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0114 SUDBURY LANE
i/y Sodbu l��uly Town of Barnstable Building ..z. ��'. �/�,��<`� F •� -.L. `�_._� l*" Post This Cai'dSoThat�t is;Vis�ble From the Street Approved PlansrMust beARetamed on Job and this Card Mustbe Kept MAE&A Posted Until FirialIns}ection�HasBeen Made r` ,,, X 'BARM gg a?-, z, p � � x ; s �/riii�� rM� j}Where a C.,ertificate of Occu ancy��s Requ',ired,such;Building shall Not be Occupied�until a Final lnspectlop nastbeen made � - iEw.,,..-r "' ". ...... _ •�a..c:.dws&:�a&,«a:v. _.:...... _... .n.,..� .�-way. ` ' ,a -x �a.. ^„�, Permit No. B-20-871 Applicant Name: Craig Orn Approvals Date Issued: 03/20/2020 Current Use: Structure Permit Type: Building-Solar Panel-Residential Expiration Date: 09/20/2020 Foundation: Location: 114 SUDBURY LANE, HYANNIS Map/Lot. 270-298 Zoning District: - RB Sheathing: Owner on Record: SANDERS,ALVIN B&KRISTIN R Contractor Name ,SUNRUN INSTALLATION SERVICES Framing: 1 INC. Address: 114 SUDBURY LANE 2 HYANNIS, MA 02601 ractoricense 180120 Chimney: . Est Project Cost: $24,000.00 Description: Installation of an interconnected rooftop PV system d,an ,energy a Insulation: storage system.38(305W) Panels 11.59 KW DC and,Vone LG Chem I,Permit Fee: $172.40 5kw Lithium Ion Battery X, Fee,Paid: $172.40 Final: Project Review Req: Nia £ ' 3 Date:' 3/20/2020 s, Plumbing/Gas 121, i, Rough Plumbing: _ a ,. Final.Plumbing: r This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within siz months after issuan All work authorized by this permit shall conform to the approved applitat-ion and theapproved construction documents for which this permit has been granted. Rough Gas: f, All construction,alterations and changes of use of any building and structuresshall be in compliance with the local zornng%by laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street orroad.and shall be maintained open for,publicinspettion for the entire duration of the work until the completion of the same. � Electrical The Certificate of Occupancy will not be issued until all applicable signatures by'the B ing and=Fire Officials are provided on th�s:permit. Minimum of Five Call Inspections Required for All Construction Work x s` _r Service: k. 1.Foundation or footing ' Rough: 2.Sheathing Inspection .. _•-- °" 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Town of Barnstable Building �Post-This�Card,So;ThatMit�swVls�ble<Fromthe;.5treetA roved Plans Must be Retacned on;-Job andth�s,CardNlust..be Ke t e�uvsrsaut M" Pos ed Unt�I Final Ins ectton Iias Been;Made z ' . Permit 16fQ' �,, :.�c<,rl^';, a.'��;„k s:� ai a+' �:. ,3,: ,,.3;..,; ., r.,;,. �, .,� :r?, ,... w .a.: z�_, ,..�. ,� � >: Where a Certificate�ofsOccupancy.syRequ�red,such�Bu�ldmg'shall iVot=be Occupieduntil�alF�nal,Ins ect�on has beenrmade � .���< x' :.,.:. ,` '.a"«.:�aA';os`a.;,Hx.. >,�,�.._.,_ Permit No. B-18-2480 Applicant Name: SOUTHERN NEW ENGLAND WINDOWS LLC. Approvals Date Issued: 08/01/2018 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 02/01/2019 Foundation: Location: 114 SUDBURY LANE,HYANNIS Map/Lot 270 298 Zoning District: RB Sheathing: RU 0-40-2 Owner on Record: SANDERS,ALVIN B St KRISTIN R Contractor Name .SOUTHERN NEW ENGLAND Framing: 1 £ WINDOWS LLC. Address: 114 SUDBURY LANE ' Is" 2 LA CoratractoLlchnseY3,245 HYANNIS, MA 02601 �, •;- Chimney: Description: Replacement Windows(4) x EstProfect Cost: $9,784.00 Permit;Fee: $49 90 Insulation: Project Review Req: , � -"-X Fee Paid` S 49.90 Final: Date 8/1/2018 Plumbing/Gas Rough Plumbing: Final Plumbing: This permit shall be deemed abandoned and invalid unless the work auth or ed bythis permit is commenced within six mohthsfafteriissuance. All work authorized b this permit shall conform to the a � � Rough Gas: y p approved application and the approved construction documents forwhich this permit has been granted._ All construction,alterations and changes of use of any building and structures shall be in compliance with the local zonmgby laws and codes. �„ W 7 Final Gas: This permit shall be displayed in a location clearly visible from access street=roar hd shall be maintained open forfpublic msp�ectiohIm for the entire duration of the work until the completion of the same. p ; Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Budding�and Fire Officials are'p vIded on is permit. Service: Minimum of Five Call Inspections Required for All Construction Work. ,,; 1.Foundation or Footing ;e 2.Sheathing Inspection ..._ �, Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department i . Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT �V y Application number:............. de Issued .. 1.�...�.�� BAMSTABLB. r F: ............. ........... MAM AUG 01 201iq Building Inspectors Initials............ 11 8AHlu hp/Parcel........... :.7R..-. ..................... TOWN OF BARNS TABf qq. qb ICE . EXPEDITED PERMIT APPLICATION: : ` ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEAnMRIZATION PROPERTY INFORWaTION Address of Project: NUMBER/ STREET VAJAGE Owner's Name: A��-� L �'s�,i► spy j Phone Number s Off-3 Ce 7-9*L 1 4 Email Address: r;s K�Q,•/. o,n Cell Phone Number Project cost$ - 7 �(= Check one -Residential Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 7$0 CMR Owner Signature: Date' .. . . E OF WORK - ❑ Siding .Windows(no header change)# q ❑ Insulation/Weatherization ❑ Doors (no-header change)# Commercial Doors iequire an inspector's review` �—I Roof(not applying more than I layer of shingles) Construction Debris will be going to 4 s e_121 a a Po'IP/ -7 - CONTRACTOR'S INFORMATION Contractor's name I�t un r`�R n�i,'so`✓` - SA-e cn de,J Lcr, (rVa c OW,S Home Improvement Contractors Registration(if applicable)# !Z.,3 L.q 5 (attach copy) Construction Supervisor's License# DI S-7 07 (attach copy) Email of Contractor -Phone number 1101 z z R 1,goo ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT,'YOU MUST OBTAIN HISTORICAPPROVAL BEFORE PERMIT CAN BE ISSUED. APPLICATIONNUMBER............................................................ *For Tents Only* Date Tent(s)will be erected Removed on 'number of tents total Does the tent.have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Check one:this event is a:for-profit non-profit event Check one:Food served Yes - No Flame Spread Sheet of each tent must be attached.Provide a site plan with the location(s),of each tent If food is being served at your event please obtain a health Department approval between the hours of 8:00am-9.30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval YWOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type - Testing Lab Offsets from combustibles:front back left side right side HOIMEOWNERIS LICENSE EXENTTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 Cliff and the Town of Barnstable. Signature Date PLICANT'S SIGNATURE Signature Date All permit applications are subject to a building official's approval prior to issuance. Renewal Agreement Document and Payment Terms Andersen. dba:Renewal By Andersen of Southern New England Alvin&Kristin Sanders Legal Name:Southern New England Windows,LLC. 114 Sudbury Ln Rl#36079, MA#173245,CT#0634555,Lead Firm#1237 Hyannis,MA 02601 wisoow RE LACEMENT 10 Reservoir Rd I Smithfield,RI 02917 H:(508)367-9274 Phone:866-563-2235 1 Fax:401-633-6602 1 sales@renewalsne.com Buyer(s)Name: Alvin & Kristin Sanders Contract Date: 07/17/18 Buyer(s)Street Address: 114 Sudbury Ln;Hyannis, MA 02601 . Primary Telephone Number:.(508)367-9274 Secondary Telephone Number.. kristin03O8@yMaii.com Primary Email. Maii . Y.. Secondary Email: i Buyer(s)hereby jointly and severally agrees to purchase the products and/or services of Southern New England Windows,LLC d/b/a Renewal By Andersen of Southern New England("Contractor"),in accordance with the terms and conditions described in this Agreement Document and Payment Terms,any documents listed in the Table of Contents,and any other document attached to this Agreement Document,the terms of which are all agreed to by the parties and incorporated herein by reference(collectively,this"Agreement"). ; Buyer(s)hereby.agrees to sign a completion certificate after Contractor has completed.all work under this Agreement. Total Job Amount: $91784 By signing this Agreement,you acknowledge that the Balance Due,and the Amount: Financed must be made by personal check,bank check,credit card,or cash.. Deposit Received: It 892 Balance Due: $4,892' Estimated Start: Estimated Completion:. 8 to.10 weeks. : 8 to 10 weeks Amount Financed: $9,784 Method of Payment: Financing We schedule installations:based on the date of the signed contract and secondarily on the date in which we complete the technical measurements.The installation date that we:are providing at this time is only an estimate.We will communicate an official date and.time at a later date.Rain and extreme weather are the most common causes for delay Notes: Taxes paid in Barnstable, Ma. Buyer(s)agrees and understands that this Agreement constitutes:the entire understandings between the parties and that there are no verbal understandings changing or modifying any of the.terms of this Agreement.No alterations to or deviations from this Agreement will be valid without the signed,written consent of both the Buyer(s)and Contractor.Buyer(s)hereby acknowledges that Buyer(s) 1),has read this Agreement, understands the terms of this Agreement;and has received a completed,signed,and dated copy of this Agreement,including the two attached Notices of Cancellation,on the date first written above and 2)was orally informed of Buyer's right to cancel this Agreement. NOTICE TO BUYER: Do not sign this contract if blank:You are entitled to a copy.of the,contract at the time you sign. YOU,THE BUYER,MAY CANCEL THIS TRANSACTION AT ANY TIME NOT LATER THAN MIDNIGHT. OF 07/20/2018 OR THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION, WHICHEVER DATE IS LATER.SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. legal Name:Souther New England Windows,LLC 'dba:Renee By Andersen of Southern New.England Buyer(s) Signature of Sales Person .. .Signature Signature Gino Montesi Alvin Sanders. Kristin Sanders Print Name of Sales Person Print Name Print Name UPDATED: 07/17/18 Page 2 / 12 Otfiee of Consumer Affairs and Eusiness Re" lation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Reqistration: 173245 Type: Supplement Card SOUTHERN NEW ENGLAND WINDOWS LL Expiration: 9l19/2018 BRIAN DENNISON 26 ALBION RD L+NCOLN, RI 02865 Update Address and return card.NIlark reason for change. Address = Renewal - Employment = Lost Card —9f ice of Consumer Affairs&Business Regulation Registration valid for individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: Office of Consumer Affairs and business Regulation Registration: 7i3745 Type: r - .Q-Part:Plaza-Suite 5Il70 Expiration: 911 9/20 18 Supplement Card Boston._NIA 02116 1UTHERN NEW ENGLAND WINDOWS LLC. :NEWAL BY ANDERSON IIAN DENNISON ALBION RC qCOLN, RI 02865 ndersecreiary Not valid without signature yam(e(� ;Y ;+�,. l Ms —095 d 0 Z. BR.AN D DENNISON 7 LAMBS POND CIRCL E ALTONA 01601 I - The Commonwealih of Massachusetts Department of IndustrialAccidents 1 Congress Street,suite 100 Boston,MA 02114-2017 www.massgov/dia Workers'Compensation Insurance.Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. A licant Information Please Print Legribly Name (Business/Organizanon/Individual): Address City/State/Zip: Its Phone : Are you as emplover?Check the appropriate box Type of project(required): 1.XI am a employer with !?P femployees-(full and/orparttime).* 7. Q New construction 2.Q I am a sole proprietor or partnership and have no employees working for me in any capacity.[No workers'comp-insurance required.] ` 8• D Remodeling i 3. I am a homeowner doing all work myself[No wprkers'comp.insurance reouired.1 9 El Demolition 4.❑I am a homeowner and wt7l be hiring contractors to conduct all work on m l D Building addition ensure that all contractors either have workers'compensation insurance or are sole Y Pr sole I wiii 11.[]Electrical repairs or additions Proprietors with no employees. 5.❑I am a genera cormactor and I have hired the sub-contractors listed on the attached sheet 12-❑Plumbing repairs or additions These sub-contractors have employees and have workers'comp.insurance= 13_F�Roof repairs 6.O eve area corporation and its officers have exercised their right of exemption per MGL c. 14.ffOther 1J�r,�,/ 152,§1(4),and we have no employees.[No workers'comp.insurance required.; 7Fury applicant that checks box i'1 must also fill out the section below showing their workers'compensation,policy information Homeowners who submit this affidavit indicating they are doing all work and then hire outside contactors must submit a new affidavit indicating such 'Contractors that check this box must attached an additions sheet showing the name of the sub-contactors 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 6d job site information Insurance Company Name: rllr� 1hQ/�s Qpm Policy 3�or Self-ins.Lic.3�: Expiratio=Date: f l 1 Job Site Address:_ /I�/ fud O ,rV 1i7. City/5tate!Zip:_ 4tiif 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 violatioL p>mishable by a foe up to 2,500.00 and/or one-year imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a foe 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 certify under th aims and penalties ofperjug that the information provided above is true and correct e Signature: D2te: �•' /—/ Phone Official use only. Do not write in this area;to be completed by city or town official. City or Town: Permit/License Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector. 5..Plumbing Inspector b.Other Contact Person: Phone#t: I qc CERTIFICA DATE(MWDD TE OF LIABILITY INSURANCE 'YYYY' THIS CERTIFICATE IS ISSUED A5 A M 12/2-17 ATTER 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 pDlicAies)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). IRODUCER D .A CoBiz Insurance, Inc.-CO FADD E: 1401 Lawrence St, Ste. 1200 NE .3D3-988-0446 Denver CO 80202 AIL FAX No:303-988 D804 RE : COMaiI cob¢insurance.com INSURERIS1 AFFORDING COVERAGE NAIC N tiSURED ESLERCO-01 INSURER A:Acadia insurance Com an 31325 Southern New England Windows, LLC. INSURER a:Firemens Insurance Company of WA,D.C. 21784 Jba Renewal by Andersen of Southern New England INSURER c:Homeland Insurance Company of New York 34452 10 Reservior Rd INSURER D Smithfield RI 02917 INSURER E: INSURER F :OVERAGES CERTIFICATE NUMBER:1252851165 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. ISR ,TR TYPE OF INSURANCE SUERSURANCE POLICY EFF POLICY F� - POLICY NUMBER MM/DD MMIDD LIMITS CLAIMS MADE OCCUR A XtCC*A1lIERC1AL GENERAL LIABILITY CPA3158728 1/72D1EEACH OCCURRENCE 51.00D,OOD RENTED. PREMISES Ea occuffencel S 304DD0 I MED EXP(Aa one person) S 10.0D0 I I PERSONAL&ADV INJURY S 1,ODD,000 GEN`L AGGREGATE UMrr APPLIES PER: GENERAL AGGREGATE S 2.000.000 X POLICY ECT 'L7 LOC i - j PRODUCTS-COMP/OP AGG $2.00D.00D OTHER: � $ A AUTOMOBILE LIABILITY N CPA3158728 1/1201E I 1/1201c COMBINED 5INGLE LIMB X FZ accident S 1 OD0 000 ANY AUTO ALL OWNED SCHEDULED BODILY INJURY(Per person) S AUTOS AUTOS BODILY INJURY(Per accident) S X HIRED AU705 X NON-OWNED PROPERTYDAMAGE AUTOS i Per accident) S g A X UMBRELLA UAB X OCCUR CPA315812E I 1112016 1111201E EACH OCCURRENCE $1D.0lX1,D00 EXCESS LIAB CLAIMS-MADE AGGREGATE S 10.00D.ODD DED I X. RETENTION S S E EMPLOYERS GOMPENSATON WCA3158725-20 { 111201E 1/1201c X PER AND EM AND PLOYERS LUU3ILITY YIN, I STATUTE ERµ ANY PROPRIETORIPARTNERIDECUTVE OFMCEWMEMBER EXCLUDED? D NIA E.L.EACH ACCIDENT $1.000,000 (Mandatory in NH) M yes desrnbe under E-L DISEASE-EA EMPLO S 1,000,01XI, DESCRIPTION OF OPERATIONS below, E DISEASE-POLICY LIMIT S 1.000,000 C Pollution Uabft 79300733400D0 Claims-Made Policy 1/12018 1/120I9 Each Occurrence $1,000.000 Retroactive Data 0 512 012 01 3 A99 a S1,0D0,000 Deductible $10,000 IESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional.Remarks Schedule,may be attached if more space Is required) :ERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE .EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. For Informational Purposes AUTHORIZED REPRESENTATIVE f ©1988-2014 ACORD CORPORATION. All rights reserved- WO RD 25.(2014101) The ACORD name and logo are registered marks of ACORD Town of BarnstableBuilding S �{v.. 6 W S �*;fxb tS s 'fit i s i s,�• }'i $S i X "•,',., N k Post;This Card SoyT,hat it�s,�/�s�ble,From the Street Approved Plans Must be:;Retamed on Job and this Card Must be Kept � tANh�^&'C .,p = ".i::�%�� �'� ��. :� � �,�, ��� �; :{ � �`� z,. a 5 �� •�'x �? r. �"3" ;� o pn O Posted Until Final Lnspect�on Has Been Made Permit +° Where a Certifica"te of Occ�u an is Re wired'"such Buildm shall Not be Occu ie nt�l a,Final Ins ection has been.made er it :�„-„,. p ., fa, q 4. �',F;. .,H,. ,a:Wig;. p. z„ .... . . .a,p, .... emu•a ,:._. .. :E Permit No. B-18-224 Applicant Name: HENRY E CASSIDY Approvals Date Issued: 02/12/2018 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 08/12/2018 Foundation: Location: 114 SUDBURY LANE, HYANNIS Map/Lot 270-298 Zoning District: RB Sheathing: Owner on Record: SANDERS,ALVIN B&KRISTIN R � 5 r� Contractor Name: CAPE COD INSULATION, INC Framing: 1 52 , Contractor Licensei 153567 Address: 114 SUDBURY LANE 2 HYANNIS, MA 02601 Es"t_ Project Cost: $4,900.00 Chimney: Description: 60 sq R-30 FGB for damming R-38 Cellulose to 516SgAtticFloor 2" Permit Fee: $85.00 T-Max to 1276 Sq Perimete; R-19 to 136 Sills"A,'oursJAit Sealing. Insulation: Fee Paid:. $85.00 Project Review Req: Dalt P1.1 2/12/2018 Final: Plumbing/Gas Rough Plumbing: =' Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within sixumonths,after=-issuance. All work authorized by this permit shall conform to the approved application and theapproved construction documeri �wh�icFiAts permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structurrees shall be in compliance with the local zornngkby la s and codes. This permit shall be displayed in a location clearly visible from access street or"road and shall be maintained open for public inspection for the entire duration of the Final Gas:. work until the completion of the same. m Electrical The Certificate of Occupancy will not be issued until all,applicable signatures by the�Bwlding and Fire OtfFicials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: t Service: 1.Foundation or Footing A Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final' 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). r Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # / Health Division Date Issued Conservation Division Application Fe Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address Village �6mnh VOOwner Address Telephone Permit Request Square feet: 1 st fl existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type_ Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 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 St//t®//VG Total Room Count (not including baths): existing neyv, �Rr�t Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric C"`'��theJrA 2 �8CentraI 'r. Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Ye s ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new ze�t E Barn: ❑ existing ❑ new size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name h Telephone Number/J ✓ ��� AddressJ License# Mityqf_lp � J �91 k Home Improvement Contractor# Email Ci ' Worker's Compensation # � 907 . � CONSTRUCTION &kEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE j U ` FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER h DATE OF INSPECTION: 3 FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. HOME OWNER WEATHERIZATION WORK PERMIT:' PLEASE COMPLETE AND SIGN THIS FORM AS THE APPLICANT HOMEOWNER. I )L), I-D nd .Ls- hereby consent to and agree that weatherization work may be done by the Weatherization Program of Housing Assistance Corporation on the property located at: 4 PA- 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'l agree to the following: 1. I give permission to Housing Assistance Corporation to access 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. I have read the provisions of this agreement and give my consent. Y Home Owner(signature) Home Owner email: Date: Agent:(signature) Date: s Agency Approved Weatherization Company All Ca a Energy_ Alternative Weatherization Ca a Cod Insulation p Cape Save Cazeault Frontier Energy Solutions Lohr Home Improvement Agency Signature: Date: For Natural Gas Customers: fI'have re iv the National rid Discou Rate Applic on form from m uditor.: i stomer Initials The Commonwealth of Massachusetts Department of lnduslrialAccidents a 1 Congress Street, Suite 100 Boston, MA 02114-2017 www.mass,gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY, Applicant Information Please Print Leeibly Name (Business/OrganizadorAndividuai): Cape Cod Insulation Address: 18 Reardon Circle City/State/Zip: South Yarmouth,MA 02664 Phone#: 508-775-1214 Are you gn employer?Cbeck the appropriate boxt Type of protect(required): l;©1 am a employer with 48 employees(full and/or part-time),r 7° ❑ New construction 2;�1 am a sole proprietor or partnership and have no employees working for me In S. Remodeling any capacity.(No workers'oomp,insuanoe required,) 371 am a homeowner doing all work myself.-[No workers'comp.insurance required.)t 9, ❑ Demolition 4:[]1 am a homoowner and will be hiring contractors to conduct all work on my property,'I will 10 Building addition ensure that all contractors either have workers'compensation Insurance or are sole 11.0 Electrlcal repairs or additions proprietors with no employees. 5.1]1 am a general contractor and I have hired the sub•contractora listed on the attached sheet. 12,0 Plumbing repairs or additions Those sub-contractors have employees and have workers'comp,insurance.t 13,[]Roof repairs 6.[]We are a corporation and Its officers have exercised their right of exemption per MGL o, 14, ✓[�Other W eatherization 152,§1(4),and we have no employees. [No workers'comp, Insurance required.) 'Any applicant that cheeks box 4 1 must also fill out the section below showing their workers'oompensadon policy information. t Homeowners who submit thin 6ffidavlt indicating they an doing all work and then hire outside contractors must submit a new affidavit indicating such. tContraotors that check this box must attached an additional sheet showing the name of the sub-oontraotors and state whether or not those entities have employees, If the subcontractors have employees,they must provide their workers'oomp,policy number. I am.an employer that Is providing workers'eomp ens all on Insurance for my employees, Below Is the policy and job site Information. Insurance Company Name: Atlantic Charter Policy#or Self-ins,Lle, #; WCE004 31902 Expiration Date, 06/30/2018 _ Job Site Address:_j City/State/Zip: �1� Attach a copy of the workers' eompens _ on policy declaration page(showing the policy num r 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$250.00 a day against the violator,A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification, I do hereby certify under the pains and penalties of perjury that the!r{lbrmation provided abov is true and correct, Si'nature,. HenryCassldy cwrnwru im vm , ' Phone#: 508.775-1214 VVV OfJlclal use only, Do not write In this area, to be completed by city or town ofj7clab City or Townt Permit/License# Issuing Authority(circle one): 1, Board of Health 2.Building Department 3, City/Town Clerk 4, Electrical Inspector%$, Plumbing Inspector 6,Other Contact Person: Phone#: ' r CAPECOD-27 KDOYLE CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDOfYYYY) 06/30/2017 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 pollcy(les)must have ADDITIONALJNSURED provisions or 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 C TACT Rogers&Gray Insurance Agency,Inc. PHONE 434 Rte 134 aC No:(877)816-2156 South Dennls,MA 02660 -MA1 .mall m ro ers ra .co INSURERS AFFORDING COVERAGE NAIC k INSURER A:Peerless Insurance Company 24198 INSURED INSURERB:Safety Insurance COMP-an 39454 Cape Cod Insulation,Inc. INSURE C:Endurance American Specialty Insurance Company 41718 18 Reardon Circle South Yarmouth,MA 02664 ws RERD:Atlantic Charter Insurance Company 44326 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 ADDL SUER TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP A LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS-MADE ❑X OCCUR EACH OCCURRENCE 1,000,000 CBP8263063 04/01/2017 04/01/2018 DAER MAGE TO RENTED 100,000 MED EXP JAny one rson 5,000 PER ONAL&ADV INJURY 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: ENERAL AGGREGATE 2,000,000 X POLICY�j�� �L06 PRODUCTS-COMP/OPAGG 2,000,000 OTHER: B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 tXEXCESS 6232707 COM 02 X SCHEDULED O4/O1I2O17 O4IO1/2018 BODILYINJURY Per arson $ AUUTOSSy/NEp X AUTOS ONLY BODILY INJURY Per accident PROPERTY AMAGE er accident $ IAR X OCCUR EACH OCCURRENCE 2,000,000 CLAIMS-MADE EXC10006636002 04/01/2017 04/01/2018AGGRE ATE 2,000,000 ETENTION$ D WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY - ANY PROPRIETORIPARTNER/EXECUTIVE YIN R/O WCE00431902 06/30/2017 06/30/2018 OFFICERIMEMBER EXCLUDED? a N/A E.L.EACH ACCIDENT 1,000,000 (Mandatory n ) If yes,describe under E.L.DISEASE-EA EMPLOYEE 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1 11000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached If more space Is required) Workers Compensation Includes Officers or Proprietors, Additional Insured status is provided under the General Liability+and Auto Liability when required by written contract or agreement with the Certificate Holder, CERTIFICATE H LDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED REPRESENTATIVE ACORD 25 f2016/031 n4CRA-9n4r a non rnDDnDATln\I An i. Commonwealth of Massachusetts Division of Professional Licensure Board of Building Re`Vulations and Standards Cons�r,�Ctf�ri �rvisor fir. - CS-100988 f Ires; 11/11/201.9 r , y+ }1+ A HENRY E CASSIDY',` 8 SHED ROW WEST YARMOGTI M� Commissioner / a , a 'S Office of Consumer Affairs and Business Regulation 10 Park Plaza • Suite 5170 Boston, Magg"nusetts 02116 Home Improveme:n:f �C.o.. tractor Registration ' ; Type: Corporation Registration' 153567 Cape Cod Insulation Inc Expiration' 12 1 18 Reard on Circla 14/2018 So, Yarmouth, MA 02664 �' c :CAJ +i 20M•06I11 P -• �' U date Address and return card, Mark reason for change, • _____�e�poa�intarz[uor��C/o�C�/��r[od� ..,...._._. ..._�.- ---.......:..;.._....._.(�..���:::Ft•�^..C�_ll.xu+.lr:s!.f�!G�t;plo:ym•orf LVl_,1.�.5±.^,a.l'�.+..... . . <OI G[�BCCm • Office of Consumer Affelrs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only Type: Corporation before the expiration date, If foun urn to: e.glstratlon laxplratlan Office of Consumer Affairs and sl ss Reg ulation 10 Perk Plaza "hout ' 11:• 56 ! 12/14/2018 Boston,MA 1 Cape Cod Insui'tfM 9 Henry Cassidy't�i.. '; 18 Reardon Clrci$''�,..� � ;' So,Yarmouth,MA ,QBq;i. ' C� ����i''f� , Undersecretary t . .r u T TOWN OF BARNSTABLE t Permit No. -------2�9a9----------- w _ t Building Inspector swr. Cash -- -- - MUM OCCUPANCY PERMIT Bond ________X t �( Issued to C6LfJticoAn Reatty TvLO- Address ;dot #35 114 Sudbwcy Lane, Wyanni,6 Wiring Inspector �, f „/ Inspection date Plumbing InspectoriL . ._.. Inspection date Gas Inspector -� � Inspection date 1a1 a r .y+?4�=+ Engineering Department .i '' .,.�. Inspection date `Board of Health }��Y J-- Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTORAUPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE B'UUI'L'DING CODE. f -� _....__ ..................................................:................... ................._.............._...._ Building Inspector .FROM. .. ' OWN OF BARN STABLE BUILDING DEPARTMENT 367 MAIN STREET 1 YANNIS,, MA Mr. Francis Laheine ..� , • 4,, s Town Ciekk wir. Phone: 776-112 SUBJECT: g FOLD HERE DATE 11AE:S-SAGE Work -has been comgletecPeer (Capri,cQrn 4c�a1 Y. Trust) . '—Please reloas:� `rjcj. SIGNED bw iL DATE f ` REPLY. . - - r7ED . ., N87-RMI _ - - _ ,RECIPIENT;.RE7gtN WHITE COPY,.RmJRN PINK COPY .PRINTED IN'U.S.A. r SENDER: SNAP OUT YELLOW COPY ONLY.SEND WHITE AND PINK COPIES WITH CARBON INTACT. Assessor's map and lot number ............:..... . O.. 4rQyOf 7N E Sewage Permit number t Z BA"STADLE, i House number - NAM 'p y p i639. j •Fp MPS Or• TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...............Construct Single Family Dwelling TYPE OF CONSTRUCTION ............Wood Frame ............................................................................................................... October..31 1................19..8:'. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .LOt... ......35 - Sudbur Lane Hyannis, MA ...............................Y...............r........ ............................................. ................................... ProposedUse ............................................................................................................................................................................. Zoning District ......R...tB............................................................Fire District .....Hyannis, 1 A Name of Owner Capricorn Realty Tx'ust Address 765 Falmouth Road, Hyannis, MA .................................... ........... ........................ .......... .. . . Name of Builder Franco Real Estate Dev, COAddress 2§5 Falmouth Road, Hyannis, I;A ... Inc. ...... .... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ........SiX..................................................Foundation ........P..C............................................................. Exierior Clapboard and/or shingles Roofing Asphalt. shinglee ......................................................... ...................................:................................................ Floors Caet Sheetrocl�................................................. ........rp.......................................................................Interior ................................... Heating Gas — F.W.A.—- `n' 40 — Copper .................................................................................Plumbing ............................::..............:..................................... FireplaceNoRe..................................................................... Cost ............$. .0.,.O.GO. OU........................ ...... .. . .. .. . .. .... .. .... . Definitive Plan Approved by Planning Board ________________________________19________. Area .....i056........s.I c�q ....ft....................� Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding e above construction. 4 Name //� /% a ::: z ! -�I.i.es 00U9P"' .............Construction Supervisor's License ....................... CAPRICORN REALTY TRUST C A=270-229 No ..2.5949 Permit for On.e...Story .................... ..... .. .. ....... .. Single Family Dwelling ............................................................................... Location ....LQ.t... ...................Hy aulds......................................... Owner ....... Type of Construction ................Frame.......................... ................................................................................ Plot ............................ Lot ................................ Permit Granted ...Zarluzxy...5.............19 84 Date of Inspection ............. . ................19 Date Completed ......................................19 2- 76 JOAssessor's map and lot number ....Q20-7�:a a W MUST CONIIECT TO TOWN SEWER FT � t t Sewage Permit num er ..... . r Z BAUSTADLE, i House number ':..1../..........a.......................... PY, 0 Yp\0� TOWN OF BA'RNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ............Const.ruc. ... t Si. ngle. ....Fam. .ily. ...Dwel. . li.ng. ..................................... .. .. ....... .... .... .. .... .. .. .... ....... .. .. TYPE OF.CONSTRUCTION ...........:Wood Frame ............................................................................................ October..31..................19..83. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .Lot.. ......35 - Sudbur Lane ........................................ Hxannis, MA ...............Y.............�............ ................................. ProposedUse ...................................................................................................................................:......................................... Zoning District .....R....B.. ....................Fire District .....Hxannis, 1"iA .................................... .............................................................. Name of Owner ,Capricorn Realty Trust ,••Address 765..Falmouth Road, Hyannis YiiA Name of Builder Franco Real Estate Dev. CoAddress 27 5 Falmouth Road, Hyannis, MA .Inc. ........................................ Nameof Architect ..................................................................Address ............................................................:....................... Number of Rooms .......Six..................................................Foundation ........P.C.^............................................:............... Exierior Clapboard and/or shingles ,..Roofing ..•Asphalt shingles .................................... .. FloorsCarpet Sheetrock.................................................................................................................................Interior ................................... j Heating Gas — F.W.A...... ...........................Plumbing ......Two...— Co ............................................ .....................F...........:................... ..... Fireplace ...None. . pp $40,000.00 .... .. .......................................................................A Approximate. Cost ...................... S...............Vt..........D... Definitive Plan Approved by Planning Board ________________________________19_______. Area ... ....I.... • Sa Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH • OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. 07111*, Name ��1. ......Pres . 000989 Construction Supervisor's License .................................... CAPR.I�CORN REALTY TRUST 0 2 5 9 4 9... Permit for .4>« ...5A. y........... - .............. M cv Location .....I Q.k...15.....1.14...S.udbur.y...Lane c-� ....... Ya17U11.S................... ................. ram. Capricorn Realty Trust Owner .................................................................:' ` Type-of. Construction Frame • .......................................... 1 .................................................................... i Plot ..................... Lot ............-................... Permit Granted ......J.anuarY...5.i........19 84= a Date of Inspection 19 Date Completed !�-� °�! ........19 • 1 P Y. t '` ' ,ML ,� .«.•.1 � ,ram - '1`4 r` Y - � .��p ��1 r � :a� .1�"'�•r"'""".'.�," _ � '6 ?_;� ' �^,4'�.��"'t�'J: 1r ��fgYr�°��"f .,�. 114 Al r�� �` � _ h is .5,yw,✓' d� {{ - !1 �g � f ��:� � ,; i 7 � LL axy 1�.1, '"^ PY �..�� � k'� e' •Y J �+ a r� � � •? �j z i.7' JF e� I :"yf'F' z ,.t.'•x* m d. c? + i ,t� �' F '. '�: r r j- c,2-' �. � i� ��•' �\`ar.� .rye'• t . �. �.%'� y y y�, , 411 CERTIFIED PLOT' PyLAN01 ` .A• Ui411 ROB-RT rc� NEVU CONSTRUCTION ''OPILY 1 EVucF s TOP OF FOUNDATION IS_____ FELT R FcG IN ABOVE L0W. POINT OF. ADJACENT A h "tASI IJ A$$ PtOAq .. /�» 1 e.�•') 1 ( f •-� SCALE /' DATE •r re A K� kr !' �'E 1 C . I CERTIFY THAT THE CLIENT,.....,,..,.__ SHOWN ON THIS PLAN 18 LOCATED ` EOISTEREO RECISTERE® JQB NOf / y ON THE GROUND AS INDICATED AND CIVIL LAND , CONFORMS TO THE ZONING LAWS ENGINEER $URVEYOR I .BYE ....:.�.:;,,,.,,,..� OF BARNSTABLE NIAS 7 12 MAIN S T R E.E.T CIL I�Y� ` ,:.,, i •� HYANt�tS ..MASS. / ' - ° � ' 1 $MEET—OF D TE REG. LAND SURVEY011IR +Y•�,>,.... ..... _,.....::e•rw.-.�w�.. -,wt-,qr+w-.wwP�.. �wx5wrrq�°`,'"'°"+�"t ,.r. rr.,,as. a.� e+y�1«a, •.L ",�,.` ",°,-,r '.." ,�� 't�*Y,..-,-��t\,., w"' ,n--e..e�ry'r'+,�,�.-!^„v�•.Syk....�s-"•tis"'r"sP�'"4-.s�� �``+'oT` VY�'"b'�''�'',''� t7`"-,« .,..-r�«»Ya�....^'^'"�.4,"'",r;�F�ijir ,�,��e;,ti�,n,w.."...-;,y..r.^•.'fti,.� ',*^'a- Assessor's office(Ist,Floor):. Assessor's map and'lot number ward of Health (3rd floor): d� w Jage Permit number ' �'�'�` t DAHd9TADLL i Engineering.Department(3rd floor) 6 rrua House number /`� �C %C•�C� 0, 1639. Definitive Plan Approved by-Planning Board 19 ' o r�Y s APPLICATIONS PROCESSED 8:30-9:30 A.M.'and 1:00-2:00 P.M.only .' TOWN . OF . BARNSTABLED BUILDING . INSPECTOR It\TI R PER t TO ' C'C' Q/V 1i�. �x !3'��/Ol,p TYPE OF CONSTRUCTION VV 6 0 OP. 19 TO THE INSPECTOR OF BUILDINGS: The undersigned/hereby applies for a permit according to the following information: Location�f H �!�J RW,, AJ49, Proposed Use St^AC"P ti e'sl/ �(11/t C 17 c Zoning District ' Fire District Name of Owner VL 454 / Address Name of Buildera/ . h6ve,�- k /0- Address QU i F Name of Architect )p `y Address ,. Number of Rooms Foundafion �pB N e~ Exterior �� Roofing j4 S 17 Al / Floors (��O o L� Interior y.Q/ / i Heating } 1 A)A Plumbing' r Fireplace �a' N e+- Approximate Cost �, d®�'/ I J Area Diagram of Lot and Building with Dimensions Fee 0, a f . k . . p . OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS r J I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regar §ng the above construction. Nam Construction Supervc r s License Q FMAGLIOSSI, A. MR. .& MRS.__ A=270-298 70--02 No 34582 Permit For SCREEN IN DECK Single Family Dwelling Location 114 Sudbury Lane _ j Hyannis Owner Mr. & Mrs. A. Magliossi r Type of Construction Frame f — • 2 n Plot Lot r Permit Granted September 20, 19 91 Date of Inspection 19 Date Completed 19 - F r UNIT com 710 r`- ' *� ,�, - - �.' -. ., - `. 1 ` .. 4 ' � .� t \f i � � • SEP Assessor's office(1st Floor): ` — ,ro '�SY�IC Sl(STEM MUST BE f TNf Assessor's map and;tot number PN B ,of Health (3rd floor): d 1 S ge:Permit number ��—q/� EN —*-� U s 02lL CODE A 1Aas97LDLL Engineering Department(3rd floor): TOWN REGV boo rb s House number //y LATION )9• Definitive Plan Approved by Planning Board 19 ��MAX x APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OFµ BARNSTABLE APPROVED 134IL.DING INSPECTOR Sarnstablu, Conservation Commis �I �RP \ Aj Signed Date TYPE OF CONSTRUCTION a ap k q 19 / TO THE INSPECTOR OF BUILDINGS: The undersigned,hereby applies for a permit according to the following/information: Location f�� �S2 GY )2Q b �4P-- / lU 1�3 .- Proposed Use Jr-,he If A/ e cY Po C 1 Zoning District ...f J I Fire District Name of Owner Y !d, /6h� � 91,<3 Address 0 Name of Builder�AC bie' pv� �� cV /R Y Address � Name of Architect )o 'V `Q_ Address i Number of Rooms Foundation co/v C ,?O y Exterior s ��� Roofing S 12 / / Floors VI�O o cY Interior y /-i 1U,51 eJ r r Heating X� O Plumbing Fireplace A o' e-- Approximate Cost '/� 000 of Area Lc�7 Diagram of Lot and Building with Dimensions Fee 0� OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regard' g the above construction. Nam w III Construction Supervisor's License a' iMAGLIOSSI, A. MR. & MRS. to { No'"54582 Permit For S:CREEiN IN DECK. `x Single Dwey-11-1-na ' Location 114 Sudbury Lane Hyannis ? _ ` Owner. Mr & Mrs. A Magliossi Type of Construction Frame Plot �'' Lot 7 Permit Granted September 20,19 91 1, f ` . Date of Inspection 19 - c Date Completed 19 cc - l i � r Tows of � Barnstable Permit# Regurlatory Services L'•Fee s 6 nronlh fit ' rue rlale s.nRv511.13L,) 9 AAS. . , few. Thomas� F..Geiler, Director-' _ Building Division Tom Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barns table.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Nol Va/id rvilhoul Red:1-Press Imprint Map/parcel Number Property Address //�� U 1) CU'o �j` C A iA Residential Value of Work X15-- sa Minimum fee of$35.00 for work under$6000.00 Owner's Name & AddressV-\kA, 04N y {1Ke� y� S'Tr rn s 6L i Contractor's Narne Se <(: ' Telephone Number 7: �CJ �_ I-Iome Improvement Contractor License#(if applicable)- Construction Supervisor's License#'(if applicable) Workman's Compensation Insurance � " �, ` Check one: ❑ I am a sole proprietor - 0 U, 2.0ILI I am the Homeowner I have Worker's Compensation Insurance TOWN OF BA NSTABLE Insurance Company Name ' 1 1I=� 1N` k Cj tAt Workman's Comp. Policy#40 e e r6 o 2 17 9 6 1 2 (2) to Copy of Insurance Compliance Certificate must accompany e eh permit. 'Permit Request (check box) Re-roof(h-ur ricIne naifed).(st,hpping old shingles).'All construction debris will'be taken to ❑ Re-roof(hurricane nailed) (not stripping: Going over existing layers of roof) [] Re-side #,,of doors Replacement Windows/doors/sliders U V.alue (maximu'm .35) fl of windows *Where required: Issuance of this permit does not exempt compliance with other town depardnentjegulations, 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:A"_64�_ Q:1WPf ILESIPORMSIbuilding permit fonnslEXPRESS.doc Revised 072110. The Conunorrwealth.of-Massachuselts ._......_..__...._._.-- Departinertl of lidits1rial Acriilertts Office of Investigations 600 Washhiglori Stieel __ft Bostozi, A14 02111 }b'S!'w was:S govIdia 'Workers' Compensation hasurance Affida,,it: Builders/Contra-rctoi•sJElectiici ns/Pl:ianbers Applicant Information e, hint LegiblN, Name (Business/Orgm zo6onUdiv dual)if t -- J�)eZe O per!jG-W TC 'R �• J CG '*'J e `�S City/State/Zip: Phone#_ Are tau an employer?Check the appropriate boa.: [00.p project(required): 1_ I am a employer with `. ❑ I am a general contractor and I ((( employees(fu11 and/or part-time).* have hired the sub-contractorsear construction 2..❑ I ant a sole proprietor or partner- listed on the attached sheet. modeling ship.and have no employees These sub-contractors have emolition working :for me in.any capacity- employees and have workers' ildin addition g [No workers' comp.irtstlrance comp-insurance,, � . required_] 5• ❑ C 'e are a corporation and its ectrical repairs ora.dditians 3.❑ I am a.homeouuer doing.all work tafcers have exercised tlitr Qibing repairs ar additions myself. [No workers'comp- right of t xemption per MGL af rep<9irs ins-urancerequired.] c. 152, 1( ),and eve have a-oemployees.[No workers' er comp-:insurance required.] *Any applicant that checks box i must also fill out the section be",sbo-wing their Tvoml ers'cotiVensa:t an policy infon=tian_ I HomeaY mers who submit this affidavit indicating they are doing 91 work and then hire outside contractors must submit.a uew affidavit indicating such ° =Con,tractors that cbeck this:box mast sttached as additional sheet showing the nsme of the sub-cmtractws and state whether or not those eatitieshave enTloyees. If the sub-c.outzactors:have employees,they must provide their workers'comp.policy number: I ant nri eutpioy et that is pray idirrg itrorkers'rar�rpet rsruYrrn irlsrrrn.rrce for rrtt'Prtrplol ees. :felow is the p.oliq and,job site inforntaliart Insurance Company Name: Policy#or Self-ins.Lic.#: W C L4 S`O U.7 I Y 61 b I O Expiration.Date: ,S. Ze/Z Job Site Addressl LK SG d d yete ,'Afi 6-- / Cit3rlState/Zip:_ &I!!�114tl rf_r kA4 Attach a copy of the workers'compensation policy declaration page(slio►idng the policy number and expiration date). Failure to secure coverage as required under Section 2.5A 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 st<•t.temetlt may be forwarded to the Office of Investigations of the D.IA for insurance coverage verification. I tlo Itleff"e.by certi ,ruder the pants aiid par.ldhies of` rjury that#ate irtforttiatiolt protrirlad a.boire is tare acid correct Jed Si tore: Date: /� — Phone#: ra9 G O -rial rise only. Do not.write h this area,to.be eonipleted by city or town official City or Toivn: Permit/License Issuing Authority(circle one): . Ll..Bolard of Health 2.Building Department 3. C,ityoiyn Cler>ti #,Electrical Inspector sue:Pluinbilr,gInspector erct Person: Phone#c - 6 of THE rp� + BARNSTAHLE, % MASS. ToWn of Barnstable� 363as9• ,e ' pIFD MA't A Regulatory Services Thomas F. Geiler, Director Building Division Thomas Perry, CBO Building Commissioner 200 Main Street, Hyannis, MA 02601 3 www.town.barnstable.ma.us Office: 508-862-403.8 F Fax: 508-790-6230 Property Owner Must Complete and SignThis Section If Using :A, Builder I, 1 4 , 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: _ :(Add ss of Job) 0 1d Signature Owner Date Print Name r If Property Owner is applying for permit, please compl4ete"the Homeowners License:Exemption Form on the reverse side. QAWPFILESIFORMSIbuilding permit forms TXPRESS.doC Revised 072110 r P�0(HE T°�1� Town of Barnstable ' Regulatory Services 13LAESTABLE, tnss. Thomas F. Geiler, Director y $ cb''ra 19. Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02661 www.town.ba rnsta b le.ma.us Office: 548-862-4038 Fax: 508-790-6230 ----------------------- HOMEOWNER LICENSE EXEMPTION Please Print DATE:UC 40b{lr I 2 1 y JOB LOCATION: i I'-/ -Vo a 1�vE y I•ws'V\ e- Ny MA,;y number street village I�Y1\nP S'TeJ et,i "HOMEOWNER"0,V-ko ny VAA0 0 y 22I name home phone# work phone# CURRENT MAILNG ADDRESS: �' kph V\A e A. o i 1�,o 3 city/t n state zip code The 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. DEFINITION OF HOMEOWNER Person(s) 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 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 minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. " Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section.127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code stales 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 person(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 homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as pan 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 form currently used by several towns. You may caret amend and adopt such a form/cenitication for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 072110 Massachusetts- Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License License: CS 65898 ' Restricted to: 00 �` _ t, SCOTT S SHIELDS .. 72 BRIAR PATCH RDA OSTERVILLE, MA 026551 ` Expiration: 7/10/2011 4t6t2 {'omnus§iurier _ Tr#• 1944 License or registration valid for individul use only ani�a�uaea�a� a � Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation Registration:; 148601 10 Park Plaza-Suite 5170 Expira6on10/1112011 Tr# 289503 �,... Boston,MA 021,16 Type,; IndN$tlual SCOTT S SHIELDS t� SCOTT SHIELDS y 72 BRIAR PATCFitR tee° o OSTERVILLE,MA 0265 Undersecretary No valid ithout signature Client#: 15130 2TRISDE ;ACORU. CERTIFICATE OF LIABILITY INSURANCE 1DATE(MM/DD1YYYY) 0/18/2010 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dowling 8r O'Neil Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Agency HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 973 lyannough Rd., PO Box 1990 Hyannis, MA 02601 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: A.I.M. TRI-S Development Corp. INSURER B: 72 Briar Patch Road _ Osterville, MA 02655 INSURER C: INSURER D: INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INS D POLICY EFFECTIVE POLICY EXPIRATION LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM DD/YY DATE MMIDD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ CLAIMS MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PRO-- LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ T_WCA WORKERS COMPENSATION AND WCC5007148012010 05/01/10 05/01/11 X OR LIMIT ER EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $500 OOO OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $500,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION 10 Days for Non-Payment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of Barnstable DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL �3n DAYS WRITTEN 200 Main Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Hyannis, MA 02601 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001/08)1 of 3 #S73825/M73824 MD O ACORD CORPORATION 1988