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Home My WebLink About0329 WOODSIDE ROAD f ��9 l�l�ood�� . 0 . . :.. i IlU ° Z UPCI21 3 a NOSLOR HASTING$,UN TOWN! OF BARNSTAB E R I S E Division of Thielsch Engineering,Inc. 2013 K4 l 10 AN 11: 19 1341 Elmwood Avenue ENGINEERING Cranston,Rhode Island 02910 DIV ISI p May 1, 2013 Thomas.Perry, CBO Town of Barnstable Building Division 200 Main Street Hyannis, MA 02601 Re: Insulation permits Dear Mr. Perry, This affidavit is to certify that all insulation work completed for 329'Woodside Road has been inspected by a Building Performance Institute (BPI) certified Professional. All work performed meets or exceeds Federal and State requirement. Sincerely, Erik Nerstheimer Supervisor of Installations, BPI certified Building Analyst Professional and Envelope Professional, RISE Engineering, a division of Thielsch Engineering, Inc. 1341 Elmwood Avenue Cranston, RI 02910 r . 401-784-3700 •800-422.5365 •Fax 401-784-3710 AI _�� THE TOWN OF BARNSTABLE AWSTME. N"& 1639. a MAI BUILDING . INSPECTOR APPLICATION FOR PERMIT TO P. 00 ........... ................. TYPE OF CONSTRUCTION ............... . . ............ . ................. . ............ ........... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a' permit accordin )fftylowing information: 1 oa Location ... ......... ................... 4,&,.1. . ....... ... . . . .................................................... ProposedUse ....... ............................................................................................................................................. F i ............... Zoning District ....... ...............................................Fire District A"k . .... .t4... ................................. Name of Owner ..... 1pmg...... %eovw-� ...Address ....... ...... Name of Builder Te4A.,e"0-,4I5... ...Address ........................................:........................................... Name of Architect "."J..Address .................................................................................... Number of Rooms .............Ce..... '........................Foundation ...1?0.U.W. ........(rp.a. ............... Exierior ........(Y�.yj 0 W. ...........5 -S.....................Roofing .......... Floors ...........(oll-fie ..............................................................Interior .......... . Heating ..../—k. ...................6 !...........Plumbing ......C. o .Oz......... e............... Fireplace ..........Y. 5......................l....................................Approximate Cost ........... Definitive Plan Approved by Planning Board ------------------------------ Diagram of Lot and Building with Dimensions el -e- SUBJECT TO APPROVAL OF BOARD OF HEALTH 2 5-/ N Lo, I hereby agree to conform to all the Rules and Regulations of the Town of Ba Sle reg arding construction. ,,,!,:, rdin e ove ............ Name .... .. Leonard, Charles W. 7 one story No .......1586 ... ... Permit for•.................................... single family d 1 1 ..............3.... Location . .........:...:.................. .................... ............:".... !:.:..S Charles W. Leonard.- Owner .............. ................... .......... ........... frame Type of Construction .......................................... .................................................................:.............. #24 Plot ............................ Lot ................................ 1 Permit Granted ......Febmaxy l.............19 73 Date of Inspection ........19 Date Completed ......./. ...... .... ..19X . PERMIT. REFUSED l �i .................................... ........................ 19 " Y a �. ........................ ................................................... 4i • �� ................................................................................ /sl or O ...................................... ..................................... ............................................................................... so Approved ................................................ 19 ............................................................................... ................................................................................ i L— _ � I11 I.o of� v�l TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 1 Parcel-•; dZ r Application # G01-�63_,j Health Division Date Issued Z� l Conservation Division Application Fee Planning Dept. Permit Fee - Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis p Project Street Address ��CI V�1 QOcd Sid e Village Bo_l V1S�i�l P Owner i I l I CI.VYI fl)u r) -Q ' I Address ba_mz) Telephone_ Q9— Z4 2� —92_4 l Permit Request A'IY ,Se ati (1 . I0Su l Ct.-4.2_ aA'c L 2-3u) Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Q 9 to 1 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full 0 Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new C) Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑.Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove u6 Yes;?❑ No Detached garage: ❑existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑new size Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: t� - cxy 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 01 ( S�e ✓1G I V)U.rl VY Telephone Number 4 31 CA-IN — 0Q Address 1�S41 rr1Wmd PN-f License Home Improvement Contractor# 120 cl—I Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE C) Fr`I 1= -Far r lS e FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. { ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL ; GAS: ROUGH FINAL FINAL BUILDING s DATE CLOSED OUT` : - I ASSOCIATION PLAN NO. ~ _ .r' I d I I ' RISE ENGINEERING Federal ID#05-0405629 RI Contractor Registration No 8186 A division of Thielsch Engineering MA Contractor Registration No 120979 CT Contractor Registration No 620120 ! 1341 Elmwood Avenue,Cranston,RI 02910 i I • (401)784-3700 FAX(401)784-3710 CONTRACT Page AM 1 R I S J1.I THIS CONTRACT IS ENTERED INTO BETWEEN RISE ENGINEERING AND THE CUSTOMER FOR WORK AS ENGINEERING DESCRIBED BELOW CUSTOMER PHONE DATE Client# William J Durken (508)428-9244 04/11/2010 109611 SERVICE STREET BILLING STREET 329 Woodside Road 329 Woodside Rd SERVICE CITY,STATE,ZIP BILLJNG CITY,STATE,LP t itwsLefts Mill, 4 A 026 AO w /d Alm {/�7 OZ6� JOB DESCRIPTION r7 a RISE Engineering will provide labor and materials to seal areas of your home against wasteful,excess air leakage. This work will be performed in concert with the use of special tools and diagnostic tests to assure that your home will be left with a healthful level of air exchange and indoor air quality.Materials to be used to seal your home can include caulks,foams,weatherstripping and other products. Primary areas for sealing include air leakage to attics,basements and other unheated areas(windows are not generally addressed.) This work will be performed at the rate of$66 per man per hour,which includes materials and testing. 19 man hours. $1,254.00 RISE Engineering will provide labor and materials to install a 8"layer of R-30 Class 1 Cellulose added to 1100 square feet of open attic space. $1,210.00 RISE Engineering will provide labor and materials to install an easily moved,insulating cover for the attic access folding stair. The cover has integral weatherstripp ing to restrict air leakage. $160.00 RISE Engineering will apply all applicable,eligible incentives to this contract. You will be billed only the Net amount. Currently,for eligible measures,the Cape Light Compact offers 100%incentive for air sealing. -$1,254.00 RISE Engineering will apply all applicable,eligible incentives to this contract. You will be billed only the Net amount. Currently,for eligible measures,the Cape Light Compact offers 75%incentive,not to exceed$2,000 per calander year. $1,027.50 D MAY r 5 2010 WE AGREE HEREBY TO FURN H SERVICES-COMPLETE IN ACCORDANCE WITH BOVE SPECIFICATIONS.FOR THE SUM OF ***Three Hundred Forty-Two&501100 Dollars $342.60 UPON FINAL INSPECTION AND APPROVAL BY RISE ENGINEERING.CUSTOMER AGREES TO REMIT AMOUNT DUE IN FULL INTEREST OF 1%WILL BE CHARGED MONTHLY ON ANY UNPAID BALANCE AFTER 30 DAYS.SEE REVE E FOR IMPORTANT INFORMATION ON GUARANTEES,RIGHTS OF RECISION,SCHEDULING,AND CONTRACTOR REGISTRATION. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES AU THORMED SIGNATURE-RISE ENGINEERING CUSTOMER ACCEPTANCE S 'VOTE:TIi!<v:;O?dTRAC'C MAY BE WITHDRAWN BY US IF NuT EXECUTED:YITH6Y DATE OF ACCEPTANCE y — ._. ------- — ---- l ^ � - ACCEPTANCE OF CONTRACT-THE ABOVE PRICES,SPECIF.CAT!ONS AND CONDiT'ONS ARE j ..•.• ,. .y - SATISFACTORY TO US AND ARE HEREBY ACCEPTED.YOU A,1E AUTHORIZED TO DO THE WORK it AS SPECIFIED.PAYMENT WILL BE MADE AS OUTLINED ABQVE f� w _ The Commonwealth oflllassachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,Mass. 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): RISE Engineering a division of Thielsch Engineering Address: 1341 Elmwood Avenue City/State/Zip: Cranston, RI 02910 _ Phone#: (401)784-3700 or 1-800-422-5365 Are you an employei? Check the appropriate box: Type of project(required): 1. ® I am an employer with - 4. ❑ I am a general contractor and I 6. 0 New construction employees(full and/or part time).* have hired.the sub-contractors +. 7 ❑Remodeling 2..Q. I am a sole proprietor or partner- listed on the attached sheet. ship and have no employees These sub-contractors have 8. 0 Demolition working for me in any capacity. employees and have workers' 9. 0 Building addition [No workers' comp.insurance comp. insurance. + required] 5.0 We are a corporation and its ( 10, 0 Electrical repairs or additions 3. ❑ lam 1 homeowner doing all work o.fiicers have exercised:their 1.1. 0 Plumbing repairs or additions y [No workers' comp. right of exemption perm MGL insurance required] t c. 152, § 1(4),and we have no i 1.2. ❑Roof repairs employees. [no workers' I13. Other Insulate comp.insurance required.] j -- - *Any applicant that checks box#/1 must also fill Tut the section below showing th..ir workers'eempensatic:,pciicy infarmatiau. _ tHomeowners who submit this affidavit indicating they are doing all work and then hire ouiside contractors must submit a new affidavit indicating such. $Contactors that check this box roust attach an additior+al sheet showing the ssame of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,tbey must provide their workers'comp. )ohcy number. I am an employer that isproviding•workers'compensation insurance for try employees. LV elow is thepolicv and job site information. Insurance Company Name: ThePres-ton A&I�nc�y _-- —_- Policy#or Self-ins.Lie.#: 3730967--C'0 __ :Expiration Date: 1/1/11 Job Site Address: -- ----- -- - -- City/State/Zip: Attac'b a copy of the workers' compensation Policy declaration page(s:tlowing the policy number and expiration (date). Failure to secul-e coverage as required under Section 25a of:v1GL 152 can lead to.il::, unposition.of criminal penalties of a fine up to '1,500.00 and/or one year impr sonment as we'-t as civil penalties in the iorai of a STOP WORK ORDER and a fine of $250.00 a.day again3t violator. Be advised that a:,op of this statement:maybe forwarded to the Office of Investigations of the DTA for coverage Verification. I do herby cent inde the pxi n�sa)9Zqenallies ofperjury that the infor.-nation provided above is true and.correct. .� Signature: Date: Prinihtame: Erik Nerstheimer Phone#: 40! 784-3700 or 1-80Q�422-5�65 axtl33 FOfficial use only Do nor write in this area to he completed. y city or tmv!.1 official ---- -- ICity or Town: ---- Issuing•Authority(circle one); 1.13oard of Heath 2. Building Department 3.City,�rc Fri 1e 1i. 4.Electrical Inspector 5.ii'lani'bi_ t-Inspector 6.Other Contact person:—_—___ _ __ Phone ' ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID 47 DATE(MMIDDnyrq PRODUCER THIEL-1 04/13/10 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION The Preston Agency, InC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1350 Division Rd Suite 303 HOLDER-.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR PO Box 810 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, East Greenwich RI 02818-0810 Phone: 401-886-8000 Fax:401-88571700 INSURERSAFFOROINGCOVERAGE NAIL# INSURED INSURERA: Zurich-American Ins CO. _ I Thielsch Engineering, Inc INSURER 8: x,,�,t-, c L1� �V,T,nL.. 611'Lty _ Thielsch Group Inc. INSURERC: North American Capacity Hi Tech R�alty, Inc. 19S Frances Avenue Craranston RI' 02910 INSURERD: Hartford Insurance Company — INSURER E' COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTVdffHSTAnIDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER OOCLIMErrr WITH RESPECT TO WHICH iHIS CERTIFICATE MAY BE ISSUED OR w�Y PERTAIN,THE INSURANCE AFFORDED BY THE PO�ICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSLONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. InbK"JIDD . LTR INSR TYPE OF INSURANCE POLICY NUMBER GATE(MMIDDM'J DATE(M ) LIMITS GENERAL LIABILITY TX EACHOCCURRENCE 1 1,000,000 COMMERCLAL.GENERALLIABILITY 3730962-00 W01/10 01/Ol/11 PREmI�StS( aocc enca) .1300,000 CLAIMS MADE D OCCUR' MEO EXP(Any.one person) A 10 000, PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE s 2,000,000 GEMI AGGREGATE LIMIT APPLIES PER: PRODUCTS COMP/OP AGG $2,0 0 0,0 0 0 POLICY X jRO LOC Emp Ben. 1,000,000 AUTOMOBILE LIABILITY A X ANY AUTO 3730963-00 04/01/10 O1/O1/11 COMBINED-SINGLE LIMIT 52,000,000 (Es accident) ALL OWNED AUTOS -- - BODILY IpIJURY �. SCHEDULED AUTOS' (Per person) HIRED AUTOS. BODILY INJURY $ NON-OWNED AUTOS (Perawde.Nl PROPERTY DAMAGE i ?Per:Lcioenl) GARAGE LIABILITY AUT6 ONLY-EA ACCIDENT .1 ANY AUTO -- - .. .. - OT)a°R T.'.Arl EA ACC s .. _ .. A.UTO.Cr+LY. AGG $- EXCESSIUMERELLALIABILRY _ EAe'HOCCURRENCE S10, 000,000 B :t OC'-UR �CLAIMShWOE lI1vID 9263637-00 04/01/10 01/01./11 nG ATE 110,000,000 DEDUCTIBLE 5 REJENfION $1D.,0 0 0 — F WORKERS COMPENSATION AND --TSTAIt,- --TLSi EIAPLOYERS'LIABILITY 11ORY LIfeITS EP. k aNY PROPRIETOR/PARTNERIEY,ECUTIVE 3,7 3 0 9 61-O D 0 4/01/10 01/01/11. E.L. ACCIDEIJT s 1,000,000 OFFICER/MEMBEREY.6Ll1DED9 E��A DISEASE.-EAEMPLOYEE 1,000,000 If yes.describe Under SPECIAL PROVISIONS balm+ I C.L.VISEAS11-PfiICY LIMIT .1 1,000,000 OT}IER C Professional Liab DVL000026.800 04/01/-10 '04/01Ill i F;:of Liab 2,000,000 D Leased/Rented Eqp 02UUNTD5678 04/O1/10 04/01/11 Fcrui;ment 100,000 OE SCRIP TON OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUS IONS.ADDED BY ENDORSEMENT I SPECIA MS"L PROIONS CERTIFICATE HOLDER CANCELLATION _ SHOULD ANY OF THE ABOVE CESCRIBEO POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL EA:OEAVOR TO'AA!L 10-— OAYS WRITTEM NOTICE TO THE CcRTIFIG.ATE HOLDER NAMED 70 TH':LEFT.8L r FAILURE TO OO SO SHALL IMPOSE NO OBLIGATION OR LIA3!LITY OF ANY!p1,10 U'b?v TH=INE:_tRE-R.ITS AGENTS OR REPRESENTATIVES. • AU,T✓HORIZED AEPRESE. ACORD 25(2001/08) ^�_----- @?.r,O:�7 CO rOR,S'!ION igSB r,.. � ;; ,c. , =•�,:�, .,�'!},q tt�:fur,,-„ :,-.T' ,I ,.;>,: ,.,p_., = -.sl irr•:��s-�p .,1.,� :}• "� e,..� .: 'ti� fi� �o- „�Y'i �� .,f3 l. ;� � � AG ,,�•-r• J,, Y45n..V.,,,� d'y�;Yt w ..r,t .;t;i �? �� ,�¢ ';t-�,s ��, �,n9 ��>., �I r.�$Z'EEI1�1 1 � } •.rfs F � !x,ra• �t�).1��4-�;t-tS'� �,�,.;;,F...w ] ,t�'G:+ :•k,+�,{f'7 i4' z.�?y.}Ik(�}}il�}T s� .�� ii�}'lEks'.7(t:t�';.�:' 1'N_„r....y�y.,.,., ww�� i�! � Ijl.1�. �'�':sa�r,a' ,i r, tk ,�,.J.. a sr �,.., �.• ��4 t ,c � t 3C y , :� �` ,,�l;� OP ID 2 11}i t j2ta � S DATE '04/12/X01`t 1��f��E�!�► � .TM,�,IN§.U. EDRSItJAME7aTYliel�chlltL�l�Jineg�r�,n9Jfy��n�d�r'Yrttun��, v�zt}}� :• �:ir•..,�s .•. ..t.�`.. :1,t .:- .. ... ., , ..• a f tl.,,��t �:la..as - �'s T!:�1,�1'-.,,rt:'2 7.91d,i�+�.. ::NeTV1i L`,c .....h'..,,hG..w,, ....:L.,tti..aOn: .._t�5-a+.,,.. ,...a. .. .. ..i1,. ..... �a.fi:...:.J;;;.ts•.r::-�.nSrtNf`:�tiuUi?th. ..:. ._:.-. .,. V �'�-. ;aa.- ,i t 4 Also for RISE Engineering, a division .df Thielech Engineering,. Inc. Gaskell Associates.; a division of Thielsdh Engineering, Inc. BAL Labo.ratory. ; .a division of Thielech Engineering, Inc. ESS Laboratory, a division of Thielech Engineering, Ind. ALCO Engineering, a. division of Thielech Engineering, Inc. Water Management' Services, a division of Thielech Engineering, Inc. i t 4 t er fang an uslness e u anon O ice91teo' o onsum g 10 Park Plaza - Suite 5 170 , Boston, ssachusetts 02116 Home Improve ontractor Registration f, Registration: 120979 Type: Supplement Card z Expiration: 3/25/2012 THIELSCH ENGINEERING M ERIK NERSTHEIMER 1341 ELMWOOD.AVE. CRANSTON, RI 02910 ,e i �Ci v�o i 4y y $v a Update Address and return card.Mark reason for change. , J, Address ❑ Renewal ❑ Employment Lost Card , DPS-CA1 0 50M-(W04-G101216 ,per T1 a Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation Registration =pg79 Type: 10 Park Plaza-Suite 5170 Iry Expira -12 Supplement Card Boston;MA 02116 THIELSCH EN& — fy ' ERIK NERSTHE - 1341 ELMWOOD CRANSTON; RI 029 .% Undersecretary Not valid without signature r a9e 1 OI 1 The Official VWebsite of the Executive Office of Public Safety and Security (EOPS) Mass.Gov Horne Public Safety ®eparftnent of Public Safety Licensee Complaints License Type Construction Supervisor License#/ 100459 Restriction WS,IC Name Erik Nerstheimer City, State, Zip North Scituate, RI, 02857 Expiration Date 3/28/2012 Status Current No complaints found for this Licensee. Back To Search Board of 73iiildin.Regulations and Standarir!r Lkense or registration valid for individi,l use only i HOME IMPROVEMENT CONTRACTOR i. before the expiration date. If found return to: 1. i Registratihon:. 120979 Board of Building Regulations and Standards {; j.25/2010 One Ashburton Place Rm 1301 = upptement Card =LSCH ENGINEER=1Nt K NERSTHEIfv1R= 1 ELMWOOD.AVE` _=^�� sNSTON Rl 0 Admrtisti iror } Not,,and without sign;-Tre ' http://de.state.nia.ss/dps/llcdeta.ils.asD?txt,gearcbL"` =(-',V.1 nn,,.�4 _ . P � , r ALL L � ,y GEC,tra t � - ��. •S,�t.� '� +"i � �"- IF FIAT--24 531 - 1 ! Engineering Dept. (3rd floor) Map I S a_ Parcel/ t:�s , Permit# N House#• ��Js Date Issued Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) Conservation Office(4th floor)(8:30-9:30/ 1:00-2:00) �'!'o` n 'a Planning Dept.(1st floor/School Admin. Bldg.) v��;� �tNEtp;- Definitive Plan Approved by Planning Board 19 TOWN OF BARNSTABLE -If.� Building Permit Application Project Street Address Village Owner � i_i ��jn/�i nJ Address v . Telephone Permit Request LeTb�,bdD/L ON��io !�r✓� Sang �(/G� 6iJ /v r/� /?.�.2BDL v✓/i4-S/7 LT X14A E r s First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family U-` Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes fro On Old King's Highway ❑Yes UNo Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing- -v-Now., - Half: Existing New No. of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No 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 ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name Telephone Number ZZ Address License# 2-- Home Improvement Contractor# /DO 74W6 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 SIGNATURE J9KDATE, /Z-� 3-� BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) " t FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED - MAP/PARCEL NO. ADDRESS VILLAGE yr, �Y • OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL ' PLUMBING: ROUGH FINAL 4 GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. nib• \ 072 ✓f22 -�YOME . IMPROVEMENT CONTRACTORS REGISTRATION I �. % Board .of Building Regulations and Standards t �= One Ashburton Place - Room 1301 I I .Boston , Massachusetts 02106 I HOME IMPROVEMENT CONTRACTOR P.ec_stration 100740 Expiration 06/23/98 Type - PRIVATE CORPORATION � QQ''_ ,�J HOME IXp�OYEy:.'ti C7YTt�nCi0R • ' E � ` Re3ist,atian 100740 CAPIZZI HOME IMPROVEMENT., INC. I Type - PRIVATE CORPORAT:OY Thomas Capizzi , Sr . Q/ Upiratioa 06/ 3/98 1645 Newton Rd . I Cotult MA 02635 I CAPIZZI HOME WROVEMENT, INC Tawas Capiz_i, Sr. Xextor, Rd. A0NUNLSTRAT,rl COWIt MA OZ-_. I �.� '�'S•� DEPARTMENT '; ''5�, `_' �i;~'• ONE A514DUR t •RUC.TTON;SUPERVISOR LICENSE 1�s k . .T :�.:; Expires: { ►S�%X1�.GA�PIZ�I-fJR:• "` -ABLE ' ' A'' Z?15 ;.,« 0266F3 :� .. The Cuntntun►vealtk of Massac•ltusctts Department of huhatrial Accidents � Office Offnty S69JAMS 600liitshittgtonStreet Bostoit,Alas. 02111 ti _ a ` ri Workers' Compensation Insurance Affidavit I �_inf_rnt ''�'"- - —-- �.:' PI- a m 1 Z w / Iocati n: � ,,�/�/f � cit.• e 77 " i//%T 4 Z& 3 5 phone" y2.9—gS�� I am a homeowner performing all work myself. I am a sole proprietor and havewo ng any capacity no one r•t in 1.:~,.:::cam--_..._....e:-:�oG.�.1a.�:aa. .L•L... .r�••�- .+. ...-'i.,�•`:...'sw._e-.�;'!�"::'.'�.C.�z..._<.-7c.::i:.... 7-.77... I am an employer providin-workers' compensation for my employees working an this_job. - company name: address: city: hnn 9- insurance co / �' / .�7 %i PntlC / 4-..�.:�.....w_�.i:....-.'•+.'.y'•,. •.;_�.:''.:.r ei,- -rr�� .:er.•c .rz!*•r'.'.-r.��i=<•--,r•�+ti..m.. s L J� _�v.�.•••.._.r±..�.:-..- - I am a sole proprietor, general contractor,or homeowner(circle one) an hired the contractors listed below who have the followin;workers' compensation polices: company name: address cih: hone#: insurance co. olicv# sa•... -4::i:Gi:�CiLJ:VGi� - T• -�'f=y'..:.��?'.'ivTM ':-!:.._ -1:��-TM ..:.�---.,t_. company name: address: city: nc#: insurance co. ttacb a polio # :A ddthonal sheet tf necessary e -:rc .�.`r'%.-�"' "" "'�""'—�"'r"'_�","'*;: ••r'^•- I--'-' _•--'.-- _=s•-'K��''-'----•..c... e.?.:`a�s�;�t'rY.•=.?�`•J`__�.',i.�.'^r:it't.-�`::�Yr :�'?.. 1�!+. '�s7�:-aH.e•.v..c•. .r �;,rr•:..•:.<r:.".'�.^• -:. Failure to secure coverage as required under Scction 25A of MGL 152 can lead to the imposition u`criminal penalties ora fine up to S1.500.00 and/or one years*imprisonment as well as civil penalties in the form or STOP WORK ORDER and a Cite orsfoo.Oo a day against me. I understand that a copy of this statement may he forwarded to the Office of Investigations of the DIA for eowera-c wt_-iGcation. I do herehr certijr and I oiJJs and nn/ties ojperjun that the injorntation provided eiove is true and correct. . Si2naturc 2-, Date - . Print name i ! Rhone# !official use only do not�writc in this area to he completed by city or town official � cih or town: permitlicense it r7t3uildin-,Department k' oLiccnsing Board iO check if inimediate response is required 0$electmcn's Office hone,. Dllcalth Department contact person: p M; nOthcr } 'MEA The Town of Barnstable • &UMS U. • � Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only Permit no. Date /Z r3-794 AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. Type of Work:.2 � i,$,/,,T, � , 2jat� Est.Cost 5E Sy6 Address of Work: .3.�-9 Owner's Name Date of Permit Application: 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 IlVIPROVEMENT 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: �- Date 1 Contsector me Registration No. OR Date Owner's Name i IMPORTANT MESSAG,'E�-,7 For A.M. Day Time �� P.M. M oZ W-0co �Si�"ar- Of Phone FAX Area Code Number Extension MOBILE Area Code Number Extension Telephoned Returned your call RUSH Came to see you Please call Special attention Wants to see you Will call again Caller on hold Message 77�7- Signed nrversal-48023 MADE IN U.S.A. ' Wit!' 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