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Home My WebLink About0423 ELLIOTT ROAD /,'� .. , �« ., .. �I , conAt 'Tip ro }� ,. M.. a , L -s Ws' 11/14/14 Thomas Perry, CBO Town of Barnstable Building Division 200 Main St , Hyannis, MA 02601 RE: Insulation Permits Hear Mr.Perry, This affidavit is to certify that all work completed for insulation work at 423 Elliot Road (application#201400568) has been inspected by a certified Building Performance Institute(BPI) Inspector. All work performed meets or exceeds Federal and State requirements. Sincerely, LAI ,, Conor McInerney ConserVision Energy co av en er+ 376 ROUTE 130,SUITE C SANDWICH,MA 02563 508-833-8384 WWW.CONSERVTODAY.COM T� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map z z. Parcel 0 8 Application #Health Division Date Issued Z 16h Conservation Division Application Fee ' Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address Village Owner_�a� Address Telephone c�-�go - `c'3 c_ c.+-��•.z y ,`��,, A Permit Request •�6� 2.w: e�.+ Z . c_w T�,., L� w,� V, o b9 L v A"Yt C. ,a C_*4ft ..�, ♦�.$sue -Y Square feet: 1 st floor: existing proposed 2nd floor: existing proposed�z TotaOnew Zoning District Flood Plain Groundwater Overlay Project Valuation Z.aco. Construction Type u-r+ Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting do mentation. T Dwelling Type: Single Family L5r- Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: YF'ull ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing 3 new Half: existing new Number of Bedrooms: `• existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas Uf'aiI ❑ 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 Appea Authorization ❑ Appeal # Recorded ❑ Commercial ❑Ye No If es site plan review y e p a ev ew# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number Address %A(__ -\'xcN,9 ev ,_ License # ®�► e Z a�� Home Improvement Contractor# � A%ems`i Email c.b Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE i Li F FOR OFFICIAL USE ONLY f. APPLICATION# ro ~ DATE ISSUED , 4` t MAP/PARCEL NO. t a ADDRESS VILLAGE OWNER . DATE OF INSPECTION: ' FOUNDATION FRAME INSULATION FIREPLACE t ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL . r FINAL BUILDING i DATE CLOSED OUT r ASSOCIATION PLAN NO. r .- i ederal ID#,004405629 RISE ENGINEERING -- --'" 1 LContractor Registration No 8186 A Contractor R Istration No120979 - A division of Thiclsch h;:ngneering �j E`: =j4 eg. tt €£ T Contractor Registration Noc626,120, 1341 Elmwood Avenue,Cranston,R 9 ' tQV: t, p l LJ p�T®/. (401)784-3700 F (401)). ®1�1 1 RM. iT FA IIII R A S E M r 1 ,,. THIS CONTRACT IS ENTERED INTO BETWEEN RISE CLC-RGS ENOINEMIM AND THE CUSTOMER FOR:WORR'At ENGINEERING oescRtsm SELOW CUSTOMER 'PHONE` DATE-- :Client 0 David A Sandell (508)790-7603 1 1/16/2013 070188 SERVICE STREET BILLING STREET 423 Elliot Road 423 Elliot Road SERVICE CITY,STATE,ZIP - Bal)NO CITY;STATE,ZIP Centerville,.MA,02632 Centerville;MA U263.2 JOB.DESCRIPTION Provide labor and materials to seal areas of}our homc;*inst.wasteful,escess,air teakage. This work.will be performed iii conceit with the use of special tools and.diagnostic tests to assure that:yourhome will bc.lcft with a healthful,I el of air eechange'and,. indoor air,quality.Materials to be used to seal yourhome can include caulks,foams,weatherstripping;and'other products.,Primary, areas for sealing include air leakage to attics,.basements,attached garages and other unheated areas(windows are:not generally addressed) (18)working hours. At the.completion of the weatherization work,and at no addit onal.cost toahe homeowner,a final blower door and/or combustion safety analysis will:be conducted by the subcontractor to ensure the safety of[he indoor air qua $I;386:00" " Provide labor and materials to seal heating and/or cool dubs Within designated tmheated areas. This work will be performed at the rate of$75.per man per hour,which includes materials. (1)working hours... $75.00: Homeowner'is responsible for the-removal.of the stored items blocking the installation ofweatherization work in the kneewall arms; Removal must occur prior to the scheduled;work start. $000 Provide labor and materials to install 2" FSK faced semi-rigid'fiberglass board insulation .(370)square feet olf kneewall area: $1,224 70 Provide labor and materials to install a 10". layer of R-35 Class-1 Cellulose added to(822)square feetof open attic space.; ' $t t01;i48 Provide labor and materials to install a 6."layer of R-22 Class I CelJulose'addedao`:(B4)rsquare feet of attic kneewall Moored space: $43086- -Provide labor:and materials to insulatethe back of(1;);attic hatch with 2 ri&i j 7 helmax booed�4Veatherstrip thepenmeter W -,. $35.12 Provide labor and materials to insulate(2) back of the kneewali hatch with 2 rigid Thermax,board,and seal the edge of the hatch with weatherstripping $8500' Provide labor and materials to insulate,the;back of the attic door wlth.2"rigid 1'herntax board and seal:the doors>edge with weatherstripping to restrict air leakage.. $72.22`. Provide labor and materials;to;ins"ta11(2)insulated exhaust hose_with roof.mounted flapper:vent to exhaust existing bathroom fon(s): $232'.2.0 06 Provide Jabor;and materials toiinstall ventilation chutes'in(8$)iafter bays to maintain air flow. $30712' Provide labor materials to install(13)4"X l 6"rectangular aluminum sofiIt`vents to increase ventilation in attic areas;Specify` color:White or Gray. $375.83` E RISE ENGINEERING Federal ID#06-0405629 RI Contractor Registratlon No 8186 A division of Thielsch Engineering tiAA Contractor RegtstraUon No 120979:::: A C.T Contractor Registratlon No.620120 1341 Elmwood Avenue,Cranston,RI 02910 (401)784-3760 FAX(401)784-3710 CONTRACT Page 2 RI -.♦l E.. "'PROGRAM,. THIS CONTRACT IS.ENTERED INTO BETWEEN RISE. . ENGINEERINGAND THE-CUSTOMER FOR WORK aB:: CLGRCS ENGIN€ERING` DESCRIBED BELOW: CUSTOMER - PHONE - DATE Cliem Y David A Sandell; (508)790=7603 rl/f&no 070199 SERVICE:STREET. - -�SlUINO STREET- 42�Elliot Road 423 Elliot.Road .SERVICE CITY,STATE;ZIP. BILLING CITY;STATE,ZIP: Centerville,MA 02632 Centerville; MA 02632_. s, JOB DESCRIPTION Provide labor and materials to install(27)square 110 of R 19'606psulatW1-fiberglass insulation to the basement ceiling:: $53.19 Provide Tabor and materials to insulate(1) 6ack of the craw.lspace door.With 2 rigid Themiax board,;and seal the edge of.the hatch with weatherstripping. $4250. "r RISE Engineering will apply all;applicable,eligible:incentives to this contract. You will be billed only the Net amount. Currently; for eligible measures,the Cape Light Compact offers 75%incentive,not,to exceed$4,099 per calendar<}year, nd;an incentive of 100%for the Air.Sealing measures., 50:00 Total; $5,421.22 Prograwlncentive:;- - $4,427.44. Customer Total: $99378 WE AGREE HEREBY TO FURNISH SERVK ES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS:FOR THE SUM OF': "'Nine Hundred NinetVJhree&781100 Dollarg $993.78 UPON FINAL INSPECTION AND APPROVAL BY RISE:ENGINEERING.CUSTOMER'.AGREESTOREMIT AMOUNT.DUE IN FULL INTEREST,OF 1%WILL BE CHARGED,MONTHLY;ON ANY <. UNPAID BALANCE -0 DAYS.SEE.REVERSE FOR MAPORTANT.INFORMATION ON:"GUARANTEES,RIOHT8 OF REC18N)N;SCHEDULINO,AND CONTRACTOR.REGISTRATION: DO NOT SIGN THIS CONTRACT:IF THERE ARE ANY BLANK SPACES AUTHORIZED BIG RE=RISE ENGINEERING - --: CUSTOMER ACCEPTANCE .`. 1 n NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US.IF:NOT,EXECUTED WITHIN 0F:ACCEPTANCE k�t .. 3 ACCEPTANCE OF CONTRACT-THE ABOVE PRICES,SPECIFICATIONS AND CONDmONS ARE SATISFACTORY Tows AND ARE HEREBY ACCEPTED.YOU ARE AUTHORIZED TO DO THE WORK DAYS; AS.SPECIFIED.PAYMENT,WILL,BE MADE AS OUTLINED ABOVE I € OWNER AUTHORIZATION FORM L, (Owner's Name). owner of the property located at Pro ert ,. ( p y Address) (Property Address); hereby authorize J S t (Subcontractor) an authorized;subcontractor for RISE Engineering,to act on my behalf to obtain a building permit and to perform work on my property; Owner's .Signatures: t l� 00146ENE-01 MVAUGHAN. ACORO` - �,..� CERTIFICATE OF LIABILITY INSURANCE 3128/261°°"'""' - 20i3 THIS CERTIFICATE IS ISSUED AS A MATTER OF. INFORMATION ONLY AND CONFERS NO RIOHTS:UPON THE CERTIFICATE HOLDER.THIS, CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATNELY AMEND; EXTEND;OR ALTER THE COVERAGE AFFORDED'BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S1,AUTHORIZED REPRESENTATIVE OR PRODUCER,AND-THE CERTIFICATE HOLDER. IMPORTANT. B the eerdficate holder Is an ADDITIONAL INSURED,the poBCy(ies)must be endorsed: If SUBROGATION E8 WAIVED,'aub)ect to the terms And eondiUone of the po0cy,certain poveWs may require an e_ndorsement.,A statement on-this coillfkate.d16—not confer rights to the, cerll@eate holder In lieu of such endorsement s vaooucER -CONTACT : Strata fc BUSIneSS Unit' Ro Ta&Dray Ins.-Dennis Branch .Pxoxe 4Rm 134 608 3984M IA 877 818.2166 South Dennis,MA 02Bfl0 aocREss: WSUR AFFORDINfi COVERAGE MAICDi lmuAaK�,.SW9CtlV01n6.co.of fhe Southeast -.INSURED ;INSURER'S:: ._ Con-Serve Energy,Inc. INsoRERc:. dba ConserVialon.Energy $07 Main St uISIIRERo:_ Hyannis,MA0266: WSURERE: . •INSURER F i-. ._•: , COVERAGES CERTIFICATE NUMBER:: _ ;REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF IRSURA- 11STE0 BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE.POLICYAERIOD INDICATED. NOTVATHSTAMOING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT YNTHRESPECTTO WHICH THIS CERTIFICATE_MAY BE ISSUED OR MAY,PERTAIN, THE'INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO.ALL THE TERMS,- AND CONDITIONS OF SUCH POUCIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS: , L7R TYE FFF EOFINSURANCE POLICYNIMB9t . : _ _.umRS: .[ oENFRutu.■am EACHOWURRENCE. 3 1,000,000 A X COxt►teRCMLt;FraEautuulalTY 2011298: 3M4f2013 3114/2014 .pqs� ■ s 100,0600 CIAaLs81A0E�OCCuf! rrEDt�tAlAn awpereanl S 10,00 PERSONAL&PDVINJURY S 1:000,0 ..:.._.,.. j`OENERALAGCfiEOATE. S OENLAGQtBGATE LIMIT:Appues-PEti:: :.PROI3UCT8-CWPI0PAOG- S 3,900,00 -. 'AVIOlrOBaELUIHt1rY ANYAU[O -'. _:BODILYINJUR-Y ._ - - 1�P�1. 5 ALLOIANED U ' :. fiODILYINJURY , ) S HIREDA _.._ AUTOS AUTOS ' - - (Pera0"TIrosHSCHMAJEp NONAIANED: ,AUTOS nua■srr.UAS_ .000IR EACHOCCURRENCE 5 OCCESSLUU! -C .. .. . $: .. M0 RETErIIION AM PLOWJW It A0Ln _ .. .._ ATu oER TH. A AwPROPMEMMORTNENEXEMMEYIN CT8b6639 311412013 :1M4126114 'El FACFTACCIpENT $ 600,0 1 OFFCER&VJAIE t EXCU OED7 .Q. NIA (t rt►6if - 1E.LDISEASE-EAiliP GYE i. so 00 ifyyen�,,ee�o10s�rider - nONOFCPERAaONSeetpr . _. ':_..... ,.......-- `. E.LOISEASE-POLCYUMIT S. 500. 1 I` OIECgIPl10NO't1PERATIOIMrtoCA710NS/VEfaf.'LES(Aerb AtAND tM,AddItmmA�s LLReScMAUI�,nafo�■fPae+iai.aWrad)-EXCLUDED OFFICERS UNDER WORKERS COMPENSATION:"CONOR'&COURTNEY MCINERNEY"NOTE THAT BLANKET ADDITIONAL INSURED OVERAGE APPLIES TO THE COMMERCIAL GENERAL:LIAB ury(IF A WRITTEN CONTRACT IS IN PLACE, CERTIFICATE HOLDER CANCELLATION SHOULDANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE: - Rise Engineering THE EXPIRAON: DAE THEREOF NOTICE ACCORDANCE 4NTH'THET POLICY PROVISIONS ALL Bl= DELIVERED l�l; 1341 Elmwood Ave. Cranston,"RI02910 _- . -AUTNOrm REPRESENTATIVE 01Aa 01988-2010 ACORD CORPORATI01 All rights reserved:, ACQRD,26(*10106) The ACORD name and logo;are reglstered;:me *of ACORD I 1 CERTIFICATE OF INSIJI.ATION Part 1 -General Address of Residence: Name Conor McInerney, LEE®AP Date of Installation: 0 376 Route 130,5URP G.S..ii-dwich,Ma 02563 P.50-833-838.1 o C•33M)32-282B f-'Ly�I1111�iikA'flklilVl!�fiJV•t%Lq'I'I a WWW.COIk;11f1+If,Ifl�ty.CUll1 Part 2 d Areas Insulated WALLS(I Sq. Et.) CEILINGS L— Sq. Ft.) FLOORS (�Sq. Ft.) Type of insulation: 'Type of Insulation: 'type of Insulation: Manufacturer: Manufacturer: Manufadturer: it-Value Installed Amount InstalledR-Value Installed Amount Installed R-Value Installed Amount Installed (#Bags) (#Bags) (#Bags) Part 3 - Certification L certify that the residence identified in Part 1 was insulated As specified in Part 2 and the installation was conducted in conformance to applicable Codes, Standards, and RZegltlations. Signature This Certificate must be Completed and prominently posted adjacent to the electrical panel. The Commonwealth ofmassachusetts Print Form Deparftnent of Industrial Accidents - Off ce of Investigations.. 1 Congress Street,Suite 100. Boston,MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Apulicant Information _ Please Print Legibly Name(gusiness/Oigan zat onzindividual).:Con=Serve•Energy,Inc dba:ConserVlslon Energy Address:376'Route 130' City/State/Zip:Sandwich, Ma 02563 Phone#s Are,you an employer?Check the appropriate box: Type of prdjet t(required): 1.❑✓ 1 am a employer with 8 4. 1 am a,general contractor and I employees.(f ill and/or,part-time).. have hired, sub-contractors 6 QNew construction 2.[] I:am a sole proprietor orpartner- listed on.the attached sheet. 7. 0 Remodeling These sub-contractors have ship and have no employees, 8. []Demolition working forme in any capacity; employees and have:workers' 9. tLidding:addition. [No workers'comp.insurance comp msurAnccJ rdquireA,] 5. We area corporation and its 10.0 Electrical repairs or additions g officers have exercised their' 3.❑ 1 am a homeowner loin all work 1LQ Plumbing repairs or additions myself.'[No workers'comp: right of exemption;per MGL 12.[]Roof rep airs, insurance required_]t c,15Z§1(4),and we have.no employees.[No workers' 13_ ✓❑Other Weatherizatlo ..:2013 _.• __ comp.insurance required.] *Any applicant that checks;box#1must 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 sheeeshowing.ihe name of the sub-contractors and'state'whether or,not those entities have+ employees. If the sub-contractors have employees,they must provide[hc¢woiliers'cyri►p.,policyrnumber am an employer that it providing workers'compensation insurance for my'employees. Below�s the:policy and job site information. Insurance Company Name:Selective Insuranceto.:of the SouthEast Policy#or Self-ins.Lc.#:WC7956539 Expiration Date:3/14/2014. Job Site Address: City/State/Zip:.- 'Attach a copy of the workers'.compensation policydeclaraton 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 penalf►es:of.a fine.up.to.$.l.i5.00.0.,0.and/or one-year.impnsonment,,as.wd I.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 maybe:forwarded:to the'Of_f ce'of Investigations of the DIA.for insurance coverage verification;. I do hereby ce W 'under the pains and ena/des gteer'ury Mat.,the informadon provided above is trae,and correct _._ Si afore: Date Phone M 508-833-8384 Official use only: Do not write in this area,to be comp/eted'by city,or town official City or Town: P.erm tlLicense;.# lssuingAuthon (circle,one):; 1:Board of Health 2.Building Department 3.City/Town Clerk. C Eleetricat Inspector 5.Plumbing Inspector; 6.Other Contact`Person:- Phone:#s COMBUSTION SAFETY Post Test Date: Site ID: POST-TEST WORST CASE CONDITIONS NATURAL CONDITIONS(IF NECESSARY) Ext.Temp: _____'F Min.Draft:__-_-Pa. If any appliance fails draft or spillage under worst case conditions.the (PxrEttioR rt:rer a eof-2.15 appliance must be re-tested under natural conditions. Turn off all exhaust CAZ baseline pressure WRT outside —_-__Pa• Ifans.open interior doors,allow the flue pipe to coot.and repreat the test. CAZ worst case pressure WRT outside _____Pa• 1f any appliance fails under natural conditions,no work can be done. Total Change in pressure ______Pa. If CO measures above looppm on any test,no work can be done. DHW DHW CO of undiluted flue gas ---_---I______PPm CO of undiluted flue gas ___i___-__PPm Draft Pa. Pass Spillage Test Y I N Draft pa. Pass Spillage Test Y I N Draft with Heating System firing -, pa. Draft with Heating System firing pa. Heating System Heating System CO of undiluted flue gas_____1__,_/__1____ppm CO of undiluted flue gas----i----i----i__PPm Draft ---_---Pa. Pass Spillage Test Y I N Draft pa. Pass Spillage Test Y I N Ambient CO (Monitor Co throughout the test and record results) Ambient CO CAZ---------ppm Living Sp._____---ppm CAZ _ppm Living Sp._____---ppm Dryer 0t : Notes: Comments: Bath Fans City: Notes: Kit.Fans City: Notes: Air Handlers Oty: Notes: Doors Note requirements for"Stop Work"and"Emergency"test results. Test the oven and/or dryer only if they were not tested at a previous visit. Gas Oven CO Test:Test undiluted sample inside Gas Dryer CO Test:Turn dryer on to highest heat exhaust port white oven is operating at steady state. setting and test at exhaust port after five minutes. Oven CO:____ppm Ambient CO:___ppm Dryer CO:___ppm Ambient CO:_ ppm See Level I and Level 11 protocols for fail limits Limit is 100 ppm Note any additional non-standard equipment, testing conditions or testing results TEST RESULT(circle): PASS FAIL* STOP* TESTER'S INITIALS:_______ All tailures must be disclosed to the customer in writing,with one copy retained for CSG s records ---------------- CSSL-102778 CONOR;D MClNERNEY 39 SIASCONSET:DR" SAGAMORE BEACH MA 02362 0809/20:14. Office of itbn`sumer Affairs&iViiness Rijuliii HOME IMPROVEMENT CONTRACTOR Registration:, 171251, TYPe Expiration:. 3/1/2014' Partnership CON-SERVE ENERGY' CONOR MCINERNEY 376 ROUTE'130 SUITE;G- SANDWICH,MA 02563 ' Unders�creten License or^regis"tratioa valid;for indivtdul use-only- before.the expiration date: If found return to: Office of Consumer.Affairs:and.Business Regulation 10 Park Plaza-Suite 5170. Boston,MA 61116 Not valid without signature 1 COMBUSTION SAFETY Post Test Date: Site ID: POST-TEST WORST CASE CONDITIONS NATURAL CONDITIONS(IF NECESSARY) Ext.Temp: °F Min.Draft:_____pa. If any appliance fails draft or spillage under worst case conditions,the � (EXTERIOR TW=eo)-2.75 appliance must be re-lasted under natural conditions. Turn off all exhaust CAZ baseline pressure WRT outside ____—pa. fans.open interior doors.allow the flue pipe to coot.and repreat the test. CAZ worst Case pressure WRT outside ___—_Pa. If any appliance fails under natural conditions,no work can be done. Total change in pressure _—____Pa. If CO measures above looppm on any test,no work can be done. DHW DHW CO of undiluted flue gas _-_—---I__^___PPm CO of undiluted flue gas Draft pa. Pass Spillage Test Y I N Draft ___pa. Pass Spillage Test Y / N Draft with Heating System firing __ pa. Draft with Heating System firing pa. Heating System Heating System CO of undiluted flue gas___/___/__/____ppm CO of undiluted flue gas ----l_^ppm Draft pa. Pass Spillage Test Y I N Draft pa. Pass Spillage Test Y / N Ambient CO (Monitor Co throughout the test and record results) Ambient CO CAZ---------ppm Living Sp._-------ppm CAZ— -ppm Living Sp._-------ppm Dryer 0t : Notes: Comments: Bath Fans 0 : Notes: Kit.Fans 0ty: Notes: Air Handlers Oty: Notes: Doors Note requirements for"Stop work'and"Emergency"test results. Test the oven andlor dryer only if they were not tested at a previous visit. Gas Oven CO Test:Test undiluted sample inside Gas Dryer CO Test:Turn dryer on to highest heat exhaust port while oven is operating at steady state. setting and test at exhaust port after five minutes. Oven CO:____ppm Ambient CO: ppm Dryer CO:___ppm Ambient CO:_ ppm See Level 1 and Level II protocols for fail limits Limit is 100 ppm Note any additional non-standard equipment, testing conditions or testing results TEST RESULT(circle): PASS FAIL* STOP* TESTER'S INITIALS:________ All failures must be disclosed to the customer in writing,with one copy retained for CSGa records / Assessor's mdip and lot'number. .Zz 7:.:/. 8.....�� ® SEPTIC SYSTEM MtJ51 INSTALLED IN COMPLIANCE ;2 1 s WITH ARTICLE II STATE : Sage Permit number ..................... . .............................. SANITARY CODE AND TOWN 5� a T 0 S' ` *THE OF BAR9911 LE_ BJHHSTADLE, i o 9 a e�� D U I L D I H G INSPECTORRasN30iss"00N00 31GUSNUVIS 30 -IVAOHddV Ol. i33rans• APPLICATION FOR PERMIT TO .... .. e .. w4%L en r. TYPE OF CONSTRUCTION .......4 .(P G .................................................................... ..............(`) .............1971"' TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location . .d.T........��.... ...4. /..4 r'�.....�............ ..� �' . ..........:.... ProposedUse ..... �� .��.!4� .. :...................................................................................................................... Zoning District ... . ..,. .........................................................Fire District l,.... ICP�i�r..... .�✓�G.L.................... Name of Owner / Lll4 .. 11 . 1-Ij60 ...Address Nameof Builder .....................................................................Address .....................................:.:..:;........................................ , Name of Architect :. :...��C'ra d v tZ.(r r ................Address �.rAS H nt!�'Co W.....5.:C:......N S,.,4.4 jP............... ............................... t . st � az--tc--0 L� Number of Rooms ............... ..................................................Foundation V............................................................... .............. e Exterior ` .......... .��':,n •.........................................................Roofing ........ .p .R. .. ........................................... Floors .....W. 4i-:�.......................................Interior ........ 2oa Heating ..........1.>....1 . ............................................................. .. .... '. Plumbing ..� • Fireplace ..................a.............................................................Approximate Cost ......... .��.t..D.iU..zt. Definitive Plan Approved by Planni:n Board -- -- ------ - Area . ........�.. ...f s.................. Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD :OF HEALTH s� 3--7 V rC/ � -71 9 � I hereby agree to conform to all the Rules and Regulati ns the Town of Barnstable regarding the above construction. 1 No .......... ........ ................ ............................. _ - 71 F ^� " �2- � l .. �Pani� for ..�� familyN -.----.'. lio� + � --~----------- ^ � ' . _�lot_#6. ..Iud...bo� 42 : 3 , Centerville � . . ....-.'----�.......'��:�::`�--~-.-----.— � Owner - . ---------. Typo of Construction ................fr�-.---- ' ' . . . -----...--.-----.-..--~-.-.--... ` ' ' ^ . Plot ............................ Lot ................................ ' ` . . ' ' Permit Granted ..........J.uly..... 2............lV 79 ~ Date of Inspection . lg , ^ , ^ --- _Comp -'d . PERMIT REFUSED l�'-.---._----...-.-.-.-.-.--,^ '.----..--..-..~.-.--'.--.---.-._..-... � . ,.....-..,.--- � . . - .---,.-.''-.,..--..-.. --.-.-.'_..-� . . ; .............................. Approved ��' 19 ' � . -------.------. ��-------.-.. -----------.--.. .-.-.-....-.-.. _�.� ' | ^ Assessor's map and lot number ' Sewage Permit number .......................................................... Py�*THE r I TOWN OF BARNSTABLE ` MARISTADLE, i M639 0 OR �0�� BUILDING INSPECTOR a' APPLICATION FOR PERMIT TO .......... ' �% . / .� ^':r *�,„ ................................................. .. ..... TYPE OF CONSTRUCTION ........ r...........`T..a:.................................................................................. ................. ......:........................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ... .r.. ..: .......e"5°.......'.-"" .-.:f"?., ....-;w ......e--- 1...!`r...........:................................................... ProposedUse ....................-5.> ... .......t.. .............................................................................................................................. Zoning District .....-T.�........................................................Fire District ...1:'//..... Name of Owner Address .. J.G'.Cr i; r�r...,..c/i sr .... Nameof Builder ....................................................................Address .................................................................................... Name of Architect 2 ; .„ S Sp t=,v 9-6 ..Address tames 4-1 -T t. Kit :e, ,• ) Number of Rooms 7...................................................Foundation ........ �.,ri c , C4 w iz r.� �s ............... .................................................................... Exterior Roofing ........ .y P . a ................................................................................ ........................................................................... Floors ................I.........................Interior tag. Q .......- ................................................................. Heating ..................................................................................Plumbing ..........:..'...... ......................................................... , Fireplace .................-..............................................................Approximate Cost .........:. ?.... ::..::................................... Definitive Plan Approved by Planning Board -----------_------_-----------19________ . Area ' Diagram of Lot and Building with Dimensions Fee `.' ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .................................................................................. Hirshberg, Alvaiy tA-227-108 No �22,46Z...... Permit for =sia g1P..•faRa1•1y ` dwellag............j..... ......... ........ Locatio ...].Rt...#r...];.1.1.iof..Rd_... s ...423. ` centerv' r Owner ....Alvan„Hirshl2erg............................. Type of Construction ....!!........fxame.................. i ...................................... .................................... - Plot ........................... Lot ................................ L k Permit Granted ,.:..auly.....12.................19 79 Date of Inspection ....................................19 Date Completed........................................19 f PERMIT REFUSED ............... ......... ......... ....... ... 19 ... ! ........ ................................... .......... ............................... ....................y... ............... .............. ................. v rr Approved ................................................ 19 + ............................................................................... ................................................................................ I f v k ` i IV IV u- tJ� loll Eo i Jc D OT Ni 0 i �%41 . 8 N - orBJ C ER 'T' 17-c E D - P,L-OT� ' PLAN -- L O CA T-1 O N v ' 4c /hA F O R:_ AL,y/S�'y .Sh/B Q � 9 S C.A L E�, � DATE-:SrfU-/E Z? / REFERENCE dr/ �L�Q•,,/ .2 :<40AeJ�U �T B-4 c/S'T�9 G3 4 E T'/ly OE EO DATE t HEREBY C'ERTfFY THAT THE BUIL' D'ING R G. LAND SURVE R SHO.w-N .._ON. •T 'H1St:-PrLAN?_J5- LOCATED-- ON THE -GROUN'-D A'S' SHOWN HEREON. MWAHO&12 13661) 0 J . M . MONAHAN, -JR. & A- SS0C__t_ATE :S REGTSTER"E.D" L- AND SURVEY.ORS, &-ENGINEERS ' sc 651 MAIN SrR EET , DENNISPORT., MASS. 02639 r5 t,,�•`" �e TOWN OF BARNSTABLE Permit No. ___-,_- 21461 Building Inspector saasrnn cash -- ' 60,, OCCUPANCY PERMIT Bond __X "No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued,by the Building Inspector." Issued to Alvan Hirshberg Address 35 Suffolk Ave. , Hyannis lot #6 A423 Elliot Road Centerville Wiring Inspector Inspection date ell Plumbing r Inspection date Gas Inspector Inspection date /Engineering Department Inspection date Z6 .- THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. ..................... ... ........_, 19 ........................ .` ............. ._._ _. _ _ r. uilding Inspector FROM TOWN OF BARNSTABLE BUILDING DEPARTMENT Mr. Francis Lahteine 367 MAIN STREET HYANNIS, MA 02601 Town Clerk Phone: 775-1120 L SUBJECT: FOLD HERE DATE April 9 1980 MESSAGE Work has been completed under Building Permit #21461 (Alvan Hirshberg). Please release Bond. SI NE DATE REPLY N87.RMI RECIPIENT: RETAIN WHITE COPY,RETURN PINK COPY L PRINTED IN U.S A. i