142A, th.e HIC Lave, or the statutorily authorized Guaranty Fund, should a problem arise: It is the responsibility of the registered HIC to obtain all permits necessary for work covered by the Home Improvement Contractor Registration Law M.G.L. c. 142A. If the HIC you are contracting with refuses, you may wish to reconsider using that-contractor's services. ofTME' Town of Barnstable Regulatory Services MAFLq Thomas F.Geiler,Director 1639. �0 wy' Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA'02601 www.town.barnsiable.maxs Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit (Address of job) Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name . Print Name Date QTORWOWNERPERMiSSIONPOOIS 62012 Town of Barnstable �tHWE ' Regulatory Services sAWvsrABLE. Thomas F.Gelder,Director pA,e� Building Divisidn . . Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstablema.us Office: 508-862-4038 . Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION J Please Print DATES JOB L OCAnON: 9 / �G� �f^1 e I d, ) number street village "HOMEOWNER° � VA; e-To lQ'n�( 0215-`7 1�0 30 '(? name ^ home phone# work phone## CURRENT MAILING ADDRESS: I(/ E r�'d I e. 4!h P . city/town . state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. F DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides'or intends to reside, on which there is, or is intended to be,a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such. "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minirnuin inspection procedures and requirements and that he/she will comply with said procedures and require nts. Si ature of Homeowner Approval of Building Official I . I Note: Three-family dwellings contain 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. . HOMEOWNER'S EXEMPTION The Code states that "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this-case,our Board carmot prpceed against the unlicensed personas it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. 'Q.•fomrs:hoineaxempt TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 1pi N OF BARNSTABLE Map Parcel Application #-. I Date Issued Health Division . .�I ?c.; ('�� �: �.{,; Conservation Division Application F Planning Dept. Permit Fee �JISIQP� Date Definitive Plan Approved by Planning Board , •� Historic - OKH _ Preservation/ Hyannis 1 Project Street Address CI 4 �C'Il✓ � �(�U Village as+e.ryl Owner ht)I Se —t-6 16---n Address Telephone ' r7 4( "— 3,�6 3 Permit Request 5b_u a-hVI o� J I u 13 n in Cc L LJ Os-e.. CUSS ►Y1 5 c,..E.a--h" 4-b k-agg c.J&J I L 6_55-CS t n 5 1 r5 n Sut �+ccsyl 6-� C or_ 1 SDc_C-e , cad Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation YS-T-h 00Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family V Two Family 0 Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) r Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: Cl existing ❑ new size_Pool: ❑ existing 0 new size _ Barn: 0 existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name RolarA i-�L II Telephone Number ��� "�� 0(a Address 4t.0 Can o T CIU-4 License# )0 �)r6 / :w 81,--4' /S— ucr_ rnA- Home Improvement Contractor# (] Q 41 -ey-p . ; I t� Email gaig.4n 120 &-+2. Sege. ✓1-Ct Worker's Compensation # VJS 5ZP416-� 4 1 ALL CONSTRUC DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 6111-ed VJ &3 e N-M 051 C-C 416 (-5W L �5� . � fiver, M-6 SIGNATURE DATE I FOR OFFICIAL USE ONLY A'OPLICATION# f; 9ATE,,ISSUED MAP./PARCEL N0. ADDRESS VILLAGE %b OWNER DATE OF'INSPECTION: FOUNDATION 4. FRAME r; INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL K PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ,< FINAL BUILDING i DATECLOSED,OUT >s AS_@gGIATION PLAN NO, E n RISE Engineering Federal ID#05-0405629 RI Contractor Registration No 8186 A division of Thielsch Engineering; MA Contractor Registration No 120979, r CT Contractor Registration No 620120 5 Dupont Avenue,South Yannouth,NIA 02664 ; 508-568.1926 X-6610 FAX i08-568-1933 CONTRACT ` Ri S E Page t PEtOCIRAiN1 THIS CONTRACT IS ENTERED INTO SETWEENFUSE ENGINEERING CLC-RCS' ENGINEERING AND THE CUSTOMER FOR WORK AS DESCRIBED BELOW CUSTOMER . PHONE DATE CLIENt A WORK ORD'en Denise Toland (215)740-; () 12/219/_'01.1 18 1865 00002 E STREEY SERVICE BILLING STREET " 94 Waterfield Road 105 Bridle.Lane SERVICE Cn•Y,STATE,ZIP BILLING UTY,STATE,ZIP Osterville,MA 026jj Ambler.M.% 19002 JOB DESCRIPTION AtR SEALING:Provide labor and materials to seal areas Of your)ionic against wasteful,excess air leakage. This work will be performed in concert with the use of special tools and diagnoslie tests to assure that your hums:will he left with a healthful Icycl ol, air exchange and indoor air quality.Materials to be used to seal your home can include caulks,roams.wealhemIripping and other Products. Primary areas for scaling include air leakage to attics.base:bents.attached gnriges:red other unheated areas(windows arc nut generally addressed.) (12)working hours. At the completion of the weatheritation work,and at nu additional cost to doe homeowner,a final blower doom'and/or combustion safety analysis will he conducted by the sub-contractor to ensure the safety of tlic indoor air quality. S92-.00 AiR SEAL WIG:Provide labor and materials to seal heating and/or cooling duc(s within designated unhcatcd areas. This work will be performed al the rate of S75 per mot per hour,which includes materials. (4)working hours. S 300.00 AIR SEAL.fNG:Provide labor end materials to install Q-Ion wwtherstripping and a doorsweep to(2)door(s)(o restrict air leakage. S 154.00 KNEEWALL FLOOR:Provide labor and materials to install a 10"layer of R-35 Class 1 Cellulose added w(04)squ;in:feet of op,lcn kneewall floor. $85.76 ATTIC ACCESS:Provide labor and materials to insulate the back of(I)attic hatch with 2"rigid'rhermas board.Weathclstrip the perimeter. S42.."air KNEEWALLS:Provide tabor and materials to install R-13 faced fiberglass u>(96)square feet of knecwall. Then install 2"rigid board insulation.Seal all scans with FSK tape. SW).7o KNEMALLS:Provide Labor and mauaidls to install 2" FSK raced semi-rigid fiberglass board insulation to(1 24)square feet of kneewall area. $•i I U.44 ATTIC ACCESS:Provide labor and materials to instal(1) easily moved,insulating cover for the attic access folding stair. A small flat surface of plywood will be created around the opening within the attic. 111is will allow the cover's integral weather-stripping;to restrict air leakage. 52�7.Gj VENTILATION:Provide labor and materials to install ventilation chutes in(16)rafter bays to maintain air flow. S55.8e, CRAWLSPACE:Provide labor and materials to install (408)square feet of R-10 ri Lid Therlax insulation to the ccnvlspace perimeter wall up to the sill and against the band joist. 51,6�9.12 BASEMENT DOOR:Provide labor and materials to insulate die back of the basement door leading to the bulkhead with 2"rigid board that me is the sections R-316.5.4 and 316.6 requirements of building code. Scat all edges:rod scans with FSK tape:. S72.22 •7 RISE En ineerin Federal ID#05.0405629 g RI Contractor Registration No 8186 A diYision of Thirlsch Engineering MA Contractor Registration No 120979 CT Contractor Registration No 620120 5 Dupont Acume,South Yarolnuth,N1A 02664 508-568.1926 X-6610 FAX 508-568.1933 CONTRACT R I S E Page 2 I'f�UCi 1Z ANI THIS CONTRACT IS ENTERED INTO BETWEEN RISE ENGINEERING (,Y,(-I2 L'ti ENGINEERING AND THE CUSTOMER FOR WORKAS DESCRIBED BEL OW • cusroMER • PHONE DATE CLIENT a WORK ORDER Denise Oland (221 i)740-3303 12/29/2014 181 865 I)0002 SERVICE STREET BILLING STREET 94 Waterficid Road 105 Bridlc I._anc SERVICE CITY.STATE,ZIP PILLING CITY,STATE.21P CIStel-ville. NIA 0205 Ambler. iqA 1900'? .JOB DESCRIPTION RISE Engineering Will apply all applicable,eligible inccnti-es to Ihii contact. You will be billed only the Net Omount. ('urrcnlly- for eligible pleasures,the Cape Li.-hl Compact offers iir„�incentive.not to exceed S4.000 pcT c:11cndar yc;Ir,and;III iucemiac of 100`k for the Air Sealing measures. i I)"the safety and health of your humc's indoor air quality.the Will be cunductine a blower door dla_nustic of the available air slow iU your home both before the work is begun,and alter the weatherii uion work is complete.We will also conduct it full assessment w the combustion s:tety of your heating system and wafer heater.This NIS a value of S%and is:It no cost lu Yuu. S91i.;1(t S Total: $4,451.29 Program Incentive: $3,705.47 Customer Total: $745.82 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF "'Seven Hundred Forty-Five& 82/100 Dollars $745.82 UPON FINAL INSPECTION AND APPROVAL BY RISE ENGINEERING.CUSTOMER AGREES TO REMIT AMOUNT DUE IN FULL.INTEREST OF 1 WILL BE CHARGED MONTHLY ON ANY UNPAID BALANCE AFTER 90 DAYS.SEE REVERSE FOR IMPORTANT INFORMATION ON GUARANTEES.RIGHTS OF RECISION.SCHEDULING,AND COIrTRACTOR REGISTRATION. NOT S THIS CONTRACT IF THERE ARE ANY BLANK SPACE A IZFD SIGNATURE-nL4E ENGINEERING CU Eq NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF,IGN WITHIN DATE OF ACCEPTAICE 3 U ACCEPTANCE OF CONTRACT-THE ABOVE PRICES.SPECIFICATIONS ACID CONDITIONS ARE SATISFACTORY TO US AND ARE HEREBY ACCEPTED.YOU ARE AUTHORMED TO OO THE WORK DAYS. AS SPECIFIED.PAYMENT WILL BE MADE AS OUTLINED ABOVE The Commonwealth of Massachusetts K F. Department of Industrial Accidents Office of Investigations 1 Congress Street, Suite 100 ,p Boston, MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): InSUIBfe 2 Save, Inc Address:410 Grove Street City/State/Zip:Fall River, MA 02720 Phone #:508-567-6706 Are you an employer? Check the appropriate box: 1. I am a employer with 20 4. ❑ I am a general contractor and I Type of project(required): ❑■; employees (full and/or part-time).* have hired the sub-contractors 6. ❑New construction 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 working for me in any capacity. employees and.have workers' [No workers' comp. insurance comp, insurance.t 9. ❑ Building addition required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doingall work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL insurance required.] t c. 152, §1(4), and we have no 12.❑ Roof repairs employees. [No workers' 13.9 Otherinsulation 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, lContra:ctors 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. Insura�ce Company Name:Liberty Mutual Insurance Policy#or Self-ins. Lic. #:XWS 56418741 Expirafion Date:12/10/2015 Job Site Address: W 0—f e(-Fi� I e_6� City/State/Zip: S�-m 1 1 C, �-1A 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 th;p7dpenalties of perjury that the information provided above is true and correctSi afure: � Date: Phone#. 508-567-6706 Off cial 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#: ' f ''moo CERTIFICATE OP LIABILITY INSURANCE �°��`"""�12/9`' " 12�9/14 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(es) must be endorsed. If SUBROGATION IS WAIVED,subje-_t 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: Anthony F. Cordeiro Insurance PHONE (SOH) 677-0407 FAX N (SOS) 677-0409 171 Pleasant Street ADDRESS: hsouza@cordeiroinsurance.com Fall River, MA 02721 INSURERtS AFFORDING FORDING COVERAGE NAICk INSURER A:Liberty Mutual Insurance INSURED I I NSU R ER B: I Insulate 2 Save, Inc. ---INSURER C: 410 Grove St. INSU_RERD: Fall River, MA 02720 INSURERE: INSURER F: I I 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._ N (-'- — 'U'ERi_'- YP-E-OF INSURN__ _ INSRI I - O NUMBER - E'FF POLICY EXP LIMITS MCY ' A E ER.ILJABIUTY i Y Y IBKS 56418741 I 12/10/14 12/10/15I EACHOCCURRENCE is 1,000,000 j DAMAGE TO RENTED S 300 000 X I CbMNERCIAL GENERAL LIABILITY i I PREMI$E,�(Ea ocwrre�ce), i CLAIMS-MADE OCCUR ! I ME—D EXP(Any ore person) 5 5,000 _ I PERSONAL&ADV INJURY is 1,OOQ,OOO GENERAL AGGREGATE is 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER I i PRODUCTS-COMP/OPAGG I S 2,0 00 .000 X POLICY I I PR? '7 LOC I I I I I S AUTOMOBILE LIABILITY 1 12 10/14� 12/10/15 COMBINEDSINGLELIMR A I I JBAA 56418741 / Eaaocidert s 1100.0 000 ANY AUTO BODILY INJURY(Per person) S AL•,LOWNED SCHEDULED AUTOS X AUTOS { { BODILY INJURY(Per accident)I(S�_ NON-OWNED I PROPERTY DAMAGE I S X HIREDAUTOS X AUTOS ( I Peraccident) — I S A }i I UMaRFup LIAR X OCCUR Y Y 56418741 i 12/10/141 12/10/15I EACH OCCURRENCE S 2 OO.O OOO EXCESS UABCLAIMS-MADEE �USO I i F RE GATE 1 S 10,O00 I DED RETENTION$ ! 1 i I S A WORKERS COMPENSATION I}tyz8 56418741 ( X! WC STATU- I LOTH•' AND EMPLOYERS'LIABILITY 12/10/14 12/10/15 _KIP _LIMITR ___E.B_.—..-- ANY PROPRIETOR/PARTNER/EXECUTNE Y!N i I E.L EACHACODENT 5 —rJ00,000 OFFICERAIEMBER EXCLUDED? N!At -- (Mandatory.in NH) I E.L DISEASE-EA EMPLOYEEi S 5OO,OOO It yes Ee scribe under r DESCRIPTION OF OPERATIONS below I I E.L.DISEASE-POLICY LIMIT S 500,000 I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks SchedWe,if more space is required) Proof of Insurance. CERTFF(,ATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORED REPRESENTATIVE I ©1988-2010 ACORD CORPORATION. All rights.reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Phnna• Fax: E-Mail: f Office of Consumer Affairs and Business Regulation 1.0 Park: Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Cow n�ttrractor Registration Registration: 180747 Type: Corporation f Expiration: 12/29/2016 Tr# 261507 INSULATE 2 SAVE , INC. l ROLAND LANGEVIN a 410 GROVE ST T w FALLRIVER, MA 02720 Update Address and return card.Mark reason for change. - Address Renewal Employment Lost Card SCA 1 Co ?OM-05/11 (*/G� l(o�n��zoreruetil��a�r��ietac�iidtrl� Office of Consumer Affairs K Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. if found return to: ko;Expiration: �egistration: t1'0747 Type: Office of Consumer Affairs and Business Regulation `016 Corporation 10 Park Plaza-Suite 5170 r�11:2 Boston MA 02116 INSULATE 2 SAVE +ING- 'P ROLAND LANGEVIN tE- 410GRC)VEST FALLRIVER,MA 02720 Undersecretary Not valid without signature Massachusetts -oepartrnert of Public Safety Board of Building Regulations and Standards Construction Supervisor t.icense: CS-103861 ROLAND LANGEVIN 536 EASTERN AVE. Fall River MA 02'123 Expiration 08/24/2015 ;ommtssioner i �TMFq, 'Town of Barnstable Regulatory Services Richard V.Scali,Director Building Division Tom Perry,Building Commissioner 200 Maim Stieet,Hyannis,VIA 02601 w,vw.towu.b arnstable_ma.us Office: 508-8624038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using,A Builder as(.)wner of the subject propcn:y ]lericby a*ori7e _ . hS �A 2 rP to act on my behalf, m all matters relative to work authorized by this budding,permit application for: QsM\,AIA :16S5 (Address of Job) Pool fences and alar= are the responsibility of the applicant. Pools are not to be filled or udLed before fence is installed and all final. inspections are performed and accCpted_ of Owner Sitnature of.Applicant Print Name Print Name Date Q:FORMS:OVi.%FRPF_2JdiSSIONPWLS t 1 Assessor's map 'and lot number ` //1 ....: Z... .......... 5 ate % 9- y- ' Sewage;,Permit number .................................... c. C. °`t"Er°�` TOWN OF BARNSTABLE 1t B9HH9TODLB; i t" 0 . .10ILDING INSPECTOR AP.PLICATIONr FOR•.-PERMIT TO ..................... w TYPE OF .CONSTRUCTION ....d:7.. ! ... .................................................................................................. `.i/............192, TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: ��" �M�catian ...�. ...... � . .............. ...... .....................©.............. ProposedUse .........................................................................................................................•...�............................................... Zoning District ....... .. .......Fire District ...64`&4, �` D .... ..... .................... Name of Owner ........ .. -P+�?� ..........Address ....'��. ....�� �..� ............................. ... 6040,0a �.Name of Builder .... ........ ......N............ '�l'.i ..............Address ................................................................................... .i /0 i/ Nameof Architect ..............................Address �.................................... .................................................................................... Number of Rooms ....... .......................................................Foundation ....,. ..e ............................................ r Exterior .... .......... ............................................Roofing ....................../..,.......................................................... Floors` ..... .... ...�........................................Interior ...............�YAI.1444= .,............................................ Heating .../...: �! ..........t....... ��t•+ .......Plumbing AAa- .....t. ...... �I - Fireplace ..................................................................................Approximate Cost ...:..�!I d d.... ..................................... Definitive Plan Approved by Planning Board ---------------____-----------19________. Area °.... .... ... . Diagram of Lot and Building with Dimensions �0 0 Fee c .. �................... SUBJECT TO APPROVAL OF BOARD OF HEALTH ` O Cl OkJ I L C A16 , e a /e,6 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ] Name ���L ..... ... DeMelo, Norberto 17944 add to single No ..................Permit for...................................... family dwelling ..............................I............................................ 94 -Waterfield Road Location ................................................................ osterville ..................................................................... Norberto DeMelo Owner, .................................................................. frame Type 'of Construction .......................................... ................................................................................ Plot ....................... Lot .................... Perm-it Granted .......Sep.tf.:%berJ2.......19 75 Daltp..of Inspection ..............e..'...�96 Pate Com m .... .......19 .......pleted PERMIT REFUSED ................................................................ 19 .......................................................................... ...........................;�................................................... ....................................................................... Approved ................................................ 19 ............................................................................... ............................................................................... �I + Assessor's map-..and lot number .. !.. �....... ...... T 17- 191- 75— Sewage Permit number .........................................................: F?"E'°� TOWN • OF BARNSTABLE ii i BAHHSTADLE. i !' 16 9- 1311 DING ' INSPECTOR '£0 MFY a' J APPLICATION FOR PERMIT TO Ira ;�.n TYPEOF CONSTRUCTION ...........:..... ..................................................:...:...........................................•.............. 3 ........... ..................................19��. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...................................................._...........................{-::............................ .................:................... ProposedUse ............................................................................................................................................................................. Zoning District ...........Fire District .. r %! ........................................................' .....�.. L'!C`i . .�f.. ' ,.� -�.�,• * i? .a'�+.'!:�... ��o .sue f1 �.✓'.,� -i� Name of Owner ...............................Address Nameof Builder ..A�,ri�lr.... ............Address..........,.�.... ;i............ 1..............................................f�......................... Nameof Architect .............................................................:....Address .......................................:............................................ Numberof Rooms ...... .................................:.....................Foundation ......... .. ............:....... ..........:........................ Exterior ....1 r-' �/ -•1� Roofing ........ <1�/' L,R�.�1 ................................................................. ............................................... Floors Cif,/l' /"..1• .' ...........................Interior 1.... 1..!-.I1��- 1 ....... ................................... .. *� Heating .> f�.vt ',t �r .t,.c. Plumbing f+ �, r /Ir / G.[l(. .. .............. . ..................... ......... ` ............................................ Fireplace` '.................................................................................Approximate Cost ...................................................................:-� Definitive Plan Approved by Planning Board -----------______-----------19________• Area . ......./........j... .........::.:s.. Diagram of Lot and Building with Dimensions Fee �V .............................................. SUBJECT TO APPROVAL OF BOARD OF, HEALTH IL i 4 I hereby agree to-conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ........ ........................................... .......................... DeMelo, Norberto A=119-24,�/ 17944, add to single No .. ............. .. Permit for .................................... family dvie 1 ling • ............................................................................... Location ..........9.4....Wa.t.e.rf ie.l.d..R.o.ad................ . .... . . ........ . .. .. . .... Osterville - ............................................................................... Norberto DeMelo Owner ........................... • frame Type of Constructiori .......... ................................................................................ Plot ............................ Lot ........... ..................... Sep.temZer 19 75 Permit Granted ................................I........19 ............Date.of Inspection ....... .......19 Date Completed ..........:...........................19 PERMIT REFUSED ................................................................ 19 ................................................................................ �..... . ........................................... ................................ ............. ........ .............. ........ .................................. I. ............ .. ..... ... . ............. Approved ......... ............................ 19 ................................................................................. ................. ............................................................. Town of Barnstable Regulatory Services - '" ° & Thomas F.Geiler,Director �6 39. Building Division Elbert Ulshoeffer,Building Commissioner 367 Main Street, Hyannis,MA 02601 Office: 50&862-4038 Fax: 508-790-6230 SHED REGISTRATION 120 square feet or less Location of shed(address) Village Property owner's name Telephone number 8/t2- ?� !aer . //q - Size of Shed Map/Parcel.# Signature.. Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? Conservation Commission(signature required) �• 7 1 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS.FORM MUST BE ACCOMPANIED BY A PLOT PLAN l r fo C3� Q-fortsis-shedreg ' P b ed w 82- 76 1, 10 I.00AG '�3� .75 . 1.00AC g (s ` .a o a _' 73 t {{ 145 2 G 145 i0 lP ' 7/ '4( ® © 72 •Slnc 59.1 0 59-5 59-Z .a8.f- 'f• 4 � L ao LFor4 52 C,ptLE APV 5-S L* L O Iw goo"! a QEE11 60 e, E K }e a M S� ' 2e 45/ 0.31 At. 46 dd47 I Fc q4 _ ; 5 0 - 0 m ' I .51 AC. z 38 40 .,• 137Ac. xs / I 49 43 wes+ 00 148 .40 AC I AC. u ® O !AC 3 ® I roe 91 N Pp jy2© pEEN CIRCLEMIN�'EpG lel1 Ie 11 JJ ' 10! Iq. 4, 1 OOPA N .BO 4 . �$ I,OOA 6L 63 64 '\ I �37 36 .a,i►c .a♦..c .Ol a.a. W 4 a At. N Iq'4'� , 3g Ac l o� I' 0 1z® 20 34-e1 I = r > o •72 AC' I 34.3 0 .1.Z AIL is o -I r •ie�' T .60 AC. a w I I ♦ 14i 1n g 21 (v z v' .74 AC. I © p 36•I 17 a O ' 34-Z• SIB .55 AC. .75 At- "- e Ac P g22 zx 5 SAC. .68, 33 as 1 11 .97 AC. 32 IB 19 `I o° 8 a�AC Z3 Cf .gJ 4C \ �\ .64 AG 14 la jA.. Zq I C. JOAO 1!6 uJ o \ l MANE 25`oa J ce 52 8 4C. 30\ \I'014C. a 535�- ..•G5 .DO At• Ka 0 O F.Aze�4: o 9 .34 AC. 1.61 AC I -0 51 8 0 5 4• 7 Pc Z9 SS 0 0 w-2 '494C. ry \ ws.ro rain- 84 © 0 0 27 La9At .0 i .26 AC. \ tor$ �o,4,•IE MI UJEd J M'-118'La 63 Pc 47 y \\ 1 ORIGINAL ISSUE: — — —.— ,� �_ 9 SCALE I 97 20 144 11 y A od t ea n• K9 •:: I