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0146 WOODLAND AVENUE
l4lo Lvooc�l�ncl �vP, -- — - �, _ _ - - f _ y M orSl o� o Zoe D. . 1Z.C . v� ti ;. s'000 sr , 8 �O 3C� - l oo` G Z 0 3E T(ACK i N0 W 2 .r'O� � l Lor 54� x r L oT 5 2 0 sa +'aa CERTIFIED PLOT . PLAN NEW, CONSTRUCTION ONLY Lorsz W008LA,� �j E /,l a Al1E � %R i�n/i S TOP OV.FOUNDATION IS N A- FEET: IN y:ADQVE LOW . POINT OF ADJACENT , .QB TA 4,UAS$ . SCALE, /" 4O' DATE 6 2-2- PIE E GII EE' INGI C . " ' 1 CERTIFY THAT THE CLIENT � � SHOWN ON THIS PLAN IS LOCATED ENC TERED REGISTERED .408 No' '"5 ON THE GROUND AS. INDICATED AND LAN1D C0KFORMS TO THE ZONING LAWS NEER SURVEYOR Ways ...��� OIr ®ARNSTABLE, MA 712.°,MAIN S T.R E.ET CM.DYi .. �z SS. H YA N R I S, MASS.- SHEET,.L OF .:J_,,; ATE REG. LAND SURVEYOR �3 Cape Save Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 11/25/17 Off, ✓0 A. Town of Barnstable 6,y. Thomas Perry CBO tiry� Building Commissioner 200 Main St. Hyannis,MA 02601 RE: Building Permit B-17-3708 TO: Building Inspector(s), This affidavit is to certify that all work completed for 146 Woodland Avenue,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 11/25/2017 09:02 5087785731 CAPE COD INSULATION PAGE 01 sA T 1 UO 11/25/2017 09:02 5087785731 CAPE COD INSULATION PAGE 02 HOME OWN EATHE I WORK PERMIT: PLEASE COMPLETE AND SIGN THIS FORM AS THE APPLICANT HOMEOWNER. l c (! hereby consent to and agree that weatherization work :. may be done by the Weatherization Program of Housing Assistance Corporation on the property located at: ; The weatherization work done will be based on programmatic priorities and availability of funding and it may include all or some of the following measures: Weather stripping; air-sealing; attic & basement insulation; mderlor wall insulation;ventilation measures In consideration of the weatherization work to be done at my home I agree to the following: t. I give permission to Housing Assistance Corporation'to access the property with such I equipment and materials as may be necessary to perform weatherization. i 2. The Housing Assl a Corporation reserves the right to inspect the fuel or utility bill for I the weatherize urIt o an ongoing basis for no more than five (5) years after the weatherizatio work is mpleted. . I have read the provis ons of thi agreement and give y con nt, I Home Owner(sionaa,ra) Q`M f � Home Owner email: Date; '- r I Agent:(signature) � Date: . v - k For Natural.Gas Customers: I.have received Natlonal.Grid Discount Rate Application form from my auditor, Customer Initials- Adam T Inc Cape Save All Cape Energy. Frontier Energy Solutions, Aftemative,Weatherization Lohr Home Improvement f3 ' Construction Tupper Construction a Cape Cod Insulation _ Sa a Town of Barnstable r� p E.ipires 6 rr_rorulrs from issue dote �l Regulatory Services Fee HASS9 3;9. � Richard V.Scali,Director $prFD iNA'�� Tom Perry,CBO, Building Commissioner ® � 200 Main Street,Hyannis, MA 02601 98 www_town.bamstable_ma_us ral �6 Office: 508-862-4038 � -7 0-6230 EXPRESS PERINUT APPLICATION - RESIDENTIAL ONL �f/6` Not valid without Red X-Press Imprint itifap/parcel Number Z 70 Property Address Al o �Al d l!/l GY —4ye n Q/Residential Value of Work$ /Q- q&2. Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address / Aga / S Cl r O r1 1 Wt1UQ (Qi`d ✓ (—IGJ/1/1r S LOnL6no Contractor's Name -, E ndv,J ' F�/I ( //rsp/( Telephone Number Horne Improvement Contractor License#(if applicabie) L73 �j s Email: Construction Supervisor's License#(if applicable) 707 �Norkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ �m the Homeowner I have Worker's Compensation Insurance Insurance Company Name F;n ame_ n`��tjroe-1C 0— Workman's Comp.Policy# \A(C A 3 158 7 Z 9 — 2,0 Copy of Insurance Compliance Certificate must accompany each permit. 8 Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof? �/eside Replacement Windows/doors/sliders. 0-Value . Z� (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: Pro a wner must sign Property Owner Letter of Permission. A copy cAthe Home Improvement Contractors License&Construction Supervisors License is require SIGNATURE: C:\Users\Decollik\AppData\Local\Microsoft\W indowslTempomry intemet Files\Content.0utlook\2 PIn I DHR\EXPRESS.doc Revised 040215 rKi,enewalu License#36079 ` A r ` A License i73243 _ RENEWAL BY AI�iDERSEN Crcr ucinse#0634553 byAndersen. Lead rirm#1237 WINDOW aalUC[M[MT mAsJer�CmPM 26 Albion Road • Lincoln,RI02865. Phone 866.563.2235•Fax 401.633.6602 rederal Tax ID#46-0966680 Southern New England Windows,LLC d/b/a Renewal by Andersen of Southern New England vi CUSTOM WINDOW AND DOOR REMODELING AGREEMENT Buyer(s)Name: �' r Q..�.�5 k/C Due ofAareemenc� ". .— f Buyer(s)Swm Address.Gty Sum,and Zip Code I P.O.Box: 1 4 oe I N Y-24l_ S p, /y�9 �S E•MaBAddeess: /7�T. fJ ["/� L�Vk.CDH),dmeTetephoneNumber: 0 & ,7WorkTelephoneNumber: 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 on the front and the reverse of this agreement and on the attached specification sheet(s)(collectively,this'Agreement"). 0 Historic O Condo ❑ HOA? Total job Amount =2 Estimated Starting Date: Method of Payment: ❑Check O Cash Financed Deposit Received(33%):Jlh9-0 S---lU LAJ Credit Cards are accepted for deposit only-maximum 1/3 of the Balance at Start of job(33%):'—_ Estim ed Completion Date: project cost(Please see Credit Cord Payment Form.)By signing this Agreement you acknowledge that the Balance at Start of job and the Balance on Substantial t' A-5 Balance on Substantial Completion of Job cannot be made by credit Completion of Job(33%): -441M" card and must be made by personal check,bank check,or cash. Buyer(s)agrees and understands that this Agreement constitutes the entire understanding between the parties,and that there are no verbal understandings changing any of the terms of this Agreement. Buyer(s) 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.DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. (Rhode Island Sales Only)Notice to Buyer:(1)Do not sign this Agreement if any of the spaces intended for the agreed terms to the extent of then available information are left blank.(2)You are entitled to a copy of this Agreement at the time you sign it.(3)You may at any time pay off the full unpaid balance due under this Agreement,and in so doing you may be entitled to receive a partial rebate of the finance and insurance charges.(4)The seller has no right to unlawfully enter your premises or commit any breach of the peace to repossess goods purchased under this Agreement.(5)You may cancel this Agreement if it has not been signed Y at the main office or a branch office of the seller, � ,provided you notify the seller at his or her main ' office or branch office shown in the Agreement by registered or certified mail,which shall be posted not later than midnight of the third cal r the da ender day after e y on which the buye the Agreement,excluding Sunday and any holiday on which t regular mail deliveries are not made.Seethe accompaa g no ice of cancellation form for ,an ex 1 p anatioa of buyer's rights. Buyer(s)received the consumer education materials provided by a Rhod Island Contracto gistration Board. (Brryer's lnilia[s) Renewal Andersen of S uthern New England B er(s) r ' uyer(s) By: �1JlIjJ' Signature of P,rr ct Manager Signature ,•�� �--�2�9Z,Y�,� Signature Name i Pnnt Ne of Product Manager Print Name a YOU, THE BUYER(S), MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO Print OFT MIDNGGHT ' HE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION.SEE THE ATTACHED NOTICE OF CANCELLATION FORMS FOR AN EXPLANATION OF THIS RIGHT. ?`- - - - - - - - - - - - - - --- - - - - - - - - - - - - - - - - - NOTICE OF CANCELLATION g`- - - - - - _ PIOTICE OF CAN ELLe-snw, Date of Transaction I i--)j- ?.You may cancel I Date of Transaction this transaction,without any penalty or obligation,within I this transaction,without any anal You may three business days from the above date.N you cancel,any three business days from the above date.If Y cancel ty to obligation,within property traded in,any payments made by you under the I property traded in,any payments made b You cancel,any Contract or Sale,and any negotiable instrument executed I Contract or Sale,and any negotiable instrument executed by you will be returned within ten business days followingb Y You under the receipt by the Seller of your cancellation note,and an receipt by theShereof your canced within ten patonss d g security interest arising out of the transaction will be security interest arising out of ac following i g the notice,and an canceled.If you cancel,you must make available to the Seller canceled.If you cancel,you must make transaction will be at your residence,in substantially as good condition as when I at your residence,in sustantially as available to the Seller received,any goods delivered to you under this Contract or I received,any goods delivered to you condition as when Sale;or you may,if you wish,comply with the instructions of I Sale;or you may,if you wish comply under this Conte the Seller resardingt the return ihipi ent of the goods-at the ;=the Seller regau ding`the return shl'Y with the' ►cacti nt or xpanse and risk It you do make the Hoods available x Seller's expense and risk If you doom en 1^good s of s�M }e�11e*and the Seller does not pick them1 t of the f a enty'da�rs of the date of cancellatio ,you retxi�ho� I to a Sel. and the Seller does a the goods av at the f fairy, the goods without any further obligation.If ou I twenty da s of the date of cancel) t Ptclt them allable eke the goods available to the Seller,or if you agree I faidisl to makeose 0 r thhe e nods with any forth'yOy may retain to mar^ Hoods to the Seller and fail to do so,then you goods available -main liable for Y 1 to return the er obli �^or Co^dactTo performance of all obligations under the remain liable for ds and o IfOU ca[tcel this transaction,mail or deliver a signed I g performance)of thef$Seller,dpo if, u agree and dated copy of this cancellation notice or g Contract.To cancel this transaction written notice,or send atelegnm any other I and dated oblitO ypU Southern New En land at 26 Albion Road,ncoln,RI 02865 a^saction I 8ations and^ g by Andersen of 1 written notice of this cancellatiomail or deliver Under the NOT LATER THAN MIDNIGHT OF !) n ) i Southern New send a teleg ^ notice a signed (Date) 7 En land at 26 to Renewal b r any other I HERBY CANCELTHI5TRgNSACT1pP1. -�� (Date) TE gg Albin Ro R THgN MIDiyIGHfi^ a ,LincoA^dersen I HEREBY OF d ^'Rl 02865` wrrh st f„t,,, 1_ CANCEL THIS l+uu ►+.m. w x ___--� fiRANSgCfiION. �( RbA Copy:Whlu Buyer-@ Signa�ure Buyer Co r�r- Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-095707 Clonstruction Supervisor BRIAN D DENNISON 7 LAMBS POND CIRCLE CHARLTON MA 0160, Y+ Expiration: Commissioner 09/08/2018 .Q �?/�'l'�J�i J' uV Office of Consumer AffairsendgAusiness Regulation 10 Park Plaza-Suite 5170 Boston,Massachusetts 02116 Home Improven en_fContractor.Registration —�._ Registration: 1.73245 - I� �I Type: Supplement Card �i f- Expiration: 9/19/201B SOUTHERN NEW ENGLAND WINDQ)N_S LLy� r BRIAN DENNISON i 26 ALBION RD LINCOLN;RI 02865 I _ Update Address and return card.M reason for change.ark Scan a e0n+-0sm �v ❑Address ❑Renewal ,—I Employment ❑Lost Card V ee of Consumer Affairs&Business Aesoladon :Registration valid for individual use.only'before the OME.IMPROVEMENT CONTRACTOR expiration date.If fu®d return'to:Office of Consumer Affairs and Business Regulation Registratl �732A5_ Type. 10 Parl:Plum-Suite 5170 Expiration 9119l2078.; Supplement Card :Boston.MA Oji16 - SOUTHERN NEW ENdQ-,.Da:W.INDOWS-LLC. RENEWAL BY AN6ER50_N _ BRIAN DENNISON ' LI ALBION LINCOW,RI 02865 Q4Jbde..ecreiry Not valid without signature I , ` The Commonwealth of Massachusetts .E Department of Industrial Accidents 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 PERNIIT T1gG AUTHORITY. Applicant Information Please Print Le "biv Name (Business/Organization/Individual): e Vj L G Address: (o ALZ jpID City/State/Zip: /J Phone . :kl - 2 Are you an employer?Check the appropriate box: Type Of project(required): I.jKl am a emplover with ZO femployees(full and/or pan-time).' ?_ New construction 2.F�I am a sole proprietor or partnership and have no employees working for me ir, S. Remodeling any capacity.[No workers`comp.insurance required.] 9. El Demolition :.�I am a homeowner doing�l work myself.[No workers'comp.insurance required:] 10 Q Building addition 4.❑1 am a homeowner and will be hiring contractors to conduct all work or:my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11_Q Electrical repairs or additions proprietors with no employees. li.Q Plumbing repairs or additions 5.❑!am a genera:contactor and I have hired the sub-contactors listed or.the attached sheet. 13.E]Roof repairs These sub-contractors have employees and have worker'comp.insurancE, E.❑We are a corporation anc m officers have exercised their right or exemption.per MGL c. 14. her G.Ji�1'1 i 5L:E 1,(4):and we have ne employees.[No workers'comp.insurance required.] I l t)Or I`-p14 c-e e!•t -Any applicant that checks box r'.must also fill out the section below showing their workers compensaboe policy information. T Homeowner:who submit this affidavit indicating they are doing all work and then,hire outside contractors mast submit a net affidavit indicating such. !Contractor--that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. Lathe sub-contractors have employees:they must provide their workers'comp.policy number. I am an emplover that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: lire lnQ $ 1P.S. L-19 — r' !! — Z Policy#or Self-ins.Lic.�: �/� �8E�7 Z� Expiration Date: Job Site Address: )11(0 I�v d cl�Q nc� City/State/Zip: I it Attach a copy of the workers' compensation policy declaration page(showing the policy num er and expiration date). Failure to secure coverage as required under MGL c. 152:§25A is a criminal violation punishable by a fine up to$I,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 th ains and penalties of perjun°that the information provided above is true and correct Si attire: Date: �o Phone lu: 7— �� f Official use only. Do not write in this area,to be completed by r#:or town official Citv or Town: Permit/License P, Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City?Ta%Tj Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone g: '^ ESLERCO-01 SANDERSO 7 FDAATM IMMIDDIYYYY) ,4�oRo CERTIFICATE OF LIABILITY INSURANCE 06/07/2017 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 policy(ies)must have ADDITIONAL INSURED 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 endorsement(s). MECT PRODUCER CoBiz Insurance,Inc.-CO 303 988-0446 Fa,No):(303)988-0804 1401 Lawrence St,Ste.1200 ,E,d):( ) COMaiI cobizinsurance.com Denver,CO 80202 SS: INSURER S AFFORDING COVERAGE NA1C> RA:Acadia Insurance Com an 3132INSURED 84 ER B:Firemens Insurance Com an of WA D.G. Z I I Southern New England Windows,LLC.dba Renewal by ER c:Libe Su lus Insurance 10725 Andersen of Southern New England26 Albion Road,Suite 1 ER DLincoln,RI 02865 ER EER F REVISION NUMBER: COVERAGES CERTIFICATE 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 ADDL SUBR POLICY NUMBER POU D EFF IP�p EXP LIMITS L TYPE OF INSURANCE IN D WVD 1,000,000 A X COMMERCIAL GENERAL LIABILITY tPREMI H OCCURRENCE 5 AGE�--- PERSONAL S 300,000I CLAIMS-MADE aX OCCUR CPA3158728 M10112017 01/01/2018 Ee5,0001 EXFn&ADV INJURY S GENERAL AGGREGATE s 2,000,U00I I G N'L AGGREGATE LIMIT APPLIES PER: 206,0W X i POLICY❑jECOT LOC I PRODUCTS-COMP/OP AGG 'S EBL AGGREGATE 5 2,p0U;000 I OTHER COMBINED SINGLE LIMIT S 1,p00,ODO1 A AUTOMOBILE LIABILITY (Ea L amdem CPA3158728 0110112017 01/01/2018 BODILY INJUR Y Per on X- ANY AUTO S ' ~-OWNED SCHEDULED BODILY INJURY Per accident s AUTOS ONLYF:J AUTOS PROPERTY DAMAGE S I I HIRED NON-OWNED (peramtlent r.J AUTOS ONLY AUTOS ONLY S 1,000,000 A X UMBRELLA 1AB X OCCUR EA 5 - CH OCCURRENCE � CPA3158728 - 01/0112017 01/01/2018 AGGREGATE EXCESS LA L CLAIMS-MADE 5 0 Aggregate 1, 15 1 0000 00001 DED X RETENTION S _ - I ' B WORKERS COMPENSATION X STATUTE1 ERA 1,000,000' AND EMPLOYERS'LIABILITY YIN WCA3158729-20 0110112017 01/01/2018 E.L.EA ACCIDENT ANY PROPRIETORIPARTNER/EXECUTIVE r-1 N 1 A E.L.FFICERIMEMBEREXCLUDED) �_ DISEASE-EAEMPLO I5 1,000,000 (Mandatory in NH) I 1,000,000 "Yes,describe under - E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS below 1,000,000 g Worker's Compensatio CA3158730-20 01012017 01 117 01/01/2017 01/0101/20 18 2018 1,000,000 DESCRIPTION Workers OF OPERATIONS Ion VEHICLES stat(ACORDs e pt ND,OH,Additional WV,Schedule,may be attached if more space is required) I I CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. - I AUTHORED REPRESENTATIVE IF OR IntQrmational Purp 01988-Y015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Town of BarnstableB "Id" j( eAu ,� ��� Post This Card So That it is,Visible.From the Street-Approved Plans Must be Retained on lob and this Card Must be Kept MASS. - . �0�;fj' Posted Until Final Inspection Has Been Made. . • .�o Where a Certificate`of Occupancy is Required,such Building shall Not be Occupied until a.Final Inspection has been made. - Permit 1 Permit No. B-17-3708 Applicant Name: William McCluskey Approvals Date Issued: 11/06/2017 Current Use:- . . Structure Permit Type: Building-Insulation-Residential Expiration Dater 05/06/2018 Foundation: Location: 146 WOODLAND AVENUE, HYANNIS Map/Lot: 27.0-315. Zoning District: RB Sheathing: Owner on Record: PASSERELLO,DONNA M Contractor Name: WILLIAM J MCCLUSKEY Framing: 1 Address: 146 WOODLAND AVENUE Contractor License: CSSL-102776 2 HYANNIS, MA 02601 Est. Project Cost: $3,700.00 Chimney: Description: Add R-30 fiberglass and cellulose to the attic. Add 1" rigid insulation Permit Fee: $85.00 to the basement.Air seal the attic plane and basement with Insulation: expanding foam. General weatherization. Fee Paid: $85.00 Date: 11/6/2017 Final: Project Review Req: 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 six months after issuance. Rough Gas: 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 structures shall be in compliance with the local zoning by-laws and codes. Final Gas: 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 work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: Rough: 1.Foundation or Footing 2.Sheathing Inspection Final: 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 Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Health 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. 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 0NL,1P#J : EM�+L S Ems" ■"`J,M�11;24/2017 09:26 5087785731 CAPE COD INSULATION . . PAGE 01 ZZ 33, 00 rn L 11,g24/2017 09:26 5087785731 CAPE COD INSULATION PAGE 02 Homg-o XNEBWEATHERIZATION WORK-PERMIT: PLEASE COMPLETE AND SIGN THIS FORM AS THE APPLICANT HOMEOWNER, I 61�1 t� �� hereby consent to and agree that weatherization work may be done by the Weatherization Program of Housing Assistance Corporation on the property located at: The weatherization work done will be based on programmatic priorities and availablMy of funding and it may include all or some of the following measures: Weather stripping; air sealing; attic&basement insulation;exterior wall insulation;,ventilation measures In consideration of the weatherization work to be done at my home I agree to the following: 1: 1 give permission to Housing Assistance Corporation to access the property with such equipment and materials as may be necessary to perform weatherization. 2. -The Housing Ass i a Corporation reserves the right to inspect the fuel or utility bill for the weatheriz unit o an ongoing basis for no more than five (5)years after the weatherizatio work is ompleted. I have read the provi ons of this agreement and give y con nt. V { Home Owner(signature) C Home Owner small: Date: j Agent:(sira) A Date: .• For Natural Gas Customers; I have received thmNational Grid Discount Rate Application form from my auditor. Customer Initials -�24/2017 09:26 5087785731 CAPE COD INSULATION PAGE 03 Housing Assistance Corporation Cape Card-• IMPORTANT NOTICE Weatherization contractors must pule a building permit from your town prior to installing any and all weatherization measures ordered by the Housing ,Assistance Corporation energy auditors- ; In order for a town to issue a permit, taxes must be current according to the town records. Your signature below indicates that.your taxes are up to date. If not, HAC will put your weatherization work on hold until you'notify HAC'that your taxes are up to date. I owledge that my taxes are current. Owner's Signature Date live learn worth grow 460 West MAIn St. Hyannis, MA 02601 hacghaconcapecod.org 308-771-5400 fax: 508-77 -7 34 Town of Barnstable r 3 1 e:Retamed.on Job.an'd`this Card Must,be.:K60t . Post;Fhis,CardSpThatit,is.Visrbje:From..h,p.$treet ,.A pprov-ed,Pans,Mustb p 111, v M"sa 0€" Posted Uritil.F�nal jnspection-Has.Been Made. .•r %.{ -. Where a C aFall pection has.benmade.uire >swfi O ',..is-,,Re innert d c " Permit No.' B-17 349-2 ;., Applicant Name. HENRY E CASSIDY Approvals __.. Date Issued: 10/17/2017 Current Use. Structure Permit Type: Buildin Insulation-Residential Expiration Date: 04/17/2018 Foundation. Yp g':.. . .. .. Location: 146 WOODLAND AVENUE, HYANNIS Map/Lot: 270-315 Zoning District: RB Sheathing: . Owner on Record: PASSERELLO, DONNA M Contractor Name: CAPE COD INSULATION, INC Framing: 1 Address: 146 WOODLAND AVENUE Contractor License: 153567 2 HYANNIS, MA 02601 Est. Project Cost: $3,500.00 Chimney: Description: INSULATION/WEATHERIZATION Permit Fee: $85.00 Insulation: Project Review Req: Fee Paid. $85.00 Date: 10/17/2017 Final: r 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 six months after issuance. Rough Gas:,.. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Final Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws 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 work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: Rough: 1.Foundation or Footing 2.Sheathing Inspection Final: 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 Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) s 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health ,. , ,Where,applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. r Work shall.not;p.roceed,until the Inspector has approved the various stages of:constru.ction - ina ,, ent ns;co r vuith u. r r d not have access.to,the uarartt- fund: as:set.f..orth�in:IVIGIe:142A :°`;_ , Fire°Departm ersg, . ......Ot.,actsng.,,., n.egrstered.-contracto.s...-q... ... g 'Y �.. ) - Building plans are to be available.on site Final All Permit Cards are the property of the APPLICANT- ISSUED RECIPIENT TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map ,�D. Parcel Application # 8 Health Division Date Issued v �7 Conservation Division Application Fe fii Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _Preservation/ Hyannis Project Street Address M4 g11,91V*1 e� Village ,// AIXI/ 1 Owner 'o .t�.c,L, ,�/�SS 2 �%//a Address .��chi t:�- CD Telephone y Permit Request �e cc Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 3 Q 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 ANo On Old King's Highway: ❑Yes No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: ❑existing ❑ new size —Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# _ Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name f'A��� ,��/ �ii�� Telephone Number Address License# ^0 Home Improvement Contractor# Worker's Compensation # 1+�C�11 b,S�3 l9a� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE `7 � 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 DATE CLOSED OUT ASSOCIATION PLAN NO. Pill The Cornrrzonwealth ofMassachumts Deparintenl ofYndustrialAcclder:is I Congress Street, Suite 100 Boston, MA 02114-2017 www.mass,gov/dla Workers, Cornpensatlon insurance Affldavlts Buliders/Contractors/Electriclans/Plumbers, TO BE PLED WITH THE PERMI'1"ri'1N0 AUTHORITY, Name (Business/Otganizador�tndlvidual); Cape Cod Insulation Ulm Print Address: 18 Reardon Circle City/Statellpt South Yormouth,MA 02604 phone #; 608-775-1214 Art you an employer?Check the appropriate boss I.�I am a employer with 48 employees(full and/or part•time),t Type of project(required); 2,❑1 un 11611 proprietor or partnership and have no employees.working for in �' El corivruotion any oepaolty,(Noworkars'oomp, Insumnoe r lred,) 8, ❑ Remodeling 3,❑I em a homeowner doing 01 work myseit'(No workers'oomp, Insurance roquircd,)t 9, ❑ Demolition 4.11 1 am a homeowner and will be hiring oontravtors to oonduot all work on my property, I will 10 ❑ Buildlag addition ensure that 01 oontraotors either have workers'compensation lnsw vws or arc sole proprielors with no employees, 11,❑ Electrical repalrs or additions S,❑I am a general oontnotor and I have hired the sub•oontraotors Ilstod on the attached sheaf, 12,❑plumbing repairs or additions R These subaontrnoton have employees and have workers'oomp,Insttranoe,t 13, 6,❑We are a oorporadon and Its ofill have exeroised tholr right orexempdon peril o, (❑�Roof repairs 152,11(4),and we havo no employees, (No workers'oomp,Insurance roqulred,) 14' 'ether Weatheriz:atlorl t applicant that submit ubmimust also oil out the scot on below showing their workers'compensation policy Information t Homeowners who eubmit�davit indlaating they are doing all work and then hire outside oontrao 1contnotort that ohok this box moat attached an addl�onal sheet showing the none of the sub-contractors ertd mate whether or not those enddes Nyeemployees, If the syb contrwWrs have em 10 ees fora must submit a new at�idevit lndloadng such mull rovide their workers'oom , Ile number, 1 am an employer'rhal is prvvlding workers' eompenratlon Insurance/or my erxpt'•oye¢s, Blow l Insurance Co s the policy and Job site mpmy Name, Atlantic Charter Polley#or Self Ins,Llo, #1 WCE004 31902 Expiration Date' 06/30/2018 Job Site Address: a,6 Attach a copy of the work�V �arpttlon policy declaration page(shownn itthe atolZip, Failure to ssoure coverage as required under MOL o, na) g p lcy number and explration date), attidlor one•year imprisonment, as well as civil penalties2n§he form of a STOP punishable by a fine up to $1,500,00 day agalnst�the violator, A copy Of�this statement may be forwarded to the OfP oa�f�y���� and a fine of up to$250,00 a coverage vodgoWon, tlgatlons of the DIA for Insurance I do Itere6y car u e pains and penaltles of penury that the irlformatton providpd above is true and cor �.+,itn, i� r,wwwwrrw, +N•w,.N , � � // , 5 •775.1 1 OfJIcla!use only, Do not write in this area, to be completed 6y city or town oyylclaG City or Towns PermIULlce nse # Issuing Authori ty (circle one)t I, Board of Health 2, Bullding Department 3, Clty/Town Clerk 4, Electrical Inspector•.,5� Plumbing In 6,Other Spector Contact Persons Phone#s_ Massaghuaells Deparlmenl of pI llo allotyy 9,oard of gulldin0 Regulallone and alandards l.Ioensel 00,100960 Oc111atr110tI0n Supervisor, I I 1 HENRY I OA1310Y;�` 8 38E0 ROW ! 1� WE91 YARMOVJ'H ' T ,1� � IIIIl1�1 ?ego, 0o missloner �xplratlonf �� 1111 S(2011 , Offlo$ of Consume-rAffairs and Business Regulatio 10 Park Playa suite s1 r0 n Boston, Mai�//' b. usetts 02116 Home Improvemer ';� ,m1 �, .ren{n.'+riv+�,+ {,�,�aotor Registration Re Istrr peg Oorporation x atloni i63887 vie ,, .1'; ;'ly;c�l!' u p ratloni So.,,Yarmouth, MA z/t a/zot s �u s / ,,aca�,c d? aoM'o6rll � ���,) Updale Add .,. ....__,,.r...�......�,.....,,,,.,,..,�,,.., teas and returnll oard l Mark r9mn for Phan 081oi of Oon�umer AJlalra & 9valnaaa R�gvlellon �����t��''"'�'ptQ��m'an►����^���' HOM81MpR0YEMENT OONYRA01'OR " �' Y;�`�'a,l, Oorporallon Raelatrellon valid forindividual use only 1',, baforl'Iha i''O;ar+re0od 1655 i�{''l,', 2Q OHloe of explratlonoona 61T0 vrm al as Ra91 plaza marANelra end a ulatlon p Insull' �, 9ooloni M 1 S Henry Oassldyy Y'��i ;;, ,, 18 Reardon Olrvl � ,�� , ('• ,��,� , S0,Yarmouth, Vnderesoretary 1 al howl9l atu A 0" CAPECOD•27 C KDOYLI Ika. � CERTIFICATE OF LIABILITY INSURANCE FDATE(MMIODIYYYY) THIS CERTIFICATE 13 ISSUED AS A MATTER OF INFOR 06/30/2017 MATION 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 ADDITIONAL INSURED provisions or be endorsed• If SUBROGATION 13 WAIVED, subject to the terms and conditions of the polic certain Policies I this Yr c es may t s certificate does not confer rights to the certificate holder In lieu of such endora'�ment s p Y require an endorsement. A statement on PRODUCER ACT MoRog ere&Gray Insurance Agency,Inc, HDNE Rte 134 A!c No Ext; FAX No: 877 816.2156 South Dennis,MA 02880 mall ro era ra .com AFFORAFFORDING NAC# INSURED fNSURffRA Peerless Inaur nce Companv 24198 afet I a 92 COMPany 39454 Cape Cod Insulation,Inc. INsugER C.Endurance American 3peclalt Insurance Company 41718 18 Reardon Circle South Yarmouth,MA 02864 lusupmuAtlantlo Charter Insurance Company 4326 INSURE INSURER I CO RAGES CER IC E NUM BE ' F THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE AODI UBR POLICY NUMBER POLICY EFF POLICY EXP A X COMMERCIAL GENERAL LIABILITY LIMITS CLAIMS-MADE a OCCUR CBP8283083 EACH CC RREN E 1,000,00C 04/01/2017 04/01/2018 DAMAGET RENTED 1�0 00C DE n Person) 5,OOC E 'LAGGR ELRIMITAP gpER; A &A N 1,000,OOC X POLICY JECT �LOC —(UNERAL AGGREGATE 21000100C OTHER: MMP P 2,000,OOC B AUTOMOBILE LIABILITY COM81Nda0l81NGLELIMIT 11000,OOC ANY AUTO gg pp 8232707 COM 02 04/0112017 04/01/2018 B I YIN RY Per arson AIURMS ONLY X AUTO$ULEO X AUTOS ONLY X n8f'o$"6Nr�L6 aR IL N R Per c i e l PeOeccR�nl AMAOE `' UMBRELLA LIAR X OCCUR X EXCESSLIAB CLAIMS-MADE EXC10008636002 04/01/2017 04/01/2018 ACH RREN E 2,000,000 DEO RETENTIONS REO 2,000,000 D WORKERS C,MPENSATIpN �— AND EMPLOYERS'LIABILITY X P R OTH• ANY PROPRIIETORRIPARTNERIEXECUTIVE R/0 WCE00431902 06/30/2017 06/30/2018KandatoryEnNqEXCLU0E07 NIA 1,000,000 It Yes describe under I E EMPLOYEE 1,000,000 DES RIPTI P A I below El L•DISEASE•P LI YUMIT 1,000,006 DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES (ACORO 101,Additional Remarks Schedule,may be attaohed If more spa 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, CE C p ---------------- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Thlelsch Engineering Inc, THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 196 Frances Avenue ACCORDANCE WITH THE POLICY PROVISIONS, Cranston,RI 02910 AUTHORIZED REPRESENTATIVE ACORD 26(2016/03) 9 CORD CORPORATION, All rights reserved, The ACORD name and logo are registered marks of ACORD HOME OWNER WEATHERIZATION WORK PERMIT: PLEASE COMPLETE AND SIGN THIS FORM AS THE APPLICANT HOMEOWNER. I i 1141 hereby consent to and agree that weatherization work may be done by the Weatherization Program of Housing Assistance Corporation on the property ' located at: L The weatherization work done will be based on programmatic priorities and availability of funding and it may include all or some of the following measures: Weather stripping; air sealing; attic& basement insulation; exterior..Wall insulation; ventilation measures In consideration of the weatherization work to be done at my home I agree to the following: 1. 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 Assi a Corporation reserves the right to inspect the fuel or utility bill for the weatherize unit o an ongoing basis for no more than five (5) years after the weatherizatio work is mpleted. I have read the provis ons of thi agreement and give y con nt. i I Home Owner(slgnature) Gam.' Home Owner email: Date: I Agent:(signature) Date: For Natural Gas Customers: r I have received# National Grid Discount Rate Application form from my auditor. Customer Initials Assessors map and lot number ...J.z®/-����� ' Sewage Permit number ........................................... ......:..... �j��//� //�� Z BA"STODLE, i House number ....................................(...(...^..:...� •1............., y MARL t639- �0 MAR p TOWN OF BARNSTABLE 4 , BUILDING INSPECTOR APPLICATION FOR PERMIT TO .......Construct Single„Fami;ly..Dwej. ng................................. TYPE OF CONSTRUCTION ................ldnad...r:ramp........................................................................................... ' t ,Tt�x?�. M................1984:.. �t .44 , TO THE INSP i OR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: I Location ........ ?.,n.i. . >r.`? .............. E?,r.............. ;T ,nx? .; .J.... 5.... ................................... ProposedUse ............................................................................................................................................................................. Zoning District ..........R..B.e...................................................Fire District ........Hyannl.s.................................................. ti Name of Ow er CPC �a?Y ..Rle.a,!.y.....'.r:?�.St...........Address ............ .6,�j 1-�''�:lmouth .Rd!.... H,,Vj T;Mis,...Mass. Name of Builder Franco Real Est.DeV. CO..,.q,I R*ddress ...............................Same Nameof Architect ..................................................................Address ....................................................:,............................. Number of Rooms . ......................................Foundation P'.c Eiierior Skl,,a;ngle,.,9...........Roofing ..............&,;P a d..t...S.k1.ingl s........................... Floors ............Carp ..............et.............................................................Interior ...............�rD.E'tY:R.ok........................................:.... 11 - Heating .......Gas...-...•F,.A..A ...........................................Plumbing .............2wo.... ..0 pFer...................................... Fireplace .......Agi...........None..............................................Approximate Cost $40 ,000.00 ....... ... . .......................... -Definitive Plan Approved by Planning Board ________________________________19________. Area .........:.........Sg.,f:t.e.,.,..•,. I' Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH h 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. { . t a Name /!,.•!1!C...... ... ?.... �sv 000989 Construction Supervisor's License CAPRICORN REALTY TRUST A=270-315 No .275$7..... N-rmit for One Story " Single Family Dwelling Location Lot, 52 f.. ,l46 Woodland Avenue,// F ................. Yarni................................................ Owner .Capricorn RealtY..Trust T Type of Construction' .-Frame ....... ........... ................................. .......................................... Plot ............................ Lot .................................. Permit Granted ... .... March 7.,. ................19 85 ............ .. . Date of Inspection 19 L. Date Completed ......................................19 • j A r ' Assessors map andICUST'ONN" ECT Number ...�:/...../.......... ttf... d��• �' �.. . ,..f•+.�.0 SIC /L,�(�., � Q�OF TH E t��I• TO,TOWN SEWER.: h o Sewage Permit- number ..........:................:............................ ,. �' ` o i ��5 A�� L House number ....:.:..........�. ...... S . rAL TOWN OF ¢= 5x BARNSTAB _ , � r ' BUILDING INSPECTOR APPLICATION FOR PERMIT TO ....: Construc,t...S„.ngle Fa ily Dwelling,,,,,,,,,,,,,,,,, -TYPE OF CONSTRUCTION ................Ko ad... "r2mp..::..:..................................................................................... Jle...26.�...............t984.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .........ho .. r,2......:...:..:..W 49a G.............. ...:....................................... ProposedUse ................................................................................. ......................................................... Zoning District ...........13.. .....:........................:. Fire District ........Hy anni S Name of Owner t..........Address .............7.6.5 11.a1mquth Rd...... Hyannis.,,,,Mass . Name of Builder Franco Real Est.Dev. Co...i..TDAddress ..........::.....:.............Same .............................................. Nameof Architect ..................................................................Address ................................................................................... Foundation P. C. Number of Rooms .......�a-.N.......:............... ................................................ ............................. Exterior ..........Roofing ...S.hindlas........................... Floors .............Ca. rd?et...........................................................Interior ...............She.e.tr:o.ck............................................. �ni iw Y _ `� o - Copper Heating .......P4Z ...-..,Y,:.c.YY.r.A.............................................Plumbing ..,........................................ Fireplace ;%4 None ,,,,,,,,,,,,,,,,,,,,,,,,,,,,Approximate. Cost $�9.,.000 .00 Definitive Plan Approved by Planning Board -----------_-------------------19________. Area ..... .•ft•,......... Diagram of,Lot and Building with.Dimensions Fee • SUBJECT TO APPROVAL OF BOARD OF .HEALTH d� OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations the Town of Barnstable regarding the above construction. Name ..... ..... Construction Supervisor's License .......000989 5 '~� RICORNL REALTY TRUST -� 275-87 No :......:... . hermit for .One Story i Single-Family Dwelling .................................................... ��- Location Lot 52, 146 Woodland Avenue Ext. - x ........ .. .. ................................................ - Ownei .....Capricorn Realty..Trust ......... 17- Type' of Construction ...Frame........................... - ..Plot....................................................................t . Lot ................................. FYI Marcia Perm ................ '" 7 ...............19 85 ,�... Date of Inspectiori Date Complet ?�r4:.... -�.......19d i— r V �k �r , �N 6 0 0 �� Vk Al U4 ir ILk �- a rl rv� ,/ ik 46 Lo r SL l { 46�.0,�'� PnQ EL� �'HAnD V LEGEND _ EXISTING SPOT ELEVATION .00 CERTIFIED PLOT PLAN EXISTING CONTOUR ---- 0 -- FINISHED SPOT ELEVATION FINISHl+O CONTOUR 0 x IN j APPROVED - BOARD OF HEALTH : o- -DATE A GENT SCALE t DikTF. LDREDGE ENGINEERING CDLN C6.ICNT I CERTIFY THAT THE PROPOSED _ EGISTEHE RE013TERE0 ° ',.' � � JOb No....._.._...,,,.. BUILDING SHOWN ON THIS PLAN CIVIL LAND CONFORMS TO THE ZONING LAWS. � ®R.�Y>i A4�: ENGINEER SURVEYOR -- �- OF BARNSTABLE , MASS. 712 MAIN STREET CH. BYE.. H Y A N N I S, MASS, � --� 4 SHEET �.OF Yfj DATE �' TOWN OF BAR,NSTABLE Permit No. s,un I Building Inspector Cash -------- --- °""�` OCCUPANCY PERMIT Bona Issued to :'��T 1 1a^n - Address r,e,;-. ? , I AF Wonc31-anri Aver! iie Est _ H�„�a*�n , Wiring Inspector �` � /�/` ,-� tiInspection date Plumbing Inspector Imo, !Inspection date Gas Inspector Inspection date Engineering Department Inspection date�•" W { g g P X En / Board of Health 't , ' _ . Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. „ 1if 19.. E �'Gfrxs` / ��. .............. .. M. .. U Buildinb Inspector TOWN OF BARNSTABLE BUILDING DEPARTMENT i sesasT st TOWN OFFICE BUILDING '� o1u�Y►�� HYANNIS, MASS. 02601 MEMO TO: Town Clerk FROM: Building Department DATE: u� An Occupancy Permit has... been issued for the building authorized by Building Permit $�.........rt /_ ...._..... .,.. ........ . . .»_....�.... issued to ...... .............. _.........._......................................... . ..........». .... ...._ ........»........... .__....:._..........�. ....»....... Please release the performance bond. " f t . ,. Ft Town of Barnstable *Permits Expires 6 months am issue date Regulatory Services Fee. 6V a ST ABLE; Thomas F. Geiler, Director + p �6 Building Division rFo rnA�°' Tom Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstab l e.ma•us Officer 508-862-4038 Fax: 5087790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint ri Map/parcel Number f Prop rty Address ` V V�i�( I Chi\ "(��: w Yin t S Residential Value of Work" 'S Minimum fee of$25.00 for work under$6000.00 Owner's Name &Address ` " 1 J ' C Contractor's Name Ce j Telephone Number Ho Improvement Contractor License# (if applicable) '� 3 — orkman's Comp ensation Insurance Check one: ®PRE M I VI am a sole proprietor amthe Homeowner SEP`1 1 2008 have Worker's Compensation Insurance C c � Insurance Company Name_ /" `. - "�t r �,- � - "=�� ��R�S�A��� e1, � L� Workman's Comp. Policy# r Q Copy of Insurance Compliance Certificate must be on file. Permit Request(check.box) . ❑ Re-roof(stripping old shingles) All constiuction debris will be taken to., - ❑Re-roof(not stripping: Going over existing layers of rood 7_Replaceme side Windows oors/sliders:U-Value_ (maximum..44) *Where required: [ssuance of thus permit does not exempt compliance with other town department regulations,i.e. Historic,Conservation,etc. 'Note: Property.Owner must sign Property Owner Letter of Permission. A copy of the Home.Improvement Contractors License is required. SIGNATURE: `� ` G+1:f\� .• l Q:\WPF[LES\FORMS\building permit forms\EXPRESS.doc The Commonwealth of Massachusetts. Department of Industrial Accidents Office of Investigations . ' a 600 Washington Street „ Boston, MA 02111 www.mass.gov/dia `Yorkers' Compensation Insurance_ Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name(Business/Organization/Individual): imL b4a e 5 Address: _ ,eS f City/State/Zip:' 1" M 033 'Phone# a ',y Are you an,employer?Check the.,appropriate box:.-..,,. 4. I am a eneral contractor acid I 'Type of project(required):3 am a employer with . ❑ g employees(full and/of part-time).* have hired the sub-contractors 6..❑New construction 2.❑ I am a sole proprietor or partner- These on the attached sheet. 7 ❑Remodeling These sub-contractors have ship:and have,no employees, 8,,❑Demolition working for me in any capacity. employees and have workers' 9: ❑Buildin addition [No workers comp comp.�•insurance) g required.] k ``` 5: ❑ We are a.corporation and its : 10,❑ Electrical repairs or additions officers have exercised.their 3 ❑ I am a homeowner doing all work 11.❑Plumbing repairs or additions myself o workers''co right of exemption per MGL Y mP : 12.❑ oof°repairs" insurance required.]t� c 152, §1(4);and we have no F = r, A 13. Other w r1 ?.: employees. [No workers comp.insurance required.] •Any applicant that checks boz#l.must alwftll out the section below shovhng"i ieir workers'compensationpolicy infomiatton.`` t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors:must.submit a new affidavit indicating such. tcontractors that.check this box must attached an additional sheet showing the name,of the subcontractors and state,whether.or not those enUnes;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 andiob site information. C' Insurance Company Name Policy#or Self ins.Lic.#. �."` Expiration Date. Job S td Address. �; l0.i .,. d l G rl Gt U��� City/State/Zip Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). k4 Failure to secure.coverage as;required under Section 25A of MGL c..152 can lead to the imposition of criminal 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 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 MA for insurance coverage verification. I do hereby certify under the pains ana~`penalties of perjury that the information provided above is true and correct < . 1 . _. Si afore: Cr^a�. ( .del Date: �/ Phone#: ! 6 q Official use only. Do not write in this area,to be completed by city or'town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person inthe service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer,or the receiver or trustee of an'individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the 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 deemed to{be an employer." MGL chapter 152, §25C(6)also states that"every state or local 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` r applicant who`has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,,.MGL,91 apter 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 compliance with the uisurance re uirements of this cha ter have been p resented to the contracting authority." q P., Applicants 'Please'fill out the workers''compensation affidavit completely,by checking the boxes that apply to your situation and,if ^necessary;supply sub-contractor(s)name(s);address(es)and phone number(s)along with their certificates)of insurance. Limited Liability Companies(LLC).,or Limited Liability Partnerships(LLP)with na employees other.than the members or partners,are not-required to carry workers'compensation insurance. If an LLC or LLP does have employees,a olic is e p yadvised that this affidavit may be submitted to the Department of Industrial _: ce coverage. Also be sure to sign and date the affidavit. The affidavit should .Accidents for.confirmahon of insurance quire -Bee be returned to the city.or town that he application for the permit or license,.is being requested,not the Department of Industrial'Accidents: Should you haveany questions regarding the law or if you.are required, obtain a workers' compensation policy;please call the Department at the number listed below. Self-insured companies should enter then self-insurance_license.number on the a ro riate 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 affi davit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant . Please be sure to fill in the,permit/license number which will be used as a ieference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need 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 cop 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 license or permit not related to any business or commercial venture r.,., (i.e.a dog lice nse or permit to burn 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 commonwealth of Massachusetts - Department of Industrial Accidents Office of Investigations 604 Washington Street Bostonx MA 02111. Tel..#617-727-4940 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 11-22-06 www.mass.gov/dia ACCRCrM CERTIFICATE OF LIABILITY INSURANCE 02/2/08YYYY) PRODUCER 1-404-995-3000 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Marsh.USA, Inc. ONLY AND CONFERS :NO RIGHTS UPON THE -CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR homedeiedmonrtrequE, Suite 1200 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 3475 Piedmont Rd NE, Suite 1200 Atlanta, GA 30305 Fax (212) 948-6902 INSURERS AFFORDING COVERAGE I NAIC# _ INSURED INSURERA:steadfast Ins C0 - 26387 Home Depot U.S.A., Inc. The Home Depot, Inc. INSURERB:Zurich American Ins.Co 16535 2455 Paces Ferry Road Building C-8 INSURER C:Illinois Natl ins Cc 23817 Atlanta, GA 30339 INSURER D:American Home Assur Cc 19380 - INSURERE:New Hampshire Ins Co 23841 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. INSR ADbT - POLICYEFFECTIVE POLICY EXPIRATION LTR NSRD PE OFINS RAN E - POLICYNUMBER DATE MM/DD/YY DATE(MMIDD/YYI LIMITS A GENERAL LIABILITY IPR 3757 608-02 03/01/08 - 63/01/09 EACHOCCURRENCE $4,000,000 - X COMMERCIAL GENERAL LIABILITY LIMITS OF POLICY ARE EXCESS DAMAG $E TO RENTED 1,000,000 PREMISESEaoccurence _ CLAIMS MADE a OCCUR "OF SIR: $1,000,000 PER CC" - MEDEXP(Anyoneperson) $EXCLUDED PERSONAL&ADV INJURY $4,000,000 - - - GENERAL AGGREGATE $4,000,000 GENI AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $4,000,000 POLICY JECT PRO- , LOC X B AUTOMOBILE LIABILITY BAP 2938863.-05 03/O1/08 03/01/09 X COMBINED SINGLE LIMIT $1,000,000 ANYAUTO - (Ea accident) 'ALL OWNED AUTOS �BODILYINJURY _ $ SCHEDULED AUTOS (Per person) HIREDAUTOS BODILY INJURY $ NON-OWNEDAUTOS - - (Per accident) X SELF INSURED AUTO PROPERTY DAMAGE $ PHYSICAL DAMAGE (Per accident) GARAGE LIABILITY - - AUTO ONLY-EAACCIDENT- $ ANYAUTO . - OTHER THAN -EA ACC $ AUTO ONLY: -AGG $ A EXCESSIUMBRELLA LIABILITY IPR 3757 608-02 03/01/08 03/01/09 EACH OCCURRENCE $5,000,000 X OCCUR CLAIMSMADE AGGREGATE $5,000,000 DEDUCTIBLES - RETENTION $ - _ $ C WORKERS COMPENSATION AND 1928757 (FL) 03/01/08 03/01/0-9 X WCSTATU- 1 OTH TOR IMITS -R D EMPLOYERS'UABILITY 1928756 (CA) 03/01/09 1,000,000 ANY PROPRIETORIPARTNER/EXECUTIV_E 03/O1/08E.L.EACH ACCIDENT $ E OFFICER/MEMBEREXCLUDED?_ 1928755(AOS) 03/01/08 03/01/09 E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under - SPECIALPROVISIONSbelow - E.L.DISEASE-POLICY LIMIT $1,000,000 OTHER F TX Employers Excess TNS-C45197967 (TX) 03/01/08 03/01/09 Occurrende/SIR 25M/2M D Workers Compensation 1928759 (QSI) 03/01/08 03/01/09 E Workers Compensation 1928758 (KY, MO, NY, WI) 03/01/08 03/01/09 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS - *FOR EVIDENCE ONLY. _ CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION THE HOME DEPOT, INC. - DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 2455._PACES FERRY RD., N.W. BUILDING C-8 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. ATLANTA, GA 30339 AUTHORIZED REPRESENTATIVE USA ACORD 25(2001/08)datkinson 8213215 ©ACORD CORPORATION 1988 I } • a 92. �\ Board ol'Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registr. 126893 Board of Building Regulations and Standards ation� Expiration g%3/2010 One Ashburton Place Rm 1301 r? Boston,Ma.02108 whType Supplement Card The Home Depot'At Home Service (MARK NIADA ;. 3200 COBB GALLERIA ATLANTA,GA 30339 Administrator Not valid wzu signature PERMIT PAYMENT RECEIPT TOWN OF BARNSTABLE BUILDING DEPARTMENT 200 MAIN STREET HYANNIS, MA 02601 DATE: 09/11/08 TIME: 12:42 -----------------TOTALS------------------ PERMIT $ PAID 25.00 AMT TENDERED: 25.00 AMT APPLIED: 25.00 CHANGE: .00 APPLICATION NUMBER: 200805052 PAYMENT METH: CHECK PAYMENT REF: 24040 Ct8/27/2eO8. 07:38 5ee5407376 PAGE 01 HOME IMPROVEMENT CONTRACT PLEASE READ THIS Sold,Furnished and Installed by. Branch Name: Boston Date: O h�l'vl7 THD At-.Home Services,Inc. d/b/a The Home Depot A 4,-lome Services Branch Number: 345A Greenwood Street,Unit 2,Worcester,MA 01607 Toll Free(800)657-5182; Fax(508)756-8823 Dort h 33 South 31 Federal iD#75-2699460;ME Lic#C 02439;RI Conk Lic#16427 CT Lic#56552.2,M1 A Home Improvement Contractor Reg-#126893 InstallationA.ddress: 1�tC \VCGC,A 1A �A City 4J State Zip Purchaser(s): Work Phone: Home Phone:- Cell Phone: 7M Win Flame Address: (If different from Installation Address) City State Zip KImail Address(to receive project communications and Home Depot updates): I DO NOT wish to receive any marketing emails front The Home Depot. Project Information: Undersigned("Customcr"),the owners of the property located at the above installation address,agrees to buy; and THD At-Home-Services,Inc.(--Inc home(Depot")agrees to frlmlah,deliver and arrange for the•installation("Installation')of a.11:materials described on the below and on the:referenced Spec Sheet(s),all of which are incorporated into this Contract by this reference,along with any applicable State Supplement and Payment Summary attached hereto and any Change Order (collectively "Contract"): Job#: pnioAd a"r"..) P ducts: Sec Sheets #: Project Amount ❑Roofing ❑Siding Windows ❑Insulation $ t� 3 3 ❑Gutters/Covers ❑.Entry Doors El Roofing Siding.❑Windows Insulation $ ❑Gutters/Covcn ❑Entry Doors ❑ Rooting Owing ❑Windows Insulation $ []Gutters/Covers ❑Entry Doors❑ Roofing Siding Windows Insulation $ OGutters/Covers [3Entry Doors ❑ . Minimum 7_15%Deposit of Contract Amoiantdue upon execution ofthis ontract. Total Contract Amount- S 2[.��`5 Maiae Purchasers may not deposit more than one-third of the Contract Amount ✓ 1 V Customer agrees that,immediately upon completion of the work for each Product,Customer will,execute a Completion Certificate (one for each Product as defined by an individual.Spec Sheet)and pay any balance due. As applicable,each Customer under this Contract agrees to be jointly and severally obligated and liable hereunder. The Home Depot.reserves the right to issue a Cbange Order or terminate this Contract or any individual Products(s)included herein,at is discretion,if The Home Depot or its authorized service provider determines that it cannot perform its obligations due to a structural problem with the home,environmental hazards such as mold,asbestos or lead paint,other safety concerns,pricing errors or because work required to complete the job was not included in the Contract. Payment Summary:. The Payment Summary#_ included as part of this Contract, sets forth the total Contract amount and payments required for the deposits and final payments by Product(as applicable). NOTICE TO CUSTOMER You are entitled to a completely tilled-in copy,of the Contract at the time you sign. Do not sign a Completion Certificate(note: there is one Completion Certificate for each listed Product as defined by individual Spec Sheets)before work on that Product is complete. in the event of terminationiof this Contract;Customer agrees to pay The Home Depot the costs of materials,labor,expenses and services provided by The home Depot or Authorized Service Provider through the date of termination,plus any otber amounts set forth in this Agreement or allowed under applicable law. THE HOME DEPOT MAX WITHHOLD AMOUNTS OWED TO THE HOME DEPOT FROM THE DEPOSIT PAYMENT' OR OTHER PAYMENTS MADE, WITHOUT LIMITING THE HOME DEPOT'S OTHER REMEDIES FOR RECOVERY OF SUCH AMOUNTS. Acceptance and Authorization:.Customer agrees and understands that this Agreement is the entire agreement between Customer and The Home Depot with regard to the Products and Installation services and supersedes all.prior discussions and agreements,either oral or written,relating to said Products and Installation.This Agreement cannot be assigned or amended except by a writing signed by Customer a d The Home Depot.Customer acknowledges and agrees that Customer has read,understands,voluntarily accepts the tem)s of and b eceived a copy of 's Agreement Accepted by: Submitted by. Gusto er's a c :, Date Sales Consultant's N ignature Date X Telephone No, -1 ,,ram1155 — Customer's Signature Date Sales Consultant License No. CANCELLATION: CUSTOMER MAX CANCEL THIS (as applicable) AGREEMENT WITHOUT PENALTY OR OBLIGATION BY DELIVERING.WRITTEN NOTICE TO THE HOME DEPOT BY MIDNIGHT ON THE THIRD BUSINESS 0AVAFTER SIGNING THIS AGREEMENT. THE STATE SUPPLEMENT ATTACHED HERETO CONTAINS A FO*d-.. TOk- ,_.,W ONE iS SPECIFICALLY PRESCRIBED BY LAW IN CUSTOMER'S STATE. NOTICE:-WDITIONAL TERIft-AND CONDITIONS ARE STATED ON TFrr,RF.VFRSF.SFT)r AND ARE PART OF THIS CONTRACT -. e.o_ae ..�.. - - ..n,:.,, o.......a e•.i.. v,.u...., n.-i..»..., a:..� c..i...-r....,..•�e-...r _ ..