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0287 MITCHELL'S WAY
i� � - , ' TOWN OF BARNSTABLE BUILDING PERMIT y .n, APPLICATION — ApplicatioMap arcel O n 2 � Health Division O d IRN � Date Issued Conservation Division o� � Application F G �+ al Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address?��t�/I 1?C/NE�LI�S t-tI/�' • Village rl'-�NAA S Owner Address Telephone y ^ -3 Permit Request T-M 0 a4a_ i l a _26 1 0,,J -aAMy E Square feet: 1 st floor: existing proposed 26d floor: existing proposed Total new. Zoning District Flood Plain Groundwater Overlay Project Valuation �500 i 00 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 ❑ 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 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 ❑ ne size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: 0 existing ❑ new size _Shed: ❑ existing ❑ new size _ Other:. Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ' U No If yes, site plan review # 4 Current Use Proposed Use APPLICANT INFORMATION w (BUILDER OR HOMEOWNER) �.. Name D d U6) M V L_�_(\) Telephone Number 50 X 7-3 2-,(4 Address Po wa-1 127 q License MqyLhA/c? 44, ' - b7iG Home Improvement Contractor# � ��-7 5 Email �6ti�, (� MUL(�F� I�xi�U�Gi//n .GOM Worker's Compensation # WtC��oU r3 62fll5 A- ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 13AAAh 6f54-F Iv SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: _ FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL i PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING 7 DATE CLOSED OUT ASSOCIATION PLAN NO. the Comrnorr'iveakh of-Vassachusetts I epartrnerrt a,f Indush ial Acciderds - `�- - - Off ce o f nvestrgatians 600 Washington Street - y Boston,41A 02111. - - ftnvt-n mass grwfdin Workers' Compensation Insurance Affidavit-Smlders/Contractnrs/EIectr,cians/Plumbers Applicant Infarmat an Please Frint Le�t�tly . Nw=(Businessno a a a�}: Nl a Lit. ✓ �3y1�ir-7 t�/L, ( �'DC ri�.�ji City/StatclZig: Phone- . ' j0�' El el Are u an employer?Check the appropriate box: � Type of project(required): 1-LJ I ant a employer with -3 4. ❑I am a general contractor and 1 6. ❑New coast=ti'on employees(full and/or part-time).* have hired the sub-contractors 2_❑ I am a sole proprietor or partner- listed on the attached sheet. 7- ❑Remodeling ship and haze no employees. These sub-contractors have 8. 0 Demolition wading far me in any capacity employees and ha-e workers' g_ ❑Building addition [No worbem'camp.insurance coop-insurance-1 re aired_] 5. ❑ We are a corporation and its 10_❑Electrical repairs or additions 3.❑ 1 am.a homeowner doing all work officers have exercised their 11_❑Plumbing repairs or additions mysdf [No workers'comp- Tit of exemption per MGL 12 ❑ c. , §14 152ave no r insu nre required_]i (}�and we h employees.[No warkxrs' 13_ Other. camp-insurance rewired_] •tkuyWKcs t&stcbec1sshmc#lmoilalsofilloutthesectionbelowshowingtheirwoskerecompensationpolicyinfbrnadon- fi Ho'meovrners who submit this sfadmm indicating they are doing all wank and then hire outside contisctors must submit a new afdarit indicating sacb- rContractors thst eheck ibis boat must attached su additional sheet shouting the name of the sub-cuauactio-a and state whether or not those entities have employees. Ifthesub-=tmctoes have employee%they musr provide their worken'rrmp.policynumber. I am ati erripl4vr flrat is pronzdirrg tvarkers'cottgwisairrrt inmiranc-e forms*ertcploy-ees Beiow is the poUcy and joh site it for mafian Insurance Company Name: Policy 4t or eSelf--ins.Lic-4: C,( f2QO 3�5 7,015 h Expiration Date: Job Site Address:,2,-� '1 AA)`(2 r-A)iAAY City/StaWZip: I 'R NM 5 /A- 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$1,50D 40 and/or one-year imprisonment,as well as civil penaltnes.in the form of a STOP WORK ORDER and a fine of up to$250_0-0 a day against the violator. Be adtdsed that a copy of this statement maybe forwarded to the Office of ' Investigations ofthe DIA for insurance coverage verification 146 hereby cm1 fy ruiner the pants andpenalfies ofpelmy fhatthe information provided abmw its true and correct Sis ature: Date: lJ kob�� Phone O,fjfcial MW orrt}. Do itat write in this area,to be co»ipieted by cily artbir oficiat City or Town Perndtffikensse# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.CitytToten Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: -- - ------- -- - - 6 Information and Instructions h&ssaalrmetfs Genmal Laws chapter 152 regirm all employers to provide workers'compensation for their employees- p to this stye,an enplayee is defined as.--every person in the service of another under any contact of hire, express or implied,oral or wriftm" association,corporation or other legal entity,or any two or more An employer is defined as"an individual,pailsership, of the foregoing engaged is a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or.trnstee of an individual,partaersT4,association or other legal entity,employing employees. However the owner of a dwe ag house having not more than three apariments and who resides therein,or the occupant of the - dwelIing house of another who employs persons to do maintea cc,construction or repair work.on such dwelling house or on the grounds or building appurrten t thereto shaIl not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also sues that"every state or local licensing agency shall withhold the issuance or renevgal 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 requh-ed-" Additionally,MGL chapter 152, §25C(7)states'Neither the commonwealth nor nay of its political subdivisions shall enter into any contract for the performance ofpubhG work until acceptable evidence of compliance with the fi n-a ce.- recluu-enients of this chapter have been presented to the contracting arthOiity:" Applicants , Please fill oiuf the workers' compensation affidavit completely,by cherkmg the boxes that apply to your sitnation and,if necessary,supply sub-contractor(s)aame(s), addresses)and phone number(s) along with their certificates) of incr„-ance. Limited Liability Companies(LLC)or Limited Liability PaoJnersbips(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance- If an.LLC or LIT does have employees,a policy is required. Be,advised that this athdayit maybe submitfy d to the Department of Industrial Accidents for confismaiion of insurance coverage. Also be Sarre to sign and date the affidavit The affidavit should be retlmmed to.the city or town that the application for thin permit or license is being requested,not the Department of Ln6Lsti,;al Accidents..Should you have any questions regarding the law or ifyou are reqaired to obtain a workers' compensation policy,please call tho Department at the number listed.below. Self-insured companies should enter their self-h su an co license nummber an the appropriate line. City or Town Officials r - 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 Investigaiions has to contact you regarding the applicant Please be sure to fill in the penmiUlicense xnnnber which will be used as a reference number. In addition, an applicant that must submit multiple perm.W iamse applications in any given year,need only submit one affidavit indicating current policy infb=ation(if necessary)and under"Job Site Address"the applicant should w itr-"all lacaficns ri (cfiy or town).-A copy of tine affidavit that has been officially stamped or marked by the city or town maybe provided to the ' applicant as proof that a valid affidavit is on file for furore permits or licenses- A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venire (Le. a dog license or permit to bum leaves eta.)said person is NOT regnhed to complete this affidavit The,Office of Investigations wound like to thank you in advance for your cooperation and should you have any questions, please do not hesitafe to give us a call The Department's address,telephone and fax number. The Co=an- m1a of MaMachu--j--f(#s D-patent of Iriduirial Aocideata �Q�T�ashin.�tQu 5�eet Boman,MA G2111 Te L 4 617 727-4900 Qxt 406 car 1-977-MASSAFE Fax 9 617-727 7M Revised 4-24-07 -mus go dia AFVC Guide to Wood Consftwdion hi F.fV4 end t!reas:11 a rfiph end Zone Massachusetts Checkdst f6r Campy ante(7sQ aIR 301' l.t)i Cb=k 1.1 SCOPE. Wind 5pesd{3-se gust)------- 7___._: 110 mph Wind Exposure C- agor}' Wind Exposure Category__:.............Engineering Re4uo-ad For Entire Project---------------------------___.._....-C • 12 APPLICABILITY -Number of Sfiries(a roof which a=eeds 3 in 12 slope shall be considered a sfnry) sfnries'S 2 stories. Roof Pr`tch12-12 - Mean RaofHeight _ft Building Wldfhr W___._—._..__.____--_r.__r. (Fig BLffl&ng LengDi,L =._. _- -----------:---(Fg 3} ---•--_.__ _ft s BO' Balding Aspect Ratio(LlW) -•-= --_-_--. _-_(Fig 4)- Nominal Height of Tallest Dpe mg _- -__-.__ -(Fig 4) 1-3 FRAMING CONNECTIONS General compliance wFth framing mnnek owns-.-: (Table 2)�_-_---------- -- -- -_ 2-1 FDUNDATIDN . Foundafian Walls meeting requirements of 7BD CMR 5404.1 Conran------------------------- ------------------------• •-----•---------- ------------• ' Concrete Masonry....------=--=----_-- �- ----—-__--- --.- _ -_-- ------ 22 ANCHORAGE TO FDUNDATIDhtt� " 5/3'Anchor Bob fmbedded or 618'Proprietary Mechanical Anchors as an alternative in concret.a only Bolt Spacing-general..........._.......................y:.(Table4)—_---------:----_.._- -- in- Bolt Spacing from endrIoint of plate 5)--__ Bolt Embedment-concrata in_>7" BDIt Embedment-masonry-_^________-_----.(Fig 5)____-- ---___ in_>_15" Plate Washer_'.-_-- -_ _7_ -._(Fig 5)-=--- __-- _-=?3'z 3'x tlR 3.1 FLOORS : Floorfiaming member spans checked _._ __._._(pei BD CMR Chapter SS)---- Maximum Floor O' ln Dimension =._ r` 6 Full Height Wall Studs at Floor Openings less ffian 2'from Exterior Wall(Fig 6)__________________________------------------------------ Mk)CIMUm Floor Joist Setbacks - Suppoifing Loadbearing Walls or 5hearwal(_-----(Fig 7)-_._-__.__.____ __- —ft s d Maximum Cantilevered Floor Joists Supposing L'oadbearing Walls orShearwrall--:- ' (Fig ft 5 d •FIQorBracing at Endwalls--__.......... _•-------__---(Fig 9)_ Floor Sheathing Type Floor Sheatung Thickness (per T&D GMR Ghapfar 55)-----._ __ in_ FIDDrSheatHng Fasferirng_....... -.-(fable 2)_ d nails of in edge[_in field '4A WALLS .. Wan Height Loadb5arfng (Fig 10 and Table 5) 5_ft 1 D' L Man- oadbBadng walls_�_- ..— -_�-(Fig ID and Table _�-----.____ ft's2D` " Wa6 Stud Spacing [Fg 10 and Table 5) —fn_5 24 o.r-Wan Story Offer fs, _- --r-_-(Figs 7 i£8)- -. _- -- ft 5 d ' 42 QCTJ=RI OIL MALLS', — 5 ` Wood Studs Laadbearing4alls (Yaffe _..-.2x -_ft_h Non-Laadbeann walls ab}e S - Gable End Wall Bracing FuII Height Endwall Studs...____----------_---(Fig ID)_-_ WSP-Atf9c Floor Lengfh ---- - (Fg 11) ft;tW[3 'Gypsum Cer3ng Length Cif WSP not used)_ - and 2 x4 Continuous Labual Bracy @ 6 ft o_G_(Fig 11)-----___________________:•- or'I x 3 cerTrng f a ing strips @ l T spacing-min with 2 x 4 blacIang @ 4 ft spacing in end joist or truss bays Double Trap Plat& Spice Length -- __-_-__---(Fg 13.and Tabia 6)�-------,__- —tt SpUr-e Connection(no.of 16d common naffs)--__.(Table I AFYC Guide to FYood Carrstruc orr irr pligfr i-YZnd Areas: II0 Firph iHrFrd Zone ' I�'Iassaclit>set Checklist for Compliance(7so uvfR Loadbea-ing Wall Connections - Laterl (no.of 16d common (fables 7)---__.__ Non-L-cadbearing Wag Connections Lateral(no-of 15d common Load Bearing Wan openings (record largest opening but check all openings for coifiptrance iD Table 9) Header Spans -_ _-- _ _--(Table 9) ft—in.511' Sm Plate Spans _. ---(Table 9) ft FLA Height Studs (no. of-siUds)__-r----(Table 9)-----.-- -- -_ _--. Non4nad Bearing WaU Openings(record largest opening bUt check a!f openings for compfance to Table 9) in_512' Sin Plate Spans_--- _-- -- -_-(Table 9)____._- _ft_in__<12" Full Height Studs(no.of studs)__--_ (fable 9)-----_-_--.-___. _-_- 5darior Watt Sheathing to Resist UpFi t and Sheaf Simutianeausfy{ Minimum Budding Dimension, W Nominal Height of Tallest Openingz - - -- --- Sheathing Type-_ -- _ _--(note 4)- Edge Hail Spacing-_-_- - - (Table 10 or note.4 if less)--._-____--- m- Field Nail Spacing------------_(Table 10)__-_____-____--- -- in. Shear Connection (no_of 16d common nails)(Table 1 Percent Fullm-Height Sheathing._--____--(fable 10)--------_---_-_�-_-__.--_� 5%Additional Sheathing for Wail with Opening>.6 a7(Design Concepts) Maximum Building Dimension;L Nominal Height of Tallest Openingz_._._------------------------------------------------------:__._ _<6'Er ' Sheathing Type__-- ----_____(note 4)__�- _�----_----- Edge Nail Spacing________-_--_--_--(Table 11 or note 4 if less)_ _-_----__--- rr?- - Field Nail Spacing_ -_- -.--(fable 11) -- Shear Connection(no_ of 16d common nails)(Table 11)___. _ _-•- Pemmnt FugHeight Sheathing--- _(table 11)-_-�- - ' ---�� 5%Additional Sheathing for Wall wilh'Opening>B'8'(Design Concepts)----------�.: Wail Cladding _ Rated for Wind Speed?--_--- ----_-.------ ----- -- -- ---- 5.1 ROOFS Roof framing member spans checked?_____—(For Rafters use AWC Span To_al,see BBRS Website) Roof Overhang _------------------- _._------ -------(Figure 19) ----:----_ft5 smaller of 2:or L13 Truss or Rafter Connections at Loadbear ng Wails Proprietary Connectors --------- -- .(Table 12)--- -_--_U= plf Lateral__----_.--___--.__._(Table 12)-__---- - --L= ptf Shear---- -�.- -----• =(Table 12)--------- --- - S= ptf_ Ridge Strap Connections,if collar Pies not Psed per page 21__• (Table 13)____.__-___ T= ptf Gable Rake Oudooker--------------------------- _ (Figure 20) .___-.•___ft 5 smaller of 2`or LIZ ' Truss or RafL-r Connecfions of Non-1 oadbearing Walls Proprietary Connectors lb. _ (Metal(no_of 16d common nails)_.(Table 14)__._.._...__•-------------•-----._.._1__ lb. Roof Sheathing Type-__-_-:--- --------(per 7BO CMR Chapters 58 and 59)------------ RcorSheativng Thickness__----•- - ---_-_-_---___- _iri_2:7116`W5P Roof Sheathing Fastening_--_-- ---.___ (Table 2)___ ----_---- ___ Notas: •1. This checks shall be met in its entirety,vduding the spedffc exception noted in 2,to comply with the raquirernents of 730 CMR5301.2.1.1 Item 1. If the cheedst is met in its entirety then the foifowing metal straps and hold downs are not required per the WFCM 110 mph Guide: a_ Sf�l Straps per Figure-5 b. 2b Gage Straps per Figure 11 c. Uprift Straps per Figure 14 ¢ All Straps per Figure 17 e_ Comer Sind Hold Downs per Figure ISa and Figure Iab 2 'Exception:Opening heights of"up to 8 ft shall be pefmilted when 50A is added to the percent full-height sheathing requ-u•ernerrts shriwn in Tables 10 and 11- 3_ The battnm mail plate in eiderior walls shall be a minimum 2 in_nominal thickness pressure treated#Z-grade. 'Y -ATVC Guide fa Wood Carrstrua on ur lj�h JYzndAr-eas_- I10,7y[i ff,7rtadZc ae MRSSachusetfs Clleckist'fot'CompTianCl (is0 C&-IRS3.0i 2 r:I)I 4 a. From Tables 10 and 11 and location of wall sheathing and Building Aspect Raflo,,determine Percent Full-Height Shearing and Nail Spacing requirements b. Wood Struciz.ual Panels shall be minimum thickness of 7116'and be installed as follows 1. Panels shall be installed W h strength axis parallel to studs. I All horimnta!joints shall occur over and be narled to framing. rn_ On single story construction,panels shall be attached to bottom platys and top inembei-of the double top Platt~ _ iv. On two story construction,upper panels shall be attached to the top member of the upper double top plate and to band joist at botbm of panel Upper attachment of lower panel shall be made to band joist and lower attachment made to lowest plate at first floor framing. v. Horimntal nall sparing at double top plates, band joists,and girders shall•be a double row of ad staggered It 3 inches on center per figures bellow:Vertical and Horizontal Nailing for Panel Attachment 5. Grazing pratedion:a)new house orhorhmntal addition—retluired tf projer-t'is i mine or doserto shore(generally,south of Rte.2B or north of Rte 6) b)vertical addd iDn—not requ[rad unless there is extensive renovation to thB fast Haar c)replacementiYWdows—needs energy conservation cnmpGa C:e only(chap 93) 6.Wood Frame Construction Manual(WFCM)for.110 MPH, Exposure B may be obtained from the American Wood Council (AWC)wabsib- t • I � li'r�I�i6IDC+-EF�TSOH . = CLSESd 1�S ATS�lhs: • • tt JI - - - a tl • tf 11 1. .t o It t J t r l a 4 tt a[t3 1tz 7 t o t{` t •L r t - I f � t t . t i t rL [?Q 1rL . W 11 ll g / •; - , -, 1 E - Er 4 FRANM Li .► 1r _ - u .• - SD 1 i [I - , - '_�— Est � _ ---•� —_ _ NAIE_ ,V�tEi_ — •� � -. - '. tZ41L?A1'7H-1hT tot 1W c tlA>LIDC•.E SPAtzYri DERL - See Daf l fln New Page - Vertical and HorEmnial HaiLng lgefall'for Panel Attachment � Vertical And HotkoLntal Nailing for Panel A2achrnent Town of Barnstable o� t • Regulatory Services i 1 MASS * Richard V.Scali,Director �► Building Division TomPerrp,Building Commissioner 200 Main Street,Hyannis,MA 02601 WwW.town.barnstablema.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize --�� to act on my behalf, in all matters relative to work authorized by this budding permit application for. (Address of Job) Pool fences and alarms are the responsibility of the a licaat. Pools are not to be Med or utilized before fence is installed and all final ' inspections are performed and accepted. Signature o Owner Signature o Applicant Pent Name n l/1 Print Name - Date QFORMS-OWNS MUvMSIONPOOIS' j r Town of Barnstable Geographic Information System y January 6,2016 290057 #298 r 290058 Q #286 290053 290055 290054 " #301 #321 #311 290059 #278 290062 #287 290060 0272 290051 #281 12. 290119 ct #262 x. Ilk *v 290050 #273 0 21 Feet 29.0107 #265 DISCLAIMERS:This map is for planning purposes only. It is not adequate for legal Map:290 Parcel:052 boundary determination or regulatory interpretation. Enlargements beyond a scale of Owner:CARVALHO,MATEUS M&MARIA R Total Assessed Value:$233300 Selected Parcel 1"=100'may not meet established map accuracy standards. The parcel lines on this map are only graphic representations of Assessors tax parcels. They are not true property Co-Owner:CARVALHO,SHELDER A Acreage:0.29 acres Abutters boundaries and do not represent accurate relationships to physical features on the map Location:287 MITCHELL'S WAY ✓ such as building locations. Buffer 1 , �e �ponvrwo�zcueal��,. ,�� _ Oft ice of ConsumerAAfairs It gu OME IMPROVEMENT C °ess Regulxt�., CIE/Registration 17517 pNT�CTOR �v iExpiration r,- h9 LLC ULLFN BUILDING . OD(=NANO,LLCDOUG . , LAS MULLEN 87 HICKORY HILL CIR,, - " OSTERVILI-E MA 02655� �' F" — n f r I \ 4 r�fi� cr�,r ' d a Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-081995 g�.K Construction Supervisor DOUGLAS W MULLEN 87 HICKORY HILL CIR ; OSTERVILLE MA 02655 7 e Expiration: Commissioner 01/D/2018 1 License or registration valid for.individuf.use only und return liet'ore the expiration date. If fo office.of.Consumer Affairs and Business Reegg ulation 10:1'?rk Plaza-Suite 5170 ^ Bueton,VIAr2116 w � _ 4 ;Not valid ithout signature Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-081995 utd*' .sk Construction Supervisor a DOUGLAS W MULLEW 87 HICKORY HILL CIR •4M OSTERVILLE MA 02656 Ex pifati6n: Commissioner 01/23/2018 DATE(MM/DD/YYYY) Aco CERTIFICATE OF LIABILITY INSURANCE 11/24/2015 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 CONTACT Lora FitzGerald NAME: Southeastern Insurance Agency, Inc. PHONE (5O8)997-6061 A/ No;(508)990-2731 439 State Rd. E-MAIL ADDRESS:lfitz@southeasternins.com P.O. BOX 79398 INSURERS AFFORDING COVERAGE NAIC# North Dartmouth MA 02747 INSURERAArbella Protection Insurance 41360 INSURED INSURER B AEIC Mullen Building & Remodeling LLC INSURER C: PO BOX 1274 INSURER D: INSURER E: Marstons Mills MA 02648 INSURER F: COVERAGES CERTIFICATE NUMBER:2015-16-1 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 TYPE OF INSURANCE ADDL WVD UBR POLICY NUMBER MIM/DDNYY MNPOLICY EFF WD/YYY LIMITS Y EXP LTR R COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE ❑$ OCCUR PREMISES EaDAMAGE TO ENTED occurrence $ 100,000 9520043214 9/8/2015 9/8/2016 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 R POLICY PRO ❑ LOC PRODUCTS-COMP/OP AGG $ 2,000,000 JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT acci e n0 $ 1,000,000 Ea d A ANY AUTO BODILY INJURY(Per person) $ ALL O IX SCHEDULED AUUTOSS AUTOS1020024224 11/12/2015 11/12/2016 BODILYINJURY(Peraccident) $ R HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident Uninsured motorist BI split limit $ 250,000 UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N R STATUTE x ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000 O00 D?OFFICER/MEMBER EXCLUDE Y❑ N/A B (Mandatory in NH) MCC50050133092015A 4/30/2015 4/3012016 E.L.DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION doug@mullenbuilding.com SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE FOR DISPLAY PURPOSES. ONLY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Mullen Building & Remodeling LLC ACCORDANCE WITH THE POLICY PROVISIONS.. PO Box 1274 Marstons Mills, MA 02648 AUTHORIZED REPRESENTATIVE Lora FitzGerald/LHL p G�o� s►� •«r-'���� @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS026/9m4m� I v AA r r : 70 _ S `0 a � _ �J! I AA 1T(A v . 10 i SUS ONES. .MIN ?05� Assessor's office (1st floor): OF?NE To Assessor's map and lot number .AA.P,...zg.................. . Board of Health (3rd floor): o Sewage Permit number ....................... Z ..................... 2 STADLE• 3 Engineering Department (3rd floor): House .number OMpYtr\ ;APPLICATIONS PROCESSED 8:30-9:30 A.M. and' 1:00-2:00 P,M. 'only rp OWN OF BARNSTABLE 4/i,/- BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...............i �'.�.1 cX ..Q....y? ' ...h. .`!Y�.'..,a......................................... TYPE OF CONSTRUCTION .............................. ..... �.�'��„...t-. ............... TO THE INSPECTOR. OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: L.Q 1 mz.� J././... ......�1 Q�............ y . .N�. .....................................:. Location .... .... ................... ............... .............. ............. S1 , -�`'"'!.., j......:c.�i, Can. C�1.... ...L 1 Proposed Use ........................Qw..... ....... /....................... ...................................... ZoningDistrict ............ G �.. ........... a.....................Fire District ..........{ ann S ` � } ..................................................... Name of Owner .... :[.c:.::= >..r...i � e:*'. -..........Address _�-..., .:.:.... .:......... .. cY_� 1 Name of Builder ........ ...... ..--....................................Address ........................................i.". `................. .�b.! �.C.,., Nameof Architect ..........G.................................................V,"Address ...........2....5................................................... ......... 5 3 2 `�- Numberof Rooms ..............•.. ... . .-................+....................Foundation ......................... ......................... `........................... Exterior ...........5. .!.`'?.j.):-P.:..}-..........................................Roofing ..........A5..All (.T- Floors CG .a fa. �........... ..............Interior ............. ....... ... Heating E' eC,.. v^... ........Plumbing i lj C............................................................. Fireplace ................... 7.......................................................Approximate Cost ............... ..... -. .S. .... .... . Definitive Plan Approved by Planning Board __________________ u --------------f 9-------- • Area .............,..;......:..;�.............. Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH v V OCCUPANCY PERMITS-REQUIRED FOR NEW DWELLINGS fY I hereby agree to conform to all the Rules and Regulations of the Town offs'Barnstable regarding the above construction. Name ....... ... ......... .7�f^.. ...................... r"�cry '* Construction Supervisors License ..................................... rA r BARNSTABLE HOLDING CO. A=290-52 29224 permit for 1'2 Story No ............ .................................... .Single Family Dwelling ............................................................................... Location .... Lot #.1.8.......287. ...Mitchell. . Way . .. . .... . ...... . .................. Hyannis ............................................................................... Owner ....Barnstable. . . . . ...Holding. . . ...Co. . . ...... . . ...... . ...... . . .... . .................. Type of Construction Frame ...................................... ................................................................................ Plot ............................ Lot ............................. Permit Granted .....A.P.t.i ................19 86 Date of Inspection ....................................19 Date Completed .............19 ; �1-7 Z-23 - !S P� • Insulate save weatherization & insulation 410 Grove St.Fall Fiver,Ma om723. Imulate2save net Vebruary 20, 2015 Thomas Perry, CBO ' 200 Main Street :Hyannis,MA02601 ARE: 287 Mitchells Way Dear Mr.Perry, This Affidavit is to certify that all work completed at 287 Mitchells Way has been inspected by a certified BPI 'Inspector.All Work Performed Meets or exceeds Federal and State Requirements.. Sincerely, 0 :Roland Langeyin :Insulate 2 Save, Inc 'President , CSL 103861 MC 180747 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel plicatiJ60��� Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address Village 41H AY)ni 5 Owner &AQ[iCA)S l,Q Q-kL Q Address . ►J!� (�n-1.P`� ��l Telephone �'��P,�` y 4S Permit Request �t V 1 ` , G 1 S}tcl( sic Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation ag Construction Type SrnStj ka*# c 1 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 ❑ 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 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 woo(161 stovd-._"L3,Ya ❑ No t.rr •- s Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ eisting ❑ newize_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: .. m 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 R4C\ Telephone Number Address 0 "Q I ' �G� l/ d ��C License # I �� 0 Home Improvement Contractor# LA Email I Wa 3'lAV Q f9 Worker's Compensation # Q o� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Alllpr T)� Mv5� SIGNATURE �� DATE FOR OFFICIAL USE ONLY APPLICATION# DATEISSUED ,f t; MAP./PARCEL NO. r ADDRESS VILLAGE yi OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FfREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL :.w FINAL 5UILDING. DAT&CLOSED OUT ASSOCIATION PLAN NO. i lowly lox mass save PARTMPATIKGCONTRACMR PERMIT AUTHORIZATION FORM I, NATEUS CARVINO ,owner of the property located at: (owner's Name.printed) 287 Mitchells Way HYANNIS IProperty Street Address) (City) hereby authorize the Mass Save Home Energy Services Program assigned Participating Contractor listed below to act on my behalf and obtain a building permit to perform insulation and/or weatherization work on my property. X 64&' ekk Owner's Signature Date FOR CSG OFFICE USE ONLY Conservation Services Group has assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: 15115 Participating Contractor Date m For Office Use Only Rev. 12132011 CONTRACTFOR Conser atlon PRODUCTS ISERVIcE WORK Services Group This service is brought to you through support from your local utility This.Ag'ceemena is made by a-nd,amon:g and. t #utelts�a ��e Conse,rvatlort Services Group(CSG) 287 Mitchalls Way Attu 'RCS Hyannis,-MA 02601-6708 50 Washington Street, Suite 3000 Sift:Ii➢ S00002306587 Westborough,M?,01�81, Project ID:PQ000031 s444 �•Pg•.N,6 1134R4 Cu:ctnmer I1�:.CA000031671`9 Federal ID No:222457170 Contract-ID:20141120 ASEAL. (Mail completed contaact,to address above) I. DESCRIPTION OF WORK TO BE PERFORMED Cutrtrau1or will peiforw or cause Lu be perfuriued the following work on these"Pre fuses"in a professional.manner and in accordance vvirh the terms of this Cortract,Including The attached recorunendat[uns/worlc order clescribirig kite work u;detail(die"Nark")w1ucil.ue irrcurpurated hrrrui by referrnce: Description Quantity Location - Perform Air Sealing at Estimated 62.5 CFM50 Per Hour 4 Livin Sac® Attic Stair Cover Thermal Barrier with carpentry_ _ _ _ Living Space Door Sweep -- $260.23 2 NIA $46.36 Exterior Door Weather Stripping 2 N/A $55.18 Sub Total: $699.05 Utility Incentive Share $699.05 Customer Contribution $0.00 PP Fo'r office use only Printed:11/20/2014 Page 1 of 2: I II. PAYMENT Customer agrees to pay Contractor for he Work,the Customer Share of the Contract Pl'ice as follows:1'a tent Fl:$3 n 7 as a Deposit payable to CSG:upon signing the Contract(not to exceed 1/3 of the total retail costs or actual costs of spegial orders,whichever is greater-.Mail cheek&contract to Attn:RCS,60 Washington st.,Ste.500%Westborough,MA W581,r1na1 Naymen CSG, t:$ 1/I l as t11e iutal payruent for the Work shall be due and payable to the Independent Installation UOntract,OP("Ilf")upon satisfactory,completion of the Work.Customer widerstands that he/she will not be required to pay the utility Incentive Share of the Contract•price in the Frn1owl6 of$ (i ti l Ca' .'The Utlity Incentive Share is dependent upon the package purchased antVor prior incentive utilizatiorl.Changes to individual line items ancUor provious incentives may increase or decrease the size of the utility Incentive Share. III. DISPUTE RESOLUTION The UC and Customer hereby mutually agree in advarue that at The event that the IIC has a dispute c•ortcetting this Contract,the IIC:may submit such dispute to a private arltih:uirnr serc�ce wltick has been approved by the Office of Cons open Affairs and Business Regulation aril Customer sh {I hr.1 e.J{uirerl to submit.to sur..h arbih•ation as provided in M.r:L.c{42A. rontractor: You May cancel this agreement if it has been signed by a party there to at a place other than an address of the seller, which. may be his main office or a branch there of, provided you notify the seller in writing at his main office or branch by ordinary mail posted, by telegram sent or by delivery, not later than midnight of the third business day following the Sig n: g of this aLareement. DO NOT SIGN THIS CgNTRACT IF THERE ARE ANY BLANK SPACES. Customer S;gnatu ' DD f I ;sate your setapplicablert:ed II(;here,if ('JR) � Initial here if you want �, f(S� the Program to assign a CSG Sipa-Wre I) t ) n,e f( CS ReX,ie.enl:alive(Printed) Participating Contractor rEWIS AND C01%DITIONS APPEAR ON Tiffl, R)EVERSE. yr l i CONTRACT FOR Conner ation CT I Services Group This service is brought to you through support from your local utility This:Agreement is made by and among (md --t 'eteus ciwigue f. rU 5 Consernatlon Services Group(CSG) 287 Mitc>iells.VlJay Attn:'IiC'S Hyannis,MA.0260I-6708 p50 Washutgtort:Street;Suite 3000 SAte`ID.S0000230'6587 Weslt oiougli;Rk 0-1581 Pioject16 P00000315444.. deg:No: 173484 CusOMMID,•C0000.0316719 l ecleraI ID-No.222457170 Contract TD::20141:1.20_WORK (Mail-compteted contiaet to address above) I. D9SCRIPTION OF WORK TO BE PERFORMED Contractor will perform or cause tr)be perfon»ed the following work on these"Prentiscs"in a professional manner and in accordance with'lie terms of this Contract,including the attached reconunendations/work order describing the vroric in detail(the"Work")which are incorporated licrent by reference: Description Quantity Location Attic Floor Open Blow Cellulose 6" 312 LivingS ace Damming 22 N/A Install 6 Fiberglass Batting In Open Kneewall Slo a $48 18 ___. P 75 Living Space _$14175 Install 2 Thermal Barrier Polyiso on Open Kneewall Sloe - __.. — — P , 75 Living.Space $330.00 Install 3 5 Fiberglass Batts in Open Gable Wall _._...p.. 8 Livinq Space.. - _ Install 2 Thermal Barrier Polyiso On Open Gable Wall - 8 ng Space..,. _ 1 3 60 _ ... $ $35 20 Kneewall Floor Enclosed Cellulose Dense Pack 8v 38 Living Space Install 2 Thermal Barrier Polyiso On Kneewall j .— _�,._..._:._._._._._.._..�..._.__ ....-,_128 Lrvmg_Space.. .._. $56320 Kneewall Floor Enclosed Cellulose Dense Pack.8_.._...... _.. 64 Living Space.. ...:.. $165.40 _ Sub Total: $1,855.77: Utility Incentive Share $1,391.83 Customer Contribution $463.94 Clf`� For office use only Printed:1 112 012 01 4 Page 2 of 2 II. PAYMENT Customgr agrees to pay Contractor for the Wort the Customer Share of the Contract Price as follows:Pa anent#1:$ �.j J as a Deposit payable to CS.Gupon signing the Contract(not to exceed 1/3 of the total retail costs or actual casts of specialorders,whichever is greater).Mail check&contract to CSG, Attn:RCS,50 Washington St.,Ste.3000,Westborough,MA 01581.Final Payment., <, ,- , . i Jn t ;S _ as the final payment for the Work shall be due and payable to the Independent Installation Contractor("IIC") upon satisfactoll,completion of the Work.Customer understands that he/she will not be_required to stay(lie Utility Incentive Share of lt:e Contract price in the amount of$ 5�. > The JJtiliti Incentive$hare is clepenclertt.upon rite package rnuchased and/or prior incentive utilization.Changes to individual lute AtIM;arrel/ot'previurra uicenlives nay irufease of decrease the size of t.IIC Utility htcentive Share. III. DISPUTE RESOLUTION The IIC acid Crrstonter hereby nuubiaUy agree in adlimcn that.in the event.that.the[IC has a dispul.e.concrmiog IN,,Crmh;ua the TiC.may g)II'llittituch disputr to a Private arbitratior. > servicewhich has been approved by the Office of Constancr Affairs anti Business Regulation and Customer shall be regiut'd to submit to such a+bihatien as prnvideci in M.(;1..c 142A. Custrtm@r. Contractor:, You may cancel this agreement if it has been signed by a party there to at a place other than an address of the seller, which;may be his main office or a branch there of, provided you notify the seller in writing at his main office or branch by ordinary mail posted, by telegram sent or by delivery, not later than midnight of the third business day following the signyng of this agreement. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. Crtslunter Si air Dal /i ,Irulic l; your selected111C here, yif ap/plical:le (nI{' initial here if you want / �� ` i < �!,G �( .. !!�^� the Program to assign a CSG S' tahue' — Participating Contractor D< e Nwr to of C:SG Repres.ntative.(Printed) TERMS AND CONMITIONS APPEAR ON 7ME REVERSE. .o I lie Commonwealth of Massachusetts Department of Industrial Accidents " Office of Investigations I Congress Street, Suite 100 Boston, MA 02I14-20I7 www Workers' Compensation Insurance Affidavit:it Build e s/Co ntractors/Electricians/Plumbers Applicant licant Information Please Print Le ibl Naive (Business/Organization/Individual): Insulate 2 Save, Inc Ad4ress:410 Grove Street City/State/Zip:Fall River, MA 02720 Phone #:508-567-6706 Are you an employer? Check the appropriate box: am a employer with 20 4. I am a general contractor and I Type of project(required): 2.0 employees (full and/or part-time).* have hired the sub-contractors 6. ❑ New construction I am a sole proprietor or partner- listed on the attached sheet. 7. [) Remodeling ship and have no employees These sub-contractors have working for me in any capacity, employees and have workers' 8. ❑ Demolition [No workers' comp. insurance comp. insurance.' - 9. ❑ Building addition required.] 5. [] We are a corporation and its 10.❑ Electrical repairs or additions 3. I am a homeowner doing all work officers have exercised their myself. [No workers'comp. right g of exemption per MGL 11.❑Plumbing repairs or additions insurance required.] t c. 152, §1(4), and we have no 12.E] Roof repairs employees. [No workers' 13.0 Other Insulation 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 attached an additional sheet showing the name of the sub-contractors and state w employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. Nether or not those entities have I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insura:tce Company Name:Liberty Mutual Insurance Policy#or Self-ins. Lic. #:XWS 56418741 12/10/2015 Expiration Date: I I'Job Site Address: __ City/State/Zip j S ctn-yi , Q ZL&o 1 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains an pe alties of perjury that the informajDat iprovided ab ve is true and correct. Si ature: e: Phone#: 508-567-6706 Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: I • V �'LG� ��Q�l?'l/?'�?�'I�lGG� ����%'I�LG��l'GZG�E!�2� Office of Consumer Affairs and. Business Regulation 1.0 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Co),Ior Registration Registration: 180747 ` Type: Corporation Expiration: 12/29/2016 Tr# 261507 INSULATE 2 SAVE , INC. 3 ROLAND LANGEVIN . 410 GROVE ST ; FALLRIVER, MA 02720 `. Update Address and return card.Mark reason for change. y� (� Address Renewal F] Employment 4—J1 Lost Card SCA 1 0 20M-05(11 ���e 1(U r e l�'t.c cturrrefC i (?7'�d de ✓+,ted<fl. Affice of Consumer Affairs&Business Regulation License or registration valid for individul use only rOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: �807g7 Type: Office of Consumer Affairs and Business Regulation =_ 10 Park Plaza-Suite 5170 ,Expiration 12/29/2016 Corporation r� Boston,MA 02116 INSULATE 2 SAVEt INC,n4 ROLAND LANGEVIN; 410 GRbVE ST FALLRIVER,MA 02720 `�~ Undersecretary Not valid without signature ------------------------------------------ Massachusetts -Department Of PVb is SrretV Soard of Budding Regulations anti S:arzda€ds Construction Supervisor � License'. GS-103861' ROLAND LANGEV`N 536 EASTERN AVE, Fact River MA OP23 ;c=`.1a1'.18s ormr 08/24J2015 I i i I 1 ,acvan� CERTIFICATE OF- LIABILITY INSURANCE 1214 THIS CEP,TIFICATE 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 CONTACT NAME: ___ _ Anthony F. Cordeiro Insurance PHONE T(508) 677-0407 ; FAx N ; (sob) 677-0409 Cr 171 Pleasant Street E-MAIL Fall River, MA 02721 ADDRESS: hsouza@cordeiroinsurance.com - __ INSUWR(S AF) FORDING COVERAGE { NAIC k INSURER A:Liberty Mutual Insurance INSURED INSURER B_ j Insulate 2 Save, Inc. INSURERC: r 410 Grove St. INSURER�_ Fall River, MA 02720 _._-- I NSU R ER E: i 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 ABOVEFOR 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. --_-. ._ i I I . .POLICY_._____NUMBER �....PM100/VEFF ...YM eogugigo'MIDDIYYYY)1 ,. . ..... - 1.1 . ILTR I —^-_TYPE OF INSURANCE �AODL SUBR MITS A GENERAL LIABILITY y Y jBKS 56418741 I 12/10/14 12/IO/15 EACH OCCURRENCE (s 1,006,000 f J . .000 006 I X{COMMERCIAL GENERAL LIABILITY I ! i I DAMAGE T O RENTED ' - - CLAIMS-MADE 300 000 LJ OCCUR i I j ME EXP(Anyone perscn) i S 5,000 l j PERSONAL&ADV INJURY s 1,00.0.000 i GENERAL AGGREGATE t s 2,00000�,_000 ._ GEN'LAGGREGATE LIMITAPPLIES PER i j PRODUCTS-COMP/OP AGG_sl 2,000,000 —I PRO- LOC I S I X 1 POLICY; I A AUTOMOBILELIABIUTY 12/10/14I 12/10/15 COMBINED SINGLELIMtT BAA 56418741 1 JEaacciderx) s 1,00.'0,000 -ANYAUTO BODILY INJURY(Per person) — ALLOWNED SCHEDULED I — `'�-- }{ E i BODILY INJURY(Per accident) S AUTOS i AUTOS i _ HIRED AUTOS X NON-OWNED ! j PROPERTY DAMAGE _ AUTOS (Per accident) !$ I I , A ! X ( UMBRELLALIAB X OCCUR 1 Y Y 'USO 56418741 12/10/141 12/10/1511 EACHOCCURRENCE !s 2,00.0,000 E$CESS LIAR CLAIMS4AADEj I i , AGGREGATE s_ 10,000 DID RETENTION S S MARKERS COMPENSATION 1 ! ' STU- i ' -! A M I IX41S 56418741 12/10/14� 12/10/151,m{TWCTA OTH DkYL Y/N AND EMPLOYERS'LIABILITY .. ! ANY -OOPRIETORlPARTNERIEXECUTIVE I i I 1 E_L.._EACHACCIDENT 3 OFFICERIMEMSFR EXCLUDED? N!AI I __.�....._...!E,._ 5O0.000 i (Mandatory.in NH) j I ' i rE.L.DISEASE-EA EMPLOYEE,S 500,000' j if yes,describe under — DESCRIPTION OF OPERATIONSbelow ( ( ! 1 E.L.DISEASE-POLICY LIMIT!S 50.0,000 DESCRIPTIQN OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Proof of Insurance. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. . AUTHORIZED RE PRE SENTamrEy'6'�\���J`� ©1988-20 10 ACORD CORPORATION. All rights;reserved.. ACORD 26(2010105) The ACORD name and logo are registered marks of ACORD Phnna• Fax: E-Mail: f ,ter TOWN OF BARNSTABLE 29224 � Permit No. _______ Building Inspector cash OCCUPANCY PERMIT Bond issued to Barnstable Holding Co. Address y Lot #18, 287 Mitchell Way, Hyannis Wiring Inspector Inspection date Plumbing I Spector s Inspection date A t t Gas Inspector Inspection date Engineering Department Inspection date Board of Health Inspection date �4 THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL ` SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSET S STATE BUILDING CODE. ............//�. .1.... /„ :.s.:Y....:::!2 Build g"Inspector ��' TOWN OF BARNSTABLE. BUILDING DEPARTMENT _ BaaiSTasi _ TOWN OFFICE BUILDING riva HYANNIS, MASS. 02601 �0�Y M i MEMO TO: Town Clerk FROM: Building Department/�� it DATE: /P",/u,v e Pol An Occupancy Permit has been issued for the building authorized by BuildingPermit #.... g 2..z.. ............................................................................................................................................. . .._ issued to ....� 77......... n e e Please release the performance bond. THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^C&L DATA e BUILDING �J TOWN OF BARNSTABLE, MASSACHUSETTS PER= = IT JOB WEATHER CARD - DATE 19 PERMIT NO. 2912214 ..+•:i;.t::APPLICANT ADDRESS 'r•, .;IJ (NO.) (STREET) (CONTR'S LICENSE) NUMBER OF " PERMIT TO (_) STORY -"- -"' "'" DWELLING UNITS (TYPE OF IMPROVEMENT) pNO. (PROPOSED USE) _..i' , O•i-- �.. ZONING AT (LOCATION) DISTRICT (NO.) (STREET) BETWEEN AND (CROSS STREET) (CROSS STREET) LOT SUBDIVISION —LOT BLOCK SIZE BUILDING IS TO BE _FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: AREA OR • ' PERMIT ^ VOLUME ESTIMATED COST $ FEE (CUBIC/SQUARE FEET) OWNER BUILDING DEPT. ADDRESS BY ( ' THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY OR PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP- PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND 1. FOUNDATIONS OR FOOTINGS. MP.DE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MEMBERS(READY TO LATH). FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE OCCUPANCY. POSE' THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPRI.YVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 � � 3 HEATING PELTING/AP R0VALS REFRIGERATION IN ECTION APPROVALS OF Hp�TH .. 0,7 H E R 2 - 2 GINEERING i `ti''nK arAL: M_T -POZEED IiNT L 'r= PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION iNSPECTiONS iNDICATED ON TH!S CARD .NSPECT'- SAS AP-,Cv_ 74!= CUS WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE CAN BE ARRANGED FOR By TELEPHONE STAGES CONS?'RUCTiON. PERMIT IS ISSUED AS NOTED ABOVE. OR WRITTEN NOTIFICATION. 4 /L// TG h✓ Z- 4F �A Ce ✓ 1 mi tz A Jk F 11__ � _ a �, N, j� n'1 -20 ' GG�•f��.�-iJ'7°if'7 70 S 20 a�io Ae 77, !J r CERTIFIED PLOT -PLAN 177 H.rL. IN r S* SCALES / 461 ATE ' 6-�k?sV �Nr�ITjOH `. ,. EF / M ,�.oe©..cz� TINY THIS PLAN.= Cl1EliT,,....,,�__.,_ I CER L ®CSTEREO REGISTERED SHOWN OIS •.LOCATZ03 J0® N4 -ON THE -4ROUND AS INDICATED AlMj CLYIL lANOCONFORMS 'TO -THE ° ZON11471AWDINEER SURVEYOR OR.DYE .:... { OF :BARNSTA®�. , MASS MAIN STREET'`; CH.6Y� ....., �.1. .... y i7 - rs. HYANAIS, -MAaS.' ' SHEET ;�.i�F,.,,.� DA E RES ,,LANE 8t1RVEYOR v Assessor's office .(1st floor):. ,,//��,,,, Z Assessor's map' and lot number ...1'I.R f......._ .0.. � ....5 Z MUST B Fr►iErO` Board of Health (3rd floor): ��� i SEPT`ED IN C�p�pN Sewage Permit number .........:................. ..-:..... INSTp E 5 BABISTME, Engineering Department (3rd floor: i . I I i MENT L CODE A o "639. e0� W IT House number ... .��.7...(1V�1. I.5..:...:..�` .............. f � CN SEA I- �OCN YPY APPLICATIONS PRR0� D 8:30 9:30 A.M. and 1:00-2:00 P.M. •only, owe A P P R $ astable Conserv>9tioZ m Sion N: OF B:A R N S T A B L E igned � Date I L D I N G INSPECTOR APPLICATION FOR PERMIT TO ............... 1.1._?.. .. ... a..1. /1 \ _...h.o ......................................... Sri l� V� \ Y`�l ti• TYPEOF*CONSTRUCTION ............................°�.......,.................�...........� �-_. ............................................................ ................................ .....6..19..�� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according-to the following information: Location .........`....". ..le......1.1.1 .....:.b' �1.."1..�! C..1.1..5......... ... ...........` . I.h{f.5.......................................................... Proposed Use ........�-�l .° .1K�.. `'"?...1... TZ� :.1�.. ...... :� .... .................................................. Zoning District ..... ........ .. ... ..................Fire District .......1.... .ay.?^ ............................................... Name of Owner .... .. . . .. ... .....ti...o..j............. . `. . .....Address .. _ f a S S ��. ........�`e-��...Name of Builder ........ .�.................. .................................Address ................... ......:...............—_. .....,, E Name of Architect ...... '� -f................................Address ...... T` 1...................` .........:e .. ' �1Number of Rooms ................ .: .. . ..�................ ....................Foundation ...... X.2... Exterior ........... )' ..........................................Roofing ...... .................................................. �, QO Interior S 1 � �G . Floors ............CG.Y. . ................................... Heating ..............C�� � ,..(. ......................................Plumbing ........Q'.v:.e.........�.... <a�e--.......�°` j Fireplace ................... .......................................................Approximate Cost ..... .-T,...`...`......... Definitive Plan Approved by Planning 'Board- ________________________________19________- Area ......./..I=?..... ......:................ . Oo Diagram of Lot and Building with Dimensions Fee / SUBJECT TO APPROVAL OF BOARD OF HEALTH to �. • 1 � III OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulation of tlie-,Town of Ba, nstable regardi abg�e construction. Name ....... . ......... .,. .................... Construction Supervisor's License -1 ! _r_. .... �# '.�BARNSTABLE HOLDING CO. A 9 29224 t: 1. No ...:............. Permit fo A7. U.qu................ 3 Single Family�wel ng ?�� .................'Lot #18",.•R::287,`�i'tc hell ..Way ........f ... r i Location e ._Hyannis y ............. ... Barns tabla Holding Co:. _ �j Owner ...............ta g �. t. ............. _ 4 - �... ...... • %•,ame ' Type of Construction ......... ..�.......................... ,y4 c , Plot ................................ tot ................................ April 18, 86 = Permit Granted ...19 Date of Inspection ....................................19_ Date Complet.0 //ST All t— iF C' �•s .".t + . f f� 4 -'_