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0055 OLD COLONY ROAD
�� �� / ��.oT=S� � - - -=- -- - - - ------- 'i I 6� 1 I { Ott •Si ot.� G"Ny Rbgwy . IENN I63 i Cape Save Inc. 7-D Huntington Avenue South Yarmouth, MA 02664' , Tel: 508-398-0398 Fag: 508-398-0399 3/15/16 Town of Barnstable Thomas Perry CBO ,. _ Cd , Building Commissioner ® 200 Main St.Hyannis,MA 02601 RE: Building Permit#B-16-443 a ` `F 6 " a TO: Building Inspector(s),. 4� This affidavit is to certify that all work completed for 55 Old Colony Road,Hyannis has been inspected by a third party Certified Building Performance Institute(BPI) Inspector. $ All work performed meets or exceeds Federal and State Requirements. Sincerely, • ` William McCluskey y i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION . � r a � Map - B3 6 Parcel Application, b I Health Division Date Issued' -V E Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic- OKH _ Preservation/ Hyannis Project Street Address © co Village an ors Owner C n �+ I cn, C I OL Address �`cr/►'LL Telephone �0 + R 5 L q D 63 Permit Request Al) I � 0 111 �&,+144 q,JI 1, A,� a r;<�' � i 45A1 J1 oq -�nr 4�1t P n S lAi +Ik a W41,9 W 6T Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation ��b 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 Unfinis ,d Area (sq.ft) Number of Baths: Full: existing new Half: existi�l new A �� Number of Bedrooms: existing _new Total Room Count (not including baths): existing new 0-cl Fir4,00r�06,6m Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other �. Central Air: ❑Yes ❑ No Fireplaces: Existing New Exist l� wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes Kko If yes, site plan review# Current Use - - Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name wavupk c Telephone Number a 3 99 Address '' 4 *w>r►�"q �JG License # 7,�C Id�1 S. I,,,rm o w��►, ('1�- b 6 '1 Home Improvement Contractor# Email Worker's Compensation # WW 11313 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE c i FOR OFFICIAL USE ONLY <' APPLICATION # ' rc DATE ISSUED ;f MAP/PARCEL NO. ADDRESS VILLAGE OWNER v DATE OF INSPECTION: FOUNDATION t FRAME INSULATION j FIREPLACE ELECTRICAL: ROUGH FINAL s PLUMBING: ROUGH FINAL r GAS: ROUGH FINAL FINAL BUILDING i DATE CLOSED OUT } f ASSOCIATION PLAN NO. HOME OWNER WEATHERIZATION WORK PERMIT. PLEASE COMPLETE AND SIGN THIS FORM AS THE APPLICANT HOMEOWNER. I �P_J( _ hereby consent to and agree that weatherization work may be done by the Weatherization Program of Housing Assistance Corporation on the property located at: The weatherization work done will be based on programmatic priorities and availability of funding and it may include all or some of the following measures: Weather stripping; air sealing; attic&basement insulation; exterior wall insulation; ventilation measures In consideration of the weatherization work to be done at my home I agree to the following: 1. 1 give permission to Housing Assistance Corporation the property with such equipment and materials as may be necessary to perform weatherization. 2. The Housing Assistance Corporation reserves the right to inspect the fuel or utility bill for the weatherized unit on an ongoing basis for no more than,five (5) years after the weatherization work is completed. have read the provisions of this agreement and give my consent. Home Owner(signature) Home Owner email: 0C(0,e t(otC uwi Date: i �D � : Agent:(signature) �. Date: Weatherization Contractors: Adam T Inc Cape Save All Cape Energy - Frontier Energy Solutions Alternative Weatherization Lahr Home Improvement Building Science Construction Resolution Energy Cape Cod Insulation Tupper Construction I O DATE(MMIDDIYYYY) A 6 CERTIFICATE OF LIABILITY INSURANCE 10/14/2015 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(les) 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 NAME NCT Colleen Crowley Risk Strategies Company PH07 o.E (781)986-4400 Fp/C'No:(781)963-4420 15 Pacella Park Drive ADI�SS:ccrowley@risk-strategies.com Suite 240 INSURER(S)AFFORDING COVERAGE NAIC# Randolph MA 62368 INSURERA:Selective Ins. of America INSURED INSURERB:Allmerica Financial Alliance Ins. Cc' 10212 Cape Save, Inc INSURERC-.Wesco Insurance Company 7 D Huntington Ave INSURER D: « INSURERE: South Yarmouth NA 02664 INSURERF: COVERAGES CERTIFICATE NUMBER:CL15101402127 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. LTRR TYPE OF INSURANCE POLICY NUMBER MPMO�ICY EFF MPMO�IBC NYYYJ EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1',000,000 A CLAIMS-MADE DAMAGE TO RENTED�OCCUR PREMISES Ea occurrence $ 100,000 S1994480 10/16/2015 10/16/2016 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ .2,000,000 POLICY[�]PE"C7 Fx_1 LOC a PRODUCTS-COMPIOPAGG $ . 2,000,000 OTHER: $ AUTOMOBILE LIABILITY Ea COMBINED SINGLE LIMIT $ 1�000,000 B ANY AUTO BODILY INJURY(Per person) $ ALL LOWNED X SCHEDULED AU ANUA46796600 11/6/2015 11/6/2016 BODILY INJURY(Per accident) $ AUTOS NON-OWNED PROPERTY DAMAGE $ X HIREDAUTOS X AUTOS Per accident $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 11000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 DED I I RETENTION Ail S1994480 10/16/2015 10/16/2016 $ WORKERS COMPENSATION officers Included for - X PER OTH- AND EMPLOYERS'LIABILITY YIN N --, W- STATUTE ER ANY PROPRIETORIPARTNERIEXECUTIVE •Coverage E.L.EACH ACCIDENT $ -500 000 OFFICERIMEMBER EXCLUDED? N NIA C (Mandatory In NH) WVC3136274 4/9/2015 t4/9/2016 E.L.DISEASE-EAEMPLOYE $ ° '500 000 If yes,describe under , DESCRIPTION OF OPERATIONS below s- - • E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached if more apace Is required) National Grid Corporate Services LLC d/b/a National, Grid, Action Inc, Colonial, Gas Company and NStar Electric are all included as Additional,Insureds with respects to the General Liability•coverage of Named Insured as required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Housiaq Assistaace CoTpor'atioa THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 460 West Main street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis, -M 02601' AUTHORIZED REPRESENTATIVE Michael Christian/CLC �r ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD NS025(201401) y, - -.The.Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 oM www massgovLdia NVorkers'Compensation.Insurance Affidavit:Builders/Contractors/Elects cians/Plumbers. TO BE FILED WITH THE.PERMITTING AUTHORITY. Applicant Information Please Print Legibly Save Inca • �1Name(Busness/Organization(Individual);Cape , Address:7-D Huntington Avenue City/State/Zip:South Yarmouth, MA 02664 Phone#:508-398-0398 Are you.an employer?Check the appropriate box: Type of project(required)- 1:✓ I am a employer with 20 employees(full andlo;gart-time).' ❑ 7. New construction 2. I am a sole.proprietor or partnership and.have no employees working for me in g y • ❑ 8: ❑Remodeling any capacity.[No workers'comp.insurance,required:] 3.❑I am a homeowner doing all work.myself:[No workers'comp..insurance required:]t. 9. ❑Demolition ' 10❑Building 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 LM 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.E]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.[]✓ Other Insulation 152,§1(4),and we have no employees.[No workers'comp.insurance required:] *Ariy applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. f 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 whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.pobcy number. 1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job.site information. Insurance Company Name-Wesco Insurance Company Policy#or Self-ins.Lic.#s WWC3136274 Expiration Date:04/09/2016 - lob Site Address: 55 Old Colony Road City/State/Zip: Hyannis 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 verification. I do hereby,cet fy under th pains and penalties of perjury that the information provided above.is true and correct Si ature: Date: 2/26/16 Phone#:508-398 0398 Official use only. Do not write in this area,'to be completed by city or town official, ' City or Town; Fermifticense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.E1.ectneal Inspector 5.Plumbing.Inspector. 6.Other• Contact Person: Phone:#: a pr Office of Consumer Affairs and Business Regulation IO Park.Plaza Szrte 5170; Boston, Massachusetts 0211b Horne Improvement:Contractor Registratlori • � � �-,_��_.., Reg�stratwn 171380 � i;�� Type Corporation Expiration:: 3/1412018 Triie 419291 rt i CAPE SAVE INC: WILLIAM McCLUSKEY i 7-D HUNTINGTON AVENUE _ ,, SOUTH=YARMOUTH, M _02664 Update Address and return card Mark reason for change: Address- � :Renewal. inED1010hient Lost Card: Jle e ranrdtrru&gu inns Begun ari�e� License or re isfration valid for individul.use onl Office of Consumer Affairs8c Business Regulation g Y , p�HOME IMPROVEMENT CONTRACTOR before the expiration date If found returmto Registration 17138p: Type: Office of Consumer Affairs and Business Regulation q , Expiration 3;14/k-1 Corporation: 10 Park Plaza Suite 5 . x Boston,MA 02116 CAPE SAVE INC. §{ WILLIAM McCLUSKEY '7=D HUNTINGTON AVENUE SOUTH'YARMOUTH,i4 664 Undersecretary Not valid: �signature . Massachusetts —Department of Public Safety �.! -Board of'.Building Regulations and,Standards ^•- .. \.10)-11i1 ulltll/11�iiTieii'i�Or�lCCi7%y Licen.se CS,SL 102776 `�� NQ WILLIAM�MC CCU UcviL 37 NAUSET ROAD .� West'Yarinouth MA - Expiration Commis�siio'nner` 06128/2017" a F > Cape Save Inc. 7-D Huntington Avenue South Yarmouth, NM 02664 Tel: 508-398-0398 Fax: 508-398-0399 P -z 3 3/17/13 Town of Barnstable Thomas Perry CBO Building Commissioner 200 Main St. Hyannis,MA 02601 RE: Building Permits Zzf x 1 j Dear Mr. Perry, . -� This affidavit is to certify that all work completed for 55 Old Colony Road,Hyannis has been inspected by a certified Building Performance Institute(BPI)Inspector. NO INSULATION WORK PERFORMED ON THIS BUILDING All work performed meets or exceeds Federal and State Requirements. Sincerely, 4 ' William McCluskey TOWN OF BARNSTABLE.BUILDING PERMIT_APPLICATION„�, Map x, 0 Parcel ® Application#�®� Health Division `Date Issued �+ Conservation Division ; ;;Application Fee e Plan ning;Dept: `Permiit Fee' S` Date Definitive Plan Approved by Planning Board Historic OKH _ Preservation / Hyannis " Project Street Address: 5 O lA ea fo r\I Q©cam. F Villagey VI!n rS Owner Cl ri 4-k u O— G7 C-Ur)(,. Address Old L (or, Telephone SOR 53 y No 7J Permit Request R e_�n av�- C K�S ones a « b e4 Aa -®®M , Square-feet:-1st floor:-existing proposed�_ 2nd floor: existing proposed Total new ` Zoning Districf Flood Plain Groundwater Overlay Project, aluation-- ° Construction Type Lot Size Grandfathered: ❑Yes ❑ No If'yes, attach supporting documentation. Dwelling Type: Single Family ,:?f ii Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes W 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: 3 existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: Gas 0 Oil ❑ Electric ❑ Other ' Central Air: WYes ❑ No Fireplaces: Existing New Existing wood/i�oal stove: 0 Yew No ti Q Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑p9w Me_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Lo Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ b rn Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name SJ3r'n k 1� Telephone Number 74� ' -7 7 S ` 1-7-7 y Address ��®� rv�S f 4�2 Qc�. License IAO qqCAA1\In S 1Y)A Oa(ad Home Improvement Contractor# 10 -751 Worker's Compensation # '700 99 930 1 o101 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO c r v I rct rvs sw,, A SIGNATURE DATE `) FOR-OFFICIAL USE ONLY 5 APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. c y The Commonwealth of MassachusettsPnnt Form Depar.tment.of.Industrial Accidents,.... = Office.of Investigations ' 1 Congress Street, Suite.100 - -Boston,MA 02114:201.7 - A www.mass.gov/dta Workers' Compensation Insurance Affidavit:,Builders/Contractors/Electricians/Plumbers` AppGCant Information Please Print Legibly •. vement Nallle:(B Sprinkle Hom usiness/Organization/Individual): ,elmpro ' 199 Barnstable Road >' Address; w. City/State/Zip:, /State/2iP Hyannis, MA 02601 Phone# "508 775-1778 Ezt: 10 , Are you an employer?Check the appropriate box. ; s Type of project(required) 1.211 am a employer with 10-12 4 I am a general contractor and I * ` have hired the sub-contractors _ 6.''.❑New construction'.` employees(full and/or part-time) .. 2:E I am a sole proprietor or partner ',listed on:the attached sheet: .7., Remodeling 'ship and have no employees These sub-contractors have "g, E Demolition working- for mein an capacity. employees and have workers'` ; y p �' 9. 0 Building addition [No workers'.comp' .insurance comp.-insurance..$ required.] 5. F We:are'a corporation and.its 10.0 Electrical repairs or additions 3.El.I am,a homeowner doing all mork .° officers have exercised their - 11:0 Plumbing repairs,'oradditions myself. [No workers' comp. - right of exemption per MGL 12.E].R6of repairs insurance required.]t- c.-152, §1(4),and we have no employees. [No workers'. 13.[] Other comp. insurance;required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavitindicating 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 whether or not those entities have- employees. If the sub-contractors have employees,they must provide.their.workers'comp:policy number: I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site.. information... - Insurance Company Name: Associated Industries of MA:"/A.LM Mutual Insurance Co Policy#or Self-ins.Lic '#:' 7004943012012 <- Expiration Date 01/01/2013 Job Site Address:5J l:� t1 City/State/Zip:.H 4 rt 1 PS Attach a.copy of the workers'-" 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 imp osition,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$250.00 a day against the violator: Be advised that a copy�of this statement may be forwarded to the Off ce of; Investigations of the DIA for insurance coverage verifcation., I do here b ce un s and enaldes o er u that the in ormation provided above is true and correct Signature. `.... _ Date !3 Phone#. 508 775=1778 Ext.'10` Official use only, Do not write in this area,"to be completed by city or town official b City or Town: Permit/License# Issuing Authority(circle one): ' 1:.Board of Healtli.2. Building Department 3 :City/Town Clerk 4.Electrical-Insp&t.or p 5.Plumbing Inspector . .6.Other Contact Person: Phone M. 12/20/2011 9 :.35 : 33 AM 8740 2 02/09 CERTIFICATE OF LIABILITY.INSURANCE D"'vivo D/Y ) TRIO caarlr:c&Tz Is IeOOm As A EATTm or ZProammioa ONLY AND Commas so axon" OYON TSE cowiricats sOLDEa. TRIO CERTIrICATR9 DOES NOT AFFIRMWZVELY OR NESATIVELY MOOD, WMZZD OR Almm THE COVXRAOE AFrOmm sy,TNR'POLICIEs ORLON. Tula cmrxFICATE or . INOORAECE DOER so? cORIrrx7 R A CONTRACT NE?NmN THE IssOIss INOOaER($), AOTSORI ZED`REPPEORETATZVE OR PaODNCER, Am ?aa CERTIFICATE solma. IMPORTANT: Zf the Certificate hOldar is an ADDITIONAL INsOam, the polioy(IGS) mast bG GAdorsed. IF 69ZROSATIO■ IO NAZVm, subject to the terms and conditions of the policy, certain policies alAy require an endors�nt. A statement on this certificate does not comer ri ts•te the certificate holder in lieu of such endorwssnt(s>. PaaP Orr _ .Bsyden 6 Sullivan III& Agency .�,D;; ..f Inc ( F. ... 6tla We.so): a�a 88 Palmouth Road rD.nfa .■..walk Hyannis, bA 02601 NfTOO■ID.. Lsu@(a) mrwas`Comm ss sAie r IrePAtD Sprinkle HCme 11wrovement Inc aim•, A:I.M: Mutual Insurance Co 33758 Irmm a. 199 Barnstable Road ,n f, Hyaaais, bA 02601 I■f11Y 1. IwIY r. - COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: . RNis =RO CEO=Ww Rm sOLraZ= or ZRsosaaoE LisRm BELOW X%Vs mass us=To-"Rse IREOa®NN1N D Mon roa WE POLser FRRZOD Z•Dummm. - 10lNSaif'ANmaG an tEQOtlO. , 'mY OR COmZTrOR Or ANY cornAm OR omR Docm m mm muracr to go= mm cmwrmmnRN im Y IssYm as Nhy saaaa, am m1sun1Q APPOEDm RY'm POLMOM assaam NaR4a Is xuzms 10 ALL Rss Rams, asCLDszoos mm OORDznm or smz roLmmm. Linn saoNN Ia►Y Oars am Psbo®By ram cLaas. - _ •: . N� Fo""an roLrctt ssr �+ TIPE Or asosAEcs POLxcY aolsaa asuuitttn ala= GENONL LZARarrr - - ' -. - .. - . Ram OCCUMARec { EICOMtAC IAL O1sIAAL LIABILITY f0®fY -- `DNm12QiR...awA�r.Aw1 a❑CWiIO MAD■ ❑OCCDR _ •. .. � tOD @ IAIp.A.{.lD.A) { ❑ Dlarm"a ADt/Iam= f GIl'L AGGAtGtTS LIMIT APPLita sa: •. ®[YN.a■oQf1Tf { EPOLICT CPAOnCT❑SAC .. .'.: - ' DROD■Rf- C®/0 l0G f_ AVIONDQUE LSAsII,1SY - COMBINED fnlOLt LIMITCIANT AUTO { (w a,amt4wt). .. PODILT IQYaI .r N am -P 1 { ALL 01060 AOTOt y-, • _ 132c®DDLID AOSOD .. 'BODILY LOtel/Nr.oelwmtl { _QOIWD ADTOD -DtfrSWI DOOM .(P.r ION-CMISD AOTOD UW- RZWA LIAD OCCOA tam occl m { 1:1� ZC { DIDP LLtA CLAIMS MADt - . DSDOCTIpf - - .a aAtStNIION i { ..WORKERS CO1010sARTON - ..® - OfIF an■fLOYOs LSNRa=TF- tan LmTf a TM PROPRIERGR/PARTWM/ - B.L. saa ACCMMM !. {- 500,000 EXECVPIVE.OrrICERS ARE - A ® incl ❑ excl 700d9d3012012 t.L. DTfssa -fout�LN>IIT a 500,000 01/01/2012 O /01/2013 B.L. DISSM -sA sanoat; f 500,000 CO■mts 'AttmENTlQ W 00oa11046 as LOCATIONS. - WORKERS' COMPENSATION,COVERAGE APPLIES TO MASSACHUSETTS EWLOXEES CERTIFICATE HOLDER CMCELLATION PROOF OF INSURANCE - - `XsO=AisY or-.Tas AtOYE DStCRZ/aD POLIc3s NO C11MMM ZEN=Tm =MAE= DARN gsss NOT=Nam ss.Dm,ZyO t• NYC=nARrs NM RSN POL=mOVIPZOEs. aufMOlNa tarm2SXWTA.TM _ 5289 /N•r!(fII� If "!1/I(ljiG�$ Kuilifin_ I�i ui.,t,.„r. .,ri I � l.,,ii� UCtirruffonsumer:f,trtrairsK`Rtlaioess Kuiat Construction SUDQ-nstSor ;iCC-rise. �"� Tx HOME IMPROVEMENT CONTRACTOR gf- Registration: 103757 Type: -;a r Expiration: 7/9/2012 Private Co oratic rP SPRINKLE HOME IMPROVEMENT, INC. BRAD K SPRINKLE 190 LOTHROPS LANE r a Brad Sprinkle W BARNSTABLE, MA 02668. 199 Barnstable Rd, Hyannis. MA 02601 tndersecretary ues, .~,,,t 6004 License or registration valid-for individul use only Failure to possess a current edition of the before the expiration date. If found return to: . Massachusetts State Building Code Office of Consumer Affairs and Business Regulation i3 cause for revocation of this license. Ill Park Plaza-Suite 5170 Boston.MA 02116 Refer to: WWW.Mass.Gov/DPS Not %alid without sign ore KM . Town of Barnstable Regulatory Services Thomas F.Geller,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us - Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I,�VAirA—_• e,�0.r k— ,as Owner of the subject'property Sprinkle.Home Improvement hereby authorize. to act on my behalf, in all matters relative to work authorized by this building+permit application for: O(1 aU01 (Ad ess of Job) Signature of Date Print Name If Property Owner is applying for permit,please complete the Homeowners.License Exemption Form on the reverse side. 3. r C:\Uses\decollik\AppData\Local\Microsoft\Windows\Temporary Intemet Files\Content.Outlook\DDV87AAZ\EXPRESS.doc Revised 072110 ° MEMBER REPORT Level, Wall.Header PASSED F 0 R T 2 piece(s) 1 3/4" x 9 1/4" 1.9E Microllam® LVL Overall Length:10' o ti ._ 10+ All Dimensions Are Horizontal;Drawing is Conceptual - , D251gri ReSUIiS °Actual Locatio" ` „ Allowed Result,x 4 ;LDFI Load:Combination(Pattern) System:Wall Member Reaction(Ibs) 3295 @ 1 1/2" 7613 Passed(43%). -- 1.0 D+1.0 L(All Spans) Member Type:Header Shear(Ibs) 2622 @ 1'1/4" 6151 Passed(43%) 1.00 1.0 D+1.0 L(All Spans) „` Building Use Residenbal, Moment(Ft-Ibs) 7830 @ 5' 11204 Passed(70%) 1:00 1.0 D-+1.0 L(All Spans) Building Code IBC Live Load Defl.(in) 0.264 @ 5' .0.325 Passed(L/443) -- 1.0 D+1.0 L(All Spans) Design Methodology:Aso Total Load Defl.(in) 0.335 @ 5' 0.488 Passed(L 349) 1.0 D+1.0 L(All Spans) Deflection criteria:LL(L/360)and TL(L/240). Bracing(Lu):All compression edges(top and bottom)must be braced.at 10'o/c unless detailed otherwise.Proper attachment and positioning of lateral' member stability. bracing is required to achieve tY•eq - A " +.`Beanng'Lengih ,„ ;Load sto5upports(Ibs) « . •' r� TM - �.`• -- SUppOrtS „•Total. Available Required Deait- Live Toml Acocssories. i-Trimmer-SPF 3.00"' 3.00" 1.50" 695 2600 3295 None 2-Trimmer-SPF 3.00" 3.00" 1:50" 695 2600 3295 None a• Tri ly ,.Dead' r Floor Live" LOadS Location Width' ,-(0.90) "(1.00)11 ".Comments-_ 1-Uniform(PSF) 0 to 10, 13'- 10.0 40.0 Residential-Living Areas - - Weyerhaeiseru NOteS SUSTAINABLE FORESTRY INITIATIVE Weyerhaeuser warrants that the sizing of its products will be in accordance with Weyerhaeuser product design criteria and published design values. l Weyerhaeuser expressly disclaims any other warranties related to the software.Refer to current Weyerhaeuser literature for installation details. (www.woodbywy.com)Accessories(Rim Board,Blocking Panels and Squash Blocks)are not designed by this software.Use of this software is not intended to circumvent the need for a design professional as determined by the authority having jurisdiction.The designer of record,builder or framer is responsible to assure that this calculation is compatible with the overall project.Products manufactured at Weyerhaeuser facilities are third-party certified to sustainable. forestry standards. The product application,input design loads,dimensions and support information have been provided by Forte Software Operator • r , 3/12/2012 3:22:21 PM Forte Software Operator- Job Notes , BILL RUBEL SPRINKLE Forte;V3.5,Design Engine:V5.5.3.2 MID CAPE HOME CENTERS o DENNIS JOB (508)398-6071 brubei@midcape.net h Pagel Of� v {may • - '. + L a • f - .. CIS 17,77, rsa llk , . Qt— n - E r , ,N s — _ —"1 • � -. •,. { is ...- t -. ,: i "I a^.ur r w, 1 i � f 7 .• • , , �' , ! _ .. ,�; — i to ° ��qqyy i 6 I. ( t ! , r I.st floor (�2nd floor Kotchn bath I]i�irig iRgo Bath Room 4 -Bed Room Bed Raom i Open:Hall Way Laingrwm: TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 91 Map 0. Parcel .. v "� Application # 4`1" . Health Division Date Issued a 61 k,3 Conservation Division Application Feed" o2 0-Y Planning Dept. Permit Fee S> Date Definitive Plan Approved by Planning Board I� r Historic - OKH _ Preservation/ Hyannis Project Street Address 5 5 0 1 C At 0A CLA Village 4 V non 15 Owner C J t z O, Mr Address S a"M 6 Telephone 107 - H 4 _ 1 Permit Request < < a l r S l in UJ o � II a h f• f+ o a Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 9 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 I Y 5 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: 1�Gas ❑ Oil ❑ Electric ❑ Other �-_'i s , 4 -� Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood d"oal stove ❑Y; ❑ No ZZ .3 Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: Dexisting T❑'nevv----)size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: L Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes XNo If yes, site plan review# rn Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Q 4 Q Name v"i �a�(r1 {. ICG �a-vw✓ Telephone Number 5b$'" !$ - 03 I o Address License# 1 d (� f 5a(A,`� Ya("Mbl�,, a 0 6� b�l Home Improvement Contractor# 9930951 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Q 4 SIGNATURE DATE 's , FOR OFFICIAL USE ONLY `. APPLICATION# i DATE ISSUED MAP/PARCEL NO. � r ADDRESS VILLAGE OWNER j DATE OF INSPECTION: FOUNDATION FRAME r t INSULATION z FIREPLACE 4 ELECTRICAL: ROUGH FINAL r PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ' FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 1 t ' The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers A Blicant Information Please Print Legibly NaMe(Business/Organization/Individual): d �I CI O A E ,�c�IC 1 4e6 34 Address: a taN at eytc�"I4��g� City/State/Zip: S YAAAOS k_- —z' one#: Are you an employer?Check the appropriate box: Type of project(required): I.[K I am a employer with 1 1 4. ❑ 1 am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g. ® Demolition working for me in any capacity.ca acit employees and have workers' 9. ❑ Building addition [No workers' cotilp. insurance comp. insurance.= 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 11.❑ Plumbing repairs or additions myself.[No workers' comp. right of exemption per MGL I2.❑ Roof repairs insurance required.] c. 152, j 1(4),and we have no `l tl employees. (No workers' 13.0 Other PS ti Of) comp. insurance required.] *Any applicant that checks box#1 must also rill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they axe 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 whether or not those entities have employees. if the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: r T F i:i t Policy#or Self-ins,Lie.#: V J y 6 { Expiration Date: (16 f 1 1 �s c G`` City/State/Zip: )Job Site Address " M Attach a copy of the workers'compensa 'on 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 Gerd fy under the pains .d enalties erjury that the information provided above is true and correct. Signature: Date: 9 Phone#: Official use only. Do not write in this area,to be completed by ciot 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 - CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYYI� 11/1/2010 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 policy0es)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[!). PRODUCER COE_CONTACT Shannon Sperrazza — - --- Frisk Strategies Company 1 Ia.IIL Ertl (781)986-4400 (A/C No)• (701)963-4420 15 Pascella Park Drive j E•MA{L ss errazza@risk-strata ies.com _—._._.__ I ADDRESS p q Suite 240 PRODUCER n0018476 -- L.OUS.iQl9ER fD#" Randolph MA 02368 INSURER(S)AFFORDiNGCOVERAGE _ i N_A_IC# ---, ---- INSURED IINSURERA:Seneca Specialty Insurance Co INSURER B—Keating Group Ins Services ^x Michael BMcCluskey, DHA: Cape Save INSURERC:Chartis Insurance _ 7 C Huntington Ave INSURER D INSURER E: _ I Soutrh Yarmouth MA, 02 644 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1011132675 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 y CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS ARID CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTRR t AM' TYPE OF INSURANCE POLICY NUMBER —---�MIUQ� i—POLICYA9/ lYYYY —LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 COMMERCIAL GENERAL LIABILITYi DAMAGE TO RENTED 1PREMlSES(Eacxurranc __ N,y_— 50,000( A CLAIMS-MADE : ' OCCUR TiAG1002608 10/16/2010;10/16/2011 MEDEXP(Anyoneperson)_t$ 1v-,000 PERSONAL 8 ADV INJURY :$ 1,000,000 _._ I GENERAL AGGREGATE $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: ! PRODUCTS-COMPIOP AGG ;S 1,000,000 X POLICY PRO- LOC $------- _._.._ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 16208200 11/6/2010 Y1/6/2011 t(Eaaccdent} ANY AUTO BODILY INJURY(Per person) 5 ALL OWNED AUTOS i, t BODILY INJURY(Per accident)1$ —-- X :SCHEDULED AUTOS ---_ —____...._:...._...__._.._— PROPERTY DAMAGE X HIRED AUTOS ! (Per accident) $ NON-OWNED AUTOS _X UMBRELLA UAB OCCUR } EACH OCCURRENCE `S 1,000,000 EXCESS LIAR �' CLAIMS•MAOE! AGGREGATES—_ — j S 1,000,000 DEDUCTIBLE - S -- __ B RETENTION $ i 1023578601 0/16/2010 10/16/2011; ~- C WORKERS COMPENSATION k7ichael McCluskeyI WCSTATU- s ;OTH-I AND EMPLOYERS'LIABILITY YIN ' ANY PROPRIETORIPAR'rNERlEXECUTIVE - exc U from coverage; L.EACH ACCIDENT $ OFF10ERttoIEMBER EXCLUDED? Y N 1 A j _—_ Sao L000 MyaensdaMo eN �; `9910951 10/21/201 ;10/21/2011;under .l DISEASE-EA EM9PLOYEE$if 500L004 DESCRIPTION OF OPERATIONS below %E.L DISEASE•POLICY LIMIT $ 500,000 +. DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) issued as evidence of insurance. Contractors-Executive Supervisors or Executive Superintendents. CERTIFICATE HOLDER CANCELLATION (508)790'-2425 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Housing Assistance Corp ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Ruth 460 West Main Street AUTHORIZED REPRESENTATIVE Hyannis, MA 02601-3698 'chael Christian/SKIS ACORD 26(2009t09) 01988-2009 ACORD CORPORATION. All rights reserved. INS026(2rows) The ACORD name and logo are registered marks of ACORD I 91te �gr�eomom6wald V Office of Consumer Affai s and Business Regulation ' r . = 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 164432 Type: Supplement Card CAPE SAVE Expiration: 10/6/2011 . WILLIAM MUCCLUSLEY -- 8201 S. HOURD CT ------------ CHAPEL HILL, NC 27516 Update Address and return card.Mark reason for change. DPS-CA1 0 5OM-04/04-GlOI216 J Address Renewal Employment Lost Card Office of Consumer Affairs&Business Regulation License or registration valid for individul use only g Y 'HOME IMPROVEMENT C( IT CTOR before the expiration date. If found return to: ✓ Office of Consumer Affairs and Business Regulation Registration:'"164432 Type: 10 Park Plaza-Suite 5170 Expiration ;S0/6j2011. Supplement Card Boston,MA 02116 CAPE SAVE WILLIAM MUCCLUSLEY` 7C HUNTING AVE S.YARMOUTH,MA 02664 Undersecretary Not valid wi ou signature _ 9assachusetts - Dcpai tmcr t r►f Public afcc� Board of Building Rc�-uh ions and Standards Construction Superviso Specialty License License: CS SL 102776 Restricted to: IC WILLIAM MC CLUSKY 37 NAUSET ROAD WEST YARMOUTH, MA 02673 c Expiration: 6/28/2013 ( +,a�nriivuaee' Tr#: 102776 I �� �... r.+Ww wr•�w Jr /rL:1JJ Yl t1l LCI`.A'i 1 `IVL.. VL V1 CAPEO SAVE Weatherization 508-398-0398 s August 22, 2010 To Whom It May Concern: William J. McCluskey is an employee of Cape Save. He is authorl2ed to negotiate contracts and building permits for our.company. Michael McCluskey Caps Save—Owner 929-593-5939 cell ,.y 7C Huntington Avenue.,South Yarmouth,AAA 026" ` 460 West Main Street Oa.J S 11yansu.s, MA 02601-3698 ... : _ ENERGY 3L HOME REPAIR AS =7-:v:• T (508) 771-5400 F (508)7 0-2425 RA 71 Y on all tines tuz�nv.haconcapec€d.org - _ - pc�_.-_�••iHo,�Hi�ceL= CAHica�tM�lMARr6Cb.!IK�Hi!' HOME OWNER WEATHERIZATION WORK PERMIT& FUEL RELEASE: PLEASE FILL OUT AND SIGN THIS FORM IF YOU ARE THE APPLICANT HOME OWNER. hereby consent to and agree that weatherization work may be done by the Weatherization Program of Housing Assistance Corporation( herein after referred as "Agency") on the property located at: The weatherization work done will be based on programmatic priorities and availability of funding and it may include all or some of the following measures: Weather-stripping&caulking of windows and doors, insulation of attics, sidewalls &basements, attic and other ventilation measures and possibly replacement of badly deteriorated windows.In consideration of the weatherization work to be done at my home I agree to the following: 1. I give permission to the "Agency" its agents and employees to travel onto or across said property with such equipment and materials as may be necessary to perform weatherization work on said property. 2. The Housing Assistance Corporation reserves the right to inspect the fuel or utility bill for the weatherized unit on an ongoing basis for no more than five (5) years after the weatherization work is completed. I have read the provisions of this ement as listed and freely give my consent. Home Owner: (Signature) Date: ' I Agent: (signature) Date- CCL HAC approved Weatherization Companyd% Caliber Building&Remodeling Cape Cod Insulation Cape Save Creswell Construction Frontier Energy Solutions Lohr& Sons Peter Smith Resolution Energy Rock Solid Construction All Cape Insulation iA49-i51: T �oFrrtrr� Town of Barnstable *Permit# ti � L'rpires 6 n o ttttsjront lVue dale Regulatory Services Fee BgRV67MBLE .o 1 Thomas F. Geiler, Director r�q MAC ;;J L;?; Building Division _ Tom Perry, CBO, Building Commissioner TOWN OF BAR(�S►A��� 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY 508-790-6230 C,, Not Valid.without Red X-Press Imprint Map/parcel Number `' 0`0 -Z Property Address 5 p` �...�vk�C fda�C'1 Residential Value of Work 0jOG5? 60 Minimum fee of$35.00 for work under$6000.00 Owner's Name & Address Contractor's Name !Z— s oes` Telephone Number, ;�Q�-C.F 7—C 45S— Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) <3 ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name Workman's Comp. Policy# `5,L-�69 Q 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 ❑ Replacement Windows/doors/sliders. U-Valu #of doors e (maximum .35) # of windows *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: SAW RLES\FORIAMuilding permit forms\EXPRESS.doc tevised 072110 18 CERTIFICATE 1818 lED AS A MOkTTI:R OF INF TION ONLY AND CONFERS NO RIGHTS UPON THE ERTiFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,E)(TEND OR ALTER THE COVERAGE AFFORDED THE POLICIES BELOW.THIS CERMFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN E ISSUING INSURER AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. MPORTANT; If the Ce»ifwate holder is an ADDITIONAL INSURED.the policy w)must be endorsed. If SUBROGATION S WAIVED.subject to the terms and condigm of the poft certain polides mwi require and pndomement A statement n thIS C13ffKata does trot comer rkft to the csrftgb holder in Hsu of such endorsement PRODUCER G H Dunn Insunium Agency Inc Po Box330 Buaarda Bay,MA02532 COMPANIES AFFORDING INSURANCE COMPANY A GRANITE STATE INSURANCE COMPANY INSURED Shied&Co Uc 175 Teada t Hwy Unk 13 TeaticlwL MA 025384)000 THIS IS TO CERTIFY THAT THE POLICIES OF INBURVVE LISTED BELOW HAVE BEEN ISSUED TO THE INURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOT WITHSTANDING ANY REQUIREMENT,TI N OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WITCH THIS CEFMFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTHE Tom.ENGLUSIOII;AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IM TMOfEttErRANae Ptxacr>emlBeR rtxlare�teanveDKte POLNiYE1�tRATiDEIOME A ComPalsA7rox EMPLOYERS UMILnY LIMITS PROPR"ORi ARTttExSIElECunvE ICERSAR@ BiCI 0 E)Oq.O 8943090 8115/2010 9115/2011 aturoRY Leatrs anIEN gaApptlwtaMA0pma8a"o r- CH ACCIDENT -mm $ M0,00 WASE POLICY LIMIT $ 500.00 ISEASE-EACH EMPLOYEE S 300 00 ESGii�TIQN OF OPRPAT[0 TIZMS NO PARTNERS ARE COVERED BY THE WORKERS COMPENSATION POLICY. CERTIFICATE HOLDER GANCELLATION TOWN OF FALMOUTH MA ala=MYOFTHEAOMOESCRMWP(XCMSBFCAHCELLW BUCfMTHE TOWN HALL EfMTM DA7ETNMWF.NQnCE WU BE DUAFERW M ACCORDANCE SB TOWN HALL SQUARE W�tTET1tEPOLUYPROYIS�NS FALMOUTH.MA 02540 AUTHORIZED REPRESENTATIVE The C'arnnroirivealth of.Massachusefts — -- Departmerct oflilditstrialAcciderrts t! - �' Office of bivestrgatrorls ' 600 Waslriltgforr Slreef Boston, :'I-l4 02111 ._� �y taunt!.nrass.go}vdh7 Workers' Campensation Insurance A.fficla,it: Bililders/Con.ti•ictoi-s,/El:ectricians/PIumbers Appplicant Information Please hint Legibly N3111e(BusinesvOrgafuzation.'Individual): _6 `..� Address: City/State/Zip: Phone ff.- Are Tau an employer?Check thg appropriate box: Type of project(required) 1.0-1-am a employer with rA 4• ❑ 1 am a general contractor and I employees(full and/or part-tune).' have hired the sub-contractors 6- ❑New construction 2-❑ I am a sole proprietor orpartner- listed on.the attached sheet. 7. ❑Remodeling ship.and have no employees These sub-contractors have g- ❑Demolition -working for me in any capacity. employees and have workers' [No workers' comp.insurance comp-insurance..? 9- ❑.Building addition re aired. 5• ❑ We are_a corporation.and its 10.❑Electrical repairs or additions � j 3.❑ .I am a homeotivner doing all work afficers have exercised their I l.❑.Plumbing repairs or additions myself. [No workers'comp. right of exemption per NMGL 12-1--1 Roof repairs insurance-reguired.]r c. 152, §1(4)., and.we have no employees.[No workers' 13.0 Other comp.insurance required.] 'Any appficaut dial checksbox#1.must also fill out the section below sbawving their workers'cowpeasa:tion policy inforn ltian- 7 Homeowners who submit this.afMnrit indicating they are doing all-wont and then hire outside contractors mast submit a-sew sfftdavit indicating sud>_ =Conlnctors that check this boor[gust attached sn sdditional sheet showing the name of the sab-cmrtrac.tors and state whether or not(hose entities have employees. Ifthe sub-contcactom.hsre employees,they must provide their workens comp.policy number. I Qnrl arr L'NfptOy'FTr t1!!Lt IS pr0}�idirfg i1�Oriti�YS f.COf71pC1 tSalYOff fllSrlY(f.)f.Ce fOY lffj efrtplaJ ees. B-eton-is fire palict and job site information. Insurance Company Dame: Policy#or Self-ins.Lic.#: �_. el 3 -5> C) b Expiration Date: Job Site Address: G5 0 l A C\6 rAn> City/State/Zip: Q p"t d 6 Attach a copy of the workers' compensation policy declaratiofa page(s vowing the policy number and expiration date). Failure to secure coverage as required under Section 25A of IYfGL c. 152 can lead'to the imposition of criminal penalties of a fine up to S 1,500.00 and/ar one-year imprisonment,as well as civil penalies in the form of a STOP ItfORP,.°ORD.ER 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 D.IA for insurance co-,,erage verification. I do here.by cert' under the iris id periaThas of pei jury that the infortnation provided above is trite and correct Si tore: Date: Phone#: " Official use only. Do not write in this area,to be coulpleted by Hty or totrlt off-IciaL Gtt or Town: PermitlLicense# Issuing Authority(circle one): 1.Board of Health 3. Building Department 3.City/Toiim CIerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: r, SOP 1HE r, t + - • RARNSTABLE. A�ss.1639. Town of Barnstable �plfD Mp`f a�0 Regulatory Services - g Y e Thomas F. Geiler, Director Building Division Thomas Perry, CBO Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.mi.us Office: 508-8624038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder .... .. . . . . as Owner of the subject property hereby authorize a -� to act on my behalf, m all matters relative to work authorized by this building permit application fox: CIA C.' (Address of Job) Signaw of Owner Date Print Name If Property Owner is applying for permit, please complete the Homeowners License Exemption Form on the reverse side. QAWPFILES\FORMS\building permit formsTXPRESS.doc Revised 072110 n g oPa�rm iculeaA `�"°0aclation 3 License or registration valid for individul use only Office of oasumer (fairs iness Regplallon IMPROVEMENT CONTRACTOR before the expiration date. If found return to: HOME IMPROV Registration: ,.;:MENT Type: Office of Consumer Affairs and Business Regulation ' 9- TH Expiration: �113/2013 Individual 10 Park Plaza-Suite 5170 Boston,MA 02116 I STUgRT. KENNETH STUARI;Z; ;:;; ;; 63 HANDY RD. `s t.' y`i,POCASSET,MA 02559:g;`; ; _ '' Undersecretary Not valid without signature Masi je ti tt�c p. cii.irtmcnt o,Ptibl�� Board of But)ct�n�r „ Rc,�Yulations anc]StanclitrtlS ,n Construction Supervisgr t:jCense e; CS 23320 KENNETH I 'STU iF 63 POCAS Expiration: 6/18/2012 � �mmi+siiner` Tr#: 30112 Building Department Compt ;nt/Inquiry Report " Date: / U Rec'd by: Lb 1� rA s) ' Assessor's No.: - Complaint Name: Location Address: WP Ono 000 CJ2/l Originator Name; Street: Village: State: - Zip: Telephone:D/C A Ott �D Complaint ❑ / Description: yQ �� f 0, �O L" 2J (/(� ? �t� Inquiry 0 Description: O 1OZA- For Office Use Only Inspector's Action/Comments Date: 1 o o Inspector: Ol L�l(%MtiQ chi Azt c.. a AA2S Follow-up Action Additional Info. Attaclied Copy Disaibuaon: White-Department He Yellow-Inspector pink-Inspector(Retum to Olfce:lfanager) k oo O - 600 - OCQ f t I CompIai dncpnry Report _ Date: (10 Rec'd bg l ' � h"n A Assessor's,No.: . a Complaint Name. Location - Address: WP Ono OUCH o2i 1 Originator Name: Street: , yam; _' State: .Tip: Telephone:DIE' / �� D� Q Complaint Description: a A f Q hnc 1 6__/ (,<) 21Ln aInquiry , Description: ForOZM=Use Only Insp ector's Action/Comments Date: Olt Spector. Follow-up Action Additional Info.Attached Copy Drsnihrmroa: lit -DepartmeatFile -_ Yellow-Inspector' �� • O Pink-Inspector(Retrrm to' IFce 3fangerl v W - " . �� f J �� � f `b '�� ��' � r _ �J� f Town of Barnstable Zoning Board of Appeals �1 Appeal No. 1995-31 - Old Colony Chapter 40 B Comprehensive Permit Decision and Notice Summary: Granted with Conditions Applicant&Owner G-P Affordable Home Corporation Address: 3111 Falmouth Road, Marstons Mills, MA 02648. Property Location: Old Colony Road, Hyannis, MA 02601 Assessor's Map/Parcel: 306-283 Zoning: RB, Residential B Zoning District Applicant's Request: Comprehensive Permit in accordance with MGL Chapter 40B, Affordable Housing, for the development of 6 single family detached dwellings 2 of which are affordable units. Procedural Provisions: MGL Chapter 40B, Section 20-23, 760 CMR 30.00, 31.00 &45.00 APPLICANT: u The Applicant is G-P Affordable Home Corporation, a Massachusetts Limited Dividend Organization (LDO) organized and doing business under the General Laws of Massachusetts Chapter 156 B addressed as 3111 Falmouth Road, Marstons Mills, MA 02648. RELIEF REQUESTED: The Applicant has applied for the issuance of a Comprehensive Permit No. 1995-31 pursuant to M.G.L., Chapter 40B, Sections 20-23, and proposes to build low or moderate income housing under the Commonwealth of Massachusetts Executive Office of Communities and Development ("EOCD") Local Initiative Program ("LIP"). The proposal is for the subdivision of a 1.81 acre parcel of land located in Hyannis Massachusetts along Old Colony Boulevard. The applicant presented several alternatives for the layout of the subdivision and homes. Alternative schemes were also looked into with varying density and lot configurations. The Board and applicant mutually agreed that the Plan titled"Site Plan of Land in (Hyannis) Barnstable MA", prepared for Funding Services, Inc., and drawn by Down Cape Engineering, Inc. which shows,a 6 lot subdivision of single family detached dwellings 2 of which are affordable units would be the approved plan for development. This determination was based upon the Board's desire to provide the maximum number of affordable units economically feasible without imposing overly dense development into the neighborhood. Lot 1 consists of 11,594 sq. ft. Lot 2 consists of 18,387 sq. ft. Lot 3 consists of 10,201 sq. ft. Lot 4 consists of 81868 sq. ft. Lot 5 consists of 17,920 sq. ft. Lot 6 consists of 11,790 sq. ft. With the exception of Lot 4, all 6 of the lots have a minimum of 10,000 sq.ft of area. The scale on this plan is 1 inch =20 feet, and it's dated May 8, 1995. The Board noted for the record that although the plan makes reference to"Funding Services, Inc., the present land owner, this comprehensive permit is issued to the applicant only, G-P Affordable Home Corporation. The homes proposed for development would be single-family detached homes, varying in design and including single story ranches, one and one-half capes and modified capes in style. The homes would range in size from two to three bedrooms and have one or two baths. The lots would be accessed by shared paved driveways and the lots will be landscaped appropriately. Of the new homes to be developed on the lots, four(4)would be for sale at market rates, and two (2) would be for sale as low or moderate income housing units as defined in M.G.L., Chapter 408, Section 20 and in 760 CMR 30.02. The low or moderate income units (also referred to as "LIP units") will be sold for a"maximum of$80,500 . The other housing units will be for sale as market-rate units, in the range of$104,900 to$114,900.per unit. TOWN OF BARNSTABLE CERTIFICATE OF OCCUPANCY PARCEL ID 000 000 021 GEOBASE ID ADDRESS 55 OLD COLONY ROAD PHONE (508)420-1232 HYANNIS, MA ZIP 02601- LOT BLOCS. LOT SIZE DBA DEVELOPMENT DISTRICT PERMIT 15124 DESCRIPTION SINGLE FAMILY DWELLING PERMIT TYPE BC00 TITLE CERTIFICATE OF OCCUPANCY CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: - THE BOND $.00 ,. CONSTRUCTION COSTS $.00 753 MI SC_ NOT CODED ELSEWHERE EAAN3TABLE, MAS& OWNER G-P AFFORDABLE HOME CORP. , Fp A ADDRESS 3111 FALMOUTH ROAD BUILD 'NG DIVISIO MARSTONS MILLS, MA BY IG DATE ISSUED 05/13/1996 EXPIRATION DATE ►� TOWN OF BARNSTABLE • BUILDING PERMI'h PARCFJL I 000 000 021. GEOBASE IL? ADDRESS 55 OLD COLONY ROAD PHONE (SOB )46 0-1'_ .y. HYANNIS),. MA � � � -ZIP: 02601- LOT S BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT P LMTT 9950 DESCRIPTION NEW SINGLE FAMILYtAFFORDA$LE HOUSING PEIRt� IT iYPT+, BUILD TITLEK NFW HES/COMM BLD(.-Deplit talent of Health, Safety :ON T'�ACT(1)RS: POLCARO HONES) and Environmental Services ARCHI'V E CTS TOTAL FEE: : $1.0'1. 47 �TME BONS) $,.0() C0NSTRUC '1:0N C t")STS $65,000.00 iC)1 'A I NGfiE FAM i 1OME DETACHED 1 P'LRCIVATR' MASS. i639. OWINER AFFORDABI,E HOME G(?IZP..; D MI►i'l 1.1 1 Fla U-10'.7TH 'ROAD C:hiSi7z,L�;, ill: BUILDINq,DIV I01V/' f CAI.. !SSIUED 08/4,8/1-995 EXPIRATION DAYS BY THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED 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 OFTHIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED APPROVED PLANS MUST BE RETAINED ON JOB AND FOR ALL CONSTRUCTION WORK: WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2.PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ELECTRICAL;PLUMBING AND MECH- 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. ANICAL INSTALLATIONS. 4.FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING NSPECTION R FIOVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS t4 vY' 2VV 1 2 c 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 y `cl�o BOARD OF OTHER: SITE PLAN REVIEW APPROVAL WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. ,. ___. _..-_.. . NOTED ABOVE. _TION...508-790-6227 / � /-D T,#S Zoning Board of Appeals Decision and Notice Appeal Number 1995-31 Old Colony Ch.40B LOCUS: The locus is a 1.81 acre parcel of land located along Old Colony Boulevard in Hyannis, shown on Barnstable Assessor's Map No. 306 as Parcel 283. PLANS and MATERIALS SUBMITTED: In seeking the Comprehensive Permit,the Applicant has submitted the following plans and materials to the Board: 1. Site Plan titled"Site Plan of Land in (Hyannis) Barnstable MA", prepared for Funding Services, Inc., and drawn by Down Cape Engineering, Inc., Dated May 8, 1995. 2. Development Cost pro forma on behalf of petitioner dated April 5, 1995 showing total development costs overall at$600,000, and each unit cost at$98,562. 3. A series of elevations of the proposed 3 styles of homes to be built: Style'A'-to be built on Lots 6+3, are Cape style with dormers and 3 bedrooms and 1 1/2 baths; Style 'B'-to be built on Lots 4+ 1, are Ranch style with 3 bedrooms and 1 and 1/2 baths;and Style 'C' -to be built on Lots 2+5, are 1 and 1/2 story Capes with 3 bedrooms and 2 baths. The home on Lot 2 and 5 are to be the affordable homes. FILING AND NOTICE: The Application was duly filed on January 27, 1995 and extended for a public hearing by the applicant. Notice was given as required by law, including the timely notification of boards and commissions of the Town of Barnstable,as applicable, and the publication March 03, and March 09, 1995, in the Barnstable Patriot, a weekly publication having circulation in the Town of Barnstable. A public hearing was opened by the Board of Appeals on the evening of March 15, 1995, and continued to April 05, 1995, and to May 03, 1995 and again to May 09, 1995 at which time the Zoning Board of Appeals rendered its decision. Board Members sitting on this appeal are: Chairman Ron Jansson, Gene Burman, Emmett Glynn,Tom DeRiemer, Dexter Bliss and Richard Boy. HEARING PROCEDURE: In accordance with the requirements of Chapter 40B, the Board notified all pertinent Town Departments and Boards, and the regional Planning Agency requesting review and input on the proposed project. Notices was sent by the Board Chairman, Gail Nightingale by letter dated January 27, 1995. Comments were received from various town boards and agencies including the following: Conservation Commission of the Town of Barnstable, dated March 15, 1995, noting that no wetlands exist on site but do exist within 100 feet of the site across from Old Colony Boulevard. The Commission expressed an interest in assuring that all drainage remains on-site. Cape Cod Commission, letter dated March 08, 1995, citing that the project is consistent with the guidelines and policies of the regional planning agency. Town of Barnstable Planning Board letter of March 10, 1995, reviewed the proposed development plans and expressed concerns for the limited distribution of affordable sites throughout the town. Letter of December 19, 1994 from Ralph Crossen, Building Commissioner, summarizing concerns expressed at Site Plan Review Committee meeting on the early plans. Board of Health letter dated March 2, 1995, noted that the development is not within a Groundwater Protection District and will be connected to Town Sewers and that it will not alter groundwater in the area. 2 Zoning Board of Appeals Decision and Notice Appeal Number 1995-31 Old Colony Ch. 40B In addition, the board received a letter from William Flynn, dated March 13, 1995,the owner of Captain Gosnold Village stressing his concerns even though he couldn't attend, about parking in the summer on Old Colony Boulevard. The Captain Gosnold Village Board of Trustees, in letter to the Board dated March 08, 1995, also expressed serious concerns over the proposed development and noted their objection to the project. FINDINGS AND DECISIONS: Standing: At the hearing of April 05, 1995, a motion was duly made, seconded and voted that the Board find the following facts as related to standing of the applicant before the Board: 1. The Applicant G-P Affordable Housing Corporation is a Limited Dividend Organization (LDO) as documented under the Articles of Organization dated May 4, 1988 and verified by the March 17, 1995 Certificate of Good Standing issued by the Commonwealth of Massachusetts Department of Revenue. 2. The Applicant's Local Initiative Program (LIP)Application was submitted to the State Executive Office of Communities and Development(EOCD) in mid December of 1994. The application was approved with conditions under the LIP on February 03, 1995 as per letter to Warren J. Rutherford from EOCD. Conditioned upon the final approval by EOCD of the proposed project as a LIP project,the project meets the requirements of 760 CMR 31.01 (1) (b), low and moderate income housing. 3. The applicant, has a Purchase and Sale(P&S)Agreement for the property from its present owner, Funding Services Inc. as per letter titled "Agreement" dated July 22, 1994. On May 09,the applicant submitted a copy of an extension of this P&S. That extension was dated May 09, 1995 and extended the P&S to June 02, 1995. Therefore, the Applicant does have standing to apply for a Comprehensive Permit under M.G.L., Chapter 40B, Sections 20-23 and 760 CMR 31.01. The Vote was as follows: AYES: Chairman Ron Jansson, Gene Burman, Emmett Glynn,Tom DeRiemer, Dexter Bliss and Richard Boy NAYS: None Findings of Fact: At the conclusion of the May 09, 1995 hearing, after discussion, based on the evidence submitted, and the finding that the Applicant has standing to apply for a Comprehensive Permit under M.G.L., Chapter 40B,the Board, by a motion duly made and seconded, voted on the following findings: 1. The Town's chief executive, Warren J. Rutherford,Town Manager, endorsed the project under the Local Initiative Program on December 13, 1994 after the project was considered by Councilor Gloria Rudman and Council President Harold Tobey. 2. Cape Community Housing Trust expressed support for the project on August 18, 1994 by letter signed by Patricia A. Pap, Clerk. 3. The Applicant has standing to apply for a Comprehensive Permit under M.G.L., Chapter 40B. However,the project will only meet the requirements of"low or moderate" housing under M.G.L. Chapter.40B upon final approval by EOCD of the project as a LIP project and upon execution of a regulatory agreement. 3 Zoning Board of Appeals Decision and Notice Appeal Number 1995-31 Old Colony Ch.40B 4. The Town of Barnstable does not meet the minimum thresholds for low and moderate income housing contained in M.G.L., Chapter 40B, Sections 20-23. According to the 1990 U.S. Census there were 18,573 year-round housing units in the Town of Barnstable. The goal under M.G.L. Chapter 40B is to provide ten percent(10%)of that housing stock as affordable, or 1,857 units. The current estimate is that there are only 719 affordable units or 3.87%. 5. The locus is a 1.81 acre site bordering and accessed from Old Colony Boulevard Hyannis, Massachusetts. The site was once developed, but is today vacant. It had also been used as a staging yard for utility improvements in the neighborhood. The lot in its present state represents a blight on the surrounding neighborhood. 6. The locus is in a RB, residential B,Zoning District. 7. The locus is not within a zone of contribution for a public water supply. 8. The surrounding neighborhood is densely developed with a variety of homes and multi-family dwellings developed on less than the one acre lot size now required under zoning for this district. Many of the surrounding dwellings and some neighboring land uses do not conform to the principal permitted uses of single family detached dwellings within the RB zoning district. 9. The proposed units will all be single family detached units on separate lots ranging from 8,868 sq.ft to 18,387 sq.ft. in land area. 10. The homes are to range in size from approximately 1,100 sq.ft.to 1,600 sq.ft. and contain from two to three bedrooms and one to two bathrooms. 11. The density of the development shall be 1 unit per 0.30 acres which is consistent with the LIP guidelines and with the recommendations of the Cape Cod Commission, the regional Planning agency and the Town of Barnstable Planning Department as well as the Cape Community Housing Trust. 12. Town sewer is available in this area and the applicant has agreed to connect each unit with town wastewater treatment prior to occupancy of the units. Connection of the units shall be in accordance with the requirements of the Department of Public Works. 13. The structures shall be connected to and served by public water. 14. Utilities,through the Commonwealth Electric Company and Colonial Gas Co., are available at the locus and shall be constructed underground. 15. The unit mix for the development will be as follows:Two (2)single family dwellings, located on Lots Numbered 2 and 5, shall be affordable housing LIP dwellings for sale at a maximum of $80,500 each. There shall be 2 LIP units available for sale at a maximum price of$80,500, which units shall be subject, in perpetuity to a deed restriction, requiring that the unit be owned and occupied by eligible persons of low or moderate income, or owned by the Town of Barnstable or EOCD pursuant to the terms of the Regulatory Agreement. In the event of the elimination of the LIP program,the definition of an"eligible low or moderate income person shall be defined by any other state or federal housing program that defines said term. Four(4)single family dwellings, shall be market units for sale at an anticipated selling price of $104,900 to$114,900. 16. Because of the threatened loss of affordable housing units within the Town of Barnstable and throughout the region (Barnstable County)due to"expiring uses" and in view of the Town's current deficit in affordable housing units, it is consistent with local needs. The Board recommended that every effort be made to give first preference to existing residents of the Town of Barnstable. 4 Zoning Board of Appeals Decision and Notice Appeal Number 1995-31 Old Colony Ch.40B The vote on the findings was as follows: AYES: Unanimous NAYS: None Decision on Waivers At the May 09, 1995, Public Hearing on this application, a motion was duly made and seconded,that based upon the findings,the Zoning Board of Appeals granted the following: Waivers from the following sections of the Town of Barnstable Zoning Ordinance: Section 2-3.2 Conformance to Bulk and Yard Regulations Section 3-1.4(5) Bulk Regulations: Minimum Lot Area and Minimum Lot Width Section 2-3.4 Lot Shape Factor In this instance,the Zoning Board of Appeal shall act as the Planning Board for approval of the plans to be recorded. The vote on the waivers was as follows: AYES: Unanimous NAYS: None Decision and Conditions The Board, based on the above findings and the waivers granted, by motion duly made and seconded, voted to grant Comprehensive Permit No. 1994-31 subject to the following terms and conditions: 1. This comprehensive permit is specifically conditioned upon final approval by EOCD of the project as a LIP project and upon execution of a regulatory agreement under the LIP program. 2. A plan, suitable for endorsement by this Board, and recording at the registry of deeds shall be prepared by the applicant. That plan shall be Plan Title: "Definitive Plan of Land in Barnstable (Hyannis), MA prepared for Funding Services", dated May 08, 1995 and scaled 1 inch=30 feet. The plan shall reference this decision and shall document the imposed setback in this decision. 3. Principal permitted use of the lots created by this Comprehensive Permit shall be limited to a single family dwelling and attached or detached accessory uses to that single family dwelling. 4. The development will provide two (2)single family dwellings, located on Lots Numbered 2 and 5, as affordable housing LIP dwellings for sale at a maximum of$80,500 each. The affordable LIP dwellings shall be subject in perpetuity to a deed restriction requiring the dwellings be owned and occupied by low or moderate income persons. All of the affordable housing units shall be at minimum three bedroom and two bathroom dwellings. 5. Setbacks for all structures shall be 30 feet from Old Colony Boulevard right of way and 10 feet for all side or rear lot lines. In addition, all homes shall be setback from the common drive easements by 25 feet. Lot coverage shall not exceed 50%of the lot area. 6. Access to the lots shall be limited to two paved driveways located over common easements as illustrated on the plans presented. No lot shall take its access from any other location along Old Colony Boulevard. The driveways are to be developed and paved with a 6" subgrade and a 2"base coarse and 1"top coarse or better and as approved by the Town of Barnstable Department of Public Works,with suitable drainage to be determined by the 5 Zoning Board of Appeals Decision and Notice Appeal Number 1995-31 Old Colony Ch.40B Department of Public Works (limited to common access going into lots) Engineering Division. The drives are to be no less than 12 feet wide and shall extend into the buildable portion of each lot with an 8 foot wide drive. Each of the access driveways are to be a minimum of 20 feet wide at the entrances to Old Colony Boulevard to allow for two cars (one entering and one exiting)turning at the location. The 20 foot wide apron shall extend for 20 feet from the edge of the right of way of Old Colony Boulevard. 7. Access easements shall be documented on the plan and easements to utilize and maintain the drives for both access and utility services shall be granted to all owners who take access from the drives. 8. All utilities shall be located underground. Any additional easements necessary for utility service shall be granted as necessary and specified on the plan to be endorsed. No structures shall be located on or above any easement. 9. All drainage and run-off shall be contained within the overall parcel and none shall be directed off-site onto neighboring properties or road ways. Each individual lot shall be graded so as to minimize run-off on to other lots, or on to the access driveways to the individual lots. 10. All dwellings shall have full basements located at minimum, 1 foot above the high groundwater as determined by test pits to be located in the area of each proposed dwelling. 11. All property bounds shall be set, and "as built'plans submitted to the file upon completion of the development. No occupancy-permits are to be issued for a particular lot until bounds have been set and all debris shall be removed and disposed of from the lot. There shall be no disposal of debris on-site. 12. No occupancy permits shall be issued until the dwelling unit is serviced with all utilities located underground, including public water and town sewers. The applicant shall be responsible for all costs to connect to utilities. 13 The dwellings shall not have electric heat, shall have full basements, low flow toilets and showers, and thermal windows and doors. 14. The entire site, including the parkway along Old Colony Boulevard for the length of the site shall be landscaped with at a minimum 3 to 4 inches of loam and seed, suitable street trees of 2 to 3 inch caliper planted along Old Colony Boulevard, 40 feet on-center for the length of the property and as approved by Town of Barnstable Tree Warden. The side and back perimeters of the parcel shall be appropriately screened with evergreens and deciduous vegetation varying in height from 3 to 5 feet at the time of planting. In addition, each home shall have appropriate landscaping installed inclusive of at a minimum one shade tree (2 inch caliper), one flowering shrub tree (1 1/2 inch caliper) and appropriate shrubs and evergreen foundation and/or entrance plantings. If any of the existing vegetation is seen by the applicant as being of value and reusable in the plan and development,the preservation of the trees can .be counted to satisfy the landscaping requirements. 15. The dwellings are to range from approximately 1,100 square feet to approximately 1,600 square feet. The dwellings will be of wood frame construction designed in a Cape Cod-style with clapboard fronts, attractively landscaped and with night lighting as represented in the plans presented to the Board. The dwellings shall range from two to three bedrooms, 1 or 2 baths and full kitchen facilities. The structures location on the draft Plan are for illustrative purposes only and the applicant shall have the ability to locate the structures within the developable envelope of each lot as defined by the required setbacks imposed by this decision. 16 A plan suitable for recording at the Barnstable County Registry of Deeds.titled"Definitive Plan of Land in Barnstable (Hyannis), MA prepared for Funding Services", dated May 08, 1995 and scaled 1 inch =30 feet and that references conditions imposed by this decision, stamped and 6 Zoning Board of Appeals Decision and Notice Appeal Number 1995-31 Old Colony Ch.40B signed by a Registered Land Surveyor shall be submitted to this Board for endorsement, and said plan shall be recorded within sixty(60)days of said endorsement. 17 Prior to the issuance of any Building Permits, a Regulatory Agreement pursuant to the Local Initiative Program and consistent with the terms of this Comprehensive Permit shall be executed by EOCD,the Town of Barnstable by its Town Manager, and the Applicant, and a copy recorded at the Barnstable County Registry of Deeds,together with the applicable Deed Restriction approved by EOCD. 18 This Comprehensive Permit is granted to G-P Affordable Home Corporation. This permit shall not be transferred to any other corporation, person or entity. 19 This Decision shall be filed at the Barnstable County Registry of Deeds within sixty(60) days of the execution and issuance of this Decision by the Town Clerk of the Town of Barnstable. 20 Addressing and Number posting shall be in accordance with Town of Barnstable General Ordinance Article 5, Exhibit E, as to location of house number and posting. 21 No parking shall be permitted along the access way or along Old Colony Boulevard. All parking shall be within each individual lot and not within the panhandle of the back lots. 22 Curbing or Cape Cod Berms shall be installed along the common drives of 12 and 20 ft width as approved by the Dept. of Public Works Engineering Division. 23 A Homeowners Association shall be initiated by the developer and dues/assessments shall be required for maintenance and replacement of common elements/utilities including driveways, sewer, water and electrical. All 6 units shall be required to be members within the Association. The vote granting this Comprehensive Permit with Conditions was as follows: AYES: Ron Jansson , Richard Boy , Dexter Bliss ,Tom DeRiemer,, Gene Burman ,and Emmett Glynn NAYS: None Order: Appeal No 1995-31 for a Comprehensive Permit in Accordance with MGL Chapter 40 B, has been granted with conditions. Any person aggrieved by this Decision may appeal to the Barnstable Superior Court as provided in Section 17 of Chapter 40A of the Massachusetts General Laws, by filing a Complaint in said Court as well as filing a Notice of such action with the Barnstable Town Clerk within twenty(20)days of the filing of this Decision with the Barnstable Town Clerk's office. Ron S.Jansson,Acting Chairman Date Signed I Linda Leppanen, Clerk of the Town of Barnstable, Barnstable County, Massachusetts, hereby certify that twenty(20)days have elapsed since the Zoning Board of Appeals filed this decision and that no appeal of the decision has been tiled in the office of the Town Clerk. Signed and sealed this day of 19 under the pains and penalties of perjury. Linda Leppanen,Town Clerk This decision must be recorded at the Registry of Deeds. 7 . The Town of Barnstable Department of Health Safety and Environmental Services 'moo ram" Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner November 4, 1998 Re: 55 Old Colony Road,Hyannis,MA To Whom It May Concern: The Town of Barnstable Zoning Ordinances allow the rebuilding of any lawful structure within two years of a catastrophic event. Our records show 55 Old Colony Road,Hyannis,MA to be a lawful structure. Therefore,the property owner would have protected rights regarding rebuilding for up to two years. Sincerely, Ralph M.Crossen Building Commissioner RMC/lan g981104a �lime The Town of Barnstable AM ,` Department of Health Safety and Environmental Services Eo ° Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner PLEASE FORWARD THE ATTACHED PAGE(S) TO: TO: First Plus Financial ATTN: Janelle FAX NO: 801-987-5496 FROM: Ralph Crossen,Building Commissioner DATE: 11/4/98 PAGE(S): 1 (EXCLUDING COVER SHEET) LOT 2 727.72' N/F WOODS - LOT 5 17,920 sf ►; LOT 3 0.41 acres o, I N O N/F CHARLES Lr cLd HARKINS 15.9'f concrete IoundotIon 1--� tf. 0 22.4- 21.8't LOT 4 N/F �O TIMOTHY CHAPIN Al � 1 i y 78,49 �O � O LOT 6 120.28► JOB # 94-155 L-5 CERTIFIED PL 0 T PLAN LOCATION : OLD COLONY ROAD HYANNIS, MA PREPARED FOR: SCALE : 1" = 30' DATE : 10-2-95 REFERENCE LOT 5 PB 515 PG 60 FUNDING SERVICEZ INC. I HEREBY CERTIFY THAT THE STRUCTURE /ez.��'OF��SSy SHOWN ON THIS PLAN IS LOCATED ON THE TIN".OTHY cyG GROUND AS SHOWN HEREON. H. m COVELLOft f.�362-9680� � 0 N0.38035 � down cape e4giueeririg, inc. h` OacpP CIVIL ENGINEERS C.x z ley'? --• LAND SURVEYORS 93e main st. yarmouth, ma DATE REG. LAND SURVEYOR ��S ©a 161 Assessor's Office(1st floor) Map Lot Permit# g�"Ta o Conservation Office(4th floor) Date Issue 2? Board of Health(3rd floor)(8:30-9:30/1:00- Engineering Dept. (3rd,floor) House#1 Planning Dept.(1st floor/School Admin. Bldg.) r� f APPLICANT SEWER CONNECTI OM THE DefinSeetess' ed by Planning Board NO�c 19 ENG t 39 � 0$TO CODISTSU °"'"`► TOWN OF,BARNSTABLE Building Permit Application ` Proje SS Old Colony.Road Lot #5 Village Nunn is Owner G-P AFFORDABLE HOME CGRP. Address 3111 Falmouth Rd., Marstons Mills MA Telephone _ (508) 42.0-1232 02648 Permit Request New single family detached wood frame construction Total 1 Story Area(include 1 story garages&decks) 1077 square feet (includes 10 X 12 deck) Total 2 Story Area(total of 1st&2nd stories) 1695 square feet Estimated Project Cost $ 65,000.00 Zoning District RB Flood Plain Zone C Water Protection /- Lot Size 17,920 s.f. +/- Grandfathered ? No De ision Bk 9756 Pg 247 Zoning Board of Appeals Authorization1 d95_31 Recorded p1 an Bk 505 P 60 Current Use Vacant lot Proposed Usesingle family residence Construction Type Wood Frame Commercial No Residential Yes Dwelling Type: Single Family X Two Family Multi-Family Age of Existing Structure to be built Basement Type: Finished Historic House No Unfinished X Old King's Highway No Number of Baths Taro (2) No. of Bedrooms Three (3) Total Room Count(not including baths) Six (6) First Floor Four (4) Heat Type and Fuel Hot air - Gas Central Air No Fireplaces No Garage: Detached. Other Detached Structures: Pool Attached Barn None X Sheds Other NcnA Builder Information Name POLCARO HOMES INC. Telephone Number 420-1232 Address p, 0. Box 457 License# 005502 Joseph C. Polcaro 3111 Falmouth Road Home Improvement Contractor# 101960 Marstons Mills MA 02648 Worker's Compensation# TNTCC 181997-01 NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Town of Barnstable Land Fill 3 SIGNATURE C� DATE BUILDING PE MIT D NIED FOR THE FOLLOWING REASON(S) K� i f FOR OFFICIAL USE ONLY i • PERMIT NO. #9950 DATE ISSUED August 28, 1995 + MAP/PARCEL NO. 000 000 021 ADDRESS 55 Old Colony Road VILLAGE Hyannis, MA 02601 OWNER G-P Affordable. Home Corp. DATE OF INSPECTION: FOUNDATION FRAME z-lz y3 E INSULATION FIREPLACE• -� ELECTRICAL: ROUGH FINAL a f, PLUMBING: ROUGH FINAL GAS: R-OUGHI FINAL FINAL BUILDING } DATE CLOSED OUTS ASSOCIATION PLArN NO r .?a HOME IMPROVEMENT CONTRACTOR v -Registration: 101960 - License or registration valid for individual Type - .PRIVATE CORPORATION use only before expiration date. If found Expiration .06/30/96 return'io One Ashburton Place Rm•1301 Boston Ma.02108 Polcaro Construction Co.,.Inc r Joseph C. Polcaro G2cc�7.7mo-;f',&P�'ta Box. 451; 3111 Falmouth Rd. l 1 ADMW)STRATM Marston M1.11s MA 02648 " I COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY _ ?Pane ctoposs State onent . OF ONE ASHBORTON PLACE �lrrseachnaatta5tate8ut�oTRc MASSACHUSETTS BOSTON,MA 02108 i;odelaoss+4if6r�se=r °`' of thisficenre. �� LICENSE CAUTION EXPIRATION DATE -CONSTH. SUPERVISOR 11 / 5/19 9 5 EFFECTIVE DATE LIC-NO. FOR PROTECTION AGAINST RESTRICTIONS THEFT, PUT RIGHT THUMB N0(NE 06/30/1193 . 00550.2 PRINT IN APPROPRIATE. BOX ON LICENSE. JO,")EPH C POLCARC 4. 17 TURTLE BACK R D BLASTING OPERATORS SS 4 028-28-0403 MILLS MA \. 02 548 MUST INCLUDE PHOTO. m PI40TO BLASTING OPR ONLY) lU lJ I, �j 0 • . NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY HEIGHT: STAMPED-OR•SIGNATURE OF THE COMMISSIONER DOB: 11 /25/1939 _ THIS DOCUMENT MUST BE I _ SIGN NAME IN FULL ABOVE SIGNATURE LINE _ CARRIEDONTHEPERSONOF I SIGNATURE OF LICENSEE THE HOLDER WHEN EN- 0T14ERS-RIGHT THUMB PHINT GAGEDWTHISOCCUPATION. I MLSSIONFR , ELEVATOR OPERATOR HOISTING ENGINEER FIRE PREVENTION .I� 00 NONE 00 NONE 35 FRONT ENO LOADER 42 PORTABLE (COMPANY) 46 PORTABLE (INDIVIDUAL) 01 OTHER- 28 ELECTRIC 36 CATCHBASIN SEWER- 43 ENGINEERED 47 ENGINEERED � 02 SPECIAL LIMITED 29 CRANES CLEANING MACHINE 44 PRE-ENGINEERED 48 PRE-ENGINEERED Z Q'T w 03 AUTOMATIC PUSHBUTTON 30 SHOVELS 37 EXTENSION LIFTS 45 HYDROSTATIC .49 HYDROSTATIC N W 04 FREIGHT 31 BACKHOES 38 SKIN HANGERS 40 SELF-SERVICE MFF' - 41 SELF-SERVICE MFF ', A,) .' w 7 0LICENSE 32 DRAGUNES 39 SELF-PROPELLED: CONSTRUCTION SUPERVISOR - - G Q O Z Q SPECIAL LL 33 .CLAMSItE RAILROADCRANE c 05 HRT 34 CABLEWAY STEAMROLLER 00 NONE 1A MASONRYONLY m W G 06 SCOTCH 1G 1 8 2 FAMILY HOMES Z ' QQ w 07 VRT VT V 08 FLUELESS _OIL BURNER TECHNICIAN `�f�C `- COL Yb _j Z 00 NONE � U) 10 GRAVITY FEED •�� f�-. �� LT( �/ r Q. Z 15 1 8 2 OIL _—- --,_, Z - Z o BLASTING NO. STREET y Z 21 ASSISTANT LL) 22 OUAHRY ' W 0 23 TMARINE(UNDER WATER)UNNEL CRY.OR TOWN STATE ZIP COO LU 'Cr LL Q C 25 RESEARCH&DEVELOPMENT LU OD CC 0 . 26 27 BA O POWDER Y c"U)N1S •(n I SPECIAL EFFECTS I.L Q N r R Z. ,F TRENCH PLUGGING PRINT NAME AND CHANGE OF ADDRESS ABOVE --J o v O z.00 0 11:02'9a 17:02 =817727 712Z C0j)U?WItW4?a&L � O/ Ma. uae& 600 'twd James.f.Camoeq &IOR, ///aeaad6a & 02f f f ' COMMftionw Workers' Compensation prance Affidavit 1, POLCARO HOMES, INC. WomsodpamraDes! wish a principal place of business at: MarStnna Mi11a MA Cl 648 (QZY/stam/�� do hereby cerffy under the pales and penalties of pe imy, that: () I ant an employer providmi g workers' cotapensadon coverage for MY employees war, this job. American Policyholders' Ins. Co. _ WrCC 181997-01 Insurance Company Policy N m.ber O l am a sole proprietor and have no one working for me in any capadty- O I am a sole proprietor, general contractor or homeowner (chcle one) and have I&ec contractors Mmd below who have the following workers' vomtpensadcn policies. Contractor Insurance ?o anyfftGcy Nt Contractor tosmance Companyipolicy N,' Contractor Insurance Company/Policy Nil O l atn a homeowner performing all the work myself.- I UndesaGne%&.u a coW of&As sruun m wM be faranded w the Otfloe of inve kxdons of the otA for camap ve ftnion and that fa, ceze.qe as mc:-ed under Section ZSA of MGL I:Z can lead to the knPa w of p obtai 002WO ccnsbftg of a Qae of up to St,500.. 1n=' imFrito-slant as welt as cm pvmwes to the fans:cia STOP WORK ORDER:ttd a Me of St00.00 a der apinsc me. Signed this 17th day of August , 19 95 N-enseef Permi=ee BuMing $ em ceasing Selectmen Office Health Departtaeat ,; - - - � r � _ sit 7 - ., .-. �a ?h ` I -t•_ r " a ..4_ i - Z t 71 1 _ POLCARO HOAAFS,INC 'PROfEa:: GAPe— - T Tal O LOCATION. '.IRY. 6 ., t 1.. �IbMHGTl�10Aq.6�'°�. ! ,.:• _ - `O � 4Y Il.r�d�lM CIA mg1.WK10Nf.gli M•IlN.- _ �.1.. -7 � �. /.•- � ^ . 508.42a.1232 DOOR xry�oe n t• _ - �'. I ✓O.✓O 1 adnLy Rl dos-/IS•A601r Leh ed•d bolt a ar.c�e>e � ".Diked frde.d.r � _ _ - far-o•. m . 216.✓s, •.. .e�ln ewddd sp..1/P•Lvy 1�•V,• - le.o• Mi r/.• - - . 1 N•.wae..eM.dep.rd' .,_ .., . ved.rdm h.dv _ ... .- •.-. ' e'-.' vo.Ye • Wdswa/idOPrd - - d.(dl das lvd•..' - I tV II.• - - _ - � O 1.i�wYs '1 .eee•1•�aJd•d•Pe.d/P•19.g .. . \pn'r,. - � •� ; dm Plrae.vpR.w - .. � N. o „ � •li•.nea<a.:cr• emaDm Y( •RG eNRGR'. IaJI• TPG Qr. •.Q Ef.6l 11CMLRKS { 1P 04 .. D _ , _ 4�0• a 10-!' 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