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Home My WebLink About0079 HELMSMAN DRIVE r/9 PEL ttys H Is Town of Barnstable RECEIPT ` MAS& ' 200 Main Street, Hyannis MA 02601 508-862-4038 639• Application for Building Permit Application No: TB-16-3740 Date Recieved: 12/22/2016 I I ► l P V Job Location: 79 HELMSMAN DRIVE,CENTERVILLE, Permit For: Building-Solar Panel-Residential Contractor's Name: SOLAR CITY CORPORATION State Lic. No: 168572 Address: 24 ST MARTIN STREET BLD 2UNIT 11, Applicant Phone: (508) 640-5397 MARLBOROUGH, MA 01752 (Home)Owner's Name: DOUGLASS,ROBERT S&SUZANNE M Phone: (774)330-2915 (Home)Owner's Address: 79 HELMSMAN DRIVE, CENTERVILLE,MA 02632 Work Description: Install solar panels on roof of existing house,with any upgrades,if applicable,as specified by PE in Design; To be interconnected with home electrical system. 2.34 kW 9 Panels JB-0263535 Total Value Of Work To Be Performed: $3,300.00 Structure Size: 0.00 0.00 '0.00 Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or,omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. . All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: Cheryl Gruenstern 12/22/2016 (508)640-5397 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost: $3,300.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $85.00 12/22/2016 $85.00 XXXX-}XXX-XXXX- Credit Card 8975 ...._. _....: ........... .. .. ...._..... _. Total Permit Fee Paid: , $85.00 I er a w xam d # 1 �THISIS NOTAPERMIT a TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map k c,3 Parcel Application # Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address �� • -s �,� z. �, Village Owner Z�� ,, �5 Addresses, Telephone '�`� �� _ Z�. \ ��z �Z� �.� V-4,a dz Z Z Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Ztxjp.C> Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family O"_ Two Family ❑ Multi-Family (# units) Age of Existing Structure k10\,9co 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 Z new Half: existing new Number of Bedrooms: Z existing —new Total Room Count (not including baths): existing (, new First Floor Room Count Heat Type and Fuel: was ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: 3--'existing 0 newt sizenE 'Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other:F= 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 c.nu--, Telephone Number 33 — `8 3%1-k Address License # Home Improvement Contractor# Z Email Worker's Compensation # ho y C ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY -� 1APPLICATION# DATE ISSUED MAP/PARCEL NO. G1 ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL L PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 1.. Board a'r oll.d ig Regt,..#2tions and S andards C`+,trci#xti'r�irtt ..tjterslva.I' iji�t�ri�kr. Ucense.'CSSt-102778 CONOR D MC 39 SIAS>ONSE f) SAGASIORE DI: 01. w�+��rrttmt sinner o$11812016'' t+"-fAr!'.�t tfs77rr.slrt'rtrrf�/r i� �+rr o>4t«'Arl,.€0�'" Office of Consumer Affairs&Rosiness Rigalatipa License or registration valid for individul use only ME IMPROVEMENT`CONTkACTOR before the expiation date. If found return'to. Istration: 171251 Type: Office of Consumer.Affairs and Business Regulation xpiration: '3t1t2018 partr emhio. 19 Park Pins-Suite 5170 Nam`- Boston,!VIA 02116 CON-SERVE ENERGY CONOR MCINERNEYTE 376 ROU 130 SUITE C AN SDWICH,MA t)2563 Vackmwc. tart' iYot..raltal 1+tlthoutsignaWre � i nrj,nc4cn j a i Ire un rnuuu anu I ne SICK i nrl!.;a i t mlLAlGS. IMPORTANT:if the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed.If SUBROGATION IS WAIVED,subject to ,thgi terms and conditions of the policy,certain policies may r quire an endomement.A.statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement s PRODUCER CONTACT NAMEi:.... - - CS&SIWORKCOMPONE PHONE FAx PO BOX 946580 �2EA):0,E : (A/C'No ADDRESS: Maitland,FL 32794-6580 INSURERS AFFORDING COVERAGE NAIC# 1-877-724 2669 INSURER A. Continental Casualtymy Ca n 20443 . UISURED INSURER 8: CONSERVISION ENERGY INSURER C: 376 ROUTE 130 INSURER o SUITE C fNSURER.E: SANDWICH,MA 02563 INSURER F:. COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE'INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDINGANY REOU(REMENT, 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"YE BEEN REDUCED BY.PAID CLAIMS. INBR - DDL. SUBR t POLICY EFP POLICY:EXP _ LTR TYPE OF Rd3URANCE Nstt. POLICY NUMBEf�_.. _ MMIOD. MID 'LIMITS A GENERAL LIABam Y 601:1316335 03111M 5 . OWJ I116 EACH OCCURRENCE 1000 000 dAMAGETORENTED COMMERCIAL GENERAL UABwry PREMISES(Ea ame,�- 360,600.: CLAIMS-MADE 0 OCCUR MED EXP(Any one Pam) s 10 000 PERSONAL&ADV BVAJRY : 1,Q00,000. } GENERAL AGGREGATE :-2,000,000. GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS<COMPIOP Am � 2,000,000 POLICY X LOC COMBINED SINGLE LIMIT - A AUTOMOBILE LIABILITY 6011316331 03/11H5 03H1116 (E.acdden() s 1,000100. ANY AUTO BODILYINJURY(Perperson) S ALL O—ED SCHEDULED .BODILY INJURY(Per acddent) .AUTOS AUTOS PROPERTY DAMAGE HIRED AUTOS AUTO (Pet acddenl)- - i {{ $ q UMBRELLA UA8 X OCCUR 6011316352. 03111/16 631111161 EACH OCCURRENCE 2,000,000 EKCESB CLAIMSMADE AGGREGATE: 000 000 DED X RETENTION 10000 ... .. .... s - < WORKERS COMPENSATION A ANo aiovERs.La►aam YIN 6011316349 03111►15 03N1116 X TORYUMRS ER ANY PROPRIETORIPARTNERIM(ECU WE E.L.EACH ACCIDENT 500 OtiQ OFFICERIMEMBER EXCLUDED?' NIA - - - (Mandatory in NH) .El-DISEASE-EA EMPLOYEE L 500 00Q If yes,describe under DESCRIPTION OF OPERATIONS below _ _ E .DISEASE-POLICY UMIT a:500 000 OTHER TORYLIMITS ER E.L.EACH ACCIDENT El;DISEASE�-:EAEMPLOYEE $ .. E.L.DISEASE:.POLICY LIMIT 8-- . Certificate Holder Is added as an additional insured as pro`ided in the blanketadditlonal insured endorsement as it pertains to work being performed by named Insured underwritten contract, INCLUDES PRIMARY AND NON-CONTRIBUTORY CERTIFICATE HOLDER ' CANCELLATION Rise En®Ineering SHOULD ANY OF THE.ABOVE DESCRIBED POLICIES BE,CANCELLED BEFORE THE EXPIRATION DATE THEREOF,. NOTICE. WILL. BE. DELIVERED'.IN. ACCORDANCE WITH THE POLICY:PROVISIONS.' 1341 Elmwood Ave ,. . Cranston RI 02910 AUTHOPWO REPRESENTATIVE a I „�u.¢ r, a •Ifiy7t!{/:,:-. a , ®1988-2010 ACORD CORPORATION,All rights reserved.. AwRR 251201Dios) The ACt2RD name and logo are registered marks of'ACORD �.. The Cotn`_`onwealth of Massachusetts Depa ent of Industrial Accidents O 'ice Of invesdgadons 6 0 Washington Street lk 600no MA 021ll wwry magov/dla Workers' Compensation Insurance davit: Builders/Contractors/Electriciansiplumbers A ikon I form No Please Print L b Name(Hush +/OcganizatioNtadividt►at); Cons rVision Energy Inc Address: 378 Route 130 City/state/Zip: SAndvAch, MA 02563 phone# 508-833-8384 Are you an employer?Check the appropriate bo s I.(] I am a employer With 6 4 l�azn a general contractor and t _ Type.°f project(rcqulred)r employees(fkM and/or part-time)• ve tiirod the sub=contractozs 6 (�New cunsttuction 2.❑ 1 am a sole proprietor orpartner 1 on ito attached sheet. 7. O Rerriodeting ship and have no etrtployees sub-coatractor9 bays g. (�Demolition working for me in any capacity; loyees and 6sve workets' jNo workers'comp.insurance c tnp.insurance?: % Q Building additron requit+ed:] 5 ❑ t3 am a corporation and its 10.0 Electrical retinas or additions 3.❑ I am a homeowner doing all work o cem have exercised their t I. Plumb'Q tng repairs or,additions myself.(No workers'comp. ti t of exemrption per MOL l2. . Roof repairs insuranccrequired j t c. 152,$t(4),and we havo[to 3a.❑ I am a homeowner acting.as a e loyees [No workers.. 13.( Other Weatherization Beneta►contractor(refer to#4) cc .insurance reyiiired.1 'Any a Hcm that ehecb box Ml mtm also fia out the sesaao be sbowin t Homeowners who adowt We atfldsvit in&i theyam do' g then watttas•ooa�q�atiml�wlioy . B tng work and then hire outside coaMaetors must submit anew a8idavit ittdieating puck tCooDaeoora thateheclt this boa must attrehed as additionai'sdset B the name of ttte M VioYoes. If the mb-eontlecte s have eatployep,th Dune �and saes wbetbe or not those entities hwe ey lmv dx*ivmkete'COM.VolicY member. J am cntRloYter rkat IS Provttdhr8 'conrpe n lra+airae jot enrptoye , Below fti tAts Worn a&A poky and j"site Inaurance Company Name. CS&S/WORKCOMP NE Policy#'or Self-iaa Lic.i�: 60 Expiration Data 3=11-2016. Job Site Address; City/State/Zip; Attach a copy of the workers'compensation policy tien page(sbow[ng the policy npmber and espiratlo®date) Failure to secure,coverage as required under.Section 2S of MGL c. t 52 can lead to tile" teton 1 . criminal fine up to$1,500.00 and/or one- ear' �pnc. penalties Y unpnsoatnen as Il as civil penalties in the form of a STOP WORK ORDER and a fine of up to t250.�a day againt the violates. Be advised t a eap}r ofthis statement may be forwarded:to the Ofiice of Investigations of the-DIA for tpsurance coverage verifi tion J der Z4"TOan tJFe pa wrd P of that the firforRr Pmrlaled abon+e b drrs oird cormlt 2 one O,�fcfa/use one Do net rvrJte in tlih;ase,Q,to be co Plettrd city or bttrR o,(ylclod. City or Tort+n: Perinit/Llcense N Issuing Authorilty(eircte one): i Board of Nettitb 2.ButWirrg Department:3 CI own Clerk .4.Eteetrfcai intrpsetor 3 Ptum,btttg inapeetoc b.Other Coo"Peso®: l Pbone#: § .. I ' M5 OWNER AUTHORIZATIONFOR oww of p9ftmvm*oftMYPMP".. ftnsu"— DateL - r i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ,Map �S� Parcel z,&eti 1`4 OF SUNSTARR\pplication # Health Division Date Issued -7 4S IS` 'zAConservation Division Application Fee Planning Dept. Permit Fee _ J' v Date Definitive Plan Approved by Planning Board ` J Historic - OKH _ Preservation / Hyannis Project Street Address Village c— Owner Address _ � .�� Q.�S ��v fz Telephone C_t�\-CA,\3 oZ�3Z Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation z.b5e . Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family a-/ 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 Z new Half: existing new Number of Bedrooms: Z. existing _new Total Room Count (not including baths): existing ce new First Floor Room Count Heat Type and Fuel: &'Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size — Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size — Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name —z Telephone Number s o - '%33 - -%3ns Address -s- % License #- Home Improvement Contractor# \-A\ z! \ Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE 1 DATE L- z>- /9— FOR OFFICIAL USE ONLY µ 7 f APPLICATION# DATE ISSUED r MAP/PARCEL NO. 1 s , ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION } FRAME INSULATION L� FIREPLACE ELECTRICAL: ROUGH FINAL ' PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. �fassactiuse p�rtr�er�t�s�P��ia��°�f�t B4ar�pfr3u�t�:ig Rcg�s�rians•arr1 Stantiarctsv r'„n+trutra„}x `i��'tK„��preialh CONOR D men tgoix 39 SLOCONS91 aR SAGAMORE B1 ACEf 1.�r. cormtii Q IW2018 .Ofrke of Coninmer Afraire& Ill guiollon License or registration valid for inidividul use only ME IMPROVEMENT CONTRACTOF before the expiration date. If found return to, 4 ogiatration: 1T1257, Type:' Office of Consumer Aff ! and Business Regulation s zpiration .311=16 Bari hIp .iQ Park Plaza-Suite 5170 c-s" Boston,MA 61116 CONSERVE EPdERQY CONOR MCINERNEY 376 ROUTE 130 SUITE G t SANDWICH,MA OT563 Undersc etary toot wand*ithout signature signature ._"4"*+' wm-e ..... �- _+:,,.wr... .�,.-.:..!:,a 4':-L'..e-�•.tn.+:•7..* _.a.w✓�r..+w. ..„ 4t. n=rrst,jtn A a A ixt sns rmwLtul+ any I nt ucn A Irwa I It rl iwtra. IMPORTANT:If the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed.If SUBROGATION IS WAIVED,subject to ,,he,tGM%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 endorsements PRODUCER CONTACT 'NAME: - - CS$SIWORKCOMPONE PHONE _ ... A/C, F No.Exl: X No PO BOX 946680" EMAIL ADDRESS: Maitland,FL 32784-6580 INSURERS AFFORDING COVERAGE NAIC# 1-877-7242669 INSURER a Continental Casualty Company 20"3 WSURED INSURER$ CONSERVISION ENERGY INSURER C 376 ROUTE 130 INSURER o: SUITE C INSURER E . INSURER F. SANDWICH,.MA 02563 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES'OF. INSURANCE 'LISTED COW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED."NOTWITHSTANDINGANY REQUIREMENT; TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY: BE ISSUED OR MAY PERTAIN. THE INSURANCE-1 AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDfCIONS OFSUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.. VISA kDDL� UBR POLICY EFF - POLICY.EXP - LTR TYPE OF WSURANCE R .- POLICY NUM13EF M POLICY MID - .. LJ►�rTTS � . A GENERAL LIABILITY Y 6011.316335 03111/15. 03/11/16 EACH OCCURRENCE 11000,600 nAMAGE TO RENTED r 900 00D COMMERCIAL GENERAL UABIUTV ��: - _��, ) !; CLAIMS-MADE'1^1 OCCUR MM EXP(Arty one PronY PERSONAL&AOV INJURY. 5 1,000,000 a: GENERAL AGGREGATE : 2.000.000 - GEWL.AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2 000 000 POLICY x LOC eSINGLE LIMIT A AUTOMOBILE UABJTY 601131633 63A 1/1 03/11/16 (Eam-denIQI : E 1,000,000" .ANY AUTO .BODILY INJURY(Per pernon) ALL OWNED SCHEDULED BODILY INJURY(Per acdderM - AUTOS AUTOS NON4)WNED PROPERTY DAMAGE - HIRED AUTOS AUTOS. - (Per Seddent).. ._ A UM13RELLA,LIAB MCLANS41ADE OCCUR 601131635 03111/15 03/11/16 EAcHOCCURRENCE .T000000 EXCESS AGGREGATE Z080,008 __]DEDIXI RETENTION S 10 000 WORKERS COMPEKSATN)N TORY UN1R5 ,T A AM EMPLOYERS'LIABBdrY YIN 60,1131634 03/11115 03/11/16 X ANY PROPRIETORIPARTNEROMCU WE El.EACH ACCIDENT 50O QOO OTCERRAEMBMEXCLUDED? NIA-. Pilia"d'tmyInKH) El-DISEASE:Fa8.IPLOYEE .$'500 000 K yes,describe under DESCRIPTION OF OPERATIONS below - .. `500 000 "�� .... .......:.....: ...... ...... ....:. ... �El:DISE0.5E-POUCV LIMIT $. - - OTHER TORYLIMITS ER E1.EACH"ACCIDENT. E.L.DISEASE-EA EMPLOYEE _ El,DISEASE POLICY LIMIT .- .. . Certificate Holder is added as an additional Insured as provided In the blanket additional Insured endorsement as it pertains to work being performed by named insured under writtan contract INCLUDES PRIMARY AND NON-CONTRIBUTORY CERTIFICATE HOLDER` CANCELLATION Rime Engineering SHOULD ANY OF THE ASOVE'DESCRUIED POLICIES BE CANCEI LED BEFORE THE; EXPIRATION [)ATE THEREOF, NOTICE WILL BE DELNERED> M. ACCORDANCE %KTH" THE..POLICY PROVISIONS. 1341 Elmwood Ave' CranSton,Ri 02910 1` 01988-2010 ACORD CORPORATION.;All rights reserved. :ACORR 25 12010io* The ACORD name and 1Q8o are registered.marks of AlCQRD w The Cotn 'onrveaith of Massachusetts De:a ent of Industrial Accidents O ce of lm►esdgadons 6(0 Washington►Street oston MA Oalll' www.m9s&9m1dio Workers' Compensation Insurance davft: Builders/Contractors/Eiectrictaas/Plnmbers A Uc n I fo ti PI Print L egib bly Name(Buiaesa/Orgaa;zatoMn�h : Cons rVision Energy Inc Address: 378 Route 130 Ci IStateJZi : "SAndvvch, MA 02563 phone#. 508-833-8384 Are you an employer?Check the approQIlWe bo I'ar$a employer with 6, 4• Q I am a general contractor and I T of pro jest(required): employees(flill and/or part-ame)• va hired'the sub-contractors 6 0 New construction 2.❑ I am s sole prerpcietor orpartna= 1 on the attached sheet, 7. [3 Retaodeling pp ship and have no employees sub-conttsctora have workin for n�is 8 ❑Demolition 8 any capacity: toyee9'and have workers' [No workers'comp.insurance c MP.fnsurapce.t 9..[�Building addition requured:]: 5: ❑ e am a corporation and itsr. l t).❑ Electrical repairs or additions 3.❑ 1 arm a homeowner doing YaII work o cers have exercised their !l. Phunb'(� mg repairs or additions.myself.[No workers'comp. ri t of exemption per MGL .12.0 Roof repairs insurance required.)t c. 152,$1(4),and we have no 3a.❑ Ig e=ndh t Q ) c loyees::(No workers' t3:[�Othef Weathed ation ` co a required:] fY that checits box MI mtac also tilCout the aeetion be showing limit woekas• a>iadotiry Hoa�owpers who sitbtttlt this a@idavit'indicatinQ thry are doing. work and then hire outside con tContraetoas that cheek this box a"attached m uactm..�submit a new jMdavit i"Caties such emptoYees. If tiro tatb•ooetractass have °°�sheet wm9 the none of dw moots sad state wt a riot those entities have Hoye.*ey�Pro dW*. workers'comp.policy rwmber. I aiw enrp/oyer thor&psot•IdirB twrrArers'conrpe h lnsaronce or Inforaraslo� f 'nJ''eJ Below b the po/ley;ondJo�site Insolence Company Name: CS&SMORKCOMP NE. Policy#or Self--ms.Lic.it 6011316349 Expiration Date 3-11-2016 Job Site Address: City/3tatolZtp Attsc6 s copy of the workers'comps®satloo policy Failure to sattrre coverage as page{ahoveir �e Po�Y cumber and eglj6tiaa date)_ wader Section 25 of MGL e. 132 can dead to the:imposition of:crirnintii penalti,ee of a free up to f 1,90t1.00 and/or one-year imprisonment,as ell as civil penalties in the form of a STOP WORK ORDER and a fine of up to,3250.00 a day a gannet the violator. Be advised t a copy of this statement may be forararded to the Office of Investigations of the DIA far insurance coverage:veriS oa !do darn+tlFs and,p"fi tlo 0 ma&e inJomratlow pro�dW shoos b dt?te and Coto 6 O�fclal:rise only: Do"1 write in thls'rweq to:be co Fisted by ct[q or tatvn.o City ar Town.: Permit/Llcense 11 Issules Authority(circle one):'" 1. Board of Hesltb 2.BtrUdlag Department 3.CI owo Clerk 4,Elft at inspectors 6.Plumbing Inspector �ihlr Contest Perso®� Phone Ats 1 OWNER 6 AUTHORIZATION FORM C� I over of prop"beated at �a e��rn�►.v� - e nee c�� '�-1'L� ��,b`� tweby at raze CorseNision Energy,to axi on my behalfto obt n a Widing perrMt to worm wo*on my p ie ®ate S/N6LE AA- AflL Y 3 46E0.2o4vM Alo GQ�.�GE G�//UOE.2 Z�t�4►.9i E tee.,/Ste= OA/LY F,LO►,t/ _ //D X.3: 7.3 G.P.O. Sty 7-1 Z SEEN/G' T.4A1%e �/S��-Z2S,4L /�/T•--USE /000 6'�1� Bo 7lotil TOT.4.L 0.4/LYFLoI�/= 33p G,.�o, OF Mgs > 7 l it 4l>f.;e } C-++ �,sa Pi TER R9CHARD 1.. SULLIVAN A. N0. 2 733 o BARTER ';{; I-;---�-;- V Na 24048 I' + -��. r•�ST3? ��. �Q R`fi � .. : � i•}1r...�� J � i,�1--..� i NA 70 /iW GZ•O FE ' � .. 6.dG, /yl/�.Cvd� BOX 8 '�.•. . i. LEdC!/P/T G�i�o S'Eo1�G W W--/ '.�/y' p 7W d at //v✓. /.vim L-.'Jb 690 - / LE,eT/FY. Tf•//ITTf/E FO�.Ie.1Dlk'ilO%A Sf/OW.V 4 �� //E,�Eo v GOMPGY.s W/T//T,yE S/O�,C,iit/E BsIxTE,2 /Vj�E I've. A.vv SE7-�/1G� .2�Qv/,eE/�lENTS o� Ti�.'� .2.EwsrE.ecpG4�✓o stieciEy�S .. T,yE ,cY aov�L,4i�V X/W AIV/iY.ST.e- - Shl�Wet,'yE,2�4N.S.4�GU�-lam//a7--1,E USEp E.L-M5KAJ-K �wC 4EL M6 NSA K Nt+t o �+ #r.y .Fit�STITJ�Gc, � _ 0 A Of t5�001 , El_ ®,Q OF PFIER �\ RICHARD o SULLiVAN § A. Na. 29733 : c BAXTER Na 24M 'poll PS eft 46 Fss/ON.p ECG �b t� �•ZB'8b Assessor's map,and lot number ..A.? .�. .... SSM SYSTEM C C == NSTA�.LED IND�� PLI�'►�6E � Er��`o Sewage Permit number ......... .... ......... . . ........ ...... ... WITa LE _ �"" y ns,r in ODE A L Bafib9TLEI E House number ..� J.....--..11L�..jn....L................................. LCi D ppONS 9 rasa .> 0 MI"I r � � TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .............. ........ . ....................... ................................... TYPE OF CONSTRUCTION ................... .... .. . . .. ............................................................... ........./...�:.1..° '.................19 TO THE INSPECTOR OF BUILDINGS: The undersigneI her by applies for a ermit according to the following information: r Location .......... ...... ...... . .. .. � r ?.L ... .............�............. ...................... . ............................... ProposedUse ..... .. .... ................................ .................. ................. ..................... Zoning District ......... ...... ........ . .. ........... ......Fire District ... .....dp,4�.. . ........... Nameof Owner ...... .... .. ........... . .. . .. . .... ................Address ...... .. .. . .. .. ................................................. Name of Builde ... ...... . ...... ....ll.I... ...........Address ...... ........................... Nameof Archit ..................................................................Address .................................................................................... Number of Rooms .............. ..................................................Foundation ... > Exterior .... . .... .. ............ . ... ...... ......Roofiing ....... ��rG% �:..... .....%� �!... .......... Floors ...........�..�......�.......lnterior ........... .. " . ........ Heating GL .......Plumbing .............,fi..... .... Fireplace ................... _ .................. ...........Approximate. Cost .................0 .. ...�.................... ..... .. ..... Definitive Plan Approved by Planning Board ----- __ -- -------- --- --- Area ... ... ..! l.. .... .... ...... . Diagram of Lot and Building with Dimensions - ld, �99�4 Fee ...... /.�.. ................... SUBJECT TO APPROVAL OF BOARD OF HEALTH 5Z9 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction.' Name ., .. 711- Cons ruction Su ervisor's License p ....��..................... 47,SMITH, JAMES K. 2897'3 121 Sto No ................. Permit for .................U............... Single_ FamilyDwelling ..........;..........................................s?........................ Location ...Lot #5, 79 HelsmalL.D.r.i.ve.............................................. „Centerville ............................................................................... Owner .....James...K......S.mi.t.h............................... Type of Construction .....Frame................:.................... a . . ............ ............................................................ Plot ............................ Lot ................................ Permit-Granted ...............................February 27,.........19 86 Date Inspection I ............................* 1.9. 11 n07 Date Completed ... ...............1 r ® to tWct j C J yo�Txsro• TOWN OF BARNSTABLE Permit No. .28.973...... BUILDING DEPARTMENT H°8;a I TOWN OFFICE BUILDING Cash p..�-///�' "�tow,v► HYANNIS,MASS.02601 Bond ......FF / CERTIFICATE OF USE AND OCCUPANCY Issued to James K. Smith Address ugt #5, 79 Helsman Drive Centerville, . Massaehusetts USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE W1TH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. June 22, 19 87 .......... ............. ....8........... Building Inspector TOWN OF BARNSTABLE BUILDING DEPARTMENT TOWN OFFICE BUILDING rua ��! �6J9• �� HYANNIS, MASS. 02601 S h MEMO TO: Town Clerk FROM: Building Department DATE: 2- /v ,v e-- 7 An��Occupancy Permit has been issued for the building authorized by Building Permit $ ......... �� . � .. ......_.............................................................. .. ...._............ _................. .. ..... issued to ._.... !. .............. �`¢ ... ...�Z..!.�.....: s'�♦�;►.vc�.......—__ Please release the performance bond. ILDING TOWN-OF BARNSTABLE, MASSACHUSETTS RMIT JOB WEATHER CARD i DATE =��}'-%'•` -/ + 19 ��'!� PERMIT NO. ''•� ' 2997 + APPLICANT ADDRESS '''-:1Y(: l::i1)i,2 (NO.) (STREET) (CONTR'S LICENSE) NUMBER OF PERMIT TO • LCl`' 1 ; DWELLING UNITS (TYPE OF IMPROVEMENT) NO. - (PROPOSED USE) AT (LOCATION) -I-f. V 11- 'l+- iCGL'.!" ;. Jii: `..+ ZONING AT DISTRICT IN0.) (STREET) I i BETWEEN AND - (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE BUILDING IS TO BE FT. WIDE BY FT. LONG BY _ FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION j (TYPE) REMARKS: i + AREA OR ;:�)° PERMIT VOLUME ESTIMATED COST $ FEE i (CUBIC/SQUARE FEET) 1,2 OWNER ....?sl?EsLci�'ie3 BUILDING DEPT. ADDRESS BY j THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART-THEREOF, EITHER TEMPORARILY OF ® PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING'CODE, MUST BE AP- PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINEC FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS t OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. ? MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MEMBERS(READY TO� 3. FINAL INSPECTION BEFORE EFORE FINAL INSPECTION HAS BEEN MADE.� OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 2 2 2 wt 3 HEATING INSPECTING APPROVALS REFRIGERATION INSPECTION APPROVALS I I C 7 ri E R _ '2 w„"""V"✓'(iV l9 \J`IC�� 2 - 19 IV WORK SnA.LL NCT PROCEED UNTIL THE PERMIT W!LL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CAR( :NSPECTOR _AAS APPROVED 714E 'JA=IOUS WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE CAN BE ARRANGED FOR BY iELEPHONI ' STAGES OF CONSTRUCTION. PERMITAS ISSUED AS NOTED ABOV.E. �OR`WRITTEN-NATIFICATION. - - t ' w� As"sessor's map and lot number .., ��... .. ,.? .... FYN T Sewage Permit number ---�... ... ��' - .g ............:....... House number. .....�...l....�I?..�.L...... ...s: 9e�sTa s, . L 1' ....i.................... 00 1639•mxf 0� 3 - TOWN OF BARNSTABLE -11.1ILDING INSPECTOR - l �� APPLICATION FOR PERMIT TO ...!. `�l' ��......... TYPEOF CONSTRUCTION ..............................................I............... .-..... .............................................. .................19 3.I TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a`permit according to the following information: � Location .......... /:...... ./ ,.. ....................... ' ................. Proposedr Use / '!'. ................................ ........................................ ......................... Zoning District ..../... � ... ......Fire District ... � ' !1�!Y :....rl l� Name of Owner ... ? Se-... . ... ....Address ..... .............................. Nameof Builders /.>. �d.. ........ .....................Address ...... ......... ............................... .............................. Nameof ArchiteS� ..................................................................Address .................................................................................... Number of Rooms ......................................Foundation � � ...� (�.....'!f-B �' Exterior ... i y.Ci �� [.�,�V......�if.�.,.�.j...�.�......Roofing ....... 1 1...�it,,,:,. ../� ...,✓fir .��........ .( .J ,: � l�C ---". Interior ...... ,.. „ Floors .............. ....... ......... .... Heating ............ r.` ,•' .e:l,( ..... r�r ......Plumbing .......... ..?5.. .. ...............................................' Fireplace .................../ ..,.....,. ........................................Approximate. Cost ............... ... ,y,I/, .. ... Definitive Plan Approved by Planning Board —:�1`9_ Area 4 ...., 1�:..... Diagram of Lot and Building with Dimensions /99 7' Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH !!// S a r OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ............. Construction Supervisor's License .... /../.&........... SMITH, JAMES K. A=193-234 No ..,289 ... Permit for ..1'1 Story................ Single Family dwelling .................. Location Lot #5....... ... 79 Helsman. . ..Drive. . ........ .... .... ... ........ .. .. . ...... k Centerville ............................................................................... Owner James K. Smith .................................................................. Type of Construction .....Frame ................................................................................ Plot ............................ Lot ................................ Permit Granted .......February 27, 19 86 ........ .................... Date of Inspection ....................................19 Date Completed 2� �