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Home My WebLink About0780 CRAIGVILLE BEACH ROAD (24) i, ikRe +w is {+a '• Qa'naw r '.� ya `4'i y r 4 G b `:i,e 6 •':n ��./��!.V..! r/ 4 ah.• -:i' } - ',ii� is .ze e:`i7:. ,� ..5• ,�..n.,�. ...i9N.- ara �rr TRY„ ' to! ,i. ., ✓-S.'J.. ar 11. ..E.�r_ '4, ../,. 'J^T. .. ; r r r " ry' _ y ,. - - a y, n. - r J3 ,Cry '1 .. ,. •.I ° R ry • y , o , r c a i 9 : J u r a Y.-- x v a z, , R, r r y _ r r , , Y� i PROJECY,�- � NAME: VlWV-t ADDRESS: � % CAM L) ,1C& PERMIT# Zo l Q U PERMIT DATE: - l M/P: ZZ Ce LARGE ROLLED PLANS ARE IN: . BOX l SLOT Data entered inMAPS program on: Id `7 t BY: I q/wpfiles/forms/archive TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 3 Map �2 Parcel I Vy-/ �� Application # Health Division Date Issued Conservation Division Application F e Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH r A _ Preservation/ Hyannis d�4 Project Street Address �l �dK� �q/ ✓�'�L� Gv ✓r�S Village e 4- r-h/ t i"e,�- Owner 41Pwe _?1ggY 1D f f 4G Address //ZQ OOSZ" 0 J% Cj Telephone L� -3 6 Permit Request D-17 Square feet: 1 st floor: existing proposed496 2nd floor: existing AdV proposed 1 Q&FTotal new (� Zoning District2-B f C Flood Plain Groundwater Overlay Project Valuation /SO,DOd Construction Type IW OOd Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) .3 Age of Existing Structure e&_) Historic House: ❑Yes B<o On Old King's Highway: ❑Yes Cho Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other -if4 Basement Finished Area (sq.ft.) "I(yff= Basement Unfinished Area (sq.ft) 3F2_ Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing 2-new Total Room Count (not including baths): existing new First Floor Room Count -� Heat Type and Fuel: YG-as ❑ Oil ❑ Electric ❑ Other C7 Central Air: ees ❑ No Fireplaces: Existing New Existing woo'/ oal stov ❑o o Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn:; .existing t,Q] new size_ Attached garage: ❑ existing ®new siz&�ZShed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded Commercial ❑Yes ❑ No If yes, site plan review# Fz' 'I co Current Use 1ZfS'/C_1e4J!�AZ gem Z Proposed Use c5 5 APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 0�� L"�'///y/ Telephone Number 617-63 9'- 32-6 Address !Z 31f X / y"91 License# (7S jQ 2;11,Y.4 2 Z Home Improvement Contractor# EEa' Worker's Compensation # S 2- / ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE t? ( AAA DATE 9`i 0113 t i' FOR OFFICIAL USE ONLY APPLICATION# ip -DATE-ISSUED 4, MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: 1 �F FRAME - (INSULATION 4 FIREPLACE ELECTRICAL: ROUGH FINAL -- - PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING ' DATE CLOSED OUT ASSOCIATION PLAN NO. �. . ' 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: Build4rs/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual):�(" 0� f,f� Vie. Address: City/State/Zip: 6,V M,4- Phone#: Cv/7—,,�-3 F>2_6 Arreeyyou an empl er?Check the appropriate box: Type of Project(required): 1.I I am a employer with 2. 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. ❑Remodeling ship and have no employees These sub-contractors have g. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp. insurance comp.insurance.: required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.7 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.[1 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. Insurance Company Name: (�I>2/G 4 e� Policy#or Self-ins.Lic.#: o t e /e_1 Expiration Date: Job Site Address: 7 k) � eny ff7J City/State/Zip: ��ese. ��/,,� XVfg- 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 her y rtify under the pain M d penalties of rjury that the information provided above is true and correct Signa Date: Phon #: Z t; — 2-41 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#: JTC CONTRACTORS INC . DATE 6/25/13 RE. PROJECT SUPERVISION Trade Winds 780 Craigsville Beach Rd Barnstable Ma To whom it may concern Please let this letter be considered confirmation that Stephen R Callahan construction supervisor's license#CS-028119 is employed by JTC Contractors Inc.for the purpose of project oversight at the above referenced location. A copy of his license is attached. Thank you esident One Buttercup Lane South Yarmouth Ma 02664 617-538-9326 .ems 4 Massachusetts Department of Public Safety Board of Building Regulations and Standards Construction Supury i%or License: CS-028119 STEPHEN R CALLAHAN ,EM 12 BAY AVE DUXBURY MA 02332 Uk c-• Expiration Commissioner 06/28/2014 Ii ' 1 ® - DATE(MMIDD/YYYY) Ro CERTIFICATE OF LIABILITY INSURANCE OP ID DLF 06/18/13 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 ORALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOTCONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. P R T: the certificate holder is an ADDITIONAL INSURED,the po Icy ies must be endorsed. If SUBROGATIONI IVED,subject to the terms and conditions of the policy,certain policies may requite an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: Debra Landry PHUNL- FAX DGP-Miles Insurance Agency,Inc JAIC No Ext: 508-824-8961 (A/C, No): 508-828-191 3 School Street P.O. Box 1018 ADDRESS: dlandry@dgpmilesins.com rKUUUUhK Taunton MA 02780-0957 CUSTOMERID#: JTCCO-1 Phone:508-824-8961 Fax:508-880-2734 INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: National Grange Insurance Co. JTC Contractors Inc INSURERB: Zurich American Insurance Cc John Callahan 1 Buttercup Lane INSURERC: U S Specialty Ins Cc South Yarmouth MA 02664 INSURER D INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE I N S R -WVD POLICY NUMBER (MMIDD/YYYY) (MM/DD/YYYY), LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1000000 C X COMMERCIAL GENERAL LIABILITY IG06C00093500 05/17/13 05/17/14 PR EMISES(Eaoccurre.) $ 100000 CLAIMS-MADE FRI OCCUR MED EXP(Any one person) $5000 PERSONAL&ADVINJURY $1000000 GENERAL AGGREGATE $2000000 GEML AGGREGATE LIMIT APPLIESPER: PRODUCTS-'COMP/OPAGG $2000000 POLICY PRO- LOC $ JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1000000 (Ea accident) A ANY AUTO M11429803 10/18/12 10/18/13 BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ X SCHEDUL®AUTOS • PROPERTY DAMAGE $ HIREDAUTOS (Per accident) NON-OWNEDAUTOS $ C X UMBRELLA LIAB X OCCUR UEP500225 05/17/13 05/17/14 EACH OCCURRENCE $1000000 EXCESS LIAB CLAIMS-MADE AGGREGATE $2000000 DEDUCTIBLE $ X RETENTION $ 0 $ B WORKERS COMPENSATION 6BO52914 06/1 4/1306/14/14 - TORY LIMITS ER AND EMPLOYERS'LIABILITY - ANY PROPRIETOR/PARTNER/EXECUFIVEO L.EACH ACCIDENT $1000000 OFFICER/MEMBER EXCLUDED? U 1A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $1000000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1000000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) 2007 HAUL UTIL TRAILER T 5BSCB18257CO20254 Contractors-Executive Supervisors or executive superintendents Proof of insurance subject to policy terms, conditions, definitions, limits, and exclusions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Mr John Howe D&E, LLC Old Hill Partners LLC AUTHORIZED REPRESENTATIVE 1120 Boston Post Rd Darien CT 06820 988 A OR : C PORA NON. All.rights reserved. ACORD 25(2009/09) The ACORD name and logo are registere ks of AdOkD l he Commonwealth of Massachusetts William Francis Galvin - Public Browse and Search Page 1 of 2 The Commonwealth of Massachusetts William Francis Galvin Secretary of the Commonwealth, Corporations Division s; One Ashburton Place, 17th floor '} Boston,MA 02108-1512 Telephone: (617)727-9640 JTC CONTRACTORS, INC. Summary Screen Help with this form ��tR"equest a Certificated r ' The exact name of the Domestic Profit Corporation: JTC CONTRACTORS,INC. Entity Type: Domestic Profit Corporation Identification Number: 001025114 Date of Organization in Massachusetts: 03/29/2010 Current Fiscal Month I Day: 12/31 The location of its principal office: No. and Street: 1 BUTTERCUP LANE City or Town: SOUTH YARMOUTH State: MA Zip: 02664 Country: USA If the business entity is organized wholly to do business outside Massachusetts,the location of that office: No. and Street: City or Town: State: Zip: Country: Name and address of the Registered Agent: Name: JOHN T. CALLAHAN, III No. and Street: 1 BUTTERCUP LANE City or Town: SOUTH YARMOUTH State:MA Zip: 02664 Country: USA The officers and all of the directors of the corporation: Title Individual Name Address(no Po Box) Expiration First,Middle,Last,Suffix Address,City or Town,State,Zip Code of Term PRESIDENT JOHN T CALLAHAN III 1 BUTTERCUP LANE SOUTH YARMOUTH,MA 02664 USA TREASURER JOHN T CALLAHAN III 1 BUTTERCUP LANE SOUTH YARMOUTH,MA 02664 USA SECRETARY JOHN T CALLAHAN IV 1 BUTTERCUP LANE SOUTH YARMOUTH,MA 02664 USA DIRECTOR JOHN T CALLAHAN IV 1 BUTTERCUP LANE SOUTH YARMOUTH,MA 02664 USA DIRECTOR JOHN T CALLAHAN III 1 BUTTERCUP LANE SOUTH YARMOUTH,MA 02664 USA http://corp.sec.state.ma.us/corp/corpsearch/CorpSearchSummary.asp?ReadFromDB=True... 6/19/2013 L EA T. 4 W,, Services- � I Regu"tory Thomas F.Crefla,Dwactur .13 aMag.Mbioll. Tom-perry,13wh&i Commissioner 200 Mak Sftr4 IE�s MA 61601 www.bmxLbarnst&ble mans Office: 508-862-4038 'Fmc 508-790-6230 Property Owner Must Compl6te, and Sign This Section If UsIgg A-Builder ID r---- -- - = , A r it f, as Owner of the subject ptop erqr A 7TTC C.f,)rA_rax:kDC?-hereby authorize to au on my-behalf; in all mattexs XebtiVIC bwork authorized by this bmIding permit 7180 Cra aA Ile- Rch Rd-CeoAff Vi 11 e ddress of Job) **Pool fences and alarms are the responsibility-of the applicant Pools are not-to be filled-before fence is*installed and pools ate not to be Utilized,until all final inspections are petfbtmed aiad accepted. of kpprLcmt Print Name PtintNamm DatW Q7MRIVM.0WMM?M&-M0N?00LS t�=e f.A joh#j . TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION MapZ-( Application # . Parcel { pp Health Division Date Issued Conservation Division Application Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis C`Proiect Street Address �-- Village �- Owner V'+.,� Address 4/J %i te) Telephone Permit Reque tCAA ID "6 .�— � CGa S L S Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new: Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new � -o Total Room Count (not including baths): existing new First Floor RQ Counts.... e-" Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/c, al stove;❑Ydg ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ e !sting ❑:dew ize_ 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# r Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ®�j��ty ��Y/ Telephone Number 'L Address /Z 6,0 4 License# �'S— D Z,?//9 ® � uY 2 L Home Improvement Contractor# Worker's Compensation # 1�a,S`z,�/y ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE s�� ,Qll�. C.TZI,�" DATE FOR OFFICIAL USE ONLY APPLICATION# ,�DATE.ISSUED MAP/PARCEL NO. " ADDRESS VILLAGE OWNER DATE OF INSPECTION: .. i +axFOUNDA�TIPk.Na.L't�f' di��fi-�'t��t3�,� FRAME w -f=INSULATION:�_, FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT , s ASSOCIATION PLAN NO: r 46 q�p DATE(MNVDD/YYYY) �•�R�® CERTIFICATE OF LIABILITY INSURANCE oPID DL 06/18/13 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 ORALTER 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. MP RTANT: If the certificate holder Is an ADDITIONAL INSURED,the po Icy les must be endorsed. BR TWAIVED,subject to the terms and conditions of the policy,certain policies may requite an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: Debra Landry PHONE FAX DGP-Miles Insurance Agency,Inc A/C,No Ex : 508-824-8961 (A/c,No): 508-828-191 3 School Street P.O. Box 1018 ADDRESS: dlandr @ dgpmiles ins.com Taunton MA 02780-0957 CUSTOMERID#: JTCCO-1 Phone:508-824-8961 Fax:508-880-2734 INSURER(S)AFFORDING COVERAGE NAIL# INSURED - - INSURERA: National GrangeInsurance.Co. JTC Contractors Inc INSURERS: Zurich American Insurance Co John Callahan 1 Buttercup Lane INSURER C: U S Specialty Ins Co South Yarmouth MA 02664 INSURER D: ` INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE•LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE INSR WVD - POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1000000 - 3 C X COMMERCIAL GENERAL LABILITY IG06C00093500 05/17/13. 05/17/14 PREMISES(�(E occurrence) $ 100000 CLAIMS-MADE ❑X OCCUR M ED EXP(Any one person) $5000 PERSONAL&ADV INJURY $ 1000000 GENERAL AGGREGATE $2000000 GEN'L AGGREGATE LIMIT APPLIES PER: _ _ _ PRODUCTS-COMP/OPAGG. $2000.000 POLICY JECT PRO- - LOC - $ AUTOMOBILE LIABILITY _ COMBINED SINGLE LIMIT $ 1000000 (Ea accident) A ANY AUTO M1M29803 10/18/12 10/18/13 BODILY INJURY(Perperson) $ ALL OWNED AUTOS ... - BODILY INJURY(Per accident) $ - X SCHEDULED AUTOS - PROPERTY DAMAGE $ HIREDAUTOS - - (Per accident) NON-OWNEDAUTOS $ - r $ C X UMBRELLA LIAB X OCCUR.- UEP500225 05/17/13 05/17/14 EACHOCCURRENCE $ 1000000 EXCESS LIAB CLAIMS-MADE - - _ - AGGREGATE $2000000 DEDUCTIBLE $ X RETENTION $ 0' - _ $ B WORKERS COMPENSATION 6BO52914 ,06/14/13 06/14/14 /177777-7 H- AND EMPLOYERS'LIABILITY. - Y/N - F TORY LIMITS I I ER ANY PROPRIETOR/PARTNER/EXECUT I VE�; .L.EACH ACCIDENT $ 1000000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) - - - E.L.DISEASE-EA EMPLOYE $1000000 If yes,describe under - DESCRIPTION OF OPERATIONS below _ - E.L.DISEASE-POLICY LIMIT $ 1000000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) 2007 HAUL UTIL TRAILER T ` 5BSCB18257CO20254 - Contractors-Executive Supervisors or executive superintendents . Proof ofinsurance °subject to policy terms, conditions, definitions; limits, ` and,exclusions. CERTIFICATE HOLDER Y= CANCELLATION - - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN. ACCORDANCE WITH THE POLICY PROVISIONS. 'Mr John Howe D&E, LLC . ..- :.- t __Old Hill Partners LLC AUTHORIZED REPRESENTATIVE ,1120 Boston Post: Rd Darien -CT_,06820` . 988 A ORD CPRPORATION. All.rights reserved. ACORD 25(2009/09) The ACORD name and logo are registere ks of D The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigation „ 600 Washington Street Boston,AM 02111" www.mass,gov/dia Workers' Compensation Insurance Affidavit: builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly. Name(Business/Organization/Individual): Address: City/State/Zip: d V M� Phone #: (/�P —3 5 2,6 Are y an empl er?Check the appropriate box: Type of roject(required): I am a employer with 21- ❑ 4. I am a general contractor and I ' 6. R New construction 1.I� employees(full and/or part-time).* have hired the sub-contractors 2.El am a sole proprietor or partner- listed on the attached sheet. �• ❑Remodeling ship and have no employees These sub-contractors have g• ❑Demolition working for me in any capacity. employees and have workers' 9 ❑Building addition [No workers' comp. insurance comp.insurance.$ required.] 5. We are a corporation and its 10.❑Electrical repairs or additions. ❑ officers have exercised their 11.❑Plumbing repairs or additions 3. I am a homeowner doing all work - myself. [No workers' comp. right of exemption per MGL c. ❑Roof repairs insurance required:]t c. 152, §1(4),and we have no employees. [No workers' 13.❑ 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 far my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: �ll. 2--9/q Expiration Date: to Job Site Address: �U �I�/ City/State/Zip: ( �sv �✓��- xva 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 her y rtify under the pain d penalties of rjury that the information provided above is true and correct, Si a Phon #: Official use only. Do not write in this area,to be completed by city or Pown official. City or Town: Permit/License# Issuing Authority(circle one): L6.60ther rd of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector ct Person: Phone#: A Massachusetts-Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-028119 �. STEPHEN R CALVAHAN" 12 BAY AVE ~'- DUXBURY MA 62332t e xpiration Commissioner 06/28/ 0014 f 1 Massachusetts -Department of Public Safety Board of Building Regulations.and Standards Construction Supersisrir *� License; CS-028119 STEPHEN R CALJ�AHAN" r 12 BAY AVE s DUXBURY MA 62332 � r Expiration 06/28/2014 Commissioner JTC CONTRACTORS INC DATE 6/25/13 RE. PROJECT SUPERVISION Trade Winds 780 Craigsville Beach Rd Barnstable Ma To whom it may concern Please let this letter be considered confirmation that Stephen R Callahan construction supervisor's license#CS-028119 is employed by JTC Contractors Inc.for the purpose of project oversight at the above referenced location.A copy of his license is attached. Thank ou President (4 One Buttercup Lane South Yarmouth Ma 02664 617-538-9326 �a >x of 13A�-��ct�1,1g ... egtYlatoty Services BARIVSTABLE, ;' Thoatfas F.Gctler,D'incfor 9 MASS. - plev Bata^�, Bu%ld ng Divisiori T..o:m Perry,BuiIdin Comnussioner 200 Main Street, Fjyanr is,,M 0260I t Office. ,50.8=862-4.038 FaX "508-790-6230 NOTICE TO THE 8U)(LDiNG DIVTStON OF CHANGE OF LICENS)CD CONSTRUCTION SUPERVISOR - z u old 'D(I E, I r4 uJ r.�•� , owner of property located at Mr®° �S o C rt o aU i Ile Be6 t hereby certtfy that Q0-n is:no longer Construction S ape rvisor<listed on the:application for the project ti ndc construe:ion as.authorized by Sao building permit# G =� � , issued:on 'ZpQ-1 0`3 F I uridersiajd that the project udder construction must cease until a successor licensed Construction Supe>visor; is submiiied:on the records'of the B.uildi'ng Division:: PRRTY OWNER ATE q/forms/newcontr,. reWence.R.5180:CM R> rev 110410 _ r �� o€ Town of B•a nsta:blc `�,l;i R 't•� Re 6 Services ry r Thomas F.Gel7er,Director � `. Suii�Tding Division. • • Tom Perry,Barg Conomissioner 200 Main Street,Erym s,bIA 02601 www.town.barnstablema.as Office: 508-862-4038 Faze 508-790-6230 Property Owner Must Complete and Sign This Section If Using A.Builder u r . a W as Owner of the subject ptoPetY hereby,authorize 'S'T'[ -nOA(' i[:;'1�, to art on my,behalf, in all matters relative to work authotized by this bolding permit Cr- ,,11 e m(4 ( ess o£Job) **Pool fences and alarms are the responsibility of the applicant Pools are not-to be filled-before fence isInstalled and pools ate not to be utilized until all final inspections are performed and accepted. Sim OWner tore of Applicant i Paint Name Paint Name Datei Q•FORMS:OWX MUMS1ONPOOLS i Coe Aoanrm dace, Room 1301 & tort, MadaelrWetta 02109 1619 .� ;v w (617) 727-3200 Oeval Patrick Governor 57" (617) n7-$732 Thomas G.Gatzunis, P.E. Commissioner CONSTRUCTION CONTROL DOCUMENT Project Title: The Residences at Trade Winds, Bldg. D Date: April 18,2013 Proiect Location: 780 Craigsville Beach Road,West Hyannisport, Massachusetts Scope of Project: New 2 story,wood framed with full basement 3 unit condominium In accordance with SECTION 116.0-116.4.2 of the 6`h edition of the Massachusetts State Building Code: I, Antonia A. Kenny Mass.Registration Number: 5446 being a registered professional Entrineer/Architect, hereby CER'CIFY that I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning: ❑ Entire Project ❑✓ Architectural ❑ Structural ❑:Mechanical ❑ Fire Protection ❑ Electrical ❑Other(specify): for the above named project and that to the best of my knowledge, such plans,. computations and specifications meet the applicable provisions of the Massachusetts State Building Code, all acceptable engineering practices and all applicable laws.for the proposed project. Furthermore, I understand and AGREE that I shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to determine that the work is proceeding in accordance with the documents approved by the building pennit and shall be responsible for the following as specified in section 116.2.2 1. Review of shop drawings, samples and other submittals of the contractor as required•by the construction contract documents as submitted for the building permit, and approval for the conformance to the design concept. 2. Review and approval of.the quality control procedures for all code-required controlled materials. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine, in general, if the work is being performed in a manner consistent with the construction documents. I shall submit periodically, in a form acceptable to the building official, a progress report together with pertinent comments. Upon completion of the work, I shall submit to the building official a final report as to the satisfactory completion and readiness of the project for occupancv. Signature and Seal oI. rag , red professional: Wa�� EO Apo®.,��; Ic pNo.5446�� BARNSTABLE, MA �oata�, ?1�aaeae�cuaet� 02r08-161� r` M r P4N6 (617) 72?-3200 Doval Patrick Governor 57" (617) 727-5732 Thomas G.Gatzunis, P.E. Commissioner CONSTRUCTION CONTROL DOCUMENT Project Title: The Residences at Trade Winds, Bldg. D Date: April 18, 2013 Project Location: 780 Craigsville Beach Road,West Hyannisport, Massachusetts - -Scope of Project: New 2.story--wood-framed with full basement-3-unit condominium - In accordance with SECTION 116.0-116.4.2 of the 6"'edition of the Massachusetts State Building Code: 1 John Bologna Mass. Registration Number: 33776 being a registered professional Engineer/Architect, hereby CERTIFY that I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning: ❑ Entire Project ❑ Architectural ❑✓ Structural ❑Mechanical ❑ Fire Protection ❑ Electrical ❑Other(specify): for the above named project and that to the best of my knowledge, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, all acceptable engineering practices and all applicable laws for the proposed project. Furthermore, I understand and AGREE'that I shall perform the necessary professional services and be present on the construction site on a regular.and periodic basis to determine that the work is proceeding in accordance with the documents approved by the building permit and shall be responsible for the following as specified in section 116.2.2: 1. Review of shop drawings, samples and other submittals of the contractor as required by .the i construction contract documents as submitted for the building permit, and approval for the conformance to the design concept. 2. Review and approval of the quality control procedures for all code-required controlled materials. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine, in general, if the work is being performed in a manner consistent with the construction documents. I shall submit periodically, in a form acceptable to the building official,a progress report together with pertinent comments. Upon completion of the work, I shall submit to the building official a final report as to the satisfactory completion and readiness of the project for occupancy. Signature aajn♦d�Seal of registered professional: .rt . JOHNS k470. ;tie u °,. No.337 w ~`�S GlSTrf' a\� r SICINAI��` _ r KILROY&WARREN, P.C. ATTORNEYS AT LAW THE ISAAC P. FAIRFIELD HqQ0 Of 6ARKSTA5LE 67 SCHOOL STREET PH BERNARD T. KILROY P.O. BOX 960 IM3 3 HYANNIS, MASSACHUSETTS-02601-0960 TELEPHONE (508)771-6900 TELEFAX(508)775-7526 E-MAIL: bkilroy@comcast.neP ` Delivered by hand: June 26,2013 Town of Barnstable 200 Main Street Hyannis, MA 02601 Attention:Thomas Perry, Building Commissioner Re: Buildings D and E of the Residences at Trade Winds Condominium(the"Condominium") -780 Craigville;Beach Road,-Centerville ; Dear Mr. Perry: This office represents Tradewinds Development-A, Inc.,a Delaware business corporation, which is the successor declarant and holder of the development rights to complete said Buildings D and E of the Condominium consisting of three units in each building. As I understand, my client,through its construction contractor,John Callahan, began the process earlier this spring to change contractors and to complete the shell for each building and the unit buildouts in each building and was proceeding until you raised an issue of whether the original "she.11 permits"for each building have the protection of the Permit Extension Act(the':Act"). further understand that you.have requested'a legal opinion that the shell permits have protection_ under the Act and are still valid and may be implemented under the state building code in effect on the date of their issue and legal proof that my client owns the rights to complete the buildings. The Act originally enacted under Section.173 of Chapter 240 of the Acts of 2010 and extended by Sections 74 and 75 of Chapter 238 of the Acts of 2012,automatically extends any . permit for a period of four years beyond its otherwise applicable expiration date. Chapter 143, Section 92 of the General Laws of Massachusetts provides that no new state building code, rule or regulation or amendments thereof shall affect any building permit lawfully issued,or any building or structure'lawfully begun in conformance with such permit, before the effective date of the state building code in a city or town, provided,that construction work under such a permit is commenced within six months after its issue,and that such work,whether under such permit or otherwise lawfully begun, proceeds in good faith continuously to completion so far as is reasonably practicable under the circumstances. As mentioned above, my client is the successor declarant of the Condominium and holder of the rights to complete the buildings. It took title to the property under a mortgage foreclosure deed.registered on August 5,2009 at the Barnstable County Registry of Deeds Land Registration- Section as Document No. 1,120,802. The underlying mortgage from the original declarant,Trade Winds Residences, LLC(the"LLC"),covered all of the property now occupied by the Condominium including buildings D and E and all permits and Licenses held by the LLC and thus transferred to my . client by said foreclosure.deed. A review of your files indicates that the shell permits for Buildings D and E were issued.to the LLC on August 10, 2007 pursuant to applications filed on May 2, 2007,that inspection reports filed by Coastal Engineering indicate that the foundations were constructed in the fall of 2007,with a notation that the slab for Building E would be installed in the spring(2008) because of the temperature,that applications for unit fit outs for the three units in each building were filed in April and May of 2008 and that an application for a permit to construct a fence to cover the foundation for building D was filed in October 30, 2009. In fact the fences were installed to encircle the foundations of both buildings in the fall of 2009: The condominium project was initiated pursuant to a special permit issued to the LLC and all five buildings with their specific designs were apart of the permit approval process and individual permits for each of the five buildings as so designed were issued under the then applicable state building code. it is reasonable to assume that the LLC and its Lender,as well as my client,relied on the issuance of the shell permits for Buildings D and E,the installation of the foundations pursuant to said permits,the filing of applications for unit buildouts and the installation of protective fencing around the foundations for Buildings D and E were sufficient activity to gain the protection built into MGLc143,s92. MGLc143,s92 provides that the work proceed in good faith continuously to completion as is reasonably practicable under the circumstances. As mentioned above,weather was a factor for building E,there was a foreclosure of the mortgage which interrupted the normal flow of construction,and, in a reasonable period of time after taking title;my clients obtained a permit to fence in the foundations to protect them in the fall of 2009. If you take the position that all reasonable activity ceased after the foundations were fenced(say November 30, 2009)and therefore the permits expired, it is my opinion that the four year automatic extension under the Act results in the shell permits having life until November 30, 2013. Please let me know if you need any other information. Si erely, Bernard-T. Kilroy