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Home My WebLink About0091 PIONEER PATH oQuic TV NO. 152 1/3 OA y - - i p DEP HomeWork§,"1"1Gr r nUL 1..2 2021 Energy, Inc TOWN OF BARNSTABLE Permit Cancellation Request SCANNED HomeWorks Energy is requesting the cancellation of the following building permit: Permit Number: Address: 91 Pioneer Path Barnstable Massachusetts 02668 t 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, oxt4 Adam Glenn CSL:#106148 Ex: 7/30/2022 HomeWorks Energy Inc. 101 Station Landing,Suite 110 Medford,MA 02155 wxpermitting@homeworksenergy.com (781) 205-2201 . .. ....... I .• Application number. ...{. .... .I. ...... Fee.............................. ...:......................................... MAM' �,d 2N Building Inspectors Initials.. ................................ I�1�Ki��S i.u �_E Date Issued...... .I2,L..� ...................................... Map/Parcel...................l! TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SID1NG/WIND O W S/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: q( /o r r-c (I rn -e NUMBER lJ STREE VILLAGE Owner's Name: grri A r S�� `J Phone Number Email Address: Cell Phone Number Project cost$ C 0,�uU Check one Residential 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 © Siding 0 Windows (no header change)# Insulation/Weatherization 0 Doors (no header change)# Commercial Doors require an inspector's review 0Roof(not applying more than 1 layer of shingles) Construction Debris will be going to t-✓~mod f4 ggCONTRACTOR'S INFORMATION Contractor's name Home Improvement Contractors Registration(if applicable)# (6�c 6 0 (attach copy) Construction Supervisor's License# (attach copy) Email of Contractor ��Z exd (� 7 Q Phone number �— ALL PROPERTIES THAT HAVE STRUCTURES OVE 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......................................................r...... *For Tents Only* f" 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 Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent Fuel source being used LP tank 20 lbs. or>Yes No , if yes, a gas permit is required. Natural Gas Yes No , if yes, a gas permit is required. If 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 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. Signature Date PLICANT9S SIGNATURE Signature Date c7 All permit applicati ns are subject to a building official's approval prior to issuance. I � a A CA ZEAULT ROOFING & REPAIRS PROPOSAL Proposal No. 18-10518 September 29, 2018 To: Dennis Stampfl Work to be performed at Pioneer Path Centerville MA We hereby propose to furnish the materials and perform the labor necessary for the completion of: NEW ROOF(Front Main House and Garage) 1. Remove existing roof 2. Install aluminum drip edge 3. Ice&Water barrier first 2ft, all skylights and penetrations 4. Cover roof with 15 lb felt 5. Re-roof with 30 yr architectural shingle 6. Install ridge vent 7. Flash all pipes and penetrations Labor and Materials $6,200 All materials is guaranteed to be as specified,and the above work to be performed in accordance with the specifications and completed in a substantial workmanlike manner for the sum of Six Thousand and Two Hundred Dollars $6,200 with payment as follows: Three Thousand and One Hundred Dollars $3,100 with signed proposal and Three Thousand and One Hundred Dollars $3,100 due upon Completion Respec Richar*P. C�azeauilt,Jr. HIC# 168607 CSL#100393 198 Five Corners Road Workmans Comp and Liability with Centerville,MA 02632 Leonard Ins of Ost (508) 420-5482 Acceptance of Proposal No. 18-10518 The above prices, specifics ' ns and conditions are satisfactory and are hereby accepted. Yo are autthh n work as specified. Pa ent is Cline above. -- `-= `--'`--- ----- p -------- - - g Signature Date / *Removal of additional layers not foreseen will result in additional charge of$75 per Sq for removal and disposal I • The Commonwealth of Massachusetts 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 Le 'bl Name(Business/Organization/Individual): C Address: Ilk City/State/Zip: CGI -` p Phone#: --rO 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 employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' [No workers' comp.insurance comp.insurance.# 9. ❑Building addition 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 L❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),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 hire 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.Lic.#: 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 insurance coverage verification. I do hereby certify under the ai and penalties of perjury that the information provided above is true and correct Signature: Date: d- a l Phone#: 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#: 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 irriplied,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-contractor(s)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 permit/license 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 future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFB Fax#617-727-7749 Revised 4-24-07 vvww.mass.gov/dia DATE MMIDD CERTIFICATE OF LIABILITY INSURANCE ' NYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON HE CERTIFICATE HOLDER/THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER HE COVERAGE AFFORDED BY THE POLICIES BELOW. HIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND HE CERTIFICATE HOLDER. IMPORTANT. If the certificate holder is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. i 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 Help-U-Insure NAME: Maria DeOliveira ac No Ext: (508)998-0321 Arc,No: 2148 Insurance Agency,Inc. ADDRESS: maria@helpyouinsure.net 148 Acushnet Avenue INSURERS)AFFORDING COVERAGE NAIC# New Bedford INSURED MA 02745 INSURER A: Travelers INSURER B: Father&Son Enterprises,Robert DeMello DBA INSURER C: 160 Sconticut Neck Road INSURER D: INSURER E: Fairhaven MA 02719 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 INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUME PERIOD NT 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. LTR 7GENER�ATLUABILITY INSD tNVD POLICY NUMBER (MOLICY-11Y117 (POLICY LIMBS COMEACH OCCURRENCECUR PREMISES Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY JE C LOC OTHER: PRODUCTS-COMPIOP AGG $ AUTOMOBILE LIABILITY 01-�L=LIMIT Ea accident) $ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED AUTOS ONLY AUTOS ONLY (Peraccident) S UMBRELLA UAB OCCUR $ EACH OCCURRENCE $ EXCESS LJAB CLAIMS-MAOE AGGREGATE g DED RETENTION$ WORKERS COMPENSATION S AND EMPLOYERS'LIABILITY �( SPER OT-H TATUTE ER - A FFICERIME BER EXCLUDED ECUTIVE YIN NIA E.L.EACH ACCIDENT Mandatory In NH) 8H01971 04/05/18 04/OS/19 $ 100,000 ties describe under E.L.DISEASE-EA EMPLOYEE s 500,000 ESNIPT10N OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 100.000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) i CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN R Cazeault Roofing and Repairs ACCORDANCE WITH THE POLICY PROVISIONS. 198 Five Comers Road AUTHORIZED REPRESENTATIVE Centerville,MA 02632 Maria,T. veogve t.l-a. Commonwealth of i'•Aassachusetts Division of Professional Licensure ^ Board or 3uilding Regulations and Standards CS-100393 Expires: 02/03/2020 RICHARD P CAZEAULT;JR.' 198 FIVE CORNERS ROAD ``. CENTERVILLE MA 02632 Commissioner C"'- .�� ciiriiiiiiir<rl�c��Gmi-iicr�i�c/%i- -- .... • Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Individual before the expiration date. If found return to: Rnistratinn Expiration Office of Consumer Affairs and Business Regulation 7 168607 ___ 03/07/2021 10 Park Plaza-Suite 5170 Boston,MA 02116 RICHARD PC AZEAULT=JR�`�'' . - D/B/A R CAZEAULMR OOFIN-GA REPAIRS RICHARD P.CAZEAOLT 198 FIVE CORNERS•;RDY;:<: '` CENTERVILLE,MA 02632 ! Undersecretary Not valid without signature l i i "OSHA- ::U&Department of Labor ` Occupational 5aletyy:and Health Administrahon " p ' 6�tcharcl��at,IEt`��e I� :has successfully oompletpd a 1l3haur-Oecupat�onal Safety and MeaRh .,. � ' Sr�rnmg Course in' �y, I ConstructtOn Safe &.Hea@h LIM L�M,(rfalner) ;:. U ¢ iDate t.i CAPECOD 11WN OF BARNSTABLE INSULATION 20"3 AM, 9. 21 IIUR GLASS SSA 1- $PRATMAM SU S1-C. JARS OYR[RS INSUTANON CSIGINOS 1-800-696-6611 DIVIgTo f Town of Barnstable Regulatory Services Building Division aB 200 Main St �{f� Hyannis, MA 02601 ^r Date: -7110 f 13 Dear Building Inspector Please accept this Affidavit as documentation that Cape Cod Insulation, Inc. performed & completed the insulation and weatherization work at the property listed below. Cape Cod Insulation did this in accordance to the specifications listed on the building permit application. All work has been inspected by a certified Building Performance Institute (BPI) inspector. All work preformed meets or exceeds Federal & State Requirements. Property Owner Property Address Village Insulation Installed: Fiberglass Cellulose R-Value Restricted Unrestricted Ceilings ( ) ( ( �,�) ( ) (x) Slopes (X) Floors ( ) ( ) ( ) ( ) ( ) Walls ( ) ( ) ( ) ( ) ( ) Sincerely hECasJr, President on, Inc. I . TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION l , Map• Parcel W (� Application # C;)&3 j S Health Division Date Issued 3 Conservation Division Application Fee to Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address ls,�/C e.e�� Village �, �� , 111,elZ Owner �p[r,(j,� f� �'/ Address -S Telephone (Fie Y-!61 4 Z. Permit Request wb w Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation yP'o�D tU , o Construction Type v T 4&1 Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Or" Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes Z< On Old King's Highway: ❑Yes Jl H16 Basement Type: ❑ Full ❑ Crawl ❑Walkout 0 Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) N Number of Baths: Full: existing new Half: existing nP`& c? Number of Bedrooms: existing _new o Total Room Count (not including bath-,): existing new First Floor Room Count, ' Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other 2 Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/` oal stove°. ❑lTes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑existing 0 new size _ Barn: ❑ existing d new size_ Attached garage: 0 existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name /' ids C� / Jy/, �llcO Telephone Number_.f7/FZZ Address License # 4&_Aw,,5 Z2 Home Improvement Contractor# L521 Worker's Compensation #yr/i/�� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE .z s' FOR OFFICIAL USE ONLY r APPLICATION# � �a DATE ISSUED MAP/PARCEL NO. 4 ADDRESS VILLAGE OWNER DATE OF INSPECTION: r; FOUNDATION. FRAMEJ l r INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL f. F PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT z o ASSOCIATION PLAN NO. { rs it r P i e� 1 ":. AJassaclu setts - Delru•nuent of Public JafctN Boartf of Buil'tlin , 12c Marion, :uul �tnntl:uds construiction Supervisor License a �' - Licen CS 100988 HENRY CASSIDY -"Y .. 8 SHED ROW ' ` WEStT 'JARMOUTH, MA 02673 -_ Expiration: 11/11/2013 (',numissiuuer Tra: 7620 dy�'L/?YyGQ��Gll1C.Cl a ) A/1 jj/ LC/l1 �j—e Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 153567 Type: Private Corporation Expiration: 12/15/2`b14 Tr# 233831 CAPE COD INSULATION, INC HENRY ASSIDY 18 REARDON CIRCLE SO. YARMOUTH, MA 02664 Update Address and return card. Marls reason for change. Address ❑ Renewal Employment I.' host Curti ,rC:[[ll� Oj(i'<r.rrJJ(r[.'P[[[,le�� • �\ t)tlice of(:ousuwcr Affairs S Business 12egululiou License or registration valid for individul use only '7`''' OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: 153567 Type: Office of Consumer Affairs and Business Regulation tx, 7Expiration: 12/15/2014 Private Corporation 10 Park Plaza-Suite 5170 rra Boston,MA 02116 CAPF COD INSULATION,�•IN(i, HeNRY CASSIDY 18 REARDON CIRCLE SO YARMOUTH• MA 02664 — --�UudersecrY 4val' -- -- - re i CAPECOD-27 SPURDY A�oRo� CERTIFICATE OF LIABILITY INSURANCE j DATE(MMIDDIYYYY) _ 4/24/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such e_n_dor_s_e_m_ ent(s). PRODUCER — CONTANAME, Cape Cod Commercial _ Rogers&Gray Ins.-Dennis Branch PHONE 508 398-7980 FAx 434 Rte 134 (ac,No,Ext1(- -)398- 980 - - -- �_(A/c,No):(877)816-2156 .South Dennis,MA 02660 E-MAIL ADDRESS:_, ` INSURER(S)AFFORDING COVERAGE NAIC fl _I_wsuRERA:PEERLESS INSURANCE COMPANY __ INSURED l INSURER B:COMMERCE INSURANCE COMPANY Cape Cod Insulation Inc INSURER C:Evanston Insurance Company 18 Reardon Circle INSURER D:Atlantic Charter Insurance Company South Yarmouth,MA 02664 I 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. [ADDLjSUBR — - POLICY POLICYEXP - LTR TYPE OF INSURANCE 'INSR_If WVD POLICY NUMBER •(MM/DDlVYI'Y) (MM/DD/YYYY LIMITS �— _. -_ _ _ _.1�_ _ _.. _ GENERAL LIABILITY I EACH OCCURRENCE $ 1,000,000 i -DAMAGE TO-RENTED- A X COMMERCIAL GENERAL LIABILITY I ICBP8263063 4/1/2013 411/2014 PREMISES(Ea occurrence)_ $ 100,000. CLAIMS-MADE i X I OCCUR I j MED E_X_P(Any one person) j$ _ 5,000: PERSONAL&ADV INJURY_ ;$ 1,000,0001 I I GENERAL AGGREGATE $ 2,000,000: GENT AGGREGATE LIMIT APPLIES PER: ; ! I PRODUCTS-COMP/OP AGG I$ 2,000,000'- POLICY JECT L_j LOC +..-. COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY i t f !(Ea accidenQ _ L$ 1,000,000i B ANY AUTO I I 112MMBCKVMK 4/1/2013 I 4/1/2014 BODILY INJURY(Per person) I$ ALL OWNED I SCHEDULED I ' I AUTOS ' X I AUTOS ; I I BODILY INJURY(Per accident) $ NON-0WNED PROPERTY DAMAGE ; (PER ACCIDENT) $X HIRED AUTOS 'X I AUTOS j I$ X UMBRELLA LIAB I X i OCCUR i I I EACH OCCURRENCE $ 1,000,000, EXCESS LIAR I I I IXONJ453512 4/1/2013 I 4/1/2014 (AGGREGATE IS 1,000,000; C I CLAIMS-MADE , DEO � X �RETENTION$ 10,000 I$ WORKERS COMPENSATION i WC STATU- OTH-• AND EMPLOYERS'LIABILITY YIN - f X TORY LIMITS ,ER D ANY PROPRIETOR/PARTNER/EXECUTIVE IWCA00525903 6/30/2012 16/30/2013 l E.L.EACH ACCIDENT Is 1,00010001 OFFICER/MEMBER EXCLUDED? IN J N/A — — ' (Mandatory In NH) I i i E.L.DISEASE E-EA EMPLOYEE$ 1,000,000: If es,describe under ! DESCRIPTION OF OPERATIONS below _ I _ _-._._,._ - - _ _ _E.L..DISEASE-POLICY LIMIT i$ 1,000,000; -- - - I 1- L ' - - DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Is required) Certificate Holder is an additional insured under General Liability when required by written Contracts or agreements. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN EVIDENCE OF INSURANCE ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD \ The Cotnntonweulth q)"Massachusetts Nnn[horm L Department oflndustrialAccidents Office of Investigutions 1 Congress Street Suite 1 DU >`'•;...,...:: �'� Boston, 111�9 U2114-2U17 www.tnuss.gov/ilia �Vutrkers' Coll,pensation Insurance Affidavit: Builders/Contractors/�;lectriciatis/.Plumbers /kp )Itcalll 1nfo1-Illation Please Print Legibly Nall c (IW.SilleSs/Urganicatiou/Individual): (IJ la a *tfe V IM�' Phone#: r2O� — 77� - lZ arc wtu an cutpfoyer? Checkppropriate box: Type of project (requireO: 1 ;ut, a employer with Z� _ `1 ❑ 1 am a general contractor and l cnyplo)�ccs (I'uII and/or part-time).* have hired the sub-contractors 6. ❑ New consfrucliurt '. I .un ,t solo propriuTar or partner- listed on the attached sheet. 7. ❑ Renuodeling ,flip mid have no employees These sub-contractors have a, ❑ Demolition working, fur me in any capacity. employees and have workers' INo workers' corrtp insurance comp. insurance: # 9. ❑ Building addition rt.�yuircd.j 5. ❑ We are a corporation and its 10.❑ C;lectrical repairs or additions wu a homeowner doing all work officers have exercised their 1 I n Plun-tbing repairs or additions nt)scl I-. I No workers' cone right of exemption per MGL p 121-1 .Roof re ors insnr (Q anrc retlnircd.J r c. 152, §1(4),and we have no (pj ��tI D employees. (No workers' 13.� Other W t K — h ----`_---- comp. insurance,required.] ggdt%:wa tltat checks box #1 must edso till out the section below showiog their workers'compensation policy information. I I,mic„ ucr�who snbotit dais aflidavit indicating they are doing all_wa,rk and then hire outside contractors must submit a new al)idavit indicating such. t 011um'111j>that chock this box must attached an additional sheet showing the ntune of the sub-conu•actoty taut state whether or not dtose etttitiw have cnq,lu�a;• Irthc sub-contractors have employees,they must provide their workers'comp.policy number. I am an empGiVer that is providing workers'compensation insurance for my employees. .Below is the policy and job site iu/ur111itiml, lii nrni�: Company Natrte:_ (t��lrlL Gy�Uf-ec� I�l�yGtV-ayIC-& — —_ — hdlc� li to ticll=ins. L.ic. -l: WGA 00,�5 Z,15 q 0 1 Expiration Date: --�_....._._.. 1tth,iic address: ---_. City/State/Zip: - Attach a ropy of the worlcer-s' compensation policy declaration page(showing the policy number and expiration-date). I;Mare to secure wvUrage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties ofa liar up tat$1,500.00 and/or one-year impri§onment, as well as civil penalties in the form of a STOP WORK ORDER and a tine of tap it)$25t►.UU it clay against the violator. Be advised that a copy of this statement may be forwarded to the Office of hlvk-<ug,tuons of the; DLA for insurance coverage verification. I du herebl,certi*l.4naer the iains.agd penalfies o/ erlaary that the hilbrnzation provided above is true and correct. tii �ltuut:�._ 41;7 Date: 3 Ujlicial ave only. Do not write in this area, to be completed by city or town official. t ita ur'fowtt: Permit/License# Issuing Authority (circ)e one): I. lioard of I-lealtl► 2. Building Department 3. City/Town Clerk 4.11ectrical Inspector 5. Plumbing Inspector n.Other t'ontucl Verson: Phone#: PARMPAf1NG mass N ass save CohTWTOR te1.fqt tt.r.r.y,r..rro:r fft.-fe; PERMIT AUTHORIZATION FORM r owner of the property located at: (Owners Name, printed) (Property Street Address) (City/Town) hereby authorize the Mass Save Home Energy Services Program assigned Participating Contractor listed below to act on my behalf and obtain a building permit to perform insulation and/or weatherization work on my property. Owne s Si ature Date FOR CSG OFFICE USE ONLY Conservation Services Group has assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: -Participating-Eontracto Date Rev. 12132011 w .. * . Town of Barnstable Permit# �J Expire n onths roan is a dale Regulary Services Fe e �kler,Director Building Division k SEp To&Y.ef� ,CBO, Building Commissioner q 10 200� A5e Hyannis,MA 02601 1 .�.o�(v OF gP`R'www.town.barnstable.ma.us Office: 508-862-4038 . Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY `� 1 Not Valid without Red X-Press Imprint �� Map/parcel Number�� [ T� -\ Property Address_�/ ��)1� x Residential Value of Work ©� Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Contractor's Name i �f��C�1��i Telephone Number 72 `" Home Improvement Contractor License#(if applicable) f Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner C'I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# �Z Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) Vke-roof(stripping old shingles) All construction debris will be taken to %n?�� l✓ /! i j� ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. 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. A opy of the Home Improvement Contractors License is required. SIGNATURE: ' -04 , Z Q:Forms:expmtrg Revise061306 i . .: ✓lie T�anvrreazusealC� ��aonac�uoeCCa—; ` ---4-----� - �- •--- -_..--- Board of Building Regulations and Standards 1 License or registration.valid for individul use on!y HOME`�IMPROVEMENT CONTRACTOR before the expiration date. Iffound return to: _ Registration:`-100497 ; Board of Building Rcaulations and Standards. tion ti%18/2005 One Ashburton Place Rri 1301 Expira Tyn Boston,e Pr'yate Corporation Nia.02108 :• DAVID COX,INC. David Cox. .• ``; 19 LAVENDER LN W.YARMOUTH,MA 02673 Not valid without si e Deputy Administra natur tor g i • 4CORD CERTIFICATE OF LIABILITY INSURANCE VOP ID K DATE(MIti'>:er/0 DaID-2 07/2''/07 PRODOCER THIS CERTIFICATE IS ISSUED AS A MATTER.OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Northwood Insurance Agency HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 805 West Main Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Hyannis blA 02601 Phone:508-771-3.632 P'ax:508-393-2955 INSURERS AFFORDING COVERAGE �NAIC 9. INSURED INSUP,ERA The Norfolk S Dedham Group INSURER E Trhlei*ne I"urmce Conpany __ David COX, Inc. 114SURERC P. 0. Box 401 hNS;URER D: S Yarmouth MA 02664 INSURER COVERAGES THE POLICIES OF!'4SLIWlCE LL3T_D 3ELOW HAVE BEEN ISSUED TO TiE INSUPEC rl4h4EC ABOVE'OR THE POLICY PER:00 INDICA70.I CT•WITHSTANDRIG AJIY REGU XEMEVT.TERM OR C;i4Ci i IOG OF ANY,70NTRACT OR 01H_R COCIR&W 1-1TY.RESP`C i TC WHICH-HIS Cc�RTiFICATE WS BE!SlzIkD OP. MAY PERTAIN.THE INSURANCE AFFOFCECl EY TrE F•OL!C ES DESCRIBED iEREir:13•3b3!EC7-0 ALL-HE-ERMS,EXC_GSI0'4S)-hD CONDITIDV=CF SUCI- POLICIE3 aOgREC,G''E L�Id!TS^r4�N71 MAv Nov_6EEV REL4JD BY'.41D CLxJM': LTR NSR TYPE OF INSURANCE UL� p NUMBER i DATE IAMIDDIYYI D?.TE iM�C�T LIMITS GENERAL LIABILITY I EACH OCCURPENCE S$1,0 00,00 0 COtMERCfA GENERAL_N81L ITr pDREW SEES:E aeccu rencej i _ $SQ,Q00 CLAIMS MADE DC.-s:: (MED_KP;Any rns Person) S$5,0 00 A I X !Business Owners i R00309545 03/14/07 03/14/08 1PEPSCNAL8A_VINJURr S$1,000,000 I GEW.EFPLP.GGRESAT` S$2,000,000 I I iErr;AGGPEC.4_cLIMiTPAF_IE:PER: I I P3UDU'_T;i-CJMP/CPS:33 S$2,000,0DD I POL ICf r—jc,CT Ll LOC AUTOMOBILE LIABILITY hI COni6!VrD S!NGLE LIS IT I S ANY AU-0 I (Ea a:adem) I ALL C+.'aVEC AUTOS I BOD1"M.Uwe 1 SCHED1ILEDAL7CX3 I I I(Per pesdr, I I IHIREDALITOG It— IJ 'eCUIL°IN3J:Y I I I IF'3!awid?rri I r4ocl-a��NE��AUTO s I _I I P?OFEF,T'r.Gava3E (P•r axidan( b i GARAGE LIABILITY ( I AUTOONLY-E ACCID='•1T •S ~�AY AU-0 T TFz4N E.ACC +UTOONL : I S AGG EXCESStUMBRELL.A LIABRIT/ I I EA.".H OCCURPENCE !S j OCCUR CLAIMS:AADE I I I S DEDUCTIBLE I S I I RETENT Or. S I 1 I S WORKERS COMPENSATION AND V' I I TCr'Y LI.M�T EP. EMPLOYERS'LIABILITf --- ----- B 16KUB91OX742207 Q7/15/07 07/15/08 1 El EACH ACCIDENT S$100 000 ANY Fit',�RIETC'F..'Pi•RTN`4'E �JE i CF°ICER/NlEtAPER E:.OLLCED? 1 DISEASE-EA.Eiw-O'(EE $100,000 If yee,•describ?undx I � SF--C PL FRCVISIONS Wilid I E.L.C'ISE43E•FOLr:'i Jr,11T S$5Q 0,Q 0 Q OTHER I I I DESCRIPTION OF OPERA.TIOrIS/LOCATIONS/VEY.ICLES!EXCLUSIONS ADDED BY ENDORSEMENT i SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION TOWNBAR SHOULC ANY OF THE ABOVE DESCRIBED POLICIES BE CPAIIELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEA%,0R TO MAIL 10 DAYS'WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,SLIT FAILURE TO DO 90 SHALL TOWN OF BA U;STABLE IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 367 bAIN STREET HYANNIS MA 02601 REPRESENTATIVES. AUTHO R'PRESE _L � ACORD 25(2001/08) V ACOR.D CORPORATION 1988 I The Commonwealth ofMassachusetts Department of Industrial accidents e Office of Investigations d ' 600 Washington Street Boston,AM 02111' wtvw.mass,gov/dia ' Workers" Compensation Insurance.Affidavit: Builders/Contractors/Electricians/Plumbers A_pplicant Information Please Print Leo_i Name(Business/Organization/Individual): :�-:m- i� !,D ddAress: City/State/Zip: ' Phone. : 701 mployer? Check the appropriate bog: :Type of project(required):• e to er with 4. I am a general contractor and I mP y 6. ❑New construction . ees {full-mrVor art time).* • have hired the sub-contractors sole proprietor or partner- listed on the'attached sheet. 7. remodeling ship and have no employees These sub-contractors have g, �]Demolition working for me in any capacity. employees and have workers' 9, Building addition [No workers' comp.insurance comp,insurance.$ required.] 5. We are a corporation and its 10.[]Electrical rep airs or additions .3.❑ I am a homeowner doing ill-work . officers have exercised their 11.❑Plumbing repairs or additions ' myself. [No workers' comp. right of exemption per MGL c. 152 1 4 and we have no 12.❑Roofrepairs insurance.required.]t ' § ( �' n 13.❑ Other employees. [No workers' comp,insurance required.] *Any applicant that checks box Rl must also fill out the section below showing their workers'compensation policy information. t Homeowoers.who submit this affidavit indicating-they are doing all work and then hire outside contractors must submit anew affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the$ub-cont atom mid state whether brnot those entities have employees. If the sub-cont actors have employees,they must provide their workers'comp,policy number. lam an employer that isproviding workers'compensation insurance for my employees. Below is.the policy and job site information. Insurance Company Name: Policy#or Self-ins Lic.#: /�� . 7'Zy� Expiration Date: f lob Site Address: _____-_ _- City/State/Zip: .Attach a copy of the workers' compensation policy.declaration page'(sho-"ing the policy number and expiration date). Faiiure.to secure coverage as requred under Section 25 A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK,ORDER and a fine of ur to$250.00 a day against the violator. Be advised that a copy-of this statemerit maybe forwarded to the Office of Investisations of the DU for insurance coverage verification, ' 7 do hereby certify u er the pains•ard penalises of perjury that the information provided above is true and cc:?-rect. Siffiature: Date: Phone#: FBoard only. Do not write in this area, to.be completed by.city or town offNaZ n: Permit(r•icense hority(circle one): Health Z.BuildingDepartment 3.City/To rn Clerk 4.E,lectrical Inspector 5.Plumbing Inspector rson: Phone#: f °F THE T°x, Town ®f Barnstable. Regulatory Services BARNSr'� "$ '$ Thomas F.Geiler,Director 9. Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.to wn.b arnstabl e.ma.us Office: 508-8.62-4038 Fax: 508-7.90-6230 Property bier Must Complete and Sign This Section If Using A Builder Ai0,efljW , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: . (Address of Job) fA Signature of Owner - Date �nntName QTORMS:OWJ MRPERMISSION TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map -Parcel 06 0 / Permit# G O `yF3ealth Division sl 2) �,ONL Date Issued k w 'LIN 106 p F tk9 �R1�1� Conservation Division s U �0 Ua /UD CJ�R Application Fee Tax Collector m.rn 0 r- 1 D Permit Fee. Treasurer M m, (LK- a -�T;i. i E-2a f,9U5T FE Planning Dept. INSTALLED IN COMPLIANCE VVITK TITLE 5 Date Definitive Plan Approved by Planning Board ENVIRONIMENTAL CODE AND Historic-OKH Preservation/Hyannis TOV-W PEOOL?IONS Project Street Address T� /'/G✓1 �� (.✓ � �� f' Village Owner r,r�-- Address Telephone 6S%ter >; iOGc G' Permit Request ea�22 I ��z ryf/y- fea&' a - e)tiE Gkr� 42( Square feet: 1 st floor: existing 4'3G proposed 3 -76 2nd floor: existing proposed S° Total new G Zoning District Flood Plain Groundwater Overlay Project Valuati � --_Nonstruction Type W 4 -4zlyyt� Lot Size V Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. 0 Dwelling Type: Single Family ZTwo Family ❑ Multi-Family(#units)/ � X�- Age of Existing Structure 1.0 )L6 } Historic House: ❑Yes (�fGo On Old King's Highway: ❑Yes am Basement Type: 21Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) q L 8 Number of Baths: Full: existing new r' Half:existing CD new Number of Bedrooms: existing new I (/ 0-C e14 5f(ny bed iva)"5 "L,IV 8e e/�.a,�,•.� Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: 216as ❑Oil ❑ Electric ❑Other Central Air: O Yes Z-Pdsf Fireplaces: Existing New Existing wood/coal stove: O Yes ❑No Detached garage:O existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:O existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# F Current Use Proposed Use BUILDER INFORMATION C-`' �. Name4,,e4r- _ Telephone Number S off- �,�7F: Address 4License# 0 C' 1MAI-S+&�5 A , 15 11 t A Home Improvement Contractor# 1/0 O,)-3 M Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO G Ku 1B SIGNATURE DATE A � � d�- FOR OFFICIAL USE ONLY i PERMIT NO. DATE ISSUED a MAP,/PARCEL-NO. ° ADDRESS VILLAGE OWNER DATE OF INSPECTION: ! FOUNDATION, , O ©k FRAME ,B Y'/c m Q'1t � � 7z'o 3 INSULATION`- iyt0 ,� sz �Los! eA T , FIREPLACE a ELECTRICAL:, ROUGH FINAL PLUMBING:,--, , ROUGH FINAL ' GAS: ROUGFf FINAL aLJ FINAL BUILDING �-Sr/�'° .� l v�/p„� /F► , DATE_CLOSED OUT' ASSO,CIAT.ION PLAN NO. �' P � 1 P °*IKE,° Town of Barnstable Regulatory Services * RAMNSTasLE. ' Thomas F.Geiler,Director mass. 0:19.�A � Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601. Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,rriodernization, 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 of Work:_ clie, S. Estimated Co st Address of Work: q U 64 e_ G` "1'` Owner's Name: e �� Date of Application: O ?� I hereby certify that: Registration is not required for the following reason(s): OWork 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 1 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: 0 �� .11'etiq Ooa3 D e U ontractor Naol Registration No. OR Date Owner's Name Q:forrmhomeaffidav, RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.00 SC).0 0 Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET I 6 NEW LIVING SPACE C -1 -\ 6 square feet x$96/sq.foot= x.0031= 0 Q76 I plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x .0031= plus from below(if applicable) ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 :5-00—s -750 sfJ IF 50.00 = >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x .0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) t Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fee 3��• G projcost The Commonwealth of Massachusetts Department of Industrial Accidents effrce ollnyest�9at�ans - 600 Washington Street . .Boston, Mass, 02111 ' 3 Workers' Com ensation Insurance A f$da� � one: � •.. location: one# ci ' ' all work myself � ... •. • ❑ •I am a homeowner Performing c aci ' ❑ I am a sole zo rietoz and have no one workin in on this •ob. •' • FEE Y iiiii�i�iiaiiiiiiriiiiieiis W �giiiir�iarii�i�iiiriii�ii,�iii��ii�iiiii�i�ii /M/Ml come ationfor mp » ay prk8r$ P r?r x n. i<:.{,;.+"n.'•S,?Yt}n?•kkfty:��:;��`'f::?<:� y.tia{�.fi•.'.!t �-,v :ti�;yh•t�?y,:t�.#`•}C a`,`• 1 ravlchng ,x:: a•t;•nH;}oTkY;P..•}t}••:$;c:k,^ L4 {;Eiy",y�`'�':.�<: t2:;Fi{y',. atyt.#xty •}.,.b,..: rt.':•?•T.`.?; ::;y+ .•w :a: <Y iJi4•::¢af:`,y. e ,• fin. wn. am 8n "J,��C, :pn•r n,;{.y{: . �•:., !'<t:fr{:r4 :'.;•.•2typti.; •.,k�:::.. :;7 i%?,: '3:. `F#,xe•}{• ,?F.,<•Yii `•r.a{fi.'v}t::.r,... 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V:•., .?n.4 ....::• •r• .::.v..:•r?{..,4.:{:':r{{ �'x:•i r:.rr....{..r....'s,..y::...:s a:?:.r . {+r .. r.,n rr.,qs.{:x.;T..y;.•;r•r{{.}•{'.{... ,,:3. ✓.'2�'ti??Y''' ],' ....:...4...:.:. . ::.:sr.t...;r .r..�..�...,<,�,. ...:r.:: v.r tea..:..,•.. ..{�: ..}.,,: : "�.n r:FF:{:; o1�'e.;#s' r,y:.;v,r:.,y.:j..v. ,.:..tLr•: %•?t4 .•4 bs}•...}...;.n¢•'.•`i`,.#{4fh4G:: /, ,/,;r.4•r,:.}•r {rr,;:k.:rr:;r,..r,:r4-f•r,C r.•.:f�•r:!a?;{F•+ .:a •,;r;;,S'•`i•}:•}: •; E�hJiLI'Si2CL',;eo::s.rvfkh,:r-. lr}%r{piv,Jx4:!+Y:•}xY,S•:::r•x•n•.:. eL�of a ffinenp to 51,500.00 md/or IMMFIRWIN"yflu1e to secure coverage v requir,a ,a,r Secdon25Abf MGL 152 cah]ead to theitnposition of crurtinalp - es atipnsoltheDlAforcoveragey�cation one ears' ec=c c�*-� well as dvil p enalties in the form of a STOP FYORK ORD$R and a fine of$100.00 a day against me I mtdersfsmd that a' y emtma be forwarded to the OMce of Inv tig t - copy of this statem y correct - fyicrrcIerthep-ainsan - d- nalries-of-perjury-th�the-information-providedabvsee�sscuari I da hereby-c�erti Date V Signature �L -7o� 7O Print name da not write in this area to be completed by dty or town offidal afflcL�luseonly _ - 0BuJ1din2DepartmUd pemit/licenue# ❑Liceming Board city or towns - ❑Ce1_ect?le's's Offle_ contact p era on: ' Information and Instructions vtassachusetts General Laws chapter�152 section 25 requires all employers to np*the S workers'anger�er any their ees.._As quoted fromtbe_`w ' an employee is.defined as ev ryp .. hire,'enress or implied,inxPlied, Oral or An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing en Sed in a joint enterprise,-and including the Legal representatives of a deceased employer, or the receiver or association or other legal entity, employing employees. However the owner.of a trustee of an individual=partnership, .. house having not more thanthree apartments and who besides therein; or the occupant of the dwelling house of dwellingconstruction ,. another who employs persons to do maintenance, or�rtb d work be andempl house or onthe'groimds,or r. building appurtenantstate or thereto'shall not because of such employment MGL chapter 152 section p also states that everyto construct obuildings cal � n the comnionw alth for ng agency shall withhold any ipplicant who has of a license or permit to operate a business not roduced acceptable evidence'of compliance with the in coverage I tghe1perfoAdditionally, rznaaceo o pu=blic w until p political subdivisions shall enter y commonwealth•nor any of its 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 maybe PP artmeat.of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and submitted to the Dep '^ date the affidavit. The•affidavrt should�be returned to the city or townthatthe application for the perrnzt or license•i`s artiment of Industrial Accidents. Should you have any questions regarding the"lava fiif*_- Of being requested,not the Dep ease call`tlie D aitaieiit atthe ni=ber-listed below:. - equiredto ob}aui.a workers' compensatioixpolioy,pl eP . . . gaze r =` City or Towns provided a space at the bcrttom'of`"tbE lute and rutted legibly, The Deparimenthas p Please be sate that the affidavit a event Office of Investigations has contact y regarding the applicant._Please in the�� to you re ar affidavit for you , . �. bei�vliichwilLbe ns�d as a reference numb'er.�Tlie affidavits may 'e're' t� b c sure.to fill iri the.p erm %licens a riu�n _ eiitb"mail of FAXjnless other arraagei inents Havebeenmade the Departm ,t y......•+ • -- : .°. •. .. � a. '� .. should ou have an estions, . ations would like to thank you in advance for you cooperation and y , _,.Y�?. The Office of k-vestig. ,.s. _, �. ..,. please do not hesitate to 9L'v cis a call. _ Wo The Department's address,telephone and fax number. �_.,... .. The•Cammonwealthrof Massachusetts _ Department of Industrial Accidents - - O�lce of lnitestlgat[ot►s • 600 Washington Street Boston,Ma. 02111 , far#: (617) 727-7749 ✓/ze �a�rvncoozuie�ilC�. a�/fi�isxec/uusell Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 110023 Expiration: 10/2/2004 Type: DBA GREGORY C.VARJIAN BUILDER GREGORY VARJIAN 98 MOCKINGBIRD LN MARSTONS MILLS, MA 02648 ✓fie -Vanvi�uvrzurea�U a�✓l/ uoead BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number.CS O49825 j' Birthdate.':;01/31 L196.1 r Expires: 01/31/2004 Tr.no: 399 Res.rictedt';1 G GREGORY C VARJIAN _ 885:RACE LANE .. NIARSTONS MILLS `MA'Q2648 Administrator i I �. `1,: __ -,-�-- -�__ i,' � ��_ _�_,\ \� � � ` 1 -i � i _ _ ___._____..__.� ___._--_-� A 5-2� �S9 ± sF z2 ; N o • _ w G JM nAL ISSUE SL THIS PLAN IS NEITHER INTENDED "a DATE oESCIRPT " BY FOR, NOR SHALL IT BE USED FOR AS=BUILT FOUNDATION PIAN-LOT /3 MORTGAGE LOAN- PURPOSES. OAR,\/S.7-A4 MASS. .G-_2EENOR/Eg..6o�e.P oc Mq WALE: 40 JD8 No. I D .I CERTIFY THAT THE FOUNDATION PA A. cyv+ 0 ¢° Bo SHOWN ON THIS PLAN IS LOCATED LEVY 2 ON THE GRWS INDIC TE . No. I0617 y f _ ED HE ACTED ON THIS CARD CAN 1 � ABOVE. 1 NOT NGEONOR BY TELEPHONE OR WRITT r r Permit Number MECcheck Compliance Report Massachusetts Energy Code MECcheck Software Version 3.2 Release la Checked By/Date TITLE: GREG VARJIAN CITY:Barnstable STATE: Massachusetts HDD: 6137 CONSTRUCTION TYPE: 1 or 2 Family,Detached HEATING SYSTEM TYPE: Other(Non-Electric Resistance) DATE: 10/29/10 DATE OF PLANS: 102902 PROJECT INFORMATION: ROG BARNSTABLE COMPANY INFORMATION: MAP INS. CO. COMPLIANCE:Passes Maximum UA=289 Your Home=289 0.0%Better Than Code Gross Glazing Area or Cavity Cont. or Door Perimeter R-Value R-Value U-Factor UA Ceiling 1: Flat Ceiling or Scissor Truss 1040 30.0 0.0 36 Wall 1: Wood Frame, 16" o.c. 1490 13.0 0.0 101 Window 1:Wood Frame,Double Pane with Low-E 243 0.400 97 Door 1: Solid 21 0.350 7 Floor 1: All-Wood Joist/Truss,Over Unconditioned Space 1020 19.0 0.0 48 Furnace 1:Forced Hot Air, 85 AFUE COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the Massachusetts Energy Code requirements in MECcheck Version 3.2 Release Ia. The heating load for this building,and the cooling load if appropriate,has 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 red in Sections 780CMR 1310 and J4.4. Builder/Designer Date ' V V i I MECcheck Inspection Checklist Massachusetts Energy Code MECcheck Software Version 3.2 Release la DATE: 10/29/10 TITLE: GREG VARJIAN I Bldg. Dept. Use Ceilings: [ ] 1. Ceiling 1: Flat Ceiling or Scissor Truss,R-30.0 cavity insulation Comments: Above-Grade Walls: [ ] 1. Wall 1: Wood Frame, 16" o.c.,R-13.0 cavity insulation Comments: Windows: [ ] 1. Window 1: Wood Frame,Double Pane with Low-E,U-factor: 0.400 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? [ ]Yes [ ]No Comments: Doors: [ ] 1. Door 1: Solid,U-factor: 0.350 Comments: Floors: [ ] 1. Floor 1: All-Wood Joist/Truss,Over Unconditioned Space,R-19.0 cavity insulation Comments: Heating and Cooling Equipment: [ ] 1. Furnace 1: Forced Hot Air, 85 AFUE or higher Make and Model Number Air Leakage: [ ] Joints,penetrations,and all other such openings in the building envelope that are sources of air leakage must be sealed. [ ] When installed in the building envelope,recessed lighting fixtures shall meet one of the following requirements: 1. Type IC rated,manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2. Type IC rated, in accordance with Standard ASTM E 283,with no more than 2.0 cfin(0.944 L/s)air movement from the the conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. Vapor Retarder: [ ] Required on the warn-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 ti equipment must be provided. [ ] Insulation R-values,glazing U-values,and heating equipment efficiency must be clearly marked on the building plans or specifications. Duct Insulation: [ ] Ducts shall be insulated per Table J4.4.7.1. Duct Construction: [ ] All accessible joints, seams, and connections of supply and return ductwork located outside conditioned space, including stud bays or joist cavities/spaces used to transport air,shall be sealed using mastic and fibrous backing tape installed according to the manufacturer's installation instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not permitted. [ ] The HVAC system must provide a means for balancing air and water systems. Temperature Controls: [ ] 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. Heating and Cooling 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. Circulating Hot Water Systems: [ ] Insulate circulating hot water pipes to the levels in Table 1. Swimming Pools: [ ] All heated swimming pools must have an on/off heater switch and require a cover unless over 20% of the heating energy is from non-depletable sources. Pool pumps require a time clock. Heating and Cooling Piping Insulation: [ ] HVAC piping conveying fluids above 120 OF or chilled fluids below 55 OF must be insulated to the levels in Table 2. i f Table 1: Minimum Insulation Thickness for Circulating Hot Water Pipes. Insulation Thickness in Inches by Pipe Sizes Heated Water Non-Circulating_ Runouts Circulating Mains and Runouts Temperature(Fl Up to 1„ Up to 1.25" 1.5"to 2.0" Over 2" 170-180 0.5 1.0 1.5 2.0 140-160 0.5 0.5 Lo 1.5 100-130 0.5 0.5 0.5 1.0 Table 2: Minimum Insulation Thickness for HVACPipes. Fluid Temp. Insulation Thickness in Inches by Pipe Sizes Piping System Types Range M 2"Runouts 1"and Less 1.25" to 2" 2.5" to 4" Heating Systems Low Pressure/Temperature 201-250 1.0 1.5 1.5 2.0 Low Temperature 120-200 0.5 1.0 1.0 1.5 Steam Condensate(for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water,Refrigerant, 40-55 0.5 0.5 0.75 1.0 and Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD(Building Department Use Only) THE Town of Barnstable • OF >� • Regulatory Services t Thomas F.Geiler, suuvsr,�s�, • ,Director 9� MAM �. Building Division Tom Pe • 1'ry,Building Com missioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 PERIM, T#_ Y / 0® FEE: $ SHED REGISTRATION 120 square feet or less QAOVS-rAet.G Location of shed(address) Village t �►nA2r. f' R081nJ FLETG�-tEQ 777 Property owner's name S l Telephone number N 1rn 12800Lf ory Size of Shed Map/Parcel# Signature • Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? Conservation Commission(signature required) PLEASE NOTE: IF YOU ARE WITIITN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE.THE APPROPRI.a,TE COMD'IISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN F l LE # MIP 9501 CENSUS TRACT # 131 CLIENT: punning, Forman. Kirrane & Terru DEED BOOK 8939 PAGE 27 OWNER: Fournier PLAN BOOK 465 PAGE OT 11 APPLICANT : ASSESSORS PLAN PLOT MORTGAGE INSPECTION PLAN OF LAND LOCATED AT 91 PIONEER PATH W. BARNSTABLE, M SACHUSETTS SCALE: 1 = 60' ,% DECEMBER 23, 1997 sog - q 2-0- 7995 i hti• ti LOT 13 52,559 SF-� QF 1t�tSPEGT1o�J "'7� co Z fff - ' -L)3 )7Z DQA►t,IAC.E EASE HE►4T ' LOT 14- i PI ON EE-R PATH I CERTIFY TO DUNNING, FORMAN, KIRRANE, & TERRY, MORTGAGE CORP , EAST, AND ITS ITLE INSURANCE COMPANY, THAT THERE ARE NO VISIBLE ENCROACHMENTS OR EASEMENTS XCEPT AS SHOWN AND THAT THIS PLAN WAS . PREPARED UNDER MY IMMEDIATE SUPER— ISION, HE LOCATION OF THE DWELLING AS SHOWN HEREON ►°''P�°`' . IS IN COMPL I ANCE W I TH THE LOCAL APPLICABLE ONING BY—LAWS WITH RESPECT TO HORIZONTAL I MENS I ONAL REQUIREMENTS . . � fE'hi E HE DWELLING SHOWN HERE DOES NOT FALL WITHIN SPECIAL FLOOD HAZARD ZONE AS DELINEATED ONc,. • MAP. OF COMMUNITY #250001-0015C DATED /19/85 BY THE F. I .A. 4a :~ Kenneth R..Terreira W Engineering, Inc. P.O. Box 1903 New Bedford-.MA 02741-1903 508 992-0020 .Fax:508 992-3374 GENERAL NOTES: (1) The declarations made above are on the basis of ■y knowledge, information, and belief as the result of a mortgage plot plan tape survey inspection made to the normal standard of care of registered land surveyors practicing in Massachusetts. (2) Declarations are made to the above named client only as of this date. (3) This plan was not made for recording purposes, .for use in preparing deed descriptions or for con- structions. (4) Verifications of property line dimensions, building offsets, fences, or lot configuration may be accomplished only by an accurate instrument survey. I SMOKE DETECTORS O.K. BARNSTA E OUILDING DEPT. -s 0 - 4 Roar ELGVA17oM LEFT E[.EViYJ7ew/ EW SMOKE DETECTOR REQUIREMENT RE NOW LAW. EVEN THE ADDITION OF A — NEW BEDROOM WILL TRIGGER AN UPGRADE OF THE SMOKE DETECTORS FOR THE WHOLE HOUSE. YOU MUST PLAN ACCORDINGLY AND HAVE YOUR l ELECTRICIAN TAKE oUrTHE APPROPRIATE �� PERMIT AT THE FIRE DEPARTMFNt• Rio an y ooa�• ,Y S1, ' ,46A2 •EL•EVA+now] G�1�� ••: „'�-�• ••••w•D�' �. - �� tFres/re Qsf• � /OFa • �0 9 n 2 2 T 0 ® p#pEBB IL ' - O 03 a 2 •11 � �d� 83 w am p a m ZE 3°o4i ��w ga m�aS�d � rog3�3 lta s� 4 ^ ' w y _ 1 ICI JI 1 X N � J O fYHn1'JN ce ji ai *e.c oc.,d-� 1 ry • a W m a° I � J.h U �J° k Z� sae K Ww3: � � Q��r ��"a.yy�'6�3��o2�ag w � d'k°log tixw. oAa. � z J•, b w : � ,��}��, a AAA Q W � �YtK7Kj°o�' 1.ro ti,2K„It t d t9 f ��dk{ i�xoq y . 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G✓r.Ja SCOOR!F .(vA PAb fi) .FilL„eAStae+�Nr _bn4.NAIL-E 6LDF}NML oPn s fsLeLr¢o rTr6 sua P-e. dxv SNo6 ,4LL ] _ � �•ax/O dox r I _ '2-5 db' .1 1I . p-ax1DNDILli ]•dxl� _MLG LhAI..BEhH /NSUGA'noN /C.30 LL6. -I•-Z'rzmlf�!�z me—.R- 'jEE ENti SPe GI. ,R/3 WAGLy R/Y FLOOR FLITCN°lF ZE y'• M1 y Po4GH +h(Ig f1C'FRaGX AGL 6A y/66 OPT y_GaAtLLLW� 7'Q:.7D J;J;Y •�G 1 ArOING a.",o tr c,AR -ox 0A.D.O. n i FeavTROv6H cL fP6o 4%D .77./ _!P OFF COaGy- �PL< MAII uy •y �SIOEf 41/G SH/N6LEf FLoo2 MATW •Y� ,�,w GJ•y�. . d 1 I I I ]E(10 G/!d'b r 1 /X YTRIH /xS DGVaf L°•OG. P'Y.ON.',W.pyry,W /6Y—F' . cool r,_ F-)..y'PouR+- - /x eI ce.ay SLO PeD-m aooef ,1xN'O_f. 4'JD.L ......_H'MIN, 9ELoro RADE G 2 3x/o R/!'+JD fT f�'NGrf02 BOLT A-L L. PER GaO� 6A pA(yH_y —Ill bH 2 o JXG OT. •j ILL-N•JEhL L ED6aR DAMP PA00FA5 ReQ�/!¢,ED P"GONG..W,A.4Ly._- a, PEIL CODE W///G."x$4mNIy7d o iPNG1fOBOLT �i 4' As/N_BELDW_ p nu...S4h5 $LOWED rSRAO�.�y/.) (/' 70 ..POPrZs - LONT• Frbf, Y'Fbu2 Y 1 ` _ lU a•yVfT CAP�c•ewwL� ._.aOli_ —.•o� 7'/O•PavR r-F'ULL i — oaoP Coact_ -- � aaOP GANG. — 4°eoNt- LAl3 /P Lr.PUux: ea-S"'CONG SL A6 r- A.cufi¢S PORLry I.0 FULL OP770N If _GV.T AC:LE r✓ENT � BCONC WADI.LU!'JO tRAM u IN6 EG77ON- 4L fIG£�Y'=/�O• ff aoT s r_.oK se F . . __. .... W/NM YEh"rEa/oIC DOOC DU .. da• _8•'aO. i'Y 9 8"RO. ]'a° MAj,,-. LITEtOu DA-'nON PLAN- T r' . _-c _YL..aooKG_ r crg�mot (J6.GO&P at 66-2 ....__.__... _--_... .. -M, _ i i O ' . �I r U _N 2 i IL Fl QC � U ty 5 f � J lui LIO I i cj ` o 5 t- x W cL J � { i 3 r� v` .: Assessor's offioe (1st floor): THE Assessors map and lot number ............. .......................... SEPTIC SYSTEM MUSTS Q� C Board of Health,(3rd_floor): 4i1,33 ALLEDINCOMpLiAN Sewage Permit number .............................................. Z 9AH39TSDLE, Engineering Departure t (3rd floor): x Yonly" � �TfTl.E Je V, MU& m� .1....F :.�.....:.... ENVIRONMENTAL CODE A ,,,t i639.p�0 House number• ................................... 'TOWN REGULATIONS crar APPLICATIONS PROCESSED 8:30.9:30 A.M. and 1:00-2:00 P.M , TOWN. OF .BARNSTABLE BUILDING INSPECTOR APPLICATION .FOR -PERMIT TO ........ CJ.6&u.4>- TYPE OF CONSTRUCTION ................. ............:..................................................... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .. .` . .I.��i..... /.1�.1��1..... ... .W.,..... .�... �........................................................ Proposed Use .........f. ./. .! t.... � IL. .........................................7................ Zoning District ........................................................................Fire District .......... �..... Name of Owner ............r. ...... ..... ..e..Address ..... ... Nameof Builder .................•...................................................Address .................................................................................... Nameof Architect ..................................................................Address .....................:................................................................ Number of Rooms ................& red...............................................Foundation ...... :.W......(W. k7 .. .. ................ AA Exterior .....0'e4e ...... ..... .S.. .....�S�u.f 7-W...Roofing ............41P .............................................. �....V 1-4 : ..� , . Floors ........... ........ .........................Interior ............. Heating ... w .........................Plumbing ................... ..... ........ :.......................... Fireplace ......... ................ ............ �i+S v.:��!,C.`/—I.J/....................Approximate Cost ......... ....�6............................... . ....... WDefinitive Plan Approved by Planning Board _______Sl_______._______19_ Area .............-... • Diagram of Lot and Building with Dimensions Fee f................................... SUBJECT TO APPROVAL OF BOARD OF HEALTH �� gA� ItIq o� I I/,A/ 1 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. 1/ f Name ...... ./��/.GS-�C ...` ......... 1 f ..•. Construction Supervisor's License .......X..1..��.�1 . ,GREENBRIER CORP. wNo�. 3334.8 Perm Two...Story ..... .......... `it for Single Family Dwelling '. ............................................ .. ................. _ Location ,Lot•.•#13 ,-.....9.1•••P i oneer Path i West -Barnstable 4 ' .................................................... .................. `� Owner Greenbrier Corp. .... .................... ... .... ......-........... - Frame � '''1� �ff �'� r.� f� ?� -f • - • Type of Construction .......................................... A� J .. .............................. ........ ........ ................ I/X• , �, '' �f yr L: ' Plot ........... ............. Lot Permit Granted ...November„9 j -19 89 . Date of Inspection ...... ...... ' ..19 Date Completed. ' ' � �� '-a ` a • ' " - /�✓ :r r � �� r+V �� sue' 71 i Fs�$� � l"'� z.•s � � �i� /' i� .r �' � � !J, r�'r 'fir Y r'3 t, 0p,4's Ala g�,?� s"-� i 'j• i 1 ].'` - - ._ - ' ! - Assessor's offioe (1st floor): Z,.,.-V E Assessor's map and lot number ..... Board of Health (3rd .floor): C-0 0 Sewage Permit, number .................................................�.. 11AMSTLEILE, Engineering Department (3rd floor I NABIL q� C 1639- ...............House number ......................... ......................... ale APPLICATIONS PROCESSED' 8:30-9:30 A.M. 'and 1:00-2:00 P.M:` only" TOWN ' OF BARNSTABLE- BUILDING - INSPECTOR APPLICATION FOR PERMIT TO ....... ..................................... 0110��R.C_J.... 07 m1l..V-K TYPE OF CONSTRUCTION ................. ...........K....( .......................................................................... . .............................9. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ........................................................ Proposed Use ........4 1A.A..e... IL4 Zoning District ........................................................................Fire District ...........�/f/`- ,/.4 14e................. Name of Owner ......... ......Address ...... Nameof Builder ....................................................................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ................../ .............................................Foundation ...... Exterior ...... Roofing ............4?okl.�.. .......................................... ..................Interior ......... ......... ................................... Floors ....... .................? ....... ..... .....(� Lee uArj .... 14 - Heating ........ f ......44 ............................Plumbing .............2_ 0 ......64.-Y1.0. ...................................... Fireplace ......... .....I............X et�.tA., A_-.4 1.(l....................Approximate Cost .......f ..... .. ....... .......—,..................................... --- Definitive Plan Approved by Planning Board -------S-y----------------19 T-1, Area .........................S.............. C)o i Diagram of Lot and Building with Dimensions Fee .......... .......................... SUBJECT TO APPROVAL OF BOARD OF HEALTH 34 LAx L� 2 � o 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. Name ........ Construction Supervisor's License .......60... % GREENBRIER CORP. A=128-004 .WOO No 33348 Permit for ..Two...P.t!?.KY.......... Single. Family_..Dwelling..... i Rg...... ..... ..... ........ ... .... Location ....Lqt... ......... ...Pioneer Path ....................... West Barnstable ................................................................................ Owner Greenbr.ier. ...Corp................... ....................... ....... ........ .. Type of Construction ......Frame .................................... .................................................................. ............ Plot ............ Lot ................................ Permit Granted .... :.N.ove.mb.e.r...9.........19 89 ' Date of Inspection ....................................19 Date Completed ......................................19 r o�rM, TOWN OF BARNSTABLE 33348 U , Permit No. ................ I BUILDING DEPARTMENT I "a"` I TOWN OFFICE BUILDING Cash .Y� ,670• X ur � HYANNIS,MASS.02601 Bond .I►/, CERTIFICATE OF USE AND OCCUPANCY Issued to Greenbrier Corp. Address Lot #13, 91 Pioneer Path West Barnstable, Mass. USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID,AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND.IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. November 14,, 19 89 Building Inspector 't;"• H �.-,,.:.,• ;. r,_ /• fl.'..�..>; ,.-' , •... .. ,...;T J+;rJ, :^ti„- ti Ra.>:�„f-i':�;.z .�•.:, M TOOF BARNSTABLE, MASSACHUSETTS UILDING V )PERM'• f XX ,7 �_ Q04.WM60 �. - ��n4 DATE November 9 (g 89 PERMIT�1 0.- 9 e. 3 � APPLICANT. Owner ADDRESS aWller } IND.) (STREET) (CONTR'S LICENSEr PERMIT TO Build dwelling Single fam11 dwellin NUMBER OF t (_) STORY_._ 1 � (TYPE OF IMPROVEMENT) N0. (PROPOSED USE) DWELLING UNITS AT (LOCATION) lot #13 91 Pioneer Path, West Barnstable ZONING RF 5 (NO.) (STREET) DISTRICT 4 I BETWEEN AND (CROSS STREET) (CROSS STREET) •i SUBDIVISION LOT LOT BLOCK SIZE .BUILDING IS TO BE FT, WIDE BY FT. LONG.BY FT, IN HEIGHT AND SHALL CONFORM IN CONSTRUCT) TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) ' R Sewage #89-665 EMARKS: - ' ` f, BOND¢. ti ' VOLUME 1244 sq. ft. 45,000 PERMIT 95.00 :r ESTIMATED COST FEE , s(CUBIC/SOUARE FEET) OWNER Greenbrier Corp. Y. V. BOX Centerville, BUILDING DEPT. ADDRESS BY 1 THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER'TEMPORARILY ► PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE A PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBT-AINI FROM'THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIO y OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. '�{ w MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE • INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL IN PERMITS ARE REQUIRED FOR SPECTION HAS BEEN ELECTRICAL, PLUMBING AND �kry I, FOUNDATIONS OR FOOTINGS. MADE. WHERE . , CERTIFICATE :OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MINAL INSPECTION TI TO BEFORE FINAL INSPECTION HAS BEEN MADE. ' 3. FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 t. z Z _ � z 3 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT Py OTHER �(6 u eMb,Q r r o BOARD OF HEALT WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT 'W!L L BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN A TOR HAS APPROVED THE VARIODUS STAGES OF I WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRIT1 CONSTRUCTION. PERMIT IS ISSUED AS NOTED ABOVE. NOTIFICATION. ( i , �,oto, 'V 52 63-9 + .s F N -p c S Ipl , NIA E�ruus THIS PLAN IS NEITHER INTENDED Na DATE I DESCCWTM By FOR, NOR SHALL IT BE USED FOR AS—BUMT FOUNDATION PLAN—LOT /3 MORTGAGE LOAN PURPOSES. Po"awe f 4rN Q/FR,1/ST.4BLE� MASS, SCAM f"_4d' JOB NO. 11Z D 1 CERTIFY THAT THE FOUNDATION Fo��4 PAIL A. 0 Sb fo SHOWN ON THIS PLAN IS LOCATED �, LEVY ON THE G 21NDLICTEL.". No. 10617 y i 77 1� T '-s -uml DATE' R6Q.SfER07LAND SURVEYOR cP1R\7��