Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0011 HOWLAND LANE
l 6 UD LPn`) 0 D D O UPC 12543 No. 53LOR ® �p05770NSJ� HASTINGS, MN .'r.era...•.. ... .. .. .,. :.... � "v..- .. .. .;....�..- ...mac.'.• .. .. ... ;,.,... _ µ.; . � Assessor;Ado'and -lot number, /! �„ _ �� a .t�y.- '^ ' P. s' ',Se'wagePermit number ���� i THEY °` °� �` TN',- NSTABLE 0W . 9,o Nb 9. :� �, �U'1LDINS +"'I NSF T R APPLICATION.FOR YPERMIT-TO .. !.... �.so.... n .... Micy TYPE EOF wO�NSTUC.TO • ..................................................... � �I .. ' S `M ' Vl .19, TO THE INSPECTOR OF'BUILDINGS: b f The undersigned hereby applies for a permit according to the following information' VI r Location ,d� aodvl c�,✓ Cru.v � yicic?n!ST�lti'l F .� Proposed.`Use �T'/f �'✓ ...... .` Z olling-1.District,'............ .... .......:� Fire District' ..................................r3GG � . ,. -41 } Name=o Ov er / f ........... �......C�.... ...... �al... ..:�°'t ...............•�enCs'�1�iL�o2G4�' - • _ .. .Address. , =« Name of Builder '........ e�t1L Glr ...........Address .:.'.... z x Name of Architect ....... .....`... .Address Number of Rooms .Foundation` ®!✓GeC?'.. :. �. 0 D .. I! a f •- Exlerior SFti�-�iLC ...:.: Roofing ... . ....:.... Floors �cr✓1�z.. .. ... �� Interior r...... '�r✓'tu�l 1G ......... ....... �ve 1p Heatmgf .. .. Plumbing ... .... .... ., Fireplace Xle, : . ... ....` ......... ....... .. Approximate Cost' 7� ... ' befiraitive.Plan:Approved by`.Planning'Board — ______ __ _____19 Area . ............. Y - -- - Diagrdm of Lot''and Building..with..Dimensions Fee. . ' .., ......... d SUBJECT TO:`APPROVAL OF 'BOARD, OF .HEALTH "`_ -_. -.� a(>,.*� "` .«"F,»'�¢�.,abh��°° r�',v.` e::tl�r-r•,�;,. �,.ry.�a: ..Pt. .,r�y'�.... .,f,' j ,,, .. _ -• • � - li hereby agree to.conform`to all' the Rules and Regulations of the Town`of.Barnstable regarding the'above-, construction. 119 r *> , ' „ - Name t: y lip ...................' ..... Bruce, George W. & Elsie R. No ,, 19140 permit for ,, add to single ................. family dwelling .................................................................... Location of f Rode...5A. .....(.Howland. . ..Lane. . ) ................. . .. . ...... ... .... .. . .... West Barnstable ............................................................................... Owner ........George W. & Elsie F. Bruce ...................................... Type of Construction frame .......................................... ................................................................................ Plot ............................ Lot ................................ Permit Granted April 22 77 Date of Inspection ....................................19 Date Completed ......... ....... ....... ..........19 PERMIT REFUSED ....................................... .................... 19 ............................................................................... ............................................................................... Approved ............................................................................... ............................................................................... � - Assessor's mop and lot number .......................................... _ ��' Permit number -------------------� -/ � ` /�-..-=- � THE ������7�J ���� �� � �� �J�� �� � �� �K �� �N � TOWN�� |� ��]� BARN STABLE �� �������� � �� N0NN �� 0 �� INSPECTOR ` ��NN�N N-0� � ���� N �������.0m 0 0N �� �� �� � ���� � ���� � ���� � ���� � �� �� _^---_ , ' � ' ^ // APPLICATION FOR PERMIT TO -'`.—.-------...=c-_......-..~..-.--...---------------- ^ TYPE� OF WNSTRUCTION ..........r........_..,.. _____---------------------------- � ^ ................................................lo'�./. --' ' ' TO THE INSPECTOR OF BUILDINGS: � The undersigned hereby applies for o permit according to the following information: Location --.-.----.---.-....-------....-----...._._.....'__.____....�____________________. ' Proposed Use .............................................................................................................................................................................. � Zoning District — - Rva [Vghc� ---------.~.------------- -------------'... ...................................... ' ` . ............. ~ � Nome of Owner —.��'.-�------_--- .............A66reo ---.�----.--------....—.—...`.........-.�—~—. | � | Nome of Builder —.-.=�'�`---'—����.--�:'J-----.A66ness ............. )...................... ..... ...................................... Nome of Architect ----------------------A66res ---------------------------- � '~' Number of Rooms ----------------------Foundohon ..�--..c—....--.. ................................................... ' Ex/orior ------.-~--------------------Roofing ---_-.-..'...-------------------' � �nK��r ' - ^^ Floors —.--.�.-.�__--------------------. ---------------------------- Heating --'— ..... ..................�.-. .. .*.. .�— Fireplace ..............'.�---------------------Approximate Cost .��...---------_.,__,_____. Definitive Plan Approved by Planning Board lV----. Area ............................................. Diagram of Lot and Building with Dimensions �oe _. 5=i,�________ SUBJECT TO APPROVAL Of BOARD Of HEALTH � ` , ` | � ` - .� ` . . . | | | | ^ | / ' | hereby agree to conform to all the Rules and Regulations of the Town of 8ornohz6le regarding the above construction. ^ ^ J Noma .................. ............................................................... � � Bruce, George W. & Elsie A=112-1 No J2140.... Perrnit for .....add to single ..................... family..'dwelling ................. ..... ......... ................. ............... Location .........off Route 6A (Howland Lane) ....................................................... ........................WeAt..Barnstable...................... Owner ......... W &...Elsie...F.....B.ruce Type of Construction ..............frate............................. ........................ ....................................................... Plot ............................ Lot ................................. Permit Granted April 22 77 ............... ........19 Date of Inspection ....................................19 Date Completed ........................................19 PERMIT REFUSED .. ..... .. . . ...... ........... ..... 19 ................ .... ..... ..... ..... .. .. ....... ......................... .................................................................. ............ .............. ................................................................ ............................................................................... Approved .............................................. 19 ............................. ................................................. ................................... ........................................... P k .f i 0 1 1. . 4 Z07- iSIN, CA • 77 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION �� o l Q0 z� Map Parcel Application # Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee ,DLA • 3 C. Date Definitive Plan Approved by Planning Board ��- Historic - OKH Preservation/ Hyannis Project Street Address I k He wAa nd W f— ''Village Owner CtNo-_A k!z>_t�Y Address J?�KeMKM AUP_ Mc W*Q(J Q Telephone Permit Request C5QkQe61 7-kk e WMT\1M -pl:�c oop_ �< T(-1c82 q� i s Z"E�- fl 3 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 00•'00 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family' ❑ Multi-Family (# units) C-15 �; Age of Existing Structure Historic House: ❑Yes ❑ No On Old King fs?Highway ❑Yei ❑ No Q Basement Type: 0 Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sqft) =� Number of Baths: Full: existing new Half: existing n,8w Number of Bedrooms: existing —new �' rn Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No . Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size` Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name k M, Telephone Number-1 Address Ct\JP, License # ��� PC_1R12)0kD C00 33H Home Improvement Contractor# AC_15175� Worker's Compensation # U_Y'-V 1 V ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE � ,r S FOR OFFICIAL USE-ONLY APPLICATION# + DATE ISSUED } MAP/PARCEL N0. ADDRESS VILLAGE OWNER DATE OF INSPECTION: - FOUNDATION k FRAME INSULATION a FIREPLACE ELECTRICAL: ROUGH ' FINAL - PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING Off Ba- l w C kur DATE CLOSED'OUT 4 ASSOCIATION PLAN NO. The Commonwealth ofMassachusetfs Deparmwnt oflndus&ialAccidentr Office of Investigations 600 Washington Street Boston, MA 19211.1 Workers' www.massgov/dia Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers -Applicant Information Please Print Legibly Name (Busin=WpOrg8l3imtion/Individnat):_ .- Address: '1 City/State/Zip: 3 Phone#: $1 Are you an employer? Check the appropriate box: 1M`I_am a employer with \y 4. I am a general contractor and I Type of project(required): employees(Ul and/or part-time).* have hired the sub-contractors 6. ❑New construction 2•❑ I am ship � a ship sole proprietor or partner- listed on the attached sheet } and have no employees These sub-contractors have ' ❑Remodeling working for me in any capacity. employees and have workers' g Demolition [No workers' comp. insurance comp.,insuranceJ 9• ❑Building addition 3.Elrequired.] We We are a corporation and its 10.0 Electrical repairs I am a homeowner doing all work officers have exercised their or additions my comp, �t of exemption per MGL self [No workers' co 11.❑Plumbing repairs or additions instu'ance required] t c. 152, §1(4), and we have no 12.MRoof repairs employees. [No workers' 13.Z]Other s comp. insurance required] Any applicant that checks box a mast also at out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they arc k---tractors that check this box mast attached as additional sb�aD work and thm hire outside contractors must submit a new affidavit indicating such. employees. If the sub-contractors have employees,they mast provide w rkurs the naTn"Of othe sub-con and sbh whether or not those entities have mP•policy unmber, I arn,an employer that is providing workers'compensation insurance or information. f my employees. Below is the po£cy and job site Insurance Company Name: Policy#or Self-ins.Lic.# G . Expiration Date: �Q Job Site Address: \ Q0 rN(A � Y� City/State/Zip, Attach a copy of the workers' compensation policy declaration page(shouting the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the ' osition of fine up to$1,500.00 and/or one-year imprisonment, as wen as civil penalties in the form of�a STOP WORK p��gt malties of awe of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office and Investigations of the DIA for insurance coverage verification I do hereby certify under the pares•and penalties o fPeriwY that the inforrnaiion provided above is true and correct Si Phone FFofHeaalth only. Do not write in this area, to be completed by city or town o cis[ n: PermitUcense# ority (circle one): I. Health Z.$aildiutg Department 3, City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector son: Phone#: I I ' . 1`. CERTIFICATE OF LIABILITY INSURANCE DATE IDDIYYYY) �� 11/3/2011 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(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Norwell Risk South NAME: Eastern Insurance Group LLC PHONE 1-800-782-0251 A/C No;781-261-2099 77 Accord Park Drive E-MAIL ADDRESS• Unit B1 PRODUCER CUSTOMp0155323 Norwell MA 02061 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA:Gotham Insurance Company INSURERB:Safety Indemnity Insurance Cc 33618 August West Chimney Cc INSURER CAtlantic Charter Insurance Gro 6 Riverside Drive INSURERD: INSURER E: Pembroke HA 02359 INSURER F: COVERAGES CERTIFICATE NUMBER:11-12 Master 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 SUBR POLICY EFF POLICY EXP LTR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES(Ea occurrence) $ 100,000 A CLAIMS-MADE ❑X OCCUR CBC10000621100 10/12/2011 0/12/2012 MEDEXP(Any one arson) $ 5,000 X $1,000 Ded Prem/ PERSONAL&ADV INJURY $ 1,000,000 Prod/Comp Ops GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY X PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 ANY AUTO BODILY INJURY(Per person) $ B ALL OWNED AUTOS 6211285 10/12/2011 0/12/2012 BODILY INJURY(Per accident) $ X SCHEDULED AUTOS PROPERTY DAMAGE X HIRED AUTOS (Peraccident) $ X NON-OWNED AUTOS PIP-Basic $ Underinsured motorist BI split $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ C WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) V00965500 /19/2011 /19/2012 E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Evidence of Insurance. CERTIFICATE HOLDER CANCELLATION 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. AUTHORIZED REPRESENTATIVE ' Ronald Cleaves/RAl ,P��r. [i — ACORD 25,2101101, ©1988-2009 ACORD CORPORATION. All rights reserved. INS026(200909) The ACORD name and logo are registered marks of ACORD Nlassuchusetts- Department of Public Safe(N GJt C e „Q��� /�y� � Board of Building Regulations and Standards Office o onsumer Affiatrs smess egu ahon Construction Supervisor License HOME IMPROVEMENT CONTRACTOR Registration:-*y.107353 Type: License: 0 23887 Expiration: .7/31/2012 Private Corporation Restricted-to: 00 F Ile AU- +ST WEST CHIMNEY:COMPANY,INC. JEFFREY S LUDLOW A �' 28 SALT RIVER RD � Jeffrey Ludlow i.* .� E FALMOUTH;MA 02536 - 300 OAK STREET UNIT 270= il PEMBROKE, MA 02359r ='• Undersecretary Y Expiration: 6/15/2012 t"ouunissioner Tr#: 27015 92e icanvinoruuea o�/l�Ci��uc�iccwlla DEPARTMENT OF PUBLIC SAFETY Oil Burner Technician Certificate IFR ."T.1L�y 1 Number: BU 021741 T c F.a r't v i K o r;N s r e c'r o a Expires: 06/15/2012 Tr.no: 5801.0 Restricted: 1517- d F.I.R E,C,I - , —d Inspector p' 28 SALT RIVER RD JEFFREYS W #FGI 83 E FALMOUTH, MA 02536 / '` s` !�U Fire Investigation Research&Education Service , Commissioner llt<3l ll i Q �� www.f-i-r-e-servicexom Tel:805.552.9958W"Ni , rCEa N"E"I ICHIMNE Valid Certificate#: 16231 Student#:47402 SwEEp Thru Jeffrey S. Ludlow ! ,,k.7 ,�. April Competent Person Training: Frame Scaffold Class Date:August 25,2010 Expiration Date:August 24,2013 Authorized By: Authorized Training Institute: Jthffrey SIA Training Program �" Ludlow �� August West" Chimney Co. Inc. Pembroke, MA r t August West Chimney Co. & Fireplace Concepts, Inc. Sales Order www.AugustWestFireplace.com Date Order# HINGHAM LOCATION PEMBROKE LOCATION 32 "iting Street 6 Riverside-Drive 10/4/2011 6183 Hingham, MA,02043 . Pembroke, AM 02359. Phone: (781) 749=1621 Phone. (781) 829-9895_ i �. Fax: (781) 740-7854 Fax: (781) 826-6185 CUSTOMER _ : : Ship To Christine Kelly 35 Kenwood Avenue Worcester, MA. 01605 Phone: 508-509-6809 Terms Rep 2%10 Net 30 JL Item Description Qty Rate Amount Re: 11 Howland Lane - Barnstable, MA. Proposal includes labor and material to Install the "Golden Flue" Chimney Lining and Restoration System for One. _ _. ... - . Center Chimney with three First-Floor Fireplaces.-The Second Floor Fire P place-is-not--- �- - - �-- included iri the scope.of this work. The second floor Fireplace S01:be ""'ane'ntly blocked at the throat of the Three (3)New Top'Sealing Dampers are included. The " Bluestone Cap will be reinstalled after liners are completed. A Staging Tower and Chimney Staging will be erected to minimize contact with the Wood Shingle Roof. MasonryMisc,S... Total for the'above work "' 23,840,00 23,840.00' Terms: $8000.00 Deposit $8000.00 at Half Completion Balance in Full on Completion ,C-ustomer=Signature: - Subtotal ' Sales Tax (6.25%) Total Page 1 .0 August West Chimney Co. & Fireplace Concepts, Inc. Sales Order www.AugustWestFireplace.com HINGHAM LOCATION PEMBROKE LOCATION Date Order# 32 Whiting Street 6 Riverside Drive 10/4/2011 6183 Hingham, AM 02043 Pembroke, AIA 02359 Phone: (781) 749-1621 Phone: (781) 829-9895 Fax: (781) 740-7854 Fax: (781) 826-6185 CUSTOMER Ship To Christine Kelly 35 Kenwood Avenue Worcester, MA. 01605 Phone: 508-509-6809 Terms Rep 2%10 Net 30 JL Item Description Qty Rate Amount Note: The Electrical/Telephone Line at side of house might have to be disconnected, temporarily for crane to set formers. Any unforseen circumstances not viable may required additional charges. Thank you Jeffrey Ludlow Please call me if you have any questions Customer Signature: Subtotal $23,840.00 Sales Tax (6.25%) $0.00 Total $23,840.00 Page 2 I _ Town of Barnstable t Regulatory Services L+nvsresr,E, MAM �g Thomas F. Geiler,Director 039. ►�+�'" Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax:. 508-790-623 0 Property Owner Must Complete and Sign This Section If Usir� A Builder as Owner of the subject property hereby authorize to act on mp behalf, in all matters relative to work authorized by this building pem3it NOw�C��d L(An2 (Address of Job) **Pool fences and alarms are the responsibilityof the applicant.e app t. Pools are not to be filled before fence is installed and pools are not to be utilized until all final inspections are performed and accepted. ture_of owner S' e of4ApplRi s Print Name Print Name Date QTORMS:0 WNERPERNOSIONPOOLS Town of Barnstable Regulatory Services RARNSTAXIM Thomas F.Geller,Director 1639. �0 Building Division ' Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-40 8 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# ` CURRENT MAILING ADDRESS: 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. 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 resiponsible for all such work Performed under the building ermit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. I The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner 4 Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware"that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt - - w - 4.' 707 "- .>✓ii,""~ .. k "!. ® .,..i. mow+.- —.�...v- _SIT if I It ' ' 1 1 1 LP.:.P..LIGJ 1 1 1 1 �1 1 1 �+1 1� P 1 1 •8 � 1 � 1 `-i f -tl O D �+ _ _ - _ >��----•- o-'�"'�� ���+ � � _ �:�:; � _�P,•-` ,ems.-:=..y.,�-�- TVL }� A YOUR BASICS An unlined or improperly lined chimney is a hazard to your home and your family. The purpose of a flue liner is to contain the heat of a chimney fire and prevent it from reaching the building itself. Under no circumstances should fires be built in fireplaces or fur- naces vented to chimneys without the benefit of a properly installed flue liner. Unlined chimneys(or chimneys with damaged lin- ers) allow heat to move through brick chimney walls very quickly and can cause adjacent wood and insulation to catch fire. In addition, improperly lined chimneys venting gas or oil burning appliances can allow poisonous gases such as carbon monoxide to leak into the dwelling with fatal consequences. There are three types of chimney liners currently used in residential and commercial chimneys: stainless steel pipes, ceramic tile, and cast-in-place linings. STAINLESS STEEL LINERS Without a doubt,stainless steel chimney liners are the least expensive option for lining or relining a chimney. The conse- quences, however can be very costly. When a stainless steel liner is exposed to extreme heat,such as a chimney fire,the charac- teristics of the metal actually change, making it for more prone to cracking, corrosion, and other deterioration. These cracks then permit high levels of heat and/or harmful gases to escape from the flue...causing structural fires or poisoning. For these reasons, stainless steel chimney liners are often replaced. Typical stainless steel liner removed after just two burning seasons. .CERAmic TILE LINERS Terra Gotta flue tiles are the most commonly used flue lining materials in new home construction. However, it is the nature of these tiles(as with all ceramic materials)to crack under the pressure of rapid temperature changes,such as those common during chimney fires. This cracking can cause tiles to fall away, exposing other building materials to extreme heat. Falling tiles can even become lodged in the damper and smoke chamber areas creating poor drafting. When ceramic tile liners fail,they must all be removed and the chimney must be relined. The interior of a clay tile lined chimney after a chimney fire. GOLDENTHE CAST-IN-PLACE LINER . . . THE The cast-in-place chimney relining system was first invented over 60 years ago in England. Golden's was the first American chim- ney lining company to install cast-in-place liners. Over the years, Golden Flue has lined thousands of chimneys, including the chim- neys of some of America's most historic homes,with this revolutionary pumped masonry process. Golden Flue has always been dedicated to innovating and improving upon the original cast-in-place system. Today Golden Flue's mixture far surpasses all other chimney liners(including other cast-in-pla(e mixtures) in heat insulation value. In addition, the installation equipment manufactured by Golden's has been recognized by the English (the inventors of the cast-in-place system) as the greatest advancement the chimney lining industry has ever seen. , THE GOLDEN FLUE DIFFERENCE! GOLDEN FLUE IS THE ON 4-1— PUMPED MASONRY LINER UL Golden Flue is made from a lava-based compound•with extremely LISTED BY UNDERWRITERS high insulating properties.Just a one inch thickness of Golden Flue LABORATORIES. �L . will prevent a structural fire caused by heat transfer! Even at tem- peratures in excess of 2100' F! The compound is combined with a GOLDEN FLUE IS THE ONLY _ .. bonder that enables it to grip the sides of your chimney. The semi- CAST-IN-PLACE LINER LISTED BY liquid mixture is actually poured down your chimney around an WARNOCK HERSEY FOR ZERO- inflated form. The form is evenly spaced from the chimney walls y CLEARANCE TO COMBUSTIBLES and creates a perfect flue every time. When the mixture cures,the WITH JUST I INCH OF LINING form is deflated and removed, leaving a solid, one-piece flue with `� no seams or joints. Golden Flue even increases the structural MATERIAL. ■-�® integrity of your chimney as it seals all cracks,fills in for missing mortar and secures ONLY GOLDEN'$ HAs 3 �. loose bricks! y COMPANIES TO ADDRESS ALL CHIMNEY NEEDS: AIR HOSE GOLDEN FLUE � - DISCHARGE PUMPING HOSE _ FORMULATES AND MANUFACTURES _ THE INDUSTRY'$ TOP-TESTED LINING MIXES, GOLDEN MANUFACTURING .. ,, .� DESIGNS AND MANUFACTURES ` ALUMINUM STATE—OF—THE—ART rc EQUIPMENT TO ROOF SCAFFOLDING ENSURE PROFICIENCY. •S INSULATED :: GOLDEN'S CHIMNEY LINING GOLDEN FLUE MIX :r. _ LINES CHIMNEYS ON A DAILY BASIS �,�'" AND TRAINS NEW GOLDEN FLUE ` T. DEALERS ON THE JOB, INFLATABLE CHIMNEY SMOKE FORMER EACH GOLDEN FLUE DEALER HAS CHAMBER BEEN CAREFULLY CHOSEN FOR THEIR CONCERN WITH CUSTOMER SAFETY,QUALITY PRODUCTS, AND TEMPORARY SUPERIOR WORKMANSHIP. , SHUTTERING J w� SUPPORT r JACK STANDpill] 4 Golden Flue has set the standard in chimney relining in the United --=M FLUE States by being this country's,leader in cast-in-place technology. Be The Cure for the Flue° +; sure you're getting America's original Golden Flue liner! ' 800-446-5354 SHOULD YOLI BE CONCERNED WITH THE METHOD IN WHICH A CAST-LINER IS INSTALLED? ONE-THIRD OF THE PRODUCTS LONGEVITY COMES • SOLELY FROM THE WAY THE PRODUCT IS INSTALLED. 41 .'Y 4 F (lay file liners must be removed for proper flue sizing. Formers are lowered into the chimney with spacers attached. This also allows for the cost4iner to adhere to the chimney walls. ti The formers are then inflated with air to the proper flue sizes. Required lining thickness is maintained by the attached spacers. IN 00 ti > GOLDEN FLUE in a semHiquid consistency,is pumped to the top of the chimney. The chimney formers are deflated and removed. A specially designed pump produces a continuous flow of GOLDEN FLUE mix. Incredibly,a new chimney has been built inside the existing chimney. This ensures a solid pour while eliminating voids or air pockets in the new liner. This stops deterioration from the inside and also adds structural integrity to the chimney. t ' it Looking into the Hue,it now resembles a well. One inch of GOLDEN FLUE is heated to 2106.5 degrees without heat penetration. It has became a one-piece solid masonry liner with no seams or joints to weaken at a later date. This alone will eliminate a structural fire. AUGUST WEST CHIMNEY &UMORUED DEALER 0 D FIREPLACE CONCEPTS C 6 RIVER SIDE DRIVE FLUE PEMBROKE, MA 02359 The Cure for the flue° (i'0ILDT,R] :�UIE:SIETS TU STA'ND.AMS.IN CUI HA'II'➢ONVW®IE. -PRESS PERMT ® l 5-b �rS3 Town of Barnstable a 2015 To Regulatory Services Faaa TO NSTABLE 'Ibomas F.Genet.Dfrsdor Tom Ferry,CM Bd Uft Coanaataalone r 200 Main Sleaat,Bo► *MA OMI Vww.ummbm:nsWble ma.va Fax: 509-790-6230 ot%o,. 508-862-4038 Not YaBd udd�otat 1�X��l� Numb- 1 � p�opsefy,Addt'ess . j�' idsasial VdM of Wc* _ Minimum iTee of 536.00 for workunder s6000.00 owmesName Z Ad*W Coutudo Ooakaoeo�r's Name,..,_�1Q1/lam ���Z „ Tela�aa�ee Nmabea f/J�-�f7-.�7 1�o®e r Lfaase s(�f applioeble) �fp..�...�� swaswbar's Lwow N(if gpuc") CT-2 as COMPIrM ioa hm moa I ass a colt p I soa du Homeav aer uve'OVasl G Compm mdm Iama w= lastasooe Comp►Nor��m,�z - . wotismsa's Comp.PlI ft w_ QI/ X �/2 C�o:ljrtistooe cmpllmsoe cwMemts mast accompany each pmmit J l petasit (dw*boxy e� w eefo �F;J .0 0v ��•e I�ooi(#trrriosm maW) ) AA ooa on debris wM be taken to (�l#ad a►nrrimuso owbQ(not sppio& Gams am' ®dstfis kym of roof) IS." #of doses ❑ pjpbosu"W'0owddaro W@Hdew.U V" 0==t=ea 3*0 of W n&YIN ilprrad$�1�t�8b'e Pamsareq rm pion ••ft red s.Qa i a nmrked o,p � a.o ,rogntrea. twhsrs tagta�ud: tsnss�ar atmr passel aom.socmm wM a6w tin dm wbomat maddkm,UL a Caerwaskm.da ***Non; ply owwar nanst d p Property Owner Letter of Per abdon. A Wotfto Hose Improves ent Cook-aeture Ileasve&Conai rmedon S opervbors Lk-m e is SIGNATUIM Town of Barnstable : Regulatory'Services Thosaes F.Geller,Olreetor Building Div#sion Thossss FeM,CDO ftwh$commissioner 200.Main Street,'Hyannis,MA 0260I ' we►�►.twva.baroatsbit.ma.aa . Cffi' : 5e1-"24038 Fax: 508-790-6230 j Property Owner Must Complete and Sign This Section If Using A Builder ' L�.��� ,�Y,�„��._, ;as Owner of the aubjectpsopezty ' hexby snthosize-_ �l�l� Ci�x to act on my behalfy is all mattes ttelative to wock sudwz4ed by this buOrUng permit application far. (Addma of job) r / SiFna6"of C*nw oe G �- pdnt Name _ ItPrOpsrty Owner is app"S ftr permit;pleaw.complate the Homeowners Licedae Zxompdon Form oa,the reverse sis;e. ' i 1 he CGrttmonweelth of h2essack:;-efts Department of.Fndustrial.4ccidlents 00TU of lrsvestigations 600 Washington Street Boston,Mgt 02111 10 www,mass.gov/dia Workers' Compensation Insurance Affidavit; Builders/Contractors/Blectriciaas/piumbers A Plic2akformation Please Prim Lecribly Name (Business/Organiz&Uon/Individu'a.': Address: City/State/Zip: Ph #: .0 oae Are ou an employer? Check the appropriate box; ' 1.( I am a employer with— 4. Type of project(required): ❑ I am a general contractor and 1 �� 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 attacbed sheet t 7. VRcmodoling ship and have•ao employees These sub-contractors have S. ❑ DetnolitloA working for ate in any capacity. workers' comp.Insurance, [NO workers' comp, insurance S. ❑ We are a corporation sad its 9. ❑Bollding addition 3.❑ required,] ofrcars have exert ised their 10.13 Bit--trical repairs or additions I am a boateowner doing all work right of exemption per MOL I l.Q Plumbing repairs or additions myself« (No workers'comp. c, I52, §1(4),'and we have no iasoraace required.]t' employees.[No woli,-as' 12.0 Roof rpairs comp. insurance required J 13.0 Otter 'Any apPtioant that eke s box t! rtwst also M out the AMU bsbM showltu chair wori�r'vwnperu�tloti Po{OJ infersnetloa t Fien+trawnory who submit this afIIdaru taelMdq thoy am doing AU wort and On hies outride oortrectots swat rubmlt a new affidavit indicating such. tContrar is that eh:ck this box tntist aiteched an additltmd sheet showing the name dodo sviyaoatrtretom and their wori;ets eom . oa P P cy Wo rmarion. 1 are are employer that Lr pro►+tdbrg workers'contperrsation Insurance for my errtoloyeec Below lr the pnLtcy cad fob site lry�'ormalton. ltssuranoe Company Name.: 7"oxl�i� Policy M or Self•ins.Lio.M 9:2�p/z2y 37 ev�_`V Bx-pQdhon Date,_ J Job Site Address:�1 a�r�l�,ytr��,b �,dp,,, . city/state/zip; Attach a copy of the Worket�' compensation policy dec—!a�rob page(shewtng the pip numberand expiration date). Failure to secure coverage as required under Section 2SA ofhia c, 1S2 oan lead to the imposition of criminal penalties of a fine up to Si,S00.00 and/or one-year imprisonment,as well as cirij penalties in the form of a STOP WORK ORDER and a Ste of up to$250.00 a day against the violator. Be advised that a copy of this stat..ment may be forwarded to the OfBae of Invettigations of snm the DLA for iaance coverage vari$catiam t do kereby csrttfy ur: er the pants and penalties of pu)ury that the tnformalion provided above is true axd correC4 04 Da QSUIat,use only. Do not write in this area, to be completed by city or town e7clad + City or.Town: 0 Permit/License; Issuing Autaorlty(circle One). 1.Board of Health I.Building Dapartruent 3.Clty/Town Clerk 6.Other 4.$IectricaI Laspxtor 5,Plumbing Inspector � � Confect Personm Phone 0: s i I i I �:/�IA�o•NtiNenDt![Kw`�JF•�4yFTl�'.fit7c�uJe`�J Qtllee of Coastttaer AfWrs&Business Regsiation Liceme or registration valid for 1»dividul use only IAE IMPROVEMENT CONTRACTOR betbre the expiration+date. It&and return to: Nlrod": IM97, Type: Office of Consumer Affairs and Business Rqulstion moom 3/2512018 Private Conmall1w 10 Park Plaza-Suite 5170 Boston,MA 02116 DAVID COX,INC. David Cox 19 LAVENDER IN �+.e_.•�dL� W.YARMOUTH,MA 02673 Undersecretary Not valid without signature Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Superi-kor License: 7 ®AVID R COX PO BOX 401 ' r South YarmwAls FAA , gin;• _xoirwuon Commissioner DAVID•2 OP ID:KG 4'4W[] C,'. ERTIFICATE OF iUABILITY INSURANCE oA.enftFoo?yn Q3tlil�04>B TIIIe CERTIFICATE fi 101111116110 Aii A MArMK OF 1WFQR'MATION ONLY AND CONFERS 00 R1QWM UOON M CERTIFICATE 1t01.091.THIS rjMTVWA-M DOli NOT AI/IRMATNELY Oil WEOIATIVAY AMEND, EXT NO OR ALTER THE COVERAOIE APPORDED By TrKE POLL in R RNrAT1VtiORP eLow. CA'm AND 0IANCN Dogs INS :R71fiCATIETHOLOQITUTE A CONTRACT 69MBEN THE ISSUING INaURER131 AU7MORMEA PORTAt1 e C ate holder 19 An AD NAL INSURED,the WIvI 1159)+rust be ondorted if 3UiRO0AT10N WAIVED,stOleet to the lum Ind condltione of the policy,certain policies mey rsguire an endamwoont. A clatoment on this certlficatte does not confer rights to the CeMco holdig In Nyeu of ah endorsem e PLIX �C*•kto. & I LZ got 3093-29!!0 Ammma cava"E 'MIC 0 INeURPA:Trayetem Insurance Company enN� t x.Inc. swum e: F.0.BOX401 INSI M4: 3 YAMOUK MA 0204 NeURER0- ! _ t.leUleeRi: RS Ti NUMBER: NSViSION N 3 A.- THIS li ER I E Fab WsUgANCE LWEV BELOW HA BEEN 13BUID TO THE IN3URW NAMED AbWE FOR THE POLICY PERIOD INDIOW790. NOTWITHSPANI3IN3 MY RZQWREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RISSPECT TO 10414 CH THIS CERT111 CATS MAY lilt 168UM OR MAY POTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBEID HEREIN LS SUBJECT TO ALL THE'ERNS, EX0L116104E AND 0"UMONS OF W N POLLNES LIMITS SW)M TRAY HAVE BEEN REDUCED SY PAID:.!AIMS. TWOf NeUNANCa .POUY NU MR M D!Y w ' LAI1T£ e eoeli�R"GINN L 11ASILI" CLAIIIeMADf: OCCUR 1 rS�1ABfi1Ta8 031tA12016 OyNAllQt6,Fa ,' co 300. edt»a owt+ers {I ! i jeD exvsu un.oen s a t3ENL AAaREOA'e JNI�APOLt[ePER 1 GEN$R1 it AvvRFGaTE� S 2.000, (�{y o.1-D CT5•wUMNOP M.S. IL Z,000, AOUC"7 OS a LOC S , Aumma"LIAN16M AN?AL•U ` ".r t?q'uRy(Pti pvw)) ? I RLL'ppw w� 9Cr+eQLlli: I eoa:r tar..uRr t?►r�cuaonu 1 S Utcts Nff,'WNfD No=ALTOS ' es UMBIS A Wle Or�pUa fFG?O�c.'7Rev-'_ I i eXCMeLIAe i ti'1 I I I S sfATUT£ t_ Alp tiYeReL1AIii7Y v1 ! rOLLOWFROMe0 0711SID14 0?/08R0/5 a rq�r�Jar 6 1t10, A jAwPmft I�iop4 .L'DIEC� aT•41 N!A •"� NS DAYS ; s. .tXS5asE•la:JE A O•fq 1 1 L 4TIG i � L ELMSEAS'E•YVII:Y'JMIT S •f �0,00 i 1 003FWN ai OFMtAT041 LOUT*"I vMOLeo NCONa toi,Ad**V st fro I"ttledws,mw bs aq ehsd!tors e>Wae is 10{uks1D TCAtdNDAR GHOL o ANY W tuts AOOYQ MINDED POIJOVIS eE OANOE.160w eVO"Of THE 00efAMN DATE Tf1i111E901, NORCa WU.L a DWIfIRfO IN Tam of 1kimm able ACCONDARC)rWM VAR POUOYSROYIU11xe. 2i0 IM111n Street HyennK MA 02E04 Aun+oR,taeRePtleetrTATIvt tD lee*40ii ACORD COR AMCN. All rightip Teesrved. IACCRC 25(")01) The ACORD nsme and W99 we hgie�mettle of AIC0140 I ' I i Town of B&rnsftble Services story . $ 'i7LOSM It.GeWr. r T011t r 24 ywo Saw. MAawl p�foe; soae62-403s - ►•Ade�o• ad . s3s os owwat odder ssMOO vow of Wok ._-- ooee��NM$A G ��+owmmt 6)oaAno�L1+e�aa d Gil app�1 /Od� � w - o�omedh °°" Flo, t UD i�a�soar�eo4ei�r JUL 0 6 ?015 To `' • V 1/N of 'VS TABLE ABLE �� toast y adc i�� Pm* ) omonmdmd0 °wM be Ubm tic C3 =1200 toot:te"6* Gob*oar----°°daft Wm rd'roolj ' ��„� �iiYi'Td G LT�iD�i D�F Culp//TCf GC�•�7.�i Dig'/ 0 off © Rq*oww gt�ye�veldooNoi#ds�.L••Vsieo 3s? tat�vlpdow�s (� awwwk mn h0000ft 4 Boor pbu ma rfad wm rsd is tDoecttoao raquIM& $I�Iih ZMolrl�l8�M 1's�i0t t'a4�• �alba town ram,t...t �. ,�Wfwrrt:rsitrk �gottl�/s�ltA000sosms*aoo� 3=it sip pwopomy tea'L4* r oil A, at**Morris borov"Hat Co" I LISWAM i Co=wumios Swparvioors 1Lk""is SftiM Tum Cl Town of Barnstable : Regulatory Services nQmm 1.Geiler,Diced w Building I)ivW00 Thou=Perm►,CDO l9"as Commisamner 200.Maba Street,'Hyannis,MA 02601 w w.tcvMbarWftbb.ma.ns offim SOW24018 Fax: SOA-790-6230 Property Owner Must Complete and Sign This Section If Using A.Builder as Owner of the vubject'PropeM hereby 140XIaa,. c%5.�1�/l� [/� to act on my behalf in on tr&MW Nktivd to Waxk tudwx4ed by this buUing permit appUca.tion for. dad (AAdme ofjob) o Date Paint himeoa _ it Paoperty►owner is&vpI*s ibr permit,pleaes-complete the Homeowners Ucekue Exemption Form am th0 reverse dde. . �� %;4e CofrtrtolKwealch df hicsszck::setfs Department of industrit=lr4tx�de,Ktr .. �. Ofice of Investigations 600 Washington Street Boston,MA 02111 www.Mass,gov/dia Workers' Compensation Insurance Affidavit: Builders/Conti actors/Mectr-icians/PIambers -A licaat Information Please Prtnf Le�toly Name (9usinesslprganitasiorAndividuat):__��f�1�_��x Address: City/State/Zip: r&Vlaaj Phone Art ou an employar7 Chsck the appropriate box; 1.VI am a employer with 4, ❑ I am a general contractor and I Type of profi t(required): employees(full and/or part-time).* have hired the sub-contractors °• ❑ New corst uctioa 2.❑ I am a sole propridtor or patter- fisted'on the attached shgot s 7. P'iLemodaliug f P abip and have ao employees These sab-contractors have B. ❑D:taaiition working for rae In any capacity. workers' comp.insurance. i ❑ (NO workers' comp. insurance S. ❑ We are a oorporatioa nail its 9. Bulldi.*tg addition regttirad.j Gat=have Mrsised their 10.❑Blecttical repairs or additions 3.❑ !Mn a 110MOOWnei doing all work right of exemption per bftsL. l i.❑Plume 4 repairs or additions myself tNo workers' comp. c. 152,§1ffl,*and we.have no 12,❑ Roof repairt tastrrsaca regttfred.j t' employees.[No VOS=7' coop, ins�ce requital 13.0 Other •Any appBeant that cheap bw¢t i muwt also 51l out tl;e sictioa below zbowiog that wow'oomFxuyatma pviioy:afonnaHaa t Piee+ttownan who submit this awavlt ladicating they arc doing e11 work tad tree Wm ootslde aontmrbrt must ruhneit a now affidavit indicating su:h. �ConLutArs that ebadt tail box nrtut attached an additional eh-.d dhowing the atmc of the saE-obetraetae8 and their wo:i=1 wmp•Perry fnfornuWan. i ant err en5plvyer that'it prvvfdina workers'eon;cersrtrtion L��trattr�for my aritplvyea•. Below is the polity and Job site • tr�*orK,alton. Insurance Company Name: Policy 0 or Self•ins.Lie;P#,,�� l�jr �/�� Expiration Date: r�s� Sob Sits Address: /� City/5tgX/zip: Attach A copy of the workers, comparsation Polley declaration page(shoring the police number and expiration date). Failure to secure coverage as required under Section 25A oflvfGL c, 152 can lead to the imposition of criminal penalties o,a t3rte tip to S I,S00,OG and/or one•ysar itnprisonmMnt,as we!1 as civil Penalties in the form of a STOP WORKORDER and a Erne of up to$250.00 a day agalast the violator. Be advised that a copy of this statement may be forwarded to the OfBee of Iltvettitations of the DIA for insurance coverage verif5eation. 1 do krreby 0xrtVfy un er thepains and pena1*4 gfper)ury that the tr{forn=60n provided move Cr trite and eorre c[ ' ate• '' —�' O,/j'letal r�.ge only, Do not wrtte In th4rr area, to be completed by cly or town orr7ciaE tr City or To wa: ` Perinit/License h if Issuing Authority(circle one): ' 1.Board of Health I. BulidingDepartment 3.City/Towa Clerk 4,Electrical T 6.Other nspaciot 5.PlambingIaspactar Contact Person., Phone#: