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0070 THOREAU DRIVE
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Project Address: Permit NumbeLB20=1-890tj CarolynrNugent t7.0.:Thoreau-Drive Barnstable Massachusetts 02632 Location Material AcIdt'l Thickness Final Assembly R-value Basement Rim Joist 6"Owens Corning Fiberglass Bath '6" 19 Attic Floor Green Fiber Cellulose 9" 49 Sincerely, Adam Glenn CSL fi106148 HomeWorks Energy Inc. HomeWorks Energy 101 Station Landing;Suite 110 Medford,MA 02155 wxpermitting@homeworksenergy.com (781) 205-2201 . Town of Barnstable Building Post This Card So That"A is Visible Fromthe'Street A_.irov-ed Plans Must Retained on Job and this Card Must bezKept Posted Uhil Fir iai Inspection Has Been Made S' Wl ere a'Certifica a of;Occupancy is Required,such Building shall Noi 6e Occupied until a Final Inspe'ctiori>has been made: er it Permit No. B-20-1890 Applicant Name: Adam Glenn Approvals Date Issued: 07/21/2020 Current Use: Structure Permit Type: Building-Insulation-'Residential Expiration Date: 01/21/2021 Foundation: Location: 70 THOREAU DRIVE,CENTERVILLE Map/Lot: 191-186 Zoning District: RC Sheathing: Owner on Record: NUGENT,CAROLYN Contractor Name HOME WORKS ENERGY INC. Framing: 1 Address: 70 THOREAU DRIVE Contractor License: 181138 2 CENTERVILLE,MA 02632 .- Est. Project Cost: $4,228.00 chimney: Description: Insulation and air sealing in the home.'No alterations-to the` Permit Fee: $85.00 - structure r Insulation: -J Fee Paid:/ $85.00 Project Review Req: ( Date: _ / 7/21/2020 Final: L-- ..,F. -,.,, Plumbing/Gas Rough Plumbing: clai This permit shall be deemed abandoned and invalid unless the worklauthoriied by this permit is commenced•within slx month" Min er iss�anM. Final Plumbing: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shallybe in compliance with the Iocal,zoriing by-laws,and codes. Rough Gas: This permit shall be displayed in a location clearly visible from access street or road and.shall be maintained open for;public inspection for the entire duration of the work until the completion of the same. Final Gas: The Certificate of Occupancy will not be issued until all applicable signatures by they Building_andtFire-Officials`a provided on this permit. Electrical Minimum of Five Call Inspections Required for All Construction Work ,r 1.Foundation or Footing Service: 2.Sheathing Inspection Rough: 3.All Fireplaces must be inspected at the throat level before firest flue,Iining is.installed. 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: S.Prior to Covering Structural Members(Frame inspection) 6.Insulation Low Voltage Rough: 7.Final Inspection before Occupancy Low Voltage Final: 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. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site Fire Department All Permit Lards are the property of the APPLICANT-ISSUED RECIPIENT Final: ` Town o o e . " . Barnstable ble ��Il�dIlng a t Post This Card So That it'i'sw�sible From'the Street,. A roved:Plans?,Must..be Retained on'1ob,and,this Card IVlust-be,Kept, " Posted Until;�,Final.Ins ectron Has=B n=ade � � �� � h Permit , x"r„ � ''.y:�r", ',- %°:.. ,",�-.'`�Sa"c' -hCa,* :-' "-'3"- u, ''; :, X ','.g .,,y .:.: +� ' 'C�} '+S �a`":n w. ;'a 9 " �'`•�°a, ��c -` s^�, '�r ,s," `' •r Where.a�:Cert�ficate.;of Occupancy.<�s,Requ�red�such�Buldmgshall Not:be:Occup�ed,unt�l,a°Finallnspection has been•made,�, �;, �t Permit No. B-20-1800 Applicant Name: Adam Glenn Approvals Date Issued: 07/21/2020 Current Use: Structure Permit Type: Building-Insulation Residential Expiration Date: 01/21/2021 Foundation: Location: 70 THOREAU DRIVE,CENTERVILLE Ma_p/Lot: 191-186 Zoning District: RC Sheathing: Owner on Record: NUGENT,CAROLYN Contractor.Name'` HOME WORKS ENERGY INC. Framing: 1 Address: 70 THOREAU DRIVE Contractor License. 181138 2 CENTERVILLE, MA 02632 Project Cost: $4,228.00 Chimney: Description: Insulation and air sealing in the hom tio e. No alterans to the y Permit Fee: $85.00 structure Insulation: -Fee Paid:{ $85.00 17 Project Review Req: , Date 4? 7/21/2020 Final . � Plumbing/Gas Rough Plumbing: UTT This permit shall be deemed abandoned and invalid unless the work authorized by this permit'is commenced within six monthsafte i� �n icia Final Plumbing: All work authorized by this permit shall conform to the approved application and 66'.approved construction documents,for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by laws aria codes. Rough 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. a Final Gas: The Certificate of Occupancy will not be issued until all applicable signatures bythe.BUiUpg and_Fire-Officials-are provided on this.pe rmit. Electrical Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing Service: 2.Sheathing Inspection x. 3.All Fireplaces must be inspected at the throat level before firest flue lining is mstalT n y Rough: 4.Wiring&Plumbing Inspections to be completed prior to frame Inspection Final' 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Rough: 7.Final Inspection before Occupancy - Low.Voltage Final: 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. Health "Persons contracting with unregistered contractors do'not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site n Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: i t"tr I Application number�rf, ., � eAMsrnei.E. Date tssued...... ......................O-------... ........ MAss. NOV9. 8 2018 Building Inspectors lnitials.. / TOWN �l BARNSTABLE Map/Parcel........�.�2� ....��5�.............................. TOWN OF BA STABLE . EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY III ORMAMN Address of Project: NUMBER STREET VILLAGE Owner's Name: 61,1 6v„ /I/v-1e1_/ Phone Number Email'Address: nos�e-�s t c��g y�hod c Cell Phone Number Project cost$ 2 70 2 — Check one Residential�_ Commercial OWNER'S AUTHORIZATION As owner of the above properly I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: See Al ad, Q i ra� Date:F71 . TYPE OF W®RiK ED Siding Windows no header change)# ( ,�_0 Insulation/Weathenzation 0 Doors (no header change)# Commercial Doors require an inspector's review tom; Roof(not applying more than 1 layer of shingles) Construction Debris will be going to w rS4 e , c �'-^G J mo ,fib, M,J� CONTRACTOR'S INFORMATION Contractor's name AaZ,,, VS Home Improvement Contractors Registration(if applicable):9 1/2-7 9 S (attach copy) Construction Supervisor's License#_ _ 0 7.0 0 7 _ _(attach copy) Email of Contractor sae S cp Ma,' • c c Phone number �o/-7IV- (3`'1 9 All PROPERTIES THAT HAVE STRUCTURE OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS!IU A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE PERMIT CAN BE ISSUED. n � APPLICATION NUMBER............................................................ *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor 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 If food is being served cat your evert please obtain a Health Department approval between the bom-p$ of 8z00am-930 am or 3e30 pm-4:30pm. Commercial events may require Fire Department approval *WOOD/C®ALJPEEILET STOVES r. Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles:front back left side right side HOMEOWNER'S V V 1`VL'R9S LICENSE E1$ENAJC TIO Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction SupeMsor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedurbs,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date /APPLICANTS SIGNATURE Signature Date H-20- IS' All permit applicat�foareubject to a building official's approval prior to issuance, r. Home Improvement Agreement: Page 1 Home Depot License Number(s): Visit www.homedepot.com/c/SV_HS_Contractor_License_Numbers for latest license info MA: 107774, 112785 Salesperson Name: Janice Campbell I Registration No. (if applicable): Home Depot U.S.A., Inc. ("Home.Depot") or service provider named below ("Service Provider") will furnish, install or service the equipment listed below at the price, terms and conditions as outlined on this form. Nugent carol New England South 1-9UHKIEM Customer Last Name Customer First Name Store #/ Branch Name Lead/Customer Order# 70 Thoreau Drive I Ienterville MA 02632 Customer Address City State Zip (518) 248-6433 nuggets1968@yahoo.com Home Phone# Work Phone# Cell Phone# Customer Email Address NOTICE OF RIGHT TO CANCEL: YOU MAY CANCEL THIS AGREEMENT WITHOUT PENALTY OR OBLIGATION BY DELIVERING WRITTEN NOTICE TO HOME DEPOT AT HOME DEPOT USA INC., 2455 PACES FERRY ROAD, BLDG. B-3, ATLANTA, GEORGIA 30339 or EMAIL The Home Depot @ customercancellationnortheast@homedepot.com BY MIDNIGHT ON THE THIRD BUSINESS DAY AFTER SIGNING, UNLESS THE STATE SUPPLEMENT PROVIDES A DIFFERENT CANCELLATION PERIOD. THE STATE SUPPLEMENT CONTAINS A FORM TO USE IF ONE IS SPECIFICALLY PRESCRIBED BY LAW IN YOUR STATE. YOUR PAYMENTS WILL BE RETURNED WITHIN TEN (10) BUSINESS DAYS AFTER HOME DEPOT'S RECEIPT OF YOUR NOTICE. YOU MUST MAKE AVAILABLE FOR PICKUP BY HOME DEPOT OR SERVICE PROVIDER, AT YOUR SERVICE ADDRESS, AND IN SUBSTANTIALLY THE SAME CONDITION AS WHEN DELIVERED, ANY MERCHANDISE OR MATERIALS DELIVERED TO YOU. OR YOU MAY CONTACT HOME DEPOT FOR INSTRUCTIONS REGARDING RETURN SHIPMENT AT HOME DEPOT'S EXPENSE. THE LAW REQUIRES THAT HOME DEPOT GIVE YOU A NOTICE EXPLAINING YOUR RIGHT-TO CANCEL. PLEASE SIGN BELOW TO ACKNOWLEDGE THAT YOU HAVE BEEN GIVEN ORAL AND WRITTEN NOTICE OF UR RIGHT TO CANCEL. Acknowledged by: 10/23/2018 Customer's Signatur6 Date Contract Price and Payment Schedule : Payment of the Contract Price is due upon signing unless a different payment schedule is required by law, specified below or in a payment addendum. Contract Price: 12702.70 Includes all applicable taxes. Excludes finance charges." Sales Tax: 10.00 (If applicable) *Maximum deposit ONL Y applicable in MD, MA, ME(331yo), NJ, Wl(99%) Dep. 125.0 % Deposit Amount 1675.68 Remaining Contract Balance 1 2027.02 The Home Depot-2455 Paces Ferry Road,N.W.Bldg.B-3,Atlanta,Georgia 30339-Customer Care:1-800466-3337 Customer Agreement(C,E,I)(31 Jan.18) v 50.1.2 ,mot g+xy ♦y i` 1 Oil .&- i 77te Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations J 1 Congress Street,Suite 100 Boston,JK4 02114-2017 www massgov/dia Workers'Compensation Insurance davit: BuilderslCont-ractors/Electricians/Plumbers Applicant Information W `�� Please Print a 'blv Name (Businessto,.gmmuontIndividual): O Pi J/ D _ Address: /B 156 S ../ VA IJR;4L Citv'State/Zip: Sh/`GWt� 14 . olvlr .Phone#: 7 �1-� I;z 75- - a /5�5— Are you an employer?Check the nropnat-e�b Type of project(required): I 1. I am a employer with . 4. -I'am a general contractor and I j s have hired the sub-contractors 6. ❑New construction 1 :mplovees(full and/or part-time). i 2_f- 1 am a sole proprietor or parmer- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have i S. ❑Demolition worJffio for me in any capacity. employees and have workers' 9 `�Bolding addition (tio workers' c ta-comp.msance comp. irct'*a*�ce.- required-] 5. ❑ We are a corporation and its 10.a Electrical repass or additions 1 3.[ I am a homeowner doing all wort officers have exercised their 11.❑Plumbing repairs or additions myself. Tlo workers' comp. right(of exemption per MGL 12 Roof repzirs itsurance required_]+ c.152,§I(4),and we have no 13.i� Other W i,/1 employee. [-No workers' comp.insurance required.] i, ('PLO(Ii�C rt Q^rt S ii •..\r.v appii;.ant tha:ch=k>box it'_must also fill out the section below showing the:T workers'compensation policy mtormation. t Homeowners who submitthis affidavit indicating they are doing a0 work and then hue outside canu=tors must submit a new affidavu indicating such. -Contractors that check this box mtut attached an additional sheet showing the name of*be sub-cout aetnts mid state whether or not those entitim have -=ptoyccs. s the sub-cparracmzt have employees,they mast provide their workers'comp.policy number. I am an employer char is providing workers'compensation insurance for my employees. Below is the policy and job size information `<ir �, � - //-- Insurance Comp �any dame: nW r J Q o th�� (/N",on! yy � "� _ (f p 6 Policy#or Self-ins.Lic.#: e" 7 >� I 0 11 Expiration Date: Job Site Address: 70 -T—K oreA,.., City;Srateizip: Ce,-4e.,'y,ife 3ttseb a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Faihrre to secure coverage as required under Section 25A of M- GL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-y imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 a day ag ' sgelaim. Be advised that a copy of this statement may be forwarded ifl the Office of Investigations of the D19 re coverage verification. I do hereby certifi,un a es at the information provided above is true and correct Phone#: a Official use only. Do nor write in this area to be complered by cloy or town official- City or Town: Permit-license# issuing Authority(circle one): L. oar of Aealih 2.Building Department 3.CitylTown Clerk 4.Electrical Inspector 5.Plumbing inspector 6.Other Contact Person: Phone;=: i The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations . 1 Congress Street, Suite 100 Boston, MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Address: �5 j�igLL S Ci IStatelZi A OM-7 t' Phone#: 771� 7G 6 " at3a�5� Are you an employer?Check the appropriate box: . Type of project(required): 1.El 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. El New construction 2.PQ I am a sole proprietor or partner- listed on the attached sheet. 7. El Remodeling `ship and have no employees These sub-contractors have g. ❑Demolition working for mein any capacity. employees and have workers' [No workers' comp.insurance comp.insurance.* 9. Building addition required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ 1 am a homeowner doing'all work officers have exercised their 11.Mt 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 employees.[No workers' 1.3.0 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. 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.#: 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 DIA for insurance coverage verification. I do hereby cer y unde the pain5Wnd penalties of perjury that the information provided above is true and correct. a r t Date: Phone#- Official use only.Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Type: Supplement Card HOME DEPOT USA INC Registration: 12785'Expiration: 04/22/2019 2455 PACES FERRY RD C-11 HSC ATi ANTA,GA 30339 Update Address and return card. Mark reason for chance. u Address ❑ Rene-a! O Employment C Lost Card =-- Office of Consumer Affairs&Business Regulation =_ HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE Suoalement Card before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulation 1 i 2755 04r221201 c 10 Park Plaza-Suite 5170 HOME DEPOT USA INC Boston,MA 02116 r i ANDREW SWEET 2455 PACES FERRY RD C-11 HSC ATLANTA,GA 30339 d IihoU signature Undersecretary 3 DATE(MWDDmYY) ACOOR& CERTIFICATE OF LIABILITY INSURANCE 022211016 THIfCERTIFICATE 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 have ADDITIONAL INSURED provisions or 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 rieu of such endomemerd(s). CONTACT PRODUCER ME MARSH USA.INC. PHONE FAX TWO ALLIANCE CENTER 3560 LENOX ROAD.SUITE 2400 E-MAIL ADDRESS: ATLANTA.GA 3032E INSURER($AFFORDING COVERAGE NAiC t fCN101642069-HomeD-GAW-1&19 INSURER A:Old Republic Insurance Co 24147 INSURED THE HOME DEPOT,INC INSURER B:New Hampshire Ins Co 23841 HOME DEPOT U.S.A..INC. INsuRER C:HomeRisk Gaptwe Insurance Company 2455 PACES FERRY ROAD INSURER D: BUILDING C-20 ATLANTA.GA 30339 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: ATL-004353439-16 REVISION NUMBER: 3 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 ADDL SUBR PODGY EFF POLICY EXP LIMITS LTR I TYPE OF INSURANCE POLICY NUMBER MMn)D Mum A I X I COMMERCIAL GENERAL LIABILITY MWZY 312717 10310112018 03/01/2019 EACH OCCURRENCE I S 9,000,000 DAMAGE TO RENTED - I i.000.000 I 1 CLAIMS-MADE 1` OCCUR I I I PREMISES Ea ocwnence $ i I LIMITS OF POLICY Y,S EXCLUDEC MED EXP(Any one person> !S IOF SIR.51M PER 000 PERSONAL 8 i ADV INJURY c 9000,COG GEN'L AGGREGATE LIMIT APPLIES PER: I j GENERAL AGGREGATE S 9A0C.100 PRO. j i I PRODUCTS-COMP/OP AGG S 9.000.DOG I y. POLICY LrI JECT LJ LOC I I OTHER: I I I S c MWTB312718 03/0112018 03/0112111 (E..QeD SINGLE utwrt s 1.0OG.OW I AUTOMOBILE LIABILITY � I Ea i ardent I I I BODILY INJURY(Per person) S X I ANY AUTO 1 OWNED Imo,SCHEDULED j I SELF INSURED AU7C'PHY DMG I BODILY INJURY(Per accrdent) $ `,_I AUTOS ONLY I�AUTOS HIREC 1 NON-OWNED I I I I I PROPERTY DAMAGE i$ AUTOS ONLY �_AUTOS ONLY I I Per acudenl I 1 UMBREW4 LIAR OCCUR ! EACH OCCURRENCE !S . EXCESS LIAR CLAIMS-MADE i AGGREGATE !$ I pED RETENTION S S B I WORKERS COMPENSATION WC 01412257 (AK,NH,NJ.VT) 0310112018 03/012015 ' X PER OTH- i AND EMPLOYERS'LIABILITY YIN I. STATUTE ER B IANYPROPRIETORIPARTNERIEXECUTNE (—I WC 01412257E(WI) D3/D12018 03/0112019 E.L.EACH ACCIDENT $ S,COO.CDC OFFICERIMEMBERE'XCLUDED� N NIA 5000iDD0 (Mandatary in NH) EL.DISEASE-EA EMPLOYEE S n yes,describe under Continued on Additional Page I I EL.DISEASE-POLICY LIMIT S S.000.00C DESCRIPTION OF OPERATIONS bebw C ;Excess AUTO I 297-,-10o,1-oazD,e 0310112018 03101/2019 Lunt4 000.000 I i I DESCRIPTION OF OPERATIONS)LOCATIONS I VEHICLES (ACORD 101.Additional Remarks Schedule,may be attached it more space is required) EVIDENCE OF INSURANCE ' CERTIFICATE HOLDER CANCELLATION HOME DEPOT USA,INC SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE 2455 PACES FERRY ROAD THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN BUILDING C-20 ACCORDANCE WITH THE POLICY PROVISIONS. ATLANTA,GA 30339 AUTHORIZED REPRESENTATIVE OI Marsh USA Inc. Manashi Mukhelee ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD - I AGENCY CUSTOMER ID: CN1 0 1 6420 6 9 LOC#: Atlanta Ac®j?& ADDITIONAL REMARKS SCHEDULE AGENCY Page 2 of 3 MARSH US;..INC. I NAMED INSURED THE HOME DEPOT,ING POLICY NUMBER HOME DEPOT U.S.A.•INC. i 2455 PACES FERRY ROAD — — BUILDING G20 i CARRIER ATLANTA.GA. 30339 NAIL CODE - ADDITIONAL REMARKS EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance i I i 'Nori:ers Compensation Continued I Carner.Indemnity Insurance Company of North Amerce 1 Pdicv Number WLn C6476319i(ALAR.F IDJA.SS,F:Y.L.A.;.iS.�iG CvK.S ,SD.TriNvsSY'. � Effective Dale:03/01018 Expiration Date,03/01/2019 I (EL;Limit 31,000.000 '..arner New Hzmpshre Insurance Compary PNrcy Number WC 014122576 (DC DE,H!.IN.ik.1C MN,MT NY,P,1) ffecbve Dale:03101f2018 xCnahOr Date 0310 i;2019 umu:S'.000.00C I Cartier ACE.Amencan Insurance Company Pchey Number WCU C64783221(QSij(A2.CA,IL,NCAR,VA,WA.I _ EffecbveDate:03/0i12018 i Etmralion Date.03101/2019 (EL umi::S1000,000 SIR S1 000.000 SIP,for the states of .CA,IL.NC.OR,L`A.'Nf•. Carver:Nabonal Union Fire Insurance Company Poicy Number.XWC 4595580(QSI)(CO.CT.GAAIE,MI,W.OH,PA.UT1 I Effective Dale 03101r018. Excuahor.Dale.03101/2019 IEL Lrmil:S1,000,000 - S1.000,000 SIR for the slates of CO..1JE.NV,;d1,OH.PA.iJT S750,000 SIR for the slate of GA S350.000 SIR Icr the state of C T Carver:National Union Fire insurance Company j Pdicy Number.X'NC 459553 i(QSI)(MA) E`fectve Dale 03101r018 Expiralion Date:0 310 1/2 0 1 9 (EL)Limit SI.000,000 SIP.:S500,000 TX Empayers XS Indemnity. ' Carrier21mios Union Insurance Company Policy Number.TNS C4916693A(TX) I Efechve Dale:03101r2018 Expiration Date.03/0Ij2019 (EL,'Linal:S10.000,000 SIR.SI OCD,caO ACORD 101 (2008101) 2008 CORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD YOU WISH TO OPEN A BUSINESS? �f For Your Information Business certificates [cost$3.0.00 for 4 ear A business certificate ONLY REGISTERS YOUR NAME in town You must do by M.G.L.-it does not give you permission to operate.) ~Business Certificates are available at the Town Clerk's Office 1 FL[36ch Main Street, Hyannis, MA 02601 [Town Hall) 7 MIS a Fill in please: - Z fiPPLIGANTS YOUR NAME: 12 I wI it��Y���. .: � .• BUSINESS " YOUR HOME ADDRESS: TELEPHONE # Home Telephone Number �q Cz 0" NA1iAE OF P4EW-Bij6fN- ESS YA /U./1/l S Y�iQ/n1T IS THIS A-NOME OCCUPATION? TYPE OF BUSINESS: A.�/2/ YES � IV��.: . _ H ADDRESS OF BUSINESS O. T � A LI U •:MAP/PARCEL NUMBER l O c When starting a new business there.are several things you must do in order.to be in compliance with the rules and gulations of the Towh of Barnstable. This form is intended to assist yoUji-i obtaining the information you fnpy need,Rd. & Main Street) to make sure you have the appropriate permits and lice ses.required to legally operate yOournbusiness (cornern this town.armouth (. BUILDING COMMI" TS OFFICE This individual h\s e "rifo> f permit requirements that pertain to this MUST COMPLY WITH HOME-OCCUPATION _ s e P typ of business. RULES AND REGULATIONS. FAILURE TO ut d Sign re** COMPLY MAY RESULT IN FIN COMMENT ES. 2 BOARD OF HEALTH This individual has b inform d -f permi requirements that pertain to this type of business. MUST COWY VM ALL COMMENTS. . �. Auth ed Signature** HAZARDOUS MATERIALS REGULATIONS' 3.:. CONSUMER AFFAIRS(LICENSING AUTHORITY) ' This individual has been informed-"of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: f= Town of Barnstable Regulatory Services d` qo Thomas F.Geiler,Director Building Division =nnxsrnaM Mass. Tom Perry,Building Commissioner 039. s � 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 ' ' Fax: 508-790-6230 Approved: Fee: Permit#: HOME OCCUPATION REGISTRATION Date: 02/oi/off Name: F Z— M ,4 FIZ P N C O Phone#: So 8 - Y/J Address: �-Q THOP6,qu Df2 Village: C/��/7�iZ UI LLr Name of Business: ( ' 64 N/tl / S Poin1t)-yick CD , Type of Busu .iess: - A //1/ / Map/Lot: 9 INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within smgle family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,promzded 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 follo"Ing conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located«Rthin 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 residential 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 sane lot containing the Customary Home Occupation,and not A ithin the required front yard. • There is no exterior storage or display of materials or equipment. • There are nocommercial 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 be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. 1,the undersigne have read and agree vnth the above restrictions for my home.occupation I an registering. Applicant: Date: O� U Homeoc.doc Rev.01/3/08 N. Asse#or's map and lot nurnWer ........ .: Sewa6e•Permit, number ................... ..................................... yo�TMETo�° TOWN OF BARNSTABLE ,, Q Z BAUSTULE, i Mb E M BUILDING INSPECTOR Opp PS a� APPLICATION FOR PERMIT TO .... .... .:::............................................................................................... TYPE OF CONSTRUCTION ......... .�.r°. ................................ ............................................... ' .19 .*. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: t Locatiori .................. ...." ....�o..:!..�"►,- ?f° �!t ....... .:�.......... ......i 00 - Proposed Use ... �.. .... .:.. .:: . .. :.....................................................................................................,......................... ZoningDistrict ................................. ....................................Fire District ... ................. .............................................. k Nameof Owner :. . ............ . .... .. ...... ............................Address ....... .... . ....... .. :.. ..:.......:...................................... Name of Builder .............�. `....................................................Address .................................................................................... Nameof Architect ..................................................................Address .......... ......................................................................... Numberof Rooms ........ ..................................................Foundation ....ao .............................................. Exlerior ....... :. � ..........................................Roofing ...... :..... 1... ............................... .... . .Interior ..... :.:.. . Floors .......................... ....................................................... . . _......6!V .. ........................................ f � Heating '�`� ...................................Plumbing �. .................!.......... Fireplace ......... Approximate Cost :., r''r.......... ... 749 Definitive Plan Approved by Planni g Board --------------------------------19________. Area . .!!.... . Diagram of Lot and Building with Dimensions Fee ........ . """'"' SUBJECT TO APPROVAL OF BOARD OF HEALTH I - - hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name . ... ............ . .............................. �.`� � Small* Alan D. ' 17542 Permit for one otmry, --. ------------ single family dwelling ' ------------------~------'' 9(« . Drive Location .�..�.������^-------------- x Centerville --------.----------,------- Alan E. Small . - . —_ ---------.------------ . ~ �u �r�mm /ypeofCnno�uchon --.----'_—_---- - --------------------------. . �p�� ---------� Lot ---#20-----. _ � - . ' Permit Granted .......De#ew.b.er'3.1........lg74 ' Dote of Inspection ........ ...........................lA Dote Completed ------------'lg ' PERMIT REFUSED ^ -------.------------- lA - -- - -------^^------------------ � r� —._—~---.---------------.--.. - ' ' ----..---------------.-----... ^ - - � ----.-------.-----..--..----. Approved ................................................ lg . � ^ ---------------..~-----.---. � ---------------------'^^^—~— :..�w�..—..:.,. t 7''- E•�,^.a 3r�.-.w.-...r--*+.roman.--.-_.,,.�^+,�•.«;.-- 7-'rr>.•.-—�.:-----..._,_a- Iy FEE ,75 a TOWN OF BARNSTABLE, MASS. DesecrUx 31 19 74 om - m THIS IS TO CERTIFY THAT A PERMIT !W HEREBY GRANTED TO °tat 1`' Alan, S �l 1 axYi la ......... _ _ ........ ............ ..... ......... '\ O (PROPERTY OWNER) )ADDRESS). Bul14 ems story Itme dmIl3.ixg � ' o ........................................................... _ [•L�.�', U�., " (BUILD) N (ALTER)+,O (REPAIR) A wd sl-4�lt� fcaily d lllns 1720 _sq'_EW=1M...__ (TYPE OF BUILDING) - (APPROXIMATE 3126) lot #20 I�op LOCATION, .............. _. _.._....' _. ......._ \ $emy (STREET AND NUMBER (VILLAGE) p 4e. " a C� NAME.OF BUILDER OR CONTRACTOR A mrD �t APPROXIMATE COST ` b ' �e�m I HEREBY AGREE TO CONFORM-TO ALL THE RULES AND REGULATIONS OF THE TOWN 0 9 OF BARNSTABLE, -REGARDING THE ABOVE CONSTRUCTION. m o P9 c.mc ................:.................... ........_ _...._.._.........._._..................._.............._..._.........................................................................._ (OWNER) (CONTRACTORI cc 1A Savage 0520 ....� * ) . BUILDING INSPECTOR' Subject to Approval of Board of Health., I1 /P ;7 Are tof vd`tF/\ d s� L:' : c {7 3x�6 t 4s� 'r' , Al!r ' � p�,•.�, i,. �� rr x.`ta1°� .�� 5 '.�. ,�Y� may¢# ,�p,y,N fiwi:�°' •Ld�"�.k B{:?. ,k. f /V.�1/\Cn�'AV ,i°t I/(d � .,,�*,,: +,,5 ci���,J�. :5� .' z_� �C•�*.S3t't� t ".: a .• ":` a .�• !� 2 �' � .r„ p}� }fir[ ,. d13 ,�. . rk Jv r'r _ # n•, TOlVN OF BARNSTABLE BULK RATE COUNCIL ON AGING U.S. POSTAGE PAID 198 SOUTH STREET NON-PROFIT ORG. HYANNIS, MA. 02601 PERMIT NO. 2 �� � q / � / S� r _ h t Y) j r 1 i i ' � � . ' .1 1 � i 1 , a i Y l5D 4 0 f 1� w G J ` r' f.'.._^'..�^�-w•.r� ..._.:ti.-r'r�ry��..r-l�-f'��.�-....���_+wgl..^G`_.�.J-.��..../.�®y„ ..-»--..-.r+^..Yv^!`"..-�-+.+-+�.w-_^rw'�+w.�r�Y'.'`+ ^^��r_...✓..lrr..�+q�..-+..�'1r.�.�1� Asses^ .r s nzr�p and lot number{ -'..... .......:.. SEPT6C SYarEf,4 gMT. BE INSTALLED IN C Sewage `Permit number .. a'7`"� 'C ;� , SART Ii3Y STlCfE , f'; �o%TNETo�� TOWN OF BARNS i BAHBSTADL"6 9 BUItLDING ' INISP-ECTOR. = O Y{1Y a, t L APPLICATIONFOR`PERMIT TO. :..'. . ... ..... ..................................................................................................... TYPE OF CONSTRUCTION_ ............... ........... . ............ ................................... ..e.....` .. . 19 TO THE INSPECTOR OF BUILDINGS: The undersigned reby applies for a p mit according to the followi information:, s LocationV77 .............. .� Proposed Use ... .. .................. Zoning District .................................. .....................................Fire District .... ................ Name of Owner Address ........ ................. .. ... ................................................. Nameof Builder ..............C..°............. .............................Address .................................................................................... Nameof Architect .........................................:........................Address .............................__....��................................................. Number of Rooms .........�..................................................Foundation wed.................. .. J Exterior ....... `. .. ...........................................Roofing .............. .......................U.0.i..!............................... Floors .........C' ...".'...................................................:.......Interior ..... ........ 1. Heating .........I..:...............................................................,.....Plumbing ..... ...s �Iv..!................................................ Fireplace ......... . ."`.. . ...................................Approximate Cost ........ ......... . Definitive Plan Approved by Planni g Board -----------------------__-------19________. Area-. .4.: .... '.. ............ a..Q Diagram of Lot and Building with Dimensions Fee 19....�..?'�.. .... .......................... SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above -construction. Name ................. ................................................... Small, Alan E. 17542 Permit for ......one story ... single family ..................... Location ........ horeau„Drive..... ............................. I , Centerville ; .................................... ` Owner Alan E. Small Type of Construction .......... T:ame..................... ..... ............................................... .............. @20 .D i Plot ............................. Lot ............................ ` December 31 74 Permit Granted .......... ...........19 Date of'tnspecti'on . .. . ..... .. ....... . ........ Date Comptefed' ry � t PERMIT REFUSED f ...................................... ...................... 19 ............................................................................... ...................t......................................................... ,i. ....s....... ................. ...................... Approved-'n . ......................................... 19 t" .......................................................... ...................................................