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1720 OLD STAGE ROAD
a r NO. 152113 ORA MAM N U" *ESSEin _ Town of Barnstable` _ Building ;Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be KeptHAILMSTASM 1i .Posted Until Final Inspection Has Been Made. Permit i63p. �e " Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit No. B-20-937 Applicant Name: ADAIR JOSE ALVES Approvals Date Issued: 04/03/2020 Current Use: Structure Permit Type: Building-Sheet Metal-Residential Expiration Date: 10/03/2020 Foundation: Location: 1720 OLD STAGE ROAD,WEST BARNSTABLE Map/Lot: 152-004-004 Zoning District: RF Sheathing: Owner on Record: SEIXAS,LARISSA A Contractor Name: ADAIR JOSE ALVES Framing: 1 Address: 37 CAPTAIN LUMBERT LANE Contractor License: 11605 2 CENTERVILLE, MA 02632 i 1 Est. Project Cost: $ 18,000.00 Chimney: Description: INSTALL TWO NEW HYDROPONIC UNITS WITH NEW DUCTOWRK Permit-Fee: $85.00 Insulation: AND NEW CONDENSERS Fee Paid: $85.00 Project Review Req: - - . Date: 4/3/2020 Final: may. wl Plumbing/Gas # Rough Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this'permit is commenced within six months after issff uan icial Final Plumbing: All work authorized by this permit shall conform to the approved application and the'approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Rough Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. S Final Gas: The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Electrical Minimum of Five Call Inspections Required for All Construction Work:i 1.Foundation or Footing Service: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed_ Rough: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection R- Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Rough: 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: ft` Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: C Commonwealth of Massachusetts Sheet Meted Permit mzp — P,Td Dame: 02y- Zy-2020 SCANNED PC=it# g Zfl —9 37 Estimated Job Cost$ 1 T<X*oo APR 0 3 2020 Permit Fee:S R 5"o 0 Plans Submimuk YES NO Plaw Reviewed: YES NO Business License# I Uhers Applicant License#14 (- p2C - Business Information: Property Ow=/Job Location Information: Nam- Fwe 5roo-� t4\j rso— 51aj.'ju, street: TO W 6 war% OA t�6 o a�� Stray I q-ZO OLD Spacs rcAFo City/Town; W o'1 Ceyh-v,\. City/Towa: Telephone:_SO'8 9Lt % q-SZ Telephone: 5C)Y 34O 78lo, Photo I.D.required/Copy of Photo I.D.attachod: YES)d— NO sdcz� J-1/M-1-umtstriated liccase J-2/M-2-restric tOd to d%TUi1kP 3-stories or I=and commercial up to 10,000 sq.ft./2-stories or less Residential: 1-2 family�[ Multi-family Condo/Townhouses Other Commercial Offioz Re ail Dial Ewa! Fire Dept Appro al kstitu mal_ Odw Square Footage: under 10,000 sq.ft.>�L over 10,000 sq.ft. Number of Stories: Shed metal work to be amopleta : New W'orlc7 Renovatioa: HVAC,�_ Metal Watessbed Roofmg KW:bm E.dnm Sygesn Metal Chimney/Vents Air Balancing Provide deWed boa of w4xt to be door: -7NS i AZ-L tL,,)O jy&,-,jD n 'c y,v1� wj Ttt n/aw 00C T c."X k Awo Nb%w C.O'.;osV1cYLS. BUILDING DEPT MAR a a 2820 TOWiv vr- Um, 11.Q 1ABLE ^lam jr✓ INSURANCE COVERAGE: I hive a="N t c Etwtsrwm pcifcy cw ft OWAaiut wt;d marts ft nqukunwft ar 1lG.L Ch.112 Yes o No ❑ If you have checked yM Indiate the type of coverage by checking the appropriate box below; A liability insurance pocky Other type of indemnity ❑ Sand ❑ 0WWE3'S IN SlAtANVf wAM5t t ae area gnt t}w 6a d rU rq=VO kuw1incs c" nqLired bl Chapter 112 of the Massachusetts General Laws,and that MY d9ratm an this I otft appkabw X&M this mommenL ; Check One Only 0ta2ler,)93 AgentSWMftft ❑ j Of Orwrer or Owner's AgotQ By checking this boas],)hw*W cwtih that all of the detaft and information I have submitted(or entered)regarding this application are true and acwrzlr to the best of my knowledge and tht an show nww wort and i�o"perl3oened undw rile perntFt ed for this application will be In w�a0 t pit of ets CQ ft and Orap W 112 of an Gera/taxes, r t Dud inspection Mquited pry to irmWw tnsbtUUW:YES NO. I PMg=InRp lions Date Cats 1 t t ff! Fia�>Iecti2n I Date C.aMats Type cffljowow �y ❑ i e ❑Master Restricted A- :AvfTown Soiefixe of Licensee �s Ucense Number- �� f $ ID Check at soeww,mass.g 2 W i rapector S4puWm of Permit Appeared M Department of Industrial Accidents Office of Investigations 600 Washington Street Boseojli;, ,1 A 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers ARplicant Information Please Print Legibly Name(eusincsuorgamzuwWltdv"W): Fi fc ST ►� HytAc S�r•�/,w � Address: 'o jt 6w�.� 44.1 L_L. on 1 City/State/Zip: w!>%c,e_b#_P,•t Phone##: 501 -Q 4 Are you an employer?Check the appropriate box: 1. 1 am a employer with 4, 1 am a general contractor and i T?�of project(required): employees(full and/or part-time). have hired the sub-contractors New construction 2. 1 am a sole proprietor or partner- listed on the attached shcct. Remodeling ship and have no employees These sub-contractor-,have g. Demolition working for me in any capacity. employees and have workers' (No%WkCM'comp,insurance COMB kLuuW r 2 9. Building addition required.) 5. We arc a corporation and its 10. Electrical repairs or additions 3. I am a homeowner doing ail work officers have exercised their 11. Plumbing repairs or additions myself. [No workers' camp. right of exemption per MGL insurance required.)t c. 152,§1(4),and we have no 12 Roof repairs employees.(No workers' 13. Other COMP. insurance rqwrcdl •Any applicant that checks box#1 must also fill out the section below showing their workers'eomprnsation policy information. t Homeowners who submit this affidavit indicating they art doing all work acid then hire outside contractors must submit a new affidavit.indrutmg such. 'Contractors that chock this box must attached an additional sheet shoving the name of the sub-contractors and state whether or not those entities have employees. If the tarn-contractors have unployees,they must provide their warners'comp.policy number. I air as eXiPLgvr Abut is pro► ding warim I coarpeAsa&r i:srtra4ce fjv w.V 4,OV&Yac Below is the information. pa4 3 aAd job cite insurance Company Name: Policy#or Self-ins.Lic.M Expiration Date: 1obSiteAddress: _ 14-40 OLD 5T!} City/Stalc/Zip: Attach a copy of the workers'compensation policy declaration page(ihowing 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$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA far insurance coverage verification. I do hereby certify unde the pains and penalties of perjury that the information provided above is true and correct; i s bat 0 1. Phone#: ,SID IV$ —3,_+Sz Official use only. Do not write in this area,to be completed by city or town official City or Town: Permii/Licenst# Issuing Authority(circle one): I.Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: -:%S'1•. ♦. rr t K ..... n .•e :L r .. .. a S. n�.... n.... ..Mom. ...... ... ... •� Town of Barnstable : Building Department Services Bryn Floreaee�CBo Building Comminloner 200 Main Sbai,Hyannis MA 02601 wWWdown.bSMtsbk nUL ua Office: S08-862-1038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section. if Using A B lder L LQt"i 55 At%fC5 5e i XCts as Owner of the subject property hereby authorize'-1`y ug.STHo.S �VAc cat!� vc.. Z to as on my behalf in all matters relative to wotk autborized by this building pemut application for. 'tlZo Old 544ge Wirt MA ozb6 ir (Address of Job) "Pool fences and alarms arc the responsibility of the applicant Poois are not to be filled or utilized before fence is.installed and au final inspections are performed and accepted. Sikrdt=of CVncr f App'cant tar►sSco Aurfs 66xju (J0 Print Name Print Name 03 1 26,L n.9n Datc Q"RMS:OWNWE kh=IONMLS Rev:OWINI7 Scanned with CafnScanner r p . rHomeWorks Energy, Inc A����P� 6 a O J 1` Permit Cancellation Request 4P J. J. HomeWorks Energy is requesting the cancellation of the following building permit: Permit Number: 20-w w. Address: 1720 Old-Stage Road Barnstable-Massachusetts 02668 Reason:The customer has declined to move forward with the insulation and weatherization work. We will no longer be planning to perform any of the originally contracted work at the associated address above at this time. Please cancel out this permit that is attached to this notice. Please reach out to the specified number below if you have any futher questions regarding this. Thank you. Sincerely, Scott Veggeberg HomeWorks Energy Inc. CSL#103832 HERS Certification#3081658 HomeWorks Energy 101 Station Landing,Suite 110 Medford,MA 02155 wxpermitting@homeworksenergy.com (508) 216-6497 Town of Barnstable _ _ _ a W. Building • ewxa�rwei.s. iPost This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept v M'E $ ;Posted Until Final Inspection Has Been Made. Permit 163P �0 uaraa+° :Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made 1 Permit No. B-19-3791 Applicant Name: Approvals Date Issued: 12/03/2019 Current Use: Structure Permit Type: Building-Addition/Alteration-Residential Expiration Date: 06/03/2020 Foundation: Location: 1720 OLD STAGE ROAD,WEST BARNSTABLE Map/Lot: 152-004-004 Zoning District: RF Sheathings ha4/ Owner on Record: BROOKS, MICHAEL D& PATRICIA M Contractor Name: w��g: 1 F b�ly 4 Address: 37 CAPTAIN LUMBERT LANE Contractor License: P�kve z4 2 CENTERVILLE,MA 02632 Est. Project Cost: $25,000.00 Chimney: Description: expanding bedroom and masterbath above garage. remove garage Permit Fee: $ 177.50 door both sides and frame one,open another with sliding door. Fee Paid: $ 177.50 Insulation:�S�/y/2 0 build one full bathroom at the garage-garage converted into Date: 12/3/2019 Final: y ?p playroom/day care. expanding exsiting bedroom up stairs. Upgrade whole house for smoke detectors. � Plumbing/Gas Project Review Req: 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. ° The Certificate of Occupancy will not be issued until all applicable signatures by the Building and fire Officials are provided on this permit. Electrical 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. Work shall not proceed until the Inspector has approved the various stages of construction. Health "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: The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Invadgations 600 Washington Street Boston,MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lezibly NaM/(Business/Organizatim4ndividual): :t& _ Jo-CI Qo5cu Ar-rt5 a(_.O h'w0 &O4vM C -tc-! ") AAddress: 18. colmes kare, City/State/Zip: Cl nn i S Phone#: 56 8' 3 6 O - F96,6 /Z Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with- 4. ❑ I am a general contractor and I * have hired the sub-contractors employees(full and/or part-time). 6. ❑New construction 2.El I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling hi and have no-employees These sub-contractors have g, ❑Demolition ship wor for me in an aci employees and have workers y capacity. = 9. ❑Building addition [NO o [ WOIkers'COnlp.inc�nan� COIDp.]IlSlr"ance. �' No ] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions officers have exercised their I L Plumb' re airs or additions 3.ff I am a homeowner doing all work ❑ rep right[No workers'comp. right of exemption per MGL 12.❑Roof repairs msun ance ]t c. 152,§1(4.9 and we have no employees.[No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hue outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insnrance coverage verification. I do hereby certify under the pains and penalties ofperjwy that the information provided above is true and correct Simaiurre•.�� Date: Phon Ojj'icial use only. Do not write in this area,to be completed by city or town official City or Town: PermittLicense# 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#: 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 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 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 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-contractors)name(s),address(es)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 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 for f rture 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 bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would lice 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 Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 - Tel.#617-727-4900 ext 406 or 1-877-MASSAM Revised 4-24-07 Fax#617-727-7749 www;maw.gov/dia va BUILDING DEPT Application Number...... ................................... BARNWABLE, NO 8 2019 MAS& Permit Fee. ....`.77—t..l �6....Other Fee ....................... %639. TOWN OF BA"STABLE Total Fee Paid............................................................... ...... TOWN OF BARNSTABLE Permit Approval by..... ..... ................ona.-J-011....... BUILDING PERMIT Map..../.... .................Parcel..... ......... APPLICATION Section I - Owner's Information and Project Location Project Address 1 - ?-0 01 J Sict g C "Road —village wes+ Sarn5-able, Owners Name-L ct v-I's-5cu A�j('c-s 5e-1')(o 5 Owners Legal Address 3-4 &tp+ r) Lurnber+ ) a-rkc- city ceyAnviIle, State rnn Zip 0 Z 6 3.2./ Owners Cell # .50 T- 'F 1 S7 - '-I ro 4 E-mail Lay-is5aa re 9mo-L I - con-, FSection 2 -Use of Structure Use Group_ F-1 Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet ❑ Single/Two Family Dwelling Section 3 -Type of Permit ❑ New Construction ❑ Move/Relocate [:] Accessory Structure E] Change of use ❑ Demo/(entire structure) ❑ Finish Basement El Family/Amnesty El Fire Alarm Rebuild El Deck Apartment ❑ Sprinkler System ❑ Addition E] Retaining wall Solar El Renovation ❑ Pool El Insulation Other-Specify Section 4 - Work Description �-bvc milli!29 bectroom above 4-he- Garage 3o 18 orz rno5kr -�x,4)rcon-) nbove 4?-)e qCJY-0qb -aq e n-c Inq C,Ve ou 12,emove-) +'Kc 92 Y - door ( 6A 5 d e c l YA 1 one orem cl-no4v,&J W 1,4-h 5)*dE door. oy-te- f:Lill -1n4hf0iov-n cl Ric qg-,rage ( 4)ne garage will be. coy.\Vt f 4 -40 CL Qlo-,u room I �,-CaAt, edrcom ups4ou'r.5 —lip--likd 5C()Ove dnecla(s - T.R.q undated: 11/1 V701 R Application Number..............................................:..... Section 5—Detail Cost of Proposed Construch n$�� -Square Footage of Project Age of Structure ° , r v Dig Safe Number # Of Bedrooms Existing Total#Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method. ❑ MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics ❑ Wiring ❑ Oil Tank Storage ❑ Smoke Detectors ❑ Plumbing ❑ Gas ❑ Fire Suppression ❑El Heating System El Masonry Chimney Add/relocate bedroom 1� I Water Supply ❑ Public ❑ Private Sewage Disposal ❑ Municipal ❑ On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: I am using a crane ❑ Yes ❑ No ,i Section 7—Flood Zone j Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No ❑ Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq. Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required Proposed I Rear Yard Required Proposed Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No Last updated: 11/15/2018 I I` F Application Number........................................... Section 9- Construction Supervisor f Name Telephone Number Address City State Zip I License Number License Type Expiration Date Contractors Email Cell # I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your license. Signature Date Section 10—Home Improvement Contractor Name Telephone Number Address City State Zip Registration Number Expiration Date I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your H.I.C... Signature Date Section 11 —Home Owners License Exemption Home Owners Name: 4a "55cu Ay reS S6XctS Telephone Number Cell or Work Number 50 F- Fl S - 9-6�- I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and 1' documentation required by 780 CMR and the Town of Barnstable. Signature Xct Date 11 1 OF 1 Z Ot C' . APPLICANT SIGNATURE Signature Date 1 i/0 7 Z 01 Print Name La Y ,S 5a, A V feS Se i XaS Telephone Number 50? -S l S• :-6-41 E-mail permit to: La r 105 5a au re-na q mct i/ o tom , T Aet nnriAted- 11 n 5noi A r Section 12 —Department Sign-Offs Health Department CCI Zoning Board(if required) ❑ Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation ❑ For commercial work,please take your plans directly to the fire department for approval i Section 13 — Owner's Authorization I, , as Owner of the subject property hereby i authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of job) Signature of Owner date Print Name a 1 1 I `J I i i i Last uvdated: 11/15/2018 .eve _ _ _Town of Barnstable _. _ w . _ Building Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept MwS& ¢ Posted Until Final Inspection Has Been Made. Permit i63¢R�6' a9. Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit No. B-20-584 Applicant Name: HOME WORKS ENERGY INC. Approvals Date Issued: 02/26/2020 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 08/26/2020 Foundation: Location: 1720 OLD STAGE ROAD,WEST BARNSTABLE Map/Lot: 152-004-004 Zoning District: RF Sheathing: Owner on Record: SEIXAS, LARISSA A Contractor Name:' ,HOME WORKS ENERGY INC. Framing: 1 Address: 37 CAPTAIN LUMBERT LANE Contractor License: 181138 2 CENTERVILLE, MA 02632 Est. Project Cost: $2,658.00 Chimney: Description: insulation Permit Fee: $85.00 Insulation: Fee Paid:, $85.00 Project Review Req: r' Final: Date: 2/26/2020 Plumbing/Gas Lam' r��Lj a Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after`issuance. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. - - - - — Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work:, 1.Foundation or Footing . Rough: 2.Sheathing Inspection - 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT I 1 �t1eE t DEPT• Application number...... ..'�� ..-Sg. ... �. Fee ................... ....?5.................................... g 2 510 MAMF� Building Inspectors Initials... .. ' 63 TOWN OF BARNS""" ql Date Issued....C!. L0 Map/Parcel.......l.5A..-OC�y..-OOY TOWN OF BARNSTABLE E�MAer,� s � EXPEDITED PERMIT APPLICATION: SCANNED ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION FEB 1610 0 Address of Project: 1720 Old Stage Road U,) NUMBER STREET VILLAGE Owner's Name: Larissa Seqxas Phone Number 508-815-7674 Email Address: Cell Phone Number Project cost $ 2658 Check one Residential yes ✓ Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: Date: TYPE OF WORK 0 Siding ED Windows (no header change) # Insulation/Weatherization 0 Doors (no header change)# Commercial Doors require an inspector's review 0 Roof(not applying more than 1 layer of shingles) Construction Debris will be going to CONTRACTOR'S INFORMATION Contractor's name Home Improvement Contractors Registration (if applicable) # ) � �� (attach copy) Construction Supervisor's License# l 0 3'�37, (attach copy) Email of Contractor Phone number ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER ............................................................ *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides? Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No . �l39 I -)Flame Spread Sheet of each tent must be attached. Provide a site plan with the location (s) of each tent '11S ; `T f food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model /I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures, specific inspections and documentation required by 780 i CMR and the Town of Barnstable. Signature Date I - APPLICA T'S SIGNATURE Signature Date All permit applications are subject to a building official's approval prior to issuance. 1 Frmr- - HomeWorks I Energy, Inc To whom it may concern, Scott Veggeberg is a current employee of Homeworks Energy Inc. and operates under our insurance policy. Policy numbers that Scott is covered by are as follows: Commercial General Liability: 793006065002 Automobile Liability: 6244378 Umbrella Liability: 7930060660002 Workers Compensation and Employers' Liability:ECC-600-4001017-2020A All HomeWorks Energy permits are pulled under his CSL license. The insurance provider is AIM Mutual Insurance Company. If you have any questions or concerns please contact Director of Weatherization Adam David Glenn at 774-365-2446 or adam.glenn@homeworksenergy.com. Thank You, Adam David Glenn Director of Weatherization HomeWorks.Energy. i ` The Commonwealth of Massuch usetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant.Information Please Print Legibly Name (Business/Organi..ationnndividual): Homeworks Energy Address: 101 Station Landing Ste 110 City/State/Zip:Medford MA 02155 Phone #:781-205-4520 Are you an employer?Check the appropriate box: Type of project(required): l I am a employer with 200 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have S. ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.x required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I I.[] Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12 ❑ Roof repairs insurance required.] c. 1�2, §1(4),and we have no Weatherization employees. [No workers' 13.❑■ Other comp. insurance required.] *Any applicant that checks box 91 must also till out the section below showing their workers compensation policy information. T Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. +Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they mast provide their workers'comp.policy number. /ani tan employer that is providing workers'compensation insurance for rary eanplrryees. Below is the policv and job site information. Insurance Company Name: NH Employers Insurance Company _ Policy#or Self-ins.Lic.#:#4001017 Expiration Date: 1/1/2021 Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP-WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. /do herehv certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: eol Date: Phone#:781-205-4520 / wxpermitting@homeworksenergy.com Official use only. Do not write in this area,to be completed by city or town official. City or.Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2.Building_ Department 3.City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: HOMEENE-01 LLARIVIERE ACORO" CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY)12/19/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS j CERTIFICATE DOES-NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Lisa Lariviere NAME: Foster Sullivan Insurance Group,LLC PHONE FAX 163 Main Street (A/C,No,Ext):(978)686-2266 301 1(A/c,No):(978)686-6410 North Andover,MA 01845 E-MAIL certificates@fostersullivangroup.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Homeland Insurance Company NY 34452 INSURED -INSURERS:Safety Indemnity Insurance Company 33618 Homeworks Energy Inc. INSURER C:NH Employers Insurance Company 13083 Homeworks IIC LLC 101 Station Landing Suite 110 INSURER D: Medford,MA 02155 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ,TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFFr411/2020 LIMITS LTRINSD WVD MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE ❑X OCCUR 7930060650002 4/1/2019DAEMI ETORENTED 500,000 PREMISES Ea occurtence $ MED EXP(Any oneperson) $ 10,000 PERSONAL BADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY jpeT LOC PRODUCTS-COMP/OP AGG S 2,000,000 OTHER: $ B AUTOMOBILE LIABILITY (Ea acIcidenNED SINGLE LIMIT $ 1,000,000 ANY AUTO 6244378 4/1/2019 4/1/2020 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY Ix AUTOSSWN p BODILY INJURY Per accident $ XAUS ONLY AUOTOS ONLY PeOacE,cidentDAMAGE $ A UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 X EXCESS LIAB CLAIMS-MADE 7930060660002 4/1/2019 4/1/2020 AGGREGATE $ 2,000,000 DED I X I RETENTIONS 0 $ C WORKERS COMPENSATION X AND EMPLOYERS'LIABILITY STAT TE ERH YIN ECC-600 4001017-2020A 111/2020 1/112021 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE � N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Evidence Only CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Homeworks EnergyInc. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 101 Station Landing Ste 110 Medford,MA 02155 AUTHORIZED REPRESENTATIVE _4_" ACORD 25(2016/03) @ 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Office of Consumer Affairs and Business Regulation. 1000 Washington Street-Suite 710 Boston,Massachusetts 02118 Home Improvement Contractor Registration Type Corporallan Registration', 181138 HOME WORKS ENERGY.INC. ey#raticn DYGMU21 .01 STATION LANDING STE 110 MEDFORD,tdA 02155 UPdate.Addroca and Return Card. 10 CoicaofCo uhetAffainaBusiaKSRe0e181bn R fValienvafldforindlvldualusaoNy HOME 19APROVEMENT CONTRACTOR TYPS:cwwa:« petBat it,e before expiration do[o.If round return ee: Roalatretl9z g&gWi,_anon office of Consumer ANafrs and Business RoguWw 18113a f)8103R0?1 10D0 Wash o st—ii-suite 710 Iit)M,E t'1CRK$ENERGY`NC Bpsten,h1 IIZt 1 I,IAXVEGGEBE?G r-.j�--- 101 STATION LANDING STE 1.10 o valid without signature 41EDreRD,WV n;i unvels9TE,xry• - . i Cornmonwe:inn of.a1.1SS3chusetts � F Construction Supeivisor Specialty y DiVis1011 of Plo1QSS1611al rLicewture - Board of Building Regulations and Standards Restricted to: d" CSSL-IC-Insulation Contractor Conl,iructrwl.'St)peWiGQr'SPLecsalty i - 1 GSSL-.103832 E spires:10113/2021 SCOTT VEGGEBERG ; B COVINGTON ST#1 _ BOSTON MA .#2127 ►t3v Failure to possess a cui ,tition.ofthe Massachusetts State Building Code is c. -or revocation of this license.- COrnrllissiort@r j,/.,:.a.,.t>n ,Y� ---= For intorrnatw,.about this license ~t Call(617)7273200 or visit www.mass.govldpl r Insulation/Air Sealing Permit Authorization Specialist: James Marcello Company: HomeWorks Energy Email: james.marcello@homeworksener Address: 101 Station Landing HomeWorks Cell: 781-974-7907 Medford,Ma 02155 Phone: 781-305-3319 Customer: Larissa Seixas Address: 1720 Old Stage Road Email: 0 West Barnstable,MA 02668 Site ID: 3969073 Phone: 508-815-7674 I, the owner of the property identified above hereby authorize HomeWorks Energy Inc., or their Partner to act on my behalf in obtaining any building permit that maybe required to perform insulation and/or Weatherization work on my property and all matters related to the work authorized by said permit if one is obtained. Any related permit application cost will come at no additional charge provided that the agreed Weatherization work is completed. In the event that a permit is pulled on your home for insulation and/or weatherization work,you may be required to have a final inspection scheduled and performed on the work by the building inspector in your town. !f this case relates to your job, you will be notified by Home Works Energy that an inspection is necessary and you will be given the proper steps on how to complete this process to close out your permit. EmailZJ4t---7 Customer Signature: � / _ Date: 2/7/2020 Larissa Seixas 1 v I . Page 1 c 0 g-;rl HomeWorks mass save Energy, Inc PARTNER 101 Station landing Ste 110,Medford,MA 02155 (781)305-3319 ext.120 Customer Name:Larissa Seixas Email:Not provided Phone:508-815-7674 Premise Address:1720 Old Stage Rd,Barnstable,MA 02668 Mailing Address:1720 Old Stage Rd,Barnstable,MA 02668 Project ID:3981330 Date:Feb.7,2020 Job Description Measure Description Location Quantity .Unit Total Costt Customer Costa WEATHERSTRIP DOOR&ADD SWEEP 3 each $240.00 $0.00 AIR SEALING 6 hr $480.00 $0.00 KNEEWALL FLOOR- 10" DENSE R-32 CELLULOSE 65 SF $140.40 $35.10 ATTIC FLAT- 15"OPEN R-52.5 CELLULOSE 576 SF $1,071.36 $267.85 VENT BATH FAN THRU ROOF 2 each $237.50 $59.37 VENTILATION CHUTES 10 each $34.90 $8.72 4"x 16"SOFFIT VENTS 5 each $144.55 $36.14 ATTIC HATCH:SEAL& INSULATE 1 each $60.00 $15.00 Project Total $2,408.71 _ Total Contractor Price and Payment Schedule HomeWorks Energy, Inc.agrees to perform the above described work,furnishing the material and labor specified for the listed tota price. Payment ofthe balance of the customer contribution is expected upon completion of the work. Customer Signature: `` Date: >I' Customer Phone: �� ,/,•y Specialist Signature: //�/ / .% /ate UMRED TIMF OFFER: The prices and incentives in this contract are subject to change in accordance with the sponsoring utility MassSave Home Services Program offers. Proposals can be sent to:inbox@HomeWorksEnergy.com I SCANNED ' l� FEB 2 6 2020 o e-� �� PLAN VIEW Name:L?r5S Se%,Ic+ Site ID: Y 9G �'07 3 Finished Sq. Ft: / 7 3 / Phone: 509- Y h; - W- y Year of House: 9��_ Electric Acct#: /y(S /4 960 9 Address: / 72 0 01 A Sf--.-!�,e 1`4 #of Floors: Gas Acct#: 0 5 y'7 30/I o f I Oc-5,�Ya Unit#:0,96(V#Occupants: a Housing Type? 4 DUCTWORK INSPECTION Ducts Insu,25 D near Ft. Duct Square /i Duct Air SealingHou 13 141s- 1 n j� f� J0��� Duct Ins ti6n J` u Insulation Removal BASEMENT INSPECTION Existing Seeing Ln/Sq.Ft. - - Bsmt Wall AG Crawl Ceiling Crawl Rim Joist Bsmt RJ w/Sill "4-,A f Bsmt RJ NO Sill Vapor Barrierl sqft. Bsmt Door Y N Blower Door? WALLS&GARAGE Drill Location? Siding Ceil.Height Existing Speeing S .Ft. Framing Exterior Wall 1 x x / Balloon/ atform Exterior Wall 2 x x Balloon/Platform Overhang x x Garage Wall x x Balloon/Platform Garage Ceiling x x Insulation Removal Sgft. Sweeps:5 WX Stripping:3 WORK SPEC'D BUT NOT CONTRACTED AOAD BLOCKS PRESEN MANDATORY) Attic I lBasement/Crawlspace I Other: K&T Y Moisture IYALWombustion Sfty IY Kneewal) I 10verhang/Garage Asbestos Y/)M Mold>100 sq.ft JY YflCO Detector Missing Y Ductwork I I Exterior Walls Vermiculite• Y/ Structl Concerns Y Other: Notes for Lead Vendor/Work Not Contracted: t KW WALL AND KW FLOOR 81ind Spec? ❑ OR KW SLOPE AND GABLE END Blind Spec? JFFTr Why? h ?SPEC'ING SQ.FT FRAMING EXISTING SPEC'ING SCI.. WALL X)6 3+;9 B —~ SLO X X FLOOR Ix )D X\ . �t QN, GABLE X X ACCESS x at`P — TRANS X iRA-- X X aka ATTIC TTIC [� �L ^� i t SLOPE X X LOPE x d x w 0 EXISTING VENTING? EXISTING VENTING? 'o EXISTING PIPES? Y/N i KW Venting Vent OF OF Hose Damming Sheathing Access Temp Access KW Ve ng -. ent B Temp Access R to )3A lino /'y+� �p'�pre- lt"rr �t3 5�6 UU ! �to (-a: ti(/ � j 0 P V s � C;) Insulated Wall X X Reed Light O Ins.Hose BF Vent OF FBF-VI Chim.O Damming 12'Root VaM 12RV Air Handler® ow Temp Access D Pull Dn DS Hatch© Wall Hatch "/ Door D/ r Roof Vent RV O ;11316 VOI: X .0058story) x X (p ATTIC 1 Blind Spec? . ❑ x x I(D' ATTIC 2 Blind Spec? ❑ (2 story)1Existing Spec'ing Sq ft Existing Spec'ing Sq ft (3story)Unfloored I `f� V4O-LG S"Ot3L .S7 Cross Batting Floored -- �-�" Floored — t6loq nsulation D Work Cath Sl0 o e _�^— Cath Slope — se on Walls — — Walls — - Access otY — Access a Gn krt t 9 Venting Propavents Vent BF BF Hose Dammingennng Pro avents Vent BF BF H se Damming e / ox:(d y L 'f 1(� TempAccess: I CL X, X CL �/ ( X Sheathing Access: 5u to - R.L Covers: ! ��Sp.FV 300= (Exist NFA Venting)_ (Needed _4 Sp.Ft/300= (Exist.NFA Venting)_ (Needed Existing Venting? r 1 NFA Venting) 7 Lit t� �I I NFA Venting) Roof Type p, I � g g? �� � cr✓ Existing Venting? � F �O ��ll nyl� Page 2 c o �- HomeWorks mass save Energy, Inc PARTNER 101 Station Landing Ste 110.Medford,MA 02155 (781)305-3319 ext.120 Customer Name:Larissa Seixas Email:Not provided Phone:508-815-7674 Premise Address: 1720 Old Stage Rd,Barnstable,MA 02668 Mailing Address:1720 Old Stage Rd,Barnstable,MA 02668 Project ID:3981330 Date:Feb.7,2020 Weatherization incentive ($1,266.53) Pre-Weatherization barrier incentive ($250.00) Air sealing incentive ($720.00) Total Program Incentive -$2,236.53 Customer Total $172.18 Total Contractor Price and Payment Schedule HomeWorks Energy, Inc.agrees to perform the above described work,furnishing the material and labor specified for the listed tota price. Payment of 1 e balance of the customer contribution is expected upon completion of the work. Customer Signature Date: Customer Phone: ' Specialist Signature: ,� Date: uM(TM TIW OFFER: The prices and Incentives In this contract are subject to change in accordance with the sponsoring utility MassSave Home Services Program offers. Proposals can be sent to:lnbox@HomeWorks£nergy.com i Project Summary Name: Larissa Seixas HomeWorks Energy,Inc. �O Phone: 508-815-7674 101 Station Landing Email: 0 Medford,Ma 02155 Site ID: 3969073 781-305-3319 HOITI2WOf� Energy,Inc. MASS SAVE Cost Incentive Air Sealing $720.00 $720.00 Weatherization _ $1,688.71 $1,266.53 Duct Sealing $0.00 $0.00 Duct Insulation $0.00 $0.00 MASS SAVE REBATES Incentive Preweatherization Barrier $0.00 IC Rated Lights $0.00 'Dryer Vent $250:00 'Attic Floor Removal $0.00 *Rebates may only be applied as reimbursement of your cost to the Contractor for services rendered. t t BEYOND MASS SAVE QTY Cost Vent Dryer-Convert Basement Window to Wood 1 $250.00 Total BMS Costs $250.00 "Additional listed work may be a requirement of the insulation proposal. HomeWorks will only remove those line items if completed prior to install date.All work performed beyond Mass Save carries no incentive.Attic Floor Removal rebates may only be applied if HomeWorks Energy completes the flooring removal. SUMMARY Cost Incentive Mass Save $2,408.71 + Beyond Mass Save $250.00 TOTAL PROJECT $2,658.71 $2,236.53 Total Copay $422.18 Customer Deposit Applied $50.00 FINAL COPAY (due on completion of work) $372.18 HomeWorks Energy, Inc. agrees to perform the above summarized work (Mass Save & Beyond Mass Save), furnishing the material and labor specified for the contract price (Total Project).All work is subject to change,and homeowner's approval is required for completion of any and all work. Preferred Day-of Week for Insulation Install: Customer: Date: 2/7/2020 LariskkaSeixas 7 l Specialist: Date: 2/7/2020 es Marce to james.marcello@homeworksenergy.com 781-974-7907 v.18 Construction Supervisor Re:Address 1720 Old Stage Road (or)application# Name Scott Veggeberg Telephone Number 508-273-7593 Address 101 Station Landing City Medford State MA Zip 02155 License Number 103832 License Type l Expiration Date 10/13/19 Contractors Email N/A Cell# 508-273-7593 I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your license. Signature Date_ I .E t Cut i Calibrr �11 - A A �% Wrap Text 1 General ®. copy - g j U - �. - i - A - _ = - #= �= ®A4erge 8.Center - $ - a/o t ( F o oa Conditional Format Cell Insert Delete Format Painter i — _— da �.a Formatting- as Fable Styles- - - Clipboard Font ry Alignment r-„ Number r Styles Cells C12 f fg A B C D E F G H 1 Application 'Address rParcel _ Owner Description _ _ GStatus �Received Est.Start �— - - : 2 20120127 720 OLD STAGE ROAD !152004004 !BROOKS, MICHAEL D&PATRICIA.M WATER HEATER 'Expired 03/05/2012 _201203408 1720 OLD STAGE ROAD �152004004 !BROOKS, MICHAEL D&PATRICIA M BOILER Expired 06/08/2012 4�201203409 1720 OLD STAGE ROAD_ 152004004 ,BROOKS, MICHAEL D&PATRICIA M BOILER Active 06/08/201.2 r 5 i 201404821 1720 OLD STAGE ROAD J52G04004 BROOKS, MICHAEL D&PATRICIA M REPLACE SERVICE FOLLOWING FIRE ,Complete`07/25/2014 6 77093 1720 OLD STAGE ROAD 1152004004 BROOKS, MICHAEL D&PATRICIA M -REROOF STRIP ICo mplete 06/07/2004� 06/07/20(K Town of Barnstable Building z 4 Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept 1AMSrABILK ASS �� Posted Until Final Inspection Has Been Made. 039. Where a CertificatePermit of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit No. B-19-893 Applicant Name: William Callahan Approvals Date Issued: 03/21/2019 Current Use: Structure Permit Type: Building- Insulation- Residential Expiration Date: 09/21/2019 Foundation: Location: 1720 OLD STAGE ROAD,WEST BARNSTABLE Map/Lot: 152-004-004 Zoning District: RF Sheathing: Owner on Record: BROOKS, MICHAEL D 8, PATRICIA M �-_ Contractor Name:' tiWILLIAM CALLAHAN Framing: 1 Address: 1720 OLD STAGE RD `I Contractor License: CS-095581 2 WEST BARNSTABLE, MA 02668 I v ��* Est. Project Cost: $5,530.00 Chimney: Description: Insulation/Air Sealing I Permit Fee: $85.00 ( Insulation: Project Review Req: ) ( Fee Paid:' $85.00 Date: ,` 3/21/2019 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. 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 bublic inspection for the entire duration of the Final Gas: work until the completion of the same. I ✓ I — —1-11 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 Rough: 2.Sheathing Inspection - 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). yI-- Fire Department Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT C5 Final: �oFt ,�y Town of Barnstable *Permit# 'g Expires 6 months from issue date yl' ' Regulatory Services Fee A�5 - 00 ' BnsrtsreBLA • 16 Thomas F.Geller'Director Building Division X-PRESS PERMIT Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 J UN 7. 2004 Office: 508-862-4038 Fax: 508-790-6230 TOWN OF BARNSTABLE EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY i raj Not Valid without Red Z Press Imprint 6 Map/parcel Number e � � �� 0 o q Property Address 1-j (:) 01cl S e_ V Q. Residential n Value of Work Owner's Name&Address u 4(ftUa "" " "%S 11 0 W Contractor's Name y�---- �`^ 11 Telephone Number— 49M Home Improvement Contractor License#(if applicable) T v Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance CheA one: am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Worka='s Comp.Policy# Permit Request(check box) E?(Re-roof(stripping old shingles) All construction debris will be taken to AAA Q`spcga-1, _Dumz 1� ❑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 with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. Improve t Contractors License is required. Signature Q:Forms:expmtrg Revise053003 ofT T°�ti Town of Barnstable Regulatory Services s 8 Thomas F.GeBer,Director 1K AM i639. ��� BuRding Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 office: 508-8624038 Fax: 508 790-6230 Property Owner Must Complete and Sign This Section If Using A Builder •.;as.Owner.Af the.subject prop rtp-- b.eb. hereby authorize .J _ N . . . . .to"act on rn- y �• in all matters relative to work authorized-by this building permit-application for: nm (Address o ob) sigaature of Owner Date Print Naive Board of Building Regulations and Standards License or registration valid for individul use only / HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registrat1gh:', 124310 Board of Building Regulations and Standards lll...11ll' Eiipi�ati .n:':;g)1/2005 One Ashburton Place Rm 1301 :).,. `Type Ind!' Boston,Ma.02108 ' mes Curley dames Curley 287 Fuller Rd. Centerville,MA 02632 Administrator Not valid without signatu P QUERY PERMITS: QUERY END QUERY PERMITS PENTAMATION----------------------------------------------------------- 07/02/04 PERMIT NUMBER 77093 PARCEL ID 152 004 004 1720 OLD STAGE ROAD PERMIT TYPE BROOF BUILDING PERMIT ROOFING DESCRIPTION REROOF STRIP CONTRACTOR PERMIT FEE 25 . 00 VARIANCE STATUS A ACTIVE CONSTRUCTION TYPE 750 GROUP TYPE 1 APPLICATION 06/07/2004 EXPIRATION VALUATION 5300 . 00 DATE ISSUED 06/07/2004 COMPLETED DEPARTMENT-----STATUS---DATE-----DEPARTMENT-----STATUS---DATE---- (N) EXT/ (P)REVIOUS/ (C) ONTRACTORS/ PR(0) PERTY/ (I)NSPECTIONS/ (H) ISTORY/ (F) EES/ (A)RCHITECTS/ (V) IOLATION/ (E)XIT t � pey C"- •TM TOWN OF BARNSTABLE Permit No. __--26837A —------ *ARM = Building Inspector cash — OCCUPANCY PERMIT sons _ � Issued to G. 2•i. Development Corp. Address Lot D, 1720 011d� Stage Road, best Barnstable Wiring Inspector c > Inspection date Plumbing Inspector�I Inspection date Gas Inspector �, ^ A Inspection date XEngineering Department Inspection Inspection date Board of Health �,yy,, �o / [in C� n� Inspection date r� 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. ................ .... r.�17.. 192 ...........1,140 / Build ing Inspector I m'�Py���•. TOWN OF B.ARNSTABLE • _ BUILDING DEPARTMENT _ »�T TOWN OFFICE BUILDING i639 HYANNISa MASS. 02601 1 MEMO TO: Town Clerk FROM: Building Department DATE: An Occupancy Permit has/been issued for the building authorized•by Building Permit $k._._�._.�' _ ... . .......................................... issued to ...1 ....,!.�.: .. ... ._ :� ...._... ...... issued Please release the performance-.bond. �• TOWN OF BARNSTABLE Permit No. 25837# ---------------------- ----- �. Building Inspector cash �YL T%t IPORtutY -- --- -- �eyo. OCCUPANCY PERMIT Bond __ N/A Issued to G. 11. Develop*tent Corp. Address lot D 1720 Old StgaP Rc nd— GIPst Aarnntabi p Wiring Inspector Inspection date Plumbing Inspector \ " Ilk Inspection date Gas Inspector ��n Inspection date Engineering Department `+ U Inspection date Board of Health ,` Inspection date 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,ACC RDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. (` 1 ..................................._........._....... 19-1�_2 ........................::...................................... _.._..__ _ ��" Building Inspector 4. TOWN OF BARNSTABLE 26837 .. Permit No. ---------------------------- t VAMIT. ' . : Building Inspector Cash ` %; g TEMPORARY OCCUPANCY PERMIT Bond ---N/A----------- Issued to G. M. Development Corp. Address -- lot D 1720 Old Sta¢e Road. West Rarnatahle Wiring Inspector Inspection date /�f� Plumbing Inspector f Inspection date Gas Inspector <' ��/1 ; Inspection date JtJ ' j Engineering Department � ,\A1�1 y v Inspection date Board of Health / Inspection date , 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 M ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. `A 19 _ ............... ...........�................�; -........._..._......__._._ 'Building Inspector } { / F • • ZD q-T �` • CERTIFIED PLOT PLAN SCALE : � �' = Ste' RATE I CERTIFY THAT MAT IS SHOWM ON THIS PLAN GROUND AND COMFORMS IS AS IT EXISTS ONTHE . TO THE TOWN REGUTATIOMS j BOYLE ASSOCIATES �j Assessors map and lot number .... .... ..... ` SEPTIC SYST THE INST Sewage Permit number ALLEY IN IEf11!/I►�30NN � AAa r,s House number. .................... ..7 �C).0��.................... T 7'0 WN.REGitdgL - a TOWN OF ,BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...... ........1..,1.u,,���•.»,G�...........................................:.. .TYPE OF CONSTRUCTION . 8,61. 1L...................................................: .............`.7...!. .....1.................19...PY' TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the followingg�information: Location �•-o'j' .. '° .. �' ..? �,n So.�p� ......Q..f�4. ........ ... .............`!V...r�............. .... ProposedUse ...... ............................................................................... .....................................................:... Zoning District ...... . . '.��c�,�a ...�.......F..............Fire District .............. 3.4, w r.. . . . . .......................................... Name of Owner G }...�or+P...Address ........7.1 ...M.a.!. ...5 ....... - .... 11 Name of Builder ...�•:.Q.v.`.5...... ...C.Q.`1 X.p..............Address ......7.A.R. 6... .......... 1 .........4�..•7.5......... �Rrna.q.Name of Architect .��4�1�S�.1f>.�....��S`.°+►�.......Address rn � } ..... Number of Rooms ............6� ...................................................Foundation .... ....60 . Exterior 4`G-. Qar ......I.."�!.C1.,. ...�.Q.ca ..Roofin ........... ........................... ... ..... .. . ................... g Floors P?: p 4 .................................................. .... ^"' .... ............................. Interior .. ..`lee`�' �C) Heating ......... W......0.C.)......................................Plumbing ........ l h..................................................... A o Fireplace .........�e�}............................................................... pproximate Cost ....... .............. ....._./....................... Definitive Plan Approved by Planning Board _______ Area .................. Diagram of Lot and Building with Dimensions Fee �J .... ©a........................... SUBJECT TO APPROVAL OF BOARD OF HEALTH 1-7 , ) s 3� bs OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Nam . ..........L... .. E.......... Construction Supervisor's License .................................... L • �G. M. DEVELOPMENT CORP. 26837*4V' TWO SV No ................. Permit for .....*............................... A Single Family..p�y�4,ygip' ....................... Lot Rd Location ...... . ................West Barnstable............................. ti Owner ..G-...M....Deve�qpmeri ... .... ......... ...... .............. Type of Construction ....Fr ........................... ................................................................................ Plot ............................ Lot ................................ Permit Granted ...August 14,... 84 .......... ............19 Date of Inspection ...................i9 Date Completed .....:.................. ......i1q 0) Assessor's m'6p7and t number � �..... .........:..... B o; ( ��Q� ��i► ,�- Sewage Permit number ......................................................... BARNSTLUL House number ..^. .., ........ 9o„�M a � 39 \� OM TOWN OF BARNSTABLE BUILDIH*G : - INSPECTOR r. APPLICATION FOR PERMIT TO Cc�hS .`..`!.�. 0..L".A.I. .. .................................:.......:.. tv II. '' .. TYPE OF CONSTRUCTION W O ............�...I. ............... .19...Y TO THE INSPECTOR OF BUILDINGS: ' The undersigned hereby applies for a permit according to the following information: Location ......LP'T.Q....... .......RA............` ..... ��n S�u.��............................................ ProposedUse ......0Akr9%1-.\.!............................................................................................................................................. Zoning District ...... . .4'. .��' .1."...�....... ................Fire District ............ 14.................................... Name of Owner .. ..n' ... '-g.\. e ...�S?ri,P.....Address ........ .....`^...5 ........ ..... ..S Name of Builder ..... .............Address ..... .�:............� J Name of Architect .���!��S1.Ya.l�..... .p5`.�}►n.......Address rna r �U..—.n `� c.'Y......YA R........................°... Number of Rooms ............ ...................................................Foundation .... ...Q..,;rce1......c� ..........................`�............. r Exterior .... A Roofing a Floors �--`^ °-" ^- ......Interior .........J.�e.. � o C\� t Cffl. ? .................u.................................. 2 Heating -.1" .w...... .�.:.\...............:...:..................Plumbing ........ ..!.�......`'............. Cv c) U Firepp Approximate Cost lace ...............7........................................................... .............. p� ...Definitive Plan Approved by Planning Board _______�_!3_'._______19__f-'_� . Area �:��...........�.-S...../u� Diagram of Lot and Building with Dimensions Fee ......6.� ..�........................ SUBJECT TO APPROVAL OF BOARD OF HEALTH l�9 y v b OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. %'fit ' . Name ............................................0./.y.s �./. ........... Construction Supervisor's License ..................................... G. M. DEVELOPMENT CORP. A=152-4-4 TWO story No ..... Permit for .................................... .......SnJ a.Fami.l . Udell ixi y.. g. ..................... Location ... ..Old-Stage..Boad... ................ ............................. Owner ... .............. Type of Construction ................................................................................ Plot ............................ Lot ................................ Permit Granted .... 14.......... 19 84 Date of Inspection.....................................19 Date Completed ......................................19 • TOWN OF BARNSTABLE Permit No. 268 i 7A %WI Building Inspector cash '�tO pY OCCUPANCY PERMIT Bona issued to G. H. Development Corp. Address Lot D, 1720 Old Stage Road, hest Barnstable Wiring Inspector Inspection date Plumbing Inspector { �w� Inspection date / Gas Inspector �. n Inspection date xEngineering Department /:;�' ✓/'�/ / /�. Inspection date Board of health ,� Inspection date - � r 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 11�OF THE MASSACHUSETTS STATE BUILDING CODE. //)) a. 19 � .G ........................................... .._.........._...._._.__ y/ Building Inspector 3 C , -- .�_ w _ � _ _ � __�� w-��_ ___. ��� -._..�. - .� r _ .� _. _ � -. � ��. rr.w- rl..__r...�._, rr'.�... - � ._�..r _ . wrr.r� .��. �+�.��. _._r� _ .. � .� _ ___ .. ... .� � • - ...r - - ... ..r - �J..�. SMOKE DETECTORS REVIEW ED 4NSTA B DING DEPT. DA T w 12- FIRE DEPARTMENT DATE �UILDI BOTH SIGNATURES ARE REQUIRED FOR PERMITTING NG oEPT NOV 0 8 2019 TOWN OF BARN STABLf ZS-7^ I t� KtrcI46'N OAy CARE- lGrea�r 0 k3ED I L i Vi nt6 teCal 0 51co �n 1720 0[-0 SA(sc 'ROAD s WEST BARN:V TA CE P1 A OZ663 r �. 8-6 h► 1� b - � b ris I ^- 1 ATTIC iZA L � ; L WALKIWO CLO56T 0 �1 MAs lie t3�'D 5 r - Pr,at� _ 51co HALL r--— — — — ——— oPrw 6PACC- 14 I -- - -f RMC A - IN06x —� OEMoLlTtoN PROPOSC'O secolvo pzook r—m .NeW WALL 1720 OLO STAGE f2Oqa tZ' r w6ST (3ARNSTA8/E MR 02665 . 1:25 1 Y 1 f� i I • 6€D 2 IN- I � — — — — - - ODEN SaAGE ATT�c I I - -- — -- — — I A77/G i FX/ST/NG S�coNA ��o�a�e 1720 oi-D STAGS' ROAD scAVE wEST awfvSTAOLE-A4A OZ668 �:ZJ