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0040 THREAD NEEDLE LANE
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(0.47±AC. 1 -t� CONCRETE FOUNDATION IQ • I o LOT 24 JOB # 92-05J CER T/F/ED PL 0 T PL A N LOCATION : LOT 6 THREAD NEEDLE LANE CENTERVILLE PREPARED FOR SCALE : 1 - - 40 ' f OMAN CONSTRUCTION REFERENCE : PLAN BOOK 1,9 I PAGE 47 �j kOF�,�5 I HEREBY CERTIFY THAT THE STRUCTURE �� JOHN S90 SHOWN ON THIS PLAN IS LOCATED ON THE Z. y GROUND AS SHOWN HEREON. DEMAREST,JR. u No.36859 zI DEMAREST-McLELLAN ENGINEERING Oslo 24 SCHOOL STREET MAY J. 199J P.O. BOX 463 WEST DENNIS. MA DATE PRO SSIONAL LAND RVEYOR „ Town of Barnstable *Permit# f Expires 6 mo the from issue date Regulatory Services XBAIRNSTABIA Fee ©D 1639. Richard V.Scali,Director Building Division Tn AIN 04 2015 wn� Tom Perry,CBO,BuildingCommissioner 200 Main Street,Hyannis,MA 02601 OF RA RIV&IAB] www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY ' 1� Not Valid without Red X-Press, Map/parcel Number 0•3 1�7 Property Address 40 Three Ponds Dr Centerville ` 600000 Residential Value . of Work$ Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Steve D'Asti 40 Three Ponds Dr Centerville, MA Contractor's Name CARE FREE HOMES Telephone Number508.997.1111 s dana.j.pickup@carefreehomescompany.coml 100503 Home Improvement Contractor License#(if applicable) Email: , Construction Supervisor's License#(if applicable) CS-095228 OWorkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner 0 I have Worker's Compensation Insurance Insurance Company Name HERLIHY INS. GROUP INC Workman's Comp.Policy#33723. Copy of Insurance Compliance.Certificate must accompany each permit. Permit Request(check box) S E E KO N K n Re-roof(hurricane nailed)(stripping old shingles) All construction.debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. i SIGNATURE: C:\Users\Decollik\AppData\LocaiMcrosoft\WitiuuwsxiciiipUIUIY iuLcinctLriiu s\wincnt.oWook\2PIOIDHR\EXPRESS.doc Revised 040215 .Acddciz6, ir-9•&f MA a2 Phow Are - 4 ycFm ag emqdoyer7 tL-zTproprmtab 414 r � �❑ Iamae�plop�ryrs$tI� r ,-tr4rFe� eaapiayem(fill mworpat-#imp)* bzvL �. ❑ } ❑ I�¢a sroIe pr ar o rparf er- fzsfed an the 9be ed sheer �- ❑ g ship aaudd have na emplus Zht's�ors have $_ ❑ worug for"is my '``r' '"assdha ewag=* M - �Tc3• `camp_kg,�,•,r-R, ° , ' ' comp-mmia� 1, 1 . q_I ❑ addiiiau ,T2, j . Elwtamacurpouaiiomzadifs. I�-❑ calre cuadditions �_❑ I a doing zu ward s h "'L II❑ =P-im ar adxEiiioas MySetf[NO"WMk='=3313- of fr6MgechfG'L RDof mpaim inM3U=e,eTliLA J T c..157,AIM zadwe fie.m 11 c°mp-ms=anm mqua 3. � _ P ' � tnes•a•�s.�b�3riz�d�Y;. �p:�damp:.IIz-^�^�f��ash coact s�aa�zaEd��tm�t�� . f -C.o-�a Est c7i�Y'thi�bmcmust stf�hed m n3t;r;r.,,4t� �n�enf fi�sub- ss m3st� rxnat�se k-�iSesfi.� M=3aylms_ If t'he MA< hIm M=l ees,dLt!Y t gmui&tip wa6a=°comp.poUry unmbec icru rtrc ar I rhr isgrrn s, ar&ers'c�tt FT}41 *gar f�{ rah y s BdvtF is fhe pa&cp aff-i pis PoaT:g crSelf-ins-T_ic J✓ F=-P rm b-nDD i Q Talc �ls3ass'J�) re� /0�t..Pl� YJ/� Ciftai�L�:Lc'�<'7lL�l�G iaffi 2t cqpy of thevrkers'crapeusaiian paircTj dscrsiian Ixag�(so3rh3g( pd xc ersriatioa Fai-lute io sew gage s wade SecEt SA oflt�iC c L�2 rya Iead to rrFcri�inal pees of a fz� to�L�UU(�D andlar� as�eII as ciril eualfi�in'Hie f�o€a BF _ y� p RIB fJ�UIlt.and a rs€ttp to 50_DO a day agamsk a violatnz_ �e advised lhd a ccrpg t¢ffXiS 9LH±=CaMaaybe fM-W3rdsd to tax DE=of I rfa �rttrFpeaagr uruF ti�atfh�itt�rxta#iva pnzvid £rcFxa f*a i� �d avFrscf or ~ E city£IMe=b`Do-:wt gibs in Sur m-eaF ikT bg cmplaW by ct ar f aim a,f�c&L CaT or Totem m Laai�d €� aIt€t 2 ng *; �5i 'FraQrr �Itfricalxecor .PhmorbmgFc r cKher . I L mux mom_uuu auu P u r L-_L ut-rxu.LLo Massachnge5tts mural L-ws chap 152 re0es MU=4LT=to prtxvida wOO='MMP—sin fur thair employers PrasaMIt7iD this sty m mvp&P=is dcfine:d as -e`VMy pasaa in ihe=vice of another mars airy confract DfIhM, express or inmplied,Dial orwritt� An nrp&T�-is defined as',zn mdividnal,paL h assDciajion,corporatism Dr otTier I Dal e�iiy,or�y ivro or mare offhe in a3oic±enterpasa,and mr}udmgfl' legal represetafrves of a deceased employer or the receiver ctt ix o sine of aninandiral,par�bip,assDciafion or other legal ertty,emplDymg�PIDYecs. ]Cowever the owl= of a d_wellatg house having not more than.three apmhnet and whD resides fheaein,at the occupant of the dwelling house of another who employs persons tD do maitmanm,contraction.or repair work on such dwelling house or on$e grounds or building agpurinnant thereto shall not because of such eooploymeat be d=med to be-an employer." I'I MGL rhapf 15-2, §25C(6)also states that¢every state Or local lice=h2g agency shall withhold theissuance or renewal of a license or permit fn operate a bmt iness or to construct bna irV in the commonwealth for any applicant who has not produced acceptable evidence of coinpftaace with.th nisuraac�coverage;required' Adrf�onaT�y,MGL chapter 152,§2-"C( )stEd=-Ntithm-tie CDmIIlonwealthnor any of itSpolitical SiI &Visions shall enter into ally coi tract for the gc�ange Df pnbEc walk until acceptable evidence of compliance vrith the m crnan ce rezluirements of this chapter have been presenjed to the contracting ardoritY.' Applicants _ Please fiII ors 'he wormers'cortex isaiioa affidavit coruplet--Iy,by chug the boxes that apply to your SitDatlDn and,if necessary, supply sub-contacctDr(s)name(s), address(m)mad phone numbers)along w>;h their=-L�ncat..e(s) of i-nam-ance. I:inuted Liability Campanics(I.LC)or LimitedLiabil�.y Partnerships(I.LP)wi$nD employees other man the memo era or Partners,are not reed to caay workers' compensation in cr>r nm- If an LLC or LLP does have employees;a policy is required- Be advised that this afadavitmay be submitz d to.the Department of Industrial Accidents for confamatiDn ofiDS nCe CDverage. AIsD be sure to sign and date the affidavit. The affidavit should be retuned tD the city or town that the application for the pa it or licease is being requested,not the Department of Industrial Accidents. Should you have any questions regaiffiang-tT,e law or ifyou are required to obtain a workers' compensation policy,please caIl the Department attire number Iistcd below. Self-irisar•ed companies should eatm their self-i1=an=license number on the appropriate Ime. aty or Town O,ffirsals Please be sure tTiaf the affidavit is cDmplee andp6ntd legibly_ The Departmenthas provided a space of the hot a. You to fill o-of in the event the Office of lnvesiigatio s has to contact you regarding th-e applica of the affidavit for nt ' Please be stye:fn ftIl in the pennitlIieense number which will be used'as a reference n=ber. In addition an applicant that must submit multiple pennif hcense applications m any given year,need only submit one affidavit indicating current policy mfoz;naiion(if necessary)and under a7 b Site Address'the applicant should write all loc�iions in (city or ' town)."A copy of the affidavit that has been officially stamped or mazked by the city or town may be provided to the applicant as proof that a valid affidavit is oa file for future permits Or licenses A.atw affidavit must be:MCd out each year.Where a home owner or cifi=is obtaining a license or permit not related to-any business or commercial vemWre, (L e,a dog license or permit to bum leaves etc.)said person is NOT reed to complete this affidavit The Office of Invcsti.gations would hike to thank you in advance for your mopm-ation.and should you have any.questions, please do nDthesiiafe to givens a call • The Departmeofs address,telephone and faxnumber_ Tho f� MMCOM slth Of Massa usetl D of cif Indmtcjal.AQUIdeat, #as-,Ili G21 I I Fax,#617-727- 4-4 P.evmed 4-24-9 > Client#:33723 CAREF DATE(NMMD/YYYY1 ACORD.. CERTIFICATE OF LIABILITY INSURANCE, 091122014 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 THEPOLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE,A CONTRACT BETWEEN THE,ISSUING INSURERS) AUTHORIZED 1 REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. ``' " 5: IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the poticy(ies)must be endorsed.If SUBROGAT10N 1S WAIVED subject to 3-- the terms and conditions ofthe policy;certain policies may require an endorsement A statement on this certificate does not con_far rights to the" certificate holder in lieu of such endomement(s); PRODUCER CONTACT NAME: Herlihy Insurance Group Inc: PHONE � : A!C No Eat,508 756-5159 Ate,No508-751'-5747 51 Pullman Street Worcester,MA 01606 ADDRESS: 508 756-5159 CUSTOMER ID It: INSURER(S►AFFORDING COVERAGE NAIL C INSURED - INSURER A;Liberty Mutual Insurance Co. _ Care Free Homes Inc f" 239 Huttleston Avenue INSURER e:EastGuard Insurance Company Fairhaven,MA 02719 INSURERC Safety Indemnity Insurance•Comp . INSURERD: -- INSURER E j INSURER F c. COVERAGES L:.',..tCERTIFICATE NUMBER.- It z,. , REVISION-NUMBER: THIS ISTO 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 WIT H RESPECT TO►NHICH THISI' CERTIFICATE MAY:BEISSUbD OR`MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES,DESCRIBED HEREIN IS SUBJECT.TO ALL THE.TERMS;.7 EXCLUSIONS AND CONDITIONS OF SUCH,POLICIES_'LIMITS SHOWN-MAY'HAVE BEEN REDUCED BY PAID CLAIMS. INSR L SUBM "P►++ itt,I LICYEFF ';POLICY£XP TYPE OF INSURANCE .POI:ICY NUMBER. . b1M/DO/YYYY MM/ODIYYYY - LIMITS A GENERAL LIABILITY . BKS56134t97 9/01%20.14 09101116116 EACH OCCURRENCE X COMMERCIAL GENERAL LIABILITY - - :PREMISES Ea''oxurrence' : $100,000 CLAIMS-MADE a-OCCUR - - MED.EXP(Any one person) $15,000 e r X .BI/PD Ded:25O, PERSONAL a ADV INJURY $1,000,000 - 9 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP Aw., $2,000 000' . POLICY 'PRO- 17 LOC C AUTOMOBILE LIABILITY 6213850 7/01129,14 07l01l26i COMBINED-SINGLE LIMIT $ (Ea accident) 1'000 D00 ANY AUTO BODILY INJURY.( P )(Per n` $ ALL.OWNED AUTOS. - • . BODILY INJURY(Per accident)` $ X SCHEDULED AUTOS PROPERTY DAMAGE $ X HIRED AUTOS (Peracatlenp X NON-OWNED AUTOS $ UMBRELLA LIAB OCCUR EACH'OCCURRENCE $ , EXCESS LIAB H.CLAIMS-MADE - .: .- AGGREGATE : $ DEDUCTIBLE $ RETENTION B WoRK S COMPENSATION CAWC587199. 9/0:112014 09/01/201 X:WC STATU: O1H AND EMPLOYERS'LIABILITY RY LIMITS,AYIN NY PROPRIETORIPARTNERIEXECUTIVE—U- - E.L.EACH ACCIDENT .- $1,000,000 OFFICERIMEMBER EXCLUDED2 NIA (Mandatory in NH) E.L.DISEASE'-EA EMPLOYEE $1;000,000 . Nyos descdbe under. DESCRIPTION OF OPERATIONS below E.L:DISEASE-POLICY LIMIT'"$1'OOO OOO .DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,,it more:epace is required) CERTIFICATE HOLDER CANCELLATION 10 Day sfor-Non-Pa ment: SHOULD ANY OF THE ABOVE DESCRIBEMPOLICIES BE GANCELLEL)BEFOREs;• THE EXPIRATION DATE THEREOF;NOTICE WILL.BE DELIYEREDYN` Town of Barnstable;Bldg Dept ACCORDANCE wrTH THE,POLICY.`PROVISIONS: 367-Main Street Barnstable,--MA 02601 - - AUTHORIZED REPRESENTATIVE Lp '0 488=2009 ORD CORPORATION."A lPd4hts resecired: ACORD 25(2009109) 1 of 1 The ACORD name and logo are registered marks of ACORD #S73454IM73450, JXC :Massachusetts Department of PuoiiC 5afet•f Board of Building Reguiahons and Standaras —c e n se CS-095228 DANA J PICKUP - 239 Huttleston Ave Fairhaven MA 02719 titiinnel 03/22/2016 orrice of Consumer Affairs& Business Rii�-ulaticn Licenee or re-istration valid for individul use only before the expiration date. If found return ta: HOME IMPROVEMENT CONTRACTOR p Registration: 100503 Type Office of Consumer Affairs and Business Ile-ulation =— 10 Park Plaza-Suite 5170 Expiration: 6/19/2016 Suppl-meet, 'rd Boston,MA 02116 CARE FREE HOMES,INC. DANA PICKUP JR. 239 Huttleston ave t - �- --- -- -Fairhaven, MA MA 02719 t:ndersecretan Not Valid wititou i�nature THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) M A 0(7E DATA �I a.at yalDlr Carr a'n�' eDprKf.L(a�.�..u► s_roc i "Orscnvnor lec er.r0r�omn.nmr. "10i�"r+'+..+rw• -_. _ ... _ per"�mC�ay.4rdror as rnr nci � e resaw+w• r fir.. ryd K.o+.�r a..nr.�.eb.+an.rw.. -- i�u�...�:y"oaw.�..�°•�......rs ' ara..rlliM leAw����Ya�.�r\.a�t•...�Y,�1lyHt.. tru..r , Main... r "wur.r�rwr.ra.u�.nvrau.wa...t - tMwr.+Fu+�rN+ro..na.mn ere*nae..r+ut.....w+a mpwtao"" Mr.IfNn rMIGO.M�1/E1�.9'UOrI RjdW\'etn.Nraa.. 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IC Wa Lll. ',!w'° s } �'►R. •1w►�i Br*rye: l g?rq�¢ and'tcs 1c>^�.etryo.h, Pr - ,.; TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel rd Permit# 44 Health Division " Date Issued Conservation Division a,S LS U)n Fee 0 Tax Collector v-�` B� Treasurer {Zo SEP S EM MUST BE : INSTALLED IN COMPLIANCE Planning Dept. WITH TITLE 5 j f e ; Date Definitive Plan Approved by Planning Board ► 'ENVIRONMENTAL CODE AM TOWN R E G U LA„ k j � r Historic-OKH Preservation/Hyannis • Project Street Address .Village ,eGZ ,2.riy,'/�Q ,.Owner Address Telephone Permit Request �- I � Square feet: 1 st floor: existing proposed c2ra 2nd floor: existing proposed _ Total new 7d- Estimated Project Cost Zoning District Flood Plain Groundwater Overlay Construction Type C_Z Lot Size c �z Grandfathered: ❑Yes ❑No If yes,attach supporting documentation. Dwelling Type: Single Family N, Two Family ❑ Multi-Family(#units) Age of Existing Structure q 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) U { Number of Baths: ,Full: existing new /D Half: existing / new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: XGas ❑Oil ❑Electric ❑.Other Central Air: Yes ❑No Fireplaces: Existing _�_ New Existing wood/coal stove: ❑Yes ANo. Detached garage'*xisting ❑new siz00.,42so PoolAexisting ❑new size do4 za Barn:❑existing ❑new size /14 Attached garage:❑existing ❑new size Shed:❑existing ❑new size 4- Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name Gv �� �� C Telephone Number S09_-- 77/-- �D . Address b �d/� � License# S D S6 3 yd 1�� 3.�- Home Improvement Contractor# Z Worker's Compensation# ZZ ALL CONSTR�ION DEBRI ULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 0 —CrD FOR OFFICIAL USE ONLY , Pt-RMIT NO. } , DATE ISSUED MAP/PARCEL NO. r ADDRESS A 1 VILL-AGE ' a • ' + � v OWNER �ti j DATE OF INSPECTION.i t L • t? r. FOUNDATION i FRAME INSULATION O O FIREPLACE ELECTRICAL: ROUGI !9"" F FINAL 0 7- :fit - •,/ �i . •' . ' • r'. PLUMBING: ROUGR3 M FINAL GAS: ROUGL FINAL- FINAL BUILDING ' mf + DATE CLOSED OUT r ASSOCIATION PLAN NO. r ESTIMATED PROJECT COST WORKSHEET Value 2 LIVING SPACE square feet X $55/sq. foot= �v W--YqGARAGE (UNFINISHED) square feet X$25/sq. foot= ' PORCH square feet X$20/sq. foot= DECK la square feet X$15/sq. foot= OTHER U square feet X$??/sq..foot= Total Estimated Project Cost g990915b - --- - - The Commonwealth of Massachusetts Department of Industrial Accidents ONCe afloyestigalfans 600 Washington Street Boston Mass. 02111 0- > Workers' `yensation Insurance Affidavit name: location: city phone# ❑ I am a homeowner performing all work myself. ❑ I am a sole proprietor and have no one working in any capacity `rI am an employer providing workers' compensation for my employees working on this job. com nnv name: 6 address: city: ,��fill��G�Q 1� �c� �oZ phone#: —7 insurance co. aad C �(s olicv# (� — 3c)- —� r ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the follo«zng workers' compensation polices: comnanv name• address: dtv phone It, insurnnce cn. ... . oiicv#....., . comnanv name. :.... .:...:. ....... .... .. ::.....::. ..:.:..: ..::..:. address: city- phone#: insurance co. :.; olicv# Failure to secure coverage as requited under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or one years'imprisonment as well as civil penalties in the forth of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage vetlIIcationn. I do hereby certify under the painssaanddppen/aalties of perjury that the information provided above is true and correct Signature , �///� Date � -a a - _ Print name i �J G Phone# 7 1— L official use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Building Department ❑Licensing Board ❑ check if immediate response is required ❑Selectmen's Otflce ❑Health Department contact person: phone#; ❑Other (mvuea 9i95 PJAI 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 coat -" , 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 recemer c: trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renews: 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 shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. , Applicants .Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and 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 being requested, not the Department of Industrial Accidents. Should you have any questions regarding the "law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicam Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be rctzuned io 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 questions. of hesitate to please don give us a call. �/// /�//i �j/,�//��/fir,. The Department's address,telephone and fax number The Commonwealth Commonwealth Of Massachusetts Department of Industrial Accidents Of ce of In esUgaUanx 600 Washington Street Boston; Ma 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 eat. 406, 409 or 375 r . The Town of Barnstable • awxNSTAar e, • Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,.demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. ;2) Type of Work: l (61� Estimated Cost �Jl_ G Address of Work: Owner's Name: Date of Application: c:;?- I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job Under$1,000 Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration Vo. OR Date Owner's Name q:forms:Affidav e' r"5�„h-^' R1�0a�-w .- c 'S. 7✓J tir I^'.- }".' / ' 'i'-""ACM ' HOME 'IMPROVEMENT ;,CONTRACTORS REGISTRATION �= ng Board _of�Buf$ldRegulatonsaYnd:;Standards .,. One AµshburtonPl'ace -Room 1,301 , Bostort; Massachusetts 02108 a+nW -1-". HOME IMPROVEMENT C0NT.RACTOR "vs. Registration 112049 � '�`ExPiration 02L19101 � . z -TYPe INDIVIDUAL ea WILLIAM .SCHIJ ZE *&� rt W -WILLIAM.:L� S�cHULZE , z r =PO BOX 288/ �;b5 CROGKER ST= p q Ta CENTERVILLEMAr02632 � "°�+k ' gi,Y'"�a,¢` ..m 40, ' .... .....� a: "✓� U/6'IYt/I)t6'�LIIh..,""'" 4�`',l2Q,JJCLC/UJeud Cv • DEPARTMENT OF PUBLIC SAFETY , C0NSTRUCTI_0%,"SUPERVI50R LICENSE Nuttier Expires w. Restricted .1 F_ MUM M L SCHULZC PO HOW g)VfA,/CENTERUILLE, MA 02632 M r 1 MAScheck COMPLIANCE REPORT Massachusetts Energy Code MAScheck Software Version 2 . 0 Permit ## Checked by/Date CITY: Hyannis STATE: Massachusetts HDD: 5973 CONSTRUCTION TYPE: 1 or 2 family, detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 2-22-2000 DATE OF PLANS: 2-22-2000 TITLE: Wentworth PROJECT INFORMATION: Pantry Addition COMPANY INFORMATION: Schulze Building Co. , LLC P.O. Box 288 Centerville, MA 02632 COMPLIANCE: PASSES Required UA = 30 Your Home = 25 Area or Insul Sheath Glazing/Door -----Perimeter- R-Value R-Value U-Value UA ----------- ------------------------------ -- CEILINGS WALLS: Wood Frame, 16" 72 30 . 0 0 . 0 -3 O.C. 172 13 . 0 3 . 0 GLAZING: Windows or Doors 6 12 DOORS 0 .400 2 18 0 . 350 6 FLOORS: Over Unconditioned Space 72 30 . 0 ---------------------------------- 2 ------------------------------- COMPLIANCE STATEMENT: The proposed building design represented in these documents is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate has been determined using the applicable Standard Design Conditions found in the Code . The HVAC equipment selected to heat or cool the building shall be no greater than 1250 of the design load as specified in sections 780CMR 1310 and L Builder/Designer Date o2 0�oZ 7 MASche,ck I14SPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2 . 0 Wentworth DATE: 2-22-2000 Bldg. Dept . Use CEILINGS: [ ] 1 . R-30 Comments/Location WALLS : [ ) 1 . Wood Frame, 16" O.C. , R-13 + R-3 Comments/Location WINDOWS AND GLASS DOORS : [ ] 1. U-value : 0 .40 For windows without labeled U-values, describe features : # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location DOORS: [ ) 1 . U-value: 0 . 35 Comments/Location FLOORS: [ ] 1. Over Unconditioned Space, R-30 Comments/Location AIR LEAKAGE: [ l Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. Recessed lights must be type IC rated and installed with no penetrations or installed inside an appropriate air-tight assembly with a 0 . 5" clearance from combustible materials and 3" clearance from insulation. VAPOR RETARDER: [ l Required on the warm-in-winter side of all non-vented framed ceilings, walls, and floors. MATERIALS IDENTIFICATION: [ ] Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. Insulation R-values and glazing U-values must be clearly marked on the building plans or specifications. DUCT INSULATION: [ ] Ducts in unconditioned spaces must be insulated to R-5 . Ducts outside the building must be insulated to R-8 . 0 . DUCT CONSTRUCTION: [ ] All ducts must be sealed with mastic .and fibrous backing tape. Pressure-sensitive tape may be used for fibrous ducts. The HVAC system must provide a means for balancing air and water systems . TEMPERATURE CONTROLS: [ ] Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. HVAC EQUIPMENT SIZING: [ ] Rated output capacity of the heating/cooling system is not greater than 125% of the design load as specified in sections 780CMR 1310 and J4 .4 . MISC REQUIREMENTS : [ ] Refer to 780 CMR, Appendix J for requirements relating to swimming pools, HVAC piping conveying fluids above 120 F or chilled fluids below 55 F, and circulating hot water systems. ----NOTES TO FIELD (Building Department Use Only) ------------------------- k 0 11 2x6 16"O.C. 2x4 72" sT. o V4"C Dx -riG 2.10/b"'O.C. _.CROSS S /oN 12 0" - CO,vCRF 6 5OA10 '7-4f8E BFzy 514 V - - - - - R�."e�c fxbri•�y wa« FooR PLA,v P�tiTRy Aooiro,v F•e Pa.' Wc,vTwv�ery FD. W. - SCALE: V + /'O" APPROVED BV - - DRAWN BY DATE: 2-I l- '1000 40 Z QV-- CEiVrLR✓/f.L IC, /CIA DRAWING NUMBER f P087 18A8-OB -11.17 En&eering Dept.(3rd floor) Map Zl Parce O Permit# , 22 /7 House# a .. Date Issued 5_4-9? Board of Health(3rd floor)-(8:15 -9:30/;-,1:00-4:30) ;� �3� .,a Conservation Office.(4th floor)(8:30- 9:30/1:00-2:00) . -� ' 1 5LPTICSYSTEM MUST BE Planning Dept. (1st floor/School Admin. Bldg.) INSTALLED i LANCE Definitive Plan Approved by Planning Board 19 WIT ENVIRONME AND I � 6 TOWN OF BARNSTABLETO N R S Building Permit Application Project Street Address _r"ra ,(��dle_ Z=,e1A-e_- Village Clh �L(L Owner ao[Av, �rf� . L✓l�e(ar Address Vkt� Telephone '1-5'- Permit bequest y �i sI Raia--, lk (o c1A1 c f,C v v—s k-S-- �/ First Floor square feet Second Floor square feet Construction Type 1✓•ev4• Fvmo,-- Estimated Project Cost $ -pa Zoning,District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No 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: UyVull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No. 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 Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) w ❑Attached(size) ❑Barn(size) t ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# - Current Use Proposed Use Builder Information Name / ,a0�L>� Telephone Numbers Address 22 License# Home Improvement Contractor# /p Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE kZe&d11 DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) y f r t, ti FOR OFFICIAL USE ONLY - - PERMIT NO. `: ~ DATE ISSUED MAP/PARCEL NO. E ADDRESS VILLAGE OWNER DATE OF INSPECTION: ` FOUNDATION FRAME INSULATION FIREPLACE , ELECTRICAL: ROUGH FINAL- " `. 4 PLUMBING: ROUH FINAL, - GAS:. _�' q 107 :FI� FINAL' _ ' r > •i? °-"" awe 4• N x - .- FINAL BUILDING 47 w . r ZJ DATE CLOSED ASSOCIATION-P12N NO-7. 1 . 1 jl �� � '"`"�' Tlrc• Cuninrunlrcultlr n�':)tussuchusctn- ,rti Dcpartrrrent ojludustrial.4cciderrts OIIieg aof1 9=92twns 600 11 a.dibigruit Street A Bustotr.Muss. 02111 Workers' Compensation Insuranec.Affidavit _ � (i •tn inf m inn• -• - - -- - - its C��'i`e-✓it� �e A(Inc. 1 am a homeowner performing all wort: myself. am a sole proprietor and have no one workings in any capacity 71 am an mplover providing workers* compensation for my employees working on this job. cnntn•ttn name 'ttitlress• city _ nhnne#• insurnncc cn nttiicv M I am a soic proprietor.!,compensation contractor. or homeowner(circle one) and have hired the contractors listed below who the foilowina workers' compensation polices: cnm am mine• adtiresr city nhnnc • nniicv d in-mr-Incrrn r �� ,�.T r^ y �.. - i•� •s---- co m ri nnv nninc ;tddresc� rite nhnne it• insurnnce cn nniicv Attach additional sheet if necessary `..�.....+�.•:•�-.-.�.� F:idurc to secure cttvcrace:ts required under section 3SA of AIGL 152 can lead to the imposition of criminal penalties of a line up to S150U.U0 anc une y cars'imprisonment as-ell as civil penalties in the form of a STOP NVORI:ORDER and a fine of 5100.00 a daV al most me. I understand tit:, Copy of Chia statement may be forwarded to the OMce of Investigations of the DIA for coverage verification. 1 do herein.crrrift•it r rite pants and penalties of prrjun•that the information prorided above is true and comet. Dace Sianature �—' ,� Print name t�Q-`�S (�c 7� Phone# otTicial use only do not write in this area to be completed by cin•or town ofllcial city or mwo• permit/license rt�1ludding Department • C3uccnsing Huard -: t s Uer Q check ifimmediate responseis required E311calh Department r�l lehrr 'i .lassachusetts General Laws chapter 152 section 25 requires all empioycrs to provide workers* compensation for tlie-ili- ,ntpioyecs. As quoted from the "la%%`- an cnipinree is defined as every person in til service of another under any ontract of ilire.�txpress or implied. oral or written. .n 4111rph rer is dcf ined as an individual. partnership. association. corporation or other legal entity. or any two or more . tc forc�_oirt�_ engaged in a joint enterprise. and including the legal representatives of a deceased cmplover, or the :cciver or tntstce of an individual • partnership. association or other legal entity. employing employees. Hox+•ever tite +%,ner of a d%%-elling house having not more than three apartments and who resides therein. or the occupant of the \%•cliin,_ house of another who employs persons to do maintenance , construction or repair work on such dwelliti�_ hous oft tit: ;_rrunds or building appurtenant thereto shall not because of such employment be deemed to be an employer. e -� -+ � � --v• �e issuance or ?GL clta ter l�_ section _5 also states that every state or local licensing abenc}•shall �thhuld tl p neiti•al of a license or hermit to operate a business or to construct buiidings in the commnn•caith for ani- 'plicant -,%•ho lias not produced acceptable evidence of compliance with the insurance coverage required Jditionali,,. neither the commonwealth nor any of its political subdivisions shall enter into any contract for the nbi-m-nnce of public work until acceptable evidence of compliance with the insurance requirements of this chapter lta en presented to the contracting authority. �plicants ase fil? in the workers' compensation affidavit completely, by checking the box that applies to your situation and TIN-in_• company names. address and phone numbers as all affidavits may be submitted to the Department of ustriai Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. Tite --�:Ivit should be returned to the cif,, or town that the application for the permit or license is being requested. the Department of Industrial Accidents. Should you have any questions regarding the "law- or if you are required ,brain a «•orkcrs• compensation policy. please call the Department at tite number listed below. or Towns ,se be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of affidavit for you to fill out in tite event the Office of Investigations itas to contact you regarding the applicant. Pleas ure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to Department by mail or FAX unless other arrangements have been made. Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. se do not hesitate to Live us a =11. Department's address. telephone and fax number. The Commonwealth Of Massachusetts r Department of Industrial Accidents Office of Investigations : 600 Washinbton Street Boston,Ma 02111 fax #: (617) 727-7749 phone #: (617) 7274900 ext. 406, 409 or 375 I r' The Town of Barnstable Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissi For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. Type of Work: � T P� ` Est. Cost ��0��-y` Address of Work: q'D Owner's Name Lev., 4,4,tell Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S1,000. _Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS LULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME MUROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby ap ly for a permit as the nt of the owner. 47 ASS Date Contractor Name Registration No. OR I vx'dy3�ror"3^wr . Yt 310 'ti., wx{.rf' ;� 5'�' � 2 - � r ^t� ti�C � i,�*rfi'f r-sY•r'x:y.F� s °� -�•'M�'3�,�.ry,.����r `r'{'`��j"�''� k�_. ',. ,.,� _ . fi A3 y a� y 13 $ -a.`�, a! tn"�„� s 5'•�^S�a�*§'� '�y .. t i -' l k t + ^• � �i.,;• ',. / a I�a�)t1� )-i. '�t�'yh ��� rCe�' '�' ''u�+ a �f;�-�a `Z+�y�t ,�`S'„C. d:.r. � - ` I c � L � ..(� '� ���"s��f ,���*•�i ,j4 5,.�^ST$.�,;$,kj- ' '�F k, $� a.� � .i_ i� Y Y.� " 17 ` � y j`" .sv ✓ �` 41,E s•�. '�-. j 7 T � 9T r _ a • �� t��a e ` c, f § "�Y { a � tip rt �-T pw i -kill c 4 r JUGiL. .�..t UpP�� OYES q,: A y `C\ a. t S; - L /J d y ial���ya AKRO ASSOCIATES, AIA, ARCHITECTS VSTEVE 48 Camp Street, Hyannis,Massachusetts 02601 617-778-6060 N M.SHUMAN, AIA HENRY L. MURPHY, JR. MURPHY AND MURPHY TELEPHONE J. DOUGLAS MURPHY (508) 775-3116 COUNSELLORS AT LAW F A X G. ARTHUR HYLAND, JR. 243 SOUTH STREET (508) 775-3720 SUSAN MERRITT-GLENNY LOCK DRAWER M ALSO ADMITTED IN CONNECTICUT HYANNIS, MASSACHUSETTS 0260 1-1 41 2 NOTARY PUBLIC REPLY OUR FILE NO. 8378-A- November 27, 1992 • Joseph DaLuz, . Building Commissioner Town of Barnstable Town Hall Main Street Hyannis, MA 02601 Re: Lot 6, . Plan Book 191, Page 47, Threadneedle Lane, Centerville, MA. Being also T:Dz3n of Barnstable Assessors Map 210, Parcel 83 (the "Locus") Dear Mr. DaLuz: This office has been asked to review certain materials submitted to us by T. Walter Wannie and Meredith S. Wannie relating to the Locus. The materials submitted include the following: 1. Deed from James J. Taylor and. Pauline N. Taylor to T. Walter Wannie, Jr. and Meredith S. Wannie, dated 9/10/65, recorded with the Barnstable County Registry of Deeds 9/15/65 in Book 1311, Page 406. This deed conveyed the Locus. 2 . Deed from T. Walter Wannie, Jr. and Meredith S. Wannie to T. Walter Wannie dated and recorded 10/23/89 in Book 6930, Page 226. This deed conveyed the Locus. 3. Deed from T. Walter Wannie, Jr. to T. Walter Wannie, Trustee T. Walter Wannie Revocable Trust u/d/t 6/29/90 dated 2/3/92, recorded. with said Registry in Book 7863, Page 15. The Locus is located within an RD-1 Zoning District of the Town which permits single -family residence dwellings. Prior to February 28, 1985 the Locus conformed to the requirements of the then existing zoning by-law relating to area, frontage, width, yard and depth. At a Special Town Meeting on February 2.8, 1985 the Town voted to increase the area requirements for most of the single family residence districts within the Town to one (1) acre. The Locus, lying as it does within an RD-1 Zoning District, was affected by the increased area requirements: Prior to the adoption of one (1) acre zoning the minimum lot area requirement in the RD-1 Zoning District was 20, 000 square feet. As a result of the above zoning amendment, said minimum lot area was increased to one (1) acre. The effective date of the zoning change was the date of its adoption by Town Meeting February 28, 1985. Massachusetts General Law Chapter 40A, Section 6, as amended, provides in pertinent part ". . . Any increase in area, footage, width, yard or depth requirements of a zoning . . . by-law, . . . shall not apply to a lot for single or two family residential use which at the time of recording . . . was not held in common ownership with any adjoining land, conforms to the then existing requirements and • had less than the proposed requirement but at least five thousand square feet of area and fifty feet of frontage. " In Abamowicz v Town of Ipswitch (1985) 481 N.E.2d 1368, 395 Mass 757, the Court noted that ". . . the most recent instrument of record prior to the effective date of the zoning change . . . ", is the document to which the Court should look in determining the ". . .Status of the lot immediately prior to (a) zoning change . . . ". On February 28, 1985, the time of the adoption of the zoning amendment changing the area requirements for Locus from 20,000 square feet to one (1) acre, the Locus was owned by T. Walter Wannie and Meredith S. Wannie pursuant to the most recent instrument of record prior to the zoning change, being the deed recorded in Book 1311, Page 406 supra. At that time neither T. Walter Wannie or Meredith S. Wannie owned any land adjoining the Locus. Accordingly, it would appear, based on the facts herein recited, that Locus is grandfathered from the increase in the lot area requirements of the zoning by-law (20,000 square feet to one (1) acre) pursuant to Massachusetts General Law Chapter 40A, Section 6 and the corresponding provisions of the Town of Barnstable Zoning By-laws Se i n 4-4.5(1) . S ' ce ely, enry L. hy, J . HUI:bb ft4b t a 4C oil c S 04,? Ac . Ae eoox 6 9 3 0' GE 2 2 6 t DHBQ ! We, T. WALTER WANNIE, JR. and MEREDITH S "WANNIE, husband and wife as tenants by the entirety, in consideration of love and affection and in further consideration- of less 'than one dollar { ($1.00) grant to T. WALTER WANNIE,` JR., "being married, of 129' Willow Run Drive, Barnstable (Centerville), Barnstable County, Massachusetts (02632) with QUITCLAIM ; COVENANTS, the land in, Barnstable (Centerville), Barnstable,' County, Massachusetts,''°, bounded and described as follows: SOUTHWEST by Thread Needle Lane as shown on the plan hereinafter described, eighty.-three and 95/100 (83.95)-feett NORTHWEST by Lot 05 as shown on said plan, one hundred sixty and 01/100 (160.01) feet; NORTHEAST by land now or formerly of Hild.. E.. Wannie and a reserved area as shown on said plan, one hundred thirty-;eight and 55/loo (138.55) feet: SOUTHEAST by a 106 Foot Path and Drainage Easement as shown on said. plan, eighty-six and r97/100 (86,93) feet. and SOUTH by said 100 Foot Path and Drainage Easement as shown on said plan,. an arc distance of ninety-six and ...•78/100. j96:78) feet, anq of fourteen . and = 17/100 ( 14 .17) feet, respectively: `" i . BEING LOT 16 as shown ,on a plan entitled, "Quail Hollow In Centerville, Plan of Land in Centerville, ' Barnstabla, Hass. as , Surveyed for James J. Taylor, Scale I in..- 40 ft. Jan. 29, 1965. ` Nelson-Bearse - Richard Lev, Surveyors, Centerville, Hass.", and recorded in Barnstable County Registry of Deeds in Plan Book 191, ;i Page 47. ' Said premises are conveyed subject to and with the benefit of ,the matters set forth or referred to in a deed recorded In Barnstable County Registry of Deeds in Book 1311, Page 406, to which reference is made for the Grantors' titl deed � WITNESS d our hands, and seals this �/j.�' tE i 1989.1 �.J ay of l� T. Walter Wannis, Jr. ` Mereaith S. Nannie Y •33 4C .MSC • � w •lS4C.3 i .. • , _00 I I .04 . • i i MAC .a• •c es 1 •'*v4c TS Se ac .30 Ac _ ,ft� e 1 .ftac 1 •� ,� of ' MI 32 No MAC , . ` � +o. •11scr"�- 'y; .:. `P'r3 a `f. - 1. Ii i'E .-( n�,•r_,... i o- TOWN OF BARNSTABLE Permit No. ................ BUILDING DEPARTMENT i "Un I Cash .... TOWN OFFICE BUILDING o. ; HYANNIS.MASS.02601 Bond ,,, ............ CERTIFICATE OF USE AND OCCUPANCY Issued to Peri S. Wentworth . Address Lot 46, 40 Threadneedle Lane Centerville, Mass. USE"GROUP - FIRE GRADING OCCUPANCY LOAD ` THIS,PERM1;17 'WILL NOT BE VALID. AND THE BUILDING'SHALL NOT BE; CCU U PIED NTIL . • SIGNED BY THE BUILDING.INSPECTOR UPON,-SATISFACTORY ,COMPLIANCE WITH N TOW REQUIREMENTS AND•IN ACCORDANCE WITH SECTION 419.0 OF THE MASSACHUSETTS STATE BUILDING CODE: December 2'.. 19 9.3.....:. / ' •� i Building Inspector Tc"ANN OFSARNSTAELE PAYABLE TO: 6JiLL:NIG COMMISSIONERS OFFICE DATE 719y Oman Construction Company 78 Studley Road South Yarmouth, MA 02664 VENDOR# AMT._ 3 6,Oy PO# 1U TOWN OF BARNSTABLE Permit No. ..g5, .37 BUILDING DEPARTMENT Cash .. f$336.00) .... TOWN OFFICE BUILDING R>tear HYANNIS.MASS.02601 Bond ................ CERTIFICATE OF USE AND OCCUPANCY Issued to Peri S. Wentworth Address Lot #61 40 Threadneedle Lane Centerville, Mass. USE GROUP FIRE GRADING OCCUPANCY LOAD- . THIS PERMIT WILL NOT BE VALID, AND THE BUILDING'SHAO. NOT:BE OCCUPIED UNTIL SIGNED BY THE BUILDING 'INSPECTOR UPON.. SATISFACTORY COMPLIANCE;WITH'TOWN REQUIREMENTS AND,IN ACCORDANCE WITH SECTION 119A OF THE MASSACHUSETTS.STATE BUILDING CODE. December . ?'... 19.... 9.�. - /f/� �� - . '�'l Gam• . . Building Inspector LOT S o` . CONCRETE FOUNDATION LOT 6 20.560±S.F . (0.47±AC. > Oil CONCRETE FOUNDAaa 5• �� T.F.' � 9s' 10.7 r LOT 24 JOB # 92-053 CER TIFIED PL 0 T PL A N LOCATION : LOT 6 THREAD. NEEDLE LANE CENTERVILLE PREPARED FOR SCALE : l - 40 REFERENCE : PLAN BOOK 191 PAGE 47 OMAN CONS TRUCT I:ON I. HEREBY CERTIFY THAT THE STRUCTURE �� OF �� JOriNRs O `r9 SHOWN ON THIS PLAN IS LOCATED ON THE z y GROUND AS SHOWN HEREON. DEMAEST,JR. o No.36859 P� DEMAREST-McLELLAN ENGINEERING su 24 SCHOOL STREET MAY J. 199J P.O. BOX 463 WEST DENNIS. MA DATE PRO SSIONAL LAND RVEYOR THE FOLLOWING IS/ARE THEBEST IMAGES FROM POOR' - QUALITY ORIGINALS) pAtA BUILDING OF BARNSTABLE, MASSACHUSETTS ® 35837 .1 ^ t 19 '• PERMIT NO. ._l 033 DATE 04 E� t �.Y�13'll:011t:}t ADDRESS ♦U ,.,ia'i t3. tc.'t° h.O. !�'--,:-"" `°-_ ICONT R'S LICENSE( �l}.:i�i it Vs+..1-.;.•--,4_l•)_`:. (N0.) (STREET) A NUMBER OF Build dwelling I _) STORY `siag!L i i'mai DWELLING UNITS j 11Sa`t 111=.i. PERMIT TO (PROPOSED uSEI NO. . (TYPE OF IMPROVEMENT) ZONING i erville lot #6 40 Threadneedle.Laae, Cent DISTRICT— 1 AT (LOCATION) (STREET) Th• - AND (CROSS STREET) ' BETWEEN (ceOSS STREET) .f��� LOT LOT BLOCK - .. . 'SUBDIVISION .-. Ei CONFORM IN CONSTRUCTION FT. LONG BY BUILDING IS TO BE FT. IN HEIGHT AND SHALC. FT. WIDE BY�-- I .BASEMENT WALLS OR FOUNDATION - (TYPE) TO TYPE USE GROUP Sewage #93-4 jREMARKS: i n C o. 33 6.00 o ) (Oman Construction 150,000 FEE 143.50 AREA OR 1944 sq. ft. ESTIMATED COST $ VOLUME (CUBIC/SO UARE FEET) t - Peri S. Wentworth BUILDING DEPT. !: rt MA BY OWNER SrIDOtlt O , ng .00t r i e, P ADDRESS 5.d. i �.. to _• .... ... - 4n RE A'PPLICA'-BLE SEPA,FOR' OF ANY APPLICABLE`SUBDIV DIVISION EST RICTIONS. or RETAINED, ON JOB A,ND�SHIS. PERMITS ARE •REQUIRED FOR_ ' MINIMUM OF THREE -:GALL APPROVED' PLANS MUST `'Q, ELECTRICAL,.PLUMBING AND IN REQUIRED FOR CARD KEPT POSTED UNTI IFINP L INSPECTION HAS BEER ME HANICAL INSTALLAT«0115 ALL.cONSTRUCTiON WORK: MADE. WHERE A CERTIFICATE OF:OCC°UPANZ.GY IS RE 4 `Il 1. FOUNDATIONS OR.FO.OTINGS. SUCH BUILDING HAL•L:NOT BE OCCUPIED UNt1L 2,'eRIORTO COVERING"ST RIUC�/R AL QUIR.ED, - -t 'MEMBERSIREADT';T-O LATH). FINALINSPECTION HAS EEN MADE ♦:,�;��" f r '' '� ^I "? 3. FINAL INSPECTION QEFORE jl�l��`� a FROM ..ST=BEET -�'�• OCCUPANCY. • IT C Y POST THIS CARD SO tLE TRICAL IgISPECTION APPROVAL$ n r T+` PLUMBING INSPECTION APPROVALS I"""1 I BUILDING INSPECTION APPROVALS (t I b flN �s- � � t r • zI�p� 2 �9s Ic lam`^oC �.� ��' LNG DEP T E T _ HEATING INSPECT {{ OVALS C' ZG \�I �i•i S OF HEALTH ' J. SITE PLAN REVIEW.;APPROVAL 1 _ El:G�t•'f— OTHER t' " 11 INSOE a RITTE PER MET W!LL ECdMc' ULL ANDX MONTHS OFjOA7ETTHE'. ARRANGEOD FORIBYT7Ei.EPIUNE OW AN[ WORK SHALL NOTPROCEED'UNTIL THE INSPEC- WORK IS NOT S fZ?iED WITHIN S N(ffIFICATION `g TOR HAS APPROVED THE VARIODUS STAGES OF I PERMIT is ISSUED `KOTED ABOVE s CONSTRUCTION. I �J I ,Wi a• l 3 .F , ! �y • , �. e»'^ernte:�.�'..i�.;iF?sfiws7m, -,.:. : .;-;�T/`�'�,:.,..:., ry,a. N'.'1,?,:. ^v Xi';ti_".'*' 1f.:"1:Y'I� `;'r�..:. .. '�y'.;:.......'YaiP.r.•^ ... ... ',::. :i'a YR.'--=--+•--+.. r,- SUILUING BER:IIT N0. 3S�Y� I D °ASSESSORS PARCEL N0. J — OF CONTINUATION OF ROAD BOND The unde=siczned ocrner/contractor hereby agree to mai:twin the road bond is force until the following wort ite_s ara coW,cleted to the sat sfaczion of the Eng.;nee_-Lng Sec::--:on of the Deoarz.-ent O.L. Pao11C WOras: lcaW and seed shoulders as soon. as w2at:.er pe��ts: . 6�1/zother (e_�lain) 'RS'i ;j✓se= LCCcu_U.;: / (� �/F 1 I ZZn 0 7l. n n (pr,.t na=E c ;G 1:iEE=.�';G h �0?.iZ�:T:ON - ,� 7-777 DEPARTMENT OF PUBLIC SAFETY r �y COMMONWEALTH 1010 COMMONWEALTH AVE. F ; OF BOSTON,MASS.02215 MASSACHUSETTS p ENCLOSE CHECK OR MONEY OF FOR REQUIRED FEE; EXPIRATION DATE MADE PAYABLE TO :. • _ ��.'• �' EFFECTIVE DATE LIC•NO. 6 RtSI'RICTIONS "COMMISSIONER, -PUBLIC SAI (DO NOT SEND CASH) ' PHOTO leuSnNc )PR ONLY), FEE: - SIGN NAME!IN FUL>L A O E'.S' TURE T NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY HEIGHT: STAMPED OR -SIGNATURE OF THE COMMISSIONER I g SIGN NA fME•IN'FULL'• OVE`SIGNAI RE THIS DOCUMENT MUST BE , SIGNATURE OF LICENSEE CARRIED ON TIIE Pf ISON OF i 1HE IIOIDLR Will FNC.AG ACOMMISSIONER OTHERS RIGHT 1HUMB PRINT 811 IN THIS Ur:(.I,II A111 I f6 t _ _y — n 00 { -- _ - _ - _ -- - i>s�z•.I er..o1 sr• Il::nr•Ir.:l r,•- hax': >•r>rr• _ ,- r —r---Z - � �� �.I I � pm i ��N � . _ -,�do• !!�— Yz v� Y �Lb w ,Z.-e 4' P: . ^I L I M� �_'..7 `r— +�L� o o,V Ivl I r� I �, I- ��d � I• a'tJ•� L- �-�p+ ri� I - �' b—L; I• _ I CE.�� _ {_ I1- �_1 r�. •.x l. n -�� yl-$� >.sl� E 1 air a . e ' 4 Ill r o s , L +1 i•.f ' I ^� _a j% f I� ATnG —i�• I S ^� t rue � I� i �� � J _ m - 2. � •\ _ .. ''� Jr larec wo,�ucrn 1 °I. � �-=rq ti -le�.,�" •�r1 avir•,h•I+-7'ro r.x•I,b7£'Qo bA•.,'o%.'.a r lJ' r I , I � . , 7. 4. -A New' Home for "` '- ' -Peri; Shelly and Julie Wentworth aceo nss«ales Al nItCHITECTs - 3' Threadneedle Lane, Centerville, MA :r_ ,e tyro v M,Hns Aa L.eu:_.ozEtn �. 5pg-770.6060 - 9LI9 'Alice L Oberdorl,AIA t _ a- .-..,- - -_ �, _ ,, . �e'm_K•wry�r ae Ear.a ruw. ;'. _ .. .. _ 01 I � j 1 I � I �• b I $. - I j i'l 1 j III q4�. yo I _ _ _ - _ a:9 1 I\ tDFun>rEv See.^,Ge i•' '15 'ram/I ` COPS w f r-1S evircn� i 1—s JiFf I -- III .r..♦d— --..--m,cTw.wu-�—�I' L_a L _ LTA • 1 ,`i_-r - - I�+ _-'ra nl ` I .. i - • f II �✓ 1 1 1 A New Home for: i ..� -. Q - _ -- � __.., _ FOCN9M:LCJ/ei oeranx Rs+� ¢ Peri, 'Shelly-and Julie Wentworth 2 _ - AKRO ASSOCIATES,AIA,ARCHITECTS Threadneedle lane Centerville, MA <. 48 C.M street, Al—hu.ens 02601 508-778-6060 -` �_'— - 51cren AL Shurtun,AlA Alice L Oberderf,AL\. IV 9L15 -- i I r f r' I� x, y , . r : = - - - - - a Z. F ' , a _ 1 _ _ I _ I a T� 11 � i T - - I ; i iLi�.� I i�k I . - = I• I Z I I � .x FL 1 - • .- becego'�—e Fer..,.,r FL...�; _ _ -� � '' - - w�ecu`s�,. u•.e�>.u.. _ - _ ". _ 1 ' A New Home for - Fex L �Ece�c Fu e FeaMuw Pcry !_ Peri,. Shelly and Julie Wentworth AICRo ASSOCIATES,AIA ARCHITECTS Threadneedle Lane, Centerville, MA SOB.r,a 6060 [ -+ C8 Camp slreel,Hyannis,Massachuselt 02601 1 Sle en M Shuman,AIA Alice L Obe do(AU 9La5 1 t� F r> - j R ' - ¢ 1 IveYee>.:rio r.tw ee¢ c� a _ - S - - - --+"� 'r,?^ sic raxln•.w ae>wc � wl sG ._.-._ -� ._...•<:, :. . ..:._ .-::. - '.r:,,,•- - .,, S .. .w� a eDwe ,_ ♦ t -J IrCernJ ••. R _ J• _H,y,- R -iYvf >D oeCEz -16C. FfaYtE k._. f '-s• -� w •'._ .:= t f:. 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'� - -' N ais arii a a+c �--I --t>n—_ _ -•- 2 GIs eR�,_ _as+sat. . -....:,N•nY,�.�l.>,..�,� i :<,_ .- _._ _ - = � . . b gl -a,rvroxew -_ l 1 _ ve r �•'' ..� Ir.p,In>lien>'�� Y Iry��)�!11 7'� .• �ase vnu>a.> tlWE IrNUIST,o! , ...1. �prpr �1or of flea � n/ vNm ww+.� �^r/- -Y<vf -3- .. _. - _L•..•j('aunt�� 1 .'-. :-: _ -�>xP>�¢�>+4 - ._ - _ - _. .__t7 y - !_'• -mu-RamD� - -'-G'1.6Rx-Y .YM4 .. _ era.: 4-1 ,a>w, . / wr� ,,.nux�n.a lsw.c - �T�.�_.1 el c � o•a�-..aK«.�e.'•�r+ar.'- I rL �C1 �>tv�C er'%MFR.)I ryz.WWn - ''� ,•y�'�YPIlIL WPW aJEt,11Vm .. _I ___-___. _I c' ..A New Home _ tmca� Wm, Sr�.n ce e i _ Peri, .Shelly and Julie Wentworth Threadneedle Lane Centerville, MA so�aA PKRO K�HS AN;w� HR9 s '— Y _ — -- — — '-— ----- .Stereo AV Shuman,AIA Alice 1.Oberdwf,AIA { t TI' _3— . K ce- -- / -" . I L S j 1. ✓i!�e 'pf! JVI'G`CGGN FtCEt�L�E , . .- i - -4'•-' x Pdlb an ,�veoc 1-.T n, pp is r i A New Home for I Peri, Shelly and Julie Wentworth w I AKRO ASSOCIATES,AIA,ARCHITECTS - .� Threadneedle Lane, Centerville, MA 48 Camp SI eN,Hyanml,Massach-ells 02601 a i v,•+ 1 $leeen M.Shuman,AIA Alice L.oberdoel,AIA —F--vim—a- ;�--•'-�`- ---n r+'�a= — ,, _ _ -- —_ _ __._ -- - �—_ _ __ _. � _ — _ _— r s- - _ < L —777 , Rn ^ ,a , 't JI 'f,•>):.v:1'.r4lf�>Ynxer.� _ oeruwcuf -1 t 'I I V I � :I _- - r 1 - ..-. o ^ j t § _ ! _- - •< _ e'er I I � i..� 1 I ( I I I-I I _ I ' el�u'Iat I j 1 _.I I _' j � .I-i. 4. , F _ .- -. _ � i t :i IL �Y may•w �.., '.. - - �. _ s-Ih.ter.+ } .,t ' _ v. Vo,a� v�rcc�c j:.� ..,• .P ':. _ � _ _ _n.' ' ` n - r. ... osC Lrcuree✓eez�sw M ... .. , New .Home for c a Q ; Peri,- Shelly and 'Julie. Wentworth att. 60 AKRO ASSOCIATES,AIA,ARCHITECTS Threadneedle' Lane, Centerville MA `,a•'60�•„n � oz i -__.-_- Steven'Al Shuman,AIA nn Alice L Oberdw(AIA' r - r - JosePM 0. Oal,uz Telephone Building Commissloner Ext. i )~ TOWN OF BARNSTABLE DUILDING DEPARTMENT ° 1 TOWN OFFICE BUILDING HYANNIS , MASS , 026,01 NG P QUTLOIERMIT PROCEDURES ' •1 . SUBMIT PLOT PLAN OF LAND FOR ZONING COMPLIANCE . 'iPERCOLAT ION TEST (SEE BOARD OF HEALTH) , ' !QL0 KINGIS HIGHWAY REGIONAL HISTORIC DISTRICT COMMITTEE APPROVAL: , REQyIREO PRIOR TO CONSTRUCTION/DEMOLITION FOR ANY PROPERTIES LOCATED 1-N T11E H I'STOR I CAL DISTRICT ( NORTH CF 'rHE MID-CAPE HIGHWAY) . a. CONSERVATION COMMISSION APPROVAL REQUIRED IF ANY WETLANDS. ARE . INVOLVE•0. 5• ! TWO (2) COMPLETE SETS OF HOUSE PLANS COPY TO ARE R U I . . DEPARTMENT FILE �}E REOUCF h .rC� U. 1 /�„ xEQU REQUIRED'; 8-B 'I.OI•N :'•` .. 6. BOARD I, /? x. I`4!i . OF HEALTH APPROVAL REQUIREO ON PERMIT APPLICATION; T• jASSESSORS OFFICE - ASSESSORS MAP LOT NUMBER MUST BE. ENT APPLICATION BY' ASSESSORS OFFICE ERED ON bUNDATLOU PERMIT —IS—SUED: AT THIS MI NT, Nn F_ Ems, B• CERTIFIED (AS BUILT) FOUNDATION SURVEYOR AND A PERFORMANCE BONG MUSTPBCNSBEY3MA.rREpIF�RRADBUiLOING E R I`,11 T. k "A PERFORMANCE BOND OF NOT' LESS THAN FOUR DOLLARS 4 FOOT OF FRONTAGE AGAINST POSSIBLE COSTS DUE TO EROSION DOR DAMAGE , WITHIN PASSABLE 'STREET RIGHTS-OF-WAY SHALL BE REQUIRED MAGI BUI-LDLNG COMMISSIONER P 4 IREO BY THE ' ANO •A BOND OR CASH -SECURITY MAY nB�Hp�QuIRE_or�BOF�AEYBUELDgNILDING. ' COMMISSIONER FOR OTHER CONSTRUCTION , SUCH BOND OR CBUI DI G TO BE HELD BY THE TOWN TREASURER ON'i' iL CH SECURITY AS PROVIDED FOR i N SECT I Ot� OCCUPANCY PERMIT IS - GRANTED PROCEEDING WITH PRIOR TO THE LAND SURVEYOR SHA!�LSCERT I F•YY ABOVE HL t{S'I':UUTU(lE I OAS A I N COMPLIANCE WITH ALL YARD REt�U I RE E 13TR , REGISTERED BEEN LOCATED 8UI_-,LDT-.NG PE,_,_R_M11 W1LL F3E IS,S_ IEp AT1Fi1S POINT, --_-- LEE TO 8 EE PA i D. 9 CERT I F I-- C-- OF OCCUPANCY ARE REC U I kED i i i NOTE: All .foundations must be dam backf i 1 l i ng. p-pr•oof ed and inspected P, prior to All fireplace Inspected at flue s must be inspect the :> first lining) , throat .level (before No to to be covered be Fore wiring , plum Inspection. �. bi69 and frame COMMONWEALTH OF' MASSACHUSETTS STATE pill AVAILABLE LDING CODE BOOKS ARE FROM; STATE BOOKSTORE STATE HOUSE TELEFHQNE : - ,BOS,�`ON, (617) 727- 2834 ° MA p2I33 , ' r 8 f33 S � r Assessor's office(1st Floor): Assessor's map and lot num -� � Ti ���� I�sa�S�' �`'�`THE ro`i Conservation ' 5---2 INSTALLED IN COMPLIANCE Board of Health(3rd floor): WITH'TITLE 5 1 11 STUL Sewage Permit number ENVIRONMENTAL CODE rua Engineering Department(3rd floor): ADD �o 'e39. House number 4/0 TOWN REGULATIONS �0j'"`, Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO CONSTRUCT A 3 BEDROOM HOME — ( 2 stories w/ basement ) TYPE OF CONSTRUCTION 5B — COMBUSTIBLE UNPROTECTED 19 93 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location Lot #6 Thread Needle Lane , Centerville MA Proposed Use SINGLE FAMILY DWELLING Zoning District RD-1 Fire District Name of Owner Peri S. Wentworth Address 64 Wingfoot Dr. Yarmouthport , MA Name of Builder :mot Address 78 S4"dle j Rd. S-YA*✓nov`Ik Name of Architect AKRO ASSOCIATES, AIA Address 4 8 Camp St . #6 , Hyannis MA Number of Rooms 7 Foundation Concrete Exterior Cedar Shingles Roofing Asphalt Shingles Floors Wood Interior Plaster Heating Gas Forced Air PlumbingWater—Copper, Waste—PVC Fireplace 2 Masonry Approximate Cost $150 , 000 . Area _ 199 3 SF �g �s Diagram of of d Building with Dimensions �$ �'�� Fee -6�- G ( 1440 SF on First Fl PLEASE SEE DRAWINGS @ $9/100 SF) OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS 17'7 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regar i e e construction. AKRO ES, AIA, ARCHITECTS Name Steven M. Shuman, AIA Construction Supervisor's License MA Reg. #4 7 0 2 REG. ARCHITECT WENTWORTH, PERI S . No 3��837 Permiffor Two Story Single Family Dwelling Location Lot #6, 40 Threadneedle Lane'' ' Centerville _ Owner Peri - S.—Wentforth• Type of Construction Frame Plot ,,. Lot Permit Granted May 6, ` 19 9 3 . Date of Inspection / 19 • Dalb C ted �oZ�f 9C3_ 19 ' _ w 1 J - - t� ♦azzn.: 3. - .r Zed � I n, '• 4 p COMMONWEALTH OF MASSACHUSETT'S —�� DF_rAR,MENT OF INDUSTRIAL ACCIDENTS L _ 600 WASHINGTON STREET fames.: Canmei' BOSTON, MASSACHUSETTS 02111 �c—m ss��ne WORKERS' COMPENSATION INSURANCE AFFIDAVIT (licensee/permirtcc) with a principal place of business/residence at: (Ciry/Stare/Zip) do hereby certify, under the pains and penalties of perjury, that: [ am an employer providing rhe.following workers' compensation coverage for my employees working on this job_ . Insurance Company Policy Number f) I am a sole proprietor and have no one working for me. [) 1 am a sole proprictor, general contractor or homeowner (circle one) and have hired the contraaors listed below who have the following workers' compensation insurance politics: tv.z /q Name of Contractor Insurance Company/Poliey Number N-2mc of Contractor Insurance Company/Policy Number Name of Contractor Insurance Company/Policy Number Q l am a homeowner performing all the work myself. NOTE: Please be aware that wbilc homeowners who employ persons to do maintenance,construction or«pair work on a dwelling of not wore than three units in wbicb the bomcowncr also reside or on the grounds appurtenant thereto in:not generally considered to be employers under the Workers'Compensation Act(GL C 152.sect. 10)),application by a bomcowner for a license or permit may evidence the legal sutus of an er`ployer uoder the Workers'Compensation Act i unocrstano that a copy of ties statement wits ix for.udcd to tt,c Dcpi .-cnt of Industrial Acddcnts'OGicc of lnsc:antt(or.covcraYc vcrifiution and that failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition ofstiminal penalties consisting of a fine of up to Sl 500.00 and/or imprisonment of up to one year and evil penalties in the form of a Stop Work Order and a fine of S100.00 a day against mc. i Signcd this GI day of 19 Licensee/Pcrmirtcc Licensor/Pcr irror p ...... ........ ............................ .............. ............................... ........ . ......... ISSUE DATE(MM DO ... .............. ................. ................ ......... ................... .. . ...................... ..............x .. .................. 5/11/93 ... ........ ..... ...... Flo A411h,4D 105 .... ..1110 : M ..... ..... El. UR .................. AN"" ...................... .. ....... PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND iDowling & 01 Neil Insurance CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE Agency, Inc. DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 222 West Main St. PO Box 19910 Hyannis, MA 02601 COMPANIES AFFORDING COVERAGE COMPANY A Travelers Insurance Company, LETTER COMPANY B I.N.A. A INSURED LETTER Anchor Design & Pool Inc. COMPANY C 143 Upper County Road LETTER Dennisport, MA 02639 COMPANY D LETTER COMPANY E ii�{:� LETTER . .... ........ ...... ..... .... ....... ......... ........ .......... ................. ....... ................................ .. ... ................................. 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. co TYPEOFINSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS, LTR DATE(MM/DD/YY) DATE(MM/DD/YY) A GE ERAL LIABILITY 660365KO042IND93 54/09/93 04/09 974 GENERALAGGREGATE $ 1 000 OOO ,.X COMMERCIAL GENERAL-LIABILIn PRODUCTS-COMP/OP AGG. $ 1,000,000 ExOCCUR.CLAIMS MADE PERSONAL&ADV.INJURY $ 500,000 WNER'S&CONTRACTOR'S PROT. EACH OCCURRENCE $ 500,000 FIRE DAMAGE(Any one fire) $ 50,000 MED.a(PENSE(Anyone person) $ 5,1000 A AUTOM0131LE LIABILITY AOBAP526K334A93 04/09/93 0470,9/94 COMBINED SINGLE $ 500,000 ' . ANY AUTO LIMIT UTC ALL OWNED AUTOS BODILYINJURY $ X SCHEDULEDAUTOS (Per person) X HIRED AUTOS BODILY INJURY $ X NON-OWNEDAUTOS (Per accident) GARAGE LIABILITY X Drive Other Car PROPERTY DAMAGE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE ................................................ . ............................ OTHER THAN . ........... ........... UMBRELLA FORM ............................. .... 04/09/93, 04/09/94 ... ............ . B WORKER'S COMPENSATIONBINDER STATUTORY LIMITS ............ ......... AND EACHACCIDENT $:::: 100,000 DISEASE-POLICY LIMIT 5 EMPLOYERS'LIABILITY D $ 00,000i -EACH EMPL OYEE LOYEE $ 100,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS - Operations" performed by. the, named. .insured as provided for by the policies and their conditions. ....................................L ................................................................ .................... 0, .............................. ....... ..... . ... ............. ........... ..... ...... .................................... ............... .. . ... . . ....... ''A " ''.. . ., :.:::: :: : . .. ............ ..... .................................. ........... .................... .. ON ................................... ..... ................. ............................. ......................... .............. ... ....... .............X ...... ....... ......................... ..................................... .......... .................................................... SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE WNW= -4Nw&ffQ- Building Inspector LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF COMPANY, VES. P IYJF,�TAGENTS OR REPRES�NTATI AUTHORIZED REPRESENTATIVE -3 101 Dowling 011 ........... ... ......... ................ ................... ...................... ................................................ . .... ................. .. ..... ................................... ...........-*.......... r. . .. . .... #. . . .. ... .... Ia iD HOME IMPROVEMENT MENT C0NTR-ACT(0R S RE-G1:3TR ;TI P•! I 01 U,i c ii` Rh 7,l.lJ a cQ; <.iiC :, and!!a'i"Ca Si iJma Ashburton Plac ii ( y' ;ilI J. ..;VC,Lon I'I•;,c ._. C'1 U,'S:Ce t l.:.., 0.2IL 00 fI f 1 Ht.Jl' E [!"Inr;0VLE TENT l.0',ITi:i l T 0R Di i I I I I Z, COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY. 1010, COMMONWEALTH AVE � OF BOSTON,MASS.02215 :!!1" '�; MASSACHUSETTS ENCLOSE CHECK OR MONEY ORDER LIC=:ENCE EXPIRATION DATE �?4/_Oi 15J95 CONSTR. '=UPERV I=�C IR FOR REQUIRED FEE, i MADE PAYABLE TO RESTRICTIONS o EFFECTIVE DATE LIC-NO. o �. "COMMISSIONER OF PUBLIC SAFETY" m T (DO NOT SEND CASH). SFEAN M DITTRIC_H # 14,, MAIN ==T 1. PHOTO,(BLASTING OPR ONLY) FEE: HYANN I S MA �2601 HEIGHT: NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY STAMPED-OR-SIGNATURE OF THE COMMISSIONER - &. I THIS DOCUMENT MUST BE ^/� y/ � OF LICENSEE SIGN NAME IN FULL-ABOVE SIGNATURE LINE CARRIED ON THE PERSON OF - THE HOLDER WHEN ENGAG- OTHERS-RIGHT THUMB PRINT ED IN THIS OCCUPATION "eyr1 X 2MM-2.87.81429 APPRV- ALITH.4crIl I : y VI 'STEM DETAIL'S ADJUSTABLE ATRAME . �. R x { 4 3 �� "See "Long Member: 42" 1 .`Assembly" Detail; 4— Wall t Deck Brace 2" x Zn Panel` +; Radius Wall Panel - Adjustable -k x Long Member Minimum (29 1/2" Long) 4" ThickIF Concrete See --� Col l a r " t-Cemen Pad" e q Detail Frac1 e I Re-bar , � . i �s 24" --s Cement 24 " Short l � u Stake Pad Brace „nitent Pad , r 77Adjustable A Frame i '= LONG MEMBER ASSEMBLY J, .�� 1 Hsi � ?.., va.1• - � .. �C. , 13x !*-Flange Hex,Bolt ,•1' Fp tK. ,Sr Y.CYx.Y.Y .� �� 1 _ a 7 yi 4 v a i Turnbuckle: .YZ '#"wr++.u�v, >yr.�. :t,r KN:? ,. ,• q -2" x 2" Adjustable Lon 2 9 Member ( 91/2 Long) S v 3/8" - 16 Flange Hex Nut TM " I- ICAL WALL'JOINT CEMENT PAD Cement Pad See "Typical Wall `1 arks Hex Bolt } l Joint" Detail k 9, 24 � { * . 24" Short' �f . Y; E Stake Brace ------------------ y' } --- --- ------------- } f {F Wall Panel r=i 1 1/2 x 1 1/2 Adjustable a 3/8 16 , Long Member (41 5/8".Long) M x: Flange Hex NutkNl ' b . '.0 J Y ' 1 k� •.R Nam.. :' � W �J� `�� ,.' f� ':: .7171 \ 70, fAl /.� v -7�L ,< j ` 1 Nk Assessor's office(1st Floor): .' Assessor's map anf lot number Conservation � ���� ',ady Board of Health(3rd floor): 00��6�L� aNOE ♦; sAusT'Ancr Sewage'Permit number `� �j/' WITH TITLE I ° rua E �, `Engineering Department(3rd floor): ®DE AND as9 ENVIRONMENTAL House number TOWN REGULATIONS Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:06-2:00 P.M.only 4 TOWN OF ", BARNSTABLE B01LDJNO INSPECTOR APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION f o ( t 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: 11` Location Proposed Use e� �r.n I" A Zoning District Fire District m f Own r �. Name o O e Address � V� Name of Builder ot \Address (?J c,2 Name of Architect \ uS� Address��c.,r.��--�5� Number of Rooms Foundation Exterior Roofing Floors Interior Heating Plumbing Fireplace Approximate Cost Z, O o G Area Diagram of Lot and Building with Dimensions Fee I � OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name Construction Supervisor's License WENTWORTH, PPERI S. J BUILD PRIVATE No 3,� 4 4 Permit For SWIMMING POOL y ®'Accessory to dwelling ` Location 40 Threadneedle Lane _ - Centerville r - r R 4 Owner Peri S. Wentworth Type of.Construction Vinyl & steel Plot t LLot f I �^ •. October 19 `93 i Permit Granted 19 Date of Inspection 19 , 3 T i Date Completed Il��L? 19 —' ^ r f -^ .y,