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HomeMy WebLinkAbout0165 CASTLEWOOD CIRCLE��� i CAPE COD �� � { ����T48h INSULATION jul TIRlR OCAS. 3CAMLESS SPRAT FOAM SUSPEND90 tttsss�- .RATTS GUTTERS INSULATION ClICINOS ��JF��{L 1-800-696-6611 ¢Oj���� Town of Barnstable Regulatory Services Building Division 200 Main St Hyannis, MA 02601 Date: Al J a. 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 Villaize �► � ✓ AyabAd2hIev IbSCaspejdoo o Circe • AIS Insulation Installed: Fiberglass Cellulose . R-Value Restricted Unrestricted Ceilings ( ) (A) ( 3/ ) ( ) (X) Slopes ( ) ( ) ( ) ( ) ( ) Floors ( ) ( ) ( ) ( ) ( ) Walls ( ) ( ) ( ) ( ) ( ) /41 r ,qea L r Sincerely He E Ca sidy r, President Ca e Cod sulation, Inc. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel V Application Health'Division " Date Issued Conservation Division Application Fee Planning Dept. t Permit Fee - _ Date Definitive Plan Approved by Planning Board n / Historic - OKH — Preservation / Hyannis I Project Street Address /'��� �5�1����®DBE Village1 � ,L, / Owner /i�'! /'r/���j�,0�9 joA/7iE lei/ Address Telephone ,? �fT�,� Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing - proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type, Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Qo*" Two Family ❑ Multi-Family (# units) ® ? Age of Existing Structure Historic House: ❑Yes 2 o On Old Kings Highw4---. ❑Yes ❑ No n, Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other 'µaw Basement Finished Area(sq.ft.)_ Basement Unfinished Area(sq.ft) . , Number of Baths: Full: existing new Half: existing new cr Number of,Bedrooms: existing —new r`'} Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No : Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size_Pool: ❑existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name rme Cl % 5�� di0 Telephone Number Address V4a2oa 4z;d�, License # �� X)66:1 /_j Home Improvement Contractor _ Worker's Compensation ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE ✓>� �/� r E ? FOR OFFICIAL USE ONLY r APPLICATION# DATE ISSUED -�- - MAP/PARCEL NO. ADDRESS VILLAGE OWNER ' x DATE OF INSPECTION: FOUNDATION FRAME INSULATION'—! FIREPLACE k z ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ., ; ROUGH t.,_•.n r FINAL FINAL BUILDING',_ ­it t. v . r DATE CLOSED OUT c ASSOCIATION PLAN NO. i t - k 94c1c6MMWMM*i if�de577O A10 Park Plaza - Sul Boston; Massachusetts 02116 , Home Improvement Contractor Registration Registration: 153567 fi Type: Private Corporation Expiration: 12/15/2012 Tr# 206433 CAPE COD INSULATION, INC HENRY CASSIDY 455 YARMOUTH RD. ( t HYANNIS, MA 02601 Update Address and return card.Mark reason for change. k y Address Renewal ❑ Employment ❑ Lost Card DPS-CAI Cp 50M-04/04-G101216 Office o mer Affairs us ne ReguI tion License or registration valid for individu!use en!y HOMP 6��Id`IP� � Before the expiration date. If found return to: Registration: 153567 Type: Office of Consumer Affairs and Business Regulation Expiration: 1,2/15/2012 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 OD INSULATION HENRY CASSIDY f 455 YARMOUTH HYANNIS,MA 0260i3r� Undersecretary t slid ith t A tune �--_ -' Uitss chusettx-Department of Public Safet, Board of Bt ildin�, Regulations and Standarifs' construction Supervisor License License: CS 100988 HENRY CASSIDY 8 SHED ROW: ' WEFT-�-ARMOUTH MA 02673 Expiration: 11/11/2013 ('ununis�i m`'1' Tr#: 7620 i The Commonwealth of Massachusetts Department of'Industrial Accidents Office of Investigations y � W 600 Washington Street „a Boston, MA 02111 cra v`� s www,mass.gov/dia Worker's compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Cd A e c ( t G , i;, Address: City/State/Z1p:__4aV2V7 ('S: �A a�'L C` Phone#: Sb� '7175 ' Z Lq Are you an employer?Check the appropriate box: Type of project(required): 1. UN I am a employer with© 4.❑ I am a general contractor and I have 6.- ❑ New construction employees(full and/or part-time).* hired the sub-contractors listed on 7_ Remodeling the attached sheet.$ 2. ❑ I am a sole proprietor or partnership These sub-contractors have 8• ❑ Demolition and have no employees working for employees and have workers' comp. 9. ❑ Building addition me in any capacity. [No workers' insurance.$ 10. Electrical repairs or additions comp insurance required.] 5.E] We are a corporation and its . officers have exercised their right of 11. Plumbing repairs or additions 3. ❑ I am a homeowner doing all work exemption per MGL c. 152§(4),and 12. Roof repairs myself. [No workers' comp. we have no employees. [No workers' 13. Other insurance required.] t ,, 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. $Contractors that check this box must attach 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. 1 am an employer that is providing workers'compensation insurance for my employees.Below is the policy and job site information. Insurance Company Name: C_f l Policy#or Self-ins.Lic. Expiration Date: J -- 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 ma e forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do here c ' under the pins and penalties of perjury that the information provided above is true and correct. Signature: Date: Phone . ci- 2' 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): .Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector, 5.Plumbing Inspector 6.Other Contact Person: Phone#: Date: 4/19/2012 Time: 10:13 AM. To: Cape Cod Insulation, Inc @ 1508-778-5735 Rogers &Cray Ins. Page: 002 Client#:4597 CCINSUL ACORD. CERTIFICATE OF LIABILITY INSURANCE D TE(MMo,2YYY) 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 endorsement(s). PRODUCER NAMEA Margaret Young Rogers&Gray Ins.-So. Dennis PHONE 508-760 4602 434 Route 134 AlC No Ext: (AIAC.No):508-258-2102 •MAIL oun m g g y - ADDRESS: Y 9 a@ro ers ra ,com P.0.BOX 1601 PR DU ER , CUSTOMER ID#: South Dennis,MA 02660-1601 INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A:Peerless Insurance 18333 Cape Cod Insulation Inc IN Company 8:Ohio Casualty Insurance Com Y Hy Yarmouth Road _• _ INSURER c:Atlantic Charter Insurance " Hyannis,MA 02601 INSURER D:Commerce Insurance Company 34754 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. IN SR TYPE OF INSURANCE DDL UBR , POLICY EFF POLICY EXP LTR POLICY NUMBERMM/DDIYYYY MM/DD1YYYY1 LIMITS A GENERAL LIABILITY CBP8263063 04/01/2011 04/01/2012 EACH OCMs2,000,000 $1 000 OOO X COMMERCIAL GENERAL LIABILITY - - DAMAGE PREMISEce $1 OO 000 CLAIMS-MADE �OCCUR , - MED EXPon) $5,000 ` - PERSONALRY $1,000,000 - - • GENERAE $2,000,000- GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000. POLICY PRO- LOC $ D AUTornoaaE unealTY 4 11MMBCKVMK 4101/2011 04/0112012 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $1,000,000 ALL OWNED AUTOS BODILY INJURY(Per person) $ �' - - X SCHEDULED AUTOS BODILY INJURY(Per acradent) $ �' - - � _- s PROPERTY DAMAGE X HIRED AUTOS (Per accident) $ X NON-OWNED AUTOS •` � .,.e.,' �- � � r $ - B UMBRELLA LIAB X OCCUR ,.. 0001254514645 , 4/01/2011 04101/2012 EACH OCCURRENCE $1 OOO OOO EXCESS LIAB CLAIMS-MADE AGGREGATE $1.000,000 RI ' X RETENTION 10000 .. C WORKERS COMPENSATION' WCA00525902 6/30/2011 06/30/201 X `"c sTATu• OTH- ANDEMPLOYERS'LIABILITY - YIN - � ANY PROPRIETOR/PARTNER/EXECUTIVE - E.L.EACH ACCIDENT $5OO OOO OFFICER/MEMBER.EXCUIDED? '.a N/A(Mandatory - fyes,d be NMIand - - - • i- E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe under � - DESCRIPTION OF OPERATIONS below - - - _ E.L.'DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS�1 VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) - Workers Comp Information Included Officers or Proprietors . a CERTIFICATE HOLDER + . CANCELLATION I f• . SHOULD ANY.OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE " THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN, ' ACCORDANCE WITH THE POLICY PROVISIONS. t � f AUTHORIZED REPRESENTATIVE - -, 0 198 6-200 9 ACORD'CORPORATION.All rights reserved. ACORD 25(2009/09) 1 of 1 The ACORD name and logo are registered marks of ACORD #S80552/M68179 ' MEE r OWNER AUTHORIZATION FORM . (Owner's Name) owner of the property located at > G'� c (Property Address) (Property Address) : 1Cj hereb authorize a, �dTril S //G(Sub tractor) an authorized subcontractor for RISE Engineering, to act on my behalf to.obtain a building permit and to perform work on my property. + Owner's Signature - D� G Date , VIE M AY .2 5 ?012 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 2 Parcel p Permit# Health Division 3/u-? 6'K— 01 OF BAWiSTABLE Date Issued Conservation Division > 3103 (: 5 Fee 3 JAN 23 P � ��30 Tax Collector � 3 � � c' SEPTIC SYSTEM IvA ��--`���� Treasurer` „ / O�3 ----- INSTALLED!!V COMPLIANCE USA'i� MPLIANC�E Planning Dept. VWTI;TITLE 5 Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE AMD TOW ! PECUL 'r O%�o�% Historic-OKH Preservation/Hyannis Project Street Address Village Owner Address 1 to 5 Cws� � J Telephone 5 Og _ 9 7 l Permit Requester�• 1 a'w 10' — ss� 5'wn M M o` (11l�t,J ac �� act Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Valuation 4 \ 1 ��;-� Zoning District Flood Plain Groundwater Overlay Construction Type 4� S Lot Size q y 3' Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. C' Dwelling Type: Single Family X Two Family ❑ Multi-Family(#units) Age of Existing Structure Vq� G Historic House: ❑Yes \1ANo On Old King's Highway: ❑Yes JJ(No Basement Type: Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) fJ O E Basement Unfinished Area(sq.ft) day Sy r7, Number of Baths: Full: existing :new � Half: existing da new Number of Bedrooms: existing o� 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 y65 New Existing wood/coal stove: ❑Yes &No Detached garage.4existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage: ❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use 3 S�— S `�a1 M BUILDER INFORMATION Name 7z s. o�Pa�►s & Telephone Number S y 7 0 �� �SrQ3 Address —"���.rc�c�� � 2 r� License# O 7 8-O 1 Home Improvement Contractor# 1 a5 j 10 Worker's Compensation# 35 Lb 3 q'35 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO 4��.t' Scxtis SIGNATURE Gv+' c DATE % J11 - FOR OFFICIAL USE ONLY s Eo PERMIT.NO. DATE ISSUED d MAP/PARCEL NO. ADDRESS VILLAGE ; OWNER., DATE OF INSPECTION: FOUNDATION 3 f FRAME I INSULATION 7 FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH 'j _ FINAL FINAL BUILDING " t DATE CLOSED OUT ` ASSOCIATION PLAN NO. -. — 84 2� o O N LP @ �V LP N EX. PROP. TBR H EX. 1e 66 ?4.18 SUNROOM GARAGE V. 10�, SEPTIC SYSTEM SHOWN TANK 0 IS DRAWN FROM AS-BUILT ON FILE AT THE TOWN N HEALTH DEPARTMENT 1007 CH EX. DWELLING MAP 272, LOT 46 165 CASTLEWOOD CIRCLE BARNSTABLE, MA �2• A�� 51�1 LOT AREA 9,435 SF A ` EX. DWELLING AREA- 912 SF GP EX. LOT COVERAGE= 9.6Z PROP. LOT COVERAGE- 10.9X CERTIFIER PL 0 T PLAN BROWN RESIDENCE I CER7IFY THAT THE IMPROVEMENTS SHOWN of M4 165 CASTLEWOOD CIRCLE HAVE BEEN LOCATED WITH AN INSTRUMENT BARNSTABLE, MRA A Res G DATE: DEC. 21, 2002 SURVEY. � ROBB �, JOB �: E00380 c SYKES SCALE:1 =30WG No. 35418 EASTBOUND s J�,�`� LAND SURVEYING, INC. l r p s P.O. Box 1836 ROBB SYKES, P.L . DATE 41 Meetinghouse Lane Sagamore Beach, MA 02562 EX151IN6i 6' POOR FROM HOU5E PROP05E2 NEW PECK(12'XIO'APPROX) ! I.2XI0 Pf FRAME @ 16"O.C. 2•LEZER BOLTER I/2"X5"LP65 52"O.C. 5,J015f HANGER5 POW ENP5 4.PI3L 51PE J015T5 2XI10 Pf TRIPLE ENP MAM(HIPPEN) 6•(5) 12V X 48"PEEP 1`I65 W/ANCHOR5 7,5/4"T96 PLY OVERLAY 6.6X6 PO5f5 9,PDX 5TEP5 ! 10.5/4"X6"Pf PECKIN6 ON 5TEP5 IO' - �-— PROP05EP 3 5FA50N PORCH - 12'X 10'(APPROX) A FRAME 5ME 3"EP5+ H ROOT 56TEIv1 C 5'519AN), NEW 6'POOR — NEW 6'POOR FROM PORCH �_ FROM PORCH (NOf 5HOWN THI5 VIEW) IC=1� EII!�!!F 1113 11-111 11�111 1=1 11' 1=11I-111-11�111=�11� FIII-1!F=�1-1� �C-! -111_!!r-i g L.I EH 1=1 f]I I-I I I-111- -I! -11I 11=1I l-I I I-!I H� L-1I1-11-11 L �I I t_ ''-I I c1119 FI!!-!! !11-1 Li-!11=1I�- �1=i i... =i l III=11�111=111-III 11 F-111=!I I=! . 1=11 r_ III I!-111 II il! !II_:I Ill_::1 ail-!�!I II_III-11-1 r=1!1=11i=!I_ kill-' EI!!-!ILIICIII IElI' II Il�il II•-1! !I=!1=!I ill!;I' !Ii it !II=1!I-Ill !ILJIEII I IHI�II��Ir1 11! !!�F�Ij�li-ll �lll !i In =1llll=ill-!_III-!II !I!=li�lir 11= II I- - ill!-"' ' =Ill=1�=11c,•^„� - -1 -1- - h- STAIR 5PEC5 O 8::RISE 11"tREAP - Project: 5cale:1/8"<1'-O" Prawinq: B. l ett erl iving mom PFsima 165 CA5UW00P CIRCLE A- PATI O ROOMS HYANNI5,MA 02601 100 Otis Street Nothtxxo,MA 01532 Phone(508)393 0400 Fax(508)393 0340 Pate:1/7/05 Sheet I of I P�'OR c� N W CJ N 0.Ol r0 D� 1' O N �; > Z7mayOTor'� � nu = �> O y ' �I Ne: NQ trt m d ci "d �l a I i7t - fil C N C P- �' frl 1 I� x x � t 7acs�z7azrm D1nA r ZO� I m m T N d n N s i ftl I al.� :: `•}! t ^�viP E "Z CP ;1 O D➢ c i Z a CTi W n —1 T _ m e w j.ts is W D O: O r O r p CP Z o o m z �'R�7 I N r� o s oc o @3� - p sa U z c c Mnt NZ z . �A za m W W: Z NM N o r { d D mac ti Rt II x M:09x::L9 \\ r(1 O t;p J 61 CP C— _I Q I--l_CR— ,o y p p m m 7a ��dM d D n 0 Z r > O m O n �2 �OZp� MUrn06 m O O S h(P Z ➢ r 0 0 Z fr1 I S I —i - C9 713 7a Z L 75 2 z m Z O D CSC N c> _ 6l ➢�l� m T i$1 76 _ T I•_---'— X CS1 C31 Om G>O D,n+ rn ➢ Z uXliv rZ-� Z��O > Qe Z r r rnr- �7a�t r M 'j) > T c rn -ip ➢ D p'O 7"m m Omp� 2 m cn.� > T—_1 y 6l d p n -a p 67 I 1 � I I r Z mD"D Z — GT'1 I� I O n S O F mSC �Od� m76 I > I z r t a �umm�y i�uctt`�-uppm m D u mZ�o�m oo= ,aoo< CP rr y y ➢�m o ran�7 o Z,5!z os o� cN c� � f d t,y1 r `G C i csi ,. - � NZ�r�Or.m ril m71mD • o 711mrTlym O ZZr a n-,S O ✓ �� I.. M �ilc ➢c 9 �\ �y� ,. ,o vT I (Si oyon o. y.�^. sus r lo n 713 Sri! �P - 3� �J Y t�G' - ➢ f t!l111t11i iltiF\\t` i I c m z m - y - a �U m pow -vm c m om OC D D Cl 700 Z m 7° --..— '� Sip p iE �C ➢ p z=1O Gl ZZ n Ou - Z S 76 r p Gl _ d cop Cc rp0 N ➢ N M.OZI. � I 75�' . �m ! jm r f(1 O O D - I r I I / Q m - 1 mD 7Qg � z _ r n mm ` D i z O >� n s 5 F 713 o u ,� vF i >. ril Z X I Z 1 s� ft� AW- m I � i1l The Town of Barnstable • aA SrAet.e. 9 MASS. g Regulatory Services tE1659.p�y Thomas F. Geiler, Director Building Division Peter F. DiMatteo, Building Commissioner 367 Main Street,Hyannis MA 02601' Office: 508-862-4038 Fax: 508-790-6230 Permit no-4a, Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION ' MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. —\ Type of Work: Estimated Cos 1 S.�s�c�� � "� Address of Work: \ Owner's Name: Date of 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 IMPROVEMENT WORK DO NOTTRAT ON PROGRAM OR GUARANTY FUND UNDER MGc. ACCESS TO THE ARBITRATION L c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as a ent of the owner: Dat �c�-A"� `R�`z.�Contractor Name�0&io Csww egistration No. OR Date Owner's Name q:forms:Affidav:rev-070601 ' A"TMVZT In accordance with Article l' Section. 114. 1.3 of the Massachusetts State 5- uilding"„Code, x certify that all debris resulting from .work as'sociated'.with Permit will be properly disposed of' at EL• �tAPdCY ' S�N� -- licensed solid was te• disposal "facility as defined .-by MM C1.1, S 1 50A,. S, ature of rpe it&x5plicanc E . I. : HARVEY & SONS in [ - - 66 HO P K (N T O N R D 'Print Name of nppli t W E S T 8 0 R O , ' . Mq a i�E2L�V1NG P.A'T� S .(RjfE: 135 ) : 1581 Firm Name (if any) 0 <STIZ�) q Address; Effective Sentember' 12 , 1991 ,the Deaartmeant of 3ealth/Code A4. Enforcement acting under chapter 2 Article 13 0= the 1986 Worcester Revised Ordin nces raquireo proof of dzsporal of debris generated as Ia result of this permit. The proof shall be a dated and signed receipt from the licensed disposal facility containing ;the following ir'formation, A description of- the debris, the weight and volume of the ' debris snd the location of the disposal facility. T a receipt must also have a signature of the owner/operator of the disposals facility. - Failure to comply with the requirements o= . tb-is Ordinance will result in enforcement action by the City. TOTAL P.02 t. 9 6 BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 078016' Birthdate: 11/08/2000 :i7 Expires: 11/08/2004 Tr,no: 78016 Restricted To: 00 R JAMES F RINGER 44 CANDICE STREET - � CLINTON, MA 01510 Administrator ri'u., .l;:g o(mra of )3uildin;1Z:gulatlGUS AiiC i...2:ra,r.:' ! hlStr(;L'frtl 1'.i(1' i.. fil7lt'lil_II JS: OTI."•' t L.r.'�:SE:ir (•c' t'F ��yr,` �! HOME IMPROVEMENT COIi T RI, i,-F. he":,-e h� t;r t exnirrt' ,_(daT.e if ,L,:ti ret;u, ,ta: �`,� yc:_r� �!'°tTildr.�?'eoc!z_,c.r.( r.('. 4t::��J ••Ttc - f,•s Pegistration:..1�5 io'o - On.( Achburwn Pl2ce P.-7 13fl Erpir'atitinr;`10/21/03 Type:_.:Private Copo-ati:ir, PATIO ROOMS OF BOSTON INC ANDREWS M.ALONc ':i::;` 100 OTIS ST - .. - NOPTHBOR _ J GH, IAA 01-53 �.tt 117101 1. r.?,' - !•i 6T YStil� IthUa Si_::AiI.I,. NS.UNIE �FORiV UQI( FQI2M��S`�`�Z40A BEN;.� .��^ Issadl_atig`etEs' ta�euili]uCh `' i�eiic�= the Massachusetts State Building,Code (780 C.VjR) includes provisions to ensure that Houses and house additions meet energy eMciency standards. This supplertlental CO?�SliMBR 1NFOR —A i :ION rOR}vf IS to be Iled as part or- the buildin it pplication when aDuiiror`ator Ona r ConstrucC'Li &ii-istallin[,:a hou5e addition With very large btrCentage of glass to opaque wall, steles to utilize a special energy COnsei vatio l exeIIlptIOn Option for "S'1111rOO111" additions to a.'I existing .l1oL'Se (780 C1VSR,. Appendix J, Section J1.1.2.3.1). .This FOiUI is not intended to prevent a homtovmeer from select: g a surrroom" oI arty' size, coiliIc�uration, orielltatio*n; Jobnm oI Construction or percent glazing; but rasher iS Only intended to assist hoIIleOh'nerS in becoming aware or some OI the IiilpOrf2nt eilei?Y Conservation and yCar= round Comfbft considerations involved iIl selecting and utilizing a "sunmoin" addition lne Connection 0i clinrnnri-i' St-UC.tUre,, to h gild; no c a :%�.� ^atr ea to LIIc I� anu energy ..>.>u'.j U:,.. w .viar :! G7 -'�lri :)I t.:r� rar`ia4i.".II rGGlrnn t,1 --• `. Train noise. in the selection and Construct1011-/Installatioil of`.suer onrlg"r inCl,udeGl bel0`N IS a no •reGuiredv vpert-Grid-� l:St OF product and dcsivrl COIISIderatlons i a-,4 a hoiiltoWner may h'Isn to consider before actually con$t-uctinc-,/installlnc, a "sunroom". It is recommended that Consumers Carefully review these options Wit..h their desi`ner, builder, Or COP traCiO-1, Iil order t0 irlii111nlze potential energy consumption and/or house discomfort issues. in addition, the qualifications and reputation Of the compariy,or individuals to be hired are impor`a-at conside aiicns. PRODUCT AND DESIGN COIISIDERATIOINNS RELATED TO "SU ROOMS" a Solar Or:.entatiol: :t.ud Natural Sha'uiii- ® Type of Glazing e Insulating value Solar heat gain m {rszLne materials Glazing to j'Jrajme sealing and gasketing materials/seal durability aradlor T'eatll?er tiglltaess of(lie sunroorn Adequate ventilation- Operable wine ows and fans ® applied Shading Systems e =flation level in-fl0ar , ::'a ils, and Ceilings o Possible Sunr oo-m-isolation froin the :Bair: house via a wail and/or door Or sli6er.' `' I-Ieatin6 and —oolin-7 Methods: !',ilICienCv, Zoning arid Co-?froIS T,T.OLrteowner-cl,—nowleGgznent :The Massachusetts Stat,', ~uiiriinn Cnee .Cectinn..Jl.l.J.2 1 eyL'Le5 3` ilia a C 'a.- � Jl GY�lly 1..'`1IV: Lie O'.''ner's avent Or r e7resentati ve) acknow)CdgC r CCCipt Of t_l's CONSUMER?N-01,UMLA l iOh FO_':UY! DTJOF to Issuance Of a �Uildiillg Permit for a prole,.: ilia t Includes "Suliroo.—,," additlOnS to an existin- residential buiilQing In accordanCe With this i-CGUIrCmCilt, iile llil(ler5iflned hereby ackmo%vled4es heat she/he has read `JIe InIO-T7lc�ti0,*1 i.il i(I}S 7pCUttlellt Coll Ge.r i to cii,irnnin rni,lfOr and oner J, CO . hat, .' 112�aLdL SIBnature Gf A,Ctu21 Du'l lino O`h'IiCr Date Print am.t Add.---Ss Oi Perrnifted Project O'vnerIAI.ddress (11 diiiC.Cni than project locanoi-j) OWncr s teiepllO+tP rumb'r The Commonwealth Massachusetts I �• ___ o Department of Industrial Accidents Office 011aresmost/oos - - _ 600 Washington Street . Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit is name: location: C`��- city 0.� �5 hone# ❑ I am a homeowner pe rmmg all work myself. ❑ I am a sole rietor and have no one workin in any capacity % /%%% %/�%%/%%////%%%/�52 a:&%%% O/%%/%%% kern' co ensation for my employees working on this job. employer provtdmg wor mP comnanv name :address.:.. c� phone#� :. .. :.. .;«:;..;;;:: i arisurance co. ❑ I am a sole proprietor, general contractor,or homeowner(circle one)and have hired the contractors listed below who have n polices: the following workers compensation p ".':.<:..'' . coin an ;name:. .........................:::.:;::::.::.;::::...................... .......... .:;:.;............ ....;:.; hors i ............................................................. ...................................................::................... 6. nsnrance ca:.;:' _...... :. :.;:::..... e#x. ci .......:........ under Section M of 31 152 can lead to the imposition of criminal penalties of a fine up to St,SKoo and/or Failure to secure coverage as required one years'imprisonment as well a,civil penalties in the form of a STOP WORK ORDER ands fine of$100.00 a day against me. I mtdetat�nd that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. 1 do hereby certify under the pains and penalties perjury that the information provided above is tn.and orre Date Signature Print name 4 S Phone# � .g� g' � 55 official use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Building Department ❑Licensing Board response is required ❑Selectmen's Office ❑check if Immediate tapo q Health Department contact person: phone##; ❑Other (revised 9/95 PJA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any contract of hire, express or implied; oral or written. 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 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and numbers along with a certificate of insurance as all affidavits maybe supplying company names, address and phone 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. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. FRIER 'lye Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Invesugatloas 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 eat. 4069 409 or 375 c Assessor's map and lot number OL "uJ ( ^� S'�%STD' ULCC' Sewage Permit 'numbe ................................q.........:... .. :. jD liCr,, �� (f �Q�°fT"E?°w�, : , T O W N OF B AR N S TABLE � i B9BHSTdDLEr � `•• - '%c ti NAM BUILDLNG IH.SP:ECTOR CO 0 �..: ry AP.,PLICATION; FOR- PERMIT'TO ...i.,1341, b.....�� :.............................. . ...................... ......................... TYPE OF CC'NSTRUCTION .... .. ....................... .............................................. .............. F ....... ..... ;.1- .................197 .. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby hh^ere�bcy�apppliiess for a permit according to the following information: Location .......1! 1... .l.<,�ll�!`'t !�.Q.d ..... '�. ......... .W /V! ( .... .....................:............ ProposedUse ........... ... .... .... .............................................................................................................. c Zoning District .......... . . . ......................... ...........Fire District .. ... ........... .............. . Name of Owner ..�. .. ..r.. r .... . ................Address AY ....... ..... . ............4. . .......................... ' .. y j� may, Name of Builder ...... . ... ....... ...... ...Address ../...�?.... �°t�.- r � r i. ,Name of Architect ..................................................................Address ..:-........ .. .... .................... ...........1 r.......................... Numberof Rooms ............... ..................................................Foundation .... .... .... .... .. ..................... Exierior ..� ....... ........._.......................Roofing ........ .... .... ....�...................... FloorsInterior ............................................. ...................................... Heating .......... ...,. ........................:......................:...Plumbing .................... .........................................................:... �d Fireplace ..................................................................................Approximate Cost ........j.3...,...........,.............. .... . .............. 0 S.1 Definitive Plan Approved by Planning Board _--------------____-----------19--------- . Area ......................................... Diagram of Lot and Building with Dimensions Fee �l — ........... ... ........................ SUBJECT TO APPROVAL OF BOARD OF HEALTH y. dp I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .. . .�.. ... ... r.............. ...............lk......... » Rmbicheao^ Rom, & Cora 17906 ' garage No -----.. Permit for .................................... . ' - --------------------------. ' ^ � ' . 165 Castlewood Circle ~ � Location --------.-----...------- uyazmzzm ______. ' ' - Roy �� Cora Rmb1���ap Owner ---_—.____.____________. frame Type of Construction -------._-----.. . --.'�—^..---.---------.------.. ~ � Plot ---------. Lot ................................ Permit --�ron��6 . ±-2�'��—~�lg 75 ~ Date of Inspection ......................... --..�l� ^ ���� /�/ / Dote {�nno|a�e� lq . '�f'+/^---'—'� PERMIT REFUSED ~.--...—...`--...-- .. `----..... lV ~ ........................ ....................................................... - ' .......................... ---_.----------.-- . ' . '_'~—^—^—''''''^-----^—^—~—'-----'` ' - .---.--. ----...-----..~—.----. ^. - . . . / Approved — �-------------' 19 - ^ . . .. -------.-------------.-----. ' . ^ ' ' ................ ........ ................................ ~ ............ i | . - o Assessor's map and lot number ........... ..................... ...... Sewage Permit number .............................................. ..y:...... aui /+ifft r TOWN OF BARNSTABLE �Q o� BABHSTABLt i OY 6Y � BVI•LDING INSPECTOR F9 Ares •i d"�..-...�.--� � � � �• r��: APPLICATION FOR PERMIT TO ��. ..... i.... .................... TYPEOF CONSTRUCTION ............ �j .. .. .... ...............................:................................................:......... ` ......(fr�n..... ....?�...� .............197 .. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according Ito• the following information: ,/ Location ......1. ... 5-7�-C t�/,C ....�'.1. .� L .......... 1 �/74��1Y....14,4-�5 .................................. ProposedUse ..........(...... .rJla.....�rr. ...................................................... ............................... Zoning District ..... ......... :...........Fire District .... :......... Name of Owner .. .?H...1 .Address ��.. l �a d l! 1 .�r .. . ...:...... .... ........... 6 Name of Builder /2n rr�`-'� ( C _. .�'-."....Address .. ' ...................... !ia ^�. Nameof Architect ..................................................................Address .............. ...................................................................... Number of Rooms ............: )(--2 .........................................Foundation .. �. .. �. .! .!� `F" .� Exterior ..:.................................................................................Roofing ......../ .`�....:..•.........:...._ .. .. `.. .r ` Ll Floors ( ,Q....... ........- ,; ....................................................Interior .............................................._..................................... Heating ?. -.'- .........Plumbing Fireplace• ..................................................................................Approximate Cost .......................�.................................. Definitive Plan Approved by Planning Board -------------------_-----------19________. Area `` f' .a r Diagram of Lot and Building with Dimensions Fee a' SUBJECT TO APPROVAL OF BOARD OF HEALTH - -C .fir 1 � � k ,f'" . I hereby agree .to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. - .. . Name .. ......................................... Rmblcbaao^ Roy & Cora A=272~46 . 17906 garage ' No ................. Permit for ................................ ' . ----.---------�-------.-----. . . 165 Castlewood Circle ' Location ........................................................... ------.. -- _ Hy \ . - ��___-- ' . Owner Roy & Cora ___. . Type of Construction .........frame ............................................................ . . ' Plot Lot ' . . . _ 5 Permit G,pnn:o Do,= or Inspection ' ' Date Completed . . PERMIT REFUSED .. ..............................k................................ . . . - . . . . . . . . . ^ . ` lA . ' --------_--.. ---------. . ' . ...................................~--�'—.-----~--. . � l . ........................... ^ � ` .—.— . . . . ' � . ' . . ' � / ^ -----..�l-------.---.—_______ ' ^ -------'-------'.------^---^' �' ^ � ^