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0036 THORNBERRY LANE
w e s � .I. - a 7 � . - ,., . S . . ,.,� A 49 Herring Pond Road I Buzzards Bay,MA 02S32 P.5O8-888-174o F.5o8-833-3377 Resolution E N E R G Y January 23, 2015 Thomas Perry, CBO , Town of Barnstable, Building Division 200 Main Street Hyannis, MA 02601 RE: Insulation/Weatherization Permits Dear Mr. Per This affidavit is to certify that all work completed for insulation work"at: i • 129 Straighway,W Hyannisport • -,,36.Thornberry Lane,Centerville , 48 Oak Neck Rd B, Hyannis has been inspected by a certified Building Performance Institute (BPI) Inspector. All work performed meets or exceeds Federal &State requirement. '- 3 _ incere �. Ph lip D Haglof 4l TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION � ulo� Map �� Parcel_�� Application # Health Division Date Issued 12_iYl/y Conservation Division Application Fee (5 Planning Dept. Permit Fee 3 S Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address 3 tocX her�C.� t-� — Village Owner D a n bolJkL10 Address 3 to Telephone to Permit Request S,, W .L 6y=� 3 fo oA c , 4s7sc,. LLA— q_ �,-I l F0 Cc t L --0 common wct_a qALr,_. 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 o1 new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths xisting new First Floor Room Count Heat Type and Fuel: •❑ Gas it ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing od/coal- ve�:3 Yes;❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ B ❑ existing LI W size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Oth r: C:; Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ CM Commercial ❑Yes U-No --- If yes, site-plan review-# — Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name �E SOLOUTION E N E R 6 Y INC. Telephone Number 69 HERRING NBNO RD. Address BUZZARDS BAY, NA 02532 License# Home Improvement Contractor# Email �'1��(�SOP�� i ``r "�� Worker's Compensation # Q, ,3';� tSY►",► ALL CONSTRUCTION DEBRIS RESULTING F M THIS PROJECT WILL BETAKEN T,Q,4 9 HERRING POND IV 8OZZARDS BAYi NA 02531 SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# DATE-ISSUED m i MAP1 PARCEL NO. t,' ADDRESS VILLAGE OWNER = -� wa DATE OF INSPECTION: FOUNDATION FRAME INSULATION. FIREPLACE' ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING` Ina$--I DATEc.CLOSED OUT" � Y ASSOCIATION.PLAN NO. A .mot. t.t..} 772e CooMWeafth oflv'issachuseffs Depmftwt of gadksMdA e O&C o0"M* on I C'or 'ess Svee4 Sae A6 ' t Boma,194 02.U4.2019 NaMe,(BusinessfOrgafflLmdon/individual): esoi [9n ;OCiergy, lnc. Address:46 t lerling Pond goad City/S e/zi :Beards Bay, MA 02632 phone#:5dg 38$1740 Are y on as employer?Cheek the knpsopriate born TYype of project(rued): I am a general contractor and I I M I arts a employer with a Q S. ❑New construction employees(fall and/or part tune).` have Hired the sub-contractors 2 ❑ I am a sole proprietor or partner- listed on the attached sheet ?. Q Remodeling Ship and have no employees These sub-contractors have 8. Q Demolition workingfor in capacity. employees and have workers' any P ty. 9. Q wilding addition U io workers' camp.insurance comp.insurmce. required.] 5. Q We are a corporation and its 10.Q Electrical repair or additions 3.Q I am a homeowner doing ail worn officers have exercised their ILQ Plumbing repairs or addrdons myself Di To workers' comp. right of exemption per NGL I2.Q Roof repairs insurance required t c.152,§I(4),and we have no weafhetizatlon employees. [i To workers' I3. ]C3iher comp.insurance required.] -Am applicant that ehedw box A must also fill out the section below showing their worlms'compensation policy information. Homeowners t,ho sub=fhis ataftitindleatingdW are doing all wort:andthen hire outside contractors must submit anew a udavitindieatingsuch. tdoniractors that cheek Us box must attached an additional sheet shouting the nettle ofihe sub-contractors and state whether or not#hose entities ha%ra employees. If the sub-connectors have cmployees,they must provide their vorkers'comp.policy number. Kam an errtpfoyer rhd is proWdfng workers,co€sapertsattoFa fneau aztce foF my en ptoyees Below is fize polky r,,7d job she Insurance Company Flame:Gorttlnentai lndernnibj Co. Police or Self ins.I.ic.*.46 8i 2479 0102 Expiration Date:0611 a120't S Job Site Address: Lity/State/Zip: Attach a copy o=fe wsa*•I;, a e0m`PP-msatgon golicy deelarataon page(showing fiche polaeY nu&138 a mad el*atst:<m&LA). Failure to secure coverage as required under Section 25A ofMOL 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 trust the violator. Be advised that a copy of this statement may be forwarded to the Office of ?nvestiovations of Or ins a cov -rerificadon. do Ize aby'en.,'10 p . a Ea of perjury that rase inform aden pa ovided above is tmae and correct a! Sit?natur ate: phone 9:!°� Q�i 4 wl Ilse oa2fy> Do r..0t itr€€re this area,to be con2pfeftd by�as to I offilciaL City or Town: -- �e tl�eer3se zosuing Auaority(circle Glad): -soma of ft, 7-lgMIMg Dmrmmt 3.CRY clera 4.ENOWC21 r 5.fs IMMg&8P%% €f C®�taot�esosa. Phoneme + f !ltL 'sD CpaRMFOCAWIFI E OF Lfli�L`�'flLM O8 SURA iiCE 06/0GYJDDMtYYi DS tf3 O�4 THiS CERTIFICATE iS ISSUED AS A MATTER OF iNFORMATiON ONLY AND-CONFERS NO RIGHTS UPON TE3Ea 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)PISURER(S),AUTHORIZED R@pRESEN TARIUl: OR PRODUCER AND THE CERTIFICATE HOLDER. j IMPORTANT:It the certificate holder is an ADDITIONAL INSURED,the ii f of the of eettaln policies ins c�bs does no d.o SUBROGATION a WAante, subieot Il u of such and eondinoas P �Y� P �Y require e[i endorsemenL A statemtslt on this eartiflttats does not confer eights in the oerti8eate holder in Ilea of such endossemant(4 PRODUCER CONTACT iVNt1E: B PHONE a`iG`�V ae 2.0 25 ciAWIiad f. '77 ...as►evs FAX A ND.E�3 ?7 93S3-C �Q �(NC.Ne): a as ADDRESS: PRODUCER (977)234-4420 cusroMpalcr: INSURER(9)AFFORDING COVERAGE ! NAICa INSURED INSunEaa Coa83.aoat:a3 Eademeti.i; eo. ! a825S a �C. INSURERS: i 49 He=3r,E Vcm,E Rdun>=Rc ! - BUz--Q=dm amrr Ia 02532-2226 INSURER D: I INSURER& CTL 1293 880009 INSURER COVERAGES CERTIFICATE NUMBER: EVlt3tON NUMBER: S THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW'HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOT WITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OFANY CONTRACT OR OTHER DOCUMENT 1!WITH•RESPEGTT0 WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCEAFFORDED SYTHE POLICIES OESCRiBED HEREIN IS SUBJECTTO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILIA1 TYPEOFO URANCE IIN�R SUeR 011CYNU6iB Alm CYEPP f 1ICYEXP M= IGENERALLtABR.tTY I IEACHOCCURRENCE is 1COMMERGIAI.GENSRALUABILiTY 177 —` DAMAGE M RENTED ( MADSS FOCCUR I =i P zee3 iS WDE 1 I { i { Ei{PfAer�en9strs �$ 3 IPERSONALAADV INJURY fS 4 GSTI.AGGREGATELIMITAPPLIES PER: 1G AGGREI,AT S +PRODUCTS-COMPIOPAGG ES POLICY �PAQJECI? ItJ]C i I ; FS L�ffOMOBiLELIABILITVICOM94VEDS¢1GLELitdTT } �ANYAUTO j r�I { If�tdatdi IS 1 ALL OWN@ AUTOS { ! BODILY INJURY IParnat i !SSCHEDULED AUTOS ! MOD YINJURYm dd tIS �HIREDAUT�OS y PROPERTYDA�IRHGE I j �idONAWNEOAUTOS ` _ r s s �i t1rABAEI.t A L1ABi "'OCCUR = i "'EACH OCCURRENCE is �T CESSLtAB `CiR4tS•MAD2 I� _i jAGGREGATe s i ,DEDUCTIBLE 1 �REfWON S I { F is .S IYORICERSCOMPLWBAMON I ! { I XJWWCSTATU• i jOTH•i A1`1R€Pr9P69Y(;R8'LIABILITY I RY GMrrs ER p�p ,�p� YIN c1 l Rth, Mo I ;NIA I z... �6m�72479mQ2�Ov ©8I2.41ZU �®Sf3A�/a jF-L ACHACCIOCNT (idandatoey In NH) I s I E.LOlseme—gAemp mti. Is 500,000 it yes.d9ecnT19 mtder � j 1! � SPECiht PROVISIONSI err ; ( iF_LDIst=Ast-POucYtuJtr S 300,00 I I : •r t DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLIM(Aticoh Aeord 101,Additional Rommtes Schedule,It Moro anaco to required) CERTIFICATE 0 CANCELLATION Fca�= e�p S�ld6de SHOULD ANY OFTHEABOVEDESCMEDPOLICMSSRCANCEL1.i DWORS-11M .= WIMOYASE RNOTICEWILLSHO REDINACCORDANCEWITH THE PALPTI6S. ram = Pm r8 )L 92532 2226 AUTHDR=REPRE.9ENTATIVE L1a 'oE�G'G _.$2 Z$ ACORO 28(2008/DB) TQBACOAO name and logo are reglsloR:u msrtte OtAGORD i IBM2029 ACORD CORPORATION.All eights ranwacl. V' 141,D*'054 006629 ✓✓ �t3 t RISE Engineering. an ctor, BglstPeUonNo5las MA Co of Registration No 120979 A.division of Tbielseb Engmeeringr ". - CT Co 3 Registration NoA20120.. 25.Mid-Tech Drive,Suite H,West YarmoiTth, tlC l L 601 CT 508-568-1926 X-6610 EAX.S08=568-19 Page RII S E, PROGRAM. Tws cbNTriacT EHTEREo 1Nro BETVJEEiI'RLaE: CLC-RCS DESCRIBED BELOW O'AND THE CUSTOMER EORNORK AS ENGINEERING CUSTOMER'. PHONE - DATE. CLIENT#: WORK ORDER Dawrt:Balkin. (:44MO-3684 06/11/2014. 146569 00.004 SERIACe STREET SLONG STREET 36 Thotnbelry I aria 36 ThombelTy Lane; SERVICE-CITY,STATE,LP BILLING CRY;STATE;zIP Centerville,MA..0263'2 Centerville,MA'02632.. JOB DESCRIPTION AIR SEALING:Provide laborand materials to seal ar6m bf your home against wasteful,excess air leakage This.work`will:be performed.in concertwith the use of special toolsand diagnostic tests to assure that your home will be left with.a:heatthful leeel;o€ air exchange and indoor air quality.Materials to be:used to seal yourhome can include caulks foams;weatherstriPpmg and:oher . . . products. Primary areas for:sealing include air leakage to.attics,basements attached garages,and.other unheated areas(wndows,are not generally addressed.) (5j working.hours: At the,completion of the weatherization work,and..at no additional costto the'homeowner,a;final'blo_wer door and/or combustion. safety analysis will;be conducted by the sub-contractor to ensure:the safety,of the.ndoor dir.quality.. $385:00 ATTIC FLAT Provide labor:and materials to iristell a 10"layer of R=35 Class I Cellulose added to(80)squaie'feet of open attic space. $I OT20 FIX EXISTING INSULATION:Slash the vapor barrier,flip,or re7position(80)square feet of.insulation in theattic area ..$20.00 _. COMMON WALLS:Provedi;ta.bor and materials to.iirigWl 3.5"R.13.faced Efberglas4)baq.:in.sulation.to(45,)square feet of kneewal1 arm., igid fiberglass insulation will.be installed:over the surface: $18,2�70 COMMON WALLS:Provide.labor and:materials.to.InsW 2"FSK faced semi-rigid fiberglass board insuladon:'to(45)squaTE feet"of common well aret $14895 Total: $843.85 -- -- Program Incentive: $714.14 Customer Total: $129.71 WE AGREE HEREBY TG FURNISH SERVICES.F COMPLETE IN ACCORDANCE WITH AidVE SPECIFICATIONS.FOR THE SUM OF *"'One Hundred Twenty.-Nine 8 711100 Dollars $129.71 UPON FINALINSPECTIONANO APPROVAL BYRR1E ENOINEBUNG; R U1 CUSTOMER AGREES TO REMAMOUNT DUE FULLtHTEREsT OF mWILL BE CHARGED MONTHLY.0 ANY .UNPAID BALANCE .SEE-REVERSE FOR RAPORTA - TKIN OWGUARAIiTEES,RIGHT S OF RECISION,SCHEDUUNO,ANDCONTRACTGR REOISTRA'N' DO NOTS19W,THIS CONTRACT IF THERE ARE ANY.BLANK SPACES [lawn aalkin lOct 29 201ax f�DNATURE•RISE ENGINEERING--� M USTOMER - - - ACCEPTANCE NOTE:TIUS CONTRACT MAY SEVATHGR'WN SY US IF NOT EXECUTED WmQN DATE OF ACCEPTANCE Yam' ACCEPTANCE OF CONTRACT-THE:ABOVE PRICES,SPECIFICATIONS AND CONDITIONS-ARE SATISFACTORY TO US AND ARE HEREBY ACCEPTED.YOU ARE AUTHOR=TO DOYHE WORK DAYS. AS SPECIFIED.PAYMENT WILL FIE MADE AS.OUTLINED ABOVE OWNER AUTHORIZATION FORM ( er's Name) owner of the property located at 3 l� / A o rn (Property Address) a2A (Property Add ) hereby authorize 1p—'��C v ' l I Y (Subcontractor) an authorized subcontractor for RISE Engineering,to art on my behalf to building permit and to perform work on my property. 0awn MM(Oct 25.2014) Owner's Signature Date wit s Office of CoRiszir ner Affairs Wd � stress�egi�la�I�� I®panic plaza.. Suite 5170 Boston,lwassadx pits 02116 Reg@siraiiant 178211 Tyrpw. Coopomiion ��pp �y g Apr•+ `.,•;. Expireffoir �6oza� RESOLUTION 49I ERRING PONES R® � _____...__._.._..... Buzz ARID BAY, MA 02532 ...�.._._ __ __ �........._._......_._____._.._-- Update Address nod ieturn curta.Mart,Wars"tmB•all'tgc. Jt ailt�gess ll2eneayse@ [ a m ployomon:C ( ] 9,m 3t Q;ratrd t r: ilJ!•,Nn/IrrlLvi///a/.''•llirJ�ra�trra/1� H,ies�BBs�mB•rcg6s�xBQt®BB�+aB13d for imavMtet fl4s�®anH� Or6ee of cousenjor/,M5rs ASusWN Imegro10"a boT.ore goo agpirallon date. orfrownd ire1Bam trio . —w! OINE IMPROVEMEW CONTRACTOR office of CessumesrMUM soma@ 81odoess Hte;aelaateoaB i Qgistraiimn: .118211 1 lyps' + - CorprnYaiton of @'nr@c(NHueso-Soolla�5@"IO pird"on: 312e02(Pt6 tHos@oto,IJJ�,N�HH� R15SO 710" PHILIP iRAGLOF ` 49 HERRING POND 62D,,.' �^�°���"�� vrsalla@ HIos t�taBa re BUZZARD BAY,MA 02532 9 intlercsecn e8nay xt :d v•B `lif.'•fi119 '-.Z9:.. ...o- �.r ' «nstrurtion Super<'iti+�r CS 907642 56 SWCONSET D!R SAGAMopE BEAc MA MS62 0712612017 j s TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION t 7 ol Map• /Parcel Application #0,0 dC;) 1 Health Division / Date Issued Conservation Division Application Fee Planning Dept. Permit Fee .: Date Definitive Plan Approved by Planning CQ Board '/Zll�y, Historic - OKH _ Preservation/ Hyannis AW Project Street Address LG I ^V .rly '�� Village C. ( f Owner N Wi✓ �G. N Address Telephone Permit Request e ' �wkS !v w t Ld ^ / i Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new 'Zoning District Flood Plain .Groundwater Overlay Project Valuation Construction Type a Lot Size Grandfathered: ❑Yes ❑ No' If yes, attach supporting documentation. Dwelling Type: Single Family I Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic Houser ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: t4 Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing � new Half: existing _neA4_ Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas 1] Oil ❑ Electric ❑ Other Central Air: �]Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Dq.tached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn l existing ne, size_ Attached garage: lexisting ❑ new size _Shed: ❑ existing ❑ new size _ Othes� CD =° Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION ` (BUILDER OR HOMEOW-NER)-. Name. Telephone Number 9-- ZL O Ft Address lon 7? License # l�f Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO "-A— SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# ' i PATE ISSUED MAP/PARCEL NO. F4 ADDRESS - VILLAGE t OWNER ti t ? DATE OF INSPECTION: __FOUNDATION FRAME f/l 3 1 `� L✓G �o6cuAR INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL-' F PLUMBING: ROUGH FINAL z ff GAS: ROUGH FINAL FINAL BUILDING = DATE CLOSED OUT ASSOCIATION PLAN NO. r The Commamveaith of MasaachusE& Deportment of Indkstrial Ac ids Office D,f inpestkations 600 Waashingim sb eet Wcwlce& Compessat an lus movie A#fi&vit Baders/Co_..�Actm & =ice::s Plumbers 'cantIlal'ormaidon Pleme PrintEgo'bly Name Address: O(Businesslo 'nllndividnal : .. (f1 Q citylstatdzip: Arc you an employer?Cheek the appa opAnte box: Type of pro] (rued): 1-❑ I am a employer with 4. ❑I am a general contractor and I S- ❑New won employees(fu11 andlarpart-time)_* have hired the sub-contracbzs 2.❑ I am a sole proprietor orpartuer- listed an the attached sheet 7- 5rRemodeling ship and bane.no employees These sub-aoatracturs have g- ❑motion vmddng for mein any capacity. employees and have wosows' 9. ❑Buihimg addition [No woricers'comp.insurance CQmP-mstaaace Z �i�d-] 5. [ ] We area corporation and its 14_❑Electrical repass or additions 3. I t`officers have exercised fheir 11 Phuabia airs or additions ❑ am a homearu�er cl8' all work -❑ g TAP ri of exemption r MGL rYryself [Na workers'�- g� �F per Roof insurance d t c_152.§1(4k and we have no b employees.[No worloers 13-0 Other comp.insurance required.] 'Aayapplucs fistchedrsbazMmast•alsofillout the smfianbelow showing lhravarke&campm„ml+m policy infamudon. Hameasuaers srho submit this affidavit iuMcsting they axe doing fll waxt•and then hue outside contmcmrs most submit z sew davit indicating mxh. 'ZCoahactzsthatch—'k tbisboz must attached m additional sheet showiagthename of Me sub-cMftscbm Ed Ma whetter otnottbnss n9tiesha*Ve employees. If the s aKmitactotsbm employees,theymastpawide their workers'comp.porky mmtber. I tun all a;tnptoyasr fhatisprm idfng workers'comper az6on i=jrtuice for my earplbyees 8elnts is tliepalicy rurrl job srig iriforma am ( ksumee,Compmryr Name: t 1 c Policy 4 or&1f in&Uc.k Fxp intion.Date: Job Site Address: 7L(f e (- Ci•: -V t 2 GigOStaw2r p: Attar Jt a tiopy of tha isarkers'compensation policy tltrIaration Page(showing the policy number and expiration datC}. Failure to secure coverage as required under Section 25A of M3L c.152.can lead to the imposition afcrirninal penalties of a fine up to 31, MOD and/or one-year imPnsorffnmf as well as cavil penalties in the form.of a STOP WORK ORDI Rand a fine of up to$..50.00 a day against the violator- Be advised that a copy of this statement maybe forwarded to the Office of InvesEigationi of the DIA for inwranre coverage verrEcatiem. I do Ttemby cerh;fy under the ' s and penaiYies ofpedw7 tliatth&Wonrzarum provided' fs fte and consent - tun- Die. ( r / Phone _ 2 Orkial am anlyt Do wt wrAr in this wear,to he completed by city or imm affidal City or Town: PermhUcense-9 Is wing AQtbority(drde on* if L Board of Health 2.Buffidang Depxrtment 3.CityfFowa C erk 4.Electrical Inspector 5.Plumbing Inspector S.Other contact P'ersom Phone 6 TDIREA OP ID: KG ACORO" DATE(MMIODIY" CERTIFICATE OF LIABILITY INSURANCE 1010812013 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 pollcy(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). r PRODUCER CORrAPhone:508-771-1632 NAME C j Northwood Ins.Agency,Inc. PHONE kX 540 Main Street,Suite 9 Fax:508-393-2955 C No E : AIC No): Hyannis,MA 02601 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC 0 INSURER A:WESTERN WORLD INSURANCE CO INSURED TDI Realty Group Inc. INSURERB:Liberty Mutual Insurance Co. P O BOX 796 INSURER C: Hyannisport, MA 02647 INSURER D: 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. 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. ILTR TYPE OF INSURANCE I POLICY NUMBER MMIDD MM R IDDNWY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY NPP8015329 01/1612013 01/1612014 PREMISES Ea occurrence $ 50,00 CLAIMS-MADE FX__1 OCCUR MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1,000,00 POLICY PR0 LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accdent $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X I WC STATU- I OTH- AND EMPLOYERS'LIABILITY T YIN ER B ANY PROPRIETOR/PARTNERIEXECUIIVE TBI091413 09/14/2013 09/14/2014 E.L EACH ACCIDENT $ 100,00 OFFICERIMEMBER EXCLUDED? El NIA(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,00 Ifyes,describe under DESCRIPTION OF OPERATIONS below E-L.DISEASE-POLICY LIMIT $ 500,00 ommercial Applica DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) General contractorContractors Executive Supervisor CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN TDI Realty Group, Inc. ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE i O 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD i n Massachusetts -Department of Public Safety �J Board of Building Regulations and Standards Construction Supervisor ' License: CS-098149 TATE D ISENSTAk PO BOX 7% Hyannis Port MA%026 jV Expiration Commissioner 03/24/2015 i - vs2e (Parrirrzoruuea��L o�C%vGaadacliciaeC�iJ- ..._ _':�. -•�.._�.—.._._ —--- F - Office of Consumer Affairs&Business Regulation License or registration valid for mdividul use only ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: y egistration f 5997 Type: 1 Office of Consumer Affairs and Business Regulation xpiration 5l29/21215 Private Corporatio 10 Park Plaza-Suite 5170 ` � 7 _ Boston,MA 02116 {, T D I REALTY GROUP INC �� i` TATE ISENSTADT r 55 LAKE AVE. E HYANNIS PORT,MA 02647 g Undersecretary Not valid without signature 1 �lime Town of Barnstable Regulatory Services r Thomas F.Geiler,Director Building Division• Tom Perry,Building Commissioner .. " 200 Main street;Hyannis,MA 02601 www.towmbarnstable.ma.us - ..J +- Office: 508-862-4038 Fr Fax 509-790-6230 Property Owner Must ` Complete and Sign This Section If Using A Builder I, Vacv ti ell&� , as Owner of the subject property hereby authorize mot. to act on inT behalf _ in all matters relative to work authorized by this building petmit 37Grftj"Fry - l G '•-� (Address of Job **Pool fences and alarms are the responsibility of the applicant. Pools � P tY PP are not to b%.-. filled or utilized before fence is installed and all final inspections are performed and accepted. Sig a e of Owner ' Signature of Applicant l�taWn Krn a .�^t4jk Print Name Print Name Dat QFORI+MOWNERPERIMSIONPOOI:S 6/2012 �"'E'"'�►. Town of Barnstable Regulatory Services Thomas F.Geiler,Director � BniTding Division Tom Perry,Building Commissioner s 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038• Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: m=ber street village r "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire'who does not possess a license,provided that the owner acts as supervisor. E DEFINITION OF HOMEOWNER Persons)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be, a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form _ acceptable to the Building Official that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) 1 � The undersigned"Homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. +I The undersigned"homeowner"certifies that he,/she understands the Town of Barnstable Building Department minimum inspection 1 procedures and requirements and that he/she will comply with said procedures and requirements.- Signature of Homeowner Xr" 0,0 J6 Approval of Building Official �tSr, i Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Buiilding.Code Section 127.0 Construction Control. "^ ' HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building per is regnred shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that�if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This-lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. ' To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns.;You may:care t amend and adopt such a form/certification for use in your community. C:1UsersldecoIlik\AppDatMLocaA crosoRlw"mdomITemporaryInternetFfleslContenLoadooklQREEUMN\EYPRESS.doc Revised 053012 a _ - V *fit. ! .� a _. W M T ' s a Ar . r . 11/14/14 Thomas Perry, CBO Town of Barnstable Building Division 200 Main St Hyannis, MA 02601 RE: Insulation Permits Hear Mr. Perry, This affidavit is to certify that all work completed for insulation work at 36 Thorberry Lane (application#201307291) has been inspected by a certified Building Performance Institute(BPI) Inspector. All work performed meets or exceeds Federal and State requirements. Sincerely, Conor McInerney ConserVision Energy CD R C> 00 NO �." 376 ROUTE 130,SUITE C SANDWICH,MA 02563 508-833-8384 WWW.CONSERVTODAY.COM \J TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION - QL�c Map Parcel Application # Health Division Date Issued Conservation Division Application Fey Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address 31 1 T Y 6Py Y 4 L4 Village I ) Owner s h � �' ��C, n Address `jj�� L vq Telephone Permit Request I �1 U OWE 1 o Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total neLn ;Zoning District Flood Plain Groundwater Overlay --- m 'Project Valuation �,O-m 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 U.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 Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number Address 3-7 b Kayk (SID License #_ S!sV ,A IA/i CXX 'en � C Home Improvement Contractor# I '2-f _s Worker's Compensation # , WL-7 qS J 34 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO LYr1rIV`Q� SIGNATURE DATE ID 7 P` F FOR OFFICIAL USE ONLY APPLICATION# DATEISSUED ' MAP/PARCEL NO. ADDRESS VILLAGE OWNER it w F DATE OF INSPECTION: 3EO.UNDAI.ON� r� FRAME -- - - -- -- - . i iINS.ULATION.' _,tCDA 111,aM FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL = - FINAL.BUILDING� - DATE CLOSED OUT ASSOCIATION PLAN NO. OWNER AUTHORIZATION FORM R ` (O.wner's Name) . owner of the property located at l (Property Address), (PropertyA dress); t hereby authorize (Subcontractor): an authorized subcontractorfor RISE Engineering,to:.act on,my behaifao obtain a building I permit.and to perform.work on my property:; Owner's Si Z Z o Date, Gl � 1 I I CONSENE-01 MVAUCPHAN ACCIRLY OATS n�0ff"YI CERTIFICATE OF LIABILITY INSURANCE 3120013.. 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 ISSUINti INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE4ERTIFICATE MOLDER. IMPORTANT: 11 the. certificate holder Is an ADDITIONAL INSURED;the policy(les)must be endorsed. If SUBROGATION ES WAIVED,subject to I! the terms and conditions of the policy,certain.poiloles may require an endorsement: A statement on this certificate&Be not confer rights to tale II certificate holder in ilau of such endomemant(s). I PRODUCER . . .. :CONTA T . ... �. .Sirate is Business Unit Roggers&Gray.Ins.-Dennis.Branch PHONE FAX. A34 Rte 134. (Fs08.3t18-7g80 Aec No 877 .816-2166 South Dennis,MA 02060 E-MAIL ADDRESS: INSUR AFFORDING COVERAGE, NAIC9 INsuRERA.Sefectivp Ins:CO of the:Southeast ;.INSURED INSURER$::- .. . Con-Serve Energy,Inc. IN SURER C: dba ConserVlsion Energy -- 607 Main St INSURER D: Hyannis,MA 02601 INSURER a: INSURER:F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: I THIS IS TO CERTIFY THAT THE:POLICIES OF INSURANCE LISTED.13ELOWHAVF BEEN ISSUED TO THE INSURED,NAIMED A60VF FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO YIMICH: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 L TYPE OFWSURANCE POLICY NUMBER .m `EFF ...Ln4HS . . .._OEHERALLIAanJTY - - EACHOCCt1RRENCE. _ $ i,000;0_. A ��.x COMMERG4LGENERALLUU�ITY 2014299 3I1412013 0/1412014 .PRE}AI ES Eaocaurenco $ loil'0001 CLAIMS-MADEX�Oepto MEDEXP(Any awpersm) $ 10,00 PERSONA!.d ADV INJURY. S . 1 eOaU,O I GENERALAGGREGATE $ 3;000;00 j Gr4rL AGGREGATE LIMIT APPI:IESPER- ` PRODUCTS-•CoMP/OPAGG. S MOM POLICY LOC S AU'4DlIOBLELtI161trr'1 - i ANY AUTO BODILY INJURY(Pe/peleon)ALL 5 . . .. .. I AUTOS D AUTOS O- BODILYINJURY(Pwo dQenl) $ NONOMED HIRED AUTOS -AUTOS PERACCIDE G S UMBRELIA LIAROCCUR - - - - EACHOCCURRENCE S EXCESS I" HcLAims-mAm �. AGGREGATE 5 _ OED RETENTION$ t, S i WORKERSCOMPUMT101i - VLFSTATU- OTH- - I AM EMPLOYERS LIMMJTY TS2LY L ILL$- £ A MY PROPRETORIPARTNER+. cuUVE Y l N C7966639 3/14�/2013 3114/201'4 E.L EACK ACCIDENT $ 500,00 I.. OFFiCERATF]U�tE:OCLUDEO? - � N!A .. ...._ (- (UWW"kiNN) E.L.018EAS E-EA EAMLOYEE S . 5a0,00 j H OC9CiW8tnder TICNOF.OPERAT)ON.SbeWw E.LOSEASE-POUCYL T S 500,000 DESCRIPTION OF OPERATIONS I.LOCATIONS I VEISCLES(A—ACORD101.AdQ kmlRemuka.Schidgle.Or Mom Vaea is-q—d) —EXCLUDED OFFICERS UNDER WORKERS COMPENSATION:CONOR&COURTNEY MCWERNEY"NOTE THAT BLANKET ADDITIONAL INSURED COVERAGE APPLIES TO THE UDMAIE cmi_GENERAL LIABILITY(IFA WRITTEN:CONTRAET 18IN PLACE). CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE A60VE DESCRIBEO:POLICIBS.BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Rise ERgineering. I ACCORDANCE VATH THE POLICY PROVISIONS. 1381 Elnwdood.AAve. Cranston;RI.02010 --: AUTHORIZED REPRESENTATIVE 01988-2010 ACORD CORPORATION: All rights reserved. ACOR0.2S("10106) The ACORO name and logo are registered marks of ACORQ The Commonwealth ofMassachusetts Print Farm Departinent of Industrial Accidelits Off ce of Investigations I Congress Street,Suite 100 Boston, MA 021144017 ' www:Mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors(ElectricianslPlumhers Applicant Information . . . Please Print Legibly Narne (Business/Orgatuzation/individual): Con_Serve.Energy,Inc dba ConserVision Energy. Address:376 Route 130 City/State/Zip:Sandwich, Ma 02563 Phone##: Are you an employer?Check.the:appropriate box: Type of project(required): 1.Q i.am a.employer with.8 4• ❑ 1.am.a general contractor and I :. have.hired thesub-contractors 6. .New construction employees(full and/t or part-time). 2..❑ I am a sole props ietor or partner- listed on.the attached:sheet: 7. ❑ Remodeling ship and have no.employees These sub-contractors.have h. ❑ Demolition working for ttie in any capacity. employees and have workers' 9. ❑Building addition [No workers'comp. insurance camp. insurance:* required.] S. ❑ We are a..corporation and its 10:❑ Electrical repairs or additions officers have exercised their 3,:❑ I am a homeownerdoing all work I Ln Plumbing repairs or.additions myself..f No workers'comp: right of exemption per MGL 12.❑.hoof repairs 'insurance required.]t c. 152,{t(4),and we.have no Weatherizafiort 2043 employees. [No workers' 1321 Other comp..insurance required] Any a pp.l.ieant that checks box#I must also fill out the section below showing their workers'compensation policy information: fl:omeowneis.who subinit this affidavit indicating they are doing.all work and then hire outside contractors mustsuhmit a nevi affidavit indicating such. ;Contractors that check this box must attached an additional sheet showing the name af.l:he sub-contractors and:statt whether.or not those entities have employees. If the sub contract rs have employees,they must provide their wotkers.'xo►np.policy number: I am.an employer&atis providing workers'compensation insurance.for my employees. Below is the policy and job site .information. Insurance Company Name:Selective Insurance Co.of the SouthEast Policy#or Self-ns.Lie.M,WC7956539 Expiration Date 3i14l2014 Job Site Address: ... .. City/State/Zip- Attach_a copy of the workers'compensation policy deciaration page(showing the policy number and expiration date.). Failure to secure coverage as required tinder Section'25A of MGL e. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as.wei{as.civil.penalties in the form of a STOP WORK ORDER.and.a fine of no to$2.50.00 a day against the violator. Be.advised that a copy of his statement may be:forwarded to the Office of Investigations:of the DIA for insurance coverage verification_ hdo hereby rerti under the sins and ehalties geerjua that the information.provided above is true and correct Si nature: �. Date.`. Z 2013 Phone#:508-833-8384 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.CityfTown Clerk. 4.Electrical Inspector 5..Plumbing Inspector 6.Other Contact Person: Phone#: CSSL-102778 r CONOR D MCLNERNEy 39 SIASCONSE:T URNE SAGAMORE 13EACH MA 02j62 08/19/2014 i Office of Consumer:affairs&Business Regulation HOME IMPROVEMEtdT CONTRACTOR = Registration: 171251. Type: Expiration:. 3/112014. Partnership CON-SERVE ENERGY CO.NOR MCINERNEY 376:ROUTE.130 SUITE.0 SANDWICH,MA 02563. Uodersercetxrr License or registration valid for.individul use:only Wore the expiration date. If found return to: Office of Consumer Affairs.,and Business Regulation, 10 Park-Plaza-Suite 5170 Boston,MA02116 Not valid without signature I TOWN OF BARNSTABLE Permit No. Building Inspector cash rY• ' ______________�___.._ _ OCCUPANCY PERMIT Bond ----_____--______� Issued to Address lot 4t-L6 36 !:1wruberry l,alie, Gente*ville Wiring Inspector Inspection date Plumbing Inspector ? .,_ Inspection date J . 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............ ...................................................................................................... IL _._...._ Building Inspector . - -, _,' � ,-. .- ' '!', .y .. ,� ,i'N. ;: ... . a .. � -.",:1^..,..:.i• „''^..^,�.�.. - .'tip. ,.�,i-`' r , a ``+ ��..� ��•'. TOWN OF BA. RNSTABLE BUILDING DEPARTMENT s saaaeT = TOWN OFFICE BUILDING HYANNIS, MA S-02601 •r MEMO TO: Town Clerk FROM: Building Department DATE: June 14, 1985 An Occupancy Permit has been issued for the building authorized by Building Permit 2 6 8 2 0 .......__.... ........................... Silvia & Silvia Assoc. issuedto ........................................._....................................................................................................................................»............................................... Please release the performance bond. rfjAswsesser's map and lot number ....................� . THEage Permit number ...o..y^ .:. . ..... ..7.. /r -� . ...... EPTIC SYSTEM MUST BE ST 2 Baaa9TenLE, House number '`'� 3 f! '�- � IN COMPLIANCE +� M�9 Die h TITLE 5 ,,�10 10?MA TOWN OF BARNS-TABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ....VPAI�f.1..4....... ....1�/'/.1.... ..................................................................... TYPE OF CONSTRUCTION �,l,/oo po.�sT.PvG d ..... ........................... .......................................................................................... . .. .................................19A y TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following Xinformat Location ... .. .. ......... ' 1�J'�..xmalw�. .........X e.* !G`...... .... .....�............. Proposed Use .... /..d1�.1.E...... -Ml.ze ........................................................ Zoning District C ---i..........................................Fire District �..%-.0.....4Y A4.................... ..... ..... ................................... �+ �v Name of Owner ., / .U.lt ....4�f.��/!/ ...�rsO4..� -.Address .`�� ��' „�• ...r ./... ofBuilder ....................................................................Address ....�................................................................................ of Architect lS�?!'�..... lJ!CU 6.` ......................Address ..11..`�f�r�,�s��ll... 1 .�. .................................. 4111-2 er of Rooms .......7........................................................Foundation ./.o.�P.frrG'........�A.4'.�i.'s.f tr.................... • . T ior .fit!, LV.......r,,, •ty.��................................................Roofing . .A ............................................................. Interior ..,00rs 0 ..... ................... .f' .co.Ti4d`l..A............................................... Heating 1.r1!�G�a.... d ... tlf�T�2...47.... '..l.........Plumbing ...4. 42....... .. ........................... i place .............:....................................................................Approximate Cost . lQ. ..Q..tl....f!.d .. ............ Definitive Plan Approved by Planning Board Y __ ______19__ __. Arec���-�f�+ ........ Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH I q 9s", SI I 3 3 l0 1 1� I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the nnabove construction. 31 Name ,a. ?%':"-...-.21;1 �................ & SILVIA ASSOCIATES, INC No ...26820 j1pp ... Permit for .l�......S� . ............... Single Family Dwelling Location L.t 18, 36 Thornberry...Lane...................... ........ Centerville ...........................................................................F Owner ...Silvia & Silvia Associates, Inc. ............................................................... Type of Construction Ycame.............................. ................................................................................ Plot ............................ Lot ................................ Permit Granted .....August..a.................19 84 Date of Inspection ..................................19 Date Completed ............19 '1�' PERMIT REFUSED 19 .. .�.b. ..................................................... c . .....4 .........0! W.. ............ Approved ................................................ 19 ............................................................................... ............................................................................... Ass{es'sor'symap and lot number ......... ......... (, , F CF THE to Sewage Permit number ...�f...r.. ✓t�(` Z BABHSTADLE, i House number ...........'.................''E...`::. '............................... 9O MAB6 s }. =o O i639 `00 MPY a• h� TOWN OF BARNSTABLE . BUILDING INSPECTOR r APPLICATION. FOR PERMIT TO 'iX c! r•9 .!f...�!.i ....: ....... ........... TYPE OF CONSTRUCTION ... 5?,0 ©�-!sT,��� 7�a Ap 19.E 7 ................................ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ... ........ �,/.�I,C�/�3E�Pl� ......... �....... ....... ..../...,�./...."_.' ...........� ?' .�....� ProposedUse ....... rt.. ....... .......................... ..................................................................................... ............................ Zoning District .......................................Fire District ...0. �/� Name of Owner .:, /..�.f•/!. .... �,. ........ .�... !!!c-.Address .. 1��..: !l !!v .,S./..�.......... i✓� cl�l// Nameof Builder .......................Address .................... ............................................................. Name of Architect ...... lRU.F.%......................Address •�/,.r...... .5 ................................. Number of Rooms ..................................................Foundation ,ce Ov u !�...................... ........................................ Exierior ./"zq�?,o...... .....................................................Roofin T� 17.9,T g ,. .... .5�................................................ . .................... Floors ... A....................................................................Interior....Interior .......���:�`-.?•".'/.�+r3;�,. :............................................... Heating !?' ,�. ..... U/.• e5f7 .......Plumbing ... .... t� 1�. .............................. Fireplace ...... ............................ ....................................Approximate Cot .... ���1•r' r.0 ' o. Definitive Plan Approved by Planning Board ----4`j__�_-_---_______________19__ ti' Area '� � .. !.....� .G'J Diagram of Lot and Building with .Dimensions Fee v SUBJECT TO APPROVAL OF BOARD OF HEALTH la 11 !ef ` - I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. 9 3/ Name•;..�.�./.,,.... .................................... .... ................. SILVTA & SILVT-A ASSOCIATES, INC. 26820... Permit for 11,- story 'N a .............. .................................... Single Family Dwelling Location Lot...18 36..Thorri.berry...I.ane........ ........... .......... . ...... Centerville ............................................................................... Owner ...Si.l.via...&...Si.1.via..Assoc.i.ates.,.Jnc. .... . ...... . .... . ...... ........... . ........ . Type of Construction Frame .......................................... ................................................................................ Plot ............................ Lot ................................ August 8, 84 Permit Granted ........................................19 Date of Inspection ....................................19 'Date Completed ......................................19 ................................................................... ..P�..E..R..M...I.T.. ........Fa.U.>>. .S. .E .D . .. ..... . . .................. .........................1.9 ?/.A.. .......... ... .. .... . . ... ............... . . . ................................................................................................ Approved ................................................ 19 ............................................................................... ............................................................................... \ N N z � v v v f j — f ' I1� SS' f - - po• V S _ - b 2c�2. / o • 1-4� i -1- 1 •'�y 7-- THE STRUCTURE SHOWN W Q5 IN LOCATED ON rHE GROUND { MASS. ON S�LSY Z S, / 984 CLsn/T�Z��G.LC � THIS SKE rCH /S FOR PURPOSES ONLY AND SHOUL Q ,Qvl'cu 6 7`, X , /984 / = 2 n" NO r BE USED FOR AN Y O rHER PURPOSE. N of 4f P 4f s9�y -4csP£ CDD SURVEY CONSUL;•ANTS (� FRANK v 76 £Nr£PP1?,lS£ RoAo WHITING NYANNIS , MASS REGISTERED L AND URVE YOR No. 29869 in FC/sT E,' A �SURNJ PRO✓EC r NO. 03 - 13z /-a/ S m A 2 O v- Z Ip c c j n � o _ L S - - note: - build this wall"for removing exci5ting wall Fnld'mq'ir.n;nq board - d n x I UA �-- _ O 0 I vl Y-IT GNEN ._ L__i -old;nq you-,+cr w+l�+l�zlvzs . i .. I D o0 +ry - Linen G..Line+Ly Lu;ldar 4 I O W Q ua 4'- /d•• i C I I W j Z # O- 7 � rsm d ��FI�hT FLOOD PLAN ,tale. 1 17 I._-,. ....._... w.�lb+,�L•z rcn,✓vet p� . _ tr.e In+:;rn,,;,,n..l�'-e,;er,n+�..l G�•.�e 1 ooe m,' t s�'� � � — Ed'�+;on.n.i+I�z tt4ss..�l�usz++s�e>o Gtt�' t w- • IW _ 0 _ S 1 00I l, All He r hen+sf Oin - z+o �'m o A La si+z zrif izJ LY Ganzr.I'G.r�+r..c f— n L Z � U G DR.ANN6 T rP=: f l—r Plan i - SHEETxxNUMBc R: � m rouya a a� o0 4 � MWURSH Y c 4. L 0 211 c 0 y 0 x Ol 7 N r , 1 L > L Arne � Ail vx'wtingyligl:};to remain (� r(re-Luild ceiling wl�ery nv-_v.. aryl. nl , LU O m 1 1 � Q - 0 �..�.,m O ..• `,r �N rr Z o O �, Z to tLe — \ # J V 3 e z w o O � O Y 03 v it ., .....r - p, hEGONIJ FLOOD-PLAN 5O�' ®Z. . \ \ T pla d..q -I' ..[c✓rda n;.v w t� !�O O O 3 O f t° 6 tI ntv # Ik-n- 1n+atG:.dv _009 Oa io N.�� 7 t±0 i �,I.00.�hh Edi#ic•n. '"J g'�'£ z T All J u E P ' All ttesure me n}s!I7'imen-.�un�.a+,. Top 3 �._.� Le z eriFivd Ey Ge oral Gs..�r.etor v n L W d p C a+tune of�,n,truet inn IV d, Omobs oe+e�.#a. DRAWING TYPE: hE�ond Floor Pfan f SHEET NUMBER: I t . I - 12 REVISIONS: t 10 L-f TEST P/T DATA -- - - - PERC. TEST DATA SEPTIC TANK DETAIL • s�zE- 1��� A�. DIST. BOX DETAIL LEACHING FAC/LITY DETAIL• ���� z,�y����� JSG`� DATE CF TESr/NG . _ -1 �-A _3 50 y 1 TEST BY eAXT Iv - `�: _ ��r s>n , rP_- - DATE OF TESTING: . 4/� � ' TANK TO CONFORM TD T/r;E 5 REOU'REMENTS TO tJNf!�RM '0 T)TiESRfJi'R£MENTS Z "�iTc� F=V-01tvrif ;, (•,(j`/�Td.S W/TNESSED BY _ - L.LLy _ --- - - rEsr BY; NO. OF OUTLETS, rl 7 F t Imo•(; -� Pt-MOf }_� - - •w'•- 4. K Af3L E CUB E R ` ... { f I W/TNESSED BY _ _.. ,•�: F rr�: y; _ ;' ��` � _ - . . _ .� �r�.. g x i i •� t '• f/N SH' GRgDE i' - s__- _ ° P'PE4Sr0N1! �1 srx /2 —T >.�:fk N _j i 3 CL�.�f�- p CI EAI _ i ' • r 1 F/Pf 5 r -• - --- ---- - - -- ------ - - --- -- - , K �I O. . LE I _ 6 M/N ? M l N o' 1'_, - 4S Rf 0U/RED� DEPTH OF TEST: �-- �~M;,ti- _ , f ,I _ � a t T -NL£t.-- i i } �1 p f I, _; I BOX- RATE' 1 N 2 P/�1 N ��, �'�_S J - - Mi.�/ ! r \ i , - - — �_ -- ' Jurc.ET TEE . i 4" . D/ST. N(E r rE E I C./. 1 TMJtJ,^,1 GAL. I I i /.NL ET AND OUTL ET + ,� 4' 0 Af N. MuM !�U'; ET rEE 0&rH �•� SEPTiC TAMP � _� M t . PRECAsr oR 81OCK 19 'EF 5 Tii BE CAST i L/OUlO DEPTH /4 AT L/OU1G� DEPTH OF 4' ; ° � ' CbVCRLTE SEEPAGE P/T j 1 DEPTH OF TEST: P�)�' ,,q`'a°r4N 24 G; (� _ _I' ^_, o, `. TA rcav I /p' I r rvl , I I —_ _ PLATE CONCRETE �,'I 29' - ��_ _ J MIN ONCRE7 BOTTOM ON BEVEL 5U8LESASE i RATE' a.. 34... e" — u CONSTRUCTION -- IL , �j�11�Tt; 1 - - - - '•� lWATERT/CHT' 'j TEE PROV10fU WHERE SLOPE z_ . t . fs N: E ' FOUNDArlm It t f i # `• • • __. _- �, TANK TO BE ABC.f TO w r THS7LW0 !� OF INLET P/PE EXCEEDS 0.08 % GW -- r c ;N A PUMPED SYSTEM ?D M/N. _,T / „ BOTTOM QF TALX h EiEL ABi-E PAS_ H ;C' C DAC% N(; UNl f SS CMIDE R �--.-- — —.--- _.-----_----- — --_ .__. __ _ __ t / WASHED STONE/ t PAVE ME NT OR 1N ZAIVt. H 20 t _�32 S• ; L 0,4 D l NG UNOER PAVE ME N'OP Vt- NO TES /N VER T ELEVA T/CANS: PLAN VIEW I. THIS PLAN IS FOR THE DESIGN AND CONSTRUCTION OF THE SEWAGE »„ DISPOSAL FAC/L/rYONLY. SCALE l = ZC >� 14 INV. AT BUILDING i�•Z _,_ ,5, 2 ALL CONSTRUCT/ON METHODS AND MA TER/ALS SHALL CONFORM TO V Ar SEPTIC TANK(IN) MASS. D.E.Q.E. T/TL E 5 A ND THE _,�a �, ? BOARD OF /NV AT S�PT/C rAN/c'{!�'IT) ti 4.a9 HEALTH REGULATIONS. ,TR0CT,' RE5 5PAL:� 5F CAF'F11.1"' t h� �f/ TKS Ar^i/ jhtr� �l �? ^• L OAT'/A/C . /1LL 1;L�1FF PIPE ;t-1AL_�. � F_ �CHC1)0L� `�0 f'ti'C. . _ _ A" _INV. AT DIST BOX(IN) 13,33 !f. .,fif•.r ..;>j''K 4: 7-f ��.,,� f/./ 'f.'+I"ArwJ-J7,,,.,- ww,, cG'.7'>•„o►i l.. .-V' ,= .R7,••A Z 1, '-�-•7 r=� °4;��`•.( N�.,1 �.�5'..�/NV AT DIS,r BOX(AUT) r /'Y-G•1' .•=t_,•..� y .(-�.�x r�zc /:7� , i� c , L�.rc� , t z , .w C doG d /✓ T �A EA FA•c'_ ;-' :., -_.:A.T- -� �: ,au T- ;G ,'r•/.G vnE;/ �i ?"sr' �/-r•.'_ vr. J. 4 a 1� { 3. O rL , c. G✓�•rG�>•.._: �..-s�G,..e*....f�ir`r"• ,c><.-,tt� y'eE.7�''"�";i" /�V✓l+"rf,7.E"/'�r:�jf 7J'✓ d,l.H'.'� �z,,y,•,a' �.�� �;�r`-,�, AT BOTTOM OF P1 T- c�G c• �-;••�G�'%S . ,�J.•lv .�'G:+a�r,c� f,�C:S:-�#rv� J�L...rKy �y $.9r rG':� ty'�vr� .�;:�. .:�„►;G-v r !:. O.vC' �eAr_+T G'o�v.'�cl.�'S ....=dqr Gc°' //+/7",G•:IC.f�QG.O y"G:1� .�--;�•p„ws r""'r�,�-Jcs�it-.•%+�.�3A%; C�,Y� M�EA,tS1a�k.;RER W'TeR,�,,,% L. Silvia & Silvia Tt ' As od>ates, Inc. OerekVmrr Owii�ren 619 Main Street DESIGN DA TA 77s-1442 Centerville, MA v _ k ! DESIGN FLOW ; CAPE COD SURVEY CONSULTANTS t✓ \ tt;/1r t� � r y 1 Q ., ` ., A . t 1 , 76 Enterprise Road (617) 775-7155 ►©' y ': R ' f, , 1 t 1 REQUIRED SEPTIC TANK Hyannis, MA 02601 (617) 775-7815 ;� ;� .,; { / ,. i S3!; ,c,�'1�?t .Q ��a-e�,J _ S •�U GAL JT p-ROX � }" ! f ', 7A�R SEPTIC TANK PRDV/DED = ' S 3�'',- GAL 14- FCC 1 Y r T 1G CCA 1,-�Touiz ` ` - ! j I Jr ��� �- Gam• REQUIRED SIZE LEACHING FAC/L/rY ICI Cho cos E.t> VA.t )0).1 f3 t> S Po' ' E1.�. ` i t]1filti ►�lC� 3 , ..'s w 4 / / �1 R41 SIZE OF LEACHING FACILITY PROVIDED s p �. ` �•: : TYPE OF SYSTEM_ 4_- 4' P IT �l� �SS4r E TITLE: PROPc)S � � • , , L 160 ► sty k �»5.�1�F ..•_44�._ e f `-ram rA,L 115 'S E S S 1__ 1) SEWAGE DISPOSAL SYSTEM Ln • DESIGN 10 _. LOCUS PLANf4 Q:/ - , - 1 . f FOR ILVtfI ILY1A k,'5SOC.� IZkaC . v SCALE AS SHOWN METERS FEET 0 S4e 71.0w 114 a.." J (a •.� y.�� ® �' DATE: 5/ 5/ej4 .+ems c� . .S,vE' 0, K COMP /DESIGN' CHECK: DATUMCam- i oT _A • �t DRAWN: { FIELD: :.' sc •ter. cy a -Z Z� FILE NO: DWG. NO JOB NO, n3-/3;- <3 r SHEET: I OF: