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0085 LONG BEACH ROAD
� � � ;.� � �y r s T'`. t G„ �s'� 3� f + .a �� j w a r Y1 d ,, � r o' _, `� ���, //// 4F J74�/�Jy �-Lz-L _ _ �.��` .r .�:i� �w:,� s� r�.'�,�, �ny J�`� �9 .�F tTv"'t�". � a t `.' �a,.4 d.3 u.� - .. 5 .. � : a.� ',�., tip �. '�, �F`F.� 'l�r �ei+; P u �� � 7 .. ,: a c a ` •, { y*v +4 _�; s, .. t ! � _ Kr C � ..., ti ... s.. - r a .� .. �q� S Y� k .. e �. a �� � - o .a o .. y � d° „ .� � .. - �.' � a. .. e � .. fin_. � - .. o _ �� -k "� ., ,. ; s � .. ' v � .. a r .. .. � � ; ... ... r n �. R ° n r ,' - .. � `, _ ,. _ - �, - �. E, - - .. _ r .. i. _ .. .. .. i �. o - ... .. .. u N �. .w F .. �. u � y '. 4 . � � � .� .. ' .. Y � ,. ,� ... a i � _ _ , .a.: r ' e � ' Y o a .• - a - .• n .. ., '' ., a I ,. .. � � ��tro Town of Barnstable Building Department - 200 Main Street BARNSTABLE, # Hyannis, MA 02601 9 MASS. $ (508)16 862-4038 gq. �� ArFD MA'i R Certificate of Occupancy . Application Number: 200806556 CO Number: 20080338 Parcel ID: 206022 CO Issue Date: 06111109 Location: 85 LONG BEACH ROAD Zoning Classification: RESIDENCE D DISTRICT Proposed Use: SINGLE FAMILY HOME Villager CENTERVILLE Gen Contractor: . BAYSIDE BUILDING, INC Permit Type: RC00 CERTIFICATE OF OCCUPANCY RES Comments: r Building Department Signature Date Signed oFtHET TOWN OF BARNS ., Lr- 3111JI-ding - Applicationit Ref: 200806556 m * BARNSTABLE, * Issue Date: 12/02/08 ��` ' ' y MASS. gjAr 16.39. A�� Applicant: BAYSIDE BUILDING,.INC Permit Number:. B 20082651 FD MP Proposed Use: SINGLE FAMILY HOME Expiration Date: 06/01/09 Location 85 LONG BEACH ROAD Zoning District RD Permit Type: RESIDENTIAL ADDITION/ALTERATIO Map Parcel 206022 Permit Fee$ 1,912.50 Contractor BAYSIDE BUILDING,INC Village CENTERVILLE App Fee$ 50.00 License Num 005645 Est Construction Cost$ 375,000 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND RE-ROOF/SHINGLE,WINDOWS,TRIM,ADD 2 DORMERS,CUPOLA, THIS CARD MUST BE KEPT POSTED UNTIL FINAL REMOVE CHIMNEY,RELOCATE DOOR,RAISE PLATE,NW FLR PLA INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: PREFONTAINE,MICHAEL,P 8i NICOLE BUILDING SHALL NOT BE'OCCUPIED UNTIL A FINAL i Address: 8 STAGECOACH WAY INSPECTIOWHASB N MADE. HOPKINTON, MA 01748 Application Entered by: SS Building Permit Issued By: THIS PERMIT CONVEYS NO R[GHT TO OCCUPY ANY STREET;:ALLY,0R-SIDEWALK OR ANY PART THEREOF,EITHER TEMPORA Y OR'PERMANENTLY. STREET ENCI O EMENTS ON PUBLIC PROPERTY;NOT SPECIFICALLYTERMITTED UNDER THE BUILDING CODE,MUST"BE APPROVED BY THE JURISDICTION. STREET:OR`ACLY GRADES'AS WELL AS DEPTH AND'LOCATION OF PUBLIC SEWERS MAY BE`OBTAINED.F,ROMTHE DEPARTMENT OF PUBLIC WORKS. THE CE ISSUAN OF,THIS PERMIT DOES NOT RELEASE-THE APPLICANT FROM THE CONDITIONS OF ANY'APPLICABLE.SUBDIVISION RESTRICTIONS MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK: I.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3 WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). 5.INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY." 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. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT;STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. x PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). v gmpit,}r9 p h" P + BUILDING INSPECTIONtAPPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 v�`j�-1M ����L `►r 1�i J���.t�' 'F 1�� :r:..��9z c��.. sty r 3 1 Heating Ins pee Approvals ,. Engineering Dept' s Fire . t / 2 -j � Y 5 Board of Health UC l Cl U J V C '. - k ,. :, s ,-�- - .?. - _ i i ,..:.. - �,. �` � t � 'r` �� �. =�. � . �;c:, ' � � ti "'r ,��� i. .�' �' /.. ati ` �. /' ,.,,� �1. �' �� `�� / i /, � ` � ,�� w�2 pu--p�o�2 �I r � �n x TOWN OF BARNSTABLE BUILDING PERMIT_APPLICATION. MapQ Parcel'' �� �. Application # y Do�G Health Division �` Date Issued Z O f Conservation Division Application F _ a Planning Dept. Permit Fee 2- Date Definitive Plan Approved by Planning Board Historic'- OKH A114- Preservation/ Hyannis N 14" Project Street;Address L d N C f3g fqCH RO.AA Village CF 41TEA V f 5?ft ,�ra�cN Owner MC-PYAI;i� r AJlCag- PIZIEFpvPAfIV0. Address kWPk-1AW7UN, Nt.4. U/ YS Telephone Y3S ; 3cUJI Permit Request l�Sif1N6LF- c-�2,�, dr f�tJ1N�{�/ �d �ftK�M�ao�' -�lZfrfl R �itc taB�T�1►p z �OF� Off f1 D R _01001 ,�'/1�01.s� Cr�1/rurv�Y iC'��G•q?� 3lD r' CA-A /iY DOW--j RAt5,9. Pt�m tfg/r!fl DN � L1962 !iEF ME R ,QA1 OF ht1`rAior td6?-y-r1aN5, Ae+94y i<,n i4e_A1 2'f 3f Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new ZoningDistrict KD Flood Plain 10�1 /'-� // Groundwater Overlay N'/�I- Project Valuation d 37S F12A Construction Type lU011p Lot Size , 5 Grandfathered: ❑Yes 1lo If yes, attach supporting documentation. Dwelling Type: Single Family,- Two Family ❑ Multi-Family(# units) Age of Existing Structure _/ g g ucture ��///� Historic House: ❑Yes �o On Old King s Highway: ❑Yes C1d No Basement Type: ❑ Full IRdC;rawl ❑Walkout ❑Other Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft) (� Number of Baths: Full: existing new S� Half: existing ! new Number of Bedrooms: S existing rnew Total Room Count (not including baths): existing /U new /o First Floor Room Count Heat Type and Fuel: ®'Gas ❑ Oil ❑ Electric ❑ Other Central Air: S/Yes ❑ No Fireplaces: Existing / New 0 Existing wood/coal stove: ❑Yes U No D etached garage: ❑ existing ❑ new size—Pool: ❑existing ❑ new size _ Barn: ❑ existing ❑ new size_ If Attached garage: ❑ existing ❑ new size _Shed: @/existing ❑ new size Other: ��•SN� $ ,lo, Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes UdNo If yes, site plan review# - Current Use PXSlbrr V tAL- Proposed Use /7�tip'/4 � :,.,. N Z Z:1 APPLICANT INFORMATION (BUILDER OR HOMEOWNER) ' Name `J /g 6 ILD/1-1fo/ I/IC- Telephone Number 7Z 7 a Yy Address X Q License# 005 6 y5— /'F1tIMA V I LS-C i 44A- O ZG 2. Home Improvement Contractor# //3-7 9(a Worker's Compensation # AEr-- 0073 c/bb- /0 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO X/`6W lA'NDP/`L__ SIGNATUR �''/ __��-�- DATE lllzl�® 1 FOR OFFICIAL USE ONLY I 'APPLICATION# likTE ISSUED A MAP/PARCEL N0. ' ADDRESS VILLAGE ` r i - OWNER DATE OF INSPECTION: FOUNDATION r FRAME obi ZI L6�o4 INSULATION FIREPLACE a , ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL it FINAL BUILDING i .� DATE CLOSED OUT ` ASSOCIATION PLAN NO. �OfTHElojy Towxl ofBarnstable °^ Regulatory' Services a HA:RNSTABLE. Thomas F. Geiler, Director. 1 kcA ss AjE'o,.�n�b Building Division Tom Perry, Building Commissioner 200 Main Street,-Hyannis, MA 02601 vyivW.to)vn.barnstnble,mn.us Office: 508-862-4038 'y Fax: 508-79M230 -Ptoperiy owner Must - Complete and'Sign This Section If Using A B.uifdet as. Owtic .of ale'subiect ptoperty ' �70 � m behalf hereby authorize c t o.act on y in an.matters relative to work authorized by this building,pe,trMt appltcatioiz for (Ad ess of rob) Signature of Owner Date Pdnt Name . F If property owner is applying for permit please complete the Homeowners License' Exemption Form on th'e reverse side. _ veparrnsertl o) Office of Investiga—tiorrs ` 600 Washington Street Bostorx, h%G4 02111 W)-Vw-mass.govIdLa Workers' Compexa.satiou RIEUrance Affidavit: Builders/Contracto>-s .�T.ectxi�cians/Plumbers Applicant Information Please Print Lelbly Name (Business/Or stizatidn/Individua[): 74 J/f �j�/d y D Alb Address: BD x S VILL_t' 44A 3 Phorte.�. 77�� tD 4fU • • f City/StatelZip Arc you an employer? Check the appropriate bo Type of project(recluued): 4. �am a general contractor and I 1.❑ I am a employer with 6. 9CW cozastivctzon r-mployees (full and/or ptirt-time).* have hired the ftib-contractors 2.❑ S am a'sole proprietor or patlucr- listed on the attached sheet. 7. ❑1Zcmodclin- ship and have pn employees These sub-contractors have g, Dcmoli�ou employees and'have workers' working for mo in any opacity. 9. []Bwlding addition uzance.� [No workers' p.•inn„a„cc comp ins 10_ - Elcctri'cal rc airs or additions . • rcgizirccL] a eorporatiori and.its 1?._ 3.❑ 1 am a homcova=doing all work of accrs bavc cxcrciscd their l l []1'lmmbirtg rcpaua or addition, mysclL.[No.workcrs' com;i_ gt of exenaptZonper MGL 12.[]Roofrcpaazs inrnranCc rcgnuzd]t 15?, §1(4), and vvc 7 ,Y no 'employees: [No workers` 13 Cr❑ Oth comp.imnzaucc required] _ *Any applicant thal chcc}cr box to zwrt also fm ovt.tha rccdon below shovnng thc:u')NVT1 Li ron-9 .�•n74on pohcy informabrn? t Homcowncri who cubmit[hie af5dxvit'indicxf-r tbcy arc doing nll.workand thrn hire outride cantincigrs timusl>ubrml unevl: tindr�ahng Duch. tcan"ciars ani tbcdcthis box must attached an xdditiawd,dbca;bovang the nine of the sub cantrar lnrz and rtaln t*nc6ther orpot lhote t ntrires 11ati e rinployccs. Jf Lhc sub cnn6;ctnrc hive ariplsiyccc,thry must prvvidb tbcir worY•crr'camp.polity nso nbG. [am art employer Cha(rs providing w.arkers' compeMsad..nn rnsurrmce for my F_Mv1gyee& .Beloit, is Glee policy and job site info rrnatio rt ' ° � y Insurance Comp any1lame .VT 'l�( d GO, © rzatZon D atn Policy#or Sc1f--ins.Lic #. .. WGF rob Sitc Addrcss: 85 Ldab �t c �-! >2 city/statc/zip; yI Attach a copy of theworlters' cozupensati'ozlpolicy declaration page (sho�ing_the policy 7gtunbrr and e�cptr,,t.clakc). Failure to secure eovcragc as required.under Srttion 25.tt.'o.f MGL c 152.:can le d to thc,xuzposihon_of rn*r.1- pc% ..: cs of 4 .r tine tip to $1,500.00 and/or one-year imprisonment, as well as cilRl pcnaltits in then of a STOP WORK ORDER and lino of up to $250.00 a day against the Vi la-tor. �3c advised that a copybf this_statcnacntmaybe forvtardcd to the Office of TAYcstiga.tions of the DIA for innmLncc coycragc Ycrihcation. - 1 I'd v hereby certify under the•pairrs crudpcnalti.es ofperjury di.af the irrf`crr:adon,p►'ovided above is true anct corms! Si atuzc: Pbonc#: 77 f /1� .Offices use only._Do not write In Otis area, !b be co Wed by c'iay or[a►vn officlaC. City or Town: PcrmitlT icenst # Xsstung Authority(circle one); 1. Board of Health 2,Building Department 3. Cit-y/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone #: f t Bayside Boilding Inc. Certificates of Insurance Bayside Building Inc 11/21/08 Certificates of Insurance Sub Contractor General Liability Workers Comp Accurate elevator 8/11/05 8/11/06 6/4/05 6/4/07 Elevators Airtech 11/24/04 11/24/08 9/19/04 11/24/08 Custom Copper Roofing and All Cape Garage Door 6/1/04 6/1/08 6/l/04 6/l/08 Garage doors Aluminum Products of Cape 8/15/04 8/15/08 8/15/04 8/15/08 Storms, screens utters American Floors 3/4/04 3/4/08 8/31/06 8/31/07 Oak floor installation and Arne Excavating&Paving 7/14/04 7/30/08 Umb7/30/04 WC Excavation 7/30/06 5/9/08 ASAP Engineering&Design Co 8/31/06 8/31/07 1/15/06 1/15/08 Engineers ATC Ceiling Systems 8/8/04 8/8/05 10/3/04 10/3/05 Suspended ceilings Atlantic Landscaping Averinos,Anthony 7/20/04 416/08 7/25/04 7/25/07 Tile Installation Avix,LLC 7/29/06 7/29/08 7/29/06 7/29/08 Audio/Video Baltic Security 5/6/04 5/6/08 Has exemption from state Alarm Installation for worker's comp Baxter,Inc. 8/1/04 8/1/08 10/6/04 3/29/08 f Frame Labor T Barnstable Land Design 4/30/05 4/30/07 7/17/05 7/ 7—/07 Barnstable Roofing&Siding, 5/12/06 5/12/07 5/4/06 5/4/07 Roofing Baxter Nye Engineering& 8/11/05 8/11/08 8/20/04 8/20/08i Engineers Bayside Electrical Contn 10/5/04 10/5/07 8/18/04 8/18/07 ECectrician , Berggren Building,Lars 10/14/06 110/14/08 12/31/06 12/31/07 Copper Fabrication Bortolotti Construction 3/7/04 3/7/08 3/7/04 3/7/08 Fill loam pLovider Boston Closet Co 11/16/04 11/16/07 11/16/04 11/16/07 Custom Closet Installation Bracken Engineering,Inc. 6/5/06 6/5/07 _6/6/06 6/6/08 Engineers t Browning Excavators,Inc. . 3/3/06 3/3/08 3/10/06 3/10/08 Excavation yJ _ BSC Group 1/1/07" 1/1/09 1/1/07 1/1/09 9[i' En ineers Budden,Robert W. 1/1/05 1/1/08 2/20/04 2/15/08 Oak flooring Installation Bayside Building Inc. Certificates of Insurance Campbell,William 8/26/04 8/26/08 7/13/04 7/13/07 Painter Cape Cod Closet Systems, 6/30/04 6/30/07 6/30/04 6/30/07 Closet Design &Installation Cape Golf Construction 4/22/05 4/22/07 4/11/05 3/7/08 Cape Cod Marble&Granite 7/l/05 7/1/08 8/16/05 8/16/08 Marble&Granite Carpet Barn Inc 111/06 5/1/08 111105 1/1/08 Carpets Catalano Architects PC 4/15/08 5/21/08 Architects Central Vacuum House 12/1/05 12/1/07 12/31/05 12/31/07 Div of EF Winslow Plumb& Central Vacuum Chaves,Robert 8/13/04 8/13/08 12/17/04 12/17/08 Electrician Clancy,John 7/1/04 7/1/07 10/1/04 10/1/07 Mason Contractor Coastal N Counters Inc 7/15/04 7/15/07 7/15/04 5/1/07 Countertops Concrete Cuts&Coring 6/7/06 6/7/08 10/6/06 10/7/07 Concrete Cuts&Coring Cook,Robert J. Interior Trim Anthony Arede DBA 3/10/06 3/10/08 3/17/06 8/24/07 Cornerstone Masonry Mason Contractor Coy's Brook,Inc 4/24/04 4/24/07 9/21/04 4/24/07 Landscape ' Christopher Costa Inc. 0/22/05 1/22/07 2/3/05 2/3/08 En ineers Creswell Construction Co.Inc. 5/19/04 5/19/07 4/31/2004 4/19/07 Siding Cunningham Construction 4/8/06 4/8/06 Dartmouth Pools&Spas 1/1/05 1/1/08 111105 .1/l/08 Pools ands as Davids Building&Remodel 111105 l/l/08 6/14/04 6/14/08 Interior trim Drew Electric,Inc. 1/21/04 8/28/07 8/28/04_ 8/28/07 Electric Fisher HVAC • 12/30/05 12/30/07 1015105 10/5/07 Heatin D.P.Fuccillo Construction Inc. 10/20/08 10/23/08 GAF Engineering 9/1/04 9/1/08 7/22/04 7/22/08 engineering Gardner Concrete Forms 4/4/2006 4/4/2008 5/1/2006 6/l/2008 Foundations Gardner Concrete Construction 4/1/06 4/1/08 4/l/06 4/l/08 Foundations Gemme,John 8/5/07 8/5/08 11/17/07 11/17/08 Tile Govoni Land Services 5/31/04 5/31/07 7/4/04 9/20/07 Land clearing Gutter Pro 11/7/05 11/7/07 11/7105 11/7/07 Hill Construction 4/29/04 4/29/08 8/14/04 8/14/08 i Bayside Building Inc. Certificates of Insurance Framer Imedia 5/2/07 5/2/08 5/2/07 5/2/08 Computer Installation&Re air In Place/DM Design 1/20/04 1/20/08 2/18/04 2/18/08 Kitchen and Bath Design J&J Concrete 7/13/04 7/13/08 l/l/05 l/l/08 Foundations J&J Tile/Joseph Alonzo 9/25/05 9/25/07 10/4/05 10/4/06 Tile JAG Cleaning Corp, 5/7/04 4/2/08 8/25/04 5/15/08 M&M Cleaning Cleanin James Construction .7/11/04 7/11/06 115105 1/5/06 Interior Trim Johnson,Steven dba SMJ 4/25/04 4/25/08 .4/25/04 4/30/08 Framer Joyce Landscaping 11/15/04 11/15/08 11/15/05 4/7/08 Landscape Contractor Just Us Country Furnishings 5/23/05 5/23/07 10/24/04 10/24/07 Interior TKWBuilt Ins Kitchen Appliance Mart and 8/12/04 8/12/08 1/l/05 1/1/08 Appliances Kitchen Creations 3/30/04 3/30/07 1/22/04 3/8/07 Cabinets L&M Glass Co,Inc 5/1/04 5/1/08 5/1/04 5/1/08 Mirrors, shower doors Lauder,Jeffrey R. 12/9/04 12/9/07 Bobcat James W.LaVallee 6/1/06 6/l/08 6/13/06 6/13/07 Flooring Lawrence Ready Mix 12/31/04 1/l/07 7/1/05 7/l/07 Concrete Suppliers MacDonald Concrete Finishing 1/9/04 1/9/08 4/7/04 4/7/07 Cellar/ ara e floors MAP Insulation Co,Inc 3/1/04 10/1/08 8/1/04 10/1/08 American Building Systems Umbrella I 1 4 1010 Maguire,James 10/4/07 10/4/08 10/4/07 10/4/08 McGuires Construction Co. 1/27/07 1/27/08 Meagher Construction -6/19/04 9/2/07 6/23/04 6/23/07 Framer Meriam Backhoe Service 5/7/06 5/7/07 Backhoe Merrick Engineering 6/30/04 6/30/08 4/4/04 4/4/08 Engineering Morse,Richard W.Sr. 3/10/05 3/10/08 7/30/04 10/11/07 Cellar/Garage floors Northern Sealcoating Inc 7/1/04 10/1/08 4/1/04 4/l/08 Driveways(paving) Northside Design/Gordon Clark 1/15/07 1/15/08 •11/30/06 11/30/07 Architect Omni Environmental Systems 1/22/05 1/22/08 2/21/04, 2/21/07 Se tic Design/Testing M K Pasic Plumbing&Heating 10/1/06 10/1/08 10/1/06 10/1/08 Plumbin /Heatin T Bayside B2ilding Inc. Certificates of Insurance Pride Flooring 6/13/04 6/13/08 6/15/04 6/15/08 Oak Floor Installation . Pro Fence 3/26/04, -3/26/08 3/26/04 3/26/08 Custom Fencing R&H Construction Inc 2/15/04 12/21/07 12/21/04 12/21/07 Excavation Race Framing 11/1/04 7/30/06 8/6/04 8/6/06 Framer Reed,Mel 7/21/04 1/21/108 7/21/04 7/21/08 Sheetrock Lawrence Robinson Masonry 9/6/08 Michael Rolfe Construction 7/11/07 7/11/08 11/13/06 11/13/07 Ryder&Wilcox Inc 11/22/04 11/22/08 11/22/04 11/22/08 Engineering Scannell,D.A.Well Drilling 9/12/04 9/12/07 9/20/04 9/20/07 Wells Shaw Woodworking 4/19/05 4/19/08 2/24/05 2/24/08 Interior Trim Shorey Mfg. 12/1/06 12/1/07 12/1/06 12/1/07 Snow's Plumbing and Heating 9/30/05 9/30/08 9/30/05 12/29/07 Plumbin /Heatin /Gas logs Stewart Painting 7/29/04 9/13/07 7/15/04 7/15/08 Painting/Power washing Taylor Made Flooring 7/22/07 7/22/08 11/11/06 11/11/08 Flooring Terra Nova Marble&Granite :7/1/04 7/1/07 7/1/04 7/1/07 Granite counters Tibbetts Engineering 12/31/05 . 12/31/07 6/30/05 6/3/08 Engineers Triple Crown/Fitz Construc 7/30/04 7/30/08 12/12/04 12/12/07 Interior trim Villani Construction,Inc. 4/12/07 4/12/08 4/l/07 4/l/08 . Weller&Assoc 8/15/04 8/15/07 none .. Engineers Whiteley,W.Vernon 10/1/04 10/1/08 10/3/04 10/3/08 Plumbing &heating 4 . ` 6 r i REScheck Software Version 4.1.3 Compliance -Certificate Project Title: Prefontaine Renovations Report Date:09/12/08 Data filename:C:\Program Files\Check\REScheck\client reports\PREFONTAINE.rck Energy Code: Massachusetts Energy Code Location: Centerville(Barnstable),Massachusetts Construction Type: 1 or 2 Family,Detached Heating Type: Other(Non-Electric Resistance) Glazing Area Percentage: 20% Heating Degree Days: 6137 Construction Site: Owner/Agent: Designer/Contractor: 85 Long Beach Road Northside Design Associates Centerville,MA 141 Main Street Yarmouthport,MA 02675 Compliance:6.4%'Better Than Code Maximum UA:732 Your UA:685 § , Ceiling 1:Flat Ceiling or Scissor Truss 2525 30.0 0.0 88 Skylight 1:Wood Frame:Double Pane 24 0.500 12 Wall 1:Wood Frame,16"o.c. 4395 19.0 0.0 210 Window 1:Wood Frame:Double Pane with Low-E 484 0.330 160 Door 1:Solid 20 0.140 3 Door 2:Glass 392 0.330 129 Floor 1:All-Wood Joist/Truss:Over Unconditioned Space 2525 30.0 0.0 83 Compliance Statement: The proposed building design described here is consistent with the building plans,specifications,and other calculations submitted with the permit application.The proposed building has been designed to meet the Massachusetts Energy Code requirements in REScheck Version 4.1.3 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist.The heating load for this building,and the coding load if appropriate,has been determined using the applicable Standard Design Conditions found in the Code.The HVAC equipment selected to heat or cool the building s e o greater than 125%of the design load as specified in Sections 780CMR 1310 and J4.4. 2 NN4me-Title Signature Date Project Title:Prefontaine Renovations Report date:09/12/08 Data filename:Q\Program Files\Chedk\REScheck\client reports\PREFONTAINE.rck Page 1 of 4 ["' REScheck Software Version 4.1.3 Inspection Checklist Date:09/12/08 Ceilings: ❑ Ceiling 1:Flat Ceiling or Scissor Truss,R-30.0 cavity insulation Comments: Above-Grade Walls: ❑ Wall 1:Wood Frame,16"o.c.,R-19.0 cavity insulation Comments: Windows: ❑ Window 1:Wood Frame:Double Pane with Low-E,U-factor:0.330 For windows without labeled U-factors,describe features: #Panes_Frame Type Thermal Break? Yes No Comments: Skylights: ❑ Skylight 1:Wood Frame:Double Pane,U-factor:0.500 #Panes Frame Type Thermal Break? Yes No Comments: Doors: ❑ Door 1:Solid,U-factor.0.140 Comments: ❑ Door 2:Glass,U-factor:0.330 Comments: Floors: ❑ Floor 1:All-Wood Joist/Truss:Over Unconditioned Space,R-30.0 cavity insulation Comments: Air Leakage: ❑ Joints,penetrations,and all other such openings in the building envelope that are sources of air leakage are sealed. ❑ When installed in the building envelope,recessed lighting fixtures#meet one of the following requirements: 1• Type IC rated,manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2• Type IC rate,in accordance with Standard ASTM E 283,with no more than 2.0 cfm(0.944 Us)air movement from the the conditioned space to the ceiling cavity.The lighting fixture has been tested at 75 PA or 1.57 Ibs/R2 pressure difference and shall be labeled. Vapor Retarder: ❑ Installed on the warm-in-winter side of all non-vented framed ceilings,walls,and floors. Materials Identification: ❑ Materials and equipment are identified so that compliance can be determined. ❑ Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided. ❑ Insulation R-values and glazing'U-factors are clearly marked on the building plans or specifications. ❑ Insulation is installed according to manufacturers instructions,in substantial contact with the surface being insulated;.and in a manner that achieves the rated R-value without compressing the insulation. Duct Insulation: Project Title:Prefontaine Renovations Report date:09/12/08 Data filename:C:\Program Files\Check\REScheck\client reports\PREFONTAINE.rck Page 2 of 4 f "'• Ducts are insulated per Table 6106.4.4.3. Duct Construction: All accessible joints,seams,and connections of supply and return ductwork located outside conditioned space,including stud bays or joist cavities/spaces used to transport air,are sealed using mastic and fibrous backing tape installed according to the manufacturer's installation instructions.Mesh tape may be omitted where gaps are less than 1/8 inch.Duct tape is not permitted. The HVAC system provides a means for balancing air and water systems. Temperature Controls: Thermostats exist for each separate HVAC system.A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor is provided. Heating and Cooling Equipment Sizing: Rated output capacity of the heating/cooling system is not greater than 125%of the design load as specified in Sections 780CMR 6106.4. Circulating Hot Water Systems: Circulating hot water pipes are insulated to the levels in Table 1. Swimming Pools: All heated swimming pools have an on/off heater switch and a cover unless over 20%of the heating energy is from non-depletable sources.Pool pumps have a time dock. Heating and Cooling Piping Insulation: HVAC piping conveying fluids above 120 degrees F or chilled fluids below 55 degrees F are insulated to the levels in Table 2. Project Title:Prefontaine Renovations Report date:O9/12/08 Data filename:C:\Program Files\Check\REScheck\client reports\PREFONTAINE.rck Page 3 of 4 Table 1:Minimum Insulation Thickness fora Circulating Hot Water Pipes Insulation Thickness in Inches by Pipe Sizes Non-Circulating Runouts Circulating Mains and Runouts Heated Water Temperature(°F) Up to 1" Up to 1.25" 1.5"to 2.0" Over 2" 170-180 0.5 1.0 1.5 2. 140-160 0.5 0.5 1.0 1.5 100-130 0.5 0.5 0.5 1.0 Table 2:Minimum Insulation Thickness for HVAC Pipes Fluid Temp. insulation Thickness In Inches by Pipe Sizes Piping System Types Range(°F) 2"Runouts 1"and Less 1.25"to 2.0" 2.5"to 4" Heating Systems Low Pressure/Temperature 201-250 1.0 1.5 1.5 2.0 Low Temperature 120-200 0.5 1.0 1.0 1.5 Steam Condensate(for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water,Refrigerant and 40-55 0.5 0.5 0.75 1.0 Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD:(Building Department Use Only) a �I Project Title:Prefontaine Renovations Report date:09/12/08 Data filename:CAProgram Files\Check\REScheck\client reports\PREFONTAINE.rck Page 4 of 4 roe ox3Tb• t NG- '-S �-�R- t0Gr TAYLOR DESIGN INC. 1 ASSOC,� SHEET NO. 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WAY AM7 s r' nos OR Y' S `4 t a 1 � J- t5 3 � �4r's k'U%Js`��t,�,�f�yr,���,,��,d•� yI��t''S #�.��C�'�'� t }.:,$ n ".t I. . 3G` r �v3 a*. r, rsjIfzh F i ^`gal,�*'�n reYh ryzr3��sYt q A - { . _.- a 5 F t rl � �,� f 7 Fa; ,. a ;J s•y yL'k ti yy ¢ 1 tr s+ aman p 100 cfgenclosed5pace 4 �5) Y>2 fi• k5 L'F b ^�ltis�'.yaSUWa Lr ���+.,� possess�a�ourr+rent�� t�o�nxof,the �,� Failurse�,to ul rm r Allow '' j is cause 0Of"ei o�ca�tioan ° the s h�ense a o k1 a ' } ti �: 5 T ai I , t ,• ✓/re Po�rrmcanrr�ealC� o�'./l2<,aacu/ruaeld ,1 Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 113786 Expiration: 7/16/2009 Tr# 131980 Private Corporation BAYSIDE BUILDING INC:j , BRIAN DACEY PO BOX 9513 BAYBERRY•,SQ CENTERVILLE,MA 02632 Administrator 77 It l License or registration valid for individul use only y §E before the expiration date. If found return to: Board of Building Regulations and Standards t' One Ashburton Place Rm 1301 . Boston,Ma.02108, J t { ot'valid without tore I' t. fl tl.'`?trl .. c ' I: TAYLOR DESIGN ASSOC., INC. SHEET NO. �1 h`."d OF P.O. Box 1313 FORESTDALE, MA 02644 CALCULATED BY /+T_ DATE TEL./FAX: (508) 790-4686 - CHECKED 8Y -DATE D 11►- `.KA►ve Cl L.11 SCALE ea- �..lCt..DrN.C7. I3 �4 Ct5_iQTc7�r..4:2.70 E,�.-_�� .... B _-rc �.. e�TT cJE''c) �cg � �4�e-ram ._.. ..... ._ Ie. - Via/ ,... __........... :. ...... ..... ........... ...� n ;.. a �. r,lif .. Z4 x'� -o GT®k. ..... .. .......; _. _._ .. ... ' 1 o TTc�e►4 tr.�. �'. oil. .... .. .. .. . "P c.- 41 c` ..........Qt?T :.J►. des C�,a� e.�t?6 .0 .; ..............__..................._.>........._......................................_............. ..... .. _... ...... ._.. ..... .... ... ...-.- ..._. ..... ...... ...... ..... ..... .._. .. ... .`............. .... 1 ` 'k 4 Y e .. ..... _..... ........ ...........<..... 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W � g. � ..... ...... 7 t ' JOB \ TAYLOR DESIGN ASSOC., INC. SHEET NO. - : OF + P.O. Box 1313 FORESTDALE, MA 02644 CALCULATED BY C"Z T DATE TEL./FAX: ('508) 790-4686 CHECKED BY DATE Pic* 6✓� jLASSCALE ......_.._........._._.................................._ ..... ._.. ... ._... ............ ...... ...... ...... _.... ...... .................. ..._. ..__ ..:.. ...... ...... .......... ...... ..._. ...... ..... ......... ....i....... ...�'..... .. l ,{- .....................__. . ........................................... .. : ..... ..._ ... .............................. i a kO . - ........... . .......:... ._.._... .... .. ..... �.. ... M t..:....... .... . Y k Z S�-p. 4.)c • .o .1- . .-A ..__.. .... .... .. k ........ .: .:..... i... : _..... -.. .. .. .. .. .._. _.. ._... _...... - ..:. .. .. .. .__. .. .. ... .. 1i.. �\ .....e .. . _ .... ....................... _ f. , .. " .. .... '.� j 1 . iQT .... ... L - .. -2 ........ .... . �` .:�► . . /w� , i . ... 61 S B yside Building Inc. Certificates of Insurance 2008 Sub Contractor General Liability Workers Comp All Cape Garage Door 6/l/04 6/l/09 6/l/04 6/l/09 Aluminum Products of Cape 8/15/04 8/15/09 8/15/04 8/15/09 Baxter Nye Engineering& 8/11/05 8/17/09 8/20/04 8/20/09 Bortolotti Construction 3/7/04 3/7/09 3/7/04 3/7/09 William Campbell 8/26/04 8/26/2009 7/13/04 7/13/09 Cape Cod Marble & Granite 7/1/05 7/1/09 8/16/05 8/16/09 Cape Cod Ready Mix Inc. l/l/07 l/l/09 1/1/07 l/l/09 Cape Concrete Forms 6/5/07 6/5/09 12/7/07 12/7/09 Carpet Barn Inc 1/l/06 5/l/09 111105 1/l/09 Casella Waste Management 4/30/08 4/30/09 5/l/08 5/1/09 Robert Chaves 8/13/04 8/13/09 12/17/04` 12/17/09 Coy's Brook, Inc 4/24/04 4/24/09 9/21/04 10/1/09 U 1/l/08 1/1/ U Davids Building&Remodel 01/01/08 l/l/09 6/14/04 8/14/09 D.P. Fuccillo Construction Inc. 10/20/06 10/20/09 10/20/08 10/23/09 Govoni Land Services 5/31/04 6/22/09 7/4/04 6/22/09 Gregoire,Mark 9/18/08 9/18/09 Hill Construction 04/29/07 4/29/09 8/14/04 8/14/09 In Place/DM Design 1/20/04 1/20/09 2/18/04 2/18/09 JAG Cleaning Corp, M&M 5/7/04. 4/2/09 8/25/04 5/15/09 Steven Johnson 4/25/04 4/25/09 4/25/04 4/30/09 Kitchen Appliance Mart and 8/12/04 8/12/09 111105 l/1/09 L &M Glass Co, Inc 5/l/04 5/1/09 5/1/04 5/1/09 MAP Insulation 10/1/07 10/1/09 10/1/07 10/1/09 Meagher Construction 6/19/04 9/2/09 6/23/04 6/23/09 Morse's Masonry 3/10/07 3/10/09 Northern Sealcoating 10/1/07 10/1/09 4/l/07 4/l/09 Pro Fence Co., Inca 3/26/07 3/26/09 3/26/07 3/26/09 Reed, Mel 7/21/04 7/21/09 7/21/04 7/21/09 Rolfe Construction Inc. 7/11/07 7/11/09 Shorey Mfg. 12/1/06 12/1/08 12/1/06 l/1/09 Snow's Plumbing and Heating 9/30/05 9/30/09 9/30/05 12/29/08 Sullivan Engineering, Inc. 6/26/08 6/26/09 1/28/08 1/28/09 Whiteley, W. Vernon 10/1/04 10/1/09 10/3/04 10/3/09 EF Winslow Pluming&Heating 12/1/06 12/1/08 1/1/07 l/1/09 i The Commonwealth of Massachusetts Department of Industrial Accidents 0. Office of Investigations 600 Washington Street Boston, MA 02111 J. www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers A pplicant Information Please Print Le 'bl Name(Businessiorganizadonividual): i /Ind Address: Lu OOER �'�.��� _��T ,i� � 1 .4 ' City/State/Zip: Phone.#: 52D6_ Are you an employer? Check the appropriate box: Type of project(required): 1.LJ I am a employer with� 4. ❑ I am a general contractor and I ❑ . employees(full and/or part-time). # have hired the sub-contractors 6. New construction 2.❑ I am a•sole proprietor or partner- listed on the attached sheet 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' 9 ❑Building addition [No workers' comp.-insurance comp-insurance.$ required.] S. ❑ We are a corporation and its 10.[�KElecttical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself.[No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance r t c. 152, §1(4),and we have no �] employees. [No workers' 13.❑Other comp.insurance required] Any applicant that checks box#1 must also M out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they arc doing all work and then hire outside contractors must submit a new affidavit indicating such. 1contractors that check this box must attached an additional sheet showing the name of the sub-contractms and state whether or not those entities have employees. If the sub-contractors have employees,they must providb their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. Insurance Company Name: ' " i �° Policy#or Self-ins.Lic.#: /�L//D� 7�7 Expiration Date: /XDb - >Job Site Address: � ,6 City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine tip 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 statemeritmay be forwarded to the Office of Investigations of the WA for insurance coverage verification. Ida hereby certify under the ains•andpenah es ofperjury that the information provided above is true and correct Si attA: Date: _ Phone Offichd use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: t Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees: Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity, or any two or,more of the foregoing engaged in a joint enterprise, and including the legal representative's of a deceased employer,or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license 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,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for.the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,its necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificates)of insurance. Limited Liability Companies'(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address" the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit.must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call The Department's address,telephone-and fax number.. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. #617-727-4904 ext 4.06 or 1-977-MASSAFE Fax# 617-727-7749 Revised 11-22-06 www.mass.gov/dia Ac5 'SF•'Avl na a tit �a u�,�I��8 0�2� ^ _ MAP Qwlsr-_� Aue,usT is flMAIL V G I Z, AUL -b" N bpi f 3o-Tarn of � dV� I _ f j � cL Mo 4 � r � PiTER SULLIVAN fib r No-29733 "Ifi i 4 PS 6 2-3'Fl!Exrt S/ONA L E� Y co I i L row 'SGALE.:45 IuO�. A . _ IUAtiI i UL'KF7 S0,uMD 1• z N �'— dip rnjM 0 i �a ~��' 64n ✓ S' N s•5 -D� c � con,L Sys FA=v - b p J _� 3 F,tl -Ira,Gc . g J 6..rew.i 0 1-ounaoq-t-ib� �t2P_ t/�41+1/LCZE17 � S�o.WAI I.. ^t+ 4 Al Ct\'D w W G wo I9 LA`N� � � 1 i w Lc, ti, PROJECT NAME: kb6lmeftl Al &b/Avr— ADDRESS: Sj3, 1-6461 (3E4ew" k!*b PERMIT# �..0080(ptj PERMIT DATE: M/P: LARGE ROLLED PLANS ARE IN: BOA �z SLOT Data entered in MAPS program on:. 12- " o4 -o8 BY: NB a/wn fi l e,s/archive f 7 . Town of Barnstable *Permit# ` Dd �'T rqy, C Expires 6 mon hs from issue date I- Regulatory Services Fee Thomas F.Geiler,Director f 63q� "���3 2008 Building Division aS Tom Perry, CBO, Building Commissioner ok � Tfl' VVV {� $.; � -STAe 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number 2_0�O 16 2-?— Property Address �j j )--U(J jC" r—1 U�^� I L i u(_G (Residential Value of Work. i e �` Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Contractor's Name C_ '2 L�-Lt—� Telephone Number 6m `t`�� '0 Home Improvement Contractor License#(if applicable) ❑Workman's Compensation Insurance Chec e: I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name N/ . Workman's Comp.Policy# Copy of•Insurance Compliance Itertificate must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to '❑ Re-roof(not stripping. Going over existing layers of roof) 00"Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property0wner must sign Property Owne Letter of Permission. A copy of the Home Improver Co actors License.is required. ,r SIGNATURE: Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revise020108 ��ie �arranzooutrect`�i o���trc�ccde�6 j Board of Building Regulations and Standards License or registration valid for individul use only . HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: ,131751 Board of Building Regulations and Standards Expiration: 9/8/2008 One Ashburton Place Rm 1301 Boston,Ma.02108 Type: Individual CHRISTOPHER S.CHILDS CHRISTOPHER CHILDS <' 106 SWAN RIVER RD 1 W.DENNIS, MA 02670 Deputy Administrator Not valid without signature f The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street . < Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumberg A.Pplicant Information Please Print Lep-ibly Name(Business/organization/lndividual): t I S-J-2) 1'/fC� C-I-k L-0-S Address: Ad(ro SW City/State/Zip: W. Ste,/VI 02 Phone.#: = 0 D Are you an employer? Check the appropriate box: Type of proj ect(required): 1.❑ I am a employer with 4. I am a general contractor and I 6. ❑New construction ployees(full and/or part-time).* have hired the sub-contractors 2.[�am a'sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, E]Demolition working for me in any capacity. employees and have workers' 9 F]Building addition [No workers' comp..' camp insurance.$ 5, We are a corporation and its 10.0 Electrical repairs or additions required.] 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152, §1(4), and we have no 13.[9 Other IDCgAlqL� employees. [No workers'. comp.insurance required.] *Any applicant that checks box 41 must also fill out the section below showing their workers'compaisation 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. xContractors that check this box mast attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employe-. 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: Policy#or Self-ins.Lic.M Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of rrimirial penalties of a fine tip to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance covcragelverification. I do hereby certify der p nd s of perjury that the information provided above is true and correct Signature- / Date: v . Q a Phone# Official use only. Do not write in this area,to be completed by city or town offk aL 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 Cnntact Person: Phone#: Information and. Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees: Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hue, express or implied, oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership, association or.other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license 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,MGL chapter 152, §25C(7)states`Neither the commonwealth nor any of its political subdivisions shall enter into any contract for.the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(cs)and phone number(s) along with their certificate(s)of insurance. Limited Liability Companies'(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers'compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the nur4ber listed below. Self insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a refercnce number. In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address" the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for fixture permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (ie. a dog license or permit to btim leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call The Department's address,telephone-and fax number. The Commonwealth of Massachusetts Department of lndustrial Accidents Office of Investigations 600'Washington Street Boston, MA 02111 TO. #617-727-4900 ext 4-06 or 1-977-MASSAFE Fax# 617-727-7749 Revised 11-22-06 www.mass.gov/dia �2 �?� FyAoo'\/ Jun 02 08 09: 49a Patriot Builders 508-432-7789 P. 2 FFR_AICI'M mill 111 5/19/2006 vc+ER THIS ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Robert E.Bouchie,Jr.Insurance Agency,inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND,EXTEND OR PO BOX 400 ALTER THE COVERAGE AFFOROEO BY THE FOLICIE9 BELOW. Catau nlet,MA. 02534 COMPANIES AFFORDING COVERAGE COMPANY A Atlantic Charter Laurance Com2any VDAC INSURED COMPANY Scott Ryan 6 COMPANY 10 Dale Ten-ace C Sandwich,MA 02653 COMPANY o '' 0. ram' THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERT D INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH TH CERTIFICATE MAY DE WOUEO OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 18 SUBJECT TO ALL THE TER 1 �' EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SWOWN MAY HAVE.BEEN REDUCED BY PAID CLAIMS. CO TTPE OF INSURANCE POUCY RUMMER POLICY EFFECTNf POLICY EXPIRATION LIMITS LTR - GATE(MMOUTYT DATE(MINODIIYI Tlwucfn�l� Ed> OERERAL LIABILITY ICE BOOILYIN)URY OOMPREMENBIVE FORM eCmLV INJURY ApO f •• PREMISESIOPERATION9 _ PROPERTY DAMAGE C f .r UNDERGROUND PROPERTY DAMAGE A G. S EXPLOSION A COLLAPSE HAZARD BI 6 PD COMBINED QL '? f PROOUCTSICOMPLETEO OPER BI A DD OOMBIWO AGG f CONTRACTUAL PERSONAL INJURY AGG f INDEPENDENT CONTRACTORS BROAD FORM PROPERTY DAMAGE - PERSONALINJURY - AUYOMOBIL!UABIUTY - BODILY INJURY ANY AUTO (Aft Dn,67A) b ALL OWNED AUTOS(P11V9te PBbf) BOOILV INJURY ALL OWNED AUTOS (Per ecclasm) A (Od Jan PA—f.,P—..q-) - HUREOAUT05 PROPERTY DAMAGE f NON40WNED AVTOB BODILY INJURY L GARAGE LIABILITY PROPERTY DAMAGE COMBINED 1 speeds IJABILITY - EACH OCCURRENCE b UMBRELLA FORM AGGREGATE S OTHER THAN UMBRELLA FORM S WOWtEm COMPENSATION AO X STAMDRv lMIT9 EIIPLOYEA6 VADILRY WCV00636003 3/26/2008 3/26/2009 EACHACCTDENT f 100,000 The workers'compensation ollcy does not provide coverage for Scott Ryan- DISEASE-POVCYLIMIT a 500,000 p18EASE-EACH EMPLOYEE S 100,000 OTHER . DESCRIPTION OF OPERATIONS(LOCAnDMWVENICLM&PeQALITEMS Attention:Please note that the Insured ha®not elected coverage for thomselvcs and there Ic no piyroll covered on this policy. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Patriot Builders EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAfL 537 Route 28 12 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. Harwich,MA 02646 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPO NOC8UGATIONORLIASILITY OF ANY KIND UPON THE COMPANY.11 AGENTS R REPftESENTATIVES. T7ORIZEDREPREGENTATMF oFTMEra,, Town of.Barn-stable Regulatory Services sa MASS. g Thomas F. Geiler,Director 16.39.�fD►�A Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us . Office: 508-8624038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Us ing A Builder I, ))k 10 , as Owner of the subject property hereby authorize act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) Signa of Owner D Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q :FORMS:O WNERPERMISS10N r� e ' Town of Barnstable *Permit ,F->0 Expires 6 months from issue date '.� Regulatory Services Fee /So� w X-PRESS PERK Thomas F.Geiler,Director 6 / JUN 2 0 2007 Building Division Tom Perry,CBO, Building Commissioner TOWN OF BARNS BLE 200 Main Street,Hyannis,MA 02601 www.town,barnstable,ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number 0<0 Property Address 8 s �►� �3d +� �� [residential Value of Work c3 c�k�,c, Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Contractor's Name 1 r v �- �-t�epl G" Telephone Number Z&& Home Improvement Contractor License#(if applicable) 96 t Z) Construction Supervisor's License#(if applicable) 6 Z-Lf`(d� l 2 13�, t o� ❑Workman's Compensation Insurance Check one: O'ram 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 be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping, Going over existing layers of roof) V❑ e-side Replacement Windows/doors/sliders. U-Value (maximum.44) *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 is required. SIGNATURE: Q:Forms:expmtrg Revise061306 The Commonwealth of Massachusetts t Department of Industrial Accidents d Office of Investigations 600 Washington Street Boston,MA 02111 .� www.mass.g ov/dia Workers' Compensation Insurance.Affidavit: Builders/Contractors/Electridans/Plumbers Applicant Information ) Please Print Legibly Name(Business/Organization/Individual): . ---j u_-c � �1 -Address: 7e City/State/Zip: ®t-r,:73 Phone.#: ` S_ �` 5 Are you an employer?Check the appropriate box: Type of project(required):. 1.❑ I am a employer with 4. 0 I am a general contractor and I 6. El New construction . . employees (full and/or part-time).* have hired the sub-contractors 2.J21—am a'ole proprietor or partner- listed on the-attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. 0 Demolition workingfor me in an capacity. employees and have workers' • Y P tY• $. 9. 0 Building addition [No workers' comp.insurance comp.insurance. required] 5. We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.[]Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' . 13.❑ Other comp. insurance required.] . *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. IContractors 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. Iam an employer that is providing workers'compensation insurance for my employees. Below is.the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DI A.for insurance coverage verification. I do hereby certify:ender the pains and penalties ofperjury that the information provided above is true and correct. Signature - \ -j�n Date: Phone# Official use only. To not write in this area,to be completed by city or town o jiciaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as".-..every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two.or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the' dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to bean employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license 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,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for.the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented'to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contiactor(s)name(s), address(es)and phone number(s) along with their certificate(s)of insurance. Limited Liability Companies(LLC) or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. 'The affidavit should be returned to the city or town that the application for the-permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete'and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all-locations in (city-or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves-etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone-and fax number:. The Commonwealth of Massachusetts Dtrl?utment of Industrial Moidonts Office of Investigations 600 Washington Street Boston, MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Revised 11-22-06 Fax# 617-727-7749 www.mass.gov(dia oFIME Town of Barnstable, h Regulatory Services *�$ � '$ Thomas F.Geller,Director =79. a10 ]Bundling Division Tom Perry, 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 ABuilder I �?'v..tt�.v ,as Owner of the subject property hereby authorize / ®,,��� �u�..«r-z,,J to act on my behalf, in all matters relative to.work authorized by this building permit application for: . - (Address of Job) Kgnalture of Owner Date Ai C 172��o�1iAi �� Print Name Q TO RM&O W NERP ERM IS S ION a'VOHS 1S tl0?!8 Lz ,• NO1QNDI1Id V(11VNOa 00 .pePw9911 U-UUMU suo 0.9m :ou v1 t00Z/=& :Bwldx3 L/WZI, :e py}tls Ot+trZO SO jsgwnN a0S1/W3df1S NOLLOtt1IM1SNOO :asueal� ,�yatecucoy,. �,t . i r�,f 1 f g%gar1 1114 IZ'IW,�l�,errs Boa o B a awns nd an ar s License or.registration valid for individu. usc only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found retch' to: (> Registration 109010 Board of Building Regulations and Star.N ds Expiration: 9/1/2008 One Ashburton Place Rm 1301 Boston. Ma.02108 Type: DBA r � PILKINGTON&SONS Donald Pilki.igton 21 Broad St �,.,...� ;.�•r,-�..,t,r� �i��---..��. Medway, MA 02053 Deputy Administrator Not valid without signat re v PERMIT PAYMENT RECEIPT TOWN OF BARNSTABLE BUILDING DEPARTMENT 200 MAIN STREET HYANNIS, MA 02601 DATE: 06/20/07 TIME: 12:28 ------------------TOTALS------------------ PERMIT $ PAID 150.00 AMT TENDERED: 150.00 AMT APPLIED: 150.00 CHANGE: .00 APPLICATION NUMBER: 200703820 PAYMENT METH: CHECK PAYMENT REF: 2614 r' Town of Barnstable *Permit 60-70 U_C 1 Fxpires 6 months from issue date Regulatory Services— Fee - Thomas F.Geiler,Director - ll'' l PERMIT Building Division in / Tom Perry,CBO, Building Commissioner SEP 2 8 2007 200 Main Street,Hyannis,MA 02601 )�N f��"�Q��� 8 www.town.barnstable.ma.us � . t �f ice. Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel NumbergOC D O Property Address esidential Value of Work Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Contractor's Name Telephone umber'-;,5T�s '� y� Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) /Z _jo ❑Workman's Compensation Insurance y Check one: Qum 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 be on file: Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side Replacement Windows/doors/sliders. U-Value (maximum.44) *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 is required. SIGNATURE: Q:Forms:expmtrg Revise061306 - The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance.Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual):. Address: �� � City/State/Zip:_ oe7*SS - 40 Phone.#: S'994 Are you an employer? Check the appropriate box: -Type of project(required):. 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part- have hired the sub-contractors 6. ❑New construction . 2.Zkram a•sole pioprietor or partner- listed on the'attached sheet. 7. ❑Remodeling ship and have no employees These sub=contractors have g,`0 Demolition working for me in any capacity. employees and have workers' co insurance.f 9• ❑Building addition. [No workers' comp. insurance mP• required.] 5. ❑ We,are a corporation and its 10.❑Electrical repairs or additions '3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself: [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.] t c. 152, §1(4),and we have no employees, [No workers' . 13.❑ Other comp.insurance required.] , *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. lam an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. Insurance Company Name: , Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date), Failure,to secure coverage as required under Section 25A of MGL c. 152.can lead to the imposition of criminal penalties of a fine tip 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 bIA for insurance coverage verification. I do hereby certify under the pains-and penalties ofperjury that the information provided abo a is ue and correct: Sienature; .......... , Date: Phone Official use only. Do not write in this area,'to be completed by city or town o�ciaL City or Town: — Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town CIerk 4.Electrical Inspector 5.PlumbEInspecter 6. Other Contact Person, Phone#: oF1HE Town of BarnstaBarnstable.J°ky . Regulatory Services + BABNSTABLE, • MASS. $ Thomas F.Geller,Director �'ATfv Mai a`� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 w-f w.town.barnstable.ma.us Office: 508-862-4038 • Fax: 508-790-6230 Prop e ltty Owner Must Complete and Sign This Section If using A.Builder as Owner of the subject property herebyauthorize to act on rnybehalf, in all matters relative to work authorized bythis Molding permit application for: (Address of.Job) Signature of Owner Date Pnnt Name Q:F0P-M S:0WNE"ERMIS SIGN li x t n s l r / LicerBOAR�OF 13Ufi,plptt3 CONSTRUCTION SUP Number: CS. 02•1407 T Blrthdate: EW c�^$+I►uert�,,, Expires: l2/3pj201)7 Tr.no: 9966 0"i t" DONALD A PILLKINCTON - ^ . I h21 BROAD ST Boa r�bi KGi�inEDWA Y. MA OM3 g guelah4d%dj5ta License or.registration valid for indivirl�s osc only l " „ ,HOME IMPROVEMENT CQN7RACTOR • '� • before the expiration date. If found,reLI: r o Registration: 109010 T Board of Building Re utations and Stance w,Expiration: 9/1/2008 g d . <. ;- One Ashburton Place Rnt 1301' - - TYpe: DBA # V Boston.Ma"02108 PILKINGTOI)&~SONS a Donald Pilkiigton 21`Broad St Medway, MA 02053 �`` Deputy Administrator _ Not valid without signature v i `7 f �FIKE To Town of Barnstable Regulatory Services ELARN 9 STAB MASS. e Thomas F.Geiler,Director Eo; & Building Division Tom Perry. Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: '�08-790-6230 March 31, 2003 Mr. Robert Wyatt, Executive Director Cape Cod Conservatory P.O. Box 127 W. Barnstable, MA 02668 Re: SPR 025-03 CC Conservatory—Decorator Showcase Proposal: 85 Long Beach Rd, Centerville(R206-022 & 0023) Dear Mr. Wyatt: Please be advised that the aforementioned application was approved at the site plan review meeting on March 27, 2003. This project has been referred to the Board of Appeals for a Temporary Use Variance. Robin C. Giangregori Zoning& Site Plan Review Coordinator : F I I! f. f f •' � r ;.'3C172Mt/.2js t r ;FElCHAF�O�' i y- 102 \� A. Na a;a � ' 07 • d,/8.Y3 I-aC.47 OTC/ �7 �ti/jL�Ls o 729 1- - G�-vaTj�l��.l is_._hoc-ATE. _v�.L:_-�•�4 ..___ �. ' , _._ ""'---- y �38 l 5,-;L�a�A� : wtZ.pdp 9AX, T M r Assessor's offioe (1st floor): Assessor's map and lot number �.. 6 �f of t"E to Board of Health (3rd floor): c� �J � Sewage Permit number ..........."....�..3.3 ................. Z 339SII9T4DLE, p M & Engineering Department (3rd floor): / {� v 0 House number ............................ .... 1... .. `! "�o Ypr a- . APPLICATIONS PROCESSED 8:30-9:30 A.M, and 1:00-2:00 P.M. only TOWN OF BARNSTABLE _ BUILDING INSPECTOR , G� APPLICATION FOR PERMIT TO ..... . ...... �!. .....� !..!✓ .... .� ................ ...................... TYPE OF CONSTRUCTION ..............4Z/ ...X�e4XI6 . ...` ..:................ 19... � TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .......... Proposed Use ........s /.!'�l �a r� /�7/ %....!?`t`J;v.................................................................................................... Zoning District .......�?.....=.!P:..............................................Fire District .. Fi✓T- Q� f Name of Owner' ��5C'+�t� _....... i� ./7.41. � /�/� ..................Address .................................................................................... Name of Builder1 �4 ... /. !i(lC,/ rruST......Address ..(J/iVTL�rf/iG�o:.. :.................................... �... 1 �.............. Name of RArchitect � 7� S -1- t/ . . i Addre ................................ ....../...y.l..�....... Number of Rooms ...... .... ��.............................................Foundation U. ' ...�IG/RJ( >`t�.............................. Exterior ... fPdf}� �fji� �r�. -5....................................Roofing ..1f� G� S1i. 4 ,a............................... Floors ... .g .. LGt'J�/v�..............................................Interior ... /I�GUfi'L ......................................................................... Heating w..... ... '4 ...................................Plumbing /7/V .,41T 7' Fireplace .....:*...761. .................................................................Approximate Cost -'FO�/Gf�G ...................................................... Definitive Plan Approved by Planning Board ________________________________19________ . Area .......................................... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH �d112 y 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 ..U '.... C \\,,;/DOIGAN, JOSEPH DR. T A=206-023 - U6, - 0-2 3 No ...3,15 .Q. Permit for ...� PUILD ............. ngle...Family,, Dwelling Location ...8.5...L.Qylg...Beach Road ................ ................................ Owner ........................ Type of Construction F r?K]ne............................. ............................................................................... Plot ............................ Lot ................................ Permit Granted January 27 , 8'8 .......................................19 Date of Inspection ....................................19 Date Completed ......................................19 r ' . ems afi Assessor s offioe=;(1st floor) , $ t 'Assess-or s map,:and lot number'. ..'�h... O'v�� �.. '� ��'�°� � ��-(�' °FTNFrO�o Board of Health'(3rd floor). '- Sewage Permit E 1,number .... - ,:..3,.sc„a' ,. .................. :r ?at? - L MIXt . , Z eAB39TODLt. Engineering. Depaent (3rd floor) // 1 -" "5V � °; d '�;2, t639 ftm - House number .... ......... .......: :.. J...1'h., . ........ 0MAI ' . APPLICATIONS PROCESSED 8:30--9:30 A.M,.,and 1:00-2:00°P.M. only` t a A p 7 ° V E TOWN , 01F BA�RNSTABLE ,zZnsZt 'e Conservation Com issi -� '•�® I � f G.4 11-SPECTOR_ - - ;':Date .: • 4 gned APPLICATION .FOR PERMIT TO .. ..:... U� ...?.r !.y,�I.� ...,�=fj/JIL4/:...lsJ TYPE OF CONSTRUCTION GiUC -t;1.. =' �I ..................... :...:... = CQ ...a....6.. 9-. .... TO THE -INSPECTOR"OF BUILDINGS: Ji ` r The undersigned ,hereby applies for, a permit according to the';following, information: N 9C QO ��uT �v�G � G'a26 3a Location` ......., ........ .. ... .:. ,....�..................... ....... . r ... �� ......... .... ... ... Proposed Use ......., /�! J ...... L.Y....f. . .. i .. .. . ........ it/T O�f` Zoning. District• . .:...� ,�� . .....Fire District ........ .,.. ,... ... ,,, a _ Name of Owner !P.... ��' ?1..A�..... ... �'7 /c//L�Q .................................... Name of BuiI erg � ...�eVal/UF'' �/7lST ...:Address ::�!U���V. ..I°a�� .. ...... .. ........ �. Name of Architect....... ............/`. ... ....:......Address ...........r...... ... ........ .... ./.... .......... ......... - Number of Rooms .... .7.�ti...... ...:..... ..........Foundation U.le4..e..�GdtlC'�.�...... y' Exlerior ... d`f! �S'�j/!�!�.1v-s.. ...... .Roofing .. 47E �S'd ...... Floors ,...Q.'C2 '.�LDG!/ .....Interior .. �./GU�L f .. ....... ............ ... r Heating ./���....BY....��� . ....::.:...Plumbing � �i7 f��Ti�_S° � ..... ...... Fireplace ...... �r�U.: . . . ..... ......... ........ ............ ............ Approximate Cost ���/ .�........:.......... .................. Definitive Plan Approved by Planning Board -- - ------- -f 9------- • Area / ..;.: .f. k Diagram of'Lot and Building`with Dimensions R Fee .... . 5l��J.!.. SUBJECT TO APPROVAL OF`BOARD OF HEALTH /2" . q e 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`.2G �% .......... ' 2� ��— Construction Supervisor's, License ..�©. +--` DOIGAN, JOSEP-- DR. ' No 3157fJ.:.. Permit for ." Rebuild....... .y Si 'g.le FamilX Dw� ,11i ......... Y location .......85..-Long.. Beach `Road Centerville Owner .......JO .... DQTgari ........ n F r•"ame + Type of.,Construction ...... .................................... of ..... .... ..........................................` _ , ......................... Plot . ..' ... Lot .............................. Permit Granted ....January.. 27.,..19 88 Date of Inspection ......... ......... y,.........1941 rr�". r r. • ' Date Completed . f.......1.'�1U pp\ l' ,.•a-�;.,ri�-��ej::���7"r;.'K :'�,�,.� �t-p�, -,.,..••�,,.,�,,.j.... �,�'� �i(tr.;:d-;�`+►`++W,.��Ars.—�,.n.�.s,..._. ,. ,-,.,en:K.^saaF.,iss., •�� .a .. _..�. .y. ,;. i 4 of*MEro a TOWN OF BARNSTABLE Permit No. !KQ........ BUILDING DEPARTMENT ( 00) lf�2l'�5g TOWN OFFICE BUILDING,639 Cash � rwa HYANNIS,MASS.02601 Bond ................ CERTIFICATE OF USE AND OCCUPANCY Issued to Dr. Joseph Doigan Address , 85 Long Beach Road Centerville, Mass, 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 WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. f ,r November 10 88 � r- ....... !.. 19.... ........... .1/............. Building Inspector Inc. P.O. Box 332 • West Dennis, MA 02670 • (617) 394-0599 24 HOUR PROTECTION David ' s P .O . .Box 426 — Centerville , MA 02632 David , We have completed the security and fire alarm system at the Dorgan residence , 85 Long Beach Road , Centerville . The fire alarm system consisting of 4 combination photoelectric smoke detectors and fixed temperature ( 135 degree ) heat detectors and 3 fire horns . This system is ' a low voltage supervised system connected to central station for dispatch and meets the requirements of the building code . This letter is to certify that the system is in operation and has been 4 completely tested . Sincerely , Robert K . Boucher kdb/RKB a Assessor's offioe (1st floor): o� Assessor's map and lot number aG t' E ^ �( WQ of TH ro 0 Board of Health (3rd floor): r- d Se-wage/'Permit number 7..................................... t Baaa9TODLE, .................. En t e ring Department (3rd floor): �/ °o NABIL House number ...........................�!1........ )?�... 9 ... 0 NO h• APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN OF BARNSTABLE X6��,B.UILDING IH P �5SECTOR 1 APPLICATION FOR PERMIT TO ..x !'����-'`'�'. � ...,. ��✓��� U� �. �'P....4... ............................... TYPEOF CONSTRUCTION ...................................................................................................................:................. p ......00?.."---`�6 .....................19-- 7 I y TO THE INSPECTOR OF BUILDINGS: The undersigned hereby/ applies for a permit according/tto the following information: Location K......ft(1.�J9. ��!�}� /... 4r ' ......0 /i'1.1>" Z(//tl ........... ........ ....................................................................................... ProposedUse .................................................................................................... ........................................................................ Zoning District .....�%. .!P' .. .: ......Fire District .... .E'vT oS7`: ........................................ ;coo K6�N:. ... .........:........ ............... Name of Owner' ��SD 9.� tS�c"�v�l� '��.........� ...y...............Address .............. ............,*...................................... ...`............................ /J Name of Builder ,/,.!r�.1/ .� cI�LP�!�g' T�CJST.. Address c l 'J7Z���Ji (p, �..74- /............... ... j. .................. ............ ....................... Nameof Architect .........:........................................................Address .................................................................................... Number of Rooms .................................................................;Foundation .............................................................................. Exlerior ....................................................................................Roofing .................................................................................... Floors ......................................................................................Interior .................................................................................... Heating Plumbing' Fireplace ..................................................................................Approximate Cost ........................................ Definitive Plan Approved by Planning Board _______________________________19________ . Area .........l.......>........................... Diagram of Lot and Building with Dimensions Fee ` " v ��� . .............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH t - 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. r Name� - Q�.�� �� 4 Construction Supervisor's License ..OlS��� `�! ..................... DORGAN, JOSEPH DR. A=206-0-23 No Al..3.31... Permit for Demolish Fire Damaged .. . . ..... Si � 1 F ily -Dwel ........ ....... ...... ......U.ng..... ..... I--�7U L� P Road Location ch Road ................................14....... 4 ;.S� ��� ;f� C enteMlle ............................................................................... Owner Dr. Joseph Dorgan. .. .............. Type of Construction Frame .......................................... ............................................................................... Plot ............................ Lot ........ Permit Granted .......October 26.,....19 87 .................... .. Date of Inspection ....................................19 Date Completed ......................................19 ffioe (1st floor): > 'map--and lot number � ..�":..:�. J. 18)y rr� 7 .'p 1 P r��`� Q�uf aTod` alth '(3rd floor): ermit number ........0. .. -3' S l � ��'� � �,'. r, Z DAMS ABLE. . JEring Department (3rd floor): / ,n � ' ��TITLE S �o16 e� J �l House number ........ ..................................................... .:.... I f;� `� ` " s `+ - 0 9' , � 0 YPY d' APPLICATIONS PROCESSED .8:30 7 9:30 A.M. 'and' 1:00-2:00^-P.M only a���` ' - •{ A P F R 0 V ED 1 sa stab be Con ervatio CT SIWN O F B A R N S T A B L E �e , ds6 �" LDING ' INSPECTOR , r 4' • /rJOG/S IyJ®�/� U i APPLICATION FOR 'PERMIT TO ..�'J ............. ......!eP................... f1.................. ....................��P........... TYPE OF CONSTRUCTION .. ..... .... ... .'......................................... ................ - a S o� 6 � 9 7 TO THE INSPECTOR` OF, BUILDINGS: The, undersigned hereby applies for a permit according to the following information: .n Location �O....... . .....................::......4, .................................. .................................................. Proposed Use ..:.............. ................................................................................... .......................................................................... Zoning District ..... �. .!e.:........:......... . ... .. Fire District ... En/T ®S7`:........................................ Name of Owner .....:.. Address ��... ..:.. r .... ... ........... .... .. Name of Builder Tr�l..,•..Address ..4�.'U m.4 Name of Architect ......`........................................:..:::..............Address Number of Rooms.•.....................................................................Foundation Exterior ...:.................................Roofing ' Floors ......................................................................................Interior :............:.............................................................. r Heating Plumbing Fireplace ............. .....................................................................Approximate Cost ............................................. Definitive Plan Approved by Planning Board ________________________________19__-_____ » Area ............. Diagram of Lot and Building with Dimensions L • . . Fee .................. ..................... SUBJECT TO APPROVAL OF BOARD OF HEALTH ' • a i 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. R w. * Nam �L� `�... ................. Construction_Supervisor's License ............... ' DORGAN, -JOSEPH DR. Dmolish Fire Damaged . h Per'mit far .... .a............................. Ingle Fahil �awelling .... .... _ y ...... ..I ............... ........ Location _............. '`85 Long?Bea )'.oad - Centervi•11ie ...... ................ . ...7...... .1. .. .. ................ Owner.....�0 ...........J eG h Dorgan.. ... . ... 'Y • '. I' ',, Type of-Construction :..... Fframe f ......*.......:............. _ [. ..~........ . ................. �. ................`..... f •' • - ' ... - - — + _— e Plot ... a`..................... Lot .............................. I e • .��fr Y .. October 26 87 s Permit Granted ...... ..'.. 19 Date of Inspections....... .4 ......... ...19 �a Date Completed j..... .... <..... ......19 a w ' car � ... 'r• - r ... _�._ .� �. �,..�.... ,� ^���_..� �oM�u N ,-r( 1�a.�E�fV o, 2.�o00� p►�'a G 1 La Ata- I � 3K 1ST ? S5 .. .vtAS P. f t d r MIL t � �I r� t�eo�����c•G , I PETER =r' i Q SULLlVAN No. 297 'O 1 r t r\� �tQoPt - k FSS'ONAI E�`O L Id d' }, .J Ul V � i Av r, 1-7, 1 c•g- 1� l�ice! 1 U G..`��_.,"'�' �® U �� • , • i Y ; �• p L "VA4 EA"r✓rU C . w `44 0.0 �.9 rj I--Dr- - FJ 6�5 2cd.r r . . N Revisions: DATE DESCRIPTION 14 c NOTES I ) ELEVATIONS BASED ON N.G.V.D. cEx,�✓,,.,.� �-�.veao� 2) PROPERTY LINES SHOWN HEREON WERE COMPILED FROM A PLAN RECORDED AT THE BARNSTABLE REGISTRY OF DEEDS IN PLAN BOOK 43 PAGE 73 References: AND DO NOT REPRESENT AN ACTUAL SURVEY ON THE GROUND PLAN OF LONG BEACH ROAD j BY NELSON BEARSE JAN 30 1931 000` FLOAT Project Title: PIER F�Oq T WOOD BULKHEAD WETLANDS Q 2 STORY POST AND O 2 5 . 0 1�-\ WOOD FR. RAIL FENCE PERMIT \\ I WOOD _ - -, �ujZ PLAN EXIS- ING \ DECK -- 5 5 - 8 _ 5 3 E--- 7T ' W = WOOD PIER `, ��• EDGE OF— -�NIO LAWN Qb -3 5 64 aW 5Vy ace4 08_ TR _ m o N10 U o aD FLOAT I VEHICLE 4— fi c W (� 8 _ 1. 6 CID - 5 6 2" STEEL 3. 8 '( � l� /' / PIPES RAMP Io REMAINS OF STOKE \ O _ Z 1 BULKHEAD p / I / CID 1 T--- LIMITS of MARSH GRASS REMAINS OF CONCk PREPARED E TE AND E RED FOR II' /�—STONE RETAftNC HALL ROBERT B. KINLIN O I � J1 ------- _ _ J � I 4 2 W 3 F- Z /C110 4� Lu --- A.M. Wilson Associates - - WOOD WALKWAY Inc. LEGEND - --- FLOAT --� EXISTING ELEVATIONS 5.0 RAMP 911 Main Street _STONE AND MORTAR Osterville/MA 02655 EXISTING CONTOURS — — BULKHEAD 617-428-1450 EDGE OF MARSH GRASS — - - Drawing Title.- SITE PLAN AS-BUILT Nei c M G�,e!G 1 J 1 l•-�1 O d' Scale' ? — 20 i 0 10 2O 40 FEET �I Date: 7- 19-88 — — Dwg No: CID ID Design: Check_-- -- ---- Drawn: j. V B. _ '_�, ni 2 - 0299 Sheet I of 7F I-CCr6-� L 0 2A q AL%,. #J I 4 �-c 1(0-6z TL K KI K. S67 Tc!n- 3 \0' 7,T, Gr e,o -rc) GV-- �_.Okt r PETER I Q �UIVVPN it i. No. 2973--, 'OA 1 =;�+d.��� \� ! �iuoPcz VIA, 'ON A L tV" 14 - �IV , C IJ tj q *7 -5 74Z- Y- e7 E313-:s vr-Q- co O-x cl QI L� r.E, -1sk I u VI �Aho :s