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HomeMy WebLinkAbout0052 MERIDETH WAY � . N , . � � � � � 3 ;.- - �. - _ � r ,;,'�,. �, d �. •. - .� B ., 1. ., e � e .d o � _ Town of Barnstable Building �, .,� ». '�' .,,. �u;: ,,' Iz . fw .; . Post.Thi's Cartl So Thats�t is Uis�ble From'the Street A roved Plans Must be Retained,ag"ob"'an th�is�CBi^d:-Must<,be Ke t SA1TMWABLE. • ,,. :�,'i X %r., ,r' } ..t, "�'5 .�:.. a p#p .� �tAss iPosted Until Final Inspection Has Been Matle g X 4 , iQg4 .. , '� ° Where'a Certificate�of Occu anc„ is Re wired such 8uildin shall$Not be Oc u ied until a Final'Ins ect�on has.,been made Permit , ,�:,�_..,�,..o'uc,M.. _,w.,:; ..a.� : _.�;c;::i5..+" wp z •F,'�,:., sw, w.,..zf Y,4.:__. zw,:aar.., „�. .;"..,mow^...,,.. 5N'fi' Permit NO. B-18-1975 Applicant Name: WINDOW WORLD OF BOSTON, LLC. Approvals Date Issued: 06/22/2018 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 12/22/2018 Foundation:- Location: 52 MERIDETH WAY,CENTERVILLE Map/Lot: 148-152 Zoning District: RC Sheathing: Owner on Record: CONDON,DAVID T Contractor Name Jeff C Steele Framing: 1 Contractor License CS 072772 2 Address: 52 MERIDETH WAY , . CENTERVILLE MA 02632 Protect Cost: $4,543.00 Chimney: Description: Windows 11 PermitkFee: $35.00 Insulation: Fees Paid " $35.00 Project Review Req: s D 6/22/2018 Final m. �...` Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized bytfiis permit is commenced within six+monthsiafter issuance. Rough Gas: All work authorized by this permit shall conform to the approved appl cationand the approved construction documents.orrwhich this permit has been granted. All construction,alterations and changes of use of any building and structu esshall�be in compliance with the local zoning by laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road a d shall be maintained open for public inspection for the entire duration of the work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building antl Fire Officials are providedon this permit. Service: Minimum of Five Call Inspections Required for All Construction Work 1.Foundation or Footing ,�., Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT I t f t � Application numb .. ....... ...�.... ....... ... �. Date Issued..............`..........,t�............................ rAMSTABM 9 z `0�' JUN 2 02018 Building Inspectors Initials... .... .......................... � FD MA'S a T�1!"�/�.� (�1-�� �,.. [[�� I /'��l /S� HNS BLE Map/Parcel................................................................. TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: 5 Z r l fe,i Jet NUMBER STAEET VILLAGE Owner's Name:Da yr d rn d o✓� Phone Number Email Address: F Cell Phone Number Project cost$T 5 N 3 Check one Residential ✓ Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with780 CMR Owner Signature: — SeP L a(-(a4,e� Ca�vy-��t— Date: TYPE OF WORK 0 Siding E I Windows (no header change)# l L© Insulation/Weatherization Doors (no header change)# Commercial Doors require an inspector's review 0 Roof(not applying more than 1 layer of shingles) Construction Debris will be going to A)a 4e - - G✓� 5 .-� /`�, CONTRACTOR'S INFORMATION Contractor's name ' S'hee�e — �1� � Wor (r� �oStvn Home Improvement Contractors Registration(if applicable)# J k_6_P,2 S (attach copy) Construction Supervisor's License# OZ 7 7 7 2— (attach copy) Email of Contractor Phone number 7?1 — 7;3 Z- q?O ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER *For Tents Only* Date Tent(s)will be erected Removed on number of tents total please attach floor Does the tent have sides?Yes No (If yes plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Check one:this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent df food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4.30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles:front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date LICANT'S SIGNATURE Signature _ Date All perms a 'ons are subject to a building official's approval prior to issuance. %%gndOW WOKld of-Boston ,. MA HIC Regtatratlon .•„ ; Number. 4ttit es Showrooms 166096 q 15A Cummings Baa rk O 295 OId Oak Street FedertillD# 11J781) 2- 805 Pembroke,MA62369 81 (7B1}932-4805 (781)$26-6281 89=9898432 www.WindowWorld(3fBoston.com Customer. 1 17,b ��eAl Phone(h),�i��j0 //$9 trists9 Address;5Z-I Z?9.t& A Phone(w) City: 4Qgt Fib/'& _ Cats MA ZI_aZ6JZ Email WINDO WORLD GLASS OPTIONS 1000 Series Singte•hung All-Weld $199 SolarZone ECde-Dual Pane $119 a✓_ T 20DO Series OH Mach/Welded Sash $215 _Triple Pane•/Krypton $369 -O 4Qm Series OH All Weld $2401m� ("Series 6000Onry) �.-..6000Series:0HAII-Weld $260• V#N0ow OPT16N5 2FtteS{ides $374 Glass Breakage Wamdnty(4000/6000).:$f5:iNC-w0El7;, 3 Lite Slider tiro mim iw,mim $575 1/2 Screens $9INCLUDED @Icdyte/;Ftited:Lils.(093,UE) $368 I�FcturetFWtS�tiw(84130UI) $445 oam 1 CLUDFA,:. Insulation an.Jambs and Head $11 �LDouble Streng"Oletss(4000/6oM $15 INCLUDED $330 Dou _ ble Locks-(>'26') SSINCLUDED 2 Lite,Casement $595 ^Full Screens $25 3 Lile C ern6[n ms.,r�,rral nH:+a+e $910 Colonial Glide(Contoured/Fiat) $65 �BassmenfHopper $484 ^_Prairie Grids... $75. SlyWind0W-SolfitMount-/.INSSeal,12660 SirrxilatedDlNde :lite $182 B6W Window-Soffit Mount/INS Seet$27.85' �TemperadbtfSti r(BSO);(TSO) .;...,;.•S75•.'.�T. �GaideniMintFow $? Obscura tass(Bs%usO} :575- Bay,Bow,Garden Oversize(+1(9 UI)$975' Oriel Style(40j.0 or 60140)` it 5 '''•.. _Beige/Almond $40 Foam-En :$35:•:,:.....:.. Wood Grain interior(Sodas 4000/e000 any)$1DD (LightOaklDarkOak/Cherryl Fox Wood PREt071aUIIT0OM913(EPA LE40SAFE'Rl MOV,00u) RiehAwo). _.Lead So%Practieas.Requlred $30 Brown Exterior(Arch.Bronze)American Terra)$100 MY HOME WAS BUILT 1N THE YEARI iflig " `F �Designer Color Extericr $175 MISCELLANEOUS' _Speciality wind o $ Custom Extoller Alum1hum Cladding Window Color l7� 1� r 0Tbxtured$90 QG-6 Smooth$90 $ 1490-5.:,..::. .. . ... .:Ouhrdd Facing Color . M, CfJ Nl k?QtSRS' . _Metal Windpw.Reirroval $75 Vgyl•fcl11n9;Po;UQBr.Sh.ar6YF:; 3t096 New ConsWelCon'lflnyiRemWe1' $t75 �ViiyrltNingFe2loAoar:6ic S1196 _SPsciairywlnQawEicterioFTririf, $ _,AwWtatigprk'eUUCustomRolMg'PatbOoor§1260 _MulitoFdrm.MuilfUnit $30 _tnstall IntarloNExtericr Stops $50 rtorc)td>�sGpfnrxke}i4QoarsJt.arsit- .Zrass +IrlsrafllnterJo►Eashig SrartsAt•$95 . aagSndm)7i6olfoorBN. §toss 5 _ �.:. 't3aiil;Srd�hg R9Ko 400r9ft. §959 10stdate Weight Boxes $20•7 i R(kmjlFi[Cladding $2co Root for Bay)BowWindows $50 Sa)eitp l Iita ar:l fC 4leas• $305_ Existing New Const EA.RM flit _;_ Grtfiipt7obr 5210 $2T ^Removal trt ExistingExistingBsy/Baer 0 ' 'z � 1� RrtelEtsrs; 37g5 !Repair SIR,Jamti or tepleaa s(Il rtaeulg $75. ::rc..,:� xterlOr;4et'nbr4clew $595 FuI15ubSill'(Sln'gte)'replacernent ' .".,..,p4ilt�rgr'iL' fig"2+a3� 5275 x •, _MuttiOn Remove{ �_W�ni}teserOpilorre § Say/Bow Conversion Ext.Reim Fit $450 $ (New Siding Wig Not Match) Door Color / : , r�sred di671de � VC y�'-Y k {�'�„ � ••�e� Ct)st �declf6e&e t d+tnedye y 4t► a' aFld(vFr away EaUedtUel y� ------ ...qr1 ".rsr rs�,.•� p] (( ;eoitamRlsra aS(6(start!pl0$ov7nginraiVei�6anwlfiiG}s'wrA...... imnQ sttw'nq,'A*higlt ergdad➢(i$citreconnect'BntdiigPBmbltees n mrsaes of 525,00,komeoamerandatCondoAs'sociesotrAppmvaliH'stodc Wstdst ApprayaL City d 9ostdnparidAg'&ttdatiapiFaiind.Res incaorccaon w{9tirWaAarlon. NO EXTRA WORK 1F NOT IN WRITINGI ustomer agrees tot a terms et payment as tCl Dews: Extra Labor&Mateiteds $` ' She setup,Permit,Disposal 8,Delivery Fees Tbtai Amount'•$ 44 Cuslom Order Depos950% $ Ck# . GitldrrcbFaCdtdR+s(alCerGpon°Cbriipla8'crt�$'�2 •�i� "• . 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Board of Building Regulations and Standards Co nstructton'Supervisor CS-072772 E*pires: M0712020 1, F JEFF C STEELE 24 SHERWOOD.AVE 1z DANVERS MA 01923 Commissioner C14 �l� �l.NFl11/nYtfle[�f/fr it^�lul;�ec�au=/Jrt Office of ConsumerAffalrs.&Business Regulation f OME'.IMPROVEAi ENT CONTRACTOR TYPE•'LLC Reglsfrafion' ExWratlon 1.t k 04/11/2020 WINDOW WORL'f)OF BOSTON,LLC. JEFF C.STEELEj. �.G 15A CUMMINGS PARK WOBURN,MA 01801 Undersecretary The Commonwealth ofltMassachusetis Department of Industrial Accidents 1 Congress Street,Suite 100 t Boston, MA 02114-2017 ,. www mass.gov/dia y1'orkers' Compensation Insurance Affidavit:Builders,Contractors/ElectrieiansTlumbers. TO BE FILED WITH THE PERMITUNG AUTHORITY. licant A Information - Please Print Leg►bly Name (Business/Organization/Individual): Address: /5-A C ten, rt s r- IC - City/State/Zip: n oleo I Phone#: -y$ 1 —q 3 7 _ Ug Q S— Are you an employer?Check the appropriate box: Type of project(required): 1.f I am a employer with� 0 mployees(fiill and/or part-time).' �7. New construction am a sole proprietor or par tnersp and have no employees working for me in ❑I lhi 8. �Remodeling 2. any capacity.[No workers'comp.insurance required-] I Q. ❑Demolition IF-] m I a a homeowner doing all work myself[No workers'comp.insurance required.l' I 10 Building addition 4.❑1 am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.D Plumbing repairs or additions 5.Q I am a general contractor and I have hired the sub-contractors listed on the attached sheet. Ii These sub-contractors have employees and have workers'comp.insurance.t 1'•❑]Roof repairs ! 5.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 1 14. then_w 1/r `1 152,§1(4),and we have no employees. [No workers'comp.insurance required] i �, i.ee I G{Ce, �erl�5 1. 'Any applicant that checks box*I 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'camp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. I Insurance Company Name: 14 a!'fi—Co,rg FA re Tn s J RAt1 C-. CQ . Policy#or Self-ins.Lic.#: Z Z VVC, C L-1 1 Expiration Date: 1— y 7— 13 Job Site Address: �7 oZ Me icle-f t, City/State/Zip: _/ 4' MA Attach a copy of the workers' compensation policy declaration page(showing the policy number and expi ation date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator:A copy of this s tement may be forwarded to the Office of Investigations of the DIA for insurance coverage verifi lion. I do hereby cer under a pai 4erjury that the information provided above is true and correct 5i store: Date: 6 " Z0'/� Phone#: — -3 2-- �Jr a use only. Do not write in this area, to be completed by city or town ofJciai 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#: - A�Rp CERT[F�CATE OE LIABILITY INSURANCE pATEg�voarYYYYd THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPOAI THE CERTIF1CATi;'NOL�D`12018 THIS CERTIFICATE DOES NOT AFFtRIUlATIVELY OR NEGATIVELY AMEND, EXTEND OR AI-TER THE COVERAGE AFFORDED I3Y THE POLICIES ROD BELOW. THIS CE121't> ROD-OEF INSURANCE DOI NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUI ldOR2dafl REPRESENTATIVE OR pUC13i,AND THE CERTIFICATE firyCgTE IIOLQER, ( IMPORTANT. "the cer-, Cate holder is an ADDMONAL INSURER,the poacyries)must have ADDITIONAL INSURED prorisiol or be endorsed, 1 !f SUBROGATION 1S WAIVED, jig,eel tO the terms and COIRIMMS-of policy,certain paTicies may require ass epdnrsetnenL }I statement an the certificate,does not confer:tights to the eeMjcate holder in lieu of scjCEt endoYsernentts). PRODUCER . C.O A Marsh&MCLe'nnan A ehey LLC .Twee CT Call Vlbteher,CIC,CfSR.CBIA 3525 ME"St. PHONE 336-544.6850 Greensboro NG 27465 MAIL �no 212.607-6516 A13 Ess.. Carf.M.r,:c t- marshmrmd.Com INSURERS)AFFORDING F.RAC-E lypro )NsuRm 1.:IraDD z sNSUMA:Alimerica Financial Benefit 34534 A incdow World Of Boston,LLC ramm a H:Hartford Fire Lnsumae C a 19682 Nor Shaver S6�ei Wswtm c:llassae.huse8s Insllrarrca Corn 22306 North b�fdkesboro NC 26659 INSURER D: POSURERE- i COVERAGES HIS CEP IN�R F: CERTIFICnz ATE NUr 3ER 9fl4641572 FtE1/I5dOId IdUII®EP T (S TO .7IFY THAT TH1 PDLtC1ES OF)JdStlRANCE`LISTED-BELOW}LAVE BEEP:ISSUEp TO THE INSURED NAMED ABOVE FOR THE POLICY PER:OA diVDICATED_ NtTirRG9HSTANDI.NG V,1Y P.EQUIP.E1f16PiT,TERM OR CONDITION OF ANY COAdTRACT OkOTHEP,„DOCUMENT BOVWTj RESPECT PO VIHI.^.H MOD CERTIFICATE MAY BE ISSUED OR Iy1AY PERTAIN,THE INSURANCE AFFOP.DED BY THE POLICIES DESCRIBED HMT EDI IS S176Ii=CT 70 ALL THE i gim priS D:CLUSIOAIS AND COAIDITIOMS OF SUCH?OLiCIE3.LIMITS SHOWN MAY HAVE BEEN P,EDUCI[z lay PA4b CLPL+AS. rlesR+ L7R TYPF QFL'JSUgANCE ADDi_SIIBR POLICY BR/61BEr' POLICYSP POUCYEX? C I A UU=ERCTALGEMRALL5A81LPT �! O17� i PdlDD.NY tdd7F3D. LIMITS 0 W7I7Jfe f 9PIr201- EACl10CCIk?RENCE CLAIM&bt4][ I A I OCCUR o'I.M0.000 . I � � DA�a O RENTED --- ; MED F.{P(Arry Wkl Amon) S k= i I �PERSOKAL8)1DV INJIP.Y S'.M=i G�TL AGGP.CGATE LAG)T APPLIES PER: I 3 POLCY LOC i G'cN_t32ALAGGTL-GATE _ 52000.Q^_C i OTHER ( ) i [PRODUCTS-COPBP'0°AUG;;2ppp.Wp A AUTOMIOINLE UAB)LrrY . . 1 i s f t AbU667b7GfS 611 2W en=a NJMUTIEO SINGLE UIER $d ANYAL'TO f(` CO.1 l�+�n! 1 OWNED S^HEDULED I i i BODILY INJUPY(PerFerep; _ I AUTOS ONLY ' I— ' . P EO EOD:LYNJURY;Per cdeenl) tiU OS 5 ONLY AUTOS ON=�' I .nRG'P--ARTY DAMAGE I i ! Pe d y C ^?C�UMBRELLA UAB` x $ OCCUR ; O�°W�> 4MP2077 4YI12096 EXCESSUAB CLAIAd"ADE 1 EACHOCCURRE�tCE SZd00,LOD AGGREGATE gZpppp�p 9 icoMPr�NSAnorJ ! i cCtS289'o $ANDEK1PLOYERs-UABIUTY YtN 3127T20fb 1/Z7lt�l9 ER ANYPPOPRIETOMPARTNERZIMLFT1E OFACEP. EREXCLUOEB? Dl l A ' I ELEACHAWDENr Ss14 (Nlaedbiory Yy in in NH) i ; ;LfESCR7ribNudar 0 Ei C5EASEOFOPERAT1DN53eIa I -EAEPLOYE S5O01) j EL MFASE-POLICY LJw S SM00 i 1 ) DESOMMONOF OPERATIONS rLOCNnON,SIVEIiM iSIACORD7Vl_AddA1oMIReaparksscftsWre,!=NDeaHachaaifmoresPaceisrequ" CERTIFICATE HOLD.ER CANCELLAMON S40ULD ANY OF THEABOVE•DESCRMED pOLICMS BE CANCELLED BEFM THE tVM nON DATE Tf�F, NOTICE WILL BE VELIUEP.ED IN ACCORDANCE WTH THE POLICY PftoWSIONS. ORRMMREPSESENTA71I { ©ISM2016 ACORD CORPORATIOR. All rights reser-red. ACORD 26 po96/03) The ACORD name and logo are registered marks of ACORD i uwia ul Dariastavie :-`{,' Building Department Services FSHe r° Brian Florence,CBO o* Building Commissioner RAMS aar.E. 200 Main Street,Hyannis,MA 02601 Mass. 7 i639• ��� www.town.barnstable.ma.us Office: 508-8624038 Fax: 508-790-6230 Approved: Fee: Permit#: HOME OCCUPATION REGISTRATION Date: Name: V (Jon d r) Phone Address: J h e' r l ' v v' Village: c— V I ( I e Name of Business: rQ Q Type of Business: l; — On I I �1 e— Map/Lot: INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,'subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the.dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • -The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • ' Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residentiat buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter,odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. There are no commercial vehicles related to the Customary Home Occupation, other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing-the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included • No person shall bg employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersimed,have read and agre yvith the ab ve restrictions for my home occupation I am registering. I Applicant: a �-Lu Date: �J? h Homeoc.doc Rev.06&0116 YOU WISH TO OPEN A BUSINESS? For Your Information: Business certifloates (cost$40,00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (\A1111011 you must do by M.G.L.-it dons not give you permission to o—p—or—ate.)�You niust first obtain the nocessary.51BIVItUres on this form at 200 Ma-1r) St., Hyannis. Take the completed form to the Town Clerk's Office, Ist Fl., 367 Main St, Hyannis, MA 02601 (Town Hitil) and got thtj Business Cortificate that Is required by law. DATE: Fill in pleaw............. S: 61 CQ roncl6n APPLICANT'S YOUR NAM�/ BUS IN FS I YOUR HOME AD[JHr--b5-, pri U_LLk 7 /iJ,9 LI TELEPHONE # Horne Telephone Number NAM E P CORPORATION NAMEIOFNEW W ISI ESS IS THIS 777777977777. C AT HOME C U OCR bdRkdb OF IS 01 Q ssih N -617."..,"na Lid When otarting a new buBiness there are several thing®you must do in ardor to be in compliance with the rules and r@gulatlons of the Tawn of Barnstrible. This form IN intended to a@gilBt you in obtaining the information you may nood, You MUST CID TO 200 Moin St. - (corn or of Yarmouth Rd. &Main Street) to make sure you have the appropplate permits and licenses required to legally @parate your business in this town. 1. BUILDING COMMISSIONER"IFFICE UST COMPLY WITH HOME OCCUPATION This individual has been i or f any pp ° quirements that pertain to thl@ type of busindjWLES AND REGULATIONS, FAILURE TO QOMPLY MAY RESULT IN FINES. Auth %SignotU 9 MENTS: �-gg 2. BOARD OF HEALTIq This individual has been informod of the permit requirements that pertain to thin type of busirim, Authorized Signature* COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requiremente that pertain to thlo type of busln@oo. Authorized Signature* COMMENTS: TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 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 Village G"e4Ze4efZ:,L�� Owner&V_Z e) Address Telephone �S 22 X,3' Permit Request L 54' jzf�Jj� 1,9 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay .Project Valuation _ �� d., e onstruction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes X-No On Old King's Highway: ❑Yes ONo Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other c� N Basement Finished Area (sq.ft.) Basement Unfinished Area (sqft) Number of Baths: Full: existing new Half: existing new CID ' Number of Bedrooms: existing _new m Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other - 4y 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 - - -r --Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name//4,Ae eo fi» �ii �,���� ' Telephone Number Address , �G�l'j�i � �i/G License # 1,14 U Home Improvement Contractor# Email j Worker's Compensation #44- ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE // FOR OFFICIAL USE ONLY R APPLICATION# DATE-ISSUED MAP-/PARCEL NO. ADDRESS VILLAGE t OWNER ' r DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE r. ELECTRICAL: ROUGH FINAL t. << PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING, PATE-LOSED;OUT AS, OGIATION_PLAN NO. a i Massachusetts -Department of P�blic Safety { Board of.Buildi6g Regula#lons Ancl Standards Cunstniction Stipervisor •� ;:•: !License: CS-100988- `\`.a I i, HENRY E CASSII)'Y .. , 8 S11ED:ROW z WEST YARMOLP11-1 ,I lit -Expiration Commissioner 11/11/2015 Of lee of Consumer Affairs and Business Regulation c E= 10 Park Plaza - Suite 51.70 Boston, Massachusetts 02116 Home Improvement.Cqq r`AQtor Registration Registration:, 153567 Type: - Private Corporation " < Expiration: 12/15/2014 Tr# 233831 CAPE COD INSULATION, 'INC' w';t HENRY CASSIDY 18 REARDON CIRCLE- — --- S0. YARMOUTH, MA 02664 Update Address and return curd. Mark reason for change. Address Renewal. UCin to ment Lost Card st:.a� �i AM ow i i � - ,. _ � Q. O L� p Y [._��. ' i �`C is`�(�(F79GI/I(U(.CPE%CL(lrG ' NC CL9J 000'i'[dGJFSCt � ,. _ (Alice of Consumer Aftnirs 8 tusiness Regulatiou License or registration valid for individul use only ;� k BIOME IMPROVEMENT CONTRACTOR before the expiration,date. If found return•to: egIstration: 153567 Type: Office of Consumer Affairs and Business Regulation expiration: 12/15/2014 Private Corporation 10 Park Plaza-Suite 5170, Boston,YIV1A 02116 GAPE COD INSULATION,t,I�1Cf- HENRY CASSIDY 'Id REARDON CIRCLE � �� ;— S0. YARMDUI i-I, MA 02664 — -••_-- Undersecretairy AOrwitho t nat re t The Commonwealth of Massachusetts ` Department of IttdustrialAccidents Office of Investigations 1 Congress Street, Suite 100 r` Boston,AM 02114-2017 v wwru,mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers A> >licant l.ntormation Please Print Legibly Name (13usiiiess/OrganiZatiun/Individual): City/sLI.CC./Zip: _ Phone#: 9A " -71 r2' �21 Are ou all employer? .Check the appropriate box: !--^ Type of project(required):- 1. 1 twit a employer with 2r-2 4. ❑ 1 am a general contractor and 1 have hired the sub-contractors 6. ❑ New constructionCntployves (full'and/or part-time). , 2.❑ 1 am a sole proprietor or partner listed on the attached sheet. 7. ❑'.Remodeling> . ship and have no ernployees These sub-contractors have g• ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑.Buildin.g addition [No workers' comp. insurance comp. insurance.$ required.] 5"❑ We are a corporation and its 10.❑ Electrical repairs or additions >.❑ I am a homeowner doing all work officers have exercised their .l l.❑=Plumbing repairs or additions j myself. [No workers' comp: right of exemption per MGL -I2.[] Roof repairs insurance requited.] t c. 152, §l(4),and we have no f employees. [No workers' 13. Other vt-y 1 Its.- comp. insurance required.] P q ] •Any appliL:wa that checks box#t must also till out the section below showing their workers'compensation policy information, t i lumeuwno s who submit this affidavit indicating they are doing all"work and then hire outside contractors must submit a new affidavit indicatingsuch: J ti:onmictors that check this boa must attached an additional sheet showing'the name of the sub-contactors and state whether of not those entities have I employees. Il'the sub-contractors have employees,they must provide their workers'comp.policy number. I ant an employer that is providing workers'compensation insurance for rrry employees. Below is the policy and job site W✓C C_� �/n/U� " _ Insurance Company Narne: t�V4�(/ v�V �C/V l*-?, V0d Policy it or Self=ins. Lie. #: WC� 00g2-2 ti Expiration Date: t � . Job Site Address: ;i/ ,�liiState/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 tine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOMORK 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 D[A for insurance coverage verification. - I do Itereby cer tfy c r tfte pains and penalties of perjury that the information provided above is true and correct, Si nann'e: Date: `c j - Official use only. Do not write in this area,to be completed by cio)or town official. ,City or Town: Permit/License# Issuing Authority (circle orre): 1. Board of Health•2. Building Department 3. City/Town Clerk 4. Electrical Inspector S. Plumbing Inspector I 6.Other IContact Person:, Phone#: CAPECOD-27 KLIGETT A AEY CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 6/13/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Rogers&Gray Insurance Agency,Inc. NAME: Barbara DeLawrencePHONE FAx 434 Rte 134 AIC No E t: A/C Not: (877)816-2156 South Dennis,MA 02660 ADDRESS:bdelawrehce@rogersgiay.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Peerless Insurance Company INSURED INSURER B:COMMERCE INSURANCE COMPANY Cape Cod Insulation Inc INSURER C:Evanston Insurance'Com any 18 Reardon Circle INSURERD:ATLANTIC CHARTER INSURANCE GROUP South Yarmouth,MA 02664 INSURER E .. - INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTVVITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN_IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL BR POLICY EFF POLICY EXP LTR POLICY NUMBER MMIDD/YYYY MM/DD/YYYY LIMITS A I X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS-MADE a OCCUR CBP8263063 04/0112014 04/01I2015 DAMAGE T RENTED1OO OOO PREMISES Ea occurrence ,$ MED EXP(Any one person) $ 6,00 r ¢ z PERSONAL&ADV INJURY $ .1,000,000" GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRO- POLICY 0 JECT LOC" s ? PRODUCTS-COMP/OP AGG $ 2,000,00 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,00 Ea accident B ANY AUTO 14MMBCKVMK 04/01/2014 '04/01/2015 BODILY INJURY(Per person) $ ALL OWNED X AUTOS SCHEDULED AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS Par. er accident $' y $ X UMBRELLA LIAB X "OCCUR M EA6H.000URRENCE $ 1,000,000 C EXCESS LIAB CLAIMS-MADE XONJ453514 04/01/2014 04101/2015 AGGREGATE $ 1 DED I X I RETENTION$ 10,000 Aggregate $ 1,000,00 WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE I ER D ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N WCA00525904 06/30/2014 06/30/2015 OFFICER/MEMBER EXCLUDED? N I A E.L.EACH ACCIDENT $ 1,000,00 (Mandatory in NH) + E.L.DISEASE-EA EMPLOYEE $ 1,000,00 If as,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is-required) Wo{kers Compensation includes Officers or Proprietors. Ad itional Insured status is provided under the General Liability and,Auto Liability when,required by written contract or agreement with the Certificate Holder. r s , CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE EVIDENCE OF INSURANCE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ' �/IQIIYW A ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Y. OWNER AUTHORIZATION .FORM as Ia (Owners Name) owner of the property located at r (Property Address) c2 l le 3� (Property A ress) hereby authorize q 72P 4 - u n ctor) an authorized subcontractor for RISE Engineering,to act on my behalf to obtain a building permit and to perform work on my property. xOwnees Signature _. �•Date 7S)►S-h To op CAPE COD , } sr � r A8r, INSULATION � �S ' ��' l nod ®� IIMMM MSAYI SLAq[LSS MMM1'fpAq fu Snfe1 Q -- ^ "M kurrfMY Itlfpl NTtoH CfILINOi0apif . 1-800-696-6611 GGG `I"own of Barnstable Regulatory Services „ Building Division 200 Main St llyannis, MA 0260 t Date: .Dear Building Inspector Please accept this Affidavit as documentation that Cape Cod Insulation, Inc. perforated &. completed the insulation and weatherization work at the property listed below. Cape Cod Insulation did this in accordance to the specifications listed on the building permit application. All work has been inspected by a certified Building Performance Institute (BP1) inspector. All work preformed meets or exceeds Federal & State Requirements. 3 Property Owner Property Address Villa��e AV tj cvvl0 M Sd' MtAe4 9eewkKv�`�, Insulation Installed: Fiberglass Cellulose R-Value Restricted Unrestricted Ceilings ( ) ( ) ( ) ( ) ( ) Slopes ( ) ( ) ( ) ( ) ( ) Walls FSK a`/ ( ) ( ) ( /V ) ( ) (X) Sincerely He ty L Cas: y Jr, President ('~' e Cod 1 . ulation, Inc. /HEREBYCERTIFY TMT TH/S LOT/3NOT GOC4TER /N F`EOERAk FLOOR HAZA/ ANE -%"AS S// wN ON THE F£oERAL F4.00o /NsaRANCE RA re 4(4P FOR THE TOWN OF N M. VN/Ty PANE4 �� ' NO. / EiFECT/YE ACT C 4or °6� BERT E. MOND, R..t..S� ,OA E NOTE: NORTH ARROW NOT TO BE y a •l/SEP FOR SO44R PVRPGESES. O k k ,! coe /V 60° 4D9- 46E ti m J00.00 Z L0T 15' NI962 kQ O 25.00 ` 601301 7 i . AX c�► WOW PW4C4L/NG �; C a �o N �¢.o' ca co' c� ti 23.6a 22.60� CSn 4 i - 2.00 � � � Ca - Oy /00 a.00 S 60 49- �6" W , C4 7 IS P4 07-PGAAI-wA s NOT �fAPE FROM OU ATI : LOV f�[V �L AN /Ns remmENT.SVRVEY.UVo /S FOR THE L o r. IS - / Y l AR 10/V 4/SE OF THE BANK aV4 Y. VNOER NO C/RCVMSTANCES ARE OFFSETS TO BE CEN TER v14 L ' VSElP FOR FENCES,. W.41.4S, HEPGeS, ETC.. s MWEO BY� of .4*?*fO)Y ENG/IVEER/NG /NC. 4� ROBERTi yGN dO EAST F,4L-4f0 NTH RIGYWAY . E. . E.4ST FA LMOUM. A1640 02536 RAYMOND ti No.21583 O sCA�r�' �.4TE' SNEfT% ,u: ' OR-IWN 46 y CHEC40r4'OR- PPPR BY' PLAN Na J D A A/ I TOWN OF BARNSTABLE Permit No. - { Building Inspector � rua OCCUPANCY PERMIT Bond Issued to V'(- Address Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date Board of Health Inspection date 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. ................ . 19............ .................................................................................................................. Building Inspector Assessor's map and lot'number .... ........... © 8C, �oFTHEtoy rr (z a Sewage Permit number .......35......a. ............... ...... r � � ff 5 � d�Q ~� _ �a,`:P-riC SYSTEM, _., . e.n.,ter: Ouse number .......... . . ..... z1........................ .................. 90 MAO& TOWN OF "BARN,S ARL�E{ BUILDING . INSPECTOR APPLICATION FOR PERMIT TO ........ �at�e�.... ....................................................................................... TYPE OF CONSTRUCTION ........�.1., OO&....� ............... .................................................................... A ( ....J g TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....... T5� .........m2r(`e i-�N �oy 0e ew u 'Ile a .............'.. ........................................................................ ProposedUse ...... ...... ........................................................................................................ Zoning District .......I 4. ��^�`r v� ,`,� Strv���� .. ...... ......:............................................Fire District .........................�..... .Q�..................................... Name ofof Owner Twvx^f:��l.... ..........Address .....3 .............!,. 1 ................. Name of Builder .. .. I �^. ..:�t:`RS.�+^ .........................Address ..0b. ...... . ��PC'..� � 1'<V''-� .......... I Name of Architect ... .Y�!�r`' �?. �O ?1...............Address �� S e;r�e� irr` ( ua ® �trv„„��� ..... Number of Rooms .......... ....................................................Foundation .....` ....... Exterior ....... .)n-���-..(..C� .� ............................Roofing ..... J.? t��T....��^.1 , �. .. .............................. f , Floors 1 �?. ' ........................................Interior ....... .............7'e�....>/.. ................ ........... .... ...Care..... .. ... ``- ��-..�::�t.'+�:?.ct��,,,, Heating .....QAA....:...1..:A_..V)...........................................Plumbing .....L� S? .'(?4r..' vC...r.. Fireplace .....Vr3: -:� .... 7 ..Approximate. Cost . Definitive Plan Approved by Planning Board ________________________________19________. Area ..../V ...s'_........ .. . .............. Diagram of Lot and Building with Dimensions Fee 7. ""�"" SUBJECT TO APPROVAL OF BOARD OF HEALTH � 14 16 q, Grk ' 1 Ov 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. 1°p Name '.../.. .. ..................... Construction Supervisor's License �19�f d FOURNAM- REALTY TRUST j No One S ......... Permit for ...............t917.. ............ fI Single Fandly..�q4.,pg . .................................. . .......... Location ... .... 5.. .2...Me.redi��.x4y....... . . .... ........ Centerville ............................................................................... Owner ...... ................ Type of Construction ......F:raWP.......................... ............................................................................... Plot .............................. Lot ................................... 0 Permit`Granted ......Jan 210 ........ 19 85 .......................... . Dat6-of Inspection :'..........?!I..................... V D6W Completed r: � `: 3 .....10