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HomeMy WebLinkAbout0116 KILKORE DRIVE � L 1<O DPF^' SPA UJL- w�,.-rs IV \f' SQ. ;S 74 l • A- CERTIFIED PLOT PLAN I CERTIFY THAT THE FOUNDATION SHOWN ON THIS PLAN IS LOCATED ON THE FOR GROUND AS SHOWN AND THAT IT CONFORMS LOT 74 KILKORE DR .& FLOODTIDE LN. TO THE MINIMUM BUILDING SETBACK HYANNIS, MA REQUIREMENTS OF THE TOWN OF BARNSTABLE. PREPARED FOR BAYSIDE BUILDING INC OF SCALE: Ifl = 30' DATE: DECEMWR 14,2000 EVEN m v M 3 y q�OEEStM SI�NP�Q WELLER & ASSOCIATES 1645 FALMOUTH- RD. - SUITE AC CENTERVILLE, MA 02632 (508), .775-0735 Y r 1 TOWN OF BARNSTABLE.BUILDING PERMIT APPLICATION Map `� Parcel 00 e/DD/ � AMICANT MUST ORTAN A SEWER Permit# �'1. J CaNNEC.ION PERMIT FROM THE Health Division ENrINEEEWa DMei01I NUOR To Date Issued Y/291,0'h CA Conservation Division, 11 Fee Tax Collectors = w`• Treasur r' ' �` moo Planning.Dept. r Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis _ L. Project Street Address-- / lL kQgC DR. x l)f y Ld T= 7 YJ O0Je �} VA S .Village Owner 6}JY5 !0 F_ k,��� • V Address � �✓/LC Telephone 1771 Permit Request TV 60415—i"C - 4- 3 1,beble6o M �MIC /Ji 677,1C -0 r2- C112 (o e4 lM e l z Square feet: 1 st floor: existing proposed f S� 2r 'floor: existing proposed Total new /SYD Valuation �14q, 976 Zoning District �' Flood Plain C_ . Groundwater Overlay Construction Type W00 D F/C ` Lot Size /0. `��9 Grandfathered: Vres ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Ga' Two Family ❑ -Multi-Family(#units) Age of Existing Structure /46 W` ` • Historic House: ❑Yes C'lo On Old King's Highway: ❑Yes U- Basement Type: dFull ❑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 3 Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: &Gas ❑Oil ❑ Electric ❑Other Central Air: Cles ❑ No Fireplaces: Existing New�_ Existing wood/coal stove: ❑Yes C9'0 Detached garage:❑existing ❑)new .size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing R new size Xa3 Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes �o If yes,site plan review# Current Use � �� 1- &T Proposed Use AF,516CAI&E BUILDER INFORMATION 1 Name 6 AY 5 /biff I�C�/u�//U6, iA­t Telephone Number `7-7/` AJ VO l Address GrX �'� License# eo5^1 V � Ti�/�- ✓� Home Improvement Contractor# Worker's Compensation# %C_l gC l /d fl/ ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO `'5fW 6V4i� L,4N6F1L - SIGNATURE DATE ff/ zfJ/ CJ� I AN FOR OFFICIAL USE ONLY PERMIT,NO. DATE ISSUED MAP/PARCEL NO. ADDRESS : ,VILLAGE' OWNER DATE OF INSPECTION f6s FOUNDATION x, ` FRAME INSULATION'' 1V FIREPLACE ELECTRICAL ROUGH • J FINAL PLUMBING:- " ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING 41 DATE CLOSED OUT ASSOCIATION PLAN NO. r• TOWN OF BARNSTABLE CERTIFICATE OF OCCUPANCY PARCEL ID 272 004 001 GEOBASE ID 37566 ADDRESS 116 KILKORE DRIVE PHONE HYANNIS ZIP LOT 74 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY PERMIT 52509 DESCRIPTION C/O, FOR SFH. BUI'LT UNDER. # 50213 PERMIT TYPE BC00 TITLE CERTIFICATE OF OCCUPANCY CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: �IME BOND $.00 CONSTRUCTION COSTS $.00 756 CERTIFICATE OF OCCUPANCY 1 PRIVATE Pi%.E���_ ; * BARNgrABLE. + MASS. 039; Ep M`A`l BUIL G V SI0 BY DATE ISSUED 04/03/2001 EXPIRATION DATE �----� - m BUILDING-, PERMIT LOT 74 BLOCK I! SIZE . DBA I EVEMPME T D S, .,',: e PER—MIT 50213 DESCRIPTION 3 BDR. P.AWC W/ �_TTAQH_Eef: 2 PERAIT TYPE. -BUILD TITLE NEW. RESIDENTIAL .Bllll`,�G P31'I 1+L1�F Sy«P.PyS�SC"�4J�E�e\�Jt .t�l 4"t.,F. k,3J..t.:.�_ S.t..1.A.d.YJI1.\11..191 -6...�I,C '_. '&..d'8.� �T:q4'� •bi6.�.�rer -f� R.$.,�. 9Ce Safety and TOTAL FEES: $509.24 � CONSTRUCTION COSTS 1-6 ,270.00 I ,I CLE FAII 110M ATTACHED,' 1PRIV TE, P1111111"k- NAM BUILDING DIVISION ssu .ep+ �1.1/28 200 ERIP L C AT lak4 DATE as THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMIPORARILY OR PERMANENTLY.Env- � CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE.JI JR!SDICTION.S i R FT OR I ALLEY GRADES AS WELL AS DEPTH A,,JD LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE IS-UANCc OF TH.S PERMIT DOES-NOT RELEASE THE APPLICANT FROM.:THE CONDITIONS OF'ANY APPLICABLE SUBDIVISION RESTRICTIONS.. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APP40VEi) PLANS MUST BE RETAINED ON JOB AND' F APPLPCABLF SEfA�fATc y 1.FOUNDATIONS OR FOOTINGS THIS CARD,KEPT POSTED UNTIL FINAL INSPECTION PEF�P.RE ARE BLE,S REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU FIECTIT$, A PLUMB;EQ RE M�: CH (READY TO LATH). PANCY IS E REQUIRED,SUCH BUILDING SHALL NOT BE. RNiCA IT,STALLATsOhS ^9� p 3.INSULATION., OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE." '4.FINAL INSPECTION BEFORE OCCUPANCY gs I 111FAM BUILDING INSPECTION APPROVALS P PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS I 2 )N5 pisl� � f �/ 2 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPART SENT BOARD OF HEAKH uwc lu� AS SIT AN REVIEW APP ROVAL _00ffo4 I 7 WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON-, INSPECTIONS INDICATE; ON THIS THE WSPECTOR HAS APPROVE STRUCTION WORK IS NOT STARTED WITHIN SIX- CARD CAN BE ARRAN^ED FOR EY.. VARIOUS STAGES OF C-ONSTRUC- MONTHS OF DATE.THE PERMIT IS ISSUED: AS TELEPHONE OR WRITTEN NOTIFIC;'; �I TION. NOTED ABOVE. TION. BUILDING. PERMIT i r A 79 I _ R -- - - ��� --I�'}��. ��� -7����� �i�'�= I --_-- __-- _---_ c�, -=_= _� go RCN I ELEV,' i'ON `/{ 91 !Y TIR I I ' L L l li REAR ELL-ti`r^I I(_DN DR?WN HT. K SMOKE-DETECTORS O.K. - B RNSTABLE BUILDING DEPT. ''ILlI I �l CI LJ Ll III, 1 'ti II'r�il'Iill�l'hill 00 I;IIII� hI �_ �� �III .i�Illil 1111.III I�liill II IIIII � �_� �_ II �jl; I II ill jli'Ills I !I�I,I I IIUi l;llll I I I I ills fill IIII]Ills I! III!! Ijllil ill iliii 7i ._ �r�I I i II I Ilil I i I p11 LI D II'i il��'II IIIIII IIII' II�iII (C] I j _ Aa 0110 0 , III i \j!All I II� '''II!III I Ii,ll `� III II I �i'I i III ��°' - lll;lliillllllli III III 11'I II I n � ' III II I IlIi1 i IIII III it i III ---- I Li�Illllll ;Illil I°I'I III IIII =— 11 I I I Ij I,I'I�I I li�li I!I:'l l lll�:l,llilll,lpll .4.6 WXATI I. �l{ _j�j�+�.� jj_ �.7 JJ- ---Ir - HIM ' 1 � GkEGG REr51DENGE-`. lh>1� 11 D E9 �' U R L DD H]M `� H IM �~c OT 74 K.ILKORE y - V r rw w r b E1 4^ < O R G n� � y o" r ¢ $ � �. � • PTD PTD 1-1-_--]i 4E 5,4' 'a� p 3/4'xS4 3/4' u x F 2-4 FC5 7252 OX ' a I ]Y. • I • I G _ a 4' I "a a La'e• ,} I _ N - , y a 0 3/J a 3 E 3 Ba IU 10 <k I PTD 19a1 F ' 3/4'xil 3/a'' .,PTD 2%1 13 0 l ]nl3 STEEL PBOJE 9 3/A'."3/4' b F ' - :. .. iA� •� t�t ern ` ��• _ � .. r b �i ti 17-4' 11'-0" p WZATIG aJ U" b (J6�\N� ..('7I 9�'��'�� (aR G(q RESII7EhICF (t1]L HDIE B UHLFOHHGC rt IHC. f —OY 74 KILKORE , 1 �l r•----� L I N 4418' • - I Isis'ExT.I I i- �j C -----------� --- ----------------- I-- '----- —�-- -----J 1 L--- 2 .. ---- — I I I I I • � I j I .. I `—eBPn P(KFET• - _—aFan PxxEr 1 j I i �� LU9 f I - 10'x7-5'CCt4cRETE MIPLL i I REAR WALL ONLY IB._B.. I 12._B. I6'z10'CONT. FCOTING r J, 3-_x12 GIR➢E. I _ iO3 7 L! a Ic•o c. al c a Ivo.c. I I 7•-0' '-b 7'-U' lb r r �31Nicz'an.STEfiL r I F— BLARING I L1 J 9�bE P'P.T. I F Ej- 1 6 L-J L_J L_J / L_J ! I _ 1 .—eEPn FoccEr �I a1 ! -I ' I i BEAI•I P�KttET •. F L.3-2_I2 GIRDER CAB NEPTtS __________ g I ml - /V CONCRETE L-;----- ' aaXa 2a'-d L'i xIC CONT. FCOTNG L _ _________- /mopp AAd. $.I UII.Bijl -2•CFFS __—_______ TO e I I i V lt7 L.___ ___J W O i3 v �� 1 4• �QE =� iz to z - '- TOP CA FOUNDATION.� i3 jI .- ;vl -, 2ICRETE WALL I Ib 10'• O ONT TING 1 I RCP'C CO.'RE �I j SOUND :I IC'il` F .^.L i`'i i j _�; SrJ1L_ .I/a• -�.� _______________ .. CRPwN BY. K y Y - F � N9 • TMAl g� ur "• � �x I ��� '' 4 n �„ (1 lfr I J m2 9� W: y� A J Va J ip 1 y rkml m > EE � f ry�� �� �1npp9�CryC Q�OD� -� A G �xC� o �g R ^MMNNIII N € 6F, f LOT 74 KILKORE 9 r yy _-- - - -- - 3 f�3�,SPBE RfRV SQUARE,vESG�1P(�RVOLf LE, MA 026= ink Pl -. . . P`OptHEIOk1, The Town of Barnstable BARNSTABLE. • Department of Health Safety and Environmental Services 9 MASS. e i639. �0 p'EDMp�p Building Division 367 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner , Inspection Correction Notice Type of Inspection Location V U) t L(:- -W 'e Permit Number Owner Builder `� SL0 � One notice to remain on job site, one notice on file in Building Department. The following items need correcting: :34 d S:Wcs or Please call: 508-8(6�2-4038 , for re-inspection. Inspected by Date DATE: It ZS cV HOUSE NUMBER CONFIRMATION TO : ASSESSORS DEPT. . FROM: D.P.W./ENG. PARCEL ID: MAP a7a PCL. - DEV. LOT: FORMERLY : NO. RD. !- RD. NO. FRONTAGE: NOW : NO. 11 (a RD. KkU'-. � )LLyE, RD. NO. a O 9--7 FRONTAGE: I S E C. R D. i t l.A,-Ic RD.NO. FRONTAGE: VILLAGE: THANK YOU, i . f i . 1 IV l-= 47. 8Z V •S L-�T 74 � t PROPOSED PLOT PLAN FOR LOT 74 KILKORE DRIVE & FLOODTIDE LANE HYANNIS, MA. PREPARED FOR OF M�J' BAYSIDE BUILDING INC. VEN UMBA SCALE: 1" =30' NOVEMBER 22, 2000 5 9 �FFSSI�NP Weller & Associates 1645 Falmouth Rd. —Suite 4C Centerville, Ma. 02632 Town of Barnstable Regulatory Services , i/ (L. lit ,0HLE , Thomas F.Geiler,Director T ���� �"� ' �' ��� Building Division2 E : ► Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us �,; Office: 508-862-4038 DIVT Fax: 508-790-6230 C PERMIT# FEE: SHED REGISTRATION 2.00 square feet or less Location of shed(address) Village Property owner's name Telephone number 6 Size of Shed 6 � I Map/Parcel# Signature e ��OWI Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? If over 120 square feet,you must file with Old King's Highway Conservation Commission(signature is required) Sign off hours for Conservationf8_00�9_:30&3-i-0-4 30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. TIIS FORM MUST. BE ACCOMTANILD BY A PLOT PLAN Q-fm ms-shedreg v REV:05201 t ,. ) 1\_ �Vr'�y`1 ��-',ram,lah-? � �� . r` . ,• a•• '. •_ .. ' any ,T S.. ♦ •. ; f -,,a• .. A _ 1 • ,# . ,_ }yam, t _ . r CERT JC d�eD, �L®T � `�tl • I CERTIFY'"THAT THE FOUNDATION SHOWN x a ON. THIS PLAN , IS LOCATED ON THE FOR • GROUND AS SHOWN AND THAT IT CONFORMS LOT 74 "KILKORE- DR. & FLOODTIDE LN. . TO THE MINIMUM. BUILDING SETBACK HYANNIS, .MA REQUIREMENTS OF THE TOWN OF BARNSTABLE. , PREPARED FOR BAY'SID9 BUILDING" ITC . ��, of Ma EVEN GCA SCALE: 1".= 30' DATE: DECEN�R 14,2000 M m v 3 7 h !y �FFS510�P Q WELLER & ASSOCIATES 1645. FALMOUTH RD. h SUITE 4C CENTERVILLE, MA 02632 42-► , (508) 775-0735 Town of Barnstable *Permit Expires 6 m the from iss date Regulatory Services Fee 9��E ard V.Scali,Director Building Division Gk9�3 MAY 2 412017 Tom Perry, CBO,Building Commissioner TOWN �^ g�i`1RNSTAKEmain Street, Hyannis,MA 02601 y y 3 ..J� °.�I'1 www.town.barnstable.ma.us 0 Office: 508-862-4038 Fax: 508-790-6230 ' EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY I t,d,,of Valid ld without Red X-Press Imprint Map/parcel Number Property Address ` K d kC✓e, it V a [Residential Value of Work$ �°0a Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address NAR1D at?p HAV✓feg i61AN0 Kozel t l! leil ka✓e— DY• 1�yoaK�i, 7a Ozb •°I Contractor's Name JAh�e/ �L�(01*4 Gx' Telephone Number e7 Home Improvement Contractor License# (if applicable) 1 007Yd. Email: T e✓H,f 8 041 :ZZ; (wee .edo Construction Supervisor's License# (if applicable) [/Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner 71 have Worker's Compensation Insurance Insurance Company Name A 0 dAY d MAY. ( y! 44f y Workman's Comp. Policy# w GZ1 5,3 X� Copy of Insurance Compliance Certificate must accompany each permit. Permit Request (check box) ❑ Re-roof(hurricane nailed) (stripping old shingles) All construction debris will be taken to Re-roof(hurricane nailed) (not stripping. Going over . existing layers of roof) Re-side 0oB /%dl♦ eO 'Po4twv/)fZ-01ept4 SWS Replacement Windows/doors/sliders.U-Value (maximum.32) #of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *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 copy of the Home Improvement Contractors License&Construction Supervisors License is required.SIGNATURE: d rAil/7 C:\Users\Decollik\Ap ata\Local\ll icrosoft\Windows\Temporary Internet Files\Content.Outlook\2PI0IDHR\EXPRESS.doc Revised 040215 Page 7 of 7 Capizzi Home Improvement Inc. Specifications and Estimates STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT I, RICK GRANDMONT, OWN THE PROPERTY LOCATED AT 116 KILKORE DRIVE 1N HYANNIS, MASSACHUSETTS. - 1 , I HAVE AUTHORIZED CAPIZZI HOME IMPROVEMENT TO ACT AS MY AGENT TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. I GIVE MY PERMISSION TO LESSEE TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. SIGNATURE OF OWNER: OWNER'S ADDRESS: 116 KILKORE DRIVE, HYANNIS MA 02601 OWNER'S TELEPHONE: 508-367-2771 LESSEE'S SIGNATURE: LESSEE'S ADDRESS: LESSEE'S TELEPHONE: APLLICANT'S SIGNATURE: APPLICANT'S ADDRESS:. , 1645 Newtown Rd., Cotuit, MA 02635 APPLICANT'S TELEPHONE: 508-428-9518 RESPONSIBLE OFFICER: RESPONSIBLE.OFFICER ADDRESS: RESPONSIBLE OFFICER TELEPHONE: . The Commonwealth of Massachusetts :Department oflndustrialAccidents 1 Congress Street,Suite 100 ?- Boston,MA 02114-2017 www mass goAdia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name(Business/Organiza.Eon/Individual): C A P i "Z Z i f4 O m e = M P IR OUE A EAI-t- LNG Address: 1 6 145' AWPrOW A ROA n. City/State/Zip:C0 to -l", 11A 02 to 3 Phone k �®c� qQ k Are you an employer?Check the appropriate box: Type of project(required): lu�mm a employer with YO employees(full and/or part time).'- 7. E]New construction 2.❑I am a sole proprietor or partnership and have no employees working forme in• $, a Remodeling any capacity.[No workers'comp,insurance required.] 3.FJ I am a homeowner doing all work myselE[No workers'comp.insurance required.]t 1 ❑Bui ld0'�Buildinngg addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my.property. I will ensure that all contractors either have workers'compensation insurance or are sole I I.❑Electrical repairs or additions proprietors with no employees., 12.[]Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.�Roof repairs . These sub-contractors have employees and have workers'comp.insurance.; _ 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14. er / 152,§1(41 and we have no employees.(No workers'comp.insurance required.] 0 D °Arty 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 than hire outside contactors must submit a new affidavit indicating such. :Contactors that check this box must attached an additional sheet showing the name ofthe sub-contractors and state whether or not those entities have employees. If the sub-contactors have employees,they must provide their workers'comp.policy.number. I am an employer that is providing workers'compensation insurancefor my employees. Below is the policy and job site information. Insurance Company Name:A M 6 U A R D —J—fJ 5 U F.ANC 'C Policy#or Self-ins.Lie.#: -9 ;Z W C-11 S 3 2.4 Expiration Date: 1 2. 1 Z 5- l-201� Job Site Address: ! �G /—/./ /CU V-4L' City/State/Zip: PYA 11011 Ph4 0 ti 66l Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c.152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage v on. I do hereby der th pains and penalties of perjury that the information provided above is true and correct Si afore: / Date: e 1.4 11 Phone#: S 6 Z zr] Of cfal 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#: Massachusetts Department of Public Safety i Board of Building Regulations and Standards License: CS-076261 � . Construction Supervisor JAMES MCCORMACK 73 FEARING HILL ROAD . WEST WAREHAM MA 02576 ='- ti Expiration: Commissioner 11/13/2017 a ��r yin.-uruu•irtarrt�/�r`r��7JJ(Ir�rlJr/1 License or registration valid for individual use only 'Office of Consumer Affairs&Business Regulation before the expiration date. If found return to:Office of Consumer Affairs and Business Regulation � F�TOME IMPROVEMENT CONTRACTOR 10 Park Plaza-Suite 5170 �� Registration: 100740 K.::�t Type: Boston,MA 02116 _"' Expiration: 6/2 312 0 1 8 Supplement Card 4 CAPIZZI HOME IMPROVEMENT, INC. JAMES MCCORMACK 1645 Newton Rd. No valid without signature Cotult,MA 02635 Undersecretary 1ci L lea% 14, u H il�i d ,a� • l ® DATE(MM/DD/YYYY) A'►`R o CERTIFICATE OF LIABILITY INSURANCEF12/30/2016 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 endorsements. PRODUCER CONTACT Rogers and Gray Processing ROGERS &GRAY INSURANCE AGENCY INC PHONE , (508)398-7980 FAC No: E-MAIL i mal ro ers ra ADDRESS: @ 9 9 Y•com 434 ROUTE 134 INSURE S AFFORDING COVERAGE NAIC# SOUTH DENNIS MA 02660 INSURERA: AMGUARD INSURANCE CO 42390 INSURED INSURER B: CAPIZZI HOME IMPROVEMENT INC INSURERC: INSURER D: 1645 NEWTOWN ROAD INSURERE: COTUIT MA 02635 1 INSURERF: COVERAGES CERTIFICATE NUMBER: 114654 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 ADDLTYPE OF INSURANCE INSD SUER POLICY NUMBER MO/DD//YYYY MLICY EFF OIIDD EXP L LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES Ea occurrence $ MED EXP Any oneperson) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ POLICY❑PRO- LOC PRODUCTS-COMPIOP AGG $ JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED N/A BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTYD dentAMAGE $ HIRED AUTOS AUTOS (per. UMBRELLA LIAB HOCCUR EACH OCCURRENCE _ $ EXCESS LIAB CLAIMS-MADE N/A AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X STATUTE ERH- AND EMPLOYERS'LIABILITY At4YPROPRIETOR/PARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT $ 1,000,000 A OFFICERIMEMBEREXCLUDED? NIA WA N/A R2WC775326 12/25/2016 12/25/2017 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below I I E.L.DISEASE-POLICY LIMIT $ 1,000,000 N/A DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/lwd/workers-compensationTnvestigations/. 14 ' CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town Of Bamstable ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street AUTHORIZED REPRESENTATIVE Hyannis MA 02601 Daniel M.Crcyey,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD .Town own of Ba nstA ble "Permit tr F:VAC anrhr fraIn 4:M1,dare Regulatory Services Pat � Thomas F.Geller, Director . Building Division, Tom Perry,CDO, Suilding Commissioner 200 Main Street,Hyannis, PtA 02601 www.town.barrstable.ma.us 0ftyo0 Fax. 508-790-6230 1 PRESS PERMIT APPLICATION - RESIDENTIAL {3�VLY No/ MUM Wtkoar Rest'x4resr Imprint Mapllrercel Nursber Property Addreat �k eftesidentlALi Value of Work Minfinum fee orS33.00.for wo,•k under$6000.00 Owner's rlarna 8 Address ��1,' Contractor's rgarne ��iDlJrl� l�k Telephone Number 7� Home Improvernanx Contractor License N(ifapplicable)- /lJf�r2'9 Construction Suporvdsror's License#,(if applicable) 06LS�__14 rg�--- ❑Warkman's C.Mpensatton Phsurance _ 1 chuck or*: I am a sole proprietor A U G 3 0 2012 I am the homeowner I have Worker's Compensation Insurance insiorant;e Company Nome �? 1lyZ TOWN OF BARNSTABLE .a.., 1 Workmen's COMP. Policy a Copy sYlnsurance Compilar,ce Cartineste mu:taccompany each parmit, Permit Request(check box) M�Fte-roof(horriesne nailed) (stripping old shingles) "Al construction debris will bo taken to (�Re-roar(hurriadnt; nailed):(not stripping, Going over existing layers orr000 C Re-side #of doors Replacement W{ndows/doorMliders. U-Vnlua (meximum.35)#of windows_ oWntri required: bwanes or this permit doss rot exempt oompliaace fth other I'*"aepvt neat resuixtions,i.e. Hil6ic.Conservat►orl,etc. +••Dote: Property Owner must slo Property Omer Letter of Permission. Acopy of the Rome Improvement Coarructors Ltcenss& Construction,Supervisors Lltrnse is re fired. SICNATURg: QAWPRtLFMFMM$iWuitdin$Me"t ibrms%EXPR6SS.doc o_.,.. ..•..,. ,to f , f The CoI1 M101 7Yealtll aflk[arssacliuserta ,Dmpartarten9 of Frulu�rsl.�eefei�rts mice Of iftPofigal oru 600 Sf'ras1dil91011,Steel Bogen,M4 O�III taas>vet.arass�Q�dt�a Warken' C MUP=WdQn Bmurwee Afrubtiit: B�dersl�Contraecta:�JlEtawcta�icia �l/Pj bens a 'bh Nm=�gaApagaaLtstttiora/lesda:aidtul}: Ci Pfqc Am In asa emplorw?Oieeaalt tie spMprlate boa: Type of prejeat(r"Wred); L flJ;IUM M a Mplaysr WA 4. Q d as a gemsru!cwtma �and i 6. ®?aew eaaste�s.tioc (W Isww °�0 have bind dw sob-caatrocrors [2.Q a aale�as•pt�nmr- Based as�af�eed a 7. Q=�nodeliu8 � and hsao�otgalo�raeae 7.�et#a�bseva $. Q.17ets9outsnts eemplOYM and have venutflerr' woddq *r tma in�cr�lty. _� 9. ®suadiag addttiea' 3. Q We asox1coqxxvvoo and its 10.❑MccWcaI repsin cr a4"cos ' 3.[� I mg it htxs¢etyu�as°t Aj all woadc ate have epoetet;sed theta 11.0 PlttissS Ma•irb or additiorsa mtysw NO sras9oaete►mw of0°apa L IO'Roofsepairs c. 132,11(41 amdwehave no MPIOYM.INOProcim. 13.❑Osier camQp.ieataras�te retp�+�.J 'ANY 10PUM OWe+Md W TAM Al apt Sian+mswratrs rsR etoe�$slvao ebstrawl�eaa'maop�.o..� lslb�aaQtdow 11;t�oaeatama tt4M lolmlt rise�des♦tt tteeey aes 44*ang"s sad&Mum Olawsc ewimra O b"s am a�o411 ta8ieslJaa euctL R%mgWjw dw toed We bees sacra ease d d to sddWwd deea Sweeft tbs 94106 OtA2>a34seoeM=M sad ears WhObw eat aqa tbM ecWlao haw Iaoiayase �,Im"seMete7ae s,ally aeawt t eMta eradayss' q sumebee. Ilk"as VAPAOW lkffi'lo pnae st+ser*wa'oanrpaarare&n insarvmeeefor my wr9plIrIVS& Adore it pia policy Rt fob eb'i 0 at Sda mo.Lk 4.-.G1'J4 Dmte: za icb&k A*WM' �11 �.�.; City/S#malp; AtJtaeh a Dopy of On w rkrra' Ad"po7997&d&Mttaae,page►426o thO PO&T slaraobOr SAd espiretion data. Para to atss m wvwW as rgtdnd=dw Sodion 25A ofih GL c. 152 con toad to the iMpositim o1crimiul pwaWn of a 4"vsp to$I'M.00 alwor ase-yr mat,as wail as am,peaA ics in the lira of o STOP WORD ORt=cad s floe cf wp to$250.00 a flay SOMW did viaktw. Be advJ sad that ae copy of this etsteumt any be fwwmrded to lice 02ke of titteta ardw MA Aar kwaswe covWAP va6t3satioa. Zip/41e�t�1 y+"ro AoPa. ara fi'+y'Mat dw ir{feswuWow premed m 8®vr Pi a!w oaid amwras 6 �2 eat ws on(r. Do not sPAW Ira lido area,to be wwpWod by city or mowt offidal t or Towel: Fertait/Licerau d IaWal Authotity(eirede aae): 1,i$oard of Remit& 7.tiWWpg Department 3.+C:ltv't'r*wn Clerk d.Elacirical Insp*cter S.Pleraa'btnj lu,;p,,Vtor 6.lea, t ®, Town of Barnstable Regulatory Services Thomas F. Geller, Director Building Division Thomas Perry, CBC Building Commissioner 200 Main Scrse4 Hyannis, MA 02601 www.town,bernstabte.me.us Me; 308-362-4038 Fax: 508-790.6230 Property Owner Must Complete and Sign This Section If Using A Builder as owner of the subject properey hereby authotizo ____ .>!!1/1 �.d� � tO act on my behalf, in d snetten rahtive to work Authorized by ties building pernvt apphcadon for: (Addtess of Job) i rw—rune of Owner DA e tint Name iC Property Owner is applying for permit,plans@ complete the Homeowners License Examptlon Form on the reverse tide. Consumer Affairs& License or registration valid for individul use only Office of Consumer Affairs&B siness Regulation j g y HOME IMPROVEMENT CONTRACTOR before the expiration date. if found return to: Registration: r100497 Type: Office of Consumer Affairs and Business Regulation ? Al. Expiration:' 3125 2014 Private Corporatio` 10 Park Plaza:Suite 5170 Boston,MA 02116 DA D COX,.ING;a�T w a hz David Cox x 19 LAVENDER LN \qii�+ ,. 6,,e W.YARMOUTH, MAYd2673= Undersecretary I Not valid without signatur i Massachusetts Department of Public Safety IV Board of Building Regulations and Stantlards � Construction Supervisor License License`. CS 63537 la DAVID R COX 1 PO BOX 401 S YARMOUTH, MA 02664 Expiration: 10/15/2013 ('unnnissio°cr Tr>#: 4314 a. ++.rmu q vautnr r axw. image 2 of 2 3a 12 11 43 AM Pa2e:2 of 2 DAVID-2 OP ID:KG CERTIFICATE OF LIABILITY INSURANCE tyATE(i,NfOANYW OTM 9112 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. TWS CERTIFICATE WE$ %07 AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFOROED BY Try PAL7CIES BELOW. T1415 CERTIFICATE OF INSURANCE DOSS NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERS} AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE-HOLDER. IMPORTANT! It the elertltteats holder Is an ADDITIONAL INSURED, the poftypes)must be endorsed. 11 SUBROGATION 13 WAIVED,subject to the!vans and eondlfions of the policy,certain poltoles may retrulrs an endorsement. A statement an this cortiflcato does not confer rights to the oeMeate holder in lisu of such endorsements. PROOII7;R 809.771-1 632 F"WE: $40�1�Str*iK Wulto B'Inc. M393-2933 Nyvftt,MA C2 1 c' Plc PDe A 85: INt UW, APFOWNG OO11EDADE MAC J W&UP&RA:Travelers Insurance Company David Cox Inc IwsomaR6!PrOOressive Casually Ins.Co P.0.Pax 401 8 Yarmouth,MIA 02 !NE JIrBR C; INSIhiE3t E: I N6 RE F• -- COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS Is TO CERTIFY THAT THE POLIOO OF IN3URANCE LISTED BELOW HAVE BEEN ISSUED TO ThE INSURED MANED ABOVE FOR THE POUCY PERIOD INDICATED, NbTWIT4STANDING ANY REQUIREMEN?,TERM OR CONDITION OF A,N'Y CONTRACT OR OTHER DOCUMENT WITH RESPECT TO YWHICF.THIS CCRTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANC£ AFFORD90 BY THE POLICIES DESCRIBED HEREIN 19 SUBJECT TO ALL THE TERMS, EXCLUSIMS AND CONDITIONS OF SUCH POLICIES LIMITS sHowN WAY HAVE BEEN REDUCED BY PAID CLAIMS, T1!IMi OF INeIiiAMOa ?QL Y NUMBERNW'' (MrANDt7lYY1'YI LIrtlITe _0990ALLIAALIfY II i i aACH+7C: 4aEyC5 �5 I,dDD,� A COMMERCI,�LGENERALLIAN.ITr I BtT14S1i11796 i 03/14/12 03PI4/13 P.ELIIaeS Eaareerre.,ea' 300,00 CLAIMSMiDE ��OCCJR I I CX�IM�on'9pu;sony S X auslrats Owners 6 �_ ` PERSONAL I .koy IN..LRYLi S 1,000,00 GENERAL A G;ZEGaTE 5 2,000,00 CqW.-AGURtGA"E-INI-APPL1='$PER: r�-1 I ;PP004G s-CnM°,UP AG, !: Z 000,00 PC'+LIC` 1 1178 LOr. I I s AVrOMOBILS UAGUTY B �ANY AWO I 04119A2 04MO/1,3 "LAY(PSI(AP 9es ALL OWNED sOEDLILEC ( 7 AUTOS AUTOS oGI_Y IrN URY lPar vma_amv t b2030 SXNON•CWNEDx HIREDAUTU AUTO$ 5 1000, , «S� LIeIBRiLLA LlAB OCCUR E C++OCCJ?:EV 5 &%CESaUA�'6 HCLAWS-MrIDE I I I AGGREC+TE f — I DEDI:=ETEN"IDN G I ! S w RK(Rs C41MOMATION AW IMPLOYOR&LMkGILMY YIN f I '} 77.1 A ANf PROMETORrPAFTIe1L.'E _-J IV_ N/A II E.L _AGE ACCIbE'�T S 100,00( c>K=ux�TlErlk aY FxcLue�rrr Y E-E (ahadMwYlt+N>♦I j6KLJLL191D1(T42212, 071SB/12 ©7/16/13 EL.G:SEn3E•cAF'APLOYEc S 100,� ItYyroer,tle6crkt»inde• - _..._.—. •— DESG'?t7N OFOPiRAT puS�jftav E .Ln;EaSC•Pt�LI-r Ltl�' S` SO6, Lf@eCWFTICN��DI�r�A�flNm I LQQATI�r�e) .}{QLEe cAttach ACOM IM,Addk30nat1 Ftvm&r E ScheQtle,ilmorr&owe is eggAro4Q David Cox is not Covered by the Workers' Comp. policy CERTIFI T[N L ER CANCELLATION TOWNIBAR 9HOULD ANY OF THE ABOVE CESMIDED POLICIIX BE CANCELLED BEFORE Town of Barnstable TKa EXPIRATION RATE THMOR, NOTLCE WILL ae~esl Wallo IN 731;Male SOWACCORDANCs WITH INC POLICY PROVINONS. Hyannis,MA 02601 . AMORMREPR.OGWrATIVe cr 019911.2010 ACORD CORPORATION. All rights reserved. ACORO 25(2D10/06) The ACORD name and logo aro registered marl*of ACORD LL,� T I #d C. i B HASTaet,t. : OFFICE OF PLANNING AND DEVELOPMENT rise � ,•� a w.it 7 r9. foM�r��i - 367 Main Street (617)775-1120 Hvannis, Mass.02601 Ext.160& 190 June 24, 1986 Mr. Francis A. Lahtie ne I"" Town Clerk Town of.Barnstable \� Town Hall \ 367 Main Street. Hyannis, Mass. 02601 Re: Subdivision #.572 Dear Mr. Lahte ire•, At 'a meeting of the Barnstable Planning Board held on June 23, 1986 it was voted to grant_ a Special Permit under Section T. of the Town by-laws . subject to review of the related docuaents by Town Counsel and subject to the Town of Barnstable Subdivision-Rules and Regulations and conditions of the Board of Health. Kilkore Dr. ,,,-Daybreak Ln. , & Mariner Ln., to be paved 261wide. The Board also accepted waivers from its' Subdivision Rules and Regu- lations as requested and listed as herewith attached. Names of ways as shown on the plan that may be duplicated elsewhere in the Town to be re named. Plan is entitled; Definitive Subdivision Plan of Lard in Barnstable, Mass. (Hyannis) Prepared for: Capricorn Realty Trust. Dated May 5, 1986. Drawn by: Cape Cod Survey Consultants, Barnstable Village, MA. Yours very truly, Joseph E. Bartell, Chairman REQUEST FOR WAIVERS FROM SUBDIVISION RULES & REGULATIONS FOR A PLAN OF LAND ENTITLED.: " COBBLESTONE LANDING LAND SITUATED IN HYANNIS BARNSTABLE, MASS. PREPARED FOR CAPRICON REALTY TRUST DATED MAY 5, 1986" The Petitioner seeks a waiver from the following provisions of the Subdivision Regulations of the Town of Barnstable Planning Board: 1 . Section 4 ,. Paragraph B, Streets , Subparagraph 3(a) Length of Dead-end Streets - Petitioner : seeks a waiver of the five hundred (500) foot maximum length dead '-end street for Aurora Lane as shown on the subdivision ' plan , said lane being in excess of 600 feet in length . .2. Request for Reduction of Intensity- Requirements of the Zoning Bylaw . Under the provisions of Section T Open Space Residential Development, paragraph 5. Minimum Requirements , subparagraph (b) Intensity Regulations, the Petitioner is seeking a reduction in the intensity regulations of the underlying zoning for the cluster subdivision plan. as follows: a'. A reduction in the minimum . lot size from 15, 000 square feet to lots ranging from the smallest lot of „ 6 ,503 - .square, feet to, . the largest lot of 13 ,727 square feet . b . A reduction in the frontage requirement from 125 feet, to a minimum of '33.73' feet for each lot shown on the subdivision plan. 97°- c:`" A reduction in the side ..and rear-yard requirements of feet each to 7 1/2 feet of both side and rear-yard setbacks . ��djj,7- A reduction in the frontyard requirement from 30, feet o a minimum of 20 feet for all lots , with the exception of lot 74, a corner lot in which the reduction sought from . the minimum frontyard setback is a 50 per cent reduction of 15 feet . e._ A reduction in the required 50 foot perimeter strip to 20 feet in those. areas as' shown on the plan . 2167j ES TIMA TED PROJEC T COST WORKSHEET ' Value q4 LIVING SPACE 5��� square feet X $`-�sq. foot = 14170 9/0 GARAGE (UNFINISHED) 56"b square feet X $25/sq. foot = M . �Q PORCH square feet X $20/sq. foot = DECK 5 square feet X $15/sq. foot OTHER square feet X $??/sq. foot = Total Estimated Project Cost For Office Use Only lnclusionary Affordable llousinq Fee Residential [j Commercial" Property Owner's Name Project Location Project Valise Permit Number "Existing Sq. Ft. *Proposed New Sq. Ft. Fee $ IAHFORM 1/3/00 •�• r� .��/pn w:n�ll�rrinnr,r/�/ r/, /INJJ,r,)�u:1ri/j BOARD OF BUILDING REGULATIONS � License: CONSTRUCTION SUPERVISOR A Number: CS 005645 B i rt h da te: 04/19/1956 / Expires: 04/19/2002 Tr.no: 18679 Restricted To: 00 BRIAN T DACEY 62 FERNBROOK LN CENTERVILLE, MA 02632 Administrator 00-35,000 cf enclosed space (MGL C.112 S.60L) 1A-Masonry only 1G-1 &2 Family Ilomes Failure to possess a current edition of the Massachusetts Slate Building Code is cause for revocation of this license. DIG SAFE CALL CENTER: (888)344-7233 1 `k - z COMMONWEALTH OF MASSACHUSETTS -- .c � DErAR-,r,IvLFI,,- ' OFINDUSTRIALACCIDENTS 600 WASHINGTON STREET ames Camcoel. BOSTON, MASSACHUSETTS 02111 �:OM-s:sslcne• WORKERS' COW'ENSATION INSURANCE- AFFIDAVIT (licensee/perrnirrec) with a principal) place of business/residence at: , (City/S131clZip) do hereby certify, undcr the pains and pcnaltics of perjury, that: am an employe: providing tic following workers' cornpcns-.jon coverage for my crnployccs working on this job. A100Q fl62AJ 1AJ.5. ore 7"crg /y_11 o q / lnsurancc Company Policy Numbcr [ 1 1 am a sole propricror and have no onc working for mc. [ 1 1 am a sole propricror, gcncral contractor or homeowner (circ!c onc) and lmvc'Ihired the contractors listed b-o«- who have the following workers' eompcnsarion insurncc polices: Y.5 1 1)x l/,-1G 47T'1C1/e--A 5#EF7-S Namc of Contactor Insurance Company/Policy Nurnbc Namc of Contractor Instance Company/Policy Nurnbc- Namc of Contactor Insurncc Cornpany/Policy Nurnbc: 1 am a 110MCO he performing all the work myself. NOTE Please 6e aware that while homeowners who employpersoes to do maintenance, construction or repair work on d-Oing of not more than three units in which the homeowner also resides or on the grounds appurtenant thereto arc not gener:!)v considered to be emplovers under the Worken' Compensation Act(GL C 152,sect- 10)), application by a homeowoer for a lice_se or permit may evidence the legal status of an employer under the Workers' Compensation Act I u derst��cr that a copy of this statement will be forwarded to the Deparr.cn.:of lndustrizl Accidents' Ofnce of Insu:ance'for cove:a: vc iitc:tion and ih:, failure to secure coverage as-required undo Section 25A of MGL 152 can lead to the imposition of citninal per.:':: s cor:sisong of a fine of up to S1500.00 and/or irnprisonmcnt of up to one ym:::sd civil penalties in the form of a Stop Work Ordc: fi.c of S)00.00 a d:y mains; mc. Sir-;tcd this day of , 19 Liccnscc.`i'crmiucC Lic�:hsor/Pcrrnittor r SUBCONTRACTOR' S INSURANCE BAYSIDE BUILDINNG: (L) ZURICH - SCPM31195788 (W) NORTHERN INS N.Y. - TC1 91911041 ENGINEEER: BAXTER & NYE ENG: (L) KEMPER - 7CQ27676000 (W) EVANSTON INS AE802232 WELLER & ASSOC: (L) NAT'L GRANGE MUT. - MSP45246 LAND CLEARING: PETER GOVONI : (L) CNA INS CO - C179997230 (W) CNA INS CO - WC179997244 EXCAVATION & SEPTIC: ROBERT J. OUR (L) U S F & G 1MP30109550901 (W) U S F & G - 771521695 NORTHERN SEALCOAT (L) TRAVELERS - 660364K8342 (W) LIBERTY MUTUAL - 312446298044 FOUNDATION: GARDNER CONCRETE FORMS : (L) ST. PAUL - BFS00000169269 (W) ST. PAUL - 7717171998 WELLS : DENNIS SCANNELL (L) TRAVELERS - 660873E5627COF92 (W) WAUSAU - 151300062926 CELLAR/GARAGE FLOORS : MASON WORKS: (L) TRAVELERS - 1680204Y4465TCT FRAMERS : ROBERT DORRER: (L) TRAVELERS - 680526K991A (W) ST. PAUL FIRE & MARINE INS CO . - 6S16UB-510X322-3-99 MIKE DUFFLEY: (L) COMMERCIAL UNION - NBF821356 (W) LIBERTY MUTUAL - WC1312492127024 DAVID HILL: (L) COMMERCIAL UNION - NBF821356 (W) LIBERTY MUTUAL WC1312492127024 MASON: SHERMAN, WAYNE: (L) COMMERCE INS CO - N60689 (W) WAUSAU INS - TO BE ASSIGNED FERNANDES WAYNE: (L) HINGHAM MUTUAL - ART9800896 DANNY TORTORA: (L) ZURICH - SCP 31874051 (W) WAUSAU INS TO BE ASSIGNED GAS PIPING: BAYSTATE PIPIMG: (L) CRUM & FORSTER - 5031766863 (W) CRUM & FORSTER - 4086081999 ELECTRICIAN: CHAVES ELECTRIC: (L) MISC. 'INS . ZDN5245913 (W) MISCELLANEOUS INS CO. - WCP0006299 AMES ELECTRIC: (L) NORTHERN INS . - NBF418165 (W) AMERICAN EMPLOYERS- QBH208297 BAYSIDE ELECTRIC : (L) ST PAUL INS. - BFS00000400422 (W) EASTERN CASUALTY - WC98695063 PLUMB & HEAT: WHITELY PLUMBING: (L) TRAVELERS - 660365K1782COF9 (W) EASTERN CASUALTY - POLICY IN MAIL ALARM SYSTEM: BALTIC SECURITY: (L) HANOVER INS - PAC105393 (W) WORKERS RISK - WCS-80414040 INTERCITY ALARM: (L) FIRST FINANCIAL - FF0131 G400831 (W) COMMERCIAL UNION - CB0743379 CENTRAL VAC: VACUUM HOUSE: MERRIMACK MUTUAL - SBP1608045 INSULATION: MAP INSULATION: (L) AMERICAN STATES - 02CC326435-3 (W) U S F & G - 7711099932 SHEETROCK: MEL REED: (L) WORCESTER INS - CB817530 (W) COMMERCIAL UNION - CBH557387 INTERIOR TRIM: DAVID' S REMODELING: (L) CGU NBFB40738 M & R CARPENTRY (L) MARYLAND INS. GRP- SCP30235965 (W) CIGNA PROP & CAS . - C80049997 K FITZPARRICK: (L) MARYLAND INS . GRP- SCP30235965 (W) CIGNA PROP & CAS . - C80049997 OAK INSTALLER: ROBERT BUDDEN: (L) COMMERCIAL UNION - NBF824090 (W) LEGION INS . - WC30024039 PAINTING: CAMPBELL PAINTING: (L) TRAVELERS - 1680251K4083COF ; (W) ASSOC INDUSTRIES OF MA. MUTUAL - AWC 7000126-01-99 GARAGE DOORS : ALL CAPE GARAGE DOOR: (L) U S F & G BFS000000348188 (W) TRAVELERS INS CO - 1810336H8138T1A99 a STORMS & GUTTERS : ALUMINUM PRODUCTS: (L) CNA INSURANCE - 1074079839 (W) CNA INSURANCE - WCC174080411 OAK FINISHER: AMERICAN FLOORS: (W) EASTERN CASUALTY - WCV3001745 CARPET, VINYL & TILE: CARPET BARN: (L) TRAVELERS 1680625Y1691TILOOS (W) MA. RETAIL MERCHANTS - 8100-06 TILE INSTALLER: TONY AVERINOS : (L) ASSURRANCE CO. - CFP26528977 (W) HARTFORD FIRE - 77WZCY2409 WIRE SHELVING: CAPE COD CLOSETS : (L) ARBELLA - NBF8410782 (W) TRAVELERS - 7PJUB-521X529-4-99 APPLIANCES : KITCHEN APPL MART: (L) FIREMENS FUND - AZC80453098 (W) HARTFORD INS CO - 77WZNB1603 MIRRORS &SHOWER DOORS : L & M GLASS : (L) COMMERCIAL UNION - CBR409003 (W) U S F & G - 0071439933 LANDSCAPE & SPRINKLER: COY' S BROOK: (L) TRAVELERS - 6880937DO453 (W) RENNAISSANCE INS - TBD DRIVEWAYS: NORTHERN SEALCOAT: (L). MARYLAND CASUALTY- EPA18716945 (W) THE PHOENIX - UB387K530 SUSPENDED CEILINGS: ATC CEILINGS : (L) TRUST INS CO - TMP1005666 (W) SAVERS PROPERTY - WC0000873 RUBBER ROOFS : CAZEAULT CO. (L) AMERICAN EQUITY - ACC 060106R-1 SIDEWALLER: ` STEPHEN CRESSWELL: (L) MARYLAND INS - SCP29031342 I d r f MAScheck COMPLIANCE REPORT Massachusetts Energy Code Permit # MAScheck Software Version 2.01 Checked by/Date CITY: Barnstable STATE: Massachusetts HDD: 6137 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 11-20-2000 DATE OF PLANS: 11/14/00 TITLE: LOT 74 KILKORE DRIVE, HYANNIS PROJECT INFORMATION: COBBLESTONE LANDING II COMPANY INFORMATION: BAYSIDE BUILDING, INC. COMPLIANCE: PASSES Required UA = 419 Your Home = 326 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 1540 30.0 0.0 54 WALLS: Wood Frame, 24" O.C. 2210 19.0 0.0 129 GLAZING: Windows or Doors 206 0.350 72 GLAZING: Skylights 32 0.400 13 DOORS 21 0.350 7 FLOORS: Over Unconditioned Space 1540 30.0 0.0 50 ------------------------------------------------------------------------------- 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 requirements of the Massachusetts Energy Code. 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 1251 of the design load as specified in Sections 780CMR 1310 and J4.4. Builder/Designer Date c MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2.01 LOT 74 KILKORE DRIVE, HYANNIS DATE: 11-20-2000 Bldg. 1 Dept. 1 Use CEILINGS: [ ] 1. R-30 Comments/Location WALLS: [ ] 1. Wood Frame, 24" O.C., R-19 Comments/Location WINDOWS AND GLASS DOORS: [ ] 1. U-value: 0.35 For windows without labeled U-values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location SKYLIGHTS: [ ] 1. U-value: 0.4 For skylights without labeled U-values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location DOORS: [ ] 1. U-value: 0.35 Comments/Location i FLOORS: [ ] 1. Over Unconditioned Space, R-30 Comments/Location 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 cfm (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 warm-in-winter side of all non-vented framed ceilings, walls, and floors. f MATERIALS IDENTIFICATION: [ ] Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. Insulation R-values and glazing U-values must be clearly marked on the building plans or specifications. DUCT INSULATION: [ ] Ducts 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. HVAC EQUIPMENT SIZING: [ ] Rated output capacity of the heating/cooling system is not greater than 125% of the design load as specified in Sections 780CMR 1310 and J4.4. [ ] SWIMMING POOLS: All heated swimming pools must have an on/off heater switch and require a cover unless over 2011 of the heating energy is from non-depletable sources. Pool pumps require a time clock. [ ] HVAC PIPING INSULATION: HVAC piping conveying fluids above 120 F or chilled fluids below 55 F must be insulated to the following levels (in.) : PIPE SIZES (in.) HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-1" 1.25-2" 2.5-4" Low pressure/temp. 201-250 1.0 1.5 1.5 2.0 Low temperature 120-200 0.5 1.0 1.0 1.5 Steam condensate any 1.0 1.0 1.5 2.0 COOLING SYSTEMS: Chilled water or 40-55 0.5 0.5 0.75 1.0 refrigerant below 40 1.0 1.0 1.5 1.5 [ ] CIRCULATING HOT WATER SYSTEMS: Insulate circulating hot water pipes to the following levels (in.) : PIPE SIZES (in.) NON-CIRCULATING CIRCULATING MAINS & RUNOUTS HEATED WATER TEMP (F) : RUNOUTS 0-1" 0-1.25" 1.5-2.0" 2.0+" 170-180 0.5 1.0 1.5 2.0