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HomeMy WebLinkAbout0016 OLD TOLL ROAD 61Y 70-11 IQ& R Ozlxford NO. 152 1/3 ORA E TE 10% ® e a o f�Gc. S C) GI �Im Town of Barnstable Building HAMSTABLIL Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept AOL ,� Posted Until Final Inspection Has Been Made. G63 Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit Permit No. B-20-2406 Applicant Name: Adam Glenn Approvals Date issued: 09/04/2020 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 03/04/2021 Foundation: Location: 16 OLD TOLL ROAD,WEST BARNSTABLE Map/Lot: 109-067 Zoning District: RF Sheathing: Owner on Record: OLIVER,BENJAMIN ROBERT&JEANNIE Contractor Name: HOME WORKS ENERGY INC. Framing: 1 Address: 16 OLD TOLL ROAD Contractor License: 181138 2 WEST BARNSTABLE, MA 02668 Est. Project Cost: .$2,364.00 Chimney: Description: Insulation and air sealing work in the home Permit Fee: $85.00 Insulation: Site ID 3995051 Fee Paid: $85.00 Project Review Req: Date: Final: 9/4/2020 Plumbing/Gas Rough Plumbing: tsu This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuan2. icia Final Plumbing: All work authorized by this permit shall conform to the approved application and thelapproved 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. Final Gas: I applicable signatures b the are provided on this ermit. The Certificate of Occupancy will not be issued until al pp g y e Building and Fire Officals p p, Electrical Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing1 Service: 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�i Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation 7.Final Inspection before Occupancy Low Voltage Rough: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Low Voltage Final: 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: Engineering Dept. Ord floor) Map q Parcel 7 tom} Permit# House# F- f Date Issued Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) 7/7117 Fee Conservation Office(4th floor)(8:30- 9:30/1:00-2:00) P —dg) SEPTIC Sy T BE I�rfini �=e rr _, Sara 19 INSTALLE IANCE W1 TOWN OF BARNSTABLrPWRONME DE AND TOWN REGULATIONS Building Permit Application Proje reet Address 704/6 0101—Tut ;P0,9D i:•5y Lda-•-11 7 j A Village WgAeVJSf t_� P Owner 'P A/S- 15-AMJe}/ Address Jb Oil `ROLL Ron- Telephone Permit Request Qox �dlo�r�i9ry First Floor p7aa square feet Second Floor square feet Construction Type Estimated Project Cost $ f .o v Zoning District Flood Plain — Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family WOO' Two Family ❑ Multi-Family(#units) Age of Existing Structure VC. Historic House ❑Yes RI-I-o On Old King's Highway ❑Yes ❑No Basement Type: U4l ull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No.of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: 59 Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes �o If yes, site plan review# Current Use Proposed Use Builder Information Name Telephone Number -,r'o Y1 36 2 7 2 Address lt9 14,e, License# D O 5/a1 7 L O Home Improvement Contractor# f a Worker's Compensation# a,, G/*O d/oZ /Z 8' NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE J DATE gg� BUILDING PERMIT DENIED FOR THE MOWING REASON(S) i FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: ti FOUNDATION (O ;. FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH `, FINAL GAS: ROUGH FINAL FINAL BUILDING7 - tr I 2 O DATE CLOSED OUT' * f l - ASSOCIATION PLAN,NO. „� Application to oil-Old Kings Highway Regional Historic District Committee in the Town of Barnstable for a 19 9 8 CERTIFICATE OF APPROPRIATENESS Application is hereby made, in triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings or photographs accompanying this application for: CHECK CATEGORIES THAT APPLY: 1. Exterior Building Construction: ❑ New Building ❑ Addition ❑ Alteration Indicate type of building: ® House ❑ Garage ❑ Commercial ❑ Other 2. Exterior Painting: 3. Signs or Billboards: ❑ New sign. ❑ Existing sign ❑ Repainting existing sign 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other (Please read other side for explanation and requirements). TYPE OR PRINT LEGIBLY DATE • 16 Old Toll Road Al2DRESS OF PROPOSED WORK West Barnstable, MA 02668 ASSESSORS MAP NO. IDS OWNER William H. & Therese Kenney ASSESSORS LOT NO. 67 HOME ADDRESS 16 Old Toil Road, West Barnstable, MA 02668 TEL. N0(508) 362-2397 FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if necessary). P.O. Box 52, Barnstable, MA 02630 Philip & Agnes Ahlgren 1 Old Toll Rd.. , .West Barnstable, MA 02668 Philip & Betty .Hi•rschberger . 11 Old Toll Rd. , West Barnstable, MA 02668 Richard C. & Linda-L. Kervin 27 Old Toll Rd. , West Barnstable, MA 0266$ AGENT OR CONTRACTOR Art Dolgoff TEL. NO. (508) 362-1172 19 McCormick •Dr. , West Barnstable, MA 02668 ADDRESS DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done (see No. 8,other side),including materials to be used, if specifications do not accompany plans. In the case of signs, give locations of existing signs and proposed locations of new signs. (Attach additional sheet, if necessary). u J �, e � E D� ' • Signed. Owner-Contractor-Agent Space below line foe Committee use. EFTS I 'E L44iRl D ljN e Certificate is'hereby Date ate imJUL I 11998 lNN OF BARNSTABLE 444 Approved ' ❑ IMPORTANT: If Certificate is a roved,approval is subject to the 10 day appeal period nrnvidaA in the Art ADDITIONAL INFORMATION FOR MAKING AND FILING AN APPLICATION FOR A CERTIFICATE OF APPROPRIATENESS The .four categories for which a Certificate of Appropriateness is required are: (application for demolition or removal is a separate form). 1. EXTERIOR BUILDING CONSTRUCTION (new or existing buildings): An.application is required for any exterior of a building to be erected or altered including windows, doors, siding, roof,. light etc., that will be visible from any public street, way or public place. The following scale drawings are required in duplicate with application: plot plan (if addition — show existing buildings in outline), floor plan and elevations. Also required are snap shots of existing buildings, where additions or alterations are to be made. No plot plan is required for addition or alteration which does not touch the ground. 2. EXTERIOR PAINTING: An application is required for any portion of a building, structure or sign to be painted that is visible from a public street, way or public place. Color samples must be attached to these applications. An application is not required when repainting existing colors, changing to white,or using colors approved by the Town Historic District Committee. 3. SIGNS OR BILLBOARDS: An application is required for any sign or billboard to be erected within the District, with the following exceptions: a. Existing signs or billboards on November 27, 1974 shall have until November 27, 1977 to secure an.approved Certificate of Appropriateness. b. Temporary signs for use in connection with any official celebration or parade or any charitable drive as long as they are removed within three days of the event. Certain other temporary signs that the Committee feels does not detract from the Act may be allowed with the prior permission of the Committee. c. Real Estate signs of not more than 3 square feet in area advertising the sale or rental of the premises on which they are ._ . erected or displayed. d. 'A single sign of not more than 1 square foot in area showing the name, occupation or address of the occupant of the premises on which they are erected or displayed in a residential zone. 4. STRUCTURE: An application is required to build or alter.any structure within the District which is defined by the Act as a combination of materials other than a building, sign or billboard, but including stone walls, flagpoles,hedges, gates, fences, etc. GENERAL REQUIREMENTS 5. Work on projects requiring approval shall not be started until the Certificate of Appropriateness has been filed with the Town Clerk by the Committee. Approval is subject to the 10 day appeal period provided in the Act. 6. No changes shall be made from the original approved specifications without advance approval of'the Commission on an amended application filed with the Committee. 7. A separate application must be filed with each project requiring a Certificate of Appropriateness. 8. Under heading of "Detailed Description of Proposed Work give detailed data on such architectural features asp: foundation, chimney, siding, roofing, roof pitch, sash and doors, window and door frames, trim, gutters —leaders, roofing and paint color. 9. Unless application is complete and legible and all material required is supplied, application will not be accepted or acted upon. Copies of the Act establishing the Regional Historic District may be obtained at the Town Hall. r Town of Barnstable ' Old King's Highway Historic District Committee SPEC' SHEET FOUNDATION 4' .concrete., 8" with footing and 2" dust cover FRONT: Red Cedar Clapboard. 5" weather light gray - match existing house Remaining Walls: lte Cedar 5" weat er. SIDING TYPE Mingles COLOi Natural Gas Fireplace direct vent CHIMNEY TYPE see specs COLOR 25 year asphalt 2 Tone Black to match ROOF MATERIAL shingle COLOR existing main house PITCH 6 pitch roof Change in bay window 8 ft. 1 in. x 4 ft-. 7 in. WINDOWS see specs Anderson SIZE (TW30-DHP3104220) i TRIM COLOR Light gray match existing house- N/A DOORS COLORS SHUTTERS vinyl .COLORS -Black GUTTERS Aluminum COLORS Light gray to match existing DECKS N/A. - MATERIALS GARAGE .DOORS N/A COLORS SIGNS N/A COLORS I N/A COLOR FENCE' . pms: Pill out completely, including measurements and materials/colors to be used. Three copies of this form 'are required for submittal of an application, along -with three copies of the plot plan, landscape plan and elevation plane, when applicable. .SPECSHT All plans submitted for approval shall be prepared to accurate scale without ` reduction, and clearly drawn so as to indicate the nature and extent of the proposed project. THE FOLLOWING INFORMATION, DOCUMENTS,AND PLANS MUST BE PROVIDED WITH YOUR APPLICATION TO THE OLD KING'S HIGHWAY COMMITTEE THREE(3)OF EACH, IN THREE U SETS APPLICATION: All sections must be completed SPEC SHEET: Complete applicable information PLOT PLAN: Show all structures on the lot and any proposed additions/changes to scale Certified site/engineered plans for new homes preferred DRAWINGS: All Elevations and please include Landscaping plans for changes in existing footprint and in new homes only. ADDITIONALLY THE FOLLOWING MAY BE SUBMITTED: PICTURES: Of area (s)affected; Street view for additions/changes. SAMPLES: Of materials/colors (i.e.color chart) AN APPLICATION MAY BE DENIED IF ANY OF THE ABOVE INFORMATION IS NOT PROVIDED WITH THE APPLICATION. THE FOLLOWING FEE(S)MUST BE SUBMITTED WITH THE APPLICATION UPON FILING MADE PAYABLE TO TOWN OF BARNSTABLE CERTIFICATE OF APPROPRIATENESS $20.00 CERTIFICATE OF EXEMPTION $10.00 CERTIFICATE FOR DEMOLITION $10.00 OR REMOVAL As of January 1, 1996, the applicant will be responsible for their legal advertisement. Please anticipate an invoice from the Barnstable Patriot that will be your responsibility to pay. The actual cost of the advertising fee will reflect the length of each ad. Approved Plans Please be advised that plans approved by the Old King's Highway Regional Historic District Committee may now be picked up at the Building Department. You no longer have to stop at the Planning Department before going to the Building Department. Remember, "There is still a ten (10) day appeal period'on approved plans'. This is necessary for each Certificate of Appropriateness and/or Demolition issued by the Old King Highway. Since the 10th day falls on a Saturday, your plans will be available on most Mondays unless there is a holiday, then the plans have to be picked up on Tuesdays. Thank You. APPIN70 WE SHALL BE PLEASED TO ANSWER ANY QUESTIONS REGARDING THESE APPLICATIONS: PLEASE CALL GWEN BROWN AT 790-6285 G O � n a xmanrm 'mo°ani a C O •��.. nor a aye x rn. 8.9'r.f „ _ .: r• a 6 cure vx mx.e..aren x..arena cmu exam UED NO � n u xaum rr ❑I emrar.rxncr: I — ® S ® x a•rr Hare a nsm ar`ram 6 r I h cr�v u HOtnffn LLLI n u.eairtm� �o°`�a r°'" 6'Y—'u 1J m PRavr T CLAP BOA" �:«. 1? xw I •x ___ �x pRa�f r x r rmrxo � O�' a _ I t r e�z�a•• I ———— t _ � �� �•f IOPINLYC f (8�R f10I IGe• — FRONT VIEW reas:r rI` $3 O� I '1 xmw m �_ta ' •50•-� r uer can � 7L� n SIDE VIEW v—rT 3r�E a v 4 � STEVEN M.LeSARON Buildv/Desi°ner ��• � W T90T8!®C8 P.11H iI 9'.T•rmoutA Ifr•.02879 q6B_ � tBo e fHHH td 1• 5�88j�9 � =s3 NowCRADB $Bill a ZsDHHT .vvre_a 8 9s EaIti 1 DRAWWG TYPE. �LFLODR PLAN f/I"�f'SCALd BACX VIEW fa^ors srreEr xusmsR: 4100 I w The Cunnnonivealth of Massachusetts �4-i� --_'=.t;:..- Department of Indrtslrial.4ccidents . i� • �- Office ol/nyesUgat/ons •:\�':'�: _=i:`' 600 N'ashin;;ton Street B/ISlott.A1usti. 02111 Workers' Compensation Insurance Affidavitrtil0 t information * _ _ Plcise PRINT le-'NZ_ T name_Z4 r7;;Lli` 1_ ne) I e- G/=r- iocitin `VC C--G----/t�/'l?/C,,.f� r_it% W /-/Y :/J-b 1_ t- 1:�JA nhnnc i4 r^CI9 I am a homeowner performing all wo • myself. 1 am a sole proprietor and have no one working in any capacity • -.r. .�_1 w-...�..«..�.w.�!�.�1ws.._a+�t�c1�.'+�Mw`.7.7R.�'i.•v.� .. W ... —�,`.�A~iw~....+.+ ►•ww..._=.. .. �. I am an employer providing workers' compensation for my employees working on this job, cnm 13 %, name: city• �/�/. �lh�'/yii! nhnnc#i• �4•` C� � ��,i� /�C ��r� insurnncern &:.Q(�2A.,l'L� iirrt! f°✓ri <%� t S __.,._...�. .. [] 1 am a sole proprietor. -eneral contractor, or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: �tidress• _-_ city: n ire ff• insurnnrr rn Policy 0 - __..._._ ... .._ ...�_�....... �....r++r .- ..r�..y.rw.i.3 - __ - ---•yam cnm env nnmv: addresc: rite nhnnc ft: s ^•>I insurance c -oli ,_s..�.�.—•.e—. Attach additional sheet if ncccssaP- -_,.; _�, ...<....�_ _.. .. - •: «�_jr :a..�..�+rw+..r�+ar�...x.lsy--•«____. .niFye.«__t:.-_�_.�aeft..sa:,:a. �y��........__�.-_��'e�YO'.�°-..d1•.�w:•::.+s�. Failure to secure coveraec as required under Section 25A of NIGL 152 can Icad to the imposition of criminal penalties of a line up ro S1.5ou.ou andiur one cars'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day against me. I understand that a cope of this statement may he forwarded to the omce of investigations of the DiA for coverage verification. l do herchr cerrift•rattler the pains and penalties of perjurt•that the information provided above is trues and correct. 9 Sicnature gig Date O �� Print name rT Ufi' 42G�ns.o��' Phone 9 n(ficial use only do not write in tl area to be completer!by city or town official city or town: permit/license rmit/license 9 Mudding Department ` ❑L►censing Board t t' [0 chctk if immediate response is required ❑Scicctmen's Office ❑11calth Department contact person: phone#: rlUther . the °• The Town of Barnstable �g Department of Health Safety and Environmental Services t1"96ag ` Building Division 367 Main Sheet,Hyannis MA 02601 Ralph crossen Office: 308-790-=7 Building Commissiaze Fax: 309-790-Q30 For office use only Permit na Date AFFIDAVIT HOME IMPROVEMENT*CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c 142A requires that the "reconstruction, alterations, renovation, repair, modernization. conversion, improvement, removal, demolition, or construction of an addition to any pre-existing t one owner occupied building co ofning at such residence or butilding be done by registered t not mom than four dwelling units or to structures which are adjacentcontractors, with certain exceptions.along with other requirements. 1st.Cost 44 O O 0 Type of work: . / 15 fir% - Address of Work. �. /�D/T Owner's Name Date of Permit Application: I hereby certify that: Registration is not required for the following renson(s): __Work excluded by law _Job under SI,000. Buiiding not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS .PULLING 'HEM OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS ARBITRAT WORK DO NOT � ACCESS TO THE ION PROGRAM OR GUARANTY FUND UNDER MGL c 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a.permit as the agent of the owner. f0 ame Registration No. Date atractor Y OR Owner's Name Date 4� � DEPARTMENT.OF PUBLIC SAFETY ' CONSTRIIC�ION SUPERVISOR LICENSE ,k - Exoires 5irtidaterj• Number.. 11 1°9q �i211111ag .• CSC�` o Res�tcte� f McCORMICK OR lJ BARNSTgBIE; 'MA .B2fi68 as .3T� e �i e�oons oieura¢ ./uaaead�uaella.r 0 jV. s Y YA�^% ' ry"iyi � AT "� ,{l�+'a.+r� � t�✓. NOMEIMPROVENENT CONTRACTOR frRegistration 104499 �7 ��5 31 raw n �yType �}}11},PRIVATE CORPORATION C � �9.I��Ff�Q t?'"�!^LQI�•'Y 1'.Wrt` I '.-r�;Y �tEzpirationS'�g01114/00 ��yt,�i ��: �"��'2ART DOL6p0�EF BUILDINfi/REMODELI�; �''S LDol9off �f ¢ �^ cCormIck =W kBarnstable5NA-0y2668�y + f G µ4 ME; `M 4,64 "w�J 1'',`,iJ.''1�41��;�}Vt.6ut `G yL�'^";ry, •N F-•. 14� 0 ~ 1 1 MAScheck COMPLIANCE REPORT Massachusetts Energy Code Permit # ; MAScheck Software Version 2.0 ; ; ' Checked by/Date ; CITY: Boston STATE: Massachusetts HDD: 5596 CONSTRUCTION TYPE: 1 or 2 family, detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 7-24-1998 DATE OF PLANS : JULY 23,1998 TITLE: ' MR. & MRS. KENNEY PROJECT INFORMATION: #16 OLD TOLL RD W.BARNSTABLE,MA. i I COMPANY INFORMATION: ART DOLGOFF BUILDING & REMODELING . #19 McCORMICK DR. W.BARNSTABLE,MA. 02668 COMPLIANCE: PASSES ` Required UA = 77 Your Home = 73 Area or Insul Sheath Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 372 38.0 0 .0 11 WALLS: Wood Frame, 16" O.C. 308 11. 0 3.0 24 GLAZING: Windows or Doors 36 0 . 320 12 GLAZING: Windows or Doors 24 0. 320 8 FLOORS: Over Unconditioned Space 372 19.0 18 ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design represented in these documents is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate Ihas been determined using the applicable Standard Design Conditions found , in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in sections 780CMR 1310 iN J4.� Builder/Designer Date ae,�l `���`{ 192,0 f , z [ ] ., Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. HVAC EQUIPMENT SIZING: [ ] ; Rated output capacity of the heating/cooling system is not greater than 125% of the design load as specified in sections 780CMR 1310 and J4.4. MISC REQUIREMENTS : [ ] Refer to 780 CMR, Appendix J for requirements relating to swimming pools, HVAC piping conveying fluids above 120 F or chilled fluids below 55 F, and circulating hot water systems. ----NOTES TO FIELD (Building Department Use Only)------------------------- A • ' MAScheck INSPECTION CHECKLIST , Massachusetts Energy Code MAScheck Software Version 2.0 MR. & MRS. KENNEY DATE: 7-24-1998 Bldg. ; Dept. ; Use ; CEILINGS : [ ] 1. R-38 Comments/Location WALLS: [ ] 1. Wood Frame, 16" O.C. , R-11 + R-3 Comments/Location WINDOWS AND GLASS DOORS: [ ] 1. U-value: 0.32 For windows without labeled U-values, describe features : # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location [ ] 2. U-value: 0.32 For windows without labeled U-values, describe features : # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location FLOORS: [ ] ; 1. Over Unconditioned Space, R-19 Comments/Location AIR LEAKAGE: [ ] ; Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. Recessed lights must be type IC rated and installed with no penetrations or installed inside an appropriate air-tight assembly with a 0 . 5" clearance from combustible materials and 3" clearance from insulation. VAPOR RETARDER: Required on the warm-in-winter side of all non-vented framed ceilings, walls, and floors. MATERIALS IDENTIFICATION: [ ] Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. Insulation R-values and glazing U-values must be clearly marked on the building plans or specifications . DUCT INSULATION: [ ] Ducts in unconditioned spaces must be insulated to R-5 . Ducts outside the building must be insulated to R-8.0 . DUCT CONSTRUCTION: [ ] All ducts must be sealed with mastic and fibrous backing tape. Pressure-sensitive tape may be used for fibrous ducts . The HVAC system must provide a means for balancing air and water systems . TEMPERATURE CONTROLS : 1 . ! + i 1 L r : - --a- ----- - --imr. Nil ! OL IPP 01 1 1 i ••��' } --}— � � I �i � i I i j ! i !rii i i —I i I ����''''��''��""''�� i--- I 1 a _ . tl L : : , I I _ ' • I i I 1 �- �•� i 1 � I ! j � I i I I , j: : n . i s _ i _ I ��� ,S 'T� f Y j� `�._.1�--..'__..�L.__r'—�—. __ - .. � __ .._,___L_j —I _�._-1•._._�L— I I L.-1—'_I ,.— � ~—_i_—t— I � � �, _a. i. ; Assessor's map and lot num er ... ...: -7............ d OEPTIC SYSTEM MUST BE r� i ........... ��:��"a1l.�.ED IN COMPLIANCE \"sITN A:�TICLE II STATE 9 SeVwage,_Permit number ........................_....................... , SANITARY CODE AND TOWN_ TOWN OF BARN XT LE r; u L y�FTFIET�� i BASBSTADDE; 9� 6 .e0� BUI.LDIN`G ' INSPECTOR wpv a APPLICATION FOR PERMIT TO .. ............................ . ............... .. ............. . .... .. TYPE OF CONSTRUCTION J°d......................T... .. I ............. ...`.% ...... ...............19,7 G TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies fgy a ermit according to the following information: Location ................................................................................................................1�...:t...F... ......:. 6/,.e........................ ProposedUse ....... 11..:. ........................................................................................................................................... ZoningDistrict ...................................../..................................Fire District .............................................................................. Name of Owner � ....`'0,!'% .�/y. C....Address .......0.6.q���....L, .. ....... �� 1�✓r��j/1'l Name of Builder Address ................................... Nameof Architect .........................J......................................Address .................................................................................... Number of Rooms..............7...............................................Foundation .... - �� Exterior ... ...'¢.....�?............ .... �...... Q„,......................Roofing ........ G.................................................. �/GiV Interior ..... . Floors Y/. /........./................................. Heating �% '../li �5..........................Plumbing ........ /........ / .`''�S .....�G .. Fireplace ......... ............................................................Approximate Cost ...............A.®®()....... .......................... Definitive Plan Approved by Planning Board -----------___—__—-----------19________. Area ���`�a.. ".. . Diagram of Lot and Building with Dimensions Fee / SUBJECT TO APPROVAL OF BOARD OF HEALTH �+. 10 , cl b r i� • I I hereby agree to,conform to all the Rules and Regulations of the Town of Barnstable regarding the above" construction. Name `�" .. .. ........... ..... ..................... . -Savery Co. , Inc. 18506 two story, No Permit for .................................... k-single family dwelling ............................................................................... Old Toll Road Location ................................................................ a a) West Barnstable 0 0 ............................................................................... 0 Savery Co., Inc. Owner .................................................................. 0 0 Type of Construction ...................frame....................... .............................................................................. Plot ............................ Lot ..........71A ...................... Permit Granted Juky 7,..... . ..................19 76 ti Date.of Inspection x .0 .;?;?,2., o. .d ..... 31171 1171 �/r a) Date Completed IV.Y.9.9..... ..........19 0 PERMIT REFUSED ................................................................ 19 c ° 10 . ............................................... ................................................................................. ............................................................................... ......................................................... E Approved ................... ....... I........ 19 0 ................................................................................ 0 ............................................................................... 1 WO; [�Yy ;. . _�. :. a. ° � ..y..__l... - - •-I— ' ; 1 i Tll Al Ir I I . r t 17 : �RA Yy -- - - -! : i M 3 ! I t To Date Time W LE YOU WE OUT M o of Phone Area Code Numb Extension TELEPHONED PLEASE CALL CALLED TO SEE YOU WILL CALL AGAIN WANTS TO SEE YOU URGENT RETURNED YOUR CALL Meese ge 4 Operator AMPAD 23-021-200 SETS EFFICIENCY* 23-421.400SETS CARBONLESS 7 - 7G Assessor's map and lot number ... ....f.......... 1�.....:...... d 0 Sewage,Permit number .........................(.:............................. yoFlHElo�° C 'TOWN OF BARNSTABLE i 33AWSTAMLe; i > o p9. BUILDING INSPECTOR APPLICATION'FOR�PERMIT TO ........ 77— ..............................ar✓�%f'`' L [i{/J oc1G/ �cz� TYPE OF CONSTRUCTION .............................:........................................................................:.............................. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location �.. ff.... e r�// _ J/ ��✓� �..:.T 7................................................. .......................:/;L;................................... ..................... ProposedUse; 9f-�''��I/ ��................ . .............................................................................. ........................................ . ZoningDistrict ........................................................................Fire District .............................................................................. Name of Owner .�/ ` �/ �...;..:,,. Address 2��4.. � �% / r,L Y ....:................................... ............0 r .... ........:.......................o...`....................................�......... r I 3 A ..................r.' Name of Builder ............... ..............:....... .......Address ................................w......................1.......................... ' Name of Architect .........................1.............. .........................Address ............Q...................................................................... Number of Rooms .............�...............................................Foundation .....` .. ....... ...................................................... Exierior ............. ...................d.......................,,.......................Roofing ........:.....,, ........................................................... Floors / �/litl�l �!/�r ,cJ . ........................................../..........................................Interior .............. ............................................... Heatingl�.�a........ .4 .Plumbing ........ .��...... ....` 4 c.f: ....1 .+..>..... Fireplace ......... .. ��.'.'.?............................................................Approximate Cost .............................. ..................................... Definitive Plan Approved by Planning Board -------------------_-----------19--------. ' Area Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH 4 � I 41, I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ' � .� � Name ............................. ................... Savery Co. , Inc. A= 09-67 ✓ 18506 two story, No ................. Permit for .................................... single family -dwelling ................................................................................ 0 C: 0 1 d 'Toll Road Location ... ............................................................v1 �2 - West Barnstable ............................................................................... 0 Savery Co. , Inc Owner.............................................. 0...................... 0 Type of Construction ...................frame....................... E . ............................. ........... ...................................... 0 Plot ............................ Lo ..........#71A �ot ...................... Permit Granted ............Ju ly. 7.. ..............19 76 a 7 Date.of Inspectio,. ......... ..........................19 Date Completed ... ..................................19 a 0 PERMIT REFUSED 0 ....... . .... ...... 19 ........11h-7 0 ............................................................................... ............................ ............................... Cu ...................... ........ ................. .............. .................. ....... . ... ..- A 'Pro .. Proved ......... ................................... 19 T 44) 0 ..p.....7p // 7**'***"**********'**'*""*"**** ...................... > 0 ..................................................................... TO A L EW USINESS OWNERS DATE: Fill in pl ase: � , its + A,•,s APPLICANT'S YOUR NAME: G BUST S N�n �� >r �r , a YOUR HOME ADDRESS: TELEPHONE/f L�!7-( yr' ,�rv� �:��� dr�,���= Telephone Number Home 0 � NAME OF NEW BUSINESS. C ab' A�5rtl 71'X ' TYPE OF BUSINESS Qa �iLT/itYa' IS THIS A HOME OCCUPATION? YES L�NO Have you been given approval from the building div'sion? YE NO 664s ADDRESS OF BUSINESS L� .T� �2 MAP/PARCEL NUMBER When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. Once you have obtained the required signatures, listed below,you may apply for a business certificate at the Town Clerk's Office (Ist floor-Town Hall). You MUST go to the following office to make sure you have all the required permits and licenses.. GO TO 200 Main St. - (corner f Yarmouth Rd. & Main Street) and you will find the following offices: 1. BUILDING COMS ONE Lof FF This individual has b�" [i4or an equ' ements that pertain to this type of business. AUVOKz Signature** COMMENTS: viz 2. BOARD OF HEAL-TV This individual has dee� informe 9th?,,,e!,r e s that pertain to this type of business. A prized Signature* COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informe f thP, licensi g requirements that pertain to this type of business. Authorized Signa re* COMMENTS: Business certificates (cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in the town (which you must do by M.G.L. -it does not give you permission to operate-you must get that through completion of the processes from the various departments involved. **SIGNIFIES APPROVAL FORA BUSINESS CERTIFICATE ONL Y. J k Engineering e • 3rd floorMap `,,✓� Permit# . g g D Pt. ( ) Ma P � �� Parcel �Y° l ,3 -s—!o House# Date Issu d - Fee 47� 19 , BARNSTABLE. MASS OWN OF BARNSTABLE 'E° `'�� Building Permit Application Project S eet Address Village t,0 . /tj /4 /2 /V S r'i4 3 C G `Lr 04 Owner Address Telephone Permit Request S `7 %1�C= - '®"r —'�- A S E Y15T 1 �, Ar (�'0 J First Floor �quare feet Sec�ond�loor square feet Construction Type - Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House U4es ❑No On Old King's Highway ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) B ement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No.of Bedrooms: Existing New Total Room Count(not including baths): Existing N First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing JDtached w Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Othe Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) j Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use �/' �� '�' >� r" wilder Information Name /Z D6�G—� T� �� « Telephone Number Address :✓—7 �2 � � � �/ TC'.r%! /L`0'License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO O 1 c0 SIGNATURE DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) ZZ j .. FOR OFFICIAL USE ONLY PERMIT NO. c r DATE ISSUED I MAP/PARCEL NO. - ADDRESS VILLAGE. - OWNER = DATE OF!INSPECTION: FOUNDATION } ` FRAME INSULATION `. FIREPLACE s ' ELECTRICAL: ROUGH FINAL r PLUMBING: ROUGH ^.FINAL _ GAS: . ROUGH FINAL r FINAL BUILDINGV/ DATE CLOSED OUT , ASSOCIATION PLAN NO. - s F�t11E The Town of Barnstable • awxrrerABUM • 16.19. ���' _ Department of Health Safety and Environmental Services Building Division ' 361-Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing-owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type..ofwork: `JT 12 i fo �' 12 P n l- Estimated Cost" D O Address ofWork: I LA-) , Owner's Name: 6 Date of Application: 91 a p' 9 1' I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job Under$1,000 Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: 9- `f / f(,0-(,/ Date Contractor Name Registration No. OR a Date Owner's Name q:fbrms:Affidav r:_-�---,--- The Commonwealth of Massachusetts = Department of Industrial Accidents == '- Office allnsestigaGons 600 Washington Street _. ;ems Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit name: A'067 641- � TV A-,10 A-Lt- D, /3.4 V'iL-10/17Z FI/U Cr location: —7 f AL P if 7 C city 'T tr /2 f Z,LCr l`'►l -• `�1�� phone# ❑ I am a homeowner performing all work myself. ❑ I am a sole ro i ietor and have no one workin in anv capacity //%%%O////10111%17////11111 ❑ I am an employer providing workers', compensation for.my employees working on this job. company name:. :::;:;::; . :.:. address::.... :. .. . ... phone#: insur nce co. olicv#. -: .. :... I am,a s le proprietor, neral contractor, or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: ' t�1 . "i ? "• t - comaanvname: TI ::::>:.:::..::,Fy . .i�'.: �. f!f}�'.: /:� -; ' C � .t?/ -/:.:;. .. >;:;. .;.. � zk a2�1�.. : :' IA �. :....J)..... ...... address. . :.... U :> ..<. �.,.;.. :.. .:. (� .:.... one :;::;::.:::;:: :.....;;;;; .: :::..;....::::: :..::.. .:... ..::::::...::: :::::.::.::::.:.::::...._.::.:_:::.:::......:::::::::;: insaranceco ::....:.../ `� ohcy.#.....: a>< >:<:>:<«:.::.::::::::::::::::;.,<;:;:::;:;::>::::>.»::><>:;<:::»>:;:;::....>:::::>:::::::,;: O»:> 811V'name- ......................:::<'::> 777777777777777M>>'.;a<i%si?i i:S:i:< 3 i'r'?>:;::<><>:>'< : <:>< _:> >»iS>::>:<::>:::>:::::, C mp address: citL. shone# ............ . :;.;....:.:... CV Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a tine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Offlce of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is truo and correct Signature Date Print name ©A&)e'T- Ty N� 1+CI — Phone# e/ ofIIcial use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Building Department ❑Licensing BL ❑checkff immediate response is required ❑Selectmen' ce❑Health Depent contact person: phone#; ❑Other (Devised 9/95 PJA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. < ► 1 i � ) S . C� ' ��1 � 4i <� Cl � � f� r ' - 1► �Ii' _� 3i ` ..� An employer is defined as an individual,partnership, association, corporation or other legal entity or any two or more of J the foregoing engaged in a joint enterprise, and including the legal representatives di deceased employer, or the receiver or trustee of an�individual,partnership, association or otherlegal 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 section 25 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,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 in the workers compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits 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.towri 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 Depaitm°ent at the number listed below. J City or Towns 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 perniit/license number which will be used as a reference number. The affidavits may be returhE Pe the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. : N . . . ► \ a The Department's"addi-ess,telephone and fax number: ► `` � ' -�• �� 1 ' \ � � The Commonwealth Of Massachusetts Y::l ks Department of Industrial Accidents Me of Invesugallons 600 Washington Street < Boston, Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 .. .. .. .... .I . 's t 4i, N, G r- t1 Y i �`�; R, ti � rr 1 y LYt� A Qcc i +� p g Vl, f-wti-.Q OC r I _ O a d O N eat.?. tS�>r iri�x i.ti 53sv r +fin •�`i Y _'Ni{�`fit S q�f^e^Kil,�f >^N�iS.t•j (p? F3 � � J a rY g''f�.�t�a�;i3.S,ye '.,�a�^•s* ....r�����'»�` ������ f ,ww�->, �\T ... •.tea.^_; 3 yi i q ' p i -CORD. CERTIFICATE OF LIABILITY INSURANCE ID 02 DATE(MMIDD/YY) OREYTI 07/30/98 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Burlingame Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Robert Burlingame HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 20D Post Office Sq ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Centerville MA 02632 COMPANIES AFFORDING COVERAGE Robert Burlingame COMPANY Phone No. 508-771-0105 Fax No.508-771-1258 A Legion Insurance Company INSURED COMPANY B Tim Morey & Patrick McCrum COMPANY DBA M&M Roofing C 9 Adams Road COMPANY W Yarmouth MA 02673 D COVERAGES 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. Co I TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE(MM/DDIYY) DATE(MM/DDNY) GENERAL LIABILITY GENERAL AGGREGATE $ COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG $ CLAIMS MADE r OCCUR PERSONAL&ADV INJURY $ OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $ FIRE DAMAGE1Anj one fire) $ MED EXP,(Any on"eison) $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM " WC STATU- OTH- WORKERS COMPENSATION AND TORY LIMITS ER EMPLOYERS*LIABILITY EL EACH ACCIDENT $ $10O 000. THE PROPRIETOR/ INCL WC3 022422 11/13/97 11/13/98 EL DISEASE-POLICY LIMIT $ $500r000, PARTNERS/EXECUTWE OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE $$1 O O OO O OTHER DESCRIPTION OF OPERATIONSILOCATIONSfVEHICLESISPECIAL ITEMS Carpentry - const of res< 3 stories CERTIFICATE HOLDER CANCELLATION ROBTYN1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Rob Tyndall BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBUGAT10N OR LIABILITY 37 Briar Patch Road Osterville MA 02655 OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Robert Burlingame ACORD 25-S(1/95) ©ACORD CORPORATION 1988 MIN III .MI ,. • -i_0! DATE :::;::............•.;..................::.:.::::i::::::::::i::::::::::::::i:::;:i:";;::::;:>;::;:;::ii:;;::::::;::;::;:::::>::::::;::::;::;::::::<::::::::::::::;::::::;:;::;:::::::::;ii:::::::::::::;::::::::>r:�:i:::5:.::.:::::::::::;::r::::::::::ii::::;:::i::i::i::::.::::::::i::>::::::::::::::::::::::::::";:i;::;:i:;:::� PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Fredericks Insurance Agency, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR F. 0. Box 427 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. S 1046 Main street COMPANIES AFFORDING COVERAGE Osterville MA 02655-0427 COMPANY (508) 428-8999 A UNDERWRITERS AT LLOYDS (f INSURED COMPANY M & M Roofing B 9 Adams Road COMPANY C West Yarmouth MA 02673- COMPANY (508) 771 9079 D 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, EXCLUS!ONS AND CONDITIONS OF SUCH POLICES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Co TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION OMITS DATE(MM/DD/YV) DATE(MM/DD/YY) 1 GENERAL LIABILITY GENERAL AGGREGATE $1000000 CGI.COMMERCIAL GENERAL LIABILITY UNASSIGNED 06/17/98 06/17/99 PRODUCTS-COMP/OPAGG $100000o CLAIMS MADE FX�OCCUR PERSONAL&ADV INJURY $ OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $1000000 FIRE DAMAGE(Any one fire) $ MED EXP,(Any one person) $ ' AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) ►aiaEO AUTOS BODILY INJURY nowaWNEOAUTOS (P«.«w«ro s PROPERTY DAMAGE • `l OARA09 LIABILITY AUTO ONLY-EA ACCIDENT 3 ANY AUTO / / / / OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM / / / / AGGREGATE $ OTHER THAN UMBRELLA FORM $ WORKERS COMPENSATION AND I WC STATU- OH- ORY LIMITS 1T EMPLOYERS'LIABILITY EL EACH ACCIDENT $ THE PROPRIETOR/PARTNERS/DECUTTVE INCL EL DISEASE-POLICY LIMIT $ OFFICERS ARE: D(CL EL DISEASE-EA EMPLOYEE $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS ROOFING CONTRACTOR �... SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL Tyndall Roofing _ oo DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Robert Tyndall, D B A BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 37 Briar Patch Road OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. osterville MA 02655 AUTHORIZED REPRESENTA :A .. 4J�,�. ..... .. .... . .1 :;;:.;;:.;;:.;:.;:;.;;>:::.;;r.;:.;;;:.;::.::::.:::::.:::.;:.:::::::::::........:::::::::.:;;;;:.:..:;;;;;:..........:::::.::.........................::.::::.::::.:::......................................... 5x/5 f—c'Argm /0-0 a IN h; V v v ' k Q GLOS. •N —_ �: _ Ej 3 /O x /5 (✓000 DEch ✓11RaIL 0, �' �FD�/ ), 23E—Ar I � I i� SGALE" �8 -�-O•• r} f aL24 SO ill 7 , 2 pncKelle¢ s �i/�iNG ��; — �(i ca/F A.1 —_ 7-fin7' il G O 0 �o�K3 3ox78 4 CTAF�FaCJ F V Q vi _ a N I I1-h ' 1co � E y 04 ——-- ---- -- 7 22 _ o -- --- - --- - ---� �_ -- - ------—- - r 34 x 8 0 6x8 2/1L 4X49"AL .3 o cn f ofic Aj f SCALE: DRAWN BY Sc,y«- /�} " =o" } SAVERY COMPANY INC. A!9-tea: REVISED RESIDENTIAL HOMES ANU BUSINESSES P.O. BOX 899 SANDWICH, MASSACHUSETTS k j i_- Z.z: .. : + cc.a�ao.�=�trT�feeuT'7 t 12 S on/o p"e"s 60'.vct7tGFtY' 4 ULL. WALC, tx!s .Ja str S — © / - r r a � r f j f 1 (eXB�i�j 4 f n `r/Y+aD BUCK �-- k/oaD nJGIt1i-nS ''f —__-- ZiD. _io.sjy iG � ' f ' tt , CQ �_.. ?fCAL 5 � Y 4 - arl .�'lQ✓CsLaN.+ +FtZi.'Jd: .gyp.-._.-....._..._._._..__�-. 4 � ' IA �" f /- e M .._..�� _ SCALE: DRAWN BY: if4• . SAYERY COMPANY INC. i, REVISED RESIDENTIAL HOMES AND BUSINESSES P.O. BOX 899 SANDWICH, MASSACHUSETTS DATE DRWG No. _ 77 II , IUndLj _J ___j - !L 1� -` { ( _ _ SCALE DRAWN BY: 1 ! i SAVERY COMPANY INC. _ REVISED Fir 1 RESIDENTIAL HOMES AND BUSINESSES FL P.O. BOX 899 SANDWICH, MASSACHUSETTS �� C_j / �' L L C ✓ °°! " i Co � DATE DRWG NO. L/a� ALNAN[N[® 8 L n+ nwa