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0057 MIZZENTOP LANE
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Y r R _ .- 3. - _ .. r .. o ,. ,. ry a h •• ~ .. .. - ,, ,. . �, 2 . _ _ `. ... ,. ._ e s� �.• , G. ,. ,. .w ,; .� �� _ - .� , n � ., r .. a , _ � _ .. .. n � � - � E -. .. -. :, ..e... ti ,� a .y, . . .: �. r. � 3.. ... ., .� .. E ., .>,. f ?, .. � .r 1 ., M. ,., ,. _ .. ;v. ��. ,. - ,,., _ .. ,z _ .. _ T , r ., . r. ;, a' ,. � . � � - _ . .�, - �. _ e. a . e � ��. r .- � .. '- a t � _ - - - ,. .. -a. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION h Map 2 Parcel 0 ! Application # U ! Q a 3a Health Division Date Issued �3 Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address Village Owner Lad- 81WA- Address Telephone 2 ` � Permit Request � l �/� lU �d hd Wlk 6VAU)1%1&/4 R-11 aAn Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation ) Construction Type �G�� Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Pl Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other S C> Basement Finished Area (sq.ft.) Basement Unfinished Area (sc ) = Number of Baths: Full: existing new Half: existing nevi c� Number of Bedrooms: existing _.new = Total Room Count (not including baths): existing new First Floor Roo Count w` m Meat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other .Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Aut orization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ t If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number &z 5..... Address,/ ��� �12 License # A µ Home Improvement Contractor# Worker's Compensation #�i>/'����5 � ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE D FOR OFFICIAL USE ONLY `f APPLICATION# s i DATE ISSUED r MAP/PARCEL NO. ADDRESS VILLAGE i� OWNER ' i DATE OF INSPECTION: FOUNDATION t FRAME INSULATION ` FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING e i DATE CLOSED OUT 'l ASSOCIATION PLAN NO. `+ Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor ' License: CS-100988 HENRY E CASSIIO 8 SHED ROW WEST YARMOLP17H p2:• J..ti..- �tl�_ s Expiration Commissioner 11/11/2015 L { s << Wrolo �r J)ovr•�c/r rr��� cl;•C?. r.� c c f lt- C)lt1c ofC onsuiller Affairs Lind BLISiness l'egUlati`011 FLflry l0 Park Plaza - Suite 5170 Boston, Mas'sachLutts 02116 - l-lon-ie lrnprovemerit Contractor Registration Registration: '153567 1 vpe: Private Corooratioli Expiration: 12/15/;?'014 G,0D INSULATION, INC III-_NR)/ CASSIDY _.._...... .... 16 RF=.ARDON CIRCLE YARMOUTH, MA 02664 - . Ulldme Address and retur'u curd. Miii k rcusou fol:ehauge. Address L I l2r.nc}v;tl { I Ij:niltluy'ntanl I I Lustt:xril li r :rrrrr,rrrue c rr(/7i r`C d 11 rt.tn.'�rrrusi(a o,uum4['Altirius ' Itusuu.ss Rogulatim, Licensee ur regismitiint valid for individill use.only I +11^IlWiNit• IMNROVk.MEN I'CON11 RACI-OR hd'U(l the Csl,itation tl,itC Ir fuuud retill'u to; {i 1 �j>irauun 15356/ Type: 01'6Qe of( onstimerAltlus and Business Regitlutiun L� AOIfdttuii. 12/I'i/2014 hrlvale Corporahcn 10 Nark Pkiza-Suite 5170 .' • kiusluu,NIA 021I6 r': � .:•:.'gin;'.+!I,q I'li)IV..1N(:,' - - r I'i r 1N t_riKi.>Ll ' I NIA Ullili4. -...------ - ._._: _ ._.. .-..: . __- :....-:.:-. .. Ilnilirsccrctarl 0[1'itI 15'If110 I Ilan re The Commonwealth of Massachusetts - Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www'm4ss.gov/dia Workers' Compensation Insurance Affidavit: Builders/Cod.tractors/l�Iectri�ciansll'lunibers Au1yGt arYt rnfort�ation Please Print ) egibiy Name (Busin"-VOrganization/lndividual): �y�/��' C/ /�✓�v���/� � t I Cily/State/Zi : r ,� : Phone #: ��� f :,U*c you all employer' check the appropriate box: Type of project(required): 1. 1 Lull a Crnployer with. 4. El am a general contractor and I ctxtployees (full and,tgt=part-time).* have hired the sub-contractors 6. [:1 New construction 2.❑ lam a sole proprietor or partner- listed on the attached sheet 7. [] Remodeling ship and have no employees These sub-contractors have $, r Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance.i 9. [] Building addition required:] 5. [] We are a corporation and its . 10.❑ Electrical repairs or additions ! . .❑ 1 am,a homeowner doingall work officers have exercised their „1 1:❑'Pltunbing 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 la.(] 1 am a homeowner acting as a employees. [No workers'. 13.ROtherZ general contractor(refer to #4) comp,insurance required.] rAnY sPPhc1Ult that checks box#,I must also fill out the section below showing chcir woticas'compcns4oif jwlicy informution. Hontcowncn who submit this affid4vit indicating chcy arc doing 41 work and then hire outside contractors must submit a new of idavit indicating such. 'Cuuuw tors that check this box must attached an additional sheet showing the name of the sub-coamicton and stars whether or not those cntirics have. ratployces. if the sub-contractors have employees,they trust provide then worken'comp.policy number. .lam an employer that is providing workers'compensation insurance for my employees. $elow is the policy and job site infurmaltun. � . . . ln$uF,Ulcc Company Name: Policy-#or Self-ins. Lic. #: vG / Expiration Dat fi Job Sur Address: CL /SrateJZt -lrGVlf6 (� tY P Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to securc,covcrage as required under Section 25A of MGL c. 152 can lead to the imposition of criininal penalties of a ri.nc up to S 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 5250.00 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 coverage verification: I do hereby cerfi# nder the nd penalties of perjury.that the information provided a ve r .true and correct Date; ID, AIV - ;G ffkta!use on ly. Do not write in this area, to be completed by city or town official City or'T`owu: Permit/License# Issuing we (circle one): I. Board of H 2. Building Department 3. City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other Contact Persotn: Phone#: 1 ' CAPECOD 27 MYOUNG OFLIABILITY DATEIMMIDDIYYYY). 7l8/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON.TF•IE 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 subjectto the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to tho cellihcate holder Nt lieu_of such endorsement(s)_ PRUnUcER L ice Ii e tF PC-514062 -- _ ----- coNTALI — — IBoyers&Gray Insurance Agency,Inc. NAME: Margaret Young 434 Rto 134 PHONE SOUtil Dennis,NIA 02660 Arc dEzl:E"MAIL -- ADDRESS;myoung(x rogersgray.com .------.- - - - INSUR�RS)AFFORDING INSURERA:PEERLESS INSURANCE COMPANY _Ir.;ulceu I INSURER 6:COMMERCE INSURANCE COMPANY— Cape Cod Insulation, Inc. INSURER C:Evanston Insurance Company i I -'i Reardon Circle INSURER o:ATLANTIC CHARTER INSURANCE GROUP South Yarmouth., MA 02664 I - INSURER E: __ _ INSURER F: - - --' COVERAGES _CERTIF ICATE NUMBER: - REVISION NUMBER: _ THIS IS I0 CER IIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICAI ED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH Till$. t CER IIFICATE MAY BE ISr UEO 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. WSR ' ( LM - _IYPE OF INSURANCE Ab61-Spell-"- O'LIC1�L-FF POEICY EkP ----___- POLICY NUMBER MMIDONYYY MMIDDIYYYY - LIMITS ' UENLRAL LIA'WLITY EACH OCGURhENCE! -- $-- -1,000,000 A X COMMERCAL CENERALLIABILITv CBP8263063' 4/1/2013 411/2014 -DAMAGE_TO RENTED_---- -- PREMISES iFa ocal ronco) $ 100,010 0 I ......... I CL.AIMS,MADE X OCCUR -" MED EXP{Any one ofaan) $ 5,000 PERSONALxADVINJURY $ -1,000,000 GENERAL AGGREGATE T $ 2,000,000 UENI A GREGATE LIMIT APPLIES PER- '- ----A— PRODUCTS-COMPlOP AGG $ 00 _ .--. - -- PRO POLICY ILOC AurornuelLe LIAmLITY C(bMBINEINCiLE LiM1T— — Ea acmLanH . ;^ _ 1,00.0,0.00 f3 ANrAUTO 13MMBCKVMK 4/1/2013 4/1/2014 BODIL,YINJURY(Perpanon) $ ALL.OS OWNED X SCHEDULED - -- --. --- X. _ AUTOS 130DILY INJURY(Per accident) $ I11RED ALA O'S X AUTOS WNED Pf3dPERIYTItCMAG --- ?. PER ACCIDENT --- _.— X Urd tiKELLA LIAd X OCCUR - EACH OCCURRENCE $. 1,000,000P ' C EXCESSuAE1 — CLAIMS MADE XONJ453512 4/112013 4/1/2014 T— AGGREGATE $ 1,000,000 DEO X RE I'ENl ION$ 10,000 - $ . L�:::_.- _ WORKERS COMPENSATION !PoC U- OTI I AND EMPLOYERS'LIABILITY STAT L 1 - U ANY PRUPRII;TOR/PARTNER/EXECUTIVE Y N. WCA00525904 6I30/2013 6/30/2014 E.L.EACH ACCIDENT $ 1,000,000 OFF'ICL-RiMEMBEl2 EXCLUDED?. , N 1 A _-.� __- (Mmrdarory in Nnd - E.L.-DISEASE-EA EMPLOYEE $ __1,000,000 � Ir y�e>,doscnUa undef DESCRIP1lON OF OPERAT'IQNS[relaw - - - E.L.DISEASE-POLICY LIMIT $ - 1,000,000 lUcSCRIPIION ON OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space is required) WorkelS COnIPLnSation includes Officers or Proprietors. Addtional Insured status is provided under the General Liability when required by written contract or agreement with the Certificate Holder. I - i - CERTIFICATE HOLDER_ —_ CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE j Capra Cod Insulation, Inc THE EXPIRATION DATE THEREOF, NOTICE WILL. BE DELIVERED 1N ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE -- ---�- - - ---- L._.... ----------- ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD N OWNER AUTHORIZATION FORD (Owners Name) owner of the property located at (Property Address) C,LaW-k je f/1 �.Lam', ��'I iiR' . G N 7Z... (Property Address) {herebyauthorizeTkisv1 h (Subcontra ) an authorized subcontractor for R E Engineering,to act on my behalf to obtain a building permit and to perform_work on my property. Owner's Signature /xj Date 1 1 .�tInliq t CAPE COD . TOWaF SARPYSTA �sL, INSULATION 2014, APR 16 88: 2 6 - - PIY6R O"45, SEA MSSSS SARAT60AM SOSP6N060 YAKS OOTT6RS -INSOSASION CSNIN03' - s�.; Town of Barnstable Regulatory Services Building Division 200 Main St Hyannis, MA 02601 Date: Dear Building Inspector Please accept this Affidavit as documentation that Cape Cod Insulation, Inc. performed & 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 (BRI) inspector. All work preformed meets or exceeds Federal & State Requirements. P_ roperty Owner Property Address Village Cyr l A� 0-1-j11 �l!►��2�� Le=n k,�v� 11� Insulation Installed: Fiberglass Cellulose R=Value Restricted Unrestricted Ceilings Slopes ( ) ( ) ( ) ( ) ( ) Floors Walls Sincerely He y E Cas y Jr, President C e Cod I I ulation, Inc. fig ' `4 4`7 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION f Map- , Parcel Application # I �( Health Division Date Issued Conservation Division Application Fee P Planning Dept, Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis Project Street Address �� ►"I Z2 '�D 1� ULD e Village W o c L i h L&II It If �s Owner ( ' Uf �� h/1� Address Telephone Qj - L� 9)(0 9 Permit Request 11' scal IYl Sl l CZ Off' ' C (►2-301 �-"3 C.rCu)ui S12c_1� C A►gLi r vertu S Ca-I _D cup d Y1sh-wwo-MO bn-e .a Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction 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 ❑ No . On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) ' Number of Baths: Full: existing new Half: existing ° + new:. Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count yea Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: 'CI`Yes ❑ No Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑existing 0 new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) NaAe RISE Engineering Telephone Number 401-784-3700 Address 1341 Elmwood Avenue License# 100459 Cranston, RI 02910 Home Improvement Contractor# 120979 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE Erik Nerstheimer for Rise Engineering ! FOR OFFICIAL USE ONLY t -APPLICATION# DATE ISSUED MAP/PARCEL NO. _ ADDRESS VILLAGE OWNER DATE OF INSPECTION: Iy FOUNDATION_ ' f ' FRAME INSULATION FIREPLACE S ELECTRICAL: ROUGH FINAL'" 4 z PLUMBING: ROUGH FINAL GAS:-- ROUGH "" FINAL 'I FINAL B_UILDING!$ , DATE CLOSED OUT I�Y ASSOCIATION PLAN NO. J ` t 4 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations. 600 Washington Street Boston, Mass. 02111 www.mass.gov/dia. Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): RISE Engineering a division of Thielsch Enzineering Address: 1341 Elmwood Avenue City/State/Zip: Cranston, RI 02910 .Phone#: (401)784-3700 or 1-800-422-5365 Are you an employer? Check the appropriate box: Type of project(required): 1. ® I am an employer with 4. ❑ 1 am a general contractor and I 6. ❑New construction employees(full and/or part time).* have hired the sub-contractors 2. ❑ I am a sole proprietor or partner_- listed on the attached sheet. 7• 0 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] 5.❑ We are a corporation and its 10. ❑Electrical repairs or additions 3. ❑ I am a homeowner doing all work officers have exercised their myself [No workers' comp. right of exemption perm MGL 11. 0 Plumbing repairs or additions insurance required]'t c: 152,§ 1(4), and we have no 12. 0 Roof repairs employees. [no workers' 13. ,Other'Insulate comp.insurance required.] L *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. tHomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contactors that check this box must attach 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. -1 am an employer that is providing workers'compensation insurance for my employees.Below is the policy and job site information. Insurance Company Name: The Preston Agency ` Policy#or Self-ins.Lic.#: 3730961-01 Expiration Date: 1/1/.1Z Job Site Address: J KA 12,ttn tho IQ Lan(L City/State/Zip: V V HA n I S PeOr, 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 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 $250.00 a.day against violator.Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certi and the Pnlns, enalties ofperjury that the information provided above is true and.correct. Si nature: '` Date: Print Name: Erik Nerstheimer Phone#:(401)784-3700 or 1-800-42 2-5165 ext] 13 Official use only Do not write in this area to be completed by city"or town official City or Town: Permit/license#: Issuing Authority(circle one): f 1.Board of Heath 2.•Building Department 3.City/Town Clerk, 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact person: Phone#: OP ID: 31 A �M CERTIFICATE OF LIABILITYINSURANCE DATE(MMIDD/YYYY) 12/30/10 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 endorsements. PRODUCER 401-886-8000 CONTACT, NAME: The Preston Agency,Inc. 401-885-1700 PHONE FAX 1360 Division Rd Suite 303 A/c No Ext: AIC No FAIL PO BOX 810 ADDRESS: East Greenwich,RI 02818-0810 cu°s°oreER ID#:THIEL-1 INSURER(S)AFFORDING COVERAGE NAIC# INSURED Thielsch Engineering,Inc INSURER A:Zurich-American Ins Co. - Thielsch Group Inc. INSURER 6:American Guarantee&Liability Hi Tech Realty Inc. 195 Frances Avenue INSURER C:North American Capacity .. Cranston,RI02910 INSURER D:Hartford Insurance Company INSURER E i 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. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE POLICY NUMBER - - MMIDDY/YYYYI 1MMlDDfYYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY 3730962-01 01/01/11_ 01/01/12 DAMAGPREMEI Eaocalrrence U RENTED $ 300,00 CLAIMS-MADE �OCCUR MED EXP(Any one person) $ 10,00 PERSONAL 8 ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00 POLICY X PRO- LOc Emp Ben. $ 1,000,00 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2,000,00 A X ANY AUTO 3730963-01 01/01/11 01/01/12 (Ea accident) ALL OWNED AUTOS BODILY INJURY(Per person) $ ` SCHEDULEDAUTOS BODILY INJURY(Per accident) $ PROPERTY DAMAGE HIRED AUTOS (Per accident) $ NON-OWNED AUTOS $ $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,00 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,00 B. AUC-485718840 01/01/11 01/01/12 DEDUCTIBLE _ g _ RETENTION $ $ WORKERS COMPENSATION - X WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N - Y R -A ANY PROPRIETOR/PARTNER/EXECUTIVE 3730961-01 - 01/01/11 01/01/12 E.L.EACH ACCIDENT $ 1,000,00 OFFICER/MEMBER EXCLUDED? a N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 1,000,00 It yes•describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,00 C Professional Liab DVL000026800 ___T04/01110 04/01/11 Prof Liab 2,000,00 D Leased/Rented Eqp 02UUNTD5678 01/01/11 01/01/12 Equipment 100,000 DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION TOWN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.' AUTHORIZED REPRESENTATIVE t. - ©1988-2009 ACORD CORPORATION. All rights reserved. F ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD i 91te ,, 4se(jgue r ano an usln anon O ice o onsume 10 Park Plaza- Suite 5170 Boston, ssachusetts 02116 Home Improve ontractor Registration Registration:. 120979 Type: Supplement Card z I w Expiration: 3/25/2012 THIELSCH ENGINEERING M ERIK NERSTHEIMER 1341 ELMWOOD•AVE: CRANSTON, RI 02910 Update Address and return card.Mark reason for change._ tir s. Address Renewal F] Employment Lost Card DPS-CA1 0 50M-04/04-G1o1216 ✓/e 'C�arrhrwouuea�i a��aaoacfivaelta � ' Office of Consumer Affairs&Bu iness Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation ° Registrationrn- bq79 Type: 10 Park Plaza-Suite 5170 Expira —12 Supplement Card Boston,MA 02116 THIELSCH EN(&[ ERIK NERSTH 1341 ELMWOOD 4�' 9 CRANSTON; R1 029� - Undersecretary Not valid without signature Licensee Details Page 1 of 1 The Official Website of the Executive Office of Public Safety and Security(EOPS) Mass.Gov Home ,a Public Safety _... ... ._...... ............. ........... Department of Public Safety Licensee Complaints License Type Construction Supervisor License# 100459 }' Restriction WS,IC Name Erik Nerstheimer City,State,Zip North Scituate,R1,,02857 Expiration Date 3/28/2012 Status Current No complaints found for this Licensee. Back To Search http://db.state.ma-us/dps/`licdetails.asp?tktSearchLN=CSL 100459 1/7/2011 03/02/2011 17:33 FAX 401 784 3710 RISE ENGINEERING R 001/001 I ' ,� RISE ENGINEERING ;_s`; ` , :.;tederai ID#aao4os629 y j!s . ;RI Contractor Registration No 8186 A division ofThieisch Engineering MA Contractor Registration No 1209T9 _ D E r, CT Contractor Registration No 620120 8 1341 Ehnwood Avenue,Cranston,Rl W 9W' f;�► �1111111 (401)784�700 FAX(401)�84-3710 wOWTRACT Page 1 , i S . .. _ THIS CONTRACT IS ENTERED INTO BETWEEN RISE ENGINEERING AND THE CUSTOMER FOR WORT{AS E NG INEEMNG DESCRIBED BELOW CUSTOMER _ - PHONE DATE - CliOnt>f Carol Brown (914)589-5287 12/02/2010 114449 SERVICE'STREET BILLING STREET �57 Mizzentop Lane P.O.Box 86 SERVICE CITY,STATE,ZIP - BR.LING CITY,STATE,ZIP West Hyannisport,MA 02672 Amawalk,NY I0501 JOB DESCRIPTION RISE Engineering will provide labor and materials to seal areas of your home against wasteful,excess air leakage. This work will be performed in concert with the use of special tools and diagnostic tests to assure that your home will be left with a healthful level of air exchange and indoor air quality.Materials to be used to seal your home can include caulks,foams,weatherstripping and other products. Primary areas for.sealing include air leakage to attics,basements and other unheated areas(windows are not generally addressed.)This measure is available for 100%rebate from the Cape Light Compact. $528.00 RISE Engineering will provide labor and materials to install a 9"layer of R-30 Class 1 Cellulose added to 448 square feet of open attic space in the addition. - $492.80 RISE Engineering will provide labor and materials to install a I I layer of R-38 Class 1 Cellulose added to 496 square feet of open attic space in the original section. $595.20 RISE Engineering will provide labor and materials to install an easily moved,insulating cover for the attic access folding stair. The cover has integral weatherstripp ing to restrict air leakage. $160.00 RISE Engineering will provide labor and materials to install 336 square feet of R-10 rigid fiberglass insulation board to the crawlspace perimeter wall. $907.20 RISE Engineering will apply all applicable,eligible incentives to this contract. You will be billed only the Net amount. Currently,for air sealing measures,the Cape Light Compact offers a 1.00%incentive,with falls outside the$2,000 per calander year cap. $528.00 RISE Engineering will apply all applicable,eligible incentives to this contract. You will be billed only the Net amount. Currently,for eligible measures,the Cape Light Compact offers 75%incentive,not to exceed$2,000 per calander year. -$1,616.40 WE AGREE HEREBY TO FURNISH SERVICES•COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF **"Five Hundred Thirty-Eight&80/100 Dollars $538.80 UPON FINAL INSPECTION AND APPROVAL BY RISE ENOINEERNO.CUSTOMER AGREES ro REMrr AMOUNT DUE IN FULL INTEREST OF 1%VVILL SE CHARGED MONTHLY ON ANY - UNPAID BAL/UICE ZE':4 R IMPORTANT INFORMATION ON GUARANTEES,RIGHTS OF RECISION,SCHEDULING,AND CONTRACTOR REGISTRATION. O NOT SIGN THIS CONTRACT IF THERE AR MAN SPACES (o AUTHORS - CUSTOMER ACCEPT NOTE:fl41S CONTRACT MAY BE NRTHDRAM BY US IF NOT EXECUTED WITHIN - DATE OF ACCEPTANCE I D 3 ACCEPTANCE OF CONTRACT.THE PRICES,SPECIFICATIONS AND COMMONS AM SATISFACTORY TO US AND ARE HEREBY ACCEPTED.YOU ARE AUTHORIZED TO DO THE WORK DAYS. - AS SPECIFIED.PAYMENT WaL BE MADE AS OUTLINED ABOVE ry c�� p�C✓ 5 ASSESSORS LOT 227-65 ASSESSORS �� LOT 32 LOT 227-98 LOT 30 C.R (Front — 6' , � SHED Ip��O AREA=7933+S.F. ?�3• �' ASSESSORS LOT 227-64 LOT 31 ";;PORCH,;; G (INn) cv 2`� O - V 1104D FLOOD ZONE "C" FO UNDA TION CERTIFICA TION . RES ZONE' "RB" TOWN.•HYANNISPORT SCALE' 1 20• PLREF 103-127 ELEV N/A SETBACKS. 20'-10�-10' 1 CERTIFY THAT THE ABOVE YANKEE LAND SURVEYORS FOUNDATION IS LOCATED ON '? THE GROUND AS SHOWN, AND ������G\�"`p� y✓ � & CONSULTANTS IT'S POSITION DOES ® �° P� `� P.0. BOX 265 ® o STE jH UNIT 1, 40 INDUSTRY ROAD CONFORM TO THE ZONING LA W 4 00, = MARSTONS MILLS, MA 02648 SETBACK REQUIREMENTS OF �. =�' �F TEL 508—428—0055 FAX 508—420-5553 BARNSTABLE _ oQ JOB STEPHEN J. DO YLE,, P.L.S. `�'� DATE.•12-08-05 NUMBER 53992FND TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION }. q67Map � `i�1 Parcel ®� - Permit# S496 1 Health Division qa4 v& Date Issued I -��- Conservation Division L,6 av For - Application Fee ®� Tax Collector A SEPTIC SYSTEM MUST&pit Fee * i g� INSTALLED IN CO Treasurer MTN TITLLt COMPLIANCE Planning Dept. EWIR�R NTAL CODE AND EGULATIONS Date Definitive Plan Approved by Planning Board •. Historic-OKH Preservation/Hyannis Project Street Address 51 M i ZZ en'To D Village T Phier�it HP Owner LAIA Cw Bcnwn Address -q kMA,,J4%Y A-vC!- Ak4 LAJ4lk &IV Telephone Permit Request fV��5fiF�2 �l,d.,., - ���� K t�L�.Y. �c,w-�d..�x ✓�a�,J Sc�`��. �p���� Square feet: 1 st floor: existing 0d proposed I Zi 2nd floor: existing proposed Total new t--1 Zoning District Flood Plain Groundwater Overlay Project Valuation L1 ti Construction Type N Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure 3cc Historic House: ❑Yes Q_No On Old King's Highway: ❑Yes ANo Basement Type: ❑Full f&Crawl ❑Walkout O Other Basement Finished Area(sq.ft.) /1 Basement Unfinished Area(sq.ft) A l ft Number of Baths: Full: existing new Half:existing new Number of Bedrooms: existing Z new Total Room Count(not including baths): existing —P-S new First Floor Room Count Heat Type and Fuel: 0 Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes A No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No i Detached garage:❑existing ❑new size Pool:❑existing 0 new size Barn:❑existing ❑new�size CD Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Tni Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑ No If yes,site plan review# -- _ NO Current Use Proposed Use j r , I BUILDER INFORMATION Name �4ae a -e (.kX_ Telephone Number Address Q& z wk 7�.3 License# CS n x-7 3 6263-), Home Improvement Contractor# Worker's Compensation# 4g V,5 A O 3 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO Arl c_ ✓dd e4, SIGNATURE DATE l 2 " FOR OFFICIAL USE ONLY HERMIT NO. DATE ISSUED _ a MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION ,�h� � ril FRAME — }� 0�. s INSULATION 0 0 FIREPLACE 20 -1 1 , ELECTRICAL: RO`UGIt,�n� FINAL CO m PLUMBING: ROUGH FINAL GAS: ROUGH FINAL • s ' FINAL BUILDING 012k109 Cot 2.91 - S' i DATE CLOSED OUT /f t ASSOCIATION PLAN NO. Town of Barnstable Regulatory Services Thomas F.Geller,Director ° is,� Building Division , Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Fax: 508-790-6230 Office: 508-862-4038 Permitao. . Date AFFIDAVIT HOME UmTROVEMENT CONTRACTOR LAW SUPPLEMENT TO PLPJvM APPLICATION MGL a 142A-requires that the"reconstruction,alterations addition to anypraehexwner occupied,modernizations 1O� improvement,removal,demolition,or construction of an Y building containing at least one but not more than four dwelling units or to structures which are adj ace-at to such residence or building be done by registered contractors,with certain exceptions,along with other^' requvtemeIl� Type of Work: 1�� Estimated Cost AddressbfWork; •1. pier s Name: Date of Application: I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law . ❑Sob Under$1,000 []Building not owner-occupied []Owner pulling own peraat Notice is hereby given that: GISTERED " OWNLRS•PUtLING THEIR OWN PERMIT OR RALINME 0 NOT HAVE CONTRACTORS F'OR APPLICABLE HOME UNDERMGL c.142A. ACCESS TO T�ARBITRATION PROGRAM OR GUARANTY FUND SIGNED UNDERPENALTIES OF PERJUPy I hereby apply-for a permit as the agent of the owner: r 1g33� tj-- a Registration No. Co tor.Name Date �.. OR Owner,s Name , Date • Q:forms:homeaffidav 780 CMR Appe WkJ TableJS.ZIb(eontinoed) e and Two-Famdy Residential Buildings Heated witb Fossil Fuel prescriptive Packages for On MAXIMUM MINIMUM Wall Floor• Basement Slab Headng/Cooiing dla�g Glaring Ceiling pp�fineler Equipment Efficiency' Area'(%) U-value= R-value' R-value4 R-valud ' Wall R value' R-values Package 5701 to 6500 Heating Degm Days' rm Noal 12/• 0.40 38 13 19 LO 6 Q ° 6 Normal R 12% 0.52 30 19 19 IO 6 85 AFUE S 12% 0.50 38 13 19 10 N/A Normal __...T_.._..... --..15%.__....._.._...-.036...._.._ 38 13 25 NIA U '15% 0.46 38 19 19 10 NIA 85 AFUE' V 15% 0.44 38 13 25 N/A 6 85 AFUE W 15% 0.52 30 19 19 10 NIA Normal X 19% 032 38 13 25 NIA N/A Normal y 19% 0.42 38 19 25 N/A 6 90 AFUE Z l8•/, 0.42 38 ' 13 19 10 6 90 AFUE AA 18% 0.50 30 19 19 to_ 1. ADDRESS OF PROPERTY: `Zti�"��o Q - 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: 4, %GLAZING AREA(#3 DIVIDED BY 92): I 5. SELECT PACKAGE(Q--AAA-'see chart above) NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: r. YES: NO: q4orms.4980303a . 780 CMR Appendix J Footnotes to TabI Cce 8.2.1b: a Glazing area is ratio of the area of the glazing assemblies (includin sliding-glass doors, skylights, and basement windowsif located in walls that enclose conditioned space,but ex uding opaque doors)to the gross wall area, expressed as aipercentage.Up to 1%of the total glazing area may b excluded from the U-value requirement. For example,3 ft oNecorative glass may be excluded from a building d sign with 300 ft of glazing area. Z After January 1, 199,%, glazing U-values must be tested and docume ed by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, taken from Table J1.5.3a. U-values are for whole units: center-of-glass U=values cannot be used. 1 I raised or oversized tru construction. If the insulation achieves the M The.ceiling.R-valu es do,not assume a rays g ' e exterior walls without com res on, R-30 insulation may be substituted for R-38 'on thickness over th P insulate ,, insulation slid R-38 insulation may be-substituted for-R-49-in lation: Ceiling R-values-represent-the sum of cavity.-_ -.. insulation plus insulating sheat�ing (if used). For ventilated eilings, insulating sheathing must be placed between the conditioned space and the ver�ilated portion of the roof. Wall R-values represent the su of the wall.cavity insu tion plus insulating sheathing(if used). Do not include I an R 19 requirement could be met EITHER exterior siding, structural sheathing, d interior drywall. or examp by R-19 cavity insulation OR R-13 vity insulation us R-6 insulating sheathing. Wall requirements apply to wood-fratine or mass(concrete,maso , og)wall con ctions,but do not apply to metal-frame construction. °The floor requirements apply to floors o r uncondi oned spaces(such as unconditioned crawlspaces,basements, or garages).Floors over outside air must me the ceil g requirements. Tl:e entire opaque portion of any individual em t wall with an average depth less than 50%below grade must mcer the same R-value requirement as above de walls:,Windows and sliding glass doors of conditioned basements must be included with the other gl g. Basement doors must meet the door U-value requirement described in Note b. 'The R-value requirements are for unheated slabs Ad an additional R-2 for heated slabs. ° If the building utilizes electric resistance heat' use c mpli�nce approach 3;4, or 5.• If you plan to install more than one piece of heating equipment or more th one pi a of cooling equipment, the equipment with the lowest -efficiency must meet or exceed the efficiency re uired by th selected package. For Heating Degree Day requirements of the c osest city or t wn see Table J5.2:1 a NOTES: a) Glazing areas and U-values are maximum cceptable levels. sulation R-values are minimum acceptable levels. R-value requirements are for insulation only d do not include s tural components. b)Opaque doors in the building envelope m have a U-value no ater than 0.35. Door U-values must be tested and documented by the manufacturer in acc rdance with the NFRC t t procedure or taken from the door U-value " in Table J1.5.3b. If a door contains glass an aggregate U-value rati for that door is not available, include the glass area of the door with your windows d use the opaque door U-v ue to determine compliance of the door. One door may be excluded from this requ' ment(i.e.,may have a U-value eater than 0.35). c)If a ceiling,wall,floor,basement wall,s ab-edge,or crawl space wall com nent includes two or more areas with different insulation levels,the component omplies if the area-weighted avers a R-value is greater than or equal to the R-value requirement for that compon nt. Glazing or door components com if the area-weighted average U- value of all windows or doors is less than r equal to the U-value requirement(0.3 for doors). 43 mot , Town of Barnstable Regulatory Services BAWMASM = Thomas F.Geiler,Director. MM o Building 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 A Builder I, t%era(a �Ctf��l ,as Owner of the subject property hereby authorize C, eiJ� Q/Lf��,Pd�S�S l�eL to act on my behalf, in all matters relative to work authorized by this building permit application for: . (Addre s of Job) 10 - IS- zoos- SignWre of Owner Date ccla L r Print Name -- `�' R�1ie V�a�ynza�2cueir�/ �✓�aaoac�t[cae�.a`. '' BOARD�OF BUILDINGREGULATIO}NSA Cleanse CONSTRUCTION;SUPER\%ISOR } 1 '+ ; Numb1 �S 0892�3 i 1 !RIC�HARRUN-- + ,� � : `Commiss`ioner Board of Building Regulations and.Stand'ards HOME IMPROVEMENT CONTRACTOR Registratrbrt 'j -358 - Fx��afL rL� .2 6 i , e LI bility Corporation - � s � ' CAPEWIDE RICHARD CAPEN :r . Mi4RSTON M1LLS,..:MA 02648 . Administrator tI - - r----------�P ------ --' �IS EXISTING — s�°e. .. NFo�rD, Iuy�ATION wA�• � � �f>K� .P ^�,-.,. �.� �)� SCREENEDPORCM 1�-I ® O Ex18T.FOIINDATION WALL6 - a ABOVE 11-u41 IHI-1�11 [� 'I tlt jj ERRQNT_FI EVATION •• ••, .{ FOOTNG E()DTINr.DETAIL 0'CONGREfWALL tlEy L f ,rk"L 1. EXISTING - 1• R _ h t IV I - � FrR F OPOR N F -- ��` � • ����T�a � '., FO MDA� TIO�PLAN: , mm.mmn k. �. tz -mm �' LL' L L� tlE4 DI@BD.Otl 0 EXI6TMG > �� {• aco 0: I- . 0 W. _ L__ __ __ O�H •.w KIiLiIEN u¢n S -¢ N:"' 0 _ - LEFT ELEVATION ® �",S 'j((�''l ��+ - .4�,�¢�' '• -0p' y m z EXISTING Sou Qm _ Er166 Rr DG BFDRD011 + Y,w 1 0 - ExIST INT.WALLS I aeo ��( { O .......... 66HGLuni[•L �a NWF oo :" NEV INT.vacs� a - I' 1 NEW AND EXISTING.FLOOR PLAN '' " ;^,, rvc ewnLn iM�' - 1 - REAR ELEVATION - �•'�• I 1 !�f 95 "1 DATE REVISION DRAWNBT PAGE SLALE BUILDER: A2@11DpBE°.e`r." MR AND MRS BROWM DFLIf.N PROPOSED NEW M/BEDROOM AND SCREEN PORGN. 09-09-2005 .0 ,1B F U4°.1'-0` 0 51 MIZZENTOPS LANE soe eemw CENTERVILLE MA. c„•�o.aL..wne,e•.ee.,wc..eu,.eero,meLe.o.wmu..ee mv.0 nag•,W.mwnm¢„r or•-1 — C103F` oR°ix,xcce.iso�sxe,uT xo,es wNn eexo,umLe •eu,,..m..e e'A' e'+4' °x EmMtR.SRAP rte. ASPHALT 64NOLES `Z shun_E Be ASPHALT PAPER 1 yy wPLY.BNEAwwd i ryp 3 i A .D iVo I i - �' • y I VENTED DRIP EDGE a L As. 6y5' I 6'AL1 .G-ER •I A. i I � b M_FAGIA -�P- 0(680FFR W4'OBARTER RD. - , T BIDEWALL W TTVEK OR EQUAL EXI5TING $ �\ 0PLT.SHEATHNG 8 � �h D FAVE DETdILS 11 SHNGLES STARTER ' 1 1 , S 1 - COARSE 1 1 US P.T.BILL elA 1 1 0 1 1 1t $U SEALER ! � 9 1 1-P NS TOP RING S CLEAR ✓ I v 1 I - A 1 1 1 ' IlM7 ANCHOR BOLTSqp ' •F==` gee d• f _t_L_1_1_ i o 1 1 D 61 D TA1 5 a l l r SLL 1 ROOD FRgMING PLAN A I � FI DOR FRAMIN•PI d . i Kit�.ei¢At vt rteuon�,xen . .. _ eiwote e`orfJcrn neoof t )ttP.n `-uP.n.Wat_r e m.welwe- m.wxuM GRADE �ttEW uA�R 4AA R M/BEDRODM m, d .r�e - un�EENEo PORGN '{ . / B_AfrEtlEt1I. ; BIG FOOL - CROSS 6EGTION(a FOOTING•D TAI S ontE REy1510N DRAWN BY pAGE ��� ✓B pesgns BUILDER: JQB1aRURES& MR AND MR5 BROWM DESIGN PROPOSED NEW M/BEDROOM AND SCREEN PORCH. 09-09.1005 Ag F2 OFA 0 59 MIZZENTOPS LANE I AL ° CENTERVILLE MA. xeAletm e°rPwxce°m 'n BR11ROeAnro°.tce°10m elx a.uimn.e LP Ei ,.n, . tee.°.also a""ca°bDn,Ra,ai`.e°vm'oen.w�x lnc..Axa.P.m. mxliuei .°Fun mw°OAw oRrJnA. ,maoe ww.o r`.mmE1O„I�roH r; Epg I I [ I I 4 G I C a � 7B1�JC1C('ri�E�e�tralevac�i{'rl.... I , ar 141 .1 .n� _-«m :ra_._. 'o• v: ^I \4aPts* -- r R TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcels !j � ✓{'_ i.� � 1 Permit# Health Division // 1 r 0 C 1 1 7 2001 Date Issued — l Conservation Division lb 1 t 9 y D Fee O Tax Collector �. / ra ► ®a" xtt' Treasure I l7!a P`�tC BVSTETY1 MUST 7k',I TALLER IN COMPLIANCES. Planning Dept. WITH TITLE 5 IVA,_ I.CCmE ANE Date Definitive Plan Approved by Planning Board �� —e IV Historic-OKH Preservation/Hyannis Project Street Address �"���" Village �� ' Owner 4!7A R Address S'� i'�r r '���✓' Telephone Permit Request 5e ., �''�!�s /�T !' �z ,!a e!-t,ezk r'c-- Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new r Valuation R O o O, 0 a Zoning District Flood Plain Groundwater Overlay Construction 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 ❑ No On Old King's Highway: ❑Yes ❑No Basement Type: ❑ Full *'Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) — Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing -Z new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: gGas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes O No Fireplaces: Existing New Existing wood/coal stove: ❑Yes i No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:Cl existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use - Proposed Use BUILDER INFORMATION 4 Name '�"" `"�� �C� a °�L�1� -� `" Telephone Number Address License# ®erp elg!.4: Home Improvement Contractor# /,S"` ole/ Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE DATE Y" FOR OFFICIAL USE ONLY PERMIT NO. a DATE ISSUED MAP/PARCEL NO. s ADDRESS - VILLAGE OWNER a � •1 f i � ' DATE OF INSPECTION: ' i FOUNDATION ' FRAME 3 , C� r r INSULATION a FIREPLACE ELECTRICAL: ROUGH FINAL ` PLUMBING: ROUGH FINAL GAS: ROUGH FINAL A 4r FINAL BUILDING '" "" ' 2 n ; r DATE .CLOSED OUT +, ! ASSOCIATION PLAN NO.$1 Y The Commonwealth of Massachusetts 4 Department of Industrial Accidents Ofllceof/ayestwat/eos 600 Washington Street Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit locatio . city /i/-o1s14 � .%�• hone f! ❑ I am a homeowner p orming all work myself Y am a sole rietor and have no one worlds in anv //%/�"�j�p�///a,, /%%/%/ //%////////////%/%/�/////l0////%�/%/% on this ob am an emp1 rovil workers compensation for my employees::::.:::::::.:::g: ::: .: ; .;:<::::»:< eom anv name:. ' x. Gress:: ... ..:.::.;...:.:..::.:.;.. ... .:.:.... 4 :...:::; bon : :> ;;:::.;:.;:: :::>:><.:::>:::>::<>:::<:»::<>:»:::.::>:::>:;;:::: of .:........ '. assurance ta.: ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the ::win workers'compensation olices: folio _. __ ........._............ .:.............,:.:::.:::.::..:::::::.:....::.:::::::.;::;::;.:.:.:<: .;:.;::.:: ;:.;>;>:<:::><::>:::<:»:::::;:::>::>::::::::>::>:.»::: g...........:.:.::. :,::.........::::::..:......:.::. ::::::::.::::...:......:.::::::::::::.:::::...::.::::::::::.:....::::.:::::::....:::::. X. com anv name: .........:. N. .... ......::.:..::.: .. ...............................:............... ......::::............... .................. .....:.... ::::.. :::::.:::.::..;;;;:.:::::::::: .:i,:.,.:;>:;�•>;.;:?<�;«:»:;>ail? »>::»:;>;;>;>;;>;::;»s;>.::;::::>;::>::;::>;::;.>::;:.;::;;;;>;;;;:;:.;;;:.;.:::.:::.::. - .....:.........:: ....:.:.. ....................... ......... .i...:..:... x...:..,....... ... f ...... .....:....... . .. x.,..i.,..,.,. ................... '•• i :.f. :::::::::::::::::. .... .... ..... ........................... ........ .... ..- ....:..:.::':�:. :??? ;.i:;??•:.:.i:;�i;:;:;}:ti;:ti;:;ii:•i:?�::v.......::..:.., :::n....::.�:::::.�:.....:::::}::::::::::. .............. ...................- ........?p?Q�:-.�:::?.l;:v:?.i::;ti•:%n::n•.:n.., y.y.J{� .......................... :.:::!vi._! ;:.... :address. .:.: ::.:.;: ...........: »`:>::: .......:::. ...::::.;. :::>:>: .::.:.:....;>:::: :::.�:::::::�ii::�ii:^iii:.:.i:.::ii>:.'i::.ii:v::<::�:::::!;:i:�:�:�iiii":�:�i'::�:�i::'�ii��i:�i�i::iiji'�:S�is3:i�`i':i:�:v:4:4a4if.?•iijviTrill::ij:{•iiiiiii::ii::;: }i^:i:,:..'.:'::v:�::v.....i?i::ii':}j>?:i:}L:;:Ji:•iii:?i��:�iiii??>'� :4iii:�i::: ........... n�pranCB �/,. Failure to secure coverage as required under Section 25A of MGL r52 can lead to the impomtl°n otertadnst penalties of a Sae tip W Sr,S00.Q0 and/or one years'imptisomnemt as wen as civil penalties in the form of a STOP WORK ORDER and a floe of 5100.00 a day against tne. I tmdetstaad than copy of this statement may be forwarded to the Office of Investigaflons of the DIA for coverage vetiSeaHon. I do hereby certify under the pains and penalties of per!►rry tltajdht imforntadon provided above is trtu mtd coned Signature e Date ���!,�•� � - �° f z etewe419 " Phone# S`�� Print name �4 ✓�� oiflcial use only do not write in this area to be completed by city or town offlcisl city or town: perssdlNcwe ti ❑Building Depart meat ❑Licensing Board ❑Selectmen's Office ❑checkifimmedide response is required ❑Health Department contact person: phone#; — ❑Other (levueo 9/95 PJAJ Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", 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 thanthree apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to doImaintenance, construction or repair work an such dwelling house or oa the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 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,neither the commonwealth nor any of its political subdivisions cshall enter into forat a performance o peen presented ublic workcontracting acceptable evidence of compliance with the insuran requirements of this authority. Applicants the box that lies to your situatiion and - Please fill in the workers' compensation affidavit completely,by checking applies supplying company names,address and phone numbers along with a certificate of insurance as all affidavits 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 e not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you being requested, eP are required to obtain a workers' compensation- policy,please call the Department at the number listed below. 17 City or Towns Please be sure that the affidavit is complete anal 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 p be sure to fill in the eimit/license number which will be used as a reference mimber. The affidavits may be reaaaed to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any que stions please do not hesitate to give us a call. EINAM �. The Department's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Office of imlesduadons 600 Washington street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 eat. 406, 409 or 375 Of THE r \` The Town of Barnstable gRegulatory Services 1639. NV MP{ Thomas F. Geiler, Director, Tf0 Building Division Peter F. DiMatteo, Building Commissioner 367 Main Street.Hyannis MA 02601 Fax: 508-790-6230 Office: 5OS-862-4038 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION air,modernization,conversion. MGL c. 142A requires that the"reconstruction.alterations.renovation,rep -exi modernization, owner-occupiedtion,conversion. improvement.removal.demolition,or construction of an addition to any to which are adjacent to building containing at least one but not more than four dwelling with other such residence or building be done by registered contractors,with certain exceptions,along requirements. 'er;ewi47 Estimated Cost Type of Work: Address of Work: Owner's Name: �� �� �..to j• Date of Application: I hereby certify that: Registration is not required for the following reason(s): FlWork excluded by law ❑Job Under$1,000 (wilding not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING IMpROVEMEN TWORK UNREGISTERED NOT HAVE CONTRACTORS FOR APPLICABLE HOME ACCESS TO THE ARBIT IT PROGRAM OR GUARANTY FUND UNDER MGL c.142 A. SIGNED UNDER PENALTIES OF PERJURY I hereby appiv for a permit as the agent of the owner. Registration No. Dat Contractor Name OR Date Owner's Name q:forms:A ffidav:re v-070601 RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 S' Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$96/sq.foot= x.0031= ply from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0031= plus from below(if applicable) ACCESSORY STRUCTURE>120 sq.ft� >120 sf-500 sf $35.00 >500 sf=750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch _x$30.00= p (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fee projcost d/ HONE IMPROVEMENT CONTRACTOR 'Registration: 115211 Expiration: 01/10/2002 Type: DBA 1 BARNSTABLE COUNTY CONST CO l' JAMES LEBOEUF fy tMO WINTER ST noMwisTRnToa HYANNIS NA 02601 Y i • 7 W j74�e BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR -1 Number,CS060349 Bird date 01/08/1956 Expires 01/05/2003 Tr.no: 6234 Restricted To: 00 ' JAMES T LEBOEUF 71 BETH LANE ' HYANNIS, MA 02601 Administrator v II�r»�IIlib bECTICIl ____` _ ALL b""'ISION LUMBER COLLAR TIE QC. 8E KI) SPF N0.Q !AII OR gETr 2 x RAFTER @ ' OTC. E x CEILING 1018t ' O,C. SHINGLE W/IS Le. rELT A�8O kRAFT f0 Fs 1• PINE FAC R. UNFAC�d t f.. w/6•MIL POLY .Apo 8APRIEA --� SdFFIT yENr 2as FLoon) PINE Soffit 11 X FLOOR col Osr ; 2"b FL�� "pC, i SILL SILL S6gl VO• .. AN[Npq BOLT • � 6'0� O.C. !• CONCREtp UNDATION ALL �� � �°�j �"� ��� �� , , I �o�rt��T � �- �' 3e�gr� � �i ::= .'= ASSESSORS < l LOT 227-65 . S ASSESSORS LOT 32 HaR G4�ti LOT 227—98 Locus LOT 30 0 C. } (FNDJ - g 10 WEST HYANNISPORT BULKHEAD LOCUS MAP PLAN REF 103-127 ASSESSORS MAP. 227„64 p PROPOSED ' #57""" ZONING. RB PORCH """" SETBACKS. 20'-10'-10' y PLOT PLAN OF LAND AREA=7933-&S.F. o LOCATED AT- ASSESSORSftj 5 7 MIZZENTOP ROAD LOT 227-64 1 •L ` �8 ,,,, �' �'� cD 3• WEST HYANNISPORT OWN. LOT 31 PROPOSED BULKHEAD PROPOSED f + ADDITION ¢ �' PREPARED 'FOR.- V _ 4 0 - . LOT-- 45 GERALD .& CAROL ANN BROWN rFNDJ ®�A.AAA ,A�� OCTOBER 12, 2005 .09 REV ' S i PPHEN ® - � v REV COYLY REV ca(FND) S YANKEE LAND SURVEYORS ®®° & CONSULTANTS GRAPHIC SCALE P.0. Box 265 UNIT 1, 40 INDUSTRY ROAD zo o 10 20 ao MARSTONS MILLS, MA 02648 ca6m 6mmmiTEL• 508-428-0055 FAX 508-420-5553 rFNoJ• , 1-°Finch = 20 ft. SHEET 1 OF I JOB ,# 53992 JF