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Home My WebLink About0095 GOOSE POINT ROAD 9.5 G71 o H :a r. 4t S` � Town ®f BarnstableBuilding E xna* s:euLe Post This Card So That it is Visible.From the Street—Approved Plans Must be Retained on Job and this Card Must be Kept � 9��® j Posted Until Final Inspection Has Been Made. 6 3\Fo niaY% Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit Permit No. B-17-4287 Applicant Name: ROGER T COX Approvals Date Issued: 12/14/2017 Current Use: °. Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date`. 06/14/2018 Foundation: Location: 95.'GOOSE-POINT ROAD,CENTERVILLE Map/Lot: 252-080 Zoning District: RD-1 Sheathing; Owner on Record: MERLESENA,STEPHEN.W. Contractor Name: ROGER T COX Framing: 1 Address: 70 MAIN STREET-SUITE 3 Contractor License: CS-073885 2 HYANNIS, MA 02601 Est. Project Cost: $ 1,S00.00 Chimney: Description: RESIDE Permit Fee: $35:00 ' Insulation: Project Review Req: Fee Paid: $35.00 Date: 12/14/2017 Final: Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Final Gas:, This permit shall be displayed in a location clearly visible from access street or•road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: Rough: 1.Foundation or Footing 2.Sheathing Inspection Final• 3.All fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Cove ring'StructuraI Members(frame Inspection) x 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 MG c.142A). Fire Department Building.plans are to be available on site Final. All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT ilk �� r Town of Barnstable *Permit# E�r�res 6 months from issue date Building Departm,�gs Fee sntwsrABLE, : Brian Florence, CBpMASS v , 9. Building Commissioner �'ArFn t °i 200 Main Street,Hyannis,MA 02601 DISC 12 2017 www.town.barnstable.m �u Office: 508-862-4038 g .�WIVI O� 1JAHNS lA D08-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number ,�a , �(� Property Address �J `� ,tJ L 1.�fU -�`u ke; �;fj p Residential Value of Work 0 Q9 00 Minimum fee of$35.00 for work under$6000.00* Owner's Name&Address CO a sc #*46 lrt C 1-4 6 -5�he a r1 efe yq Contractor's Name Aqgl, Telephone Number 0 '), �� GSi' Home Improvement Contractor License#(if applicable) 33 - Email: roa CoX C Construction Supervisor's License#(if applicable) Cs�- O ❑Workman's Compensation Insurance Check one: I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) gcNjr(c;�/c ��C�Re-roof(hurricane nailed)(stripping old shingles) All construction debris will betaken to_ -� /1 Re-roof(hurricane nailed not stripping. Goingover existinglayers of roof) 5` ei. 7;o^ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is . required. SIGNATURE: Q MPFILESTORMSTXPRESS2017 j k^ Yh-e Comuromveakh rt,f Massad iusetts Departmait o,frradustrialAcciderds - 0 c of 1Fn�siigatia�ss ` 600 Washizigton,S`treet - Briton,MA 02M • ft�rvturttassgftv�din Workers' CampensafranInsnranceAffidavit:BnildersiContractursMec&kians/Piumbers Applicant Infarimafran Please PFint Name�asiaessflOrgaz�e}afFa�al� dG tom/` `� �►' Address:r Sa � e e� ta, r p. rJ e tears;o oe S-o - .� 9-�So-2 Are you an employer?Check the app priate born: ' Type of project(required): L❑ I aril a employes.vrith 4 ❑I am a general contractor and I 6. ❑New construction employees(fall andfor part-time).* 'have hired the sub-contactors 1 2.A I am a sole propzietof orparfner- listed outhe attached sheet. 7- ❑Remodeling ship and have no-employees These sob-contxactom have g-,❑Demolition woe3dng forme is any capacity. employees and hate workers' [No tu?dmm'comp.istsusance comp-msuraum 9. ❑Building addition required] .5. ❑ We are a corporation and its 10-❑Electrical repairs or additions officers ha esescis d ve a their 3_ I am a bomeovener do' w 1 L Plumbin r❑ doing all-work ❑ g e airs or additions P - mysidi o ycor�' fLot of egeMp p ❑ � �F- fiouer MGL 17 Rflofr - inaza ceie edj F c.152, §1(41 andwe have no 13_❑Othes employees.[No WodM corm-msurance mT ired_] 'uayapg[icsnt�iatcherksbas�lma.-taLsofiIlonFthesecuoabeIow�nsdngt�eeiruradce�s'campeasatio-apari�yiaformsaa� j #�ameoarflaiswho sahaut dais�dat�t ia�riting they axe dain:�aIF w�cud rhea hue antside rontiacmrs�st submit a nem affidaeat iadics3iao ss�cb_ ZCdnbxct=ff=dhacl Ws box neststMchedsaadditions]shed sboumg the nmeof the sub-coaftwAnmsndstabewhetheror not those eaddeshrm employees.Ifthesob-cmtactt=hweemPIcyep-%dLe}'=astpmvidethev worken'tomp policynumber. - I one an stnplr�r flint is prat�dir�workers'coerrperesrrlirrte itesrirateca fvr itr;}*etalv£aj�es $etaav is riT«a pmticy argil jab azta. -• . informatiom - Insurance Company Name: Policy,cr Self--iris I.ic_ ExpirationDate: Job Site Address_ city/State/zip: Attach a copy of the work-ere compensatioupolicy-dedaration page(showing the policy number and expiration date). Fail=to secure coverage as requiredunder Section 25A of MGL c.152 can lead to the imposition of criminal penalties of a hoe up to$1,50U 00 andror one-yearimprism==A,as well as civil peualties.in the form of a STOP WORK ORDERand a hne of up to$250.00 a clay against ffie violator_ Be adiised twat a copy of this statement maybe forwarded to the Office of Irrvest gatiom ofthe DIA,for insurance coverage vedfitatiorL Ida here-by cedp tt[ler tkR s at[d ears o.f parjut?'thutflte inf0tMcr€zvreprmzried abot,s is bare aced correct �Yi2�atnre_ , Date- Phone G 1 b JV P Ofokial use early. Da itat tvrita frj ttais area,€o be cutsp£etesd by clip artonm effi a£ City or Town- Perrmtf-&ease# Issuing Authority(carte one): L Board of Elt%d& 2.IBmTcfing Department 3.CRyff-own Clem 4.Electrical Inspector S.Plumbing Inspector 6.Otherr contact Person: Phone#: juformation and lastructions Massaalrmeffs CT&=-al Laws Cbvfcr M requires an employers D provide wQrkedS'compensation for bier MVIOY=- 2arMEEttO-this ,an=r P&5 ee is defined as.6.every person is lho service of another under any contract of hire, express or implied,oral or An Moyer is defined as"an inc$viMnal,pa fnMShip,assorfidion,corporation or oihez legal e=tfty, or any two or mole of the foregoing engaged is a Joint Vie,and incladmg the legal zcpeseofafives of a deceased employer,or the receiver or trastee of an.iadividnal,part=Ship,association or other legal entity,employing employees- However the owner of a dwelling horse haying not more than three apartments and who resides f amin,or the octet of the - dw Uin house of another who ezopIoys pe ma s to do mature,con taction or repair wow on such dwelling house or on the grounds or bm'Idmg appuit thereto shall n of because of sash employment be deemed to be an employer-7 MGL chapter 152,§2scp also states that"every state or local licensing agency shall withhoId fhe issuance or renewal of a Hcen a or permit to operate a business or to construct buildings in the commonwealth for any. applicant who has not produced acceptable evidence of compliance with the insurance.coverage required." Additionally,MC=L chapter 152,§25C(7)slams al�Teiiher the conom awmalth nor�y of its political subdivisions shall ente-s into any contract for the pmfunomat ofpubho woil-until acceptable evidence of compliance wn iize mso ance.. u-egL.fx e ems of this cbaptea.have been presented to the col a aufhozity_" Applicants Please a out the world rs'compensation affidavit completely;by checking i boxes�apply to youir situation and,if necessary,s-apply sub-mnt car i(s)name(s), addresses)and l)hone mmrbea(s)along wsth their cmtificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Parft=sbips(LIP)withno employees other than the members or partners;are not requn ed to cany wmicers'compensation insruance. If an LLC or LLP does have employes,apolicyisregaaed. Be,advised that this affidayitmaybesubmith--dto the Deparc--tmentof Industrial Accidents for confnmation of ias c� 9 coverage Also be sure to sign and date the afudavif The affidavit should bez-etomed to$e city or town that the application for the pezmit or license is being requested,not the Depa rtmeat of . das -ial A c;a0M . Shonldyou have any questions regailing tale law or ifyou are mguired to obtain a workers' compensation policy,please call theDepartnentatthenumbezlisiedbelow. Self-ins�nedcompanies shouldentertheir self-finu ance Hc:=e number on fhe appropriate line. City or Town Officials f _ Please be snre fhat the affidavit is complete andpriird Iegibly. The Depntineathas provided a space at the bottom of the affidavit for you to EL ourt in the event the Office of Inv t;�t;�n�has to corrfactyouregardingtbe applicant Pleas e b e sure tr)fill in fhe peumifllicense number which will be used as a reference number. In addition,an applicant ffiat must submit multiple peMitllIicense applications is aay given year,need only subnut one affidavit indira-�=Mt policy jafbrnation.(if necessuy)and under`Job Site Address"the applicant should write"an locations i (may or town)--A copy of-the-a$davitfiiathas been officially stamped ormadcedbyihe clay or town maybe provided to the " applicant as proof that a valid affidavit is on file for fnfine'pMM s or licenses Anew affidavit must be filled Olt each year-Where a home owner or citizen is obtaining a license or permit not related to any business or commercial yentum (Le_ a dog license or permit to burn leaves etc.)said person is NOT required to completes this affidavit The Office of Investigations-would IAM to th�ok you in advance for your cooperation and should you have any q o ns please do not hesaat-e to gim uis a call The Departmeuif's add=.s,telephone and fax n=obm-- 'fie�a tIE of 11� - - , De-partmm)�of 1ra&istzal Accidents D I�fA�11F -Tf,-1<4 617 727-49W Qxt 4-06 car I--977 Tvi'A SCAM Fax 9 617 727 7749 Revised 4-24-07 � �� r. OFIHE Tp� Town of.Barnstable * Building Department BAIMN Brian Florence,CBO �►ss. 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 I, ��v� �l► $e K^, ,as Owner of the subject property hereby authorize e-/` cor to act on my behalf, in all matters relative to work authorized by this building permit application for: S� t a/ CJ`Ac ^it��J. qS &Qd 4 (AdAress of job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspectio s are performed and accepted. Signatute o er Signa e of Applicant POC�O�( Print Name Print 14=e cw�> QTORM&OWNERPERMLSSIONPOOLS Rev:10/17 JLVvvu V1 "al llDLau1G �oFtHe r�� Building Department ,Y o„ Brian Florence CBO ESrAB Building Commissioner re MASS. g' 200 Main Street, Hyannis,MA 02601 tj 039. AlfD MA'1" www.town.barnstable-ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEO_WNER LICENSE EXEMPTION, ' Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER i •" "i Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the buildinE hermit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection.procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic.feet or larger will be required to.comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." r Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require, as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. i } Massachusetts Department of Public Safae� ,.' f eoar�f of Buiiing RegutatlF$frs and St�44� L it a ri s eFjCS=073885 ' rvisor a: C�,:struct�on Supe _ on ..,. ROGER T COX 19 SOUTHEAST LANE CENTERVILLE MA 02362 r ,,,� �Xpirati4n: l o311212018 Commiss oper. Cep /�R ef�iCtt4otip ess sty/edto. S e�%�ia�Cts 4pe� • seps3 p e4//o/ �sc� dace oc4b ePS a� Of 4 et(9 7�e9�o �• PlCtp a eP to h eo S<. 4//dA°ss °f V)ra/n ce')s �9 C eSs �P sc4r�e o r o�db , Se foa�r'o y� `offh P4 o�0,a ss MgSs s�h4s GO ye e f e s use ��ie�poanmaarurseaCC�z o�C�ac`cc�eC� f . Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Individual. before the expiration date. If found return to: ,Registration Expiration Office of Consumer Affairs and Business Regulation !✓= 375 08/06/2019 10 Park Plaza-.Suite 5170 -j? Boston,MA 02116 kVRGEF T. G- _ h; E__: yi ROGER T.COX 19 SOUTHEAST LANE=� ,;" _ Not Valid Without signature CENTERVILLE,MA 02632 Undersecretary f. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map- 2 Parcel= TOY,1IM of ?,t,,R STABLE. — Application # Health Division - ?t . E; Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis �41e,�Yu Project Stree Address / Village ki✓d'� Owner dress l� �J` J Telephone 0 Permit Reque 'A,, 4-7 p-- Aloe (I All Square feet: 1 st floor: existing��proposed T�Pnd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation CO-0 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ;d 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) 14° Number of Baths: Full: existing L, new - Half: existing new Number of Bedrooms: existing _I new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: 4,Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes I No Fireplaces: Existing I New Existing wood/coal stove: ❑Yes *No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 6 J Telephone Number / 7 ✓0// / Address C(s 1 4 -`7 /0�) License # C_� 6 5:F Home Improvement Contractor# 178 Email =-m//1 �CO �l Worker's Compensation ( 100— A ONSTRU TION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Orlco SIGNATURE DATE I�1ZLAT ((2 t " FOR OFFICIAL USE ONLY APPLICATION# 4 DATE ISSUED MAP/PARCEL NO. x ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION x FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. Mass. Corporations, external master page Page 1 of 2 Aft wfY-.,S✓� u f. ?J , Corporations Division Business Entity Summary ID Number: 001158452 Request certificate {New search Summary for: GOOSE POINT ONE LLC The exact name of the Domestic Limited Liability Company (LLC): GOOSE POINT ONE LLC Entity type: Domestic Limited Liability Company (LLC) Identification Number: 001158452 Date of Organization in Massachusetts: 01-21-2015 Last date certain: The location or address where the records are maintained (A PO box is not a valid location or address): ° Address: 70 MAIN STREET SUITE 3 City or town, State, Zip code, HYANNIS, MA 02601 USA Country: The name and address of the Resident Agent: Name: , INCORP SERVICES INC. Address: 44 SCHOOL STREET SUITE 325 . City or town, State, Zip code, BOSTON, . MA 02108 USA Country: The name and business address of each Manager: Title Individual name Address MANAGER STEPHEN W MERLESENA 70 MAIN STREET HYANNIS, MA 02601 USA In addition to the manager(s), the name and business address of the person(s) authorized to execute documents to be filed with the Corporations Division: Title Individual name Address The name and business address of the person(s) authorized to execute, acknowledge, deliver, and record any recordable instrument purporting to affect an interest in real property: Title Individual name Address http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.aspx?FEIN=001158452&... 11/3/2016 Mass. Corporations, external master page w Page 2 of 2 REAL PROPERTY ISTEP HEN W MERLESENA 170 MAIN STREET HYANNIS, MA 02601 USA ❑ ❑Confidential ❑Merger ❑ Consent Data Allowed Manufacturing View filings for this business entity: ALL FILINGS Annual Report Annual Report - Professional Articles of Entity Conversion Certificate of Amendment View filings Comments or notes associated with this business entity: : New search i http://corp.sec.state.ma.us/Corp Web/CorpSearch/CorpSummary.aspx?FEIN=00115 8452&... 11/3/2016 CONSTRUCTION CO.u c 546A Higgins Crowell Rd West Yarmouth,MA 02673 Phone 508-778-0111 Fax 508-778-5010 Registration#178434 ,License#069058 Date: 11 I Attn: Building Department I hereby authorize Tupper Construction Co., LLC to pull the permits necessary to complete the project described on the attached permit application form. Thank you, Owners' Signatures Print Owners' Karnes: `�we a .J Street Address: �j(} eri 1, - 1 f .r. Office of Consumer Affairs.an ` • ' �'r�.�rCC��e+t��'��J ab d Business.R egulation 10 Park Plaza- Suite 5170 Boston,Massachusetts 02116 Home Improvement Contractor Registration Registration: 17e434 TyPe: LLC TUPPER CONSTRUCTION CO,LLC, E"Pi��Qn 411078 Tnlf 410201 RICHARD TUPPER 546 A HIGGINS CROWAL,L Rp W. YARMOUTH, MA 02673 m-------_. Update Address and retu —.rn car d. k"nab ICA s t3 .fls,i, _ oo for change. L Address ;_ Renewal EmPlayment Loost Card' t)itiet of Consumer Aifsit s A Rkwat"Re"tioa Litnase ar •� HOME IMPROVEMENT C.OM[RAGTOR before the registration valid for individual an only y to Reglsbadon: 178434 of esPiratioa date. 1f found return to: Type. m of Consumer Affairs and Business Regulation „r Expiration: 4/18/2018 LLC r�. to Suite S170 TUPPER CONSTRUCTION CO,LLC. fin' RICHARD TUPPER 546 A HIGGINS CROWELL Rp W.YARMOUTH.MA 02679 - „ Ugdericc,�ry Not Without signature .— EUILDING PERFORMANCE INSTITUTEe INC 107"arMss Road,Sute 210 Mafia,NY 1202o (SM 274.1274 WWW bpl.org oy, Richard Tu ePln>a: " 0iEE vERSE&W FOR DbB-GUMNS MD E9000N DATES) Unrestricted-Bu Mass husetts -Department of l gB ofany uee group whi h fi uf�lie Safety awn 4011 titan 35,4W g1�fps("Im)of Beane of Building Regularom Ana s#araara6 enclosed-splice,. Con.tructiun Supvr%ieuC 'License: C13-Od9Q68 Richard S T4ppar; t�ros►veli West •uth» f Failure to possess a wrrent edition of the Nla�}f�b State sumi �`` qW �Code,is.cause.for[avticatlon of this Iicem, Fo►DPSUeensinglni ►otlonvisitc www:Mass.Gov/bP5 commissioner 1?J31l2t16 k :4co INSURANCE D CERTIFICATE OF LIABILITY NCE ATE`MMMDNM)10/3/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS:CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions ol'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 NAME: Lora FitzGerald Southeastern Insurance Agency, Inc. PHONE No aH. ($OB)997-6061 FAX Not <508)940-2731 439 State Rd. E-MAIL.S: P.O. Box 79398 ADDRES Ifitz@southeasternins.com INSURER S AFFORDING COVERAGE NAIC N North Dartmouth MA 02747 INSURED NSURERAArbalia Protection Insurance 41360 'INSURERS Boston Insurance Brokers a Inc Tupper Construction Co LLC - INSURER C: 546A Higgins Crowell Road INSURERD: INSURER E i West Yarmouth MA 02673 INSURERF:. COVERAGES CERTIFICATE NUMBER:2016-17 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. NOTVVITHSTAN DING 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. I�R TYPE OF INSURANCE IA00WVD POLICY NUMBER MMMIIDDCDIYYW POLICY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE �OGCUR PREMIS_ EaDWIZAGE TOocccurrence Is 100,000 9520045208 11/1/2016 11/1/2017 MED EXP(Any one pars-) $ 5,000 PERSON&&ADV INJURY IS 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE ,$ 2,000,000 MX POLICY JEC LOG PRODUCTS-COMP/OP AGG '.$ 2,600,000 OTHER: AUTOMOBILE LIABILITY COMBINED IN LE LIMIT (Eaaecident) $ 1;000,000 A ANY AUTO SODILY INJURY(Perperson) $ ALL I A TOSSED X AUTOS 10200093a9 12/1/2015 12/1/2016 BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-0WNED PROPERTY DAMAGE AUTOS er accident $ Uninsured motorist 81 split limit $ 250,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE ffi DED I I RETENTION I Is WORKERS COMPENSATION PER TH- AND EMPLOYERS'LIABILITY YIN STATUTE I I ER ANY PROPRIETORIPARTNERIEXECTIVE $ 'OFFICER/MEMBER EXCLUDED? ❑ NIA E.L.EACH ACCIDENT 1000DDO B (Mandatory In NH) WCC5005593012016A 10/3/2016 10/3/2017 E.L.DISEASE-EA EMPLOYE1$ 1,000,000 r yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 11000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) r CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE' For 'Informational Purposes Only THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Tupper Construction Co.., LLC ACCORDANCE WITH THE POLICY PROVISIONS. 546A Higgins Crowell Road West Yarmouth, MA 02673 AUTHORIZED REPRESENTATIVE Ashley Paiva/AMP 01988-2014 ACORD CORPORATION. All rights reserved. ACORD 28(2014101) The ACORD name and logo are registered marks of ACORD INS025 ranaaslti - ' The Commonwealth of Massachusetts . Department of Industrial Accidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 www.massgov/dia Workers!Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. . Applicant Information Please Print Legibiv Name(Business/Organization/Individual): Tupper Construction Co LLC Address: 546A Higgins Crowell Rd City/State/Zip: West Yarmouth, MA 02673 Phone#: 508-778-0111 .Are you an employer?Check the appropriate box: Type of project{required}; LE I am a employer with 10 employees(full and/or part-time).'! 7. New construction 2E]I am a sole proprietor or partnership and have no employees working for me in $. Remodeling n any capacity.[No workers'camp.insurance required.] � 3.D I am a homeowner doingall work myself 9. El Demolition ys [No;workers'comp.,insurance required.] 4. h I am a homeowner and will be hirin contractors to conduct all worts on m 10.0 Building addition: ❑ 6. y property. I will ensure that all contractors either have workers'compensation insurance or are sole I 1.E]Electrical repairs or additions proprietors with no employees: 12. Plumbing repairs or additions S.❑1 am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13:QRoofre airs These sub-contractors have employees and have workers comp.insurance I P 6Q We are.a corporation and its officers have exercised their right of exemption per MGI,e. 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. '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 statc.whetheror not those entities have. employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that isproviding workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:AEIC Policy#or Self-ins.Lie.#: WCC5005593012016A Expiration Date: 10/3/17 Job site Address: 95 Goose Point Rd 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 cerh #f0id-ve—iftpains and penalties of perjury that the information provided above is true and correct Si afire: Date: 11/1/16 Phone#:508-778-0111 Official use only. Do not write in this area,to be completed by city or town offyiat City or Town: Permit/License#_ Issuing Authority(circle one): I.Board of health. 2.Building Department 3.Cityt own Clerk 4.Electrical Inspector' 5.Plumbing In #.Other Contact Person Phone#: i REScheck Software`Version 4.6.2 Compliance Certificate 6 Project Remodel Energy Code: 2015 IECC ` Location: Centerville (Barnstable). Construction Type: Single-family y Project Type: Alteration Climate Zone: 5 (6137 HDD) p Permit Date: Permit Number: ` Construction Site: Owner/Agent: Designer/Contractor: 95 Goose Point Rd. Centerville, MA 4 Envelope Assemblies ` cmc rMaw M r Wall 1:Wood Frame, 16" o.c. ___ __ ___ ___ --- Exemption: Framing cavity not exposed. Window 1:Wood Frame:Double Pane with Low-E 24 0.280 7 Wall 2:Wood Frame, 16"o.c. __ __ ___ ___ _-_ ' Exemption: Framing cavity filled with insulation Window 2:Vinyl/Fiberglass Frame:Double Pane with Low-E 24 0.280 7 Wall 3:Wood Frame, 16"o.c. _ . __ __ __ --- Exemption: Framing cavity not exposed. Door 1: Solid 18 0.300 5 Ceiling 1: Flat Ceiling or Scissor Truss ___ ___ __ __ Exemption: Framing cavity not exposed. Floor 1:All-Wood joist/Truss:Over Unconditioned Sp(proposed 432 30.0. 30.0 0.016 7 Compliance Statement: The proposed building desid here i con istent with the building plans,specifications,I and other calculations submitted with the permit application.T bull ing h s been designed to meet the 2015 IECC requir ents in eck V rsion 4 2 and to comply with the manuire njjts lis ed in the REScheck Inspection Checklist. Name`-7TItre i I NiZnature Date Project Title: Remodel Report date: 11/02/16 Data filename: Untitled.rck Page 1 of 9 REScheck Software Version 4.6.2 00 Inspection Checklist Energy Code: 2015 IECC Requirements: 0.0% were addressed directly in the REScheck software Text in the "Comments/Assumptions" column is provided by the user in the REScheck Requirements screen. For each requirement,the user certifies that a code requirement will be met and how that is documented,or that an exception is being claimed. Where compliance is itemized in a separate table, a reference to that table is provided. Section Plans Verified P�eld 1/er�f�ed j _4qq , h; Pre-Inspection/PIarr Review' Valueµ"'tea, `' a Complies? Comments/Assum Mons .. Value , p -- 103.1, ;Construction drawings and "° " ` ' ' ❑Complies ; 103,2 ;documentation demonstrate x - Does Not e ❑ F [PR1]1 energy code compliance for the ',building envelope.Thermal ❑Not Observable ; envelope represented on []Not Applicable , ;construction documents. . ' �:� 103.1, :Construction drawings and p ❑Comp lies 103.2, :documentation demonstrate _ ❑Does Not 403.7 ;energy code compliance for y k [PR3]1 ;lighting and mechanical systems ❑Not Observable ;Systems serving multiple c ,' 'r �' `''� � ❑Not Applicable dwelling units must demonstrate :compliance with the IECC !Commercial Provisions: 302.1 , Heating and cooling equipment is: Heating: Heating: ;❑Complies 403.7 sized per ACCA Manual S based 1 Btu/hr Btu/hr ;❑Does Not [PR2Y on loads calculated per ACCA Cooling: ; Cooling: i Manual J or other methods ❑Not Observable , approved by the code official. Btu/hr ; Btu/hr ;❑Not Applicable Additional Comments/Assumptions: 4 f 1 High Impact(Tier 1) ,]Medium Impact(Tier 2) 3'. Low Impact(Tier 3) Project Title: Remodel Report date: 11/02/16 Data filename: Untitled.rck Page 2 of 9 seCtlon . #.a ,�°r < �, � fps#i , Foundat�on,lnspectlon; ; Complles� r� °., Commen s/Ass mp#Ions" ` h: &frRe (� { � �I w 4 ?x,. � .��,, � � t�.i �'s �>� , v�,� `�r�' 303_.2 1: A protective covering is installed to ;❑Complies [F01112. protect exposed exterior insulation ;❑Does Not and extends a minimum of 6 in.below ; grade. :❑Not Observable: ❑Not Applicable ' 403:9 Snow-and ice-melting system controls;❑Complies [FO12]? installed. ;❑Does Not ❑Not Observable ❑Not Applicable Additional Comments/Assumptions: a ' { _ x 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3: Low Impact(Tier 3) Project Title: Remodel Report date: 11/02/16 Data filename: Untitled.rck Page 3 of 9 I section b . ' # framing/Rough In Iris,pection Plans Verified',J, Field Verified'y Complies? " Comments/Assumptlons:n & Re ID°: =�. x Value'„ Value 402.1.1. ;Door U-factor. U- ; U- ;❑Complies :See the Envelope Assemblies 402.3.4 ;❑Does Not ;table for values. [FRl]1 ❑Not Observable ❑Not Applicable ' 402.1.1, ;Glazing U-factor(area-weighted U- ; U- ;❑Complies ;See the Envelope Assemblies 402.3.1, average). :❑Does Not ;table for values. 402.3. , 402.3.6, '❑Not Observable ; ; 402.5 ❑Not Applicable [FR2]1 a 303.1.3 U-factors of fenestration products ; .R`.T ❑Complies ; [FR4]1 are determined in accordance F'" . ❑Does Not ;with the NFRC test procedure or ; 1 t x l taken from the default table. ❑Not Observable t �,� , fk f � ❑Not Applicable licable •,. s .i .�fi. 402.4.1.1 �Air barrier and thermal barrier ❑Complies [FR23]1 "installed per manufacturer's ❑Does Not ;instructions. ❑Not Observable ; ❑Not Applicable 402.4.3 ;Fenestration that is not site built ❑Complies [FR20]1 is listed and labeled as meeting k ' ❑Does Not AAMA/WDMA/CSA 101/I.S.2/A440h, �� or has infiltration rates per NFRC '" x{ ❑Not Observable 400 that do not exceed code *u gam ' r '` ❑Not Applicable Q ,r1•` yJG i �, i. , ,limits. � ;.� � , ®,:: ;�� t � :,�•,r".,R." ;. 402:4 5 IC-rated recessed lighting fixtures `f ' " a" 9 9 r.; ❑Complies [FR16]2 sealed at housing/interior finish ❑Does Not ` and labeled to indicate<_2.0 cfm - - leakage at 75 Pa. f ❑Not Observable ❑Not Applicable 403.2.1 !Supply and return ducts in attics ' A ' Y'%❑Complies ; [FR12]1 insulated >= R-8 where duct is � w�:, i ❑Does Not ,, 4 >=3 inches in diameter and>_ � R-6 where<3 inches.Su I and ;� � �: ,��?� N ,� ❑Not Observable ; PP Y ❑Not Applicable return ducts in other portions of • ,- pp ;the building insulated>=R-6 for " tr . diameter>=3 inches and R-4.2 for<3 inches in diameter. r . 4033.3.5 l Building cavities are not used as " r♦' []Complies [FR15]3 ducts or plenums. Y ❑Does Not tl ' P &• ❑Not Observable , . .,PI'.• �.. x"=� ❑Not Applicable j 403:4 HVAC piping conveying fluids R- R- ;[]Complies [FR17]z above 105 gF or chilled fluids ;❑Does Not below 55 4F are insulated to>_R- 3. ;' . ;❑Not Observable ;5 ;❑Not Applicable 403.4.1 Protection of insulation on HVAC d ❑Complies - � w [FR24]1 piping. ❑Does Not t' t �• ,. ❑Not Observable ❑Not Applicable I I 5.3 . Hot water pipes are insulated to R- R- ;❑Complies [FR18]12 2tR-3. ". ❑Does Not E- ;❑Not Observable , ❑Not Applicable 4 4 'Automatic or gravity dampers are ❑Compiles ; [FR19]z . (installed on all outdoor air °$ x ; intakes and exhausts. ❑Does Not ; ❑Not Observable ; u ❑Not Applicable 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Remodel Report date: 11/02/16 Data filename: Untitled.rck Page 4 of 9 Additional Comments/Assumptions: 1 4 1 t 1 a t + 1 4 � • 1 JHigh Impact(Tier 1) 2` Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Remodel Report date: 11/02/16 Data filename: Untitled.rck Page 5 of 9 e v, . „. t ♦ :u �,. Plans Verified Field;VerlfiedA , Insulation Inspection ,^:, �< Compll,es? GpmmentQMsumptions :.jai �7 ValUe,.n Value , 4 ,, w �, 4 r r Pti a 303:.1 All installed insulation is labeled ��. � per' �` s�� S` ❑C [IN13p or the installed R-values E rr� " ❑Does omplies Not provided. x, []Not Observable - ❑Not Applicable " 402.1.1, ;Floor insulation R-value. R- R- ;❑Complies ;See the Envelope Assemblies 402.2.E Wood ;❑ Wood E]Does Not table for values. [IN1]1 ; ❑ Steel ;❑ Steel ;❑Not Observable jONot Applicable 303.2, ;floor insulation installed per ;,q ?w # �".[]Complies 402.2.7 manufacturer's instructions and _ s� �` ❑Does Not [IN2]1 in substantial contact with the * a" underside of the subfloor, or floor n-� ," $ .T []Not Observable <`' :framing cavity insulation is in z1 ❑Not Applicable ; contact with the top side of sheathing,or continuous insulation is installed on the A, w R underside of floor framing ands y h extends from the bottom to the top of all perimeter floor framing »: �y members. k < 402.1.1, ;Wall insulation R-value.If this is a: R- ; R- :UComplies ;See the Envelope assemblies 402.2.5, mass wall with at least lh of the �❑ Wood ❑ Wood ;❑Does Not ;table for values. 402.2.6 wall insulation on the wall [IN3]1 exterior,the exterior insulation ;❑ Mass ;El Mass ;❑Not Observable ; ;requirement applies(FR10). ;❑ Steel Steel ;❑Not Applicable 303,2 Wall insulation is installed per , rtp w';❑Complies [IN4]1 :manufacturer's instructions. ❑Does Not ❑Not Observable ❑Not Applicable Additional Comments/Assumptions: i 1 High Impact(Tier 1) '2,' Medium Impact(Tier 2) 13 ILow Impact(Tier 3) Project Title: Remodel Report date: 11/02/16 Data filename: Untitled.rck Page 6 of 9 Section K r Plans Verified Field Verifiied: = , # , Final`.Inspection ProvEs�ons', i 1 fl Complies? Comments/Assumptions Value Value�� .n a r t. ' 'e a .. • .. ._.R4p,piz+3*`' 4�t^ ..�il..•/I$ vi'_.f'T�.•}',3y�i6.� >r�� i n': 402.1.1, '.Ceiling insulation R-value. R- ; R- ;❑Complies, ;See the Envelope Assemblies 402.2.1, ;❑ Wood ❑ Wood ;❑Does Not ;table for values. 402.2.2, ; Steel F] Steel ''!❑Not Observable 402.2.6 1 ; [Fill' ;0Not Applicable ; 303 1.1.1,;;Ceiling insulation installed per a `,:❑Complies 303.2 manufacturer's instructions. ;c `] ' ts � ` ❑Does Not ` [FI2]1 ;Blown insulation marked every ftz. r [:]Not Observable ; 300 ❑Not Applicable 402 2 3 .' IVented attics with air permeable ' k. °� " s ❑Complies ` [FI221 insulation include baffle adjacent 3 A" ❑Does Not to soffit and eave vents that W extends over insulation. m ❑Not Observable , /,. ti a�` ❑Not Applicable „ -�, , 402.2.4 ;Attic access hatch and door R- R- ;❑Complies ; [FI311 ;insulation all-value of the ;❑Does Not ' ;adjacent assembly. QNot Observable ;❑Not Applicable ; 402.4.1.2 ;Blower door test @ 50 Pa. <=5 ACH 50= ACH 50= ;❑Complies [FI17]1 lach in Climate Zones 1-2,and QDoes Not <=3 ach in Climate Zones 3-8. ❑Not Observable ' ; ❑Not Applicable 403.2.3 1 Duct tightness test result of<=4 ; cfm/100 - cfm/100 ;❑Complies ; [FI4]1 cfm/100 ft2 across the system or ftz ft� :❑Does Not <=3 cfm/100 ft2 without air handler @ 25 Pa. For rough-in ;❑Not Observable I tests,verification may need to ;❑Not Applicable ;occur during Framing Inspection. j 403.3.2 ;Ducts are pressure tested to cfm/100 cfm/100 ;❑Complies ;. [FI27]1 determine air leakage with ftz ftz ;❑Does Not :either: Rough-in test:Total 'leakage measured with a UNot Observable 1 pressure differential of 0.1 inch ;❑Not Applicable ; w.g.across the system including ;the manufacturer's air handler ; enclosure if installed at time of ; test. Postconstruction test:Total ^ leakage measured with a pressure differential of 0.1 inch 1 w.g.across the entire system including the manufacturer's air handler enclosure. i s , 403.3.2.1 ;Air handler leakage designated `�`� l� f ❑Complies [FI24]1 by manufacturer at<=2%of ❑Does Not design air flow. QNot Observable ; ❑Not Applicable ' 4011,1 Programmable thermostats wk ❑Complies ; [FI9]2 installed for control of primary ❑Does Not -, heating and cooling systems and r '`, l initially set by manufacturer to l :[:]Not Observable r codes ecifications. zr" ❑Not Applicable P Nr . . . ` 403:1 2 j Heat pump thermostat installed :`. m ❑Complies IFilb A on heat pumps. ❑Does Not QNot Observable - , e ❑Not Applicable 403.5 1 <jCirculating service hot water �� R ❑Complies ; [FI11]2 systems have automatic or ❑Does Not accessible manual controls. ` t mot' QNot Observable I ❑Not Applicable 1 JHigh Impact(Tier 1) 2 Medium Impact(Tier 2) '3 Low Impact(Tier 3) Project Title: Remodel Report date: 11/02/16 Data filename: Untitled.rck Page 7 of 9 Plans Verified Feld Verified.,, . # # Final Inspection ProvEs�ons;� ,6 ,Complies? Qomments/Assumptions Value Valuer a d0 eq 403.E 1 All mechanical ventilations stem nd listed `x , ❑Complies ; [FI25]z afans not part of tested a r t ` []Does Not rj HVAC equipment meet efficacy and air flow limits. `� ❑Not Observable ❑Not Applicable 403`2 ='Hot water boilers supplying heat ❑Complies ; [FI26]zthrough one-ortwo pipe heating ❑ systems have outdoor setback Does Not control to lower boiler water �'f []Not Observable ; temperature based on outdoor " °° ° ❑Not Applicable ; temperature. :} 403 5Z1.1 Heated water circulation systems � � ❑Complies [FI28] have a circulation pump.The y' + , �" r: ❑Does Not system return plipe is a dedicated `'. ❑Not Observable return pipe or a cold water supply pipe.Gravity and thermos- ❑Not Applicable syphon circulation systems are �n not present. Controls for Y" :circulating hot water system pumps start the pump with signal Y ; ;for hot water demand within the 4 a. occupancy.Controls1 ta automatically turn off the pump when water is in circulation loop` " ; is at set-point temperature and j no demand for hot water exists. 403;5.1.2; Electric heat trace systems ❑Complies [FI29]z comply with IEEE 515.1 or UL ❑Does Not a515. Controls automatically adjust the energy input to the y ❑Not Observable ; a heat tracing to maintain the s ❑Not Applicable desired water temperature in the ' piping. �4��.�ry�� w �r �ver •• 1 403,5 2 ;)Water distribution systems that II � ❑Complies [FI30]z have recirculation pumps that a ❑Does Not pump water from a heated water `_z supply pipe back to the heatedr, { a ❑ of Observable water source through a cold ' s ❑Not Applicable water supply pipe have a demand recirculation water system.Pumps have controls li that manage operation of the pump and limit the temperature of the water entering the cold " ` water piping to 100F. 4b3 5 4 Drain water heat recovery units }.4r "I . � r o- ' ❑Complies ; k ' rr� [FI31]z tested in accordance with CSA �� •a ❑Does Not (B55.1. Potable water-side 4 pressure loss of drain water heat ❑Not Observable 1 recovery units< 3 psi for ❑Not Applicable ; individual units connected to one or two shOWerS.iPOtabl@ Water- side pressure loss of drain water rv heat recovery units< 2 psi forE individual units connected to �;� jthree or more showers. , -. - I 404.1 75%of lamps in permanent " ❑Complies ; [FI6]1 :fixtures or 75%of permanent []Does Not ;fixtures have high efficacy lamps Does not apply to low-voltage ❑Not Observable ; lighting. �A` ❑Not Applicable w ,•.h .a i ,:"air. r ;.x 4041.1 Fuel gas lighting systems have R ,6 } ❑Complies ; [FI23]3 #no continuous pilot light. r;w, ` IL r ❑Does Not ❑Not Observable j �. � K„ ONO Applicable 1 lHigh Impact(Tier 1) 2 Medium Impact(Tier 2) 3`:Low Impact(Tier 3) Project Title: Remodel Report date: 11/02/16 Data filename: Untitled.rck Page 8 of 9 i Section Plans Verified ::Field Verified: x �,nrti� M Ei al Inspection Provisions �.. � r r. ,,Complies? JComments/Assumptions,; Value ,u;ha P P ; � ,� �. �; 1 v ❑Complies 4012 Compliance certificate posted. , [FI7] ❑Does Not > ❑Not Observable "r ❑Not Applicable 303:3 Manufacturer manuals for d ❑Complies [FI18]3 mechanical and water heating ;y ❑Does Not systems have been provided. �B rya ❑Not Observable []Not Applicable Additional.Comments/Assumptions: 1 High Impact(Tier 1) 2. Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Remodel Report date: 11/02/16 Data filename: Untitled.rck Page 9 of 9 _ r n D .D 4• k . of O t Town of`Barnstable-Fin-al'Inspection-Affd-av-it Date: 41A / 1 Thomas Perry, CBO Building Division .200 Main Street Hyannis, MA 02601 RE: Insulation Permits Dear Mr. Perry; This affidavit is to rt�at ll work completed at: Street: � Ir'l �' CipcCP Village 1 has been i spected by a certified Building Performance Institute`(BPI) Inspector. All work performed meets or exceeds federal.and state requirements. CD :: *Permit application n m er: 6:i LO_ col SO M Issue date: 3 = Ln Sincerely, " ' Francis Sheehan President`` Frontier Energy Solutions, Inc. 502 Harwich Road Brewster, MA 02631 "Office` 774-237-0410 Email: fssfrontierenergy@gmail.com , i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 5 � ppqq Ma V N parcel Application 41-ib Health Division Date Issued �3�' L Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/Hyannis EM A-r-L Project Street Address 111S L200.. Ph11ir &&k,Y1,1 Villages��— Owne -2 "` o Ct1 �,� Addresses ��l�f��L=>r"` Tele hori - �� ;�s�'�'I/-- 6J°(0( p eLl/� � �b Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type.q�l&T J6 Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family AL 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 .Ralf: existing new Number of Bedrooms: existing _new �O Total Room Count not including baths): existing new ®'t` Fi Flood m( g ) g � oo Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other ?3 O -0 Central Air: ❑Yes ❑ No Fireplaces: Existing New _isting wood/coal stove: ❑Yes ❑ No b3 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 C•3 tTo If es, site plan review# Current Use `f Proposed Use �rIS i '} ln, v P APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name d Jn0 6Z fA;7J QQS i (V_-Wephone Number 77&/c)3-/- C /6 Acj,dress License# lost/ Home Improvement Contractor# Email � i�� L T0)&;J)1k:UC0Y0orker's Compensation JU/fU—!W//�3/��6 ALL CONST/R�UCTI N /DEB S ESULTING FROM THIS PROJECT WILL BETAKEN TO GL� I PA!!/• //^I / l SIGNATURE DATE x } FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ,1 ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH - FINAL GAS: ROUGH FINAL FINAL BUILDING u S ' DATE CLOSED OUT ASSOCIATION PLAN NO. f ; Feb 11 2016 04:23PM Green lfie Reap'-S 247677 page 3 Town lof'Raritstable � • B'trf�t�i�ng�fYision 200lkamsbtct;Hyanwi-MA OMOI www:t4tvn.bar�bftawi.as . . ' Office: SD : 624038 Fax: 50.8-790.-6234 Propexv, Ownerm*ust ' _ Usim.AluRder f �c3EM�' ,is-Cong-pf Cie SLtl*' 1' p m ail mu�exs:relative to w+or�caut?�orizied�y��is�buil rrtit application for. Shs o Reece r. are tie i+es jr 0 .the_4E iit=t PID-091 - ponecl aud..acift pted. Q+PORI�d�011►Ii88�Ep1VPOOT.Y S f , r The Commonwe�rlth of Massachusetts; Department oflntiustizal Acciuitents 1 Congress Street;;.Suue I00> Boston,lVlA 02114 2017 :www;mass gov/din.: 1Forkers'Compensation Insurance Affidavit Btlders/Contractors%Electricisns%Plumlers TO BE;EILEW.W TH THE PERIVIITTING AUTHORITY:. µ' Applicant Information r Please Prin"t Legibly T1aCIle($.ustness%Organtzation/Indiv-dual) {�j� Address`: �t&P=t c ` i City/State/Zlp SI�1�S [ 42(� ( Phonel#, A're you an employer'Chee6 the appropriate box: - , it of project(required): S fly[aRi a pem to er:wnth p y employees(full and/or part ume);' 7 Liu leWiCOCtion �._ 2. I am.asole ptopt or or pat tnersht and have no em to ees world for tne.in $. a RemOdelin P,.. P y.. anY�actt3.[No workers"comp.:uuivance.rejwred.] g 3. I'amahoineownerdotn allurorktnself oworkers;co 9. Den10liti0R\ mp m mane requi ed]r 4.a[am-a homeowner and wily'be htrmg;i ontractots to conduct of t work.on my property:hwill 10 Building'addtton ensure:that ail contractors-either have'workers'-.compensation insurance or are.'sole: 11,.[]Electrical repairs=or;addtttotis proprietors wtth,no employees 12, Plumbing repairs or.'additions ave* I ari ageacontcoad[hh�redhb rsled lies > c h _sub contractors have'employees and have workers comp insurance 13 aRoof repairs; .. 613 W.e area corpoiatton and its officers Have exercised theuright of t Xtimpuon pei MGL c 1'4„ Other 152,§ (4),and we have rioemployees (No workers comp:tpstuance regtured;] 'Any appltcanf,that checks box#l:must also lilt out the_section bi low shovvin ir workers cotnpt nsation poltcy;triforntatton_ t homeowners who:subrritt dtts affidavtttndicattng,they;are dotng'ail work and then hive outstde'contractors musts 6'rmt a new:affidavirindicattnk:is chi: [Contractors tltat check[tits box-must attached an addutonal sheet;showmg the name o€the stilrconttactors_and state whether-o.not those;enttties have' employees..If the sub-conttactoi§.have employees;they must proytde thetr`.'worker3'CC4n„ li' number_:; P Po �Y I atn an employer that uProvcduta Co for»ry a loyees Below is the policy imd�ob site r'nforniatro> . Insurance CompanyNamei. u Policy#or Self ins;:,Lte #. 1 I�a Coo l�"Za( /� Expiration Date o I b Site Addre City/State/Z Y Attach a copy o the workers compensation policy declaration page(showiIIg the policy.num:er a'nd t zpirahon date):_ Failure to secure coverage.a$requued under MGL c 152 §25A is a crunmal:wiolatton punishabl' by` fine,up.to$1;500.00: -an or one;year impiisonrrient,as well:W.Ciyi,!penalties in the form of a STOP WORK ORDER and a fine of:ap to$250 00 a day;againsf the violator A.copy of this statenent'may,be forwarded to the Office ofInvestigations of the DIA for insurance. coverage vertficahon::' I do.hereb. eertt `under,fhe airs s o e F fP rfury°[fiat the information pravule rtbov u true.and correct: , Date:: Phone#. 'j 7s{. 2 ' Official us'e or:ly Do not,-wrue'in#hrs area,to be completed by city or town offciaL City or Towia: Permit/I Isstung Au#Locity(circle:one : 1 Board:of 8ealth.2.-BuildingDepartmeiit 3:City/Town Clerk 4 Electrical Inspector 5 Plumiainghaspector Contact;Person: Phone#. . t Irfr rr4n<f �r�a;?/r -Office of C josumer ARain&9.iWilm RegulBpon OME)MRROVEMENT CONTRACTOR T �6uene ar reEisttuuon valid for indii,irlu)use onix �: � §§oglstredon t6p1354: YPa� - beforeahe er,pvgt4on Jnte:1f found rtiturn to �; � � 'Expira8on;, 9t8l2078 t,i.0 Ofdce;ofConsutn"er AfTatradnd Business Rt.g6IM itii a t )0 Puck PtnzA-:5uite.$f.70 PROW ER.fNERCsY;SOtUT1QN5 . Bes1An.,t1A 021 i'6.. ' 'PRANCIS'``$H°EMAN - - - p of EWSTfR MA l}261 Undcrsrcrrtart ,.:..^�:^^-^---�^-`•-• �twa:'•with .3ignntui•e' _; . . -.,....._.....:__.----.-.�-.-.:.._...,�„ ��- f Construthop upem40tSpecianY �o�sAexw*ea s des Restricted to CSSL'-1C Instilatwn Ccritrectoc Fdoard of aw�?n4.n�ag+tf 4uans t•,e SCAeAn:s Lt�ansa CSS1105941 ;�� - _ '�.t}th:b$°so'i;.4b�+...�.�r wC. k.w.x r,•,a."r : x ,. , FRANCIS;S SNEENAN tot.' RD t3REVYSTER:MA OZWt, Filiwe to possess A Current ed4hon of the MassaChuseps- l , ,r;it r State t3uiIding Code Is cause for revoebt)on of Iiiis I}txnse< DPS;ltcenstng(Mormation visit.YYVYW.MASS.00y/DPS u� +S3K �", 04/17fi018 r r 3/-16/2015 -12 :35 : 3.9 PM 8626 ® 02/02 . ► CERTIFICATE OF LIABILITY INSURANCE °A�'M6'201.5 03h 6I2015 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(les) must be endorsed. If SUBROGATIOWIS 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). , NNTT PRODUCER 00509-001 NAUTeCT Jeffrey Ford' �Xt Rogers 8�Gray Insurance Agency. - AfC.NNo:Ext: (800)553-1801- A1C.No.: (508)398=024b 434 Route 134 EMca South Dennis,MA 02660 a AD ESS: :• INSUREli(S)AF0 INSURERA A.I.M.Mutual Insurance Company 3 8' INSURED INSURER B: Frontier Energy Solutions Inc <' INSURER C- 502 Harwich Road. INSURER[): Brewster, MA 02631 INSURER E COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF°ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, " EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS., ILTR TYPE OF INSURANCE I DDL SU POLICY NUMBER MIDD,Y� LIMITS GENERAL LIABILITY R 1' EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ PREMISES Ea occurrence CLAIMS-MADE El OCCUR _ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ r GENERALAGGREGATE $ EN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIO_P AGG $ OLICY RO- OC AUTOMOBILE LIABILITY ' COMBINED.SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY.(Per person) $ ALL OWNED SCHEDUUED AUTOS AUTOS BODILY INJURY(Per accident) $ F HIRED AUTOS NON-OWNED PROPERTY DAMAGE • AUTOS Per accident) $ $ UMBRELLA LIAB , OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS MADE AGGREGATE $ DED _ RETENTION $ y�RKER WC g7p �I TH $ AND EPAPS��MPENSATION X TORY LIMITS OER L RS'LIABILITY A PROPRIEB RIPARTNERIEXECUTIJEYIN "' E.L.EACH ACCIDENT $ 1,000,000.00 A o IC rM MB REx D y❑ NIA VWC-100-6015315-2015A • y3l14120T5. 3/14/2016 (Mandatory In NH) E.L.DISEASE-EA.EMPLOYEE $ 1,000,000.00 D If TCRIN�❑F OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 11,000,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is'required) _ CERTIFICATE HOLDER CANCELLATION Tovm of SandWch 16 Jan Sebastian Drive SHOULD ANY OF THE ABOVE DESCRIBED POLICIES•BE CANCELLED BEFORE Sandveich,MA 02563 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCEWITH THE POLICY PROVISIONS.' AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 2630 f t 3/14/2016 Print Page Print this page Owner Information -Map/Block/Lot: 252 /080/ - Use Code: 1010 ` Owner Map/Block/Lot GIS MAPS 252 /080/ �GOOSK POINT ONE LLC 70 MAIN ST SUITE 3 Property Address Owner Name as of 1/1/15 95 GOOSE POINT ROAD ` .'HYANNIS, MA. 02601 Co-Owner Name Village: Centerville ,Town Sewer At Address: No GIS Zoning Value: RD-1 • Assessed Values 2016 - Map/Block/Lot: 252 /080/. Use Code: 1,010 2016 Appraised Value 2016 Assessed Value Past Comparisons Building Value: $ 111,000 $ I n,000 Year Total Assessed Value Extra Features: $ 47,900 $ 47,900 2015 - $ 277,700 2014 - $ 277,800 $ 2,000 $ 2,000 - Outbuildings: 2013 - $ 277,900 $ 119,000 $ 119,000 2012 - $ 276000 Land Value: _ 2011 - $ 270,800 2010 - $ 270,700 2009 - $ 301,300 2016 Totals $ 279,900 $ 2799900 2008 - $ 336,100 2007 - $ 335,100 i Tax Information 2016 -Map/Block/Lot: 252 /080/- Use Code: 1010 Taxes C.O.M.M. FD Tax $ 445.04 (Residential)'- Community Preservation $ 78.18 Act Tax i Town Tax (Residential) $ Fiscal Year 2016 TAX RATES HERE 25605.87. http:/Avww.townafbarnstable.us/Assessing/printl6.asp?ap=0&searchp�rcel=252080 1/4 3/14/2016 a Print Page - .3,129.09 Sales History-Map/Block/Lot: 252% 080/-Use Code: 1010 History: Owner: Sale Date Book/Page: Sale Price: GOOSE POINT-ONE LLC 2015=05-1'5 28872/97 $250000 RICHARDS, JEFF J & SUSAN K 1996-OS-15 10232/1-82 7 $113000 BAMBER, RUTH H 1996-05-15 . 10232/181 $1 BAMBER, RUTH H 1984-0945 4247/301 $98000 GORDON, HAROLD 1971-11-�06 2258/301 $0 MERLESENA, STEPHEN W 2016-01-08 293 82/l 82 $1 Photos 252 / 080/-Use Code:4010 Sketches- Map/Block/Lot: 252 / 080/,- Use Code: 1010 .,12' oy�D" 12. 18 24 =38' 4. GAR' AS 2 6 1222 BMT` :2 AsBuilt Card N/A - • Constructions Details - Map/Block/Lot: 252 /080/- Use Code:`1010 http:/AAfww.townofbarnstabl6.us/Assessingiptintl6.asp?ap=O&searchparcel=252080 2/4 T14/2016 Print Page ' Building Details Land Building value $ 11.1;000• Bedrooms 3 Bedrooms USE CODE 1010 r 4 . 'Replacement Cost,,,-- `$146,037`. Bathrooms 2 Full-O Half Lot Size (Acres) 0.76 .. _'' ' Model Residential Total-Room's 6 Rooms Appraised $ 119,000.' - Value - Style Ranch Heat Fuel Oil Assessed.Value $ 119,000 . Grade " Average Heat Type Hot Water Year Built .1972 AC Type None. Effective Interior HardwoodCarpet 24 depreciation � Floors �t Stories 1 Story Interior Walls Drywall Living Area sq/ft 1,492 Exterior Wood Shingle Walls Gross Area sq/ft . 3,632 Roof Gable/Hip Structure Roof Cover Asph/F Gls/Cmp • Outbuildings &.,Extra Features - Map/Block/Lot: 2521 OW- Use Code: 1010- Code' Description Units/SQ ft Appraised Value= Assessed Value Enclosed:porch- FEP 96 $ 5,700 $ 5,700 roof,ceiling FPLl Fireplace 1'.story - 1 $ 3,40.0 , .13,400 Basement BMT ` 1492 $ 28,300 $ 28,300 Unfinished GAR Attaclied Garage 432 $ 10,500 $ 10,500 WDCK'- _Wood',Decking 120 $ 2,000 $2,000 s w/railings; . Sketch Legend Property.Sketch Legend z , B2N Barn-any 2nd story area ' FPC Open Porch Concrete Floor, REF Reference Only BAS First Floor,Living Area FTS ` Third StoryLiving Area(Finished)SOL, Solarium BMT Basement Area. FUS 'Second Story Living Area SPE~ Pool Enclosure (Unfinished) (Finished) BRN Barn GAR Garage TQS Three Quarters Story ' (Finished) CAN Canopy , - GAZ Gazebo UAT Attic Area(Unfinished) CLP Loading Platform GRN Greenhouse UHS Half Story(Unfinished) httpJ/www.townofbarnstable.us/Assessing/printl6.asp?ap=O&searchparcel=252080 3/4 3/14/2016 Print Page FAT Attic Area,(Finished) GXT Garage Extension Front UST Utility Area (Unfinished) FCP Carport KEN Kennel UTQ Three Quarters Story r: (Unfinished) FIEP .. Enclosed Porch MZ1 Mezzanine,Unfinished.; UUA Unfinished Utility Attic FHS Half Story(Finished) PRG Pergola UUS Full Upper 2nd Story' (Unfinished) FOP Open or Screened in Porch PRT Portico WDK Wood Deck ' PTO Patio Microsoft VBScdpt runtime error'800a01a8'. Object required: /Assessing/print16.asp, line 151 { y ' 1 http://www.townofbarnstable.us/Assessing/printl6.asp?ap=0&searchparce1=252080 4/4 to Town of Barnstable *Per' # S a Z O Expires 6 months from issue date �T Regulatory Services" Fee B MSTasI.e,MAW • 16 9. Thomas F.Geiler,Director t6; ♦� - . Building Division � � Tom Perry,CBO,'Building Commissioner ENI 200 Main Street,Hyannis,MA 02601 DECO www.town.barnstable.ma.us C 2 2015 Office: 508-862-4038 T® O6Ag-6S�A1�. EXPRESS PERMIT APPLICATION. - RESIDENTIAL LE 252/080 Not valid without Red X-Press Imprint Map/parcel Number Property Address 95 Goose Point Rd Centerville EiResidential Value of Work$ 8000.00 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Stephen Merlesena 116E 31 st St, Apt 4R, NY NY 10016 914-815-5062 Contractor's Name Richard Tupper- Telephone Number-.(5 0 8) 7.78=0111 Home Improvement Con tractor License#(if applicable) 178434 Email:-a n4tup'percn- Coma Construction Supervisor's License#(if applicable) CS-0 6 9 0 5 8.' :BWorkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner - 91CI have Worker's Compensation Insurance. :x ' Insurance Company Name ,AE I C w Workman's Comp.Policy# WCC 5005593012012 r 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 Nadset bisposal ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows . . #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required.' Separate Electrical&Fire Permits,required. *Where required: Issuance of this permit does not exempt compliance with other town,department regulations,i.e Historic,Conservation,etc. ***Note: Property hOwtermust sign Property Owner Letter of Permission. A copyof`the Home Improvement Contractors License+&Construction Supervisors License is , „ uired.. , F SIGNATURE: C:\Users\decollik\Ap ataT..al ticrosoft\Windows\Temporary Internet Files\C6ntent.Outlook\8R76BDVA\EXPRESS.doc x-: t Revised 061313 ' ' ' f n.1 CONSTRUCTION CO.LLc �546A Higgins Crowell Rd West Yarmouth, MA 02673 Phone 508-778-0111 Fax 508-77&5010 Registration#178434 License#069058 Date: Mtn, Building Department I hereby authorize Tupper Construction Co., LLC to pull the permits necessary to complete the project described on the attached permit application form. Thank you, Owners` Signatures d v 5`i- �cc INKS i1:� Print Owners' Names: �% i `F,�� t Street Address: JAIJi g` The Commonwealth of Massachusetts ' Department of Industrial Accidents Office of Inyestigations w 1 Congress St r eet Suite 100 , . Boston,MA.02114-2017. &" www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electrician's/Ptumbers' Aaulicant Information Please Print Lesibly Name(Business/Organization/Individual): Tupper Construction Co. LLC - Address:546A Higgins Crowell Rd W. Yarmouth MA 02673 City/State/Zip:West Yarmouth, MA 02673 photle#:508-778-0111 F2 [3 e you an employer?Check the appropriate box:. ❑ I am a employer with 10 4. I am a general contractor and I Type of project(required). employees (full and/or part-time).* have hired the sub-contractors" 6• ❑New construction I am a sole proprietor or partner listed on the.attached sheet: ,' 7. Remodeling., ' ship and have no employees These sub-contractors have. 8, ❑Demolition. working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance.* 9• ❑Building addition required.] a 5. ❑ We are a corporation and its ` 10.❑Electrical repairs or additions 3.❑ I am a homeowner doingall work- `officers have exercised their',,,' ]1.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL insurance required. r 12.❑Roof repairs . , q ] ' c. I52, §1(4),and we have no. employees. [No workers' 13•❑ Other :comp. insurance required.] - *Any applicant that cheeks 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:AEIC Policy#or Self-_ins. Lic. #:WCC5005593012007 k Y •Expiration Date: 10/3/15 Job Site Address:--C7,6— � `C' / ®C (� /� City/State/Zip:C eITP� 4i " I 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 r .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 o.f the D.IA for insurance coverage verification: I do hereby Certify er the pains an enalties ofperjury that the,information provided above is true and correct Signature: W Date: �� V ' Phone#: 5087780111 . , Official use-only. Do not write inahis area,to.be completed by city or town official. z City or Town: t° ' Permit/L icense# , Issuing Authority(circle one):' , � r ' g . : 1..Board-of Health 2 Building Department 3.City/Town Clerk, 4.Electrical Inspector'S.Plumbing Inspector 6.Other Contact Persn: . o '' Phone# ' • Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5.170 Boston,Massachusetts 02116 Horne Improvement Contractor Registration Registration: 178434 Type: LLC Expiration 4/16/2015 Tr# 251075 ' TUPPER CONSTRUCTION CO, LLC. RICHARD TUPPER -.—__- 79 B MID-TECH DR. --W. YARMOUTH, MA 02673 — -- -- Update Address and return card.Mark reason for change. SEA S w 20M-0a't t J Address iu] Renewal Employment Lost Card ,� r'��a�riirricc.irtura/!�_cf^.�lr;,;rirrtre!/,t a`--` -Office of Consumer Affairs&Business Regulation License or registration valid for individut use only ? -;'30ME IMPROVEMENT CONTRACTOR before the expi date. If found return to: registration: 17gd34 Type: office of C ffairs and Business Regulation expiration: 4116f2Q16 LLC lb Pa aza-Su'a 5170 TUPPER CONSTRUCTION CO,LLC. r / / RICHARD TUPPER 79 B MID-TECH DR. W.YARMOUTH,MA 02673 UndersecretaryNa tthout signature 1 Massachusetts -Departmel;t or Public Safety BUILDING PERFORMANCE INSTITUTE, INC Board 04 vi+iiding:Regu'ca•.o ns an i . araards i07 Hermes Road,Suite 210 C3n.iroatiu,t Super.i.±sr Malta,NY 12020 ; License: CS-0$9M (877)274-1274 www.bpi.org Richard S Tupper ' 546 A Higgins Crasvelir West Yarmouth f A 73 4 wa P Richard Tupper BN toa:so40940 .. .. .. i . Commissioner 12I3V2016 4 (SEE REVERSE SIDE r0° Unrestricted-Buildings of any use group winch contain less than 35,000 cubic feet(991m)of CEITMED PROFESSIONAL OESIGNA'RON EXPIRATION OAT'_ enclosed space. Building Analyst Ftofessional 511512038 failure to,possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For DPS Licensing information visit: www.Mass.GovfDPs', + BUILDING PERFORMANCE INSTITUTE, INCL. ACORL�® DATE(MMIDD/YYYY) �� CERTIFICATE OF LIABILITY INSURANCE 12/1/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERT191CATE 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 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 Lora FitzGerald_ NAME: Southeastern Insurance Agency, Inc. PHONE M (508)997-6061 FAC No:(508)990-2731 439 State Rd. E-MAIL ADDRESS:lfitz@southeasternins.com P.O. BOX 79398 INSURERS AFFORDING COVERAGE .NAIC# North Dartmouth MA 02747 INSURERAArbella Protection Insurance 41360 INSURED INSURERB:Boston Insurance Brokerage Inc Tupper Construction Co LLC INSURER C 546A Higgins Crowell Road INSURERD: INSURER E: West Yarmouth MA 02673 INSURERF: COVERAGES CERTIFICATE NUMBER:2015-2016-1 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 CONTRACTOR 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 UBR - - POLICY EFF POLICY EXP e - LTR POLICY NUMBER MM/DD MM/DD LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 ` A CLAIMS-MADE �OCCUR PREMISES TO RENTED 100,000 PREMISES Ea occurrence $ 9520045208 ;, 11/1/2015 11/1/2016 MED EXP(Any one person) $ . 5,000 PERSONAL&ADV INJURY, $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 R POLICY PRO- ❑ LOC 2,000 00 JECT PRODUCTS-COMP/OP AGG $ 0 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000 000 Ea accident r ANY AUTO " BODILY INJURY(Per person) $ A ° ALL OS Ix SCHEDULED1020009389 12/1/2015 12/1/2016 BODILY INJURY Per accident $AUTOS AUTOS ( )X HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident Uninsured motorist BI split limit $ 250,000 UMBRELLA LIAB OCCUP. EACH OCCURRENCE I$ EXCESS LIAB ' A CLAIMS-MADE � '^ AGGREGATEFT DED RETENTION$ 4600658368. 11/1/2015 .11/1/2016 + $ i r . WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N a STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE - - E.L.EACH ACCIDENT $ 1 000 000 B OFFICER/MEMBER EXCLUDED? NIA ;s "r - - _. _ , (Mandatory in NH) WCC5005593012015A 10/3/2015 10/3/2016 E.L.DISEASE-EA EMPLOYE $ 1 000 000 P If yes,describe under DESCRIPTION OF OPERATIONS below E.L.-DISEASE-POLICY LIMIT $ 11,000,000 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 For informational .purposes,only ; THE EXPIRATION DATE THEREOF, NOTICE WILL, BE -DELIVERED 'IN Tupper Construction Co. ,LLC k ACCORDANCE WITH THE POLICY PROVISIONS. 546A Higgins Crowell Road: r W Yarmouth, MA', 02673 AUTHORIZED REPRESENTATIVE Lora' FitzGerald/MEM } ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01)' The ACORD name and logo are registered marks of ACORD INS025120140 n ; ,. - fi Town of Barnstable �IHE Regulatory Services Richard V.-Scali,Director _ NST Building Division BARNSTABLE NAM 1639. �� Thomas Perry, CBO �639_zo�, Building Commissioner 575 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 50.8-862-4038 Fax: 508-790-6230 February 22, 2016 Richard Tupper 546 A Higgins Crowell Rd. ' West Yarmouth,MA. 02673 y RE: 95 Goose Point Rd., Centerville Map: 038 Parcel: 004 Dear Mr. Tupper, This letter is in response to application number 20160162 submitted to do work at the above referenced address. As discussed in a phone conversation on January 26, 2016, the application can not be approved at this time because of the following: 1) The construction documents submitted are incomplete (basement information not included, insulation details not included, smoke detector upgrade information not included). Please do not hesitate to contact this office with any questions. Respectfully, . Lauzon . Local Inspector Jeffrey.lauzon@town.barnstable.ma.us' i (508) 862-4034 M ,�=� P�� v �� Z�a 3 kL- Tt © SMOKE IAA 2 Pp 1E TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION TO' 11 OF &UNSTABLE Map Parcel v 5 �p Application # Health Division `'' Date Issued Conservation Division Application Fee -D Planning Dept. fi 1�i,t Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Stre Address Jr' GO©S'Q &P47 Xd/ Village Owner' 4?1-IeJ Address �/Jf J/- `I X N11VA010 Telephone Permit Request ( ' Square feet: 1 st floor:,witting roposed 2nd floor: existing proposed Total new Zoning District .1;§� Flood Plain Groundwater Overlay Project ValuatioA�� onstruction Type Lot Size 'Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure / 9�� 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: __3 existing —new Total Room Count (not including baths): existing V new First Floor Room Count Heat Type and Fuel: ❑ Gas VOil ❑ Electric ❑ Other Central Air: ❑Yes U No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number Address � ��f �,I�C�/C� License # e t Contractor# rrler's tomipopensation #k( C��S" Y0 )0,-,�- ALL CO T N RIS RESU ING F H S PR JECT WILL BE TAKEN TO SIGNATU DATE ` ; �jo 4 FOR OFFICIAL USE ONLY R ir) APPLICATION# DATE ISSUED ' t MAP/PARCEL NO. ADDRESS VILLAGE OWNER P, r ' r ` f' DATE OF INSPECTION: r p FRAME . iNSULATION,r, FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL k` FINAL BUILDING DATE CLOSED OUT. r .ASSOCIATION PLAN NO. r li1114 j -.1 , TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION .d IDS✓ 'k J} � Va Parcel r Application # Health Division Date Issued 777 Conservation Division M Application Fee - V ,-Planning Dept. tee- Permit Fee Date Definitive Plan Approved b Planning Board pp Y 9 � .. 6 t Historic - OKH _ Preservation/ Hyannis Project Street,Address T J 66Qos 2 r2 Village C/ /A� Owner, ) / C��Q`� / �Q 1 CJI�� Address Telephone yi - 15-soy Per Request Square feet: 1 st floor: )i'sting ' roposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuatio onstruction Type Lot SizeJ� _ Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ .. _Multi-Family (#-units)J Age of Existing Structure //7-� Historic House:` ❑Yes ❑ No On Old_J�ng's Highway: ❑Yes ❑ No -Basement Type: 0 Full _❑ Crawl ❑Walkout ;y 20 Othery u t- Basement-Finished Area (sq.ft.) -� Basement Unfhished`�'Area (sq.ft) Number of Baths: Full: existing new ' Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing 69 new First Floor Room Count Heat Type and Fuel: ❑ Gas 4t it ❑ Electric ❑ Other Central Air: ❑Yes GYNo Fireplaces: Existing New Existing wood/coal-stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing O+new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size,,�, ;Other:,_,_ _- +a.7 ! xt Zoning Board of Appeals Authorization ❑ Appeal # Recorded 0? /6;, Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION r (BUILDER OR HOMEOWNER) Name - ti ! Telephone Number" Address /� j �//�f /`(r 4,,t11c1 License# 0J D 6 ,-; die'Iftr e t Contractor# Y-) rker's Compensation #vU ✓ �� ALL CON TR�JC I N�'EBRIS RESULT IN F q��/THIS PROJECT WILL BETAKEN TOZ SIGNATU ` E DATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. K- II ". CONSTRUCTION CO.LLc 546A Higgins Crowell Rd West Yarmouth,MA 02673 Phone 508-778-0111 Fax 508-778-5010 Registration#178434 License#069058 Date: 10 a Attn: Building Department; I hereby authorize Tupper Construction Co., LLC to pull the permits.necessary to complete the project described on the attached permit application form. Thank you, r Owners' ~% / - Signatures 'i., Print Owners Names J 7 ''f cv- (611(XU`�i c� ,t, Street Address: 7 1 � The Commonwealth of Massachusetts Department of lndustrialAccidents Ogee of Investigations 1 Congress Street, Suite 100 v" Boston,MA 02114-2017 www massgov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/individual): TUPPER CONSTRUCTION CO LLC Address:546A HIGGINS CROWELL RD City/State/Zip:WEST YARMOUTH MA02673 Phone#:508-778-0111 Are you an employer? Check the appropriate box: f Type of project(required): 1.Q I am a employer with 10 4. ❑ 1 am a general contractor and employees (full and/or part-time).* have hired the sub-contractors _ 6. ❑New construction 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling shipand have no employees These sub=contractors have ` 8. [:] Demolition working :for me in any capacity. employees and have workers' comp. insurance.* 9. ❑ .Building addition [No workers' comp. insurance P• required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work _officers have exercised their 11.❑ Plumbing repairs or additions myself [No workers' comp. right of exemption per MGG 12.❑ Roof repairs insurance required.] T c. 1.52, §1(4),and.we have no employees. [No workers' 1,3.❑ Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy.information. a 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 isproviding workers'compensation insurance for my employees. Below is the policy and job site . information. Insurance Company Name:AEIC Policy#or Self-ins. Lic.#:WCC5005593012015A Expiration Date: 10/3t16 Job Site Address: 95 Goose Point Rd City/state/zip:Centerville MA Attach a copy of the workers' compensation policy declaration page(showing thepolicy number and expiration date). Failure to secure coverage..as required under Section 25A of MOL c. 1.52 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 insura "verage.verification. I do Hereby certify and r Ae pains nd p nalties of perjury that the information provided above is true and correct. Si ature: Date: 1-8/16 Phone#: 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 . A - Contact Person: Phone#: .ACORD® CERTIFICATE'OF LIABILITY INSURANCE DA211/2015Y) �.� NCE 12/1/2015 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 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 FDORE Lora Fitz Gerald Southeastern Insurance Agency, Inc. (508)997-6061 w (sos)99o-2T31 II L-_. _ A/C Nok 439 State Rd. lfitz@southeasternins.com : P.O. Box 79398 INSURER(S)AFFORDING COVERAGE NAIC IIINorth Dartmouth MA 02747 INSURERA Arbella Protection Insurance �41360 INSURED ' INSURER B BOB t_O_n Insurance Brokerage Inc Tupper Construction Co LLC INSURERC: 546A Higgins Crowell Road INSURER0: INSURER E: West Yarmouth MA 02673 INSURERF: COVERAGES CERTIFICATE NUMBER:2015-2016-1 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 REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR i DOL S0 LTR I TYPE OF INSURANCE 1NE12 vwjvn POLICY NUMBER l POLICY Y EFF MPOOLIICDYY EXP - LIMITS X COMMERCIAL GENERAL LIABILITY AMK6CCE'T0REP-C�' 1,000,000 A J CLAIMS-MADE OCCUR PREMISE Ea occurrence S 100,000 1 9520045208 11/1/2015 11/1/2016 MEDEXP(Anyone person) $ 5,000 PERSONAL&ADV INJURY S 1,000,000 GENL AGGREGATE LIMIT APPLIES.PER: GENERAL AGGREGATE $ 2,000,000 X POLICY r I JECT PRO- i I - u LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER. - S AUTOMOBILE LIABILITY COMBINED SINGLE-MITS 1,000,000 Ea accident - A I ANY AUTO I * " BODILY INJURY(Per person) $ ALL OWNED SCHEDULED I 12/1/2015 12/1/2016 !BODILY INJURY_(Per accident) $ AUTOS X AUTOS I {l1020009389 X HIREDAUTOS X AUTO-OWNED • I f - I PROPERTY DAMAGE ._(Per ac i ant $ _ UMBRELLA LU16 OCCUR Uninsured motonst 81 s lit limit $ 250,000 EACH OCCURRENCE' S A I EXCESS LUIB CLAIMS-MADE AGGREGATE S DED RETENTION$ 7460'0058368 111/1/2015 11/1/2016 ry $ WORKERS COMPENSATION PER O H- ANDEMPLOYERS'LIABILITY STATUTE ER ;ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N I - ( OFFICERIMEMBER EXCLUDED? NIA I E.L.EACH ACCIDENT $. 1�000.,000 B (Mandatory In NH) WCC5005593012015A 10/3/2015 10%3/2016 E.L.DISEASE-EA EMPLOYE$ 1,000,000 If yes,describe under . DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S_ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS!.VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) CERTIFICATE HOLDER CANCELLATION y' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE For informational purposes only THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Tupper Construction Co. ,.LLC ACCORDANCE WITH THE POLICY PROVISIONS. 546A Higgins Crowell Road W Yarmouth, MA 02673 AUTHORIZED REPRESENTATIVE Lora FitzGerald/MEM ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025 r�otaoll Office of Consumer Affairs and Business Regulation 19 Park Plaza- Suite 5170 Boston, Massachusetts 02116 l-i01•ne 1mProvement Contractor Registration Registration: 178434 Type: LLC Expiration: 4111o/2016 Tr# 251075 TUPPER CONSTRUCTION CO,.LLC. RICHARD TUPPER -- 79 B MID-TECH DR. W. YARMOUTH, MA 02673 'Update Address and return card.Mark reason for change. SCA 1 20hi:,tt tddress Renewal - Employment Lost _ard OtTice of Cmryemer aiftaiss ci 6uc�,�css RYantatinu License or registrattroA valid for individu7 use only ? F1.0,CIME JMPROt1EMENT CONTRACTOR before the expi data if found return to,- w egistration' i78434 Type. OwIct.of C +'fairs and Business Reguiation 4 rExpiration. 4116/2016 LLC 10 Par, aza-Su'a 5170 TUPPER CONSTRUC'ROty'CO,LLC, BoAbM RYA 02ikd RICHARD TUPPER 79 B MtD-TECH DR. W.YARMOUTii,MA 02673 � �� ......... �—_... .......,.. __ tindtrsecretary No I athoutsagnature t Massaciiuset s -Dep1rtme;i ei Li6I;c Sz,at, BUILDING PERFORMANCE NSTITUTE, :NC 3'aar, Ofs .0 r� anaa i07 He,mes Rord,5uile'210 c: .,r+.•_tc�ui is,4 tv.., Malta N .2020 License: C_QW69058 t +w 877;274 1274 Richard S Toppers- �S G rOartll.R02 West Yarmouth NIA 02S .71 ;* Je` Richard Tupper. saLos�o' . 13110116 T Unrestricted-Buildings of any use ngr�oup which contain less than35,000 cubic feet(991 )of CERt?Ficli ROFiSSiONAL 0MGP;i,`.nV _xFiHA7:Ot:DA:5 enclosed space: Building 1ria[ustprofessional SiISf201S Failure to possess a current edition of.the Massachusetts State Building Code is cause far revocation of this license- " For OPSUrer*inginformationvisit: wwrw.Mass.60vlD125 BUILDING PERFORMANCE INSTITUTE, INC l - 7NET°�� TOWN OF BARNSTABLE` BAR35TADLE. i NM a�e� BUILDING INSPECTOR APPLICATION FOR PERMIT TO .......... �. ........1 ., �. � A.�....... TYPE OF CONSTRUCTION ...............4ti .... ....... ..................................................... .............�.. Ik......19...7 , TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ......./�....... ...............................................................::.................................... olze Proposed Use ..............*d .......................................................................................................................................... Zoning District .......C.,. e0 � ,��L Fire District ... z,=A, !� 1�^ ........................... Name of Owner . ei ,.... ..ly., ..............Address ��. ...r�..��/�!. ��1 ...lT..l........ .4�,J. . Name of Builder .,A, ..s4� T s d 6°.Address �-��.,� f f?'.. �!!e . C . ...... �/F� v A Nameof Architect ..................................................................Address ........................................................ ......................... Number of Rooms ................'�...............................................Foundation ......��.. ....... ..��.!L.�:.�............,.........:....... Exterior ......�� ...��..............................................................Roofing ...... ..... .�..l.f. ..t��. !:�!. :............... Floors ........... ., ..........................................................Interior .........;1� Gf1 Heating ........... /..�J�....�!f/././.../..! �4................................Plumbing ........... . Y ........... ..o ,Yl�.. ................ Fireplace .......1��5............U)c ..... 3.F.. /1......Approkimate Cost ...........3,,,..a, ...................................... Definitive Plan Approved by Planning Board ----------------____-----------19________. � ?4� i,01�- Diagram of Lot and Building with Dimensions pJ d o SUBJECT TO APPROVAL OF BOARD OF HEALTH � � . tLL- o LLJ m L w Owe' � < A � � mw m Ile I� � d L- 0 0 LL w n. O H cn U) - - - - - 1~ m Lw ac ' w / V) 1G WSW F- o < 44 ¢ �- O z y < < (n a ® U r V Q 4 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. w.z4,124 Name .. ..... ...;4 f....................... Kelleher, F. No ..15137... Permit for .,,,,,..._one story...... ' single family dwelling ...................................................... i Location °�`7 ...Goose. :.. ... Point Road ..................... .... .... ...... .......... ......... Centerville , ............................................................................... t Owner F. Kelleher I .................................................................. Type of Construction ....................frame...................... .................................................................... _ ± Plot ............................ Lot ..........#10( l Permit Granted ....June 16 72 00 7� Date of Inspection ..7 � ..?.�.... A- Date Completed ....... ........19 PERMIT REFUSED ................................................................ 19 ..................................... ...................................... { ................................................................................ t f: . ............................................................................... y �- .• 14 Approved 1 ............................................................................... .................... ......................................................... I 4 , +e a - s _ fit'LU _ - — 12> y�y•�� a Existing Deck { 4 , g 18-O CD r . . existing diningroom' T - Bedroom 1 4 i existing kitchen . - ---- convert existing garage to .. n handicap accesable bedroom: and bath x all Framing to remain `r _ � � 6 µ _ • Ln u< 0., =" unheated mudroom - existing-I[vim groom - r �. . Bedroom,2 41 remove existing garage door, 4k t , Den and install Andersen tw 2-24310 eX t St I n la Out lu per 1 t' n ion 546A Hi J§ ins Crowell Rd PHONE:508-778-0111 Ge�ltsry i i I s, �'�, g F , West Yarmouth, ,508-778- 010 . MA ;, admin@tupperco.com PAGE Ic sJ6 FAX' 5 ", �• .� -n tupperco.com a DRAWN BY'Rick .� ` ; _• . � _ #:5 02673SCALE: NA DATE: January 08, 2016 . _ Blockin � 8' C, typical .floor J system- 2x10 oists at 12"O,C. �� 4 -2� - 314" t$g O>S.B, over C1, convert existing garage to handicap accesable bedroom and bath N Q x all framing to remain Existing sheetrock and insulation to remain remove existing garage door and install andersen tw 2-24310 x 4'-0716 i l=loor Framing 135 Goose Point Rd, Tupper Construction 546A_Higgins Crowell Rd PHONE:508-778-0111 Centerville, MA West Yarmouth, FAX:508-778-5010 MA admin@tupperco.com DRAWN BY:Rick PAGE #:2 02673 SCALE: 1/4"= 1' DATE: January 08, 2016 12-"sono tubes 4' deep with bigfoot - �f New Handicap ramp and conector to existing deck for emergency egress to rear of building III' ,M 3, M 9: 37 S 1'.0 N 1. ' j en Bedroom 1 j \/ 71 0 moke CO detector F-7S -proppeed hands-cap Qrt 4 9 bed and bath 4 smoke GO detector J-Ti Smoke detector - - 2'-6` on in f I or 30 insulati o0 in stall celulose to R-48 in attic Existing den existing layout smoke detector 5'-l%"x 4'-0'4" i 111 bedroom 2 I J 9KE DETE TORS REVIEWED 95 Goose Point Rd. �N�fi�Ol:E�1�1601 DEPT, DATE Centerville, MA DATE i� irAnrn�r DRAWN BY:Rick PAGE #:* SCALE: NA DATE: October 31 , 2016 --------------------------------------------------------------------------------------------------------------------------------------------------------,----- ---------------------------------- II I-- I - I-- I -----------------------------------------------'-------------------------------------------------------------------------------------- -------••------- � 1 I 1 1 I I I I I I I I I I 1 1 I 1 1 I I I I 1 I I I I I I 1 l 1 I� 1 9 I 1 1 1 I I I I I 1 I I SmokslCO 1 1 1 1 ! 1 1 I 1 t I 1 I 1 1 I 1 1 t 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 I 1 1 1 1 1 1 1 1 1 I 1 I I I I 1 I I 1 1 1 1 1 1 existing basement ' 1 1 1 1 t I 1 1 1 1 1 1 I 1 1 i i 1 1 1 1 1 I 1 I I 1 I 1 1 1 I 1 1 1 I 1 I 1 I 1 1 1 1 I 1 I , 1 1 i 1 ---------------------------------- :----------------------------------------------------------------------------------------------------------------------------------------------- i .------------------------------------------------------------------------------------------------------------------------------------------------------------ c35 Goose Point Rd, Centerville, MA DRAWN BY:Rick PAGE #ii SCALE: NA DATE: October 31 2016 Blockin � S' typical floor s lstem- 41-2V211 2x1O joists-at12"O.G. 3/4 t4g 0.5.15, over w convert existing garage to handicap accesable bedroom and bath cv Q all framing to remain Existing sheetrock and insulation to remain r, remove existing garage door and install andersen tw 2-24310 V-1V x 4'-016" s Floor Framing r 32 9a Coos+° fi''o i nt fi`cl, Tupper Construction MA 546A Higgins Crowell Rd PHONE:508-778-011.1 C�nt�r1/f Ile, FAX:508-778-5010 West Yarrr`mfouth, MA admin@tupperco.com DRAWN BY:Rick PAGE #4 02673�,. SCALE: 1/411= 11 { DATE: January 08, 2016