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0274 BAY LANE
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A a..z_. , � .,.,., r { i i.4 ,l .,_ .....„,.� 'v` .;4, r- i_,. ,- ,Yn,..,.,,..,, x _ -:.._ .. yi>•.t_-'�,w„-:-,.-.tm,x.,� M."+.aNe': ...#,.;.;:�w.t�.rl, ±.i'D: _.....�. ..' .r.: Town of Barnstable i Clin ,.. - Post=_This Card So That r#-is VisibleFrom the Street ""ApprovedgPlans;Mus#be Retained on•Job and this Card Must be.Kept �6sa Posted"lln#il Final Inspection Has Been Made M k h :x y+ , Where a Cert�fica"te of Qecu ;anc rs Re'"u�red;"such Buildm shall Not be Qecu ied unt l a'Frnal Ins ectron has been made Permit �..�. ,.,.>......�.r�a,��.�:����x�.., ar__.p..«..,,Y ......aq,.�� ,,�.,� _�., �����F,a �g=.;ems �s: ,,,�. �r :v,�.�p� ,�, ,. p .x., .,. .;:� .�. .«W, .u.,., . . Permit No. B-18-3135 Applicant Name: Steven Bishopric Approvals Date Issued: 09/26/2018 Current Use:' Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 03/26/2019 Foundation: Location: 274 BAY LANE,CENTERVILLE Map/Lot: 186-023 Zoning District: RD-1 -Sheathing: Owner on Record: THEBERGE,VALERIE TR Contracto,r Name., ;eSTEVEN J BISHOPRIC - Framing: 1 . Address: 12 TUBWRECK ROAD a Contractor License CS-047928 2 MEDFIELD, MA 02052 Est 'Project Cost: $20,000.00 Chimney: � y: .Description: Window replacement&sidewall P.ermrt Fee: $ 102.00 ' insulation: Project Review Req: Fee Paid:" $ 102.00 Date 9/26/2018 Final: Plumbing/Gas L J 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.th'is permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning bylaws 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. A Service: Minimum of Five Call Inspections Required for All Construction Work:' 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 T See attached •standard construction detail- sheet (SCD-1) for Cabinetwork as per owner's requirements REVISIONS by GENERAL NOTES i SPECIFICATIONS addlt Tonal notes and details. Z 11 e Qeeeeee /rPMt es EM Allsurfaces dleturbed Dynewconstruction shall be patched andf3nie hod to match adjacent surfaces. and others where aaDle. Frame-in any openings where windows or door. are to be removed and _ ftnish to match adjacent surfaces. All new exterior and interior trim shall match existing.. All work in progress shall be adequately braced, shored and windows noted shall be 'Anderson Permashield" complete with screens, herdware, trim, wood grl Ile insert. s ineuleted glass (provide protected until builds ng Is completed. a,t.r.a to price for "high performance glass"). tour R�OL/v6t1'T Contractor shall conform in all respects to the rules,. regulations Floor and well finishes as per owner's requirements. (' and ate tutee governing construction safety. Contractor is solely D q rements. \ 7V(INI IEt To NATcu 16r.S-hNb F-- responslble for same and shall hold architect harmless from all 'L / IStt Fa•�t / \ liability at lsing therefrom. Electrical fixtures as per owner's requirement.. 42 FtYwouD 5(IeLTHWG (wv' E1 vations indicate final appearance. All existing roofs, facial, electrical switches and outlets to match existing. �q gu to ra, aid Ing, windows, door., etc. shall be removed as required p by new work. lumDing fixtures as per owner'A requirements Po WapaE �_ \ +$� R"41 •' ?a6 1 r _ Al notes shall be common to Diane, elevations.and sections. Tie new plumbing fixtures to existing supply. and drainage systems. a, Yls('piK Hh16 _ "'N.vM 6P'T'f ER S((1N6(PS Tt> MA?cF( 6K15t)Hb—� IT' '�Wes-n�G w1 xa N F. _0ee,+so 6A TO tMTc 11 C) AwM 61)TTeR Qn! Lb S'T U o`{ LI_ L -...----- i jq ppJ;woo� ,� V UM -1 4 I6 o,c p L. Zt�aal(( IZ4�IL"�t � Fss.TI 6 oAK Ra1c;Ht PP L!r _ Fig"SHeK(R�u6 V&V WN Te fl — '} cIMP ep ram" g, P(•wtEM1 �-�9ycoHc•%cm, wf JF+ bvR-D-WA,EJE.Ry ZNp c009501I GG LCII 6 MIL v 'bull+ EL-F-yATION 5CACE'Wello WEST EIFV. Sut6''y4'a l�o' "H le, ebowi y J v U Z sEr fW'PeR 6nY wlNDaw kt'(ERi(ATE. - y t1*4 wits pT , /\ gUIL DIH6 liiC TVPA 54Ite 30-110j1 LLJ Lj x 5Kwe-Le!Tv MATa1 FxvvTIe16 .�. . t Fr6GA)`TRIM To MATu( E,clsr6 -_ � IU - _ LiJ tc wn hun-eo g I I. I, I •1.. ••I SCAM KetM 3 I I I saaswtL DDAA 11116-up EAST ELEVATtOf sunset Y+'= 110" PleIVT%4 LQVATIOW laic: y4'Iel=pt pr j OF 'L 'wa„a f t A Ao7rT mN , ! v v� C e J • F o T- u o zsrs _ IL Yi 10. 10 r� 7x = I. ae: CArTefts. ' 1 II 10 o e, CHI L1 6 Sal. fr �' rZ r� • II h� _ %)ngg {.9ri1.t< a� 1 > 4[Its" a 9 't %?•.at- _ Z flflfl I 'v -Ni 4I C; t,x, z ; O i a e.' °.rY ::t �'' <i�•ei m:. s � I .01 I I ` ts Hl [ e y 11.3t 3 3� 1 � � F� A I pFj 3 CAKOIALKS fE� HERBERT VOLLIV'IA N AIN ARCHITECT �. o o o tour o: ChrY l �I :r kr ,. 3,'t5 ` o • Mi4e, cENtF �n�E,MR H.k Ioo�B r;:� - �,; _ _ ■ _. � c t STANDARD LEGEND A P NOTE:not all symbols will appear on a"map . A 4=a GOLF COURSE FAIRWAY EDGE OF DECIDUOUS TREES _ `• - - - - _ - _ _ L \ z � _ EDGE OF BRUSH ORCHARD OR NURSERY �p V— -" EDGE OF CONIFEROUS TREES MARSH AREA \ —- - -— EDGE OF WATER FP -_--- . DIRT ROAD DRIVEWAY _---PARKING LOT PAVED ROAD — — — DRAINAGE DITCH ` —————— PATH/TRAIL PARCEL LINE _ - MAP no�----- MAP# c - 21--PARCEL NUMBER #1/6e Re HOUSE NUMBER 2 FOOT CONTOUR LINE 10 FOOT CONTOUR LINE 0 X 4.CI SPOT ELEVATION cr�o STONE WALL -X—X— FENCE �'- RETAINING WALL RAIL ROAD TRACK STONE JETTY SWIMMING POOL \ PORCH/DECK { 0 BUILDING/STRUCTURE FLF�L DOCK/PIER/JETTY HYDRANT ' / \ \\0 6 VALVE ® MANHOLE r O POST (D7 FIAG POLE T O W N O F B A R N S T A B L E O E O A R A P N I C I N F O R M A T I O N S Y S T E M S U N I T p SIGN ® STORM DRAIN M PRINIEo Ste:IN FEEr *NOTE:This map is an enlargement of a Edpy,, l lines are only graphic representations DATA SOURCES:Plannmrirs(man-made features)were interpreted Tram 1995 aerial photographs by The James " 1"=100 scale map and may NOT meet iesThey are not true locations and W.Sewall Comporry.Topography and vegetation were interpreted from 1989 aerial photographs by GEOD 0 MLITY POLETOWER 0 20 40 National Mop Acarecy Standards at this ual relationships to physical objects Caporation. Plommetriq tpogmphy,and vegetation ware mapped to meet National Map Accuracy Standards I INCH=40 FEET* enlarged sao a at a scale of 1°=100.Parcel lines were dpiNnd from 1999 sown of Bondable Assessors tax maps. P LIGHT POLE OK�X f-Mnn%etnnaorvafinn Ann .Ian 1 R 'XM VA-MAR The Commonwealth of Massachusetts =- Department of Industrial Accidents °-'Y -- Oficeoffoyestfgatfolls 600 Washington Street Boston,Mass. 02111 workers' Compensation Insurance Affidavit , nniic:ut iiifarmnrzuU:,;�������������������� name: location: city I am a homeowner performing all work myself. I am a sole provrietor and have no one working in aav ca acity �J I am an emplover providing workers' compensation for my emplavees working on this job - - - ....,.:..::..... comnanv name: address: ... ........ CID, _.. insvr:nce Co. oilev# %/%%/ % ///%/////i/////////// //////////. // I am a sole proprietor, general contractor,.or homemmer_(circle_pne)and have hired the contractors listed below who have _ r the follo«ing workers' compensation polices: - .. comnanv name: :::.;...;... ... ......... . i address: aw _ : _ :...:::.:::..:;.:.:.: :..;. :::::::. ....... . •: .. : :.:` :•..::>:•: hone#.. : ��' ..... .-. - ctty: _ . insurnnce co. ""`^ // /%//////� .. ////// G ///// / / %// /////%/////////// % r:z — ................................ .. .:....:. ::;:i::5•a:: :`:: ;:r:::;::::::::?:i`;�•?i'i:::i i;r i::9 is-rz:3::::i:% :: is<i i�[i«>i�isi:;:'`:i;:i':�:;i:; ::ii:::: ::. i.. :;: :::iii v:i i......•. -•:...•:::..::�::: ................................W.:....:.::::::::::•::::.:::::::::::::. ... ...... n..-. .. ;.......:: comnanv name: ......:::.::. address: hone ciri: .::.::.. .:..:::..::..:..::......:. . iv#:.:. insurance co. g; to secure coverage as required under.Section 2SA of MGL 152 can lead to the imposition of criminal penalties of s flue up to SI.500.00 and/or one yeah'tntprisonment as well as civil penalties in the form of a STOP WORK ORDER and a tine of 5100.00 a day against me. I understand that a copy of this statement may be forwarded to the OMce of Investigations of the for coverage verification. I do herenv certify under the pains and penalties of perjury that the information provided above is tw.and eorred V�J Signature , Print:ame Phone# 6� � G`1 I W „aiciai use only do not write in this area to be completed by city or town official permit/license# ❑Building Department city or town: QLicensing Board ❑selectmen's Office cnecic if imtiteaiate response is required ❑Health Department phone#; Other :-Icontact person: '1 x Information and Instructions all to ers to provide workers' compensation for their Massachusetts General Laws chapter 152 section 25 requires emp y employees. As quoted from the"law",an employee of as every person in the service of another under any con�r of hire, express or implied, oral or written. as an An employer is defined individual,partnership, association, corporation or other legal entity, or any two or more ci the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the receive= association or other legal entity, employing employees. However the owner of a trustee of an individual,partnership or the occupant of the dwelling house of dwelling house having not more than three apartments-and who resides therein, p persons to do mainteaance, =wraction or repair work on such dwelling house or on the grounds r another who employs P e of such employment be deemed to be an employer. building appurtenant thereto shall not bacons . MGL chapter 152 section 25 also states that.every_.state or local Iicensing agency shall withhold the issuance or renev . y PP o of a license or permit to operate.-a business or to-construct-.buildings n.the_commonwealth for-an a Lcant..w. not produced acceptable evidence-of compliance=_with.the insurance coverage required Additionally, neither-the c =act for the erfom=ce'of pubLc.wo bdivismnssbalL eater into auy._ _ _P ._ commonwealth nor any of its political su have been presented to the contaac "c acceptable evidence of compliance with the � � of thu chapter- authority. _ .. f Applicants n the box that applies to your situatron and Please fill in the workers' compens . affidavit-ca _p Y��'cher�ng .. _. _ of insurance as all affidavits maybe. ` ' supplying and O'c c.mrml'ers aiamg a►ith a-certificate. _ tYx;. PP Y�company 'address .. ...- M _-- --}� !��'/(�'}�//��//�.rnsuraace-coverag Also be-sure.to sign and p submitted to the Departmeat of.._Industria to the or town the^application for the permit or Lccase is date the affidavit. 'Ilia affidavrt'should'be __�_ —Y _.:__ _ __ . e' » th.. `law or=r€S c not the Deparmzent,of Acadeats ..Should you have.aa5 quest�°ns.regarding - _:, being requested, artmeat-atthe z.unber.Iistedbelow.: _ . � oh lease call the Dep are aworkers _aomnpeasatsonP. aY,P _ City or Towns _m is lete and printed legibly. The Department has provided a space at the bottom of*. Please be sure that the affidavitcomp ' .the.apglie t. please__. affidavit for you to fill out in the eveatthe Ofiice_of avestigartons has to contact °°you°regarding wdl be used. The affidavits may b as_a reference a returned t to fill in the permr<lhcense number which member. . _ _... N.�,.�... be sure have been made. the Departlneat by mail or FAX unless other e Office of Investigations would ble to thank you in advamce far you cooperation and should you have any questions. Th please do not hesitate to give us a call- The Deparnneat's address,telephone aad fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Oltice of imtesduadons 600 Washington Street Boston;Ma. 02111 fax#: (617) 727-7749 phone#: (617) 7274900 eat. 406, 409 or 375 MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION Two Center Plaza Boston,Massachusetts 02108-1904 (617)723-3800 Ma Only(800)392-6108,FAX(800)851-8424 2/512015 Form of Notice of Casualty Loss to Building Under Mass.Gen.Laws,Ch.139,Sec.313 BARNSTABLE BUILDING COMMISSIONER 367 MAIN STREET 367 MAIN STREET HYANNIS MA 02601 Re: Insured: VIRGINIA R CAROTHERS Property Address: 274 BAY LANE,CENTERVILLE,MA 02632 Policy Number: 0944303 Type Loss: Fire(including Fire caused by Lightning Date of Loss: 02/02/2015 , Claim Number: 329511 Claim has been made involving loss,damage or destruction of the above captioned property,which may either exceed$1000.00 or cause Massachusetts General Laws,Chapter 143,section 6 to be applicable. If any notice under Massachusetts General Laws,Chapter 139,Section 3B is appropriate,please direct it to the attention of the writer and include a reference to the captioned insured,location,policy number,date of loss and claim or file number. MPIUA Claims Division CMA00021 r t Town of Barnstable *P a � t# p Expi 6 months from issue date Regulatory Services F o * 11natvsrns14 •. MASS' Thomas F.Geiler,Director S pent OMArAfir Building Division APR Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 ,'0� www.town.barnstable.ma.us /V OF's,� Office: 508-862-4038 Fax: 508-790�62T/�Q�� EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number g�jja_ Property Address U,Kesidential Value of Work /Q V 3 I Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address 14 . / A /�As Contractor's Name 1 %(/►OwaA S �� tom. Telephone Number. _ Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) 999/ orkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner U-1 have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Jn9l Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping._Going over existing layers of roof) d 7la,{jiA; ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders.U-Value ' (maximum.35)#of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: . C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary)lntemet Files\Content.Outlook\DDV87AAZ\EXPRESS.doe. Revised 072110 f ANL The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,M4 02111 yt MII.rrtasx go Idista Workers' Compensation Insurance Affidavit: B lders/Contracturs/Electricians/Plumbers Applicant Information Please Print Legibly Name gkisiwssr0rgwiizat1on&dividua1)_ b o'f 6 :w�A< n � - Address: 32 City/State/Zip: 1 AAA OX one 47 00 .216 Pr_ Are you an employer?Check the appropriat box: Type of project(requhvd): 1. am a employer oath 4. ❑ 1 am a general contractor and I * have hired the sub-contractors b_ ❑New construction employees(full and/or past-time)_ - 2.❑ I am a sole proprietor or partner listed on the attached sheet, 7_ ❑Remodeling ship and have no employees These sub-contractors have S_ Demolition w for me in an capacity. employees and have workers'' o Y � t5'- 9_ ❑Building addition. [No workers'comp_insuurmce comp.insurance-,realuired_] 5- ❑ We are a corporation and its. 10.❑Electrical repairs or additions 3..❑ II am a homeowner doing all v<<osfc t officers Have exercised their 1 L❑P g repair.-or additions myself.[No workers'c V., right of exemption per MGL 12. oof repairs insurance required.]5 c. 152,§1(4),and we have no employees_[No workers' 13.❑Other Comp_insurance.required_J - *Any applicant that checks box#1 most also fill airs the section below showing their workers'compensation policy information_ 1 Homeowners who submit this affida"indicating they are dam g all work and.then Lire outside contractors must submit a new affidavit indicating such. ¢Contractors that check this box must attached an additional sheet showing the nape of the sub-cantractt,rs and state whether at not those entities have employees. Ifthe sub-contactors have employees,they must provide their workers'comp.policy number_ lout an employes?tliat is prmRditig workers'conymnsadioat insurance for my employees. Belviv is thepolicy arrd jab.sitta information. / Insurance.Company Name_ �^+, { Policy 4 or Self ins_Lic_#: C So I &pimtion Dilate. Job Site Address. City/State/zip. Attach a copy of the workers'co p usatiom policy declaration page(showing the policy number and expurakion date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to`i 1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ODDER,and a fine of up to$250.00 a day against the-,-iclator_ Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification_ I do hereby cerd&under the pains and natties'of pedupy that the hiforaradon pta sided abovre is true and correct 5i ture: Date: Phone#_ � Official use only: Do not mite in this area,to be completed by city or town official City or Town: Pert.-iVUcense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Tawa Clerk d,.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 07/06/2011 15:40 5084209227 MARK W' SYLVIA PAGE 01 3 � A'G'o CERTIFICATE OF LIABILITY INSURANCE F CATEMWDDNM) 07l062011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER,THIS CERTIFICATE NOES 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,tits Pollcy(les)must be endorsed. H SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A state mant an this oerlifioste does not confer rights to the certificate holder in lieu of such endonsem s. PRODUCER TACT Mark Sylvia Insurance Agency LLC Tit Main Street P E :(M)428-0440 �. .IAM No: E�ANL PAD DRESS: MA 026W R ..... _. INBURER161AFFORDINGCOVERAGE NAIC* INSURED -SU�A, Ferro Fa"C,9uelly Ineyronpe Doyle& Thomas Construction,Inc. •--- P/.O BOX 1 e8 INSURER 9: --- Centervi)le,MA 02832.016E INSURERC INSURER D• ..-- tNeUR11R E• y — INSURERF: - - COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE.IJSTED 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 VNTH 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 SItOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. AML TYPE OF MAURANCt1 Poky NUMBER Pow— D E7fF _ LMRTS A ow=ALLlA nm 2DOIX6495 7121120 1 7n12012 EACH OCCURRENCE•• ! 11000,000 X COMMERCIALVENERALUASILI[TY I 50 000 CLA1Ms�nAOEE �occuR IIIFJE IEeyewrefk*J MED EXP one pn'pn) I 5, ... 000 PERSONAL m ADV INJURY S GENERALAOOREGAT7 2 000,000 GEPIL AGGREGATE LIMIT APPLES PER PRODUCTS-COMPIOP No • ZQW 000 X POL LOC i AUTWOeILE UABAM WMBINW SINGLE LIMIT I aew")(Ea ANY AUTO •-• -•- --- eODILY INJURY(Per pmw) ALLOVMEDAUTOS , 60DILYRUURY(Pereeemntd) ; SCHEDULED AUTOS PROPERTY OHMAGE- " HIRED AUTOS I NON4NAM AUTOS S - UMBRELLA LIA6H,LcA:u1A:-MAbE O rACN OCCURRENCE I _•. _ OtCaSSL1A8 Ap •{rAT'E I_ .... OEDUGTISLE I ... RETENTION 8 Alit,URS OOM r�tt r 001 W5390 7112011 771�0 2 BTATu X .EB ANY PROPRI�Tppf�� TNERIEXECUnVE YIN ILL EACH ACCIDENT I 800 0OO OFFICERMQMBER�EX0DEw Q to _. (hyyaeenaa aftqdobw In NyN�)� E.L.DISEASE.EA RMIPLOYE I 100 000 DESCRI� F RATIONS b4kw E.L DISEASE-POUCY LIMB S GOO 000 068CRWnDN OF OPERA""I LOCATM IS I VEIROLLS(AWCR WORD 401,AddlSMI Reeirlre Sd iall e,a men.paee le nqund) Carpentry CERTIFICATE HOLM - CANCELLATION (508)420-79E9 Doyle&'Thornse Construction Inc SHOULD ANY OF THE ABOVE DESCIU131M POLICIES BE CANCELLED BEFORE PO Box 188 THE ExPI NTf1 THE POLICY THEREOF, EREOF, SO TIE WILL BE DELIVERED IN CentarAlle,MA 02632 AUTHOR®REPAMNTAtM 6128`114M ACORD CORPORATION. All rights reserved. ACORD 25(20OW09) The ACORD name and logo are replete red marks of ACORD Office of Consumer Affairs&Business Regulation : License or,registration valid for mdivdul'use only HOME CONTRACTOR before the expiration'date If found return to: i Registration r'Dr�14,5954 Type: Office of Consumer Affairs and Business Regulation. Expiration 3118/201 Pnvate Corporate' lO Park Plaza-$uite 5170 f Boston,MA 02116 +� Y'St DOYLE+,THOMA$ O yS['41N r TROY THOMASa 499 NOTTINGHAM�tR CENTERVILLE,MA 020. ,. Undersecretary Not v td w'- out signature Massachusetts-Department of Public Safety r AWBu:►rct of Building,Regulittions and Standards Construction Sppervisor Spectalty-kicense a'l;icense CSSL 9991-3 4 < Restricted to RF WS TH °�OMAS _ _ F. 499 NOTTINGHAM DRIVE �CENTERylj'4-E MA 02632 � • s s Expiration: 4/13/2012 Cunmiusn�aer+ Tr#: 99913 5u6n - ■ 05 - SPECIALIZING IN ALL FORMS OF ROOFING & SIDING doyleandthomasconstruction.com • P.O. BOX 168 aeB. CENTERVILLE, MA 02632 Fully Licensed & Insured Construction Supervisor Lic# 99913 Doyle and Thomas Inc. Proposes to perform the following work: Location of proposed work: Mr. & Mrs. Carothers 274 Bay Lane Centerville, MA 02632 Date on which construction should begin: Winter/Spring 2012 The homeowner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that cannot be avoided by the contractor shall not be considered as a violation of this contract. The contractor agrees that when such delays become known to the contractor,the contractor will advise the homeowner as soon as possible. The homeowner hereby acknowledges that in certain remodeling work,the demolition process may reveal defects in the existing structure which must be repaired, creating additional work which may need to be carried out in order to complete the work described in this contract. In such case the homeowner agrees that the duration of the work and the schedule date of completion may differ, and that such variation is not to be considered a violation of this contract. The total cost for labor and materials under this contract: $10,244.34 30 yr. GAF/Elk Timf berline High Definition architectural shingles(Lifetime Ltd.Warranty) In the event that while stripping the roof we find rot that needs to be replaced,the homeowner then has to agree and authorize any replacement or restoration. Then in addition to the above contract price,the homeowner agrees to compensate the contractor for any repairs or restoration at the hourly rate of$45.00 for a carpenter and$30.00 for a carpenters laborer, plus the cost of materials. Thank You For Giving Us The Opportunity To Help You Improve -Roof to be stripped and cleaned of all old shingles and debris -Roof to be papered with weather watch leak barrier and synthetic roof underlayment, installed with Timberline architectural shingles using galvanized nails. (Storm nailed) -All new 8 inch drip edge and pipe flanges to be installed -Cobra ridge vent to be installed on all ridges -Timberetex premium ridge cap to be installed -5 yard dump trailer will be needed on site; and will be removed at completion of the job -All gutters will be cleaned at completion of the job -Contractor will be responsible for all building permits needed at the property NOTICE REQUIRED BY LAW With the agreement of the contract$500.00 of estimate is due. _ Further payments under this contract are as follows: 1/2 of the estimate due at the start; and remainder due at completion of the job. Balance of all materials and labor shall be payable in full upon completion of work described in this contract. Payment as agreed upon shall be made when due. Any payments which are delayed shall be subject to a finance charge of 1.5% per month. The contractor warranties the work completed under this contract for a period of one year from the date of completion. During the stated warranty period the contractor shall be responsible for the service of the repair or adjustment, but the contractor shall not be responsible for the normal maintenance, repair due to abuse, misuse, and or normal wear and tear,which shall be the responsibility of the homeowner. All warranties for the materials supplied by the contractor shall be passed directly to the homeowner. The homeowner may be required to register or mail in such warranty card or evidence of ownership in order to activate such warranties. Homeowner failure shall not create any responsibility for the contractor under the warranty provisions;the choice of repair of replacement shall be at the discretion of the contractor. The homeowner acknowledges that the form,content,and notices contained in this contract are intended to comply with the applicable portions of the Mass. General Law Chapter 142A, and regulations promulgated there under. In the event of any instance of non-compliance,only such portion shall be invalid and the remainder of this contract shall be in full force effect. In addition, any such portion not in compliance shall be read and interpreted so as to have its intended meaning to the maximum extent allowed under such law and regulation. Signed as a sealed instrument on this date: Date: i 1 t1 I Homeowner Contra for TOWN OF BARNSTABLE BUILDING PEkMIT APPLICATION Map 1&0 Parcel 023 Applicatio ' Health-Division G IJ,�Qr Date Issued 23 c Conservation Division JtI V 0 Application Fee PlanningDept. TO 3 ?016 p �VN OFQq��Ws�ge : Permit Fee , Date Definitive Plan Approved by Planning Board LE Historic - OKH _ Preservation/ Hyannis Project Street Address Village Owner Address S:Y•i Telephone 4g�� - a-71-e a7 I Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation _jqcx- Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 61"' Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ Co 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 zA4-ol-e-McCarthy Construction Telephone Number P® Box 52 Address — Uzestrjcnnis, 1N4A 02670 License # Cell (508) 250-6964 %CS1 5. 8633--Hi[ ~-9 69393 Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED f MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION ,a - FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. rT Town of)Barnstable � . -0 egulat®ry S.e�•c�ces . •' xunvszxeis, Ridiard V.gcali,Director o;►�<' Ou dlmg)Division Tom Percy,Building(oa, sioner 200 Ivla n Street;I�7rdnnis;�1A 0ZG01 in,�-WAown.barnstWe.ma.as Office: 508-862-4038 fax:;508_?-90;6230 Property Owner Must Corz���e�e�aizt�S, snl 7`I3is Scctio��.. 7. f ZJs_ifigf .B (Let ` ( v ;as Chvner orr thC-SaibjeG� he:reby'autlaonze ( ( ra ac pn my be W ; in all:;mamm rdatrve-to vlork aulonizedbil dlis Wldi ig pemmd:aPPlication.for.. i Pahl'fehEes aril�Iarz s.are t ie re pbuslb]icy of ehe applicaa i ' a1� are not.to'1�e filled��r uu c 'before ft:nrc,is mslA6cl-`an&k f, ibsfiect oat are aeifey need;an di kcepted. Sigtnat 'e of:Oeaer S�guaiure=of"rpplit -.l;?rm-i t Name PHat;Narzi Date y Q:FORMS:01'v`�iFit��J�tJSS1.ONPt3�1>S' - ' ;P 1 Office of Consumer Affairs and Business Regulation 10 Park, Plaza - Suite 5170 Boston, Massachusetts 02116 , Home linprovement Contractor Registration' Registration: 169393 Type: Individual q r Expiration: 6/16/2017• Tr# 264961 MICHAEL MCCARTHY MICHAEL MCCARTHY -- — P.O. BOX 52 — WEST DENNIS, MA 02670 - -- Update Address and return card.Mark reason for change. SCAT 20M-osnl L Address _ Renewal Employment ;_1 Lost Card ( e- C,�TG19Y[L'/l LOCCGIC�C ��ZCIdSC[.OIL[Z:iB�CJ . License or registration valid for.individul use only Office of Consumer Affairs&Business Regulation gHOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: - 1 Registration 169393 Type: Office of Consumer Affairs and Business Regulation -` Expiration 6/1672017 Individual 10 Park Plaza-Suite 5170 Boston,MA 02116 MICHAEL MCCARTHY MICHAEL MCCARTHY ',x 6 RANGLEY LN. SOUTH DENNIS,MA 02660 r Undersecretary Not id with t signature Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-058633 ``.r.,,Is MICHAEL J MCCR ' PO BOX 52 W DENNIS MA 82672' .T Expiration Commissioner 04/10/2016 The Commonwealth ofMassMchus'etts Department ofln(histrialAccidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 wi mw.massgov/dia llrorkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO HE FlLklI WITH T14E PERMITTING:AUTHORITY. . Applicant Information Please Print Le ibly Name (Business/Organizatior✓rndividual): Mike McCarthy Construction po Box 52 Address: we a Dennis, MA 02670 City/State/Zip: Cell 0$)#280-6964 _ UIr_169393 Are you an employer?Check the appropriate box: • Type of project(required): 1.�am a employer with . employees(full and/or part-time).* 7. New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in - $. Remodeling any capacity.[No workers'comp.insurance required.] 3.0 1 am a homeowner doing all work myscit:{No workers'comp.insurance required.)1 9• ❑Demolition 4.E]I am a homeowner and will be hiring conbactors 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:[]Electrical repairs or additions proprietors with no employees. 5.❑I am a general contractor and i have hired the sub-contractors listed on the attached sheet. 12. Plumbing repairs or additions These sub-contractors have employees and have workcrs'comp.insurance.; 13.❑/Roof repairs 6.❑We area corporation and its officers have exercised their right of exemption per MCL c. 14.[Other ",fh«,,«}„ 152,§1(4),and we have no employees.[No workcrs'comp.insurance required.) *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy infbrmalion. t Homeowners who submit Ibis affidavit indicating they am 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 sub-contractors•and stele whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. 1'ant an employer that isproviding workers'cornpensation_insurance for my employees. BelD)v is the policy and job site information: M Insurance Company Name: 1 / 1 �,,�"� T, o Policy#or Self-ins.Lie.M. VVL—ic--- -(G n c S(, ->,f sA Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MOL 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 t a' s enalties ofperjury that the information provided above is true and correct: Date: Phone M 1'SC i) -G f C r Official use only. Do not write in this area,to be completed by city or town official. Siature 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#: f M r DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 12/07/2016 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(s an ADDITIONAL INSURED,the policy(lei)must be endorsed.' If SUBROGATION IS WANED,subject:to ' the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 01962-001 CN '?CT Bryden&Sullivan Ins Agcy of Dennis Inc I e, t; (508)398-6060 ,No•; (508)394-2267 PO Box 1497 �: So Dennis,MA 02660 INSURERAFFORDING COVERAGE NAIC# INSURER : A.I.M.Mutual Insurance Company INSURED INSURER B Michael McCarthy Construction Inc INSURER : P O Box 52 INSURER D: West Dennis, MA 02670 . INSURER E i INSURER F, COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE.POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED 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. ILTR TYPE OF INSURANCE leek W I i POLICY NUMBER MNN% AM% LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ PRE I E e occurrence) CLAIMS-MADE OCCUR MED EXP(Any one person) $ PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE $ EN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG. $ OLICY f ECOT- OC AUTOMOBILE LIABILITY EaMBINED SINGLE LIMB $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE, $. AUTOS (Per accidentl UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LJAB CLAIMS MADE AGGREGATE $ yyoRKDEERDg c����RNE�TEENNTIIONN $ yy�gTpTU TH $ AND EMPLOYERS LIABILITY X TORY LIMITS OER A AONYICROPRIETORR/f ARTNEF3/��(ECUTNE Ya NIA VWC-100-6017656-2015A 12/15/2015 12N5/2016 E.L.EACH ACCIDENT $ 1,000,000.00 ((Mandatory In NH) EXXCCLLUUDffi E.L.DISEASE-EA EMPLOYEE $ 1,000,000.00 D�SsCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000.00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,fl more space Is required) CERTIFICATE HOLDER CANCELLATION Cape Light Compact I PO Box 427 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Barnstable,MA 02630 THE EXPIRATION DATE THEREOF; NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.Alll_l rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD f ®f Massachusetts Department of Public Safety Board,of.Building Regulations and Standards License: CS-058633 • - "'= i Construction Supervisor _4- ' MICHAEL J MCCARTHY P.O.BOX 62 WEST DENNIS MA 0.2UN, - ^^� CA-- Expiration: Commissioner 04/10/2018 I Construction Supervisor { Restricted to: Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(991 cubic meters)of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. DPS Licensing information visit:WWW.MASS.GOVIDPS , e Liberty Mutual Group l�j lJ 1 ,lJL7L P.O,Box 8094 i Wausau,WI 54402-8094 # Telephone: (800)653-7893 May 05,2000 FAX: (715)843-2650 1 F WILLIAM P DEVANEY 115 MAIN ST ; CENTERVILLE,MA 02632 RE: Your Workers Compensation policy Policy number: WC1-31S-321766-010 a Effective date: April 27,2000 - Dear Policyholder: Liberty Mutual is pleased to have been selected to service your Workers Compensation policy. We are completing our review of your application and expect to send your policy,along with an explanato.ry r service package,within the next 30 days. However,to assist you in the interim,we are providing you - with your newly assigned policy number(referenced above)and the following toll-free number if you need to report a claim. To help us serve you effectively,please have your policy number available when calling this number. To Report a Claim: (800)462-5026 . Prompt reporting of accidents is critical. It"enables us to get involved in treatment early,to manage° - medical costs and set the stage for a successful return to work: r Please direct all other questions you may have to your producer. Producer of Record: DIMARM INS AGCY Producer Phone No. (508)746-1245 You applied for coverage for the state(s)of If you open operations in any other state,please contact your producer. Depending on the state,we may or may not be ablp to provide coverage for you. We look forward to servicing your business. Sincerely, j Andrea Brown Involuntary Market Operations cc:` DIMARZ10 INS AGCYof ` ' IM00260995 WC1-31S-321766-010 Pa ei 1 g � r 1 •. li t . �fdfdi,� - Ct 11m BOARD OF BUILDINGREGULATIONSLicense CONSTRUCTION SUPERVISOR Number CS 075903Birthdate j06/23/1952Expires O3/23/2003 Tr.no 75903 4 ,� $S r fS I t - - lr 7 tS•h/ ., Restricted To00 •' WILLIAM P DEVANEY' ? I f 115 MAIN ST 1.• .-6�i% /T' j CENTERVILLE, MA 02632 Administrator i I - 0 • ����, � iK.m:' '..ur�raayuvnror. qurira�a�ctgm.ay.V,o - - ,.+awL.c:,W..s< A • ' / 100'gl/IXd1t6tlC(L� p� / / } , •• � aL14.� CfLILdCI[a( s + HOME IMPROVEMENT CONTRACTOR Registration: 130669 �4 1 xpiratioq: 04/06/2002 1 Type: Individual ` t#` VILLIAN P. DEVANEY„ a kir G�ce�n�o�i IAN DEVANEY sTi IS MAIN ST.' t+, ADMINISTRATOR CENTERVILLE MA' 02632 F `. i to� • Iy1; , The Town of Barnstable +' eaxrrgrABLE. Regulatory Services '°lEn►�a't° Thomas F. Geiler, Director Building Division Ralph Crossen, Building Commissioner 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 ! Fax' 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION''_--_—_ ` MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion,o - improvement,removal,-demolition,or construction of an addition to any pre=existing.owner-occupied building containing at least one but not more than four dwelling units or to structures which-are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other - requirements. Type of Work: /T��( 1-1 D N _. Estimated Cost,..-. .. . .. u--�...0-._ Address of Work: Owner's Name: ( P � Date-of Application 1 I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the own be Date Contractor Name Registration No. OR Date Owner's Name q:forms:Affidav 1i0�A4p�edtsJ 'tablsJS.Zib( with Foag Feds . Ptmeeipdre Pasica5es for Aae aad?we"Familf Reddeadai Beiidle�Stated MAXIMUM AmmuN 'l I �$ 410 Ceirm wall Floor gamma Fgid=cy' Anal(-A) WSU FIB 1'arfs�e 1Gtald 5701 to 6600 Horde;DRUM Days' Q 129A 0.40 31 13 t9 10 6 Noemai R 12% om 30 19 19 -10 6 Noma! S IrA 650 33 13 19 to . 6 1S ARM T 15% Q36 31 25 WA WA Ntamai U 15% OA6 31 19 19 10 6 NamW ii i�yi v �e 13 WA sw !S AE;JE W IVA am 30 19 19 t0 • 6 =S AFUE x IV/. om 31 13 25 WA WA Noma! v IVA OA2 31 19 n WA WA Nmmai Z IV/. 0.42 31 13 19 t0 6 90AFUE AA 11'/. 0.50 '30 1 19 19 10 1 6 90 AFUE 1. ADDRESS OF PROPERTY:, -1!7T 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: 4. %GLAZING AREA(#3 DIVIDED BY#2): 5. SELECT PACKAGE(Q—AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. t BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-f980303a _ i 780 CMR Appendix J Footnotes to Table J5.2.1b: Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and basement windows if located in walls that enclose conditioned space,but excluding opaque doors) to the gross wall area,expressed as a percentage.Up to 1%of the total glazing area may be excluded from the U-value requirement. For example,3 ft of decorative glass may be excluded from a building design with 300 fl of glazing area. 2 After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRQ test procedum or taken from Table J1.5.3a. U-values are for whole units:center-of-glass U-values cannot be used ' The ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness-over the exterior walls without compression, R-30 insulation may be substituted for R-38 insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R values represent the sum of cavity insulation plus insulating sheathing(rf used). For ventilated ceilings, insulating sheathing must be placed between die condoned space buts rue Zcu'ulaed par-don wan of:h:vx:L - 'Wall R-values represent the sum of the wall cavity insulation plus insulazmg sheathing (if used). Do not include exterior siding,structural sheathing,and interior drywall.For example,an R-19 requirement could be met EITHER by R-19 cavity insulation OR R 13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-frame or mass.(concrete,masonry,log)wall constmctions,but do not apply to metal-frame construction. The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces, basements, or garages).Floors over outside air must meet the ceiling requir Fly e�..:.-.- `The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R value requirement as above-grade walls. Windows.and sliding glass doors of conditioned basements must be included with the other.glazing. Basement doors must meet the door U-value requirement described in Note b. - w _w 'The R-value requirements;are for unheated slabs.Add an additional R 2 for heated slabs. If the building utilizes electric zesistan=heating-mse compliance-approach 3, 4, or 5. If you plan to install more than one pie of heating equipment or more than one piece of cooling equip ent,-the equipment with the lowest efficiency must meet or exceed the efficiency required.by the selected package. - 'For Beating Degree Day requimments-ofthe closest city or town see Table J5.2.1a .. .9 NOTES: a)Glazing areas and U-values are maximum acceptable.levels._Insulation It:values are minimum acceptable levels. R value requirements are for insulation only and-do not include structural components. b)Opaque doors in the building envelope-must have a U-value no greater than 0.35. Door U-values racist be tested and documented by the manufacturer.ia.accordance with the.NFRC^ust..procedure or taken from the door U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c)If a ceiling,wall,floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels,the component complies if the area-weighted average R value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(035 for doors). ♦ I A 43 ESTIMA TED PROJECT COST WORKSHEET LIVING SPACE Value (high end construction) square feet X$115/sq. foot= (above average construction) 63(,o square feet X$96/sq. foot= (" average construction) square feet X$57/sq. foot= GARAGE (UNFINISHED) square feet X.$25/sq. foot= PORCH square feet X$20/sq. foot= DECK square feet X$15/sq. foot= OTHER__ . square feet X$??/sq. foot= Total Estimated Project ct Value For Office Use Only Inclusionery Affor-darb/e. Housing Fee Residential Commercial" Property Owner's Name Project Location Project Value Permit Number "Existing Sq. Ft. "ProposedNew Sq. Ft. Fee $ IMFORM 1/3/00 } r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Permit# F ` �O (I— Health Division " gi- _ Date Issued i ,�� ►� �7�ve.� � Conservation Division t� �'®Q °! Fee 9 Tax Collector A S`C_ 44 Treasurer U��2Q�� SEPTIC SYSTEM INSTALLED IN COMPUX,_ WITH TITLE 5 try-Plar�n+wg-Beard ENVIRONMENTAL CODEQ TOWN REGULATIONS Project Street Address , Village tl eL Owner e w U Address Lyl, Telephone 7i ° Permit Request - V—`ftr c5qo Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Valuation � 2� -Zoning District Flood Plain Groundwater Overlay Construction Type I _ Lot Size 4, " GrandfatKered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family W Two Family ❑ Multi-Family(#units) Age of Existing Structure 950 L*fnj�;r Historic House: ❑Yes 94t On Old King's Highway: ❑Yes ANo Basement Type: ❑ Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Are (sq.ft) Number of Baths: Full: existing, _ new Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new f First Floor Room Count Heat Type and Fuel: ❑Gas 5(Oil ❑ Electric ❑Other Central Air: ❑Yes allo Fireplaces: Existing �' New Existing wood/coal stove: ❑Yes Flo Detached garage:❑existing ❑new size pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:Uexisting ❑new size� �7sShed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use _ Csj r,&_ Proposed Use BUILDER INFORMATION s 1 Name dyu& Telephone Number Address License# Home Improvement Contractor# C9 Worker's Compensation# � �� Z� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE e - FOR OFFICIAL USE ONLY PERMIT NO. 4q ((o V } DATE ISSOED MAP/PARCEL NO. `1 ADDRESS' ' ~ • '3 VILLAGE ~, OWNER •� '' ..;' . � '± } I Fg + DATE OF INSPECTION FOUNDATION FRAME - - INSULATION- FIREPLACE . " - r FIREPLACE . ELECTRICAL:, ROUGH,_ FINAL PLUMBING: * ROUGH _ FINAL GAS: ROUGH FINAL FINAL BUILDING y ~ S DATE CLOSED'OUT ASSOCIATION PLAN NO. i7 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION H 5�)Map Parcel 023 Application # Health Division Date Issued Ih /33Ar ,/) Conservation Division Application Fee lX Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address �]� Village C'c I I L Owner Vim_ C lIa <<, Address S�n� Telephone 77/ " 8'1-7 1 Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay — Project Valuation ��w — Construction Type s :; C Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting dMurnOtation. Dwelling Type: Single Family U,,**' Two Family ❑ Multi-Family (# units) - a Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Hjghway: ®Yes fJ No. Basement Type: ❑ Full ❑ Crawl ❑ Walkout ❑ Other 01' 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 Mice McCarthy Constiruction Telephone Number Address PO Box 52 License # west Dennis, Cell (508) 280-6964 Home Improvement Contractor# CSL- HIC-169393 Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO M• SIGNATURE DATE 1`191f/r r w FOR OFFICIAL USE ONLY APPLICATION# h DATE ISSUED r MAP PARCEL NO. s.re ADDRESS VILLAGE OWNER y DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL l PLUMBING: ROUGH FINAL GAS: ROUGH FINAL s' FINAL BUILDING } DATE CLOSED OUT e _ ASSOCIATION PLAN NO. t The Commonwealth of Massachusetts Department oflndustrialAccidents Office of Investigations 600 Washington Street Boston,MA 02111 imp.mass gov/dia Workers' Compensation Insurance Affidavit: l ujlders/Contractors/Eleatricians/Plumbers `. Applicant Information Please Print Le 'bI Mike McCarthy Construction Name(Business/Organizagon4ndividuai):- PO Box 52 Address: West Dennis, ]VIA 02670 City/State/Zip: CSIIpa§§#3 HIC-169393 Are u an employer?Check the appropriate box: Type of project(required): 1. I am a employer with'J 4. ❑ 1 am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole propridtor or partner- listed on the attached sheet t . []Remodeling ship and have no employees These sub-contractors have 8. []Demolition working for me in any capacity, workers'comp,insurance. 9. ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its 10.[]Electrical repairs or additions required,] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL I I.❑Plumbing repairs or additions myself.[No workers'comp, c.152,§1(4),'and we have no 12.11 R °f repairs Insurance required.]t employees.[No workers' 13.Q'Other comp.Insurance required] *Any applicant that checks box 11 most also fill out the section below showing their wodw,compensation policy hdbrmadon. t Homeowners who submit this affidavit indicating they am doing all work and then hire outside contractors most submit a new afildevii indicating such. (Contractors that check this box must attached an additional sheet showing the name of the sub•coatmctm and their workers'comp.policy khrmadon. lam an employer that Isproviding workers'compensallon Insurance for my employees Below lr thepoltcy andJob site Information. Insurance Company Name: P •n ���� Policy#or Self ins.Lic.M V W L 1W �d►1G�6- Expiration Date: Job Site Address: psluCity/State/Zlp: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A ofMGL c.152 can lead to the imposition of criminal penalties of a fine,up to$1,500.00 and/or one-year imprisonment;as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the,violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DU fbr insurance coverage verification. I do hereby cent&k d e pa a enallies ofpr4ury that the lr{/ormallon provided above is true and correct Si ture: tee IQ ag i Phone M. Ojflclal use on y Do not write In this area,to be completed by city or town official; t C[ or Town;City Permit/License,0, Issuing Authority(circle one): 1.Board of Health 2,Building Department 3,City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector j 6.Other Contact Person: Phone#: 1 ,4c40kIrl ' CERTIFICATE OF LIABILITY INSURANCE DA0120/YYYY) 07 O7/10/2014 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 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 enddrsement(s). PRODUCER 01 962-001 &aUPCT Bryden&Sullivan Ins Agcy of Dennis Inc IV8,1e.Et): (508)398-6060 1 x No,; (508)394-2267 PO Box 1497 �S{ ss: So Dennis,MA 02660 INSUREM DIINGS.OYERAGE AIC A $UBEBA; A.I.M.Mutual Insurance Company _ 26158 INSURED Michael McCarthy Construction Inc U P 0 Box 52 West Dennis,MA 02670 g --- 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. N07WITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO 1A1-ITCH 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. IN TYPE OF INSURANCE INSR POLICY NUMBER MM/DD/YYYY �i� 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 $ �OLICY �UECT �I`OC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT,d $ t ANY AUTO BODILY INJURY(Per person) $ ALL TO OWNED SCHEDULED BODILY INJURY(Per accident) $ AU' AUTOS _ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Iper UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS MADE AGGREGATE $ DED RETENTION $ $ �� �P�R&�SE? PS�CI Tl4Ef� y X ,AN11 1 S A OFFICER/MEMBER EXCLUDIED7 ECUTNE� NIA A VWC-100-6017656-2014A 7/17/2014 7/17/2015 E.L.EACH ACCIDENT $ 600,000.00 (Mandatory In NH) E.L. `u t� E.L.DISEASE-EA EMPLOYEE $ 500,000.00 D9SCRIPTI A 99PERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000.00 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,it more space Is required) Workers Compensation Coverage applies to MA employees only. CERTIFICATE HOLDER CANCELLATION Thlelsch Engineering 195 Francis Avenue SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cranston,RI 02910 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE `�G.aC.Jt 01988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD - yy Massachusetts -Department of Public Safety Board of Building Regulations and St• andards Cnn.+trnctiun Supervisor License: CS-058633 0. MICHAEL J MCC AR PO BOX 52 W DENNIS MA 6267;V- P _ r " "t \ Expiration Commissioner 04/10/2016 0 W t M ow W C,af/ &J/j a,C//?/e ej el ff/ /j, Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 169393 Type: Individual . Expiration: 6/16/2015 Tr# 238121 MICHAEL MCCARTHY MICHAEL MCCARTHY P.O. BOX 52 WEST DENNIS MA 02670 / Update Address and returh•card.Mark reason for change. SCA 1 Co 20M•05/11 ❑ Address ❑ Renewal 0"Employment Lost Card �1V OWNER AUTHORIZATION FORM x (Owner'"s Name '�-- . •- owner of the property located at propert Address ,t 't" , I t�Can " �v L(Property Address)�t hereby authoriz.'e !' ��-tA C��LAI(Ij -(Subcontractor) an authorized subcontractor for RISE Engineering,to act on my behalf-to obtain a building permit and to perform work on my property: :..� �'�3--ter '—" Owner's Signature • - ,Date' •