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0130 OLD CRAIGVILLE ROAD
/�'7 QZ6� U' ¢��,�e� xao 3(D r sp��� Town of Barnstable Building e1abt341.+'R1 taa CtlThis iSco',.tTeh,a'.`.`t rt is Vrsible<,"Fr'om,th..'e, bS' t,reect hBA'n`upipldrr,"o�nv edsh Pal lal nNso 3Mt"-bues t�O bcec,uR t,e iteadmuendt iol na J`oinba al;nI„nda s t4 h,,e icst Cioanr�dh aMs ubset ebne mKaedpet Permit y m i LPosU CM Poste Whe tre Permit NO. B-19-559 Applicant Name: Lloyd R Smith Vivint Solar LLC Approvals Date Issued: 02/25/2019 Current Use: Structure Permit Type: Building-Solar Panel-Residential Expiration Date: 08/25/2019 Foundation: Location: 130 OLD CRAIGVILLE ROAD, HYANNIS Map/Lot: 248 121 Zoning District: RB Sheathing: Owner on Record: PRACH, LISA '\TContractor�Name � BRIEN LANGILL Framing: 1 Address: 115 SUDBURY LANE Contractor Ucerise�v CS 106675 2 HYANNIS,MA 02601 V, Est Project Cost: $ 17,050.00 Chimney: Description: Installation_ of roof mounted photovoltaic solar systems 7 75kw 25 ,e-MI t ee: $ 136.96 Insulation: Panels Fee Paid $ 136.96 Project Review Req: ` Final: ;.' Dane. 2/25/2019 . ;.A ,✓ 1., ....... .. .. Plumbing/Gas `-5� Rough Plumbing: bu ,. . .. Ildi This permit shall be deemed abandoned and invalid unless the work authonze'i& this permit is commenced within six months after issuan final Plumbing: All work authorized by this permit shall conform to the approved application and the approved construction documents for which;this permit has been granted. All construction,alterations and changes of use of any building and structu�res;sh la Fbe in compliance with the local zoning by laws d codes. .Rough Gas: This permit shall be displayed in a location clearly visible from access street or roaad and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. The Certificate of Occupancy will not be issued until all applicable signatures by,the Bwldmg and:Fire Officals areprov ed on this permit. Electrical Minimum of Five Call Inspections Required for All Construction Work:• , � 1.Foundation or Footing- a 3 Service: 2.Sheathing Inspection '',,, 3.All Fireplaces must be inspected at the throat level before firest flue lmn�is nsta�IledM Rough: p P g . . s . 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Rough: 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Health "Persons co acting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: c� Building plans are to be available on site Fire Department '! All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: �FTHETpy, Town of Barnstable *Permit#Z I Hqq Regulatory Services Fees6monthsfrom issue date • BARNSfABt E °oo '"A9. A,� Richard V.Scali,Director CFO MA'l Building Division �ePRESS PERMIT Tom Perry,CBO,Building Commissioner SEP 17 2015 200 Main Street,Hyannis;MA 02 www.town.barnstable.ma.us �WN OF BARNSTAB F Office: 508-862-4038 Fax: 50�AO-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY 7 Not Valid without Red X-Press Imprint Map/parcel Number U (� Property Address t ',)U d LAI� fC9?A61"C2AC k-4 e [.Residential Value of Work$ bow . Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address ��y��i-� b I N o Contractor's N Telephone Number -)a ( Q,3% O_W� Home Improvement Contractor License#(if applicable) obi(,®(Q 3 Email: Construction Supervisor's License#(if applicable) OWorkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner �I have Worker's Compensation Insurance ®�` Insurance Company Name ( E Workman's Comp.Policy#--. (Q y-Uh .- S 6 Z Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) QKRe-roof(hurricane nailed)(stripping old shingles) All construction debris will betaken to 1p(A)rr 0ty0S oc ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Valuc (maximum.32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property ner st sign Property Owner Letter of Permission. cop of the Hom Improvement Contractors License&Construction Supervisors License is r q red. SIGNATURE: C:\Users\Decollik\AppData cal\Micros \Windows\T mpor Inte Files\Content.Outlook\2PIOIDHR\EXPRESS.doe Revised 040215 CF tME Tp� * BARNSTABLE, 1` . ,.� Town of Barnstable AjEO��A Regulatory Services Richard V.Scali,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, �V65L Z (A)60 k , as Owner of the subject property hereby authorize 1 AkL✓VX AVJ � ViOM 5 ?fJ;CL• to act on my behalf, in all matters relative to work authorized by this building permit application for: L"bD OLO ( _ lNgL cc Lc L Rb (Address of Job) Si gnauxe of Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\Decollik\AppData\LocalWicrosoft\Windows\Temporary Intemet Files\Content.Outlook\2PIOIDHR\EXPRESS.doc Revised 040215 T'Ite Commonwealth of Massaclitisetts Department of Industrial Accidents Office of Investigations . I Congress Street,Suite 100 r3 Boston, 4 2 MA 0211017 ' Y wsv;v.mass.gov1d a Worlcers, Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plelmbers Applicant Information Please Print Legibly Name(Business/Organization/Individual):_ I' i Q-� L�M 1L5 (�C.. Address:_ 0Y 6V_ ((�(a S (o VU L(S OA.) 5 1 R 1-4- City/State/Zip: U tO k 6 Al Phone#: -7 d 3 6 ®� Are you an employer?Check the appropriate box: Type of project(requited): 1. I am a employer with 4. I am a general contractor and I employees(full and/or part-time)." have hired the sub-contractors 6. New construction .2. I an!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. employees and have workers' 9 Building addition [No workers' comp. insurance comp. insurance.t 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 I 1 Plumbing repairs or additions myself. [No workers' com right of exemption per MGL p• 2. Roof repairs insurance required.]T c• 152,§1(4),and we have no employees. [No workers' 1 . Other comp. insurance required.] *Any applicant that checks box dl 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. tContraetors that cltcek 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 ant an employer that is providing workers'cotttpertsation insurance for ttty employees. Beloty Is the policy and job site hTortnation. p Insurance Company Name: Policy#or Self-ins.Lic.#: Vr KU 6 ' 6 7-Q 6 c6q — 3 —1(6pnation Date: Job Site Address: (10 QU6 0QA-LG0LLL,'C kb City/State/Zip: f5#412N S-kWqiC1 V•' " Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requited 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 in ance coverag itication. I do-hereby certify r tder to ai n enalti s of Ittry that theittfonrtation provided above is true and correct. Siamature = --_.. ___......._ .. _. ..._ Date: Q _ n Phone#: 0-7 Official rise only. Do not sprite 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#: Serving Greater Boston for Over 25 Years! HALLMARK Dave Tomolillo HAL4NARK HOMES REMODELING CSL#: 064063 HIC#: 158936 Standards & Quality are out Priority! SolarCity Quote — Re-Roof August 31, 2015 JB-0261504 Kuber Bindukar 130 Old Craigville Rd Barnstable,MA 02601 (508) 292-9163 kuberbindukar@hotmail.com Roofing Specification: Pull Roof • Remove old comp shingles down to the existing roof sheathing • Remove all nails and replace up to 32 square ft.of plywood if needed ■ Additional plywood will be charged at$55.00 per sheet • Apply 6'of Water Shield along the lower eaves • Apply 3'of Water Shield along the valleys • Install new vent pipe water diverters where needed • Apply 15 lb.felt underlayment as protective base • Install 8"aluminum drip edge along entire roofline perimeter • Includes [00']roof ridge ventilation system and[42'] color matching caps • Apply Water Shield around the chimney • Re-lead perimeter of[1]chimney(s)with new lead • Install new secondary chimney step flashing • Removal of roofing debris by dumpster • Total number of roof squares [18] • Owens Corning'"TruDefinition®Duration®30-year Architectural shingles. • Providing all Insurances,Licenses and Permits Total cost of materials and labor: $7,910.00 I authorize Hallmark Homes Associates,Inc.to obtain all necessary building permits on my behalf. Hallmark Homes Associates,Inc.• P.O.Box 885,Medford,MA 02155• (781)838-0789 www.HallmarkHomesRemodeling.com AC 0 MAC Inv tT f 40� o Front 0f House 1„d fi F� w k Ke Hallmark Homes Associates,Inc.• P.O.Box 885,Medford,MA 02155• (781)838-0789• www.HallmarkHomesRemodeling.com '4 R� CERTIFICATE OF LIABILITY INSURANCE EDATE'16/20 0 9/11i/20 5 15 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 Peter A.Rossetti Ins.Agcy. PHONE Peter A. Rossetti Ins.AgC FAX 436 Lincoln Avenue AlC No Ext:781-233-1855 Alc No 781-231-3752 Saugus,MA 01906 E-MAIL Peter A.Rossetti Ins,Agcy. ADDRESS:pnickerson@rossettiinsurance.com INSURERS AFFORDING COVERAGE NAIC If INSURER A..Western World INSURED Hallmark Homes Associates Inc INSURER B:Pilgrim Insurance PO BOX 885 INSURER C:Travelers Medford,MA 02155 INSURER D: INSURER E-. INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR I TYPE OF INSURANCE DD POUCY EFF POLICY EXP LTR IN S p WVD POLICY NUMBER MMIOD/YYYY MMIDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS-MADE ®OCCUR NPP1349917 06/11/2015 06/11/2016 PREMISES Ea occurrence $ 50,000 MED EXP(Any one person) $ 1,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: Emp Ben. $ N AUTOMOBILE LIABILITY Ee e c EDtSINGLE LIMIT $ 1,000,00 B ANY AUTO PRCOOOOI O01303 04/23/2015 04/23/2016 BODILY INJURY(Per person) $ ALL OWNEDXN SCHEDULED - AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE X HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE S DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITYSTATUTE X ER C ANY PROPRIETOR/PARTNEMXECUTIVE Y/N 6KUB-5B29684-3-14 03/17/2015 03/17/2016 E.L.EACH ACCIDENT $ 1,000,00 OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Carpentry Operations. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Inspectional Services ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Beard of Buffding RC`cg.is.'•a`tions —and Jrar4dw-ara5 - .r ,r �, unrestricted-Buildings of any use group which License: CS-064063 �� �� _. contain less than 35,000 cubic feet(991m )of DAV D F TOMOLILLO enclosed space. 56 WILSON ST fk MEDFORD MA 02155 F! 1 r_f.Ji if a-i i 0 n CoT�€:isso =r 03/15/2016 Failure to possess a current edition of the Massachusetts State Building Code is cause for(evocation of this license. For DP5 licensing information visit'. www.Mass.Gov/DPs 1111/ I AAyy 11 3-S., �TSRI1 _ DRIVER'S . .LICENSE14, Ii Y91f tYE ,+ ..� t L1 li i+�4W'• I I `�` 'Y'� -. • ' 1 p + 1+ 5 I. 5 "` 4o END -3d NUMBER r II �t1 i , + , �r4 , `�;1 {I s T ?� NONE ���'d�JO�� www.mass.govirmv a'1[ l r rt �, / { W 02 013 raaoi-tsaou ! } 1,r. �• I�+ '1�:" 't'.:: ,1 f a;olv24 3 aos :• 03•IS7961 ,1yryl i1 `dd`pp )/y, �1j td�� 1�I�► }� -'/� GLASS- .�} �7�i�i i�.�tiiV •.1 i 1'hlt:F .G['i'i Sil.� 9e Z q a S ali hlcl k+s 0nn 26A01Y U3wl `2O®� 03 �5 111.cuss 1"REST 15 sex M in NGT 6 00 •. - R D NONE ENDOMEMENTS- N r rnous- y •` ,e ar .,..,,�!"S�IOL#l.i, f .r*w NONE `DAVID FM s 56 Wilson Street 1 �,�a ! i � Medford,MA 02155 c - RQrr B_LOCLPERtdAN_NTINIC ��� DD 02.2s201iSFevi7f::TSu a• -_ GHIU2G_ar ADDRSS P . � �.rir �r..uv In r:ri!rrrr�lli r��-f Cr7�lut irr- ."'• �' Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR i- - T License or registration valid for individul use only -tifZegistration: 158936 Type: ion date. If fo ' und return to: Expiration: 3/18/2016 Private Corporatic before the expiration Office of Consumer Affairs and Business Reg ulation HALLMARK HOMES ASSOCIATES INC. 10 Park Plaza-Suite 5170 t Boston,MA 02116 DAVID TOMOLILLO 1 STONEHILL DR.1 F STONEHAM,MA 02180 Undersecretary �0 ,! Not valid wit out signature F r Y s ' �t[TT jf S iwan a r�i 1m a # _eA t s. ,,SfG��t:clunmends OutreaW raidug Cours as at"jjFntatton to eccupaUnaal safetT _;`�,. j�°a'+'�M' e_c �n antliteDlllt ror rtnrket5 1 arUcipauon rs�olunwry S�orALn mart rccen c tJdttignut . �trNbing`hn�cciRc:ha=trdc eC{heu,toh Tliic courx cnmplcUun card does nol ecplrc L This card acknowledges that'the recipient has successfully`completed a N UN 1 3p-houW. r Occupational'Safety aril Health Training Course In Construction Safety anct Health Mlch'ael Arenella x Use or tU.ctrbulion of Qus ctrd for fraudulent purposes:mLludtut,false claims ar harm - O ricetvcd ttmmag tnaj czsltlt m:ptoseeuhon under 1N US C 7001 S'otenhal petndhes r ,. __ lei ra_ 7essle a todudesubslnnh.11ertmmat fines,unprtsonmen[up tnfsT:�eatS.or.hnth lnef name priflt or type).' (Course end date) �Fror OSFiArOul�r,.uch1"ralmni F'rii ram en In ITmmme at:vl luu ha.;M �:gc�.W_ubv -�� -------- - - l- 27— Cape Save Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 1/21/15 Thomas Perry CBO Town of Barnstable Building Division 200 Main St. Hyannis,MA 02601 RE: Insulation Permit 201408642 Dear Mr. Perry This affidavit is to certify that all work completed for 130 Old Craigville 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 N01 919VlSUVO AO N ,0i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map , Parcel l Application Q6 a Health Division Date Issued iZ-iS'—ly Conservation Division Application Fee 1 Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis � ( Project Street Address ' 130 0 Id Cr,��1'11 e � d Village Owner Ul ` vL Address © a Telephone Permit Request ! + R'30 c e l l0, 10`—+0 the a4i\r , 'k'3 4 "5e,— JPB1._k e j rP.1114 n -+0 +k C, G, NJ 'IZ- 13 r, (�. - 9� br f�-}a he d brl R- l ° 1 _ ddAt ° n lYI Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuatio44 U0 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 .. ".;� PO Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wooer al stove:=❑Yet ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑es sting Ll"hew ize_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: m Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ • w Commercial ❑Yes XNo If yes, site plan review # - Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) cc 4 ff� Telephone Number $ Name da�►�B inc, h D 03 99 = Address 6.n4gA- n AXz License # "Lr_ SerVA t fn&)A:A, 01661, Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 1 cCCjhNib j SIGNATURE Z DATE 1 \"11 ( I i FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING. i DATE CLOSED OUT ASSOCIATION PLAN NO. + Building Permit Authorization I, Kuber Bindukar , as owner hereby give my permission to Cape Save, Inc. 7-D Huntington Avenue South Yarmouth,MA 02664 Office:508-398-0398 to take all necessary steps to obtain a building permit to perform work at my property located at 130 Old Craigville Road Hyannis, MA 02601 Signed J `` The CoinMOftwealik ofXassachrrsetts Department of Industrial Accidents: -Office of Investigations 4 - Pr I Congres's Street,SWte 100 r u Boston,.MA OM4-201 T www.Mass gov/did Workers' Compensation Insurance Affidavit: Builders/ContractorslElectncians/Plumbers. Applicant Information Please Print Letibly. Name(Business/Organization/Indvidual) Cape Save Inc Address: 7D Huntington Ave City/State/Zip: South Yarmouth,MA 02664 Phone#: 50:8-39870398 Are you an employer?Check the appropriate box: Type of project(required);. i. 1 Toyer with 4. 0 1 am a general contractor and l am-a employer �o 6. ❑.New construction employees(full -time). part-time); have hired the sub-contractors 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.'forme inany capacity:: employees and have workers.' [3.Building addition; [No workers'comp:insurance comp;.in t 5. We area corporation:and its 10.D Electrical repairs or additions re9 u�red.] officers have;-exercised their. 1 LE];Plumbin re airs or additions I,M 1 am..a homeowner doing all work g P myself.[Noworkers' comp:. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152, fi1(4) and vve;have no employees..[No workers.' 13, ;:Other: _Insulation comp.insurance.retauiced.]. 'Atiy applicant that checks box#1 must also Pill ou�the section beiow showing their workers'cmnpeasation policy ntto ni.ation. t Homeownom who submit this atf idavit in iicall g,they arc diiing all work and then hire outside contractors must submit a new affidavit indteatingsuch, Contractors-that check;this box must attached an additional slicer sho++ pg the name'of the!sub-conttrctors and state whether or ilot those entities have: employees. il;the sub-contractors have employees;the}roust-provide;their workers comp:policy number: lrz an erspfoyer that is providing►Gurkers'coutpensatinn insetrarice far any employees. Below is thepolicy and job:site, infurniation:; - Insurance Company Name: Wesco Insurance Comparty Policy#or Self--ins.Lic.#.: _WWC3085633.. _. Expiratimi'Date:• 04/.09/2015 b 6 l Cra� ,r�rII 1 S Job Site Address: �� CitylState/Zip: G rl l Attack.a copy of the,workers'compensation pol> y declaration page(showing the policy n`um ant!expiration date) failure to secure coverage asrequired under Section 25A-of MGL c. 152 can lead to the imposition of cnminal penalties of-a fine up to 1,500.00 and/or one-year impnsontiient,as well as civil penalties in the form of a'STOP WORK ORDER ands fine . of up to$250.00 a day against,the:violato.r, Se advised that a copy of this statement may'be forwarded to.the Office of Investigations of the D1A'for insitanee coverage verification: do hereb cer under_the sins and- etzalties o er' that the in o»nation provided shove is true and:.correct, oat re:, Date t a 7 [t Phone :._50$-399=6398 __ ...._ .. '.: . ' '. _ •. Official(da only: Do::not write in dth area„fo be.r1i leted;by citywr town Ociot Issuing Authority,(circle one),: `I.Board-of Health 2:Building,Department 3.City/Town Clerk. 4..Electrical Inspector S.Plumbing Inspector 6.other Contadt,Person: Phone:#:... _ ._ '4C4 CERTIFICATE QF LIABIL-ITY INSURANCE OATE(MMIDD ��' � 11/1a/2014o14 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 PRODyCER,AND THE:CERTIFICATE HOLDER, IMPORTANT If the certificate holder Is an ADDITIONAL INSURED;the pollcyjfi s)must be endorsed: If SUBROGATION IS WAIVED,.subject to the termsand Conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the Certificate holder In ileu of such endorsements. PRODUCER NAh9Ei Colleen Crowley Risk Strategies Company PHONE (781)986-4400 A!C No:(7e1)963-4420 15 Pacella Park4Driv® :ccrowl' frisk-strateg es,.com Suite 240 INSURERSAFFORDINGCOVERAGE _. NAIC� Randolph MA 02368 INSURERA:Seleciive Ins. P or America IksuREo 'it SURERsAllmerica Financial Alliance 10212 Cape Save;, Inc INS LIRE RC`:WeSCO Insurance Company . 7 D Huntingtom,;Ave INSURER D INSURER :. South YaSmouth M ,02664 .INSURERF: COVERAGES :CERTIFICATE NUMBER:CL14111085532 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 SHOWNMAY HAVE BEEN REDUCED BY PAID CLAIMS. ILT TYPE OF INSURANCE,..' AD 77 P041CYEFF: POLICV:EXP POLICY NUMBER NM! LIMITS GF_NERAL LIABILITY EACH OCCURRENCE $ _ 1,.0001 000 }[ COMMERCIAL GENERAL LIABILITY =KGE-TO RENTED PREMISES Ee occurrenc $ 100.,000 A CLAIMS MADE Q OCCUR 91994480 10/16/2014 0/16/2015 MED EXP Any one person : $" 10,,000 PERSONAL&ADV,INWRY: $ 1,000;000 GENERAL AGGREGATE $ 2,000:,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ ?,000',000 71 POLICY X PRO- FRI LOC $ AUTOMOBILE LIABILITY E ,aocident 1 000 000 ANY AUTO BODILY INJURY(Per person) $ B ALL OW X NED SCHEDULED ` 6796600 1/6/2014 1Z/6/2015 AUTOS AUTOS BODILY INJURY(Per ecciderfl $ `X. HIREOAUTOS x NON-OVoNEO Per ROPERTY AUTOS eccl G ' $ dent X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 1,000}000 A EXCESS CIAO CLAIMS-0AADE AGGREGATE $ 1,000°,000 DED <; RETENTION 011 1994480 0/16/2014 0/16/2015 $ C WORKERS COMPENSATION fficeis Included for X ;WC TAT.0 0 H- AND EMPLOYERS,LIABILITYIMT ANY PROPRIETORIPARTNERIE�CUTIVE Y!N overage. E.LEACHACCIDENT OFFICERIMEMBER EXCLUDED'! FK--1 NIA 3085633 /9/2014 /9%2015 (Mandatory,to NH) E.L.DISEASE-EA EMPLOYE $ 500' 000 t1 yes,describe under DESCRIPTION OF.OPERATIONS below E.L.bISEASE-POLICY LIMIT $ 500 000 DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES(Attach ACORD 101,Addltlonal Remarks Schedule;It"more space Is required) Issued as evidence of insurance. Issued as evidence of insurance. Thielsoh11pgineering, Inc: is,listed as additional insured as respects General Liability as required by written contract. CERTIFICATE HOLDER CANCELLATION msonq@capelightcoMact.org SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF; NOTICE WILL BE DELIVERED IN Cape Light Coact ACCORDANCE WITH TMEPO.LICYPROVISIONS. Attn: Margaret song PO -Box 427/SCH AUrMOR12EARERRESENrATiVE 31951-lain-Street Barnstable, MA 02630 chael Christian/CLC ACORD 25(20.10105) ©1988-2010 ACORD CORPORATION. All rights reserved- INS025(201005),01 The ACORD name and logo are registered marks of ACORD Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Col;tractor Registration Registration: 171380 Type: Corporation Expiration: 3/14l2016 Tr# 249649 CAPE SAVE INC. WILLIAM McCLUSKEY u ' 7-D HUNTINGTON AVENUE SOUTH YARMOUTH, MA 02664 Update Address and return card.Mark reason for change. sCA 1 0 20M-05111 E] Address E] Renewal Employment Q Lost Card Ole !(t-!//%It(%ewor(Al?r,,1F,#(ejjrirl stJe116 Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: -71,380 Type:: Office of Consumer Affairs and Business Regulation ' /'- 10 Park Plaza-Suite 5170 �s Expiration ;3t14/207.6; Corporation Boston,MA 02116 CAPE SAVE INC. WILLIAM McCLUSKEY 7-D HUNTINGTON AVENUE SOUTH YARMOUTH,MA 02664 �— Undersecretary Not vali rthout signature f Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor Specialty License: CSSL-102776 WILLIAM J MC C-LUSV3 - 37 NAUSET ROAD s West Yarmouth NIA 02 q ""' Expiration Commissioner 06/28/2015 �* TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Maps Parcel I Application # �Z Health Division °' Date Issued �u. Conservation`Division ply-' `.: Application Fee .�• Planning Dept. Permit Fee V,®Jop/ Date Definitive Plan Approved by Planning Board Historic OKH _ Preservation/Hyannis Project Street Address I' d4zp (2,yi6!! Village /I/t/xi/_->, Owner Address' Telephone 50 7?8 Permit Request 29/''-ldv�ff. Square feet: 1 st floor: existing proposed 2-'/C 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project.Valuation s®® Construction Type We"O 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: YFull ❑ 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: � ❑Oil ❑ Electric ❑Other Central Air: ❑Yes 7No Fireplaces: Existing New Existing wood/coal stove: ❑Yes No Detached garage: ❑existing ❑ new size—Pool: ❑existing ❑ new size _ Barn: ❑ existing� new size_ _ Attached garage: ❑ existing ❑ new size _She exis d: ting ❑ new size G Other: � �— ' E co � Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes axo If yes, site plan review# r- Current Use Proposed Use :5--1t/YAe__ APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name N�t/s� i�l/�/� Telephone Number L 77�S Address 13(9 694407 c.C' �vrl�.� �'� License # 1 A� ." S. �Y�d Home Improvement Contractor# Worker's Compensation # P ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO J .0�ZT tXCd9 SIGNATURE u�� C� DATE y S FOR OFFICIAL USE ONLY b s APPLICATION# f DATE ISSUED MAP/PARCEL N0. - ADDRESS VILLAGE 15 OWNER , DATE OF INSPECTION: } FOUNDATION FRAME E: INSULATION ! i FIREPLACE ELECTRICAL: ROUGH FINAL Lj PLUMBING: ROUGH FINAL GAS: ROUGH FINAL I FINAL BUILDING �s 1} DATE CLOSED OUT - ASSOCIATION PLAN NO. rt .. The Cormnoitwearth of Massachusetts Departrner.rt of Industrialticcideitts Office of Investigations 600 Washineon Street < Boston, M4 OZXXX www.mass.gov/dia Workers' Compensation Insurance AffidaNft: Bugders/Contractors/Electricians/Plumbers Applicant Information Please Print Legit Name (Business/Organization/Tndividual): aoit]i(,/ /� Address: .1� 040 •4/�'�/�C.�L �C F-2 - City/State/Zip: ��LstiIi(/f 5 ,/Y� Phol�e. 4013 t Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4: ❑ 1 am a general contractor and 1 6 F]New construction employees (full and/or part=time).* have hired the sub-contractors 2.❑ 1 am a•sole proprietor or partner- listed on the attached sheet. T Remodeling ship and have no employees These sub-contractors have g• Demolition employees and have workers' 9 Building addition working for me in any capacity, ' [No workers' comp. insurance comp. insurance.t 5. ❑ %are a corporation and its 10.❑Electrical repairs or additions required,] 3.� 1 am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checka 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 anew affidavit indicating such. 1Conlractors that check this box must attacbed an additional shett showing the name of the suh-contractors and state whether or not those entities have employers. Lf the sub-contractors have employees,they mud providb their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the polity and job site information. - lnsu=ce Company Name: Policy#or Self-ins. Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).. Failure to secure coverage as required under Section 25A of MOL c. 152 can lead to the imposition of rrimfrial penalties of a fine tip to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK.ORDER and s 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 Investi ations of the DIA for instance coves e verification. I do hereby certify under the pains and en:aldies of perjury that the information provided.above is true and correct i`Si afore: Date: 7 r v Phone# `�U 7/ b U 7� Official use only. Do not write in this area, ro be completed by city or town official_ City or Torun: PernuiCLicense# Issuing Authority(circle one): 1.Board of Health`2.Building Department I City/Town Clerk 4.Electrical Inspector. 5,Plumbing Inspector 6. Other Contact Person: Phone It: Information and histr,uCtions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees: Pursuant to this statute, an emptayee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An a' toyer is defined as "an individual,partnership, association, corporation or other legal entity, or any two or more Inp of the foregoing engaged in a joint enterprise, and including the legal represent atives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the 1,p p, owner of a dwelling house avi h hn not more than three apartments and who resides therein, or the occupant of the g dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be dccmcd to be an employer." MGL chapter 152, §25C(6) also states that"every state or Iocal licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7) states 'Neither the commonwealth nor any of its political subdivisions shall enter into any contract,for,the performance of public work until acceptable evidence of corzrplianec with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers compensation affidavit completely,by checking the boxes that apply to your situation and, if. necessary, supply sub contractors)na.me(s), address andhone numbcxs ph one ( ) along with their certificates) of with no employees other than the. insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) members or partners, arc not required to carry workers' compensation insurance. If an LLC or LLP does have of Industrial Beadvised that this affidavit may be submitted to the Department s olic is required. B. Y employee , a policy Accidents for confirmation of insurance coverage. Also be.sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a wor kers' compensation policy,please call the Department at the number listed below. Self insured companies should enter their self-insuranr,c license number on the appropriate line. City or Town Officials 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 6f Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/licensc number which will be used as a refcrcacc number. In addition, an applicant that must submit multiple permit/licensc applications in any given year,)aced only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address" the applicant should write "all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a liccus c or permit not related to any business or commercial venture (Le. a dog license or permit to bum leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call The Department's address, telephone-and fax number: The Cbmmoz w. -,aJ.tla of MassachuscM Depaztment of lndustxlal ArcidQ�,nts Office of Imyesti - V.ons 600 Washington Street Boston, MA 02111 Tcl. # 617-727-4-900 ext'405 or 1-M-MASSAFE Fax## 617-727-774 9 Revised 11-22-06 wunw_mass..gov/di a Town of Barnstable �p4 THt ropy y�� o Regulatory Services Thomas F. Geiler,Director * HARNSrABLE, MASS' $ ` _ 059. Building Division PTFo �a Tom Perry,Building Corturussioner 200 Main Street, Hyannis, MA 02601 www.town.barnstabl e.ma.us Office: 508-862-4038 Fax: 5.08-790-6230 H0112EOWIVER LICENSE EXEMPTION Please Print DATE: 6 //� JOB LOCATION: 13a �G� ��C ��Ty/�/� �� III-QWNIS number ,.� street village "HOMEOWNER": .yl� /�/�,C� name home phone# wo hone#.rk p / CURRENT MAILING ADDRESS: /3 DLL C 4z,_I/iG4;Z �fl city/town state zip code T'he current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. ' DEFINMON OF ROMEMVNER Persons) who owns a parcel of land on which he/she resides or intends to reside, on which there is,or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A' person who constructs more than one home in a two-year period shall not be considered a homeowner, Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other ` applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department a '' minimum inspection procedures and requirements and that he/she will comply with said procedures and require ents. Signature of Homeowner Approval of Building Official f Note: Three-family dwellings containing 35,000 cubic feet or larger will be.required-to comply with the State Building Code Section 1.27.0 Construction Control. ROMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this'section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a parson(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of-a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2,15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The hom"cowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a forrn currently used by several towns. You may care t amend and adopt such a form/ccrtification for use in your community. - i 0*-114E r Town of Barnstable ti Regulatory Services RAR� N��syABLE, Thomas F. Geiler,Director rfb. �a Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using .A Builder 7 , as Owner of the subject property hereby authorize to act on my behalf, in all.matters relative to work authorized by this building permit application for: (Address of fob) Signature of Owner Date Print Name If Property Owner is applying for permit please complete the Homeoc mcrs License Exemption Forth on the reverse side. I :w� �i►��CL �o�.u/E Town of Barnstable Geographic Information System Parcel Viewer Custom Map Abutters Map Size EJ Zoom Out D U fJ D U U®In rw y r R.a (� ® � m- 7PG Map: 248 Parce Location: 130 OLD CRAIG) 248113 #119 248110 Owner: FINKLE, BONNIE " tl 119 N 26 248112 , 248119 N 110 1�'131 Location Information Y Map &Parcel 248121 �41 Location 130 OLI 248120 Ov u 120 , ' Acreage 0.27 act Current Owner Mailing Address FINKLE, 2 81 8 130 OLI 248147 HYANNI 221 N11 E k 130 Appraised Value (FY 2001 �0248264 Extra Features $29,OOC Out Buildings $700 24$2$2 . Land $164,O C N 140 Buildings $180,6C Total Appraised $374,3C 248203 #32 248122 Assessed Value (FY 2008 g150 248262 q2F Extra Features $29,OOC 0 FAet Out Buildings $700 q 10 Land $164,OC =- Buildings $180,6C Total Assessed $374,3C Set Scale 1" = 62 I Aerial Photos Lj Copyright 2005-2007 Town of Barnstable,MA All rights reserved.Send questions or comments to GIS BarnstableMA v0.2.91 [Production] e, . a Al Mrs. Bonnie A Finkle DO Old Craigeville Rd Hyannis,MA02601 Cozad F . �. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION- r Map Parcel _ /` I Permit# "1c24� ( Health Division Date Issued 111,2 Conservation Division Fee •o p 0 Tax Collector - � c4 Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address / V v q ig I, V Village 1V / Owner e + lye-( gJ F,y k le Address 13 n � �� l r d Telephone• rO K 72-3— 0(el Permit Request c t! Square feet: 1 st floor: existing_ proposed Vic- 2nd floor: existing 903 . proposed 5 Me Total new Estimated Project Cost . 006. ''Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family , Two Family ❑ Multi-Family(#units) Age of ExistingStructure Historic House: ❑Yes o On Old Kin 's Highway: ❑Yes o � 9 Basement Type: g Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new — Half:existing - - new µ Number of Bedrooms: existing new Total Room Count(not including baths) existing new First Floor Room Count • ` Heat Type and Fuel: 0 Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes No Fireplaces: Existing �_ New Existing wood/coal stove: ❑Yes No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:�existing ❑new size A / Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes J No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name cva J� A ol,J Telephone Number rOdp^7f Address C/o Cah t �l e A,dweetK/JP License# C S D7YO 03 I�•D• , o 7 y,b la I f�Gr 40�e/c AGO Home Improvement Contractor# 'a U3 I -tea 2 2. 0�- J Q0 e /Lf L�_D- Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO D d u1-0Ic L uw� ��• SIGNATURE DATE �� �� { FOR OFFICIAL USE ONLY ,C PERMIT NO. _r _ DATE ISSUED MAP/PARCEL NO.ADDRESS VILLAGE " OWNER _. DATE OF INSPECTION: ' FOUNDATION FRAME INSULATION Ir FIREPLACE s. ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL J FINAL BUILDING ` P' DATE CLOSED OUT ASSOCIATION PLAN NO. �{ r .y The Commonwealth of Massachusetts _- ``� _�- '�' ��'��--• Department of Industrial Accidents office of/osesti 2deffs 600 Washington Street Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit name: location: city phone# ' ' ❑ I am a homeowner performing all work myself. ❑ lam a sole rietor and have no one worIan in any capacity I am an employer providing workers' compensation for my employees worlang on this job. address f . :::: .. .::: 1 '�:�°' �°"... • ..:.:.. .:...:::.:.... ::.:............. ........::::.::: insurance co.:�� :. :. �'1 `'• A:� . ,,:: . .a7 //% ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: tomany name. :>:;;:::::;;;:::::: ... ....................... .....::::::... :._.;'. #.... hone ..>..,;:>: >.... ...... .......::..:•.:...:........:..:......... '•:vS::::itili::iii::::::;;: oiicv .:.:............::.:,::<:.:::..................... .:,,.::,...:::;.;-:.:::.. c anvname*, ::;;:>: . address. ,:.:;..:::>.>:: :.ci ::h'- :N. t�6one# .................................................................. vi:\::ti;:iv'y�; .,...:::::.�:::::::::::.�:•:.�::•:::::raw::::.� ......:: . .: ..:::::::•::. :::::•::::•.:::: �iiii:4ii:::::::::::::.�::::.�w:::•:::::.�w.�:::;.•.... .... ... ..:v:::.•.. ..:::::...:.:::n:...:::•::.....:::•:i.�::::L:::•:vb:::::::::;. ...... :..... ... .; .:.::i::::::::::•.•;{i ryi:-::4'i;Gi::;•::::•<:::v::::::..�:v;•i::::i:!.iiii::^i:.tii:i:::!.::'ii:::v::::::::::::.::.�::.::•:'::.:' :'#:::ii:;:!•is�:�:::::;:j:::?:::ii.!}:?:'••:::.::::•::•:.::.::r:::.::........ ::..:.:.::..:....:....::.., .,,,.,. ,........ olity FaOute to secare coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a 8ne to$1,500.00 and/or one yeah'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a nne of$100.00 a day against um I understand flat a copy of this statement may be forwarded to the Olace of Investigations of the DIA for coverage verincation. I do hereby cerdALFuler the pains and penalties of perjury that the information provided above is&w.and coned Si Date �� a gnature Print name Phone# 12 V-^/o'"��,�,f Ccontactperson: only do not write in this area to be completed by city or town oifldal town:— permiUllcense# B uilding Departrnent sing Board immediate response is required tmen's Oilice th Department phone#, r�� (nwed 9/95 PJA) 1 own of narnslaujte Department of Health Safety and Environmental Services Building Division - \ 367 Main Street,Hyannis MA 02601 Office: 508-8624038 Ralph Crossen Fax: 508-790-6230 Building'Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. C"F Type of Work: �'� Ad`►1 1 ;S Estimated CostO Address of Work: 1 gyp c(c3 : Sr Owner's Name: Cc) Lk,,N iL 1 e- Date of AppIication: /Cf I hereby certify that: Registration is not required for the following reason(s): Work excluded by law oJob Under$1,000 Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner Date/ Contractor Name Registration No. OR Date Owner's Name q:forms:Aff day . ` DATE(MM/DO/YY) `. ACI�R® �ER�I:F[ TE QF LIAEIL`[T1f fI1SCJR/ N7EMERCPRI ' 03/25/99 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Paul Peters Agency, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR P O Box 669 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Falmouth MA 02541-0669 COMPANIES AFFORDING COVERAGE COMPANY Phone No. 508-548-2500 Fax No. A AMERICAN EMPLOYERS INS. CO INSURED COMPANY B COMMERCIAL UNION INSURANCE CO COMPANY Mercantile Property Management C Western Surety Company PO BOX 790 COMPANY Buzzards Bay MA 02532 D CQVERAGES 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. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LTR DATE(MM/DD/YY) DATE(MM/DD/YY) LIMITS GENERAL LIABILITY GENERAL AGGREGATE s2,000,000 A X COMMERCIAL GENERAL LIABILITY ABR448660 03/01/99 03/01/00 PRODUCTS-COMP/OPAGG $ 2,000,000 CLAIMS MADE a OCCUR PERSONAL&ADV INJURY $ ] 000 000 OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE(Any one fire) $ 100,000 MED EXP(Any one person) $ 5,000 AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENTANY $ O OTHER THAN AUTO ONLY. .: EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM $ WORKERS COMPENSATION AND WC STATU- OTH EMPLOYERS'LIABILITY TORY LIMITS ER EL EACH ACCIDENT $ 100,000 THE B PARTNERS/EXECUTIVE S/EXER/ INCL CB(99)H157461 03/07/99 03/07/00 EL DISEASE-POLICY LIMIT $ 50Q 000 PARTNERS/EXECUTIVE r B OFFICERS ARE. EXCL EL DISEASE-EA EMPLOYEE $ 100,000 OTHER C Employee Dishonest 68579390 02/21/99 02/21/00 10,000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS Real Estate Property Management/Massachusetts CERTIFIC 4TE HOLDER ' CANCELLATION . ... SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND U *E COMPANY,ITS AGENTS QR REPRESENTATIVES. AUTHORIZED REP ESE rta , ACO.RD CORPIORATION 1988.. ANDERSEN WINDOWSDOORS Double Hung Windows Residential Specialty Shapes (continued) Residential Tiltwash (HP) 0.31 Elliptical (HP) 0.30 Tiltwash (HPSun) -0.33 Elliptical (HPSun) 0.32 Double-Hung Transom (HP) 0.30 Circle and Oval (HP) 0.30 Double-Hung Transom (HPSun) 0.32 Circle and Oval (HPSun) 0.31 Double-Hung Picture (HP) 0.31 Flexiframe (HP) 0.30 Double-Hung Picture (HPSun) 0.33 Flexiframe (HPSun) 0.32 Builders Select Double-Hung (Clear) 0.47 Arch (HP) 0.30 Narroline Double-Hung (HP) 0.32 Arch (HPSun) 0.32 Narroline Double-Hung (HPSun) 0.33 Springline (HP) 0.30 Narroline Transom (HP) 0.30 Springline (HPSun) 0.33 Narroline Transom (HPSun) 0.32 Narroline Picture (HP) 0.31 Skylights & Roof Windows Narroline Picture (HPSun) 0.33 Skylight (HP) 0.47 , Skylight (HPSun) 0.49 Casement Windows Stationary Roof Window (HP) 0.52 Builders Select Double-Pane Insulating 0.46 Stationary Roof Window (HPSun) 0.54 Double-Pane Insulating (HP) 0.30 Venting Roof Window (HP) 0.52 Picture Window Insulating(HP) 0.27 Venting Roof Window (HPSun) 0.54 Awning Windows Patio Doors Builders Select Double-Pane Insulating 0.46 Frenchwood Hinged (HP) 0.31 Double-Pane Insulating (HP) 0.30 Frenchwood Hinged (HPSun) 0.33 Picture Window Insulating (HP) 0.27 Frenchwood Outswing (HP) 0.32 Frenchwood Outswing (HPSun) 0.33 Specialty Shapes Frenchwood Gliding (HP) 0.30 Circle Top (HP) 0.29 Frenchwood Gliding (HPSun) 0.32 Circle Top (HPSun) 0.31 Perma-Shield Gliding (HP). 0.29 Circle Top-Double Hung (HP) 0.30 Perma-Shield Gliding (HPSun) 0.31 Circle Top-Double Hung (HPSun) 0.32. Builders Select Gliding 0.49 Clad Windows Clear Low-E w/Argon Primed Windows Clear Low-E w/Argon Casement 0.52 0.37 Casement 0.48 0.32 Awning 0.52 0.37 Awning 0.48 0.32 Casement Picture 0.52 0.33 Casement Picture 0.48 0.29 Double Hung 0.53 0.36 Double Hung 0.50 0.34 Double Hung Picture 0.50 0.32 Double Hung Picture 0.47 0.28 Vista Slider 0.55 0.37 Vista Slider 0.52 0.34 Sash Look Transom 0.51 0.34 Sash Look Transom 0.49 0.31 Round Top 0.50 0.34 Round Top 0.48 0.32 Spandrel 0.51 0.31 Spandrel 0.48 0.28 Clad Doors Primed Doors French Manor 0.47 0.31 French Manor 0.46 0.30 Manor Entry 0.47 0.31 Manor Entry 0.46 0.30 Manor Center Hinged 0.47 0.31 Manor Center Hinged 0.46 0.30 Manor Sliding 0.51 0.35 Manor Sliding 0.49 0.33 Manor Outswing 0.47 0.31 Manor Outswing 0.47 0.31 Manor Sashed Transom 0.54 0.42 Manor Sashed Transom 0.45 0.32 Hallmark Hinged 0.46 0.31 Hallmark Hinged 0.46 0.31 SPD Sliding 0.56 0.36 SPD Sliding 0.54 0.33 U-Value test results in accordance with NFRC - 100 �• 01999 Harvey Industries, Inc. a M HARVEY INDUSTRIES GS U-Value Test Results 9001 - • Based on residential sizes • R Value = 1 divided by U-Value • Whole window values • U Values are subject to change • U-Values in accordance with NFRC - 100 without notice WINDOWSMANUFACTURED DOORS Windows Clear Insulated Low-E AdvantEd e 9 • Classic Double Hung (Mechanical) 0.51 0.40 0.37 •Classic Double Hung (Welded) 0.51 0.39 0.36 •Classic Plus DH W/CFW 0.33 0.27 0.26 • Signature Double Hung 0.51 0.39 0.36 • Signature Double Hung,(Welded) 0.50 0.39 0.36 • Slimline Double Hung 0.52 0.40 0.36 •Thermal One Single Hung 0.53 0.41 0.37 • Majesty Double Hung 0.54 0.44 0.40 • Majesty Fixed Casement (PW) 0.53 0.40 0.37 • Majesty Casement/Awning 0.56 0.45 0.42 • Majesty Picture Window (DH) 0.53 0.43 0.38 •Vinyl Casement/Awning 0.47 0.36 0.33 •Vinyl Casement/Awning &Thermal Panel 0.32 026 0.25 Vinyl Designer Shapes 0.49 0.34 . 0.30 •Vinyl Hopper 0.47: 3 0.36 0.33 •Vinyl Picture Window 0.46 0.33 0.30 •Vinyl Picture Window Deadlite 0.51 0.37 0.33 •Vinyl Roller-2 Ute & 3 Ute 0.50 0.38 0.35 VICON SERIES Clear Insulated Low-E AdvantEdge New Construction Vinyl Window •Vicon Casement/Awning 0.47 0.36 0.33 •Vicon Picture Window 0.46 0.33 0.30 •Vicon 1000 Single Hung 0.53 0.41 0.37 •Vicon 2000;Double Hung 0.52 0.40 0.36 • Vicon Classic Double Hung 0.51 0.40 0.37 •Vicon Designer Shapes 0.49 0.34 0.30 HARVEY PATIO DOOR Temp. Clear Temp. Low-E Temp. Argon • Solid Vinyl Patio Door 0.50 0.41 0.38 •Vicon Patio Door WA WA WA VELUX SKYLIGHTS . - 48 Type • Model FS 0.58 0.37 0.41 • Model FSF - - 0.40 • Model VS 0.60 0.43 0.47 ` ✓fie �o�r�arrcaruueafCl a�:`�o�acfiti:lell6 ., BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR a Number: CS 074003 Birthdate: 11/22/1955 Expires: 11/22/2002 Tr.no: 74003 - J Restricted To: 00 CRAIG J MCGOWAN 37 VILLAGE DR L.�•..o-v ;��{'td' EAST SANDWICH, MA 02537 Administrator 1. - HOME IMPROVEMENT CONTRACTOR Registration: 129831 Expiration: 11/09/2001 Type: Private Corporalio MERCANTILE PROPERTY MGMNT CRAIG MCGONAN &-9'q-L0/18 WATERHOUSE RD ADMINISTRATOR BOURNE MA 02532