HomeMy WebLinkAbout0047 COVENTRY LANE t
Oxforcr NO. 152113 ORA
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B U I L D I N G P E R F O R M A N C E T E S T I N G
Duct Leakage Report
47 Coventry Lane Test Mode
West Barnstable Pressurization
06/05/2019 Test Pressure
Mcdonnell Mechnical* 25.0 Pascals
Testing Equipment
2015 IECC Energy Code Minneapolis
4
Total CFM@25 or Total Duct Leakage Percentage
82.00 0.03
Total Square Footage
2468.00
Maximum Allowable Leakage
98.72
HVAC Duct Test
rrr
LoOtioln�- S ft'Servod CFM 25 . Gai a Duct Leakage°Ic
Unconditioned 1202 C 40 0.03
Basement fWZ 11
180 STATE ROAD SUITE 2U SAGAMORE BEACH,MA 02562-(508)833-3100-ENERGYCODEHELP.COM-INFO@ENERGYCODEHELP.COM
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ON M�E E N E RGY ,RATERS L {C
B U I L D I N G P E R F O R M A N C E T E S T I N G
Location S ft Served Rin C00 6 Gau a Duct Leakage oxo
Unconditioned 1266 C 42 4'3c���may` 0.03
Attic a^' FWQ."
180 STATE ROAD SUITE 2U SAGAMORE BEACH,MA 02562-(508)833-3100-ENERGYCODEHELP.COM-INFO@ENERGYCODEHELP.COM
powered by cgocanvas www.gocanvas.com 196D21 A5-1 D7D-4689-9756-099382A7212D
Town of Barnstable Building
sg� Post This Card So That it is Visible From the Street=Approved Plans Must be Retained on Job and this Card Must be Kept
KAM Posted Until Final Inspection Has Been Made.039. Permit
s Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until aFinal Inspection has been made.
Permit No. B-19-1820 Applicant Name: Barbara Marshall Approvals
Date Issued: 06/07/2019 Current Use: Structure
Permit Type: Building-Sheet Metal-Residential Expiration Date: 12/07/2019 Foundation:
Location: 47 COVENTRY LANE,WEST BARNSTABLE Map/Lot:- 110-004-004 Zoning District: RF Sheathing:
Owner on Record: STEERE,LUCY DUFFIELD Contractor Name:, JAMES E MCDONNELL Framing: 1
Address: 47 COVENTRY LN Contractor License: 2721 2
WEST BARNSTABLE, MA 02668 _ Est. Project Cost: $8,000.00 Chimney:
Description: Supply and install all duct work associated with two central heating Permit Fee: $85.00
and air conditioning systems, 1 located in the basement and 1 in the Insulation:
Fee Paid:' $85.00
attic. Final:
Supply and install all duct work associated with exhaust fans. _ Date: 6/7/2019
Supply and install all duct work associated with hood exhaust,if , `r
necessary rr— Plumbing/Gas
Rough Plumbing:
Project Review Req: DUCT LEAKAGE TEST REQUIRED. __ 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
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).
Building plans are to be available on site Fire Department
All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT 0 W Lrolf Final:
L'i+►p� SEa'r'
AG R I BA LAN C E@ C).O
�C ® ® � 0
Company Name Cape Cod Insulation Inc. Phone:Number 508-775-1214
Applicator Name .clie
iv Installation Date 5-6.2019
Jobsite .Address 47 Coventry Ln. W. Barnstable MA. A-S:ide Lot Ws GE018379
Permit Number B-Side Lot #'s P1245-5502919
IN
Walls
Attic 8.5" R-38 340
A
www.®emIOGC.Cof11
Town of Barnstable Building
tPost This Card So That it is Visible From the Street-Approved Plans Must be Retainedon Job and this Card Must.be Kept
b
(Posted Until Final Inspection Has Been Made.' Permit
Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made.
Permit No. B-19-1010 Applicant Name: George Davis Approvals
Date Issued: 04/02/2019 Current Use: Structure
Permit Type: Building-Addition/Alteration-Residential Expiration Date: 10/02/2019 Foundation:
Location: 47 COVENTRY LANE,WEST BARNSTABLE Map/Lot: 110-004-004 Zoning District: RF Sheathing:
Owner on Record: STEERE, LUCY DUFFIELD Contractor Name: GEORGE F DAVIS Framing: 1
Address: 47 COVENTRY LN I Contractor License: CS-056130 2
WEST BARNSTABLE, MA 02668 Est. Project Cost: $122,300.00 Chimney: ,
Description: Add full dormer to existing finished space above garage. Replace Permit Fee: $673.73
existing gable roof over front entry with hip style roof. Replace all Insulation:
Fee Paid: $673.73
windows and exterior doors in the home.
Date: 4/2/2019 Final:
Project Review Req: 9—
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.
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. I
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:
iWhere 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:
Vie _ Town of Barnstable Building
MA Post This Card So That it is Visible From the Street-Approved Plans Must be Retained.on Job and this Card Must be`Kept
DAMM
MASS.
,� Posted Until Final InspectionMas Been Made. Pit
6�. Where a Certificate of Occupancy is Required,such Building shall-Not be Occupied until a Final Inspection has been1made Permit
m
Permit No. B-19-557 Applicant Name: George Davis Approvals
Date issued: 03/14/2019 Current Use: Structure
Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 09/14/2019 Foundation:
Residential Map/Lot: 110-004-004 - Zoning District: RF Sheathing:
Location: 47 COVENTRY LANE,WEST BARNSTABLE
Contractor Name'`GEORGE F DAVIS Framing. 1
Owner on Record: STEERE, LUCY DUFFIELD Contractor License: CS-056130
2
Address: 47 COVENTRY LN -- -
-.� Est. Project Cost: $85,000.00 Chimney:
WEST BARNSTABLE, MA 02668 i a
i Permit Fee: $483.50
Description: Interior renovations-Renovate kitchen,three bathroomsand closet ) Insulation:
in den. Fee Paid: $483.50
Date: / 3/14/2019 Final:
Project Review Req: Interior work only No Dormer or porchlon this permit —_- `
Plumbing/Gas
Rough Plumbing:
t. 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 str.'uctures 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. t M-
1 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.
"Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final:
Building plans are to be available on site Fire Department
All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final:
OtIkHz Town ®f Barnstable Permit#
Expires 6 monNrs jrour issue dal
STAB Regulatory Services FF�ARNe
� M & ,�$ Thomas F. Geilcr, Director
163
PlfO A1At A
Building ]Jivisionll��-���
Tom Perry, CBO, Building Commissioner
200 Main Street, Hyannis, MA 02601
wwNv.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RE,SIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number 1�6 00(-�
Property Address
ZO
Residential Value of Work ee ,eV J. d4:�' Minimum fee of$25.00 for w k under S6000.00
Owner's Name & Address
:e6ft&"
Contractor's Name �� � � Telephone Number C_: dd— '
Home Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable) �1 � CRESS PERMIT
T
n —� ace-�---
Workman's Compensation Insurance SEP 1 200
Check one:
❑ I am a sole proprietor TOWN OF BARNSTABI_E
- .❑—I am the Homeowner__ — — --.. ..
I have Worker's Compensation Insurance
Insurance Company Name
Workman's Comp. Policy#—C ►
Copy of Insurance Compliance Certificate must be on file.
Permit Request(check box)
Re-roof(.stripping old shingles) All construction debris will be taken to
❑ Re-roof(not stripping. Going over existing layers of roof}
❑ Re-side
❑ Replacement Windows. U-Value (maximum .44)
*Where required: Issuance of this permit does not exempt compliance Nvith other town department regulations,i.e.Historic,Conservation,etc.
""*Note: Property, Owner must sign Property Owner Letter of Permission, ,
Home Improv t ntr ctors License& Construct Supervisors License is required. %
SIGNATURE:
n\wnrirr.c�rnutvrctt •nrrccU;XPRh..C.SPI?RMIT.I�nC:
o
The Commonwealth of Massachusetts
Department oflndustrial Accidents
Office of Investigations
d 600 Washington Street
Boston, MA 02111
iY•'y wwlv.mass.gov/dia
ance Affidavit: Builders/Contractors/Electricians/Plumbers
Workers' Compensation Insur
Applicant Information PIease Print Le ibl
Name(Business/Organization/lndividual):
Address:
City/State/Zip Phone.M :v4
Are you an employer? Check the appropriate box: Type of project(required):
1 -art a employer with 4• ❑ 1 am a general contractor and I
� have hired the sub-contractors 6• ❑New construction
employees (full and/or part-tiin.e).
2.❑ I am a sole proprietor or pa.rtaer-
listed on the attached sheet. T. ❑ Remodeling
ship and have no employees These sub-contractors have g. ❑Demolition
working for me in any capacity. employees and have workers' 9 ❑Building addition
[No workers'-comp. insurance comp. insurance.$
required.]
5. ❑ We are a corporation and its �10.❑ Electrical repairs or additions .
3.❑ 1 am a homeowner doing all work officers have exercised their I I j— Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12,�{Rnof repairs
insurance required.] t c. 152, §1(4), and we have no ff�"`�'��
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.
lContractors that check this box must attached an additional sheet showing the name of the subcontractors 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: I&IOCAVIWA
,p
Policy#or Self-ins. Lic,#: 1 <, �0 Expiration Date: �✓
Job Site Address: ll City/State/Zip:
Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date).
Failure fo secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of crimitial 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 DIA for insurance coverage verification
1 do hereby certi under the pains and la
that the information provided above is true and correct.
Date:
Si ature: ,�qq
Phone # �l� ,-p
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 S. Plumbing Inspector
6. Other
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees.
Pursuant to this statute, an employee is defined as "..:every person in.the service of another under any contract of hire,
express or implied, oral or written."
An employer is defined as "an individual,partnership, association, corporation or other legal entity, or any two or more
of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the
receiver,or tiustee 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 local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced-acceptable evidence of compliance with the insurance coverage required."
Additionally,MGL chapter 152, §25C(7) states `Neither the commonwealth nor any of its political subdivisions shall .
u�suance
enter into any contract for,the performance of public work until acceptable evidence of compliance with the
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-conti'actor(s)name(s), addresses)and.phone number(s) along with their certificate(s) of
insurance. Limited Liability Companies(LLC) or Limited Liability Partnerships (LLP)with no employees other than the
members or partners, are not required to carry workers'compensation insurance. If an LLC or LLP does have
employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested, not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy,please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete'and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office 6f Inv,eskigati'ons has to contact you regarding the applicant.
Please be sure to fill in the permit/license number hich will be used as a reference number. In,addition, an applicant
that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current
policy information(if necessary) and under"Job Site Address" (he applicant should write"all locations iu (city or
town).".A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year. Where a home owner or citizen is obtaining a license or permit not related io any business or commercial venture
(i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit.
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call.
The Department's address, telephone-and fax number:
The Commonwealth of Massachusetts
Deeputrnent of Ludustri,al Accidents
Office of Investigati.ans•
600 Washington Street
Boston, MA 02111
Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE
Fax# 617-727-7749
Revised 11-22-06
www.ma.ss.gov/dia
Town of Barn-stable
Regulatory Services
i
Thomas). Geiler,Director
o JBuuilding Division
0
Tom Perry, Building Commissioner
200 Main Street, Hyanais, MA 02601
Fvwvv.town.barnstable.ma.us
i
i Office: 508-862-4038 Fax: 508-790-
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 application for.
-(Addt4s of Job)
Signature of Owner Date
Print Name
If Property Owner is applying for permit please complete the
Homeowners License Exemption Form on the reverse side.
a
To of Barnstable
,,'THE rT
Regulatory Services
Thomas F. Geiler,Director
Building Division
rED '�A Tom Per
ry,Building Commissioner
o
•200 Main:Street,—Hyaimis;•NFA1 02601
rt m.town.barnstabie_ma.us
Office: 509-862-4038 Fax: 508-790-6230
HOMEOWNER LICFNSE EXEMPT`ON
Please Print
DATE:
JOB LOCATION:
number s trcct village
"HOMEOWNER":
name home phone# work phone#
CURRENT MAILING ADDRESS:
city/town state zip code
The ciment 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
SuperVis()T.
DEFINITION OF HOMEO� ER
Persons)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)
Th.e 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 Barpstable.Building Department
minimum inspection procedures and requirements and that he/she will comply with said procedures and
requirements.
Signatiirc of Homeowner
Approval of Building Official
Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the
State Building Code Section 127.0 Construction Control.
HOMEOWNER'S EXEMPTION
The Code states that "Any homeowner performing work for which a building permit is required shall be exempt from the provisions
of this section(Section 109.1.1 -Licensing of construction Superyisors);provided that if the homeowner engages a pmon(s)for hire to do such
work, that such Homeowner shall act as supervisor."
Many homeowners who use this rXCMPtion arc unaware that they arc assurrung the responsbt7itics of a supervisor(see Appendix Q,
Rules&Regulations for Licensing Construction Supervisors,Scction 2.15) This lack of awarrncss often results in serious problems,particularly
when the homeowner hires unlicensed persons In this case,our Board cannot proceed against the unlicensed person'as it would with a licensed
Supervisor. The homeowner acting as Supervisor is ultimately rc..ponsble.
To ensure that the homeowner is fully aware of his/her mspanmbilitics,many communities require,as part of the permit application,
that the homeowner ecrtify thkt he/she understands the rrsponsibilitirs 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 forn-Jecrtification.for use in your community.
C■
T4C 7 WO �3#kO�
7-0
7-0
IU
S� ovc c /-z c L 9
S TLZ-:) E:
i
✓�ie •»o»vi�cd��cueall� c�✓jla"—Ilaseo
` \ License or registration valid for individul use only
Board of Building Regulations and Standards
� HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
;y = Regulations and Standards
Board of Building
Registration: 110649 .One Ashburton Place Rm 1301
+' Expiration: 11/3/2010, Tr# 276541 Boston,Ma.02108
Type: Individual
THOMAS A.HILCHEY
THOMAS HILCHEY _
82 Old Chatham Road. Not valid without signature
HARWICH,MA 02645 Administrator
,. .. Boar of w mg .egu,a o, an_ an ar s
—Construction_Supervisor_License ___,____
License• CS 34718
Birttidate ,9/19/1953
Expiration 9/19/2009 Tr# 6391
,� iks +tr� Restriction 00
THOMAS A-HILCHEY
82 OLD CHATHAM RD
HARWICH,MA 02645 Commissioner
i
V
AR WCIP Liberty
ISSUING OFFICE 181 Workm Compemation wA
INFORMATION PAGE EtnployersIaabllity Policy
ACCOUNT NO. SUB ACCT NO. Libetty Mutual twat ante Group/Boston
1.329413 0000 LIBERTY hf[JTUAL FM INSURANCE CO 16996
POLICY NO. TD/CD SALES OFFICE CODE SALES CODE N/R 1ST
WC2-31S-329413-029 XX X WrESTON 102 REPRMENTATIVE 3000 2 YEAR
ASSIGNED 2001
Item 1.Name of THOMAS FULCHEY
Insured FEIN 03-1449294
Address 82 OLD CHATHAM RD
RISK ID 049214
HARWIC1:1,MA 02W
Status 01 .INDIVIDUAL
Other workplaces not sizown above: SEE ITEM 4
Mo.Day Ycor o-Day eer
Item 2.Policy Period: From 03-13-2009 to 03-13-2010
12:01 AM standard time at the address of the insured as stated herein.
Item 3.Coveraga
A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states Listed
here:
ARIA
B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in item 3A. The limits of our
liability under Part Two are:
Bodily Injury by Accident 100,000 each accident
Bodily Injury by Disesse 500,000 policy limit
Bodily Injury by Diseast 100,000 each employee
C. Other States insurance.: Part Three of the policy applies to the states,if any,listed here:
SEE END WC 20 03 06A
-- D-This-policy-includes-these-endorsements-and-schedules:—SEE-E-WIENSION OF—MFOR1vfATION-PA-GE-- ---
Item 4.Premium -The premium for this policy will be determined by our Manuals of Rules Classl6cadons Rates and Raring Plans.
All information re uired below is svb'ect to verit3cadon and than e b audit.
Promivm-gssis--Rate— LINE.110
Per$100 Eitimatcd
Code ErtiruMad or RE- AAPu61
Classifications No. Total Annuel Premiums mttncraiioa promlums
SEE EXTENSION OI±INFORMATION PAGE
Minimum Premium $ 500 ( IV1A ) Total Estimated Annual Premium $ 9,944
Interim adjustment of premium shall be made: ANNUAL
This policy,including all endorsements issued therewith,is hereby countersigned by
AmMilud Ropme nterlye Dare 03-03-09
Loa.Code Term. oper. Audit 8asls Periodlo Poyrneni Rating nasie Pol.14-0. Homo state DiMdeod RENEWAL OP.
03.03.09 NR MA WC2-31S-329413.028
0Po 4030 iii Copyright 1987 National Council on Compensation Insurance NYC 00 00 01 A
Broker copy
I
. . �. r / v e vv
Assessor's office(Ist Floor): / l
Assessors map and lot number �xl (�7 3 o�THE
Conservation(4th Floor): y1 ^�—�SOW4 V/mki„r,A }' °'Q^�`�`^"'p��4�N`�^�>}�to ' kAA--, W
MUST DE
Board of Health(3rd floor): 1 c INSTALLED IN COMPLIANCE �oo ,ago. d°
Sewage Permit number -- ,S�g^�� r
Engineering Department(3rd floor): WITH TITLE 5
House number I 41 GJS _ EW/ NMENTAL CODE AND o��r
Definitive Plan Approved by Planning Board 19 WN SEC °"T.a'� p,0
APPLICATIONS PROCESSED 8:30 9:30 A.M.and 1:00-2:00 P.M.only
TOWN OF .BARNSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO 3h u�D
TYPE OF CONSTRUCTION S i ►�C LE t`t,r��
19
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location �"f 3 Coves r�-2-j Lpy �rc ,M-r!-•j!
Proposed Use I DF rsTl i4L_—
Zoning District r Fire District
Name of Owner A'V'AE C— 1'tca b t t- C-C. Address �� t3o�c ► _- , u t— �E►J Xis,,
Name of Builder eUFjzpyJ—Lt') (L. Address —PO• gnx t8�, 11 NNE , }•, d"�
Name of Architect Address
Number of Rooms Foundation ?Cj'trLAE1)
Exterior �Z<< cDk B9150n k)+C1TE C,--DA wr-
Roofing H46v--T I►JC! �c
Floors':� / 1" ',la e11k Interior X—" h C--a0 gy=h 4!r� Sin WLCom- )L
Heating���4 �QS (O i Ptt'WO*rN l� Plumbing fi— �,Cl l OXJCIt.LI�l PZ � 11 t E.P*:: f,
Fireplace Approximate Cost to too '
Area ✓ *S
Diagram of Lot and/ uilding ith Dimensions Fee
G V /
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstabl regardi• g the above construction.
Name
Construction Si ipervisor's License
AMEK. HOLDING OF C:'C.
47:COVENTRY LANE, WEST BARNSTABLE
No -3-7-G-9-L9— ' Permit For Two Story
IS, F. D.
Location Amek .Holding Of C: C. ,
4
Owner
Type of Construction
Plot Lot ,
Permit Granted 19
Date of Inspection:
Frame �/7/ � 19 - -
Insulation % /p' 19
aD�Q.s— -
Fireplace � � 19 '
Date Completed ,`'y�y��— 19 rj
I
Application to
9 9 4 0 61
•
Old Kings Highway Regional Historic District Committee
in the Town of Barnstable for a
CERTI FICATE OF APPROPRIATENESS
Application is hereby made, in triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470,
Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings or photographs
accompanying this application for:
CHECK CATEGORIES THAT APPLY:
1. Exterior Building Construct io ,"New Building ❑ Addition Q -.Alteration
Indicate type of building: House 016ara e
g ❑ Commercial ❑ Other
2 Exterior Painting:
.2 Signs or Billboards: ❑ New sign ❑ Existing sign ❑ Repainting existing sign
4. Structure: Q Fence ❑ Wall ❑ Flagpole ❑.Other
(Please read other side for explanation and requirements).
TYPE OR PRINT LEGIBLY DATE )/Itl&� J/��1
ADDRESS OF PROPOSED WORK -2 -/1 V5 AJ V& ASSESSORS MAP NO. ZZA
OWNER A,/A� df )t)/'-S ASSESSORS LOT NO.
HOME AODREss(2 ,eJ �a X �Q� I� , ` /Vnli�S ��ZO TEL. NO. _39i 169n
FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public
street or way. (Attach additional sheet if necessary),
n
AGI=NT OR CONTRACTOR TEL. NO.
ADDRESS -
6L�&k ),q/,
DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done (see No. 8,other side), including
materials:to be used, if specifications do not accompany plans In the case of signs, give locations of existing signs and proposed
locations of new signs.,(Attach additional iheet, if necessary)-
`10' a �,cs ' �TtieEii_Zep>#z ,))-A WT-Y -E . L4) F-fo A& rt is . .w r-rN -T- a
�_�� w-n-►4cl-�Hj•` v�rc_.�a y EI E�2,r"-�5�E- ,.,< <. ..
el eo EDeACC_ F e:E PLrA cE .
D ;Signed
O D owner-Contractor-Agent
space t)elow line for Committee use -. •
Received by H.O.C.
Date The Certi to is hereby 10T Date
Time
By c
Aul,rovecf IMPORTANT If Certificate is approved, approval is subject to the 10 day appeal period
provided in the Act.
ADDITIONAL INFORMATION FOR MAKING AND FILING AN APPLICATION
FOR A CERTIFICATE OF APPROPRIATENESS
The four categories for which a Certificate of Appropriateness is required are: (application for demolition or removal is a
separate form).
1. EXTERIOR BUILDING CONSTRUCTION (new or existing buildings): An application is required for any exterior of a
building to be erected or altered including windows, doors, siding, roof, light etc., that will be visible from any public street,
way or public place. The following scale drawings are required in duplicate with application: plot plan (if addition — show
existing buildings in outline), floor plan and elevations. Also required are snap shots of existing buildings, where additions or
alterations are to be made. No plot plan is required for addition or.alteration which does not touch the ground.
2. EXTERIOR PAINTING: An application is required for any portion of a building, structure or sign to be painted that is visible from a public street. way or public place. Color samples must be attached to,these applications. An application is no-
renuirecl when repainting existing colors, changing to white,or using colors approved by the Town Historic District Committee
3. SIGNS OR BILLBOARDS: An application is required for any sign or billboard to be erected within the District. with th
following exceptions:
a. Existing signs or billboards on November 27. 1974 shall have until November 27. 1977 to secure an approved Certificat
of Appropriateness.
b. Temporary signs for use in connection with any official celebration or parade or any charitable drive as long as they ar
removed within three days of the event. Certain other temporary signs that the Committee feels does not detract fror
the Act may be allowed with the prior permission of the Committee.
c. Real Estate signs of not more than 3 square feet in area advertising the sale or rental of the premises on which they a
erected or displayed. i
d. A single sign of not more than 1 square foot in area showing the name, occupation or address of the occupant of t'.'
premises on which they are erected or displayed in a residential zone.
4. STRUCTURE: An application is required to build or alter any structure within the District which is defined by the Act as
combination of materials other than a building, sign or billboard, but including stone walls, flagpoles.hedges, gates, fences, et
GENERAL REQUIREMENTS
5. Work on protects requiring
, < •.-: : :.:. . „_.
q g a pproval shail not be started until the Certificate of Appropriateness h ,
_as been file,d with the Toy
- Clerk by the Committee.'•Approval is subject to the 10da4 appeal period provided in the Act.
'6. No changes shall be made from'the'original a { z
g approved specifications without advance approval of 'the Commission on
'" _amended application filed with the Committee. -:
7. A separate application must be filed with each protect requiring a Certificate of Appropriateness.*
n e
9 ppropriateness.
.8. Under heading of "Detailed Description of Proposed Work" give detailed dataon such architectural featurei as: foundati.
"chimney, Tiding, roofing, roof pitch, sash and doors, window and door frameV,' trim, gutters —leaders, roofing and paint co:
9. Unless application is complete and legible and all material required is supplied, application will not be accepted or acted ur
Copies of the Act establishing the Regional Historic District may be obtained at the Town Hall. 1
I
OLD H I G.HWAY H I SO,R.IsC Q I STR I C.T',
40
it CZ
FOUNDATION 6u.2Ep
E'bA Pt
.0 ING° TYPt lv+�� Cc- c �iE �
� 4W c
CHI MNEY TYPE + e%
COLOR -
ROOF MATER I AL. N -1- ,
r'v 5 COLOR
PITCH-
WINDOWS jt'I VC0 1�c��Pat-
_ - SIZE . . D-14
TR I M COLOR IA K)6�
DOORS: -
- COLOR
SHUTTERS
GUTTERSAria ovi
DECK. - '
Q 111'
GARAtE 004A�- NT ..� \
- ----�.�COLORYU�It1 G�4 STD 'T/aN
.Note-:l Ri 1 1 Out comp 1 e.te-1 Y. I MC10a l ng measurements and
matgr-i a l Vco.l or% to tie used.,
Three Copies of this form are regwi.red for supmitta.l
of an app I 1 cation,, along with, three- copies each of
O O D Ot`hg plot plan. 1 atYdsea an ano elevation plan: ,
S O When appllCable, Ae p 1
.*Plot' .A l:an heed .not be "Cert i f i e-d".. but snow i o -Mcw
all structures on 'the lot to sc3 i e.
�' SKET'CH P;LA�;N.
PREPARED. POR:
COVE Y
.R.E.E P Rvi, t `,Y
5
LOCATION : LOT 3 COVE*MY'LANE -WEST�-BARNSTABLE - -
REFERENCE : PLAN BOOK 454 PAGE- 96`
SCALE. . 1` 50,
DATE, .- MAY 4;- 1994
L.OT 2 .
m�
�cS;
• �x
5a x�
m LOT 3
31,147 + S.F. PROPOSED DECK
(0.72. ± AC.)
DAD DM .
DD
O EMAREST—McLELLAN ENGINEERING
24 SCHOOL STREET P.O. BOX 463
WEST DENNIS, MA. 02670
COMMONWEALTH OF MASSACHUSETTS
DEFARIMFNT OF INDUSTRIAL ACC_IDE1*M, -
640 WASHINGTON STREET
�a•nes Carnoal: BO$TON,MASSACHUSEI'I5 02111
-or-,:ssione•
WORKERS' COMPENSATION INSURANCE AFFIDAVIT
1, Everett W. Boy,-Jr.
gianseelpermitts5d
with a principal place of business/residence ar.
24 School, Street, P.O. Box 186, West Dennis, Massachusetts 02670
(Gry/Sute2ip)
do hereby certify, under the pains and penalties of perjury,that: `
R) 1 am an employer providing the following workers' compensation coverage for my employees working on this
job.
Aetna WC# 006-C-23219584CAA
Insurance Company Policy Number
(� I am a sole proprietor and have no one working for me.
( J I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contraaors listed below
who have the following workers' compensation insurance policies: '
Name of Contractor Insurance Compaay/Policy Number
Name of Contraaor Insurance Company/Policy Number
Name of Contmaor Insurance Company/Policy Number
Q 1 am a homeowner performing all the work myself.
NOTE: Please be aware that while homeowners who employ persons to do saaintenanee,construction or repair work on a
dwelling of not more than three units in which the homeowner also resides or on the grounds appurtenant thereto are not generafly
considered to be employers under the Workers'Compensation Act(GL C 152.sect. 1(5)),application by a homeowner for a license
or permit may evidence the legal tutus of an employer under the Workers'Compensation Act
1 understand that a copy of this statement will be forwarded to the Department of Industrial Accidents'Office of Insurance for coverage
verineation and that failure to secure coverage as required under Section 25A of MGL 152 an lead to the imposition of criminal paWtics
consisti fine of up to$1500.00 and/or imprisonment of up to one year and civil penalties in the form of a Stop Work Order and a
fine S 100.0 a day against me.
Si a th" 2�3rt�" day ofPT-. , 19
Lic see/Perminec Licensor/Permittor
COVENT RY LANE RCS. 00,
50
A,37 w
1�
�a6
t
1q8• �7 , ,
LOT 2
0
.W
LOT 3
31,147 ± S.F.
(0.72 ± AC.) CR�f ION
CO pAl
FD�F,700
6a7,k o.
�d
15�
I
JOB # 93-020
CERTIFIED PL 0T PLAN PREPARED FOR :
LOCATION :ASES MAP 110 PAR 4-4 COVENTRY LANE
WEST BARNSTABLE- REEF REALTY
SCALE :
REFERENCE : LOT 3 PLAN BOOK 454 PACE 96 �N OF AjAss9
JOHN cy
I HEREBY CERTIFY THAT. THE STRUCTURE o Z. Gn
SHOWN ON THIS PLAN IS LOCATED ON THE DEMAREST,JR.
GROUND AS SHOWN HEREON. v No.36859
DMosu �
DEMAREST - McLELLAN ENGINEERING
24 SCHOOL STREET P. 0. BOX 463 DECEMBER 15, 1994
WEST DENNIS, MA 02670
(508) 398-7710 DATE �ROFIYSIOXAL LA URVEYOR
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TO
WN OF BARNSTABLE'
uilding DepartmentwFoundation permit
Date o
ame
cation
nsp. of Bldgs.
INC
}DA. The Town of Barnstable
1619.••►9. Inspection Department
Oo�0 Wri►`, 367 Main Street, Hyannis, MA 02601
508-790-6227
Joseph D. DaLuz
Building Commissioner
(2-
�
--� _ ------�—
-15 �
I 'Arm it
itWN OF BARNSTABLE, MASSACHUSETTS
V _ DA
TE -- - F '-'.I T N
APPLICANT ) - I , - ADDRESS Q. Fo . a I., '-032,809
(NO.) (STREET) (CONTR'S L-CENSE�
PFRIAIT TO BUilCl I)Weiling 2 Sin I STORY cjic. Family Dwelli jjg NUMBER OF
(TYPE OF IMPROVEMENT) No. (PROPOSED USE) �� ) DWELLING UNITS
AT (LOCATION) - Lot #3, 47 Coventry Lane, West Barnstable Z ON I NG RF
(NO.) (STREET) DISTRICT
BETWEEN AND
'CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT—BLOCK—SIZE
BUILDING IS TO BE—FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTIC1.
To TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: ' Sewage #94"589
Bo`ld
AREA OR 3584 sq. ft. 110,000. 00
VOLUME PERMIT $
ESTIMATED COST $ FEE 51,,0'
(CUBIC/SOUARE FEET) I
6Y4 E R
'Amek Holding of C.C.
I BU
ADDRESS _jP-0. Box. 186, West Dennis
BYILDIN
THIS
H I S PERIJITTLYC 0 NVEYS NO RIGHT TO OCCUPY ANY STREET ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORA ILY rr
.... t 11 1
PFR E ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE-BUILDING_ CODE, MUSTB-1E AP-
,L
01 PROVED tjY THEJURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE 0 AINECI PROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CO OITIONf
OF ANY A PLICABLE SUBDIVISION RESTRICTIONS.
NI P�F, THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE
j-A I _U_
.,P ECII( I REQUIRED FOR
ALLL, CON.
L ON RUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR
C INCjr_ ELECTRICAL, PLUMBING ANO
I. F ; IONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIO"'
%. PFZIC� 0 COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL
Ri IZS(READY TO LATH).
3. F,NAL INSPECTION BEFORE FINAL INSPECTION HAS BEEN MADE.
OCCUP kNCY.-.'
— POST THIS -CARD SO ITIS VISIBLE FROM STREET
IPILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS
ELECTRICAL INSPECTION APPROVALS
IM6,
R.1-k"n 1z aw'jum
2 2
qj- 2 I-1q7 21
10 40ge Lj#f'� --,ps
III A0401• aw 0141"'All"'t
HEATING INSPECTI N APPROVALS ENGINr�cRING DEPAR ARTM NT
L
^Or
5 50,
BOAR F H
A
•
h u- SITE PLAN REVIEW APPROVAL
et' Lat"z
ILL NOT PROCEED UNTIL THE INSPEC- PERMIT W!LL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE
PROVED THE VARIOLI(JS STAGES OF WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN
I
ON PERMIT ;S ISSUED AS NOTED ABOVE:.
,C-.--+�f�•. •s.:�iti,i•i.'s.�;,.Z V .�5,-T...L k.� _,•':...'.:- •�',F',:..v.�,F.'r%4'4r.+L7.'4^.•>Y'.:.j.�w..•sk�.'r'r v:yJ.a ;L.� ,.y�,r.,.-, .Fy.t .. ..�'.`.y'(+.NJJ'.,./-�)!''.'.�/,a _ :.�.-i�. ..��,i -.r^r+
TOWN OF BARNSTABLE permit No. ... ................
BUILDING DEPARTMENT
I ""n I Cash
TOWN OFFICE BUILDING
■YL
�� .670• X
yrorr� HYANNIS.MASS.02601 Bond
CERTIFICATE OF USE AND OCCUPANCY
Issued to Amek Holding of Cape Cod
Address 47 Coventry Lane (Lot #3)
West Barnstable, MA
USE GROUP FIRE GRADING OCCUPANCY LOAD
THIS PERMIT WILL NOT BE VALID. AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL
SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS AND IN ACCORDANCE;WITH SECTION 119.0 OF THE MASSACHUSETTS STATE
BUILDING CODE. I
April 17 Iq..95
. .......... .. ... ..... ......... .. ....... �` ... ...............
Building Inspector ;
t•
TOWN OF BARNSTABLE Permit No. .� .......
BUILDING DEPARTMENT
' ................
.... y TOWN OFFICE BUILDING Cash
A
HYANNIS,MASS.02501 Bond
CERTIFICATE OF USE AND OCCUPANCY
Issued to Amek Holding of Cape Cod
Address 47 Coventry Lane (Lot #3)
West Barnstable, MA
USE GROUP FIRE GRADING OCCUPANCY LOAD
THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL
SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE
BUILDING CODE. '
April 17 95 uj f 1 U�
.. ....... .. .... ............. 19................. ................ .........................
Building Inspector ;
r
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.. -. _ ) .. ., s n.. .+. ., - .. ... .. _..<,.. .•j- , ♦ � ✓ ... _ ,. .. . \ 1. ,
-� - �_. . ._ 1+. _ i.,L...,.3 a.a.::..r'�or...�a_s .a�.Y.a�:l..--. .r._... _.. h.: ... .•.,,.,.......,...,....:.......�-. .. .. ... .r .. _-- - - - -.._-_ -.
�•-er.a.a'.....,�:L.-. t airs.y..a.,��c-t:a�..>.7woo...i.,}ra...�..+.::r.Ly�....�� .,..�a,e-....s..,..-.-.wi.s�,._e..r.....wd,..�tx ..,, >;...sa.3.�.ar__«.a1.ct,.:�..�-t#.i.:.....u�>. z. ..�.k+.•.•1,�., i.w.�,t _ _ _.__._ ____._......_. _.___..._,____....._- _ -•,
• - l J
A55E5<4V_S HAF: 110 ( I
io TEST Holes LdS CP* gals NOTES :
)
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