Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0125 BLANTYRE AVENUE
f 43Ire R6, �31Qr, s R 404 r 'Town of Barnstable Building Post This Card-' ard So That it"is Visible,!=rom the Street hApproved Plans;Must be Retained on Job and this Card Must be Ke MItNS pt CAtlL6, '� p �.� _ � �, Posted Until Final Ins ect�on Has Been Made &orb° Where a Certificate of Occupancyris Required,suchffiBuildmg shall Not be Occupied until a Final Inspection fias been made Permit _. w,._.; Permit No. B-19-4106 Applicant Name: Stephen Dickinson _ Approvals Date Issued: 12/09/2019 Current Use: Structure Foundation- Permit Type: Building-Addition/Alteration-Residential Expiration Date: 06/09/2020 ` Location: 125 BLANTYRE AVENUE,CENTERVILLE Map/Lot: 229-108 Zoning District: RD-1 Sheathing: Owner on.Record: WALLER,STEPHEN G&WARD,JANE B Contractor Name` . STEPHEN T DICKINSON Framing: 1 Address: 125 BLANTYRE AVENUE Contractor License: CS;081843 2 CENTERVILLE, MA 02632 Est Project Cost: $ 10,816.00 Chimney: Description: same for same replacing slider no structural changes; , Permit Fee: $ 105.16 Insulation: Project Review Req: Fee Paid $ 105.16 Date£ 12/9/2019 Final Plumbing/Gas Rough Plumbing: Building Official s Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after;issuance. All work authorized by this permit shall conform to the approved application a'iO44he approved construction documents,for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structuresshall 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 pub�lic,inspection for the entire duration of the Final Gas: work until the completion of the same. Z. d Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building end Fire Officials are provided on this�permit. Minimum of Five Call Inspections Required for All Construction Work: _3 Service: 1.Foundation or Footing Rough:- 2.Sheathing Inspection »r .. - g 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 All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: Town of Barnstable Building�rA Post This Card So That it is Visible From the Street Approved'Plans Must be Reta�nedrton Job and this Card s be Kept Posted Until.Final Inspection Has Been Made „ Where a Certificate of Occupancy is Required,su �� i d ch Building shall Not be Occupied'until a Final Inspection;has been,made Permit No. B-18-3724 Applicant Name: LUX RENOVATIONS LLC. DBA OWENS CORNING Approvals BASEMENT FINISHING SYSTEMS Structure Date Issued: 12/10/2018 Current Use: Foundation: Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 06/10/2019 Sheathing: Residential `2 Map/Lot 229-108 ` Zoning,District: RD-1 Location: 125 BLANTYRE AVENUE,CENTERVILLE Framing�dl — _ 1 Contractor Name: LUX RENOVATIONS LLC. DBA 1 Owner on Record: WALLER,STEPHEN G StWARD,JANE B OWENS CORNING BASEMENT 2 "� -- FINISHING SYSTEMS Chimney: Address: 125 BLANTYRE AVENUE ; Contractor License:, 137943 CENTERVILLE, MA 02632 I 0K ® _ t® Insulation. Description: . Finish portion of basement to be used as family room using Owens Est Project Cost: $40,486.00 corning basement-finishing system : z. PermitFee: $256.48Final:6 �— —� Fee Paid: 5256.48 Plumbin Project Review Req: FAMILY ROOM. NO SLEEPING IN BASEMENT. g/Gas Date: 12/10/2018 Rough Plumbing: .... p Yr Final Plumbing: Rough Gas: Building Official Final Gas: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced r-w within six months after issuance. All work authorized by this permit shall conform to the approved application'and.thepapproved construction docum`entsfohich this permit has been granted. "---«Y •= Electrical 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 streefor'road'and-`shall be maintained open for public inspection for the entire duration of the Service: work until the completion of the same. �x Rough: The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire-Officials"are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: Final: 1.Foundation or Footing 2.Sheathing Inspection Low Voltage Rough: 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 Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Health 77Final Inspection before Occupancy Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Fire Department 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). ApplicationNumber..R .o...�.. .........�.......:............ s BUILDING ®EPT. VV�' y • MA98. Pelt Fee........................................ Other Fee.................:...... �¢ ' • Total Fee Paid................................................................... W OF BARNSI"ABI.E a�! TOWN OF STABLE Pews�•• .........................on.. .1.....�......d.... BUILDING PERMIT or - Map........ .a..................... U=L........................................... APPLICATION F,y►a � s -r Section 1- Owner's Information and Project Location Project Address V111age� / Owners Name Owners Legal Address f D S' ! - • State ' zip 0��3 Owners Cell# .2 10 68 ao E-mail Section 2—Use of Structare Use Group ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet ❑ Single/Two Family Dwelling Section 3—Type of Permit ❑ New Conshuction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire structare) Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment ❑ Sprinkler System ❑ Addition ❑ Retaining wall ❑ Solar ❑ Renovation ❑ Pool ❑ Insulation Other—Specify Section 4 -Work Description T sct tmLqfr&-2/9/201 S ' 1 Application Number.................................................... Section 5-Detail Cost of Proposed Construction i/Q#Fri Square Footage of Project 1(dO i Age of Structure_ - Dig Safe Number #Of Bedrooms Existing 3 "Total#Of Bedrooms(proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics ❑ Wiring ❑ Oil Tank Storage ❑ Smoke Detectors ❑ Plumbing Gas ❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney ❑Add/relocate bedroom Water Supply Public ❑ Private Sewage Disposal ❑ Municipal "ROn site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: I an using a crane ❑ Yes D"'No Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No 2' i Section 8—Zoning Information A Zoning District Proposed Use Lot Area Sq.Ft. j Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No { Last=riwtfA M2.018 Ward,James 125 Blantyre Ave Centerville,MA 02632 210-683-2654 I a a v. o e , o2 c t .. i .,....... ,.... . ...". ."..- I. I I I a : 1 I I 1 - - I i r' I I r I ' I !. l ' I I I ! . I I t I • I i I i I , r I f I ' Fo 13 14 18 i _ I ,e � _ •I i I _ � _ I .I I .I i i _ 1 • I I .I - I - I I I I `III I I I 20 21 + I I I I I _, I i I _• i I ... _ I I I az .. __._I i.. L. I\\ i I I -! •--I' �_. , I. 'I- --T I I �• j .. i 1 ' 23 r ' 24 I , I , f P�'rrt►it. v I 27 I I I 2e I I I : ]t �_— p _ i BU 1 I.. �L E + Nov liar ' I I/ I I ; I I I ]6 r 1 I I • I _ I ; I I I. I 41, ]9 40 41 I I i I I I P I I I 42 I !. i I I ! I. I .i__�..._ _. .. — — f -'- 'I --'_ _ -I I , - - - I43 I .I. ....I. 1 i.. { Ward,lames 125 Blantyre Ave Centerville,MA 02632 210-683-2654 t I � I ' � I 1 I I I J '•. .I ..'I ._ ..� � — i i I I ..J _ !. i � I � ' —�_—i I { Vol e j i L. .,. I I .._- I .,_, _....� .�.__,...— -- _I - 1�1 _ -I•- --I--_ _� i._. , _�.._ 1 , __{_ ,----f---- ,! ___i-_•-.I ._ ff i I I i . .� �� I ! _�.._� I I y + ._ i. T. _,- 07 ,a --.; _....I._..4,.__ �.�.:�. _I_ .L ! I I _., , _....i..:.,.._.-.�_�"..r�'__" i ..., ...W I. ..- ', ..j.. .I .i j... � �i_. :1�_j i- I .' ..,i....'.. 1. i ...• I .W 7 I I I I I 16 I I I zo v I I I 1 ( i.. , .I,.. !�. ; -i-' f• ' -1. -i i:. ,_ ' I .L.. �. f I i .. I... :.. � ,.._.. ,. y '. 22 I I I I _� far s�a} lel L!e t ! ( Bldg. p �... { I J _. saga arm ff - I 24 27 I I I I I LI '— ' , ..,.. ..I 1 .i.. - ;. .. 29 I I t i . rI .!.�.. , ! I .�...� _ av o , J I' I. _L. TOUVM(30 ,�R!RI"tr'i �i I I !., I . --i 1 ..._..I _._ I 1 I _.._..I I L_ L_._I. C,--..,---� I 41 — C I ,42 I I! 42 .' i 45 ..i.__-.!__ ......L„. .-.:; ... ' I I I .; ._I .. ..!.. .:.y. I , .I .i... + ! ..I i� _. 1 __.,•_L•. ,..I_. ' •I I - _ .I ... 46 Owens Corning Basement Finishin • g Systems of New England Ward,iemes.�� Contractor I Agent Authorization From 125`66;tyre`Ave Centerville,MA 02632 210-683-2654 authorize Owe ns Corning Basement Finishing Systems of Boston to sign the building permit application on my behalf,to perform the work at: Home Owners Signature: Date: D Project Manager Signature: Date: 60 Shawmut Road • Canton, MA 02021 • Phone: 781-821-0060 • Fax: 781-821-8552 0 www.ocboston.com • � T7te Co • . mmomuealth of MassachUMM Department of Industrial Accidents 1 Congress Street, Suite 100 Bos�tOn� �i N ,�MA 02.1-14-2017 SY .��l�I7�. 4ss go IIifi{{ «'orkers,Compe cation.insurance Affidavit:BuMers/Co o TO BE FILED WITH THE pKRMWMG AUTHORM. mber3. Applicant Information Name(Business/orgaruzatton/Individuat): LUX RENOVATtOh1S, LLC Please Print Letplh Address:60 SHAWMUT ROAD City/State/Zip:CANTON, MA.02021 781-8+L1-00M Phone#: x Are Von an employer?Check the appropriate box: 1.�I am a employer with 17 1 full Type of project(� }' �Pees andlor :-employe-( part-time 2.❑I am a sole proprietor or partnership and have no employees A orking far me in 7- any capacity.[No workers'comp.insurance required.] 8- R)Remodeling 3.aI am a homeowner doing all work myself.[No workers'comp•insurance require&I 1 4• O Demolition 4.❑I am a homeowner and will be hiring contractors to ooduct all work on my property. I will 10 Ong addition ensure that all contractors either have workers'compensation insurance or are sole �j proprietors with no employees. 1 l L1 Electrical repairs or additions 50 I am a general contractor and I have hired the sub contractors li 12sted on the attached sheet, ❑P�� or add�ons These sub-contractors have employees and have workers'comp,insurance 2 DoRoof repairs 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14 r 152,§1(4),and we have no employees.(No workers'comp,insurance required] tAnY applicant that checks box#1 must also fill out the section below showing their wori=s' Homeowners who submit this affidavit indicating they are doing all work and then hire outside P�cF�°�a°` xCorrtrown that sub his box must attached an gait a new affidavit mdicwn acb_ additional sheet showing the name of the sd—attactars and stone whether or not ftw a==haw z employees. If the sub-contractors have employees,they must provide their workers cDmp•policy manber. , I am an employer that is proving nwrkers'compensation insurance or information. f M Mrloyem Below is the policy andJob site Insurance Company Name:LIBERTY MUTUAL Policy#or Self-ins.Lic.#:XW057350449 E 5/29t2019ExpirationDate: Job Site Address: , Attach a copy of the workers'co sat p�(showing thhee p on Policy declaration t lky poo licy nun%er and �_ _ m;date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation and/or one-year punishable by a fine up:to%1,5Q10:00 y imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250 00 a day against the violator.A copy of this statement maybe forwarded to the Office of Investigations of the DIA for:insurance coverage verification, Idoh a ere'y �'y un ca and penalties of perjury that the nnforma on protnded ahorae is trine and comer Si tun Date:� Phone# 781-821-00 I J/9//Ir Of°f icial use only. Do not write in this area,to be completed by city,or torsi o fficiaL City or Town: ., PermitfLiceuse# Issuing Authority(circle one):. ` 1.Board of Health 2.Building Department 3.City/Town Clerk 4. 6.Other Electrical Inspector g:Plumbing Ir Contact Person: Phone#: &xe RI , Office of Consumer Affairs and Business Regulation 10 Park Plaza- Suite 5170 Boston, M `&-(z usetts 02116 Home Improvemet :Contractor Registration �`) =- = Type: Supplement Card t w Registration: 137943 LUX RENOVATIONS, LLC. 1.411 -- r Expiration: 02/04/2019 60 Shawmut Rd Laf > Canton, MA 02021 �n.'.� �. , � w e =c. .:rt;M . Update Address and return card. Mark reason for,change. SCA 1 % 20M•05111 ❑ A+ v s"f-Fenewaf G Empioymeni u-?ots:;t,ard .v. &2e�anznzaivaetcC a�6? ccc�ic�aelta Office of ConsumerAffairs&Business Regulation isr HOME IMPROVEMENT CONTRACTOR - _ Registration valid for individual use only TYPE:Supplement Card before the expiration date. If found return to: :r _ e9istration Expiration Office of Consumer Affairs and Business Regulation 10 Park Plaza=Suite 5170 02/04/2019 ;•==_ ;. Boston,MA 02116 LUX RENOVAT;IQL�� L4Lf--C<=; '-- DB/A Owens CQru{-Pa-Bement Finishing Systems EDWARD ALLEN 60 Shawmut Rd 'wN -4 Canton,MA 02021 Undersecretary Not valid without signature Massachusetts Department of Public Safety ~a Board.of Building Regulations and Standards Licenser CS-075131 Construction Supervisor EDWARD T ALLEN 30 STORMY HILL. rr DEDHAM MA 02026 Expiration: /Commissioner 02/2.712019 . Q M AeC> ® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) Iil.� 10/04/2018 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). PRODUCER CONTACT 9 NAME: Jane Logan Gordon Atlantic Insurance PnHO No EM; (781)659-2262 FAX WC,No: (781)659-4725 306 Washington Street E-MAILE ADDRESS- jane@gordonaUanticinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# Norwell MA 02061 INSURERA: American Fire and Casualty Co. 24066 INSURED INSURERS: Safety insurance Co. 39454 Lux Renovations,LLC INSURER C: Ohio Casualty Insurance Company 24074 dba Owens Coming of New England INSURERD: 60 ShaWmUt Rd. INSURER E: Canton MA 02021 INSURER F: COVERAGES CERTIFICATE NUMBER: Master JL 8/29/18 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE INSD WVD POLICYNUMBER MM/0D EF MOLIC P LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 I Z11 DAMAGE TO RENTED CLAIMS-MADE I I OCCUR PREMISES Ea occurrence $ 100,000 MED EXP(Any oneperson) $ 15,000 A Y Y BKA57350449 09/05/2018 09/05/2019 PERSONAL&ADV INJURY $ 1,900,000 GEN'L AGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 RPOLICY JEa LOC PRODUCTS-COMP/OP AGG $ 2,000,000 XOTHER: CG0001 4/13 Prop Ding Borrowed $ AUTOMOBILE LIABILITY CsOMBINEO SINGLE LIMIT $ 1,000,000 Ea accident ANY AUTO BODILY INJURY(Per person) $ BI&PD CSL B OWNED X SCHEDULED AUTOS ONLY AUTOS Y Y 5902260 04/04/2018 04/04/2019 BODILY INJURY(Per accident) $ BI&PD CSL X HIRED NON-OWNED PROPERTY AUTOS ONLY X AUTOS ONLY P r accid entDAMAGE $ BI&PD CSL Underinsured motorist BI $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,000,000 C X EXCESS LIAR CLAIMS-MADE Y Y US057350449-FOLLOW FORM 09/05/2018 09/05/2019 AGGREGATE g 1,000,000 OED I X RETENTION$ 10,000 $ WORKERS COMPENSATION PER O YIN TH- AND EMPLOYERS'LIABILITY /� STATUTE I I ER ANY PROPRIETORIPARTNER/EXECUTIVE 1,000,000 C OFFICER/MEMBER EXCLUDED? -rY NIA Y XWO57350449 05/24/2018 05/24/2019 E.L.EACH ACCIDENT $ (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached If more space Is required) Home Improvement Contractor-GL Blanket Additional Insured(Al)Primary&Non-Contributory With Waiver of Subrogation for Ongoing&Completed Operations,Per Project Aggregate(CG8810 4/13,CG85834/13,CG2503 5/09).Auto Liability Blanket Al Primary&Non-Contriburory&Waiver of Subrogation(SCA 005 4/17),WC Blanket Waiver of Subrogation when required by contact signed prior to the loss. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEIIED BEFORE. THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELWERED IN INSURED'S COPY ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) , The ACORD name and logo are registered marks of ACORD Application Number........................................... Section 9—.Construction Supervisor Name 4& &4�� Telephone Number 77 j,' 9?3 501,7 7 Address`6 City State Zip 6 2na License Number (37-gI43 License Type (1 Expiration Date ,2�l i Contractors Email ��1 c,.w.e,�,� c�- Cell# -77q 953 96,�7 I understand my responsibilities under the rules and regulations for Licensed Contraction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your license. Signature Date it q/1 Section-10—Home Improvement Contractor Name_ •. �. Telephone Number •7-7 Iq • 9q3- 0:2 7 AddressL ,„,� /&t City tate zip c— ?A a I Registration Number t_3 3 Expiration Date : I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town ofBamstable Attach a copy of your H.LC... . SignatureA, Date Section 11—Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date 4 APPLICANT SIGNATURE r Signature Date Print Name CEward 41 zn Telephone Number_ -7?4 993 Q0.77 E-mail permit to: A Z/X)1), cam, �� Section 12 —Department Sign-Offs Health:Department © Zoning Board(if required) Historic District ❑ Site Plan Review Cif required) ❑ Fire Department ❑ 4 Conservation ❑ For commercial work,please take your plans directly to the fire deparbnent for approval Section 13—Owner's Authorization L as Owner of the-subject property hereby authorize to act on my behalf; in all matters relative to work authorized by this building permit application for: (Address of job) Signature of Owner- ` date ; Print Name I� Last=dated:2J9M 18 Town of Barnstable Building - Post This Card So T at=rt"isVisibleFrom LheStreet :;:A „roved.=Plans Must be.Retamed�on:I„ob and"this Cad:Must be Kept . x �" I" in 'I Ins ect on'Has:Beei MadeF 44 :; 16sa Posted Unti .F a.. = P " „ fir. . s s Permit •' UV- re a':Certificafe'of.Occu anc: `�i Re u red suchrBuildm shall Not be Occu ied un#il a Fina) lnspect�on has been made :,,taat.;'»-,�. Permit No. B-18-2791 Applicant Name:, Stephen Waller Approvals Date Issued: 10/04/2018 Current Use: Structure Permit Type: Building-Stove Expiration Date: 04/04/2019 Foundation: Location: 125 BLANTYRE AVENUE,CENTERVILLE Map/Lot 229-108 Zoning District: RD-1 Sheathing: Owner on Record: WALLER,STEPHEN G&WARD,JANE B '` Contractor:lVa`me:. NATHAN CAPUTO DBA ALL CAPE Framing: 1" Address: 125 BLANTYRE AVENUE CHIMNEY SWEEP 2 Centerville, MA 02632 ContractorLicense 144689 Chimney: Description: Install pellet stove Est Protect Cost: $500.00 Permit�'Fee: Insulation: $35.00 ProjectReview•Req: & J Fee Paid $35.00 Final " Als /b Date: 10/4/2018 Plumbing/Gas fin pAtif�7 -... Rough Plumbing: Final Plumbing: This permit shall be deemed abandoned and invalid unless the work aut1`1ho red by this permit is commenced within siz•months after'issuance. Rough Gas: All work authorized by this permit shall conform to the approved applcation,and th"eapproved 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. s " - F Electrical The Certificate of Occupancy will not be issued until all applicable signatures by,the Building andFire Officials are;prowded on this"`permit. 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 CoveringStructural Members Frame Inspection) Low Voltage Rough: � P 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Town of BarnstableBuilding Post�This<Card So That rt�s�/Isible�From the Street. A roved':Plans Must beRetalnedon.Job and;this;Card Must._be Kept, Permit M" Posted Until FinalIalnspec�tion HasBeen Made�,"�',, � � � �� � �, � �� � Where a Certificate oaf Occu_pancy��,is Requred�such B��fl°d, g shall ot,b�Occ �p_ �y_ V � ��4�� 41 , Permit No. B-18-1384 Applicant Name: Jason Stoots Approvals Date Issued: 06/04/2018 Current Use: Structure Permit Type: Building-Solar Panel-Residential Expiration Date: 12/04/2018 Foundation: Location: 125 BLANTYRE AVENUE,CENTERVILLE Map/Lot 229 108 Zoning District: RD-1 Sheathing: Owner on Record: WALLER,STEPHEN G&WARD,JANE B Contctor Fame JASON D STOOTS Framing: 1 Address: 125 BLANTYRE AVENUE ;' ContractorLicense CS 090293 2 CENTERVILLE, MA 02632 East P,roJect Cost: $50,000.00 Chimney: �r �.. Description: Solar PV Installation-11.16kW's,31 modules,roof mounted,flush �Permit Fee:. $305.00 mounted,grid tied,& net metered. k Insulation: fee Paid $305.00 , / 0 Project Review Req: D te „ 6/4/2018 Final: . < � Plumbing/Gas 1, E� Rough Plumbing: BuildingOfficial Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authonzed by this permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved apprica�tion.ar d the approved construction documents for w�hkth this permit has been granted. Rough Gas: zlKAll construction,alterations and changes of use of any building and st uc[ureshall be in compliance with the local zoning ylaw�s nd codes. This permit shall be displayed in a location clearly visible from access street or,road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. "' P as Electrical The Certificate of Occupancy will not be issued until all applicable signatures'by the Building andlTire Officials a e provided on this permit. Minimum of Five Call Inspections Required for All Construction Work i Service: 1.Foundation or Footing '` 2.Sheathing Inspection '` u., R? a Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Perso on ractt with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). �t Building plans are to be available on site Fire Department �c�, All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: J 7 Town of Barnstable Build ing � Post This Card•So.-That rtxis,Vis�ble From�the�Street,.,A roved Plan`s:Nlust:be-Retained on�Job and.:this Card'Must be Ke t � ; •- �ABtr$rA�1.E, E�� / ,*x, ° €r ,' :,r a' ,,.,", ' ,. p xr pp.:� fN 7 ',. '' =rr '," 3 "�'` p 3' �''� 6"E& Permit � Where��a Certificate,-ofOccw anc �Is,Re wired such Buildm shall Not_be Uccu ied<�wntil a Flnal',Ins ect�grl has,been made ��'' Permit No. B-18-1127 Applicant Name: Russell Cazeault Approvals ' Date Issued: 04/27/2018 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 10/27/2018 Foundation: Location: 125 BLANTYRE AVENUE,CENTERVILLE Map/Lot 229 108 Zoning District: RD-1 Sheathing: Owner on Record: HOSIE,DAVID R TR Z V ContractorMN me ,PAUL J. CAZEAULT&SONS, INC. framing: 1 Address: 125 BLANTYRE AVE Contractor.License: 103714 2 CENTERVILLE, MA 02632 Est P�roi�ect Cost: $41,125.00 Chimney: Description: Remove 2 layers of asphalt shingles on the entire homeexcept for , Permit Fee: $209.74 the garage. Install new standing seam metal roof Insulation: Al'51NO Fee Paid r $209.74 Project Review Req: Date 4/27/2018 Final: Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: w This permit shall be deemed abandoned and invalid unless the work authorzed bythis permit is commenced within six monthsafter issuance. All work authorized by this permit shall conform to the approved application and pe'approved construction documents:foTr which this permit has been granted. Rough 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 cir road and shall be maintained open for public a specti, for the entire duration of the Final Gas: work until the completion of the same. �~� Electrical The Certificate of Occupancy will not be issued until all applicable signatures byith'I-A e Building and�Fire Officials are provided�on this�permit. Minimum of Five Call Inspections Required for All Construction Work Service: 1.Foundation or Footing 2.Sheathing Inspection ` {� Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: _ y Town 4 Barnstable , 7' a 200 Main Street, Hyaruus MA 02601 508-862-4038 s634 Application for Building Permit'. Application No: TB-18-1127 Date Recieved:' 4/16/2018 Job Location: 125 BLANTYRE AVENUE,CENTERVILLE Permit For: Building-Siding/Windows/Roof/Doors 2'1 lb Contractor's Name: PAUL J. CAZEAULT &SONS, INC: State Lic. No: 103714 (� Address- 1031 MAIN ST, OSTERVILLE, MA 026'M Applicant:Phone: (508)428-1177 (Home)Owner's Name: HOSIE,DAVID R TR Phone: (202)999-7066 (Home)Owner's Address: 125 BLANTYRE AVE', CENTERVILLE,MA 02632 Work Description: Remove 2 layers of asphalt shingles on the entire home except for the garage.Install new standing seam metal roof. .cA CA . Total Value Of Work To Be Performed: $41,125.00 _ — Structure Size: 0.00 0.00 Width Depth n Total Area. fir`•, I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application.'I understand that when a permit is issued,it is apermit to?proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge_ and belief. - All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least24 hours in advance. Signed: 'Russell Cazeault 4/16/2018 (508)428-1177 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost :` $41,125.00 Date Paid 'Amount Paid Check#or CC# Pay Type• ._...... .,.,..,___._.._ Total Permit Fee: $209,74 4/16/2018 $209 74 XXXX XXXX-XXXX- Credit card w 0985 .:.... .........: ..... Total Permit Fee Paid: -$209.74 �► R , r, Town of Barnstable Building M''t'',`:{S�Y�' ,„{'''a"C""'"'""r.:>y'"""+_rnNwr,�. u^,y"_' """�<• ,a- �.».,m-�yo- �s: ys"' t",€+ ".„y.M'°"},cs+a'N !^. �w^r• '�' '�:3 ,j ,6.#""�»s.�: '*: a�'M: =;.s..«.n r�c,Mq!w"M' ,"';= P ¢PostThisECard So That it i5`,Visible'From=the Street .Approved Plans Must'be`Retained on.Job and this Card Must be Keptr BARIVSCAHI.F A - tt '""� Posted Until Final Inspection Has Been Made e s439• �� � ,., �..' S,� .,. � �r,rr•��t, rr : �*.., ,�r� k.,:'=i ., �3�;.. :� �. '���;a �;:r ...d�.w � ,,.g.;�i Y , Where a:Certificate; Occ pancy is Required,_such�Builtl�ng shall Not be Occup ed unt I,aiFina=lµlnspection has been made '-#~ ��1 1� ��. Permit No. B-18-417 Applicant Name: THOMAS D GUARIGLIO Approvals Date Issued: 03/01/2018 Current Use: Structure Permit Type: Building Addition/Alteration-Residential Expiration Date: 09/01/2018 Foundation: Location: 125 BLANTYRE AVENUE,CENTERVILLE Map/Lot: 229-108 Zoning District: RD-1 Sheathing: Owner on Record:' HOSIE, DAVID R TR Contractor;Nameti THOMAS D GUARIGLIO Framing: 1 a Contractor,License CS-049538 : Address: 125 BLANTYRE AVE 2 CENTERVILLE, MA 02632 Est Project Cost: $100,000.00. Chimney: Description: New Kitchen, New Bathrooms(2 Full,2 Half) New Kitchen Window. Permit Fee: $560.00 Insulation: New 2nd Floor Windows(5),Wood Floors and Living Room" Master y Fee Paid:. $560.00 BedRoom, Remove Bearing(Load)Wall Between Kitchen and Dining Final: Remove Base Board FHW Heat Install(4)Split-systems and Radiant , Date 3/1/2018 FL Heat. = / Plumbing/Gas "PUT H.I.C. DATA IN WHEN CURRENT ,•`= 4{ Rough Plumbing: Building Official Final Plumbing: Project Review Req: R ._ Rough Gas: This permit shall be deemed abandoned and invalid unless the work authonied by this permit is commenced within six months after'issuance. 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 o�road and shall be,maintained open for public inspection for the entire duration of the Electrical work until the completion of the same. Service:The Certificate of Occupancy will not be'issued until all applicable signatures`by the Building and Fire Officials are provided on>this permit. Minimum of Five Call Inspections Required for All Construction Work: R °` .�� 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) Low Voltage Final: 6.Insulation 7.Final Inspection before Occupancy . Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Final.: Work shall not proceed until the Inspector has approved the various stages of construction. Fire Department "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT pplication Numb". --1 "rl Permit Fee................. ... .................Other Fee........................ 0 03 e� 9 szA8 TOWN6 M otalFee Paid......... . ............................................ ...... C O i639• 1v �fD MA'1 A BUIL C ftl 14 APPLICATION .......... . .... ....... Section I —Owner's Information and Project Location Project Address i a 5- 13,1-Al-TY1`Z t A�,`/E Village CF_N'T Ft R=V P L I-G: Owners Name JA N E WAR b� 9- 57 E�P 0 WA k R Owners Legal Address 5 12"5 I_A N TYR i` A V j� City C E N`_E R V 11_t_� State M A zip O a 3 a Owners Cell# aZ 10 6 3 " a G ter-"!J E-mail J a-h e&h 7'6 P S are Section 2 — Structural Use OSingle/Two Family Dwelling Commercial Structure over 35,000 cubic feet ❑Commercial Structure under 35,000 cubic feet Section 3 —Type of Permit New Construction ❑ Move/RQcate Accessory Sucture Change of use '-]Demo/(entire structure) Finish Basement El Family/Amnesty E3 Fire Alarm Rebuild ❑ Deck Apartment Prinkler System El Addition Retaining wall Solar Renovation ❑ Pool ❑ Insulation Other- Specify Section 4 - Work Description { iV�i1/ �JT��/�'/✓n Ni:v✓ 13��'1��?o®/.xS'���F'ye.� , a 1�A�.J=� ai�sEW 1�/r; cn/IN Aaw �/_5y1[_2' *� FL. WInIbOtNS15 , W6DI� lCL,D�RS� LtV�dUG RM. KAASTe:- St l M 13a ?.F_"K6Vjf 13 EAR IA lL3 C &ggbJ W�.LL 13W—rWS;Wl klTG14KK J J,Mb i� in.JsnJ6 t��MOVc-� 13,ASF:� g6 1=tJw WEAy- iOTA1-kt/-4 Pti-S'S'1 7.>-'--mX4 R T IApplication Number........ V ......................... Section 5—Detail Cost of Proposed Construction '00, 0 0®. -Square Footage of Project Age of Structure AI;2 tE A A f Dig Safe Number # Of Bedrooms Existing 3 Total# Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑WFCM Checklist ❑ Design Section 6—Project Specifics 12 Wiring ❑il Tank Storage U'oke Detectors ❑Plumbing ❑Gas ❑ Fire Suppression [Heating System ❑ Masonry Chimney ❑Add/relocate bedroom Water Supply Li Public Li Private Sewage Disposal Municipal] On Site ❑ Historic District Hyannis H'ric District Old Kings Hi--�way Debris Disposal Facility: klAftlj,114 'T' RA N5E%' I am using a crane El Yes ;9 No S'TA T Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes 5� No ❑ Section 8—Zoning Information Zoning District Proposed Use Lot Area.Sq.Ft. Total Frontage Percentage of Lot Coverage # of Dwelling Units (on site) Setbacks Front Yard Required ProposedVol', �® p Rear Yard Required Proposed 9 V®2 'yeS' Side Yard Required Proposed �Q Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No Application Number........................................... Section 9—Construction Supervisor Name TH OMAS GUA R I GL-1 O Telephone Number 5"0 S �W j 0 - d j'6 a Address G MAL L A RA LAPS City HPW 14 H State M A Zip O z License Number O�L753$ License Type Expiration Date 3 4 7 Contractors Email lidvnq�y!yam f !�g/�a a eovw Cell# SD e- a.3 - 3 9-4-7 I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures, specific inspections and documentation required by 780 CMR and the Town of Barnstable. Attach a copy of your license. Signature Date 2 P.- /g Section Id*—" Home Improvement Contractor Name Telephone Number Address City State Zip Registration Number D Expiration Date :2 - l - le I understand my responsibilities under the rules,and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures, specific inspections and documentation required by 780 CMR and the Town of Barnstable. Attach a copy of your H.I.C... r- Signature Date Section 11 —Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the constructionG� inspection procedures, specific inspections and documentati6 �* o required by 780 CMR and the Town of Barnstable. Goo 10, Signature Date 9tP APPLICANT SIGNATURE Signature Date 2 - Print Name Telephone Number E-mail permit to: /1 g � e> . G o-P7 Section 12 —Department Sign-Offs Health Department ❑ Zoning Board (if required) ❑ Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation ❑ For commercial work,please take your plans directly to the fire department for approval. Section 13— Owner's Authorization as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of job) Signature of Owner date Print Name Last updated: 12/28/2017 INN A • snataseast.e "`"M Town of Barnstable CEO MA'l A Building Department Brian Florence,CBO Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, j ���� ��T-IPW 4—L,(aswn re of the property subject p p rtY ereby authorize -TJ-'14t>MA.S G LJ14 2 ( GL/� to act on my behalf, in all matters relative to work authorized by this building permit application for: (Addres Job) S� ' ture of Owner Dat, Wo Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\decollik\AppData\Local\Microsoft\Windows\INetCache\Content.Outlook\9NNOKXYW\RESIDENI'ILONLYEXPRESS.doc 09/26/17 J s Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-049538 r g� Construction Supervisor THOMAS D GUARIGLIO.:. 6 6 MALLARD LANE " HARWICH MA 02645 c a Expiration i Commissioner 03/07/2018 y C��e�roocanraracaeatC��^/lta�a�cc�usetf , office of Consumer Affairs&Business Regulation y - OME IMPROVEMENT CONTRACTOR registration: 101114 Type: y xpiration:��2A//201_8--� Individual THOMAS GUARIGL104 r :r` Thomas Guariglio 6 Mallard Lane -- Harwich,MA 02645 Undersecretan- From: HICRegistration (SCA) hicredistration@state.ma.us Subject: Home Improvement Contractor Application-Action Required Date: Feb 9, 2018, 3:56:21 PM To: Tomghomes@yahoo.com , The home improvement contractor application for THOMAS GUARIGLIO has been approved., If you applied online, please use the following link to log in to your account and make payment to complete the registration: http i./Ihic.oca.state:ma.us/HIC/ If you have already submitted payment for your registrationby mail, your registration is being processed and an HIC certificate of registration will be mailed out in the next three business days. o�� ���? r The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 600 Washington Street Boston,MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lesibly Name (Business/Organization/Individual):`Tj G-'H d M F--G G QA P—1 Cam(_ ,_ Q Address: ry M A L LA,R 'J`� City/State/Zip: 1HA 1ZW 14 MA, Off(®-f3 Phone#: �d S '4'3d a O,3`G � Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7.,g Remodeling ship and have no employees These sub-contractors have g• ❑Demolition workingfor me in an capacity. employees and have workers' y p n'• 9. ❑Building addition [No workers' comp.insurance comp.insurance.; required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.0 Other comp:insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have .employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. n Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Si mature: Date: l?s Phone#: ��`b ,� !� — _10::� 19- 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#: TG HOMES-SUB-CONTRACTORS WORKERS COMPENSATION INFORMATION / TG HOMES-Tom Guariglio Sean Smith-A&S Construction / General Contractor Foundations, Excavation&Septic Ace American Insurance Company PO Box 1396;Orleans, MA 6562UB-4 425P87-5-16 Travelers Indemnity Co #UB-0187N208-15 Summit Insulation Thomas Thibert-Electrician PO Box 1337; Harwich, MA 02645 44 Kendrick Rd; Harwich, MA AIM Mutual Insurance Co Granite State Ins.Co VWC-100-6015914-2015A WC004961905 Hutchinson Roofing-Michael Hutchinson Scott Brazil PO Box 534; Brewster, MA 02631 Stairs AIM Mutual Insurance Co PO Box 777;Truro, MA #VWC-100-6005898-2015A WCC5008740012009 Dick Bindig American Waterproofing-Kenyon Keyes Pindig Plumbing&Heating 133 Tonset Rd;Orleans, MA PO Box 553;S.Orleans, MA 02662 #6608155 The Hartford Ins.Company #WCO8WECRH3903 Kikorian Hardwood Floors, Inc Ryan Stevens-HVAC PO Box 1200; Brewster, MA 184 Brook Trail; Brewster, MA #08WECT1869 Hartford Insurance 08W ECCQ1567 Randy Clark-Clark's Drywall Mike Steinmetz-Painter 1780 Orleans Rd; Harwich,MA 51 Boulder Road; Brewster, MA Travelers ARWC Travelers Indemnity #K-F3T*3+P- UB3A59333 MAC Electric °W}41TE pLJ�%tiV� -► NEAT IN G- 102 North Westgate Rd; Harwich, MA Insurance Certificate Requested •�ft tv t.614" Jet 4 J 1iv W t - -xvL 4v i� I K Vr Dt141NGAREA ..._ z � ~ t -F_V:M o va---'NON I-OAb - ` a a K�lCV1 E_ i N� 4 Roam LA ^ .pi.yi7i lei 57y.. dti ii t»t ( — ' T1 rt I we-otsivaiq ftwrtTv .. I e tl- Ftit fl ` 1i OV —BEAT{W-6_-3 I L. 0` *1 CLc2S. Ti f F-L wA ' N t m -w B.G.ary i a , 1 flume wvaw= _- JANIE V✓�4 1J_R. S`r P K E IJ WA,LL—E` R _ -- - _:_� G�NTH c�V l LL_•� Iv��., ---------- - __ _ __ G , O r� k-' r IV �.'��' � `�• 1 to IV v ,` VC .01 L _ / 4 '. !•��, Z.� t� F L.il 4a 6-S i� � M �� 1 t tom,!�... . 2-C3 `I ui { i • !!11 J'j Q ' ' taN.ere �� to . C7 I � Qi i Ln R.O 4 M Y' r. LOW vi 8 . i I fl , iy '. JSCaG�t� �,/ j a6:1cr_xs WhttF- WALL i '• 1 0 R. a - G 1 J W, O-LM• R. P L /4%. N ®Boise Cascade Triple 1-3/4" x 9-1/2" VERSA-LAM® 2.0 3100 SP Floor Beam\FB01 Dry 1 span No cantilevers 1 0/12 slope February 6,2018 08:31:36 BC CALC®Design Report Build 6080 File Name: tom.bcc Job Name: Description: Designs\FB01 Address- Specifier: City, State, Zip: , Designer: Customer: Company: Code reports: ESR-1040 Misc: 12-05-00 B BO Total Horizontal Product Length=12-05-00 Reaction Summary(Down/Uplift) (Ibs) Bearing Live Dead Snow Wind Roof Live BO, 3-1/2" 3,228/0 1,058/0 B1, 3-1/2" 3,228/0 1,058/0 Live Dead Snow Wind Roof Live Trib. Load Summary Tag Description Load Type Ref. Start End 100% 90% 115% 160% 125% 1 Standard Load Unf.Area(lb/ft^2) L 00-00-00 12-05-00 40 12 13-00-00 Controls Summary Value %Allowable Duration Case Location Pos. Moment 12,342 ft-Ibs 58.9% 100% 1 06-02-08 End Shear 3,539 Ibs 37.3% 100% 1 01-01-00 Total Load Defl. U339(0.423") 70.8% n/a 1 06-02-08 Live Load Defl. U450(0.319") 80% n/a 2 06-02-08 .Max Defl. 0.423" 42.3% n/a 1 .06-02-08 Span/Depth 15.1 n/a n/a 0 00-00-00 Squash Blocks Valid %Allow %Allow Bearing Supports Dim.(L x W) Value Support Member Material BO Post 3-1/2"x 3-1/2" 4,287 Ibs n/a 46.7% Unspecified B1 Post 3-1/2"x 3-1/2" 4,287 Ibs n/a 46.7% Unspecified Cautions Member is not fully supported at post BO. A connector is required at this bearing. Member is not fully supported at post B1. A connector is required at this bearing. Notes Design meets Code minimum (U240)Total load deflection criteria. Design meets Code minimum (U360) Live load deflection criteria. Design meets arbitrary(1") Maximum Total load deflection criteria. Calculations assume member is fully braced. Design based on Dry Service Condition. Fastener Manufacturer.TrussLok(tm) Page 1 of 2 ..� AwBoisecescade Triple 1-3/4" x 9-1/2" VERSA-LAM® 2.0 3100 SP Floor Beam\F13O1 Dry 1 span No cantilevers 1 0/12 slope February 6,2018 08:31:36 BC CALC®Design Report Build 6080 File Name: tom.bcc Job Name: Description: Designs\FB01 Address: Specifier: City, State, Zip: , Designer: Customer: Company: Code reports: ESR-1040 Misc: Connection Diagram Disclosure r�I b d Completeness and accuracy of input must Li be verified by anyone who would rely on a output as evidence of suitability for particular application.Output here based on building code-accepted design properties and analysis methods. • • • Installation of Boise Cascade engineered wood products must be in accordance with current Installation Guide and applicable e building codes.To obtain Installation Guide or ask questions,please call a minimum =2" c=5-1/2" (800)232-0788 before installation. b minimum=4" d=24 e minimum= 1" BC CALC®,BC FRAMER®,AJSTM' ALLJOIST®,BC RIM BOARD-,BCI®, . All TrussLok screws may be installed from one side of multiple ply VERSA-LAM beams. BOISE GLULAM1m SIMPLE FRAMING SYSTEMAll TrussLok screws may be installed from one side of multiply Versa-Lam beams. PLUS®®ERSA-RIM®,M®,VERSA RIM Member has no side loads. VERSA-STRAND®,VERSA-STUDS are Connectors are: FMTSL005 trademarks of Boise Cascade Wood Products L.L.C. a. ®961seCascade Double 1-3/4" x 9-1/4" VERSA-LAMO 2.0 3100 SP* Roof Beam\RB01 Dry 1 span No cantilevers 1 0/12 slope February 6, 2018 08:31:25 BC CALC®Design Report Build 6080 File Name: tom.bcc j< I'P'G r-I E Job Name: Description: Designs\RB01 ,� �� ati Address: Specifier: City, State, Zip: , Designer: Customer: Company: Code reports: ESR-1040 Misc: �o 12 I 2 I I I BO 07-08-00 B 1 Total Horizontal Product Length=07-08-00 Reaction Summary(Down/Uplift) (lbs) Bearing Live Dead Snow Wind Roof Live BO, 3-1/2" 1,150/0 1,128/0 1,495/0 B1, 3-1/2' 1,150/0 1,128/0 1,495/0 Live Dead Snow Wind Roof Live Trib. Load Summary Tag Description Load Type Ref. Start End 100% 90% 115% 160% 125% 1 Roof/Snow Loading Unf.Area(lb/f:12) L 00-00-00 07-08-00 15 30 13-00-00 2 Floor Loading Unf.Area(ib/ft^2) L 00-00-00 07-08-00 40 12 07-06-00 Controls Summary Value %Allowable Duration Case Location Pos. Moment 5,273 ft-Ibs 34.5% 115% 6 03-10-00 End Shear 2,250 Ibs 31.8% 115% 6 01-00-12 Total Load Defl. U999(0.107") n/a n/a 6 03-10-00 Live Load Defl. U999(0.068") n/a n/a 12 03-10-00 Max Defl. 0.107" n/a n/a 6 03-10-00 Span/Depth 9.4 n/a n/a 0 00-00-00 Squash Blocks Valid - %Allow %Allow Bearing Supports Dim.(L x W) Value Support" Member Material BO Post 3-1/2"x 3-1/2" 3,112 Ibs n/a 33.9% Unspecified B1 Post 3-1/2"x 3-1/2" 3,112 Ibs n/a 33.9% Unspecified Cautions For roof members with slope(1/4)/12 or less final design must ensure that ponding instability will not occur. For roof members with slope(1/2)/12 or less final design must account for Rain-on-Snow surcharge load. Notes Design meets User specified(U240)Total load deflection criteria. Design meets User specified(U360) Live load deflection criteria. Design meets arbitrary(1") Maximum Total load deflection criteria. Calculations assume member is fully braced. * Cut from: 1-3/4"x 9-1/2"VERSA-LAM®2.0 3100 SP Design based on Dry Service Condition. Fastener Manufacturer:TrussLok(tm) Page 1 of 2 r � tBqlseCascade Double 1-3/4" x 9-1/4" VERSA-LAM® 2.0 3100 SP* Roof Beam\RB01 Dry 1 span No cantilevers 1 0/12 slope February 6, 2018 08:31:25 BC CALC®Design Report Build 6080 File Name: tom.bcc Job Name: Description: Designs\RB01 Address: Specifier: City, State, Zip: , Designer: Customer: Company: Code reports: ESR-1040 Misc: Connection Diagram Disclosure r•�I b d Completeness and accuracy of input must L be verified by anyone who would rely on a output as evidence of suitability for • • • particular application.Output here based on building code-accepted design properties and analysis methods. Installation of Boise Cascade engineered wood products must be in accordance with e current Installation Guide and applicable building codes.To obtain Installation Guide a minimum =2" C= 5-1/4" or ask questions,please call (800)232-0788 before installation. b minimum =4" d=24" e minimum= 1" BC CALC®,BC FRAMER®,AJS-, ALLJOISTO,BC RIM BOARD-,BCI®, All TrussLok screws may be installed from one side of multiple ply VERSA-LAM beams. BOISE GLULAMTM SIMPLE FRAMING All TrussLok screws may be installed from one side of multiply Versa-Lam beams. SYSTEM®,VERSA-LAM®,VERSA-RIM Member has no side loads. PLUS®,VERSA-RIM®,VERSA-STRAND®,VERSA-STUD®are Connectors are: FMTSL338 trademarks of Boise Cascade Wood Products L.L.C. Town of BarnstableBuilding Post This Card So That it�is'V�s�ble';Fromthe Street ;ApprovedPlans".Must be:Retained on Job andahis Card Must be Kept �' ■AflfV3fA81.Fn ., c.y t +, w ._- ,, .�.;., .-- ..p ,S }` � 'a. ,^g�Y'T" � a .. �- . "+"� Posted�Until Final Inspection=HasBeen.Made ` - ;� � , s f63SA mr x^ D": F 4, P `+ „ 8 ; #: k .4' is ,, .� .K Perl111t � Where a Certificate'of-0cc�upanc�y is Required;such Buildmg'shall Not�b�e;'Occupied until,a Final;lnspectiMon�hasbeen�made , Permit No. B-18-414 Applicant Name: RETROFIT INSULATION, INC. Approvals Date Issued: 03/01/2018 Current Use: Structure Permit Type: Building Insulation-Residential Expiration Date: 09/01/2018 Foundation: Location: 125 BLANTYRE AVENUE,CENTERVILLE Map/Lot 229-108 Zoning District: RD-1 Sheathing: Owner on Record: HOSIE, DAVID R TR Contractor Name ,,RETROFIT INSULATION, INC. Framing: .1 a. Address: 125 BLANTYRE AVE Contractor License '160461 2 _ ,.' CENTERVILLE, MA 02632 Est..Project Cost: $5,815.17 Chimney: Description: insulation in attic and kneewall Permit Fee: $85.00 I Insulation: ... ' Fee Paid:,. $85.00 Project Review Req: Final: i Date: 3/1/2018 Plumbing/Gas, Rough Plumbing w '° ; ;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 ssuance. Rough Gas: All work authorized bythis permit shall conform to the approved application and theapproved 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 s work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Bui'ldingand Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: r 1.Foundation orFootin g {. -'_}` ROugh.: -T. `. 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 Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy 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 TOWN OF BARNSTABLE"BUILDING PERMIT APPLICATION Map Parcel b Application # - `2 I Health Division Date Issued ! �� Conservation Division Application Fee Planning Dept. Permit Fee 3J'r Date Definitive Plan Approved by Planning Board yj Historic - OKH _ Preservation/Hyannis Project Street Address l S' (� �,q nl �y C-C AOC . C ,�Jk2ry like 6"A 04 (a3 Z Village 11 Owner �-t��ne�J �,J 1 e/L Address Telephone 9.3 Z Z Permit Reques t e< `A, ) bp 5�N i L ( tr ,,SJ\c IA-A, c, R)L_ R r,,D A y&As CID, P t 6%/-) 6 0 4C E> - VAJe-f-�A�� L R-1 � 0(n Im nA(%( Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project ValuatiA S 1 t , 11 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 21_� 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 (sgat {' Number of Baths: Full: existing new Half: existing ' neaa ; Number of Bedrooms: existing _new -a Total Room Count (not including baths): existing new First Floor Roo Count4" ti rn 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) oll Name ,`CT(-O_�P1A'-Ij 3,AG -i 6-) Telephone Number LON) Address bu License # 16d. 7 ? 1 "(N 0 77 Home Improvement Contractor# l> `� l Email L Worker's Compensation # D ALL 4NSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO� Sk SIGNATURE LA DATE L5rJ/ �" `Y FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME f INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL _ PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT t ASSOCIATION PLAN NO. ;E c1 S The Commonwealth of Massachusetts. _ Department of Industrial Accidents > 1 Congress Street, Suite 100 F . Boston,MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly' Name(Business/Organization/Individual):RetroFit Insulation Address:PO Box 105 City/State/Zip:Seekonk, MA 02771. Phone#:.508-989-6436 Are you an employer?Check the appropriate box: Type of project(required): 1.[D I am a employer.with 10 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 ❑ 8. ❑Remodeling any capacity.[No workers'comp.insurance required.].. 9. ❑Demolition 3.❑I am a homeowner doing all work myself,[No workers'comp.insurance required.]t 10❑Building addition ' 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'.compensation insurance or are sole I I.❑Electrical repairs or additions proprietors with no employees. a 12.❑Plumbing repairs or additions' 5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑ p Roof repairs These sub-contractors have employees and have workers'comp.insurance., 6.F1 We are a corporation and its officers have exercised their right of exemption per MGL c. 14•[:]Other 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this 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 sub-contractors and state whether or not those entities have'. employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. " Insurance Company Name:STAR Ins. Policy#or Self-ins.Lic.#:V9WC802160 Expiration Date:8/2/18 Job Site Address:125 Blantyre Ave. City/State/Zip:Centerville, MA 02632 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c.,152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in'the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under th ains d penalties of perjury that the information provided above is true/and correct Signature: v Date: Phone#:508-989-6436 Official use only. Do not wra a en t is 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#: DocpSign EnJelope ID:C9E8237B-3A47.4F!7-B51E.CBB326944372 Town of Barnstable Regulatory Services . 8AAJX�VVrrSC.TT0AJRIFMr V4 Richard V.Scab,.Director - ,� � �° : .Building Division Paul Roma ., Building Commissioner 200 Main Street,Hyannis,MA.02601 www.town.barnstable.ma:us Office: 508-8624038 Fax-'508-790-6230 Property Owner Must Complete and Sign This Section _ L STEPHEN WALLER as Owner of the subject property hereby authorize � ,, to act on my behalf, o71-.,,... L�t✓f m c)j in all matters relative to work authorized by this building permit application for: . 1.25'Blantyre Avenue Centerville, MA 02632 {Address of Job} . DoeoS- d byte Sfi �1/24/2018 1 8:55 AM EST ..........._......................._........._...._ _...._.......... ....:........_ Signature of Owner ..Date . -STEVE WALLER Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form. , r C:OUserskdccoliikiAppbata\LocaiMcrosoftlWindowiMNetCachelContent'butlook\L7U69L'F2lEXPRESS(2),doc 01/25/17 _. p �'f.- F wt �k ty'; t i ;"x 'e r yv .&_ - - - $ ✓-ia wv * ! > f x& e� q' a a i ,xs: a 4t s *.� ,� .y. Y' 3 N ,.3a ' Y A f�z i Sk a. Y _ T ,�'k� t ay 's Sf' ,� lJ y i ,.., ',� lellll: - d#' 'a}3 1 3 x3 `"p x1yx A _H,;., _. ., .,, ,. .. z 9 C9r nartr�rea#fi tx# a a i u t w , p z ��� v I "",,,,�",jyisi6ji,�i6f,pf.df"�i,eiiit,Lic,t��re�,'-f"' , ,"'A�4 , ,��.,,:,�.;, ". - -�:�i atd refuldir�a i�euai�cs aid„51nd� ds ('�yy]A ys Yar�J/v fff pu4 p 5y q _ ,k �wiJxlQli Wi✓ �i� L,:i { '4,. '•,. K1"s ��?a X• �XP 'yy `r.- »4 CSSi.f�€���'1.71 � ,y" � 1t 019 1-11.1 ,, a 1, q, I I . 46SEOH'i Ri I ; "I V "-" u*a � ttd„„, K SKCaiUK 141't7 b11;- x a C x,y. 3' •a. ' -�a I :1" , I 1, ......r ,. si " fin: �' �S. # ,, a e 1 r u , rA a „ 11, v - vaXfk"� Von ;• a_ { r5 ^ Y ;' _ 1 : a} vZ ,,r 4 >��n f ...: f k - .x t' a`. & $ 01 wC Y l b 3 P `6x l F � ^;z ,ah S F ';,fit Sf" �. �r � '. $ �' 4G. ; y. v _'" _ a s. �. fi a srs �"va �' ' ,n � Ij �. x.:.F 't s y v > _ E > , , . , "` F. ,,. ,. X a t , sz- Yea"' :% `,is> 4 a? ,fh air l > ^ �. �, w,4,b 5`: P , .'.' S '.�< .�11.r. s �d as t .> :. "! ^� , ` w x, q� .� > '' § y $ . ¢ x -,X 5,T AY ON E �ll . »tt,- Y : - �� � S &, 1 '" ",. x $ a a5 k cox �. �+, <c wt , ;fix ..., x x s e F x #�"y -A ,4 F3 hr.. , r,� z �, =vY .'s� a a' e'1 b r" s ', ,."e "i s E s' 1 , 4 F"t $ A f € 3"'R ' a E r ✓ , s - "p � t z �' ?;sm >"9� ,r.,zR ua".te �a3Awa x ,, i $ $ '9R ; RF � - ,4 e ! - 1 -5 Na 111 § 4 `i P -f h ,y 3jdyi, kk ! k X d ri . t. ,f. -'z /tea f , � :T _ ¢t k . S� ai' ! & #,S i ; ! � h .?': b , ..'_, `a, ,. ......,M.. ,.,i, >_,�M... s«_6,k... .u_ " «r._.,. ".,. .,»n...:"i.,,� . ,,,,_ .�,-r,, .�.>x .,,,,,'.& d. - - - > a V "� "S, K6 '» §§�Y f".: i o f t i8 �"2... .r § "� � s : F fY .a« 'L: .... y ta� )JI 4(aeA i—S rc � r $ � , .; z r ♦ �pA g. Y /� x fi EE �b� �Tii3JdY! �W�MT > y S k s f .." . 8 » .spa. t t °i- S i F r� �'� .��� � m �S In_' �A`` q 2 } 'F #"•fig ry 3a ' £,a x z w� �- a1Y .:y >` t x T t y $: t r �y���� .f ! m y,> „ ��"- r �o `Y'"`" ! x'i .mac^ r 1 �' p� '. 3 y,,.,.� _..� b m , .�`f � s 'IWIl `$ i s� F P&., 5 '! 5 �, . .4 YY jg�/N 7` a '� ' ; I, . I sx 1 �'♦ a ��x? w 3a £' E5r ��4 z� a �^" •' z _. SA1 � ." a t� �## " fi s n� Aga rzbiloliri `` a , iIY03'. Y .� , wd ? % Y,I q g't'*A Y v ,,�'�► i�F aC#T '`m 3 1 S: .: .3 §f. aly1 � { ll� .- k 4 g. a�r. F - ..,� d : �' �.644 F , __V� F,:�, ii�� � I '�Fll` , , -.1 Z /♦i.i�li�r! 'tH Y VY 'a iiP ii1R#�♦I Fj' #z'[ iti X4tilli t zff S':`� afi f'Ill` tr F S < I I s �" �x a 'tea t giro N< , %.tom § , ", axe d Y :. a7' L £'� /.'X i 2 lm e'F 'W.yy ^°Y d. , t k'`` a.� 6 ff x�r:s f !t .,11 K. �� c ,� z a }aX k br ri e 7� s�--r t ? m •^i .. �' w� MF s.��„im 4°7 Fi11 s E sC�,w.4 _a f f� �: I;RIM� ,, d' '3k p - 'k cr 'f ' t` -ffi 11 i1. r ��F r �.ax. t - € Y f ,,a g k a,' X r,,,,p s' '' r`F�' r rir " ` r'�,»: s .e,. m - g s;k x y -x z k„�` '�, i S F �` - '« - rL -f,?:. r y:2 Y , .E' yY a� � rr '` +�a a,_ 3' a _ ?s i ,ar'C.ilr r a- .: ^�6 I ''"Yc' �', fy,.x��.l z ,,,,t f s"'>vF� .. A s.'e.,. J so ax k �b. �� aY "`�° � r ,t ? b ;l S'a t IF r..<.. .,,r. _s •r rK..,fit"F/ly :+v ✓ ds aON" E c 'bB ca ,. 'b` `�!' , Wkf` s y i a ✓ zbwl 3; s 6:;� ! ` a r33 .�'#r2� #f n ti ' .E, 1t {`Yr � 'r.f ��, s b r ✓ r.v m, iW, ,' '< d. ,z',° a y F f y° - q �wxh �.''„ �', S s ' a,`:z✓,'�, x s:_ .>r ym$t % 8 ? ,., a,"', s. t ' o-�a3 a _ u ,. W.r k r " � Ill ti w 'V ` }' ;. r✓'. f� Fr �v " a .. ar ? .,�E k�. :�=. f#» a s '" rya P' ,, ¢(; r �, z ,� - s .r dark r r 3 z1 : e s a„'" �' '.,n r _ �r �YTs ,a -", r_ x t a" f> b f 4 i{ f' TeX �Iell �" )'' f, 'fir t ?tea Yam.' d f af� '',w a r a �, a q F1.a rk� ni .. 't i '3. s F 4 _' „ lll,il Yn . S x' a 9� ➢ 1 �' ., a X 15 r �, a d A _ s _ .,:a avS'tye.x, X'q. F ,P ., f a.� X �, r - N : r`' z 7 - a x h _ ..a a h• ,r �v t . ran fr. r "'' -gym d~Z tf �c { ra"Z¢nyq1. 2 K, a. 9 ,p §%. '� y a , arc" § r � 1 u Fr a,^ .s4 Y § ,Y Y W A k 7 X' � Y ' Y Y u`r S'� Y,.»4ng�F ., _,4. a: �z r _ d✓ t- if ^1a ,�.w,<..,.-�'.x, ... ,. .»..,��...,.. ....� .�.G:..._«....,.�..•_..� '�",.. .." .. ._a,.a �''br. .._ �.. ,. ,s ':;^_... _ t5 ,..,�... .; „✓”"! RETRINS-01 DCARVALHO ✓`11C: `IG0R"4 - DATE(MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 07/27/2017 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). PRODUCER License#1780862 - CONTACT Diane Carvalho - NAME: HUB International New England PHONE FAX 222 Milliken Boulevard (A/C,No,EXt): (A/C,No): Fall River,MA 02721 a DRIE s:diane.carvalho@hubinternationaLcom INSURERS AFFORDING COVERAGE NAIC# .INSURER A:Selective Insurance Company Of South Carolina 19259 INSURED INSURER B:National Liability&Fire Insurance Company 20052 ' RetroFit Insulation,Inc. INSURER C: PO BOX 105 INSURER D: Seekonk,MA 02771 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LT D D M IDD M/DD A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE �OCCUR S 2187653 08/16/2017 08/15/2018 DAMAGE TO RENTED 100,000 PREMISES Ea occurrence $ MED EXP Any oneperson) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 . GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,0.00 PRO- 2,000,000 POLICY[JECT LOC PRODUCTS-COMP/OPAGG $ OTHER: $ A AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT 1,000,000 Ea accident) $ ANY AUTO A 9100182 08/11/2017 08/11/2018 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY X AUTOS BODILY INJURY Per accident $ X HIRED X NONAWNED - PROPERTY DAMAGE . AUTOS ONLY AUTO ONLY Per accident $ $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE S 2187653 08/15/2017 08/15/2018 AGGREGATE ' $ 1,000,000 DED RETENTION$ $ B WORKERS COMPENSATION PER AND EMPLOYERS'LIABILITY STATUTE I i EERH YIN 9WC802160 08/02/2017 0810212018 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT - $ WFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 1,000,000 If es,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION' SHOULD ANY OF THE ABOVE DESCRIBED_ POLICIES BE CANCELLED BEFORE National Grid THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 40 Sylvan Road 02451 AUTHORIZED REPRESENTATIVE ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD p Y XtSTtyr- t 32- 0.1 ' " r ffi f•i t 27. It fig - u ` fo_ t" ,f. .;.. �.h<�! � rl P•�^j�.. �.f; �( J.. /l fir, �•t. is �, •� �•) ' �,�-'�.�,.�',,���f S/L L ELE!/._ F'E.E 7".48o N'E .LPO,a,U Q �y. .?y �L� A N 2E G�,�E/nlrC+;� '�-y�.r)n�G/i,,,.�.^.•TJ" M'��.k. '�dY'J efs.'.s'•4FA �Y+4�r'�!t✓ t!V�4�.�V.�l lryV�-� �G. 1�, �q+.-I�.L. a f _ .0. _ ,• I AIL-Z6 3Y C,6Er/FY TAVA T 71-/E 6XI57= J f4�' f ♦. Y /MG FOUAIDAT/O�V 40CA7'/ON /SC27 ' AS SNQ/�VN gNL7_ 'c"p _CO�/FOQ�j i'O�/TiS! THE 0U/LD/NG 5E7`43AC.e 4 TO Y ,Z.�. ZWA.1.lVlZ293 a fi"i f✓>�.�'-1 Ici l�sl F-t , � C._ cvc c. 7- �✓�or C .��? B G!/iGGO .ST: 3�A2M0 t✓Ts�/l�.E'T,�,q, Asse or' nn s.:yap;and:lot number ..... t �. r . � SEPTIC SYSTEM MUST BE � INSTALLED :IN 'COMPLIANCEr �. Sewage',Permit number ..:................... n...... WITH ARTICLE II STATE SANITARY CODE AND TOWN THETOW N 4 OF' B.A RNST S E ; y �1 r7 J `' Z 'B"i TODLE, i r ' [ 1639. BUItDIHG ( INSPECTOR A MPY r• F r ? APPLICATION, FOR PERMIT TO �� �Y ............... TYPE OF CONSTRUCTION ....................... ... ......................................................... ................................. V ..............................................I TO THE INSPECTOR OF BUILDINGS: The undersigned hereby appli s for a permit according to the following information: Location 1 ...�.Y.. :_.r..........:...... ........................................... rj. . ............. . .............. Proposed Use ....... r .. .... ..!�I °.. .... .......... ................... Zoning District / ..........Fire District .............. .................... ...... ............ ......................... .. �' ^....Address f ll..� � ..p..7.`!..'�... !.�r Name of Owner .. ...�.�....... ...... ....:.... ....... .. /� ... ....... Name of Builder .....Lt'...1. `.1? . ....... z./eP!i .:' Address ..... �''. %' . .! . ................................. Name of Architect ... .... ..� r..... .f'?� i....Address .............................. Number of Rooms ...............Foundation ........................:......:................... ............................. ............................................. . , f, �/aa Exlerior .....:.�!�.�:...:4-..•.......C...�'/..�..d'�,.�r...`�� ..Roofing ........ ......7 ..�� a...��. ............................................... Floors 3 o- .............Inferior. �,�'/..I'7 %./<..... � } Heating �ax .a`G ...:.......................... Plumbing ....................• . .......... .... p PP ...,r......r�....... . ,....Fireplace .............an zf.- ..................................................A roximate Cost .........��J c� � .)....................... ... Definitive Plan Approved by Planning Board ________________________________19________. Area .........>.......:.... ,.�. .......... Diagram of Lot and Building With Dimensions Fee ....:..... /.......................... . S JECT TO APPROVAL OF BOARD OF HEALTH �o�/, ` . 13 I hereby agree to conform to all the Rules and Regulations of :the Tow f rnstable regarding the a ove construction. Name .....:. ........ ....................................... Crawford, Raymond 18344 "two story, •N '..... .....'Perniit.'fo {_ " single ,family dixelling - t ` .•�......... ..... .i•`i1.B •. .................. lantyxe Avenue Location'.......... . _ Centerville .. >.-'' � ` Raymond Crawford" CK Owner ..................................... .: frame ,;��' _ Type of Construction ..............................:........... 'f .+"'" /� � K lot .•................��...... Lot . rS: .I . �. A. S,ermit Granted .........A AT 1 27...t~:...: 1976 -t Dto of Inspection �. .....................�:......::19 Date Completec!'I 1. ............... 19 PERMIT REFUSED ............ ..:... ........ .. .... 19 ........... .*,.................. r .............. ......... ..`..... ........ ' . .....:.............. . ......................... ...... . }.. .� r Approved ............................... 19 ............................................................................... ,1 ................................................... .............:. , 1 , 746 Assessor's map and lot 'number ..... Sewage Permit number ....................0 .., TOWN OF BARNSTABLE 639. BUILDING ASPECTOR APPLICATION FOR PERMIT TO ......Fe., .......IZT, .......................................... d , 67 V ...................................................................................................TYPE OF CONSTRUCTION .... ............. .............................................. TO THE INSPECTOR OF BUILDINGS. The undersigned hereby applies for a permit according to the following information: Location ............. ..... .......jy........e�;.......................!.................... ................................................................................ ProposedUse .............................Z�.................................................................................................................I........................... a, _-fl/ i ce I / . .......... n. —��Z�..� .......... Zoning District ... ............................................................Fire District ................... ........ ....................... • .......... ..........................h� Name of Owner ...Address ....... .............. ..... .. ..... r. • Address Name of Builder ...... ..i�7 .... ......... ... ................ ... ................................. Nameof Architect ............................................ ...Address .................................................................................... Numberof-Rooms ................... .........................................Foundation ............................................................................... ........�7 .................. .1.................Roofing ................... ...... .....................................Exterior .................. I............ I,- ....................................... Floors ................ri r 1:1 ....................................:.................................Interior ....... Heating ..................................................................................Plumbing .....................6�.......................................................... Fireplace .............. ........... ...................................................Approximate Cost ..........sG.......!.................................................. Definitive Plan Approved by Planning Board --------------------------------19--------- Area ..... .......... .... ....... ... .... .. Diagram of Lot and Building with Dimensions Fee ............. ............................. SUBJECT TO APPROVAL OF BOARD OF HEALTH Cam. I hereby agree to conform to all the Rules and Regulations of the Town of Ba-rnstable regarding the above construction. Name ........................... Crawford, Raymond A=229-108( .'10 18343 two sto Y, No ................. Permit for .............. k single family dwelling ...............................t........................... ..... ............. Location 1.2�51an.tyr.e...Aven.ue......./................ ............... ...... . ........ .... Centerville ..................................................... ......................... or Raymond Craw/d Owner Raymond.................................................. Type of Construction .......... .. . ..................... .............................................. ................................. Plot ............................ L t .................. ............. A P it 27 76 Permit Granted ........... ............................19 Date of Inspection .. ...............................19 Date Completed ...... ......................... ........19 PE IT REFUSED ................................ ........... ................... 19 ............................... ........ ....... .............................. .... ....... ...... ............... ............... .......................... ......... ........... . .............................. .................................... ........... Approved . .......... ............................. ... 19 ................... ..... ... ................. .................... ...................... ........... A r �.6 t l,% 2�. t �62 2- r r .,, t fC �" n�7v:2f li.i r !!! Y ar flEK f6T L780✓E V0.d.D t , SCALE _ �`` C'Z»,A7 NEk?E£jY CE.PTi jY TA-IA T 7/1E EXIST- � ` /A/& C'OUAIDA 7-/0N I-OCA7'10,v /S 0,:2,eAeZ 45 6�410WAI AN1D_ ' E% _CONF0�0,-J I+Ylrq THE $U/LD/NG SET(�i4CC'. ' QU�PEM��t/T OF TiS/,E TOWN OF £! YA eA4o Un •Q7-A-14. } /Zz aJ • - .. Town 00 7 of Barnstable *Permit# Expires 6 months from issue date .� Regulatory Services Fee i,7 MASS. E 1639. ,10� Thomas F.Geiler,Director °rEo�r s • Building Division X-PRESS P.ERMIT Tom Perry,CBO; Building Commissioner . 200 Main Street,Hyannis,MA 02601 JUN 2 1'2012 www.town.barnstable.ma.us Office: 508-862-4038 Fax: SQ$- MI EXPRESS PERT APPLICATION - RESIDE BAflN� t��� Not Valid without Red X-Press InTrinf Map/parcel Number. Property Address t residential Value of Work r r ► . Minimum f of$35.00 for work under$6000.00 Owner's Name&Address i' Contractor's Name Telephone Number � c Home Improvement Contractor License#(if applicable),. Construction Supervisor's License#(if applicable) Y7zeq- orr an's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I the Homeowner have Worker's Compe ation Insurance Insurance Company Name Workman's Comp.Policy# '? Copy of Insurance Compliance Certificate.must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) N/Re-side #of doors eplacement Windows/doors/sliders.,U-Value ! (maximum.35)#of windows_ *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e:Historic,Conservation etc. ***Note: Property Owner must sign Property Owner Letter of Permission. _. A copy of the H rovement Contractors License&Construction Supervisors License is r uired. -SIGNATURE: QAWPFILESTO building permit formslEXPRESS.doc Revised 051 F 1 u The Cominommealth ofmnssachuse& Departrnent o,f lIndustrial Acrid Office o,f Investigadorrs 600 Washington Street Boston,CIA 02111 n�rvkttimr�go�►i�din . Workers compensation Insurance Aff davit BudderslContr2ctorslF.� ns/Plumbiers Appfic-ant Information Please Print 'h Ndt7IE($ncinntsna7ati Add�ie: city/stat1d ;. Phone# ✓ Arey+uu,an employer?Ch .kthe appropriate,boz Type of ro ect r ��,, // 4. I am a Yip project 1 (required): 1_�Iam a employer vaith ❑ ges>esal contractor and I . employees(full and/o have hired the sub-tonhwtars 6- ❑New camshruction 2_❑ I aim a sole proprietor or partner listed on the attached sheet. 7- and have no employees s These sub-contractors hone � �P S_ ❑Demolition wcd ng far m�e in any capacity employees and have workers' [No workers' cutup insurance comp.insurari Y 9_ ❑Budding additican required-] 5_ ❑ We are a cotporation and its 14-0 Electrical repairs or additions 3:❑ I am a homeowner doing al work officers haveexercised te 1I.O Plumbing repairs or.additions myself.[No worloers'comp. right of exemption per MGL 12-❑RDof repairs insurance required_]l c.152,§1(41 and we have no 13.❑{lther employees_[No workers' comp.insurance required.] *Any applCmit@litchecksboa#1 must also filloutibe section below showinsaingthenwoders'.c ati=P0HCYiufi� Homeawnees who submit this affidavit indicating'they are doing all work and then hue outside tonnstnus mast submit anew affidzvit indicating such IConuactors that ch8ck thus boat must attached as additional sheet showing the name of the sue-contractors and state whetber or=these entities haM employees.,If the.sob-coatac-ors bave employees,they must provide their workers'tamp.polity number. I aunt an emplo.�vr that is prrVingtuor ors'ca rsadvn.insurance for my seuplq we& Bdory is the policy aR+d job s in,formation. Insurance Company Name: AV Policy#or Self rue.Lit. :Expiration Date:' Job Site Address: Citylstate zip: i3mn I Attach a copy of the workers'compensaii olicy declaration page(showing the policy number.and expiration date). Failure to secure coverage as required under ection 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500-00 andlor onB-year imprisormenk as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250-00 a.day against the Molatcor. vised that a copy of this statement may be brwarded to the Office of Investigatioms @r DIA for insiran o ge . on I do hereby c n a pro .f'peunly that Ae in fotmuatim ptmi&d above-�1rus and correct Si Date: f Ph O,kfal use only. Do not write in this area,to be completed by city or town o ffic l. City or Town: Permitffikense 4 Issuing Authority(time one): I:Board of Health 2.$nMing Department 3.CityjTown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other. Contact Person: Phone ti: 6 C��ie rparr�nw�rccuea ac u�eG� j " ffice of Consumer Affairs&Business Regulation' License or registration valid for milividul use'only ME IMPROVEMENT CONTRACTOR before the expiration date. If found r6Pgrn to: Office of Consumer Affairs and Business. egulation j egistration::100503 TYpel 10 Park Plaza=Suite 5170 Expiration '6/19[2014,•y Supplement and Boston,MA 021-16 ' iCARE FREE HOMES INC DANA PICKUP JR 239 Huttleston ave FairhaVen,MA 02719 j Undersecretary Not valid without sig a e Massachusetts -Department of.Public Safety Board of Building Regulations and Standards Construction Supen180r License: CS-095228 _:a DANA J PICK 1 ri i. 19 HAMLEV9* Fairhaven E M� 02719( r Commissioner Expiration 03/22/2014 NN CARE FREE . Ol�leS Inc:: • . . Y ; 239 Huttleston Avenue Fairhaven,Mass 02719 Telephone 508-997-1111 Fax 508-997-1297 Website:www.carefreehomescompany.com To the Town of: Job Address: J - 4 1 I, owner of the home Cus er Name ' at the above location, authorize Care Free Homes,Inc. as my agent to'obtain all'necessary permits and to perform all home im rovemerits tom home'as stated in the accom an in p p P Y p Y g , = At. f. contract and application. _ Customer Signature Date ' , UN-21-2012 03 . 11 PM - - - •••��� r �� 'v.'% I La v1 L.IM12IILI 1 7 INCUI"'(ANt;h, 9/07/2011 THIS CERTIFICATE is ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDMK THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAOII AFFORDED BY THE POLICIES BELOW,THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT 131TWEEN THE 18SUINO INSURER($),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. e os es s o r is an , e P01 ay es must a endorsed. A Al ,eu e o the terms and conditions of the policy,certain policies may require an endorsement.A statement on this eartIfIcats does not Confer rights to the Certificate holder In Ileu of such andoreement s. PRODUCER Herlihy Insurance Agency, Inc. 606 7566169 51 Pullman Street - No: 606 751.9747 Worcester,MA 01606 no 60e 756.6159 INSURER s APPORDINO COVaRAGE NAIC e INeugeo Care Free Homes Inc INAURFAA:Interguard Insurance Company 239 Nutllsston Avenue INSURER e;Safety Indemnity Insurence Comp Fairhaven,MA 02719 INSURER c: INSURER 0 INEUM IR E INSURER P; 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 POUCY 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 19 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, TYPE OP INSURANCE POLICY Nurag LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PR rrtino CLAIMS-MADE El OCOU 11 R. MED EXP An one span $ PERSONAL A ADV INJURY GENI'RAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER, PRODUCTS•COMPIOP Ar;C POLICY P LOG ® AUTOMOBILE LIABILITY 6213650 $ o7/01/zD11 071o1/2oi COMBINED SINGLE LIMIT $. ANY AUTO (Es argldsnt). i ALL OWNED AUTOS BODILY INJURY(Per person) 9 X SCHEDULED AUTO® f BODILY INJURY(Per accident) $ PROPERTY DAMAGE X HIRESAUT08 I (Parseeldent1 9 X NON-OWNED AUT08 $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCEe9LIAR CLAIMS•MADE CU AGORECCU 139DUCTIBLE T $ A AND IMPS YERS'LI A ION ILIT CAWC244043 9/01/2011 09101/201KS X A ' AND t1MPLOYlgs'LIABILITY IN oFpICERIMSMBER D(C URTNN-10 EXECUTIVE N WA E.L.EACH ACCIbENT gi OOO QOQ (Msndatory In NH) It a deacrlba under E,L,DISEASE-EA EMPLOYEE $i 00O 000 E.L. ASE-POL C IT si.po,coo OEeCRIPTION OF OPERATIONS/LOCATIONS I Yt IICLIS(ANach ACORD 101,Addlllonal RemVh schedule,If more space Is required) IFIC LDE - CA ATI 0 D r N men SHOULD ANY OF THE ABOVE DESCRIBED POLICIES Be CANCELLED BEFORE Town of Barnstable THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, BuIlding,Depprtmenf 367 Main Street AUTHORIZED REPRESENTATIVE Barnstable,MA 02601 101961114009 A CO RATION.All rights reserved. ACORD 25(2009/09) 1 of 1 The ACORD name and logo are registered ms of ACORD #846666/M46747 P82 �oF� l ti Town of Barnstable . *Permit# IT Regulatory Services Fees6°r rr74s r°""'S e``°� BAI2vSG\BLE, 00 $,orb Mp`f 5 Zulu Thomas-F. Geiler, Director T()WN OF BARNSTABLE Building Division 4uh 0,( Tom Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma us Off-ice: 508-862-403 8 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY No!Valid wilhout Red X-Press Inrprinl Map/parcel Number Property Address ! I,tl a"I l-C Ave Cci'llery'_l1c [Residential ValucofWork 'I r1 t pp p Minimum fee of$35.00 for work under$6000.00 Owner's Name & Address �pra� yy Cr�t,� r- ^ IZ5Yrc Svc Ce,,je_rVtt!l� Contractor's Narne P dAll q `�V p Telephone Number �;_f 4 V? Home Improvement Contractor License#(if applicable) t'OU SO Construction Supervisor's License#(if applicable) LYworkman's Compensation Insurance - Check one: ❑ I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance I , Insurance Company Name Workman's Comp. Policy# Clyyj c q yI `1 Z Copy of Insurance Compliance Certificate must accompany each permit. Permit Request (check box) ❑ Re-roof(hurricane nailed) (stripping old shingles) Ah construction debris will be taken to ❑ Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side #of doors ' [Replacement Windows/doors/sliders.'U-Va]ue g 3 (maximum 35)# of windows I� *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 H me provement Contractors License & Construction Supervisors License is re fired. SIGNATURE: Q:\WPFILES\FORMS\building permit forms\EX PRESS.doc Revised 072110 t; 4 c. The +Carr inorriveallh ofMassachuse/ts -- Department of Industrial Accidents - r--' C1ffiCe of IlP1JeSl`rb!71"rOrlS 600 Washington Street A Boston, ALA_02111 tom, t�/ . w iv.rnass.govldia 'Workers' Compensation Insurance Affidavit: Builders/Conti-,tctors/Electliciiin's/Pl:umbers Applicant Information Please Print LegibIN Name (Bnsiness�Orgauizatian/Iadividr�al): ��r� �(-L� �O Wl� S Address.- ZI�( t-1 ilT1l e City/state/Zip: Al f-�A vG tit Phone 4. S G R 1'7 'J//l / Are ou all employer? Check the appropriate.boa:: T e of project :r . uire 1_ I am a employer with 70 4• ❑ I am a general contractor and I 3P P ] { e9 �� ertiployees(full and/or part-time).* have hired the sub-contractors 6. ❑I Tew ronstnrctiom 2_❑ I am a sole proprietor or,partuer- listed on the attached sheet. 7- R-�ernodeling ship.and have no employees These sub-contractors have g_ ❑ Demolition working :far me in any capacity. employees and Have workers' '(No workers' coup,insurance comp_insurance. I 9. ❑.Building addition required:] 5. ❑ We are.a corporation and its 10.❑Electrical repairs or additions ofly.cers have exercised their 3.❑ I.anr a hotneotitmer doing.all work 11.❑Plumbing repairs or additions myself, [No workers'comp. right of exemption per NfGL 12.❑Roof repairs iusuurance:required.]F c- 152, §1(4)„and. ve have no employees. [No workers' 11❑'Other comp.:insurance required.] *Any applicant that checks box#Lmust also fill outrhe section below'showing their worl€ers'minpensation policy information_ f Flonieuv ners wbo submit this affidavit inilicatiug they are doing all wont and then hire outside contractors must submit a new a$rdavit indicating such ICoatractnrs than cheek this box must attached an additional:shre.et showing the name of the sub-contractors and stare whether or not those eatities has=e employees. Ifthe sub-conimctors:have emplayees,they.must provide their workers'comp.polity number. (Arr1 A7!�Nipl�y` r tltrrt ES proNTdIrtg it"orkers'CQTl7p8t LSatlott 27fShcra.rrGB fOY J!!>;'t2li'tp7a3aesS. :Be oti'!s the poiiCy alyd jnb site 1rtfQYNlYLtlDlt, / jr_rj j Insurance Company Name: 1 n l/Gr Policy*or Self-ins.Lic.#: CA-Vic ,717 14 Z 1 Expiration Date: /to Job Site Address: R'A dyr it Ave. City/State/zip: Cr Vxkr✓t lie MA , Attach a rcopy of the workers'compensation policy'declaration page(shoiAng the policy number and expiration dote). Failure to secure coverage as required under Section 2.5A of NfGL 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 STOR'WORK ORDER and a fine of up to$250A0 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the D.IA for insurance co gage verification. I do hereby c. fy rrrtder Pie pains a d n 'es of ir t lily hat the is forrrtattan provider+a.boiv is true arld correct Si re.tu : Date: Phone M 0 ` q q !7 I/! / L6. O use on v. Do not irrite in this area,to be cvtripleted by city or town o�ciat own: Permit/License# . uthority(circle one): of Health 2.Building Department 3.City/Town Clerk 4,Electrical Inspector 5.Plumbing Inspector erson: Phone#: 6 N ;tsti;tchusctts- Uepartmcnt of Pu t ('N hlic S; Board of Buildin;2 Regulations and.Staudal-(*W. Construction Supervisor License License: CS 83166 Restricted to: 00 NATHAN J PICKUP 239 HUTTLESTON AVE FAIRHAVEN, MA 02719 Expiration: 1/18/2012 Commissioner Tr#: 13584 -d . A-0Jl46EiY'�(S6tdP4tY.fh� ti?tsXvw.a. - . � ✓/ae;,�a.�Unwov,�.lecil� 0�,/1�.�aurclzuaetta _ _ __.._.-- ., Office of Consumer Affairs&Business Regulation License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation Registration 100503 Type: 10 Park Plaza-Suite 5170 Expiration ti/19/2�12 Supplement Card. Boston, N4A 02116 CARE FREE HOMESINC :� NATHAN PICKUP �f 239 Huttleston av4l. Fairhaven,MA 02719` r Undersecretary Not valid without signatu e a S - .'.. . f . i r , Client#:33723 " CAREF ACORD- CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDNYYY) 09/02/09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Herlihy Insurance Group Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 51 Pullman Street HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Worcester,MA 01606 508 756-5159 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A Acadia Insurance Company Care Free Homes Inc INSURER B: Interguard Insurance Company 239 Huttleston Ave INSURER c: Travelers Insurance Company Falrhaven,MA 02719 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD 114DICAI'ED.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. INSRADD' LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY C-XPfftAT10N DATE(MM/DD/YY)_ DATE(PIM/I Y L1591T3_ A GENERAL LIABILITY CPA026567411 09/01/09 09/01/10 EACHOCCURRE14CE $1.000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RE4NNIEDPREMISES Me $250 000 CLAIMS MADE ®OCCUR MED EXP(Any one person) $5 000 PERSONAL&ADV INJURY $1 00O 000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2 000 000 POLICY PRO- LOC JECT C AUTOMOBILE LIABILITY BA701 I N54709SEL 07/01/09 07/01/10 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $1,000,000 ALL OWNED AUTOS BODILY INJURY $ X SCHEDULED AUTOS (Per person) X HIRED AUTOS ` BODILY INJURY $ X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACCTHAN AUTO ONLY: AGG $ EXCESSNMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR FI CLAIMS MADE AGGREGATE $ •v $ DEDUCTIBLE $ RETENTION $ $ B WORKERS COMPENSATION AND CAWC917429 09/01/09 09/01/10 X OR WCYSTATU- OTH- Ld ITS I ER EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $1 00O 000 ANY PROPRIETOR/PARTNERIEXECUTIVE , OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $1 000,000 if yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $1 OOO 000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS - - CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of Barnstable DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN Building Department NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 367 Main Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Barnstable,.MA 02601 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001108)1 of 2 #M38934 L 82 0 ACORD CORPORATION 1988 OFFICE: (508) 997-1111 ;a MA.'Builders Lic. #021330 FAX: (508) 997-1297 _ '` C A R E FREE Home Improvement TOLL FREE: 1-800-407-1111 Contractor's License WEBSITE: ® CS Inc.. #100503 MA: www.carefreehomescompany.cOM 239 HUTTLESTON N� I IT�i F I 1,�IIA 02l 19 NAME 6.2 ADDRESS /�S_ A �'�sy 2I- AU Cc ` ���Uf -f DATE 7 I v ADDRESS OF JOB iK^� �M! l ZIP CODE TELS�*775'hGn�,y SUbi JOB DESCRIPTION ,. Lv�s 2�.tvt u� 200"'t 2 1.0 64Ittli _ l tJI vt., *V L v i�c 'l�rs z SQ' L C AA Cu /& sIr z TX/^A Dou (Ap m.al a ti TIC 2sz Hr�CC 70 "4SC L ��S IL''', Mill rA ol( ,� t U-4- aA_ hk.. !tit 0 C 4S$_wA 4ivti' GV I! .WQWW,, CyA Guc tW CGw A& ( Iti W �oG +mot 2on�cs' ?M nn C `moo o Q _ U0 l'L 41.E C123 y'L�4AW 0 A(L Gu tinr cx�ti.s� Kr$U i,cp�v .3nr PACu4gS- . AtL � �n,o )� � HA�� L tit/ri1, - p 121 ALL G 00 IL lor-S Scheduled Start Y Scheduled Completion—AWOL 1702 L(j£, *5 A.,Replacement of missing or rotted lumber is not included unless specified. B.All start&completion dates are approximate and could change due to weather conditions. C. Stripping of roof includes removal of up to two(2) layers of shingles, each additional layer to be charged @ ftz. D. Replacement of rotted roof boards/plywood to be charged @ ftz. E. Exisiting chimnet flashings will be reused; replacement, if necessary, is not included. F Care Free Homes, Inc. is not responsible for mold/mildew conditions that are pre-existing or result from leaks not.brought to the attention of C.F.H., Inc. promptly. The Company hereby proposes to furnish labor and material to complete the above work for the amount herein. Fulfillment of this order is contingent, however, upon the want of strikes,fires,and any natural disasters,the ability to obtain materials,or any other conditions beyond the control of the Company. Cost of Project$ /7 d Q C) PAYMENT TERMS_0N COA1�94 rf�J Date r 1. You,the Owner may cancel transaction at any time prior to midnight of the third business day after the date of this transaction. 2. ou,the Owners agre pay any and all expenses incurred by.Care Free Homes,,lnc. in collecting money due under this contract andlnforcing the �k6rms o this contract, including but not limited to, reasonable attorney's fees, interest and court costs. NOT IS CONTRACT IF THERE ARE ANY BLANK SPACES CARE F S I C. ACCEPTED: By: Buyer acknowledges Owner: receipt of fully completed copy of this Areement Owner: All contractors and subcontractors shall be registered by the director and any inquiries about a contractor or subcontractor relating to a registration should be directed to: Director, Home Improvement Contractor Registration One Ashburton Place, Room 1301 i w P�oFTNE Tati Town of Barnstable *Permit# y �.e Expires onths from issue date BARNSM13i E, = Regulatory Services Fee o. MASS. Thomas F.Geiler,Director ��ED MA't a Building Division X-PRESS PERMIT Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 JUL L 9 ' 2004 )ffice: 508-862-4038 - 508-790-6230 TOWN OF BARNSTABLE EXPRESS PERNUT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint 'parcel Number SIR( 10 erty Address . 4�5 r esidential Value of Work ® � -,r's Name&Address -actor's Name / /� /® Telephone Number__ Improvement Contractor License#(if applicable) _ 1�l.105 0 truction Supervisor's License#(if applicable) orkman's Compensation Insurance 1: Check one: ❑ I am a sole proprietor JA66e Homeowner have Worker's Compensation Insurance - AA ace Company Name ,L man's Comp.Policy# !/� e�C, ��oc��(✓ t R;;Re-roof st check box) (stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) a ❑ Other(specify) *Where required: Issuance of this permit not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ,e 02/13/1995 19:55 915087906230 41 r, PAGE 01 I . Town of Barnstable Regulatory Services # eA Mug Thomas F.Geller,Director Building Division Tom Perry, Ou[lding Commissioner 200 Main Stmeat, Hyannis,MA 02601 www.town.barnstable.ma.us Office. 508-962fi038 Fax: 509-790-6230 Property Owner Must Complete and Sign 11iiis Section If Using A.Builder 4 DokAT141 CRAWPaz ,as Owner of the subject pmperty hereby authorize I J'4TI4A-fj ACKy P to act on my behalf, in all matters relative to work authorized by this building permit application for. !2S �i 44TYPC- Avt Address of Job) 1003 AMJ 2LIak2ka-4 Signature of er Date I. 2EtT+-1 Y CFI-w��P� FriAt Name Q:FORMS:G�4VN>APERMlSSION Za itµ Ir-.•--- GTfie� � ./�aaaac�ivaelt .,per oorvnao7uue of Die dii-ng ltegulations and Standards HOME IM ROVEMEW CONTRACTOR Regi�� 100503 19/2006 r plement Card 7 CARE FREE H NATHAN PICK~ 239 Huttleston ar,��'' 1,`> Fairhaven,MA 02719 Administrator