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0096 CRYSTAL RIDGE ROAD
9� � l� .. � � � 4 s ' � � T 781-871_8252 �i F: 781-857 1977 July 1, 2015 '.._ Thomas Perry, CBO Town of Barnstable Building Division 200 Main Street Hyannis, MA 02601 RE: INSULATION PERMITS : SHERRI HARDING Dear Mr. Perry, This affidavit is to certify that all work completed for insulation work at 96 CRYSTAL RIDGE ROAD, Cam-, MA has been inspected by a certified Building Performance Institute (BPI) Inspector. All.work performed meets or exceeds Federal & State requirement. Sincerely, Victor Cimino limb 267 N. Quincy Street • Abington, MA 02351 www.insul-proinc.com TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION,, TEAIN 0IF BARNS -pplic« Map Parcel I . d �.J l�- `..� Apation #13 0 _VO CO Health Division Rr r± �a ,�gate lsued 10�10)/�/ LON VL 3Q A 1 5 Conservation Division Application Fe/� Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board D T V T 31 Historic - OKH _ Preservation / Hyannis Project Street Address 7( 0_' J f61 I'%JSL Village Owner �o�h ftiYl Address ��o Telephone 0 - 2 0' Gd 7�' Permit Request Q tr f el! ffC6 G A h V z /1 e/) 1 i,nf 4 2 (`��-1 yJ �'� /.✓►ti �( o� �� �cr ll ha h� � i�ffiR�l rfk Ac� rr.Jj Artec mil/ Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay _Project Valuation Z,? 2 C/6 Construction Type Lot Size / Grandfathered: ❑Yes, ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count 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 T r��-��� / Vic ?a/' Telephone Number OP7/- F2S2- Address Z //, Qvin ry T T License # Home Improvement Contractor# yy`Z3 Email V/C raf e f/) r4, P/O f n6, Cam Worker's Compensation #X A UQ 66 2 (J Y 3 .52/y ALL CONSTRUCTION^DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO Ck r-!!: SIGNATUREY DATE IiF FOR OFFICIAL USE ONLY APPLICATION# DATE,ISSUED MAP,/PARCEL NO. s l ADDRESS VILLAGE OWNER t DATE OF.INSPECTION. FOUNDATION FRAME 5,. INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING y DDATE:uCLQSED OUT ASSOCIATION PLAN NO. I N T he Uommonwealth of Massaehusetls Department of Industrial Accidents ' 1 Office of Investigations 1 Congress Street,Suite 100 Y Boston,MA 02114-2017 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/organization/individual): 4.f C, Address: Z 6 ,7 AK Q 41 h J�c/ 1�b r7 City/State/Zip: A2 i f'�� /!2 S - OZ 1S1 Phone#: !f7/-lr2S1- Are y an employer?Check the appropriate bos: Type of project(required): 1. I am a employer with l s 4. ❑ I am a general contractor and I employees(full and/or part-time)_* have hired the sub-contractors 6. El New,construction 2.❑ I am'a sole proprietor or partner- listed on the attached sheet. 7. []Remodeling ship and have no employees These sub-contractors have S. ❑Demolition working for me in an}-capacih-. employees and have workers 9. ❑-Building addition [No workers'comp.insurance comp.insurance.+ ] re uired. 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions required.) 3.❑ 1 am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12 oof insurance required.]t c. 152. §1(4),and we have no repairs employees. [No workers' 13.[1rOther i N1,/t7-/®7 comp.insurance required.] "Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. 1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. _ Insurance Company Name: I l ri ye(elJ Policy#or Self-ins.Lic.#: )< A V/3 6(9 L (b Y 3 5 L l Lt Expiration Date: 516 15 Job Site Address: /t�O C P�4I f g �s� City/State/Zip:CG tc,/ ,/1 5 O 261f Attach'a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereb under the pains and enaldes o ormation provided abm�e is true and correct er u at the in Si afore: Date: --- Phone#: Official use on&. Do not nTite in this area,to he completed by cih,or town official Cih or Tones: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#• 1 Aca CERTIFICATE DATEIMMIDDnYYY) `..� ATE OF LIABILITY.INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endomement(s). PRODUCER NAMNEACT Denise.Butcher Strategic Insurance Solutions, Inc. PHONE (617)558-7100 x122 FAX .(781)459-8282 2000 Commonwealth Avenue -MAILADDRESS.db@atrategicinsure.com INSURE S AFFORDING COVERAGE NAIC# Newton MA 02466 INSURERA:ScottSCkAle Insurance Co an INSURED INSURERS-Commerce Insurance Company 4754 Insul-Pro Insulation Co. , Inc. INSURERC:Torus National Insurance Co 267 N. Quincy St INSURERD:Travelers Casualty & Surety Cc INSURER E Abington MA 02351 INSURER F: COVERAGES CERTIFICATE NUMBERCL145602872 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. ITLR TYPE OF INSURANCE POLICY EFF POLICY EXP POLICY NUMBER MID M LIMRS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL UABIUTY PREMISES Ea owE c $ 50,000 A CLAIMS-MADE ®OCCUR PS1914781 /13/2014 /13/2015 MEDEXP(Any one ran) $ 10,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES iPER: PRODUCTS-COMPIOP AGG $ 2,000,000 X POLICY PRO LOC $ AUTOMOBILE LIABILRY CO aBI tlED SINGLE UMrr 1,000,000 B ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED ELS563 /5/2014 /5/2015 AUTOS AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS $ Per accide $ UMBRELLA UAB X OCCUR EACH OCCURRENCE $ 5,000,000 C X ���L kB CLAIMS-MADE AGGREGATE $ 5,000,000 DED I X I RETENTION$ 9425PI41ALI /5/2014 /5/2015 D WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN X ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBEREXCLUDED7 NIA E.L EACH'ACCIDENT $ 1,000,000 (Mandatory In NH) KAUB6626Y35214 /6/2014 /6/2015 If yea,describe under E.E.L.DISEASE-EA EMPLOYE $ 1,000,000 . DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,mdrdonal Remarkaschedule.If more snarle is reoulred) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE y Denise Butcher/DMB ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 rmtnrLat m Thra Aflfion names 2nA Innn—►aniatarafi mars of Ar'non ST j Federal ID:#,06-0405629. RISE Engineering RI Poniractor Registration No:'si86_ MA Contractor Registration ND.120979. # A division of Thielsch Engineering: GT Contractor Registration No 620120` 25 D11d-Tech Drive,Suite>fl,WesfYarmouth, 0 C NTRAC:T :.. 508 568-1926 X4197 TAX 508-568=1933: ... Page.. 1 I - 'MIS:CONTRA6T IS ENTERED INTO BETWEEN RISE CLC RCS ENGINEERWGANDTIIE:CIISTOMERFORWORKA8;-:-. I:PdGfFrls £$ING DEscolatbSELOW- CUSTOMER PHONE DATE CLIENT WORK ORDER: John R Starr (508)42$=070 06/24/2014 160028 .06002 .....SERVICE STREET. BILLING STREET 96 Crystal Rtdge Road Road 96 Cry. stal.Ridge Road. SERVICE CITY;:STATE,ZIP: BILLING CITY;STATE,.ZIP Cotutt,MA;02635:. COttltf;MA 026,35 y 400"DESCRIPTION AIR SEALING:Provide labor..and materials to seal;'areas of your:home agamstwasteful,excess airleakage This work will be performed in concert with the useof spe6►al tools and:diagnostic tests to a3sure that:your home rvill beaeft with a healthful level of air exchange and indoor air quality.Materials to be Used to seal;iyour home can include Caulks,foams;weatherstripping,and other products. Primary;aceas.for sealing ndude::air leakage to attics„basements attached garages:and other unheated areas(windows are: not,generally addressed) (18)warking hours., At.the completion of the Weather iation work,-and At:no additional coM. the:hotneorvner.64hal blowerdoorand/orcombustion safety analysiswt. be"conducted by thesuti-contraetor to ensure the safety of the indoor air quality. tIJ8.6:00: . A171C ACCESS;,Provide labor and materials to insulate(3) back of the kfi6nVall;hatch with2"rigid Tltermax.board:and seat the edge of the hatch with yveatherstrippine: $127�0 KNEEWALLS Provide labor and maierialsto install2' FSK-.faced semirigid fiberglass;board insulation 1o.(366)squarefeetoE .. kneewall Area. $:12,11.46 Total $2;7,24.96 Program Incentiye: $2,390.22 Customer'Total: $134.74 WE AGREE HEREBY TO.FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.'FOR THE SUM OF "*Three Hundred Thirty-Four&.,74110.0,.10161lars $3304 UPON FINAL INSPECTION AND.APPROVAL SY RISE ENGINEERING.CUSTOMER AGREES TO REMIT AMOUNT:DUE IN FULL:INTEREST OF vA WILL BE cHAROEO7MONTHLY;ON ANY UNPAID BALANCE'AFTER JO YS.SEE REVERSE FOR IMPORTANT INFORMATION GUARANTEES.RIGHTS OF RECISION SCHEDULING,AND CONTRACTOWREGISTRATIOWc DO NOT SIGN THIS CONTRACT IF THERE ARE,ANY,BLANK SPACES: 'AUTNOR R �SIGNA -R1 INEERIN �� � � U TOMER EPTANCE NOTE:THIS CT MAY.BE WITHDRAWN.BY:US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE �...,.. .. i ACCEPTANCE OF CONTRACT•THE ABOVE PRICESj SP CIFICATIONS AND CONDITIONS ARE BATISFACTGRYTP;US A14C ARE NEREUY ACCEPTED YOU I�REAUTNORIZEDTQDQ THE.WORK . � DAYS. - AS SPECIFIED PAYMENT WILL REMADE 4S OUTLINED ABOy€ i - _ Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-089969 VICTOR CHVIINO= 267 N.QUINCY ABINGTON MA�2351 Expiration Commissioner 05/11/2016 (exe _ �01 ffice of Consumer Affairs&Business g _ ME IMPROVEMENT CONTRACTOR License or registration valid for individul use only lstration: TRACTOR before the ex i - 149123 p ration date. Y piration 11128/2015 TYAe: Office of If found return to: Private Corporatiort IO Park Plaza Affairs and Business Regulation INSUL-PRO,INC. -Suite 5170 Boston,MA 02116 VICTOR CIMINO - 267 N.QUINCY STREET. ABINGTON,MA 02351 ! Undersecretary Not valid without signature OWNER AUTHORIZATION FORM I; k J,14, -. &4AA� (Qwner'.s Name) owner of the property Located at. ( roperty Address (Property-Address) Al hereby:a'uthorize. (Subc6nfractor): an authorizedsubcontractor for RISE.Engineering, to act on my behalf Wobtain a building permit and to perform work pn my`property.. wner's Si ature: 1 Date: DS O 1r! E auc 20 a. ■ ..■■■■■■■■am°m.■ ■ .... ��.....■�...■■. ■■��1 ; .�al■..■.ani���®®®■■■owl ®®.®®� ■�■■..■■... ■�IL4� � !'■�.� �,.� - - ..■■■Ni`...■■.■Emmomm .... ■ARMEWOU. MEN ■■... 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I■ ■.■. ■■■®®. �.11■IS■.■■C a■m1I■a■.■■m ■ MEMO .�.■■■M.■■■®.�� ■.' t'�l®■■... ■®■�Q.■■.....0 mimmosommummomms ■■.■.■..NOM �.�iEsll"C.�i1I 0 per PH Pm .■.lil�I■■■ I ■■. ■. ® l(I■■■ ■E■■ ■■■.■.■..■■■■.■■C�■III. ■■.miu'■■ollm.■■min HI®.■■■■■■■■ ■.■..■■■.■..■■.■■■vl..■■.\11.■mo■■■■■®all■...■■■■.. ■.■..■.■■■■■.. ..s1®.■■R� (1.■■'t ■..■®.®t�■■..■■■..■ ■.■■...■■■.■■■ .■■ f.®�1■ i Il...!■..■.■®it.■■...■■■. ■■■.■.■■■.MEMOSEEMMECNN ONE .1CC1■ ®.�®®®�����1 ■■■C■■■r�.WME 0 on �■■.... .■........■■■..■..®..........[vim■®�®®®��®......■■■ 0 a'ALIZOWIM, §s MEN ....■..■■®.■■..■..■■...■■■.■■■..■■■... ■■■■■■■■....■.■..■®■..■...■..■■■..........■. .■ ■.■■.■■■.■■■ ■ ■■®.■ .■.■.....■■.�..■■!.■.■■. ..■..■.■■■.■■■■.■■®.■..■■...■....■.■... ...■... .....■■....■.■■..■®...■..........■...■. ®��.�..MiA ■ t ERM Town of Barns t#- � table Permit# O� Expires 6 onti vm is&date } Regulatory Services Fee 2012 M14g F. Thomas F Geiler,Director - • pin�► , . TO F BARNSTABLE Building Division Tom Perry, CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 -EXPRESS PERAM APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number efG d,)(� Property.Address (� Residential Value of Work Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address ' Q 414�__T Contractor's Name ' Telephone Number Z, Home Improvement Contractor License#(if applicable)_ Construction Supervisor's License#(if applicable) ( / orkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner J�iLhave Worker's Compensation Insurance Insurance Company Names Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. ' Permit Request(check box) Kam-=--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 #of doors ❑ Replacement Windows/doors/sliders.U-Value - (maximum.35)#of windows ❑ 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 regaMons,i.e.Historic,Conservation,etc", ***Note: operty Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is j r quired SIGNATURE: Q:IWP=S\FORMSIbuilding permit fnrms RESS.dor, W-700:01 SEAN E. ANDERSON CQNSTRUCTION1 LLB'. SGT±o;dr idge Fat1i sea@opeo d.net West�wyeiouth,NQA 02673 Proposal sealan&rsonw mtruction.c„ii 1.508 280 7326 To: 1c5hn Starr From: Sean Anderson Subject: 96 Crystal Ridge: rcof re-do Date: 09/26;�2012 job Description: • Pemove;/dispose of existing asphalt roof-shingles. -A Ice 81k water shield installed along 1 st 3'of roof deck,in valleys,around chimney and around all penetrations.,/ ® #15-=e1t paper,installed for other quality roof underlay-ment)along remainder of roof deck_. ® $"white,drip-edge installed along roof--edge. ® CcrtainteedS Landmark Pro©roof shingles installed over ne+zly-papered deck(color and grade:Colonial Slate). ® EPDM rubber roof ng installed over small,flat garage roof. L nAX � ® Roof vented to code using Cobras ridge-.vent Roof deck-opened at ridge if necessary. • lob area cleaned and magnetized for nails.daily. ® All su,rrounding surfaces covered.for debris. Cost for described'cork: $ 16,400.00 (includes all materials,labor and disposal) Notes: 'c guarantee all of our:�orkmariship for ten fears. Please call anytime if you have am? questions. Pay schedule: - =pletien. 5(5_6 AIOVri l(10 v/`? Acceptance of Proposal: The above price and specifications are Customers signature: Satisfactory and hereby accepted. In the event of non-payment,the customer shall be responsible for all costs of collection, Sean E.Anderson: including stauutora interest and reasonable J se iO).capecod.net seanmi.+ersonconstmction.corn 1.508 7:;W6 y Roofing Addendum Contractor: Sean Anderson Customer: John & Sherri Starr 96 Crystal Ridge Road Cotuit, MA 02635 Date: 9/27/12 Job Description Changes from 9/26/12 Sean Anderson proposal: 3rd Bullet: Starr and Anderson to define and agree upon roof underlayment 5th Bullet: Use CertainTeed Landmark Pro Colonial Slate Max Def 7tn Bullet: CertainTeed starter and CertainTeed hip and ridge will be used (required) for CertainTeed warranty Additional: Sean Anderson and his employees and subcontractors agree to comply with all installation instructions for CertainTeed Landmark Pro shingles (copy attached). Sean Anderson, his employees and subcontractors, agree to repair any damage to the property caused as a result of this work. Project Timing: Work to begin October 2 or 3, 2012 subject only to delays caused .by weather. Work to be carried out continuously daily (except Sunday) with deviation from continuous work only due to inclement weather. Completion expected in 7-10 days. Payment Terms: Since this is a short project (7-10 days in.total), we agree to pay as follows: 1/3 of total price ($5466.67) at commencement of work with all materials on site and delivery of town permit and insurance certificate stating liability and workman's comp. coverage 1/3 5466.67 when work($ ) at least 50% complete f Roofing Addendum Page 2 1/3 ($5,466.68) immediately after successful completion as approved by Starrs, written documentation of all materials warranties as advertised in CertainTeed literature, Sean Anderson warranty of 10 . years for workmanship per the proposal, and, receipt of labor and materials lien waivers. Agreed to and Accepted by: John Starr C C� Sherri Starr / ,� ,,_ �✓ Sean Anderson Date: ® Ar_rarr AR a - Read Before You Start Application Fastening— IMPORTANT Steep Slope(greater than 21:12): To obtain stated area coverage and to achieve designed performance, Use SIX nails and FOUR spots of asphalt roofing hese directions must be followed, including 5 5/8"(143 mm) sningla cement"for every full Landmark PRO shingle,located exposure to weather. Roof Den as shown below(within illustrated shaded areas). Notes:Fasteners must be placed between the lower Proper Crooked Unau-Daw, 0,arOriwn 2 nail lines. Landmark PRO shingles conform to: sailing ASTM D3462 For decks 3/4'(19 mm)thick,or thicker,nails must go SLOPE 12 (375 »- AS ASTM D3018Type I --(305 mm)-� —(375 mMT_+-(305 mm}�- at least 3/4'(19 mm)into the deck On thinner decks, NauNG ASTM E108 Class A Fire Resistance AREA: Nzging s nails must go at least 1/8"(3.2 mm)through the 1•(25 mm) Mnwer,��,1 ASTM D3161 Class F Wind Resistance deck.Nails must be 11 or 12 gauge roofing nails, nad umsr UL 997 Wind Resistance corrosion-resistant, Of with at least 3/8'(9.5 mm)heads, m UL 2390/ASTM D6381 Class,H Wind Resistance and at least 1"(25 mm)long. ASTM D7158 Class H Wind Pesistance I NYC-MEA-120-79M IMPORTANT:NAILS MUST BE LOCATED WITHIN Roofing Cement CSA Standard A123.5-98(&-05) THE FACTORY-APPLIED NAIL LINES,TARGETING Nailing areas for steep slopes(greater than 21:12) Ontario BMECAuthorization 7 Nail bet ween lowe 97-10-219 SHADED AREAS SHOWN BELOW.SHADING and rStorm-Nailing" r 2 nail lines as shown above. (SMEC report available upon request) IS SHOWN ON ILLUSTRATIONS ONLY,NOT THE FINISHED PRODUCT Apply FOUR 1"(25 mm)diameter spots of asphalt roofing cement beneath shingle as shown above. Low and Standard Slope(2:12 to 21:12): Asphalt roofing cement meeting ASTM D4586 Type If �SITEEIIP ZED(2tr,2) Use FOUR nails for every full Landmark PRO shingle, is suggested. ssP.App :_ located within illustrated shaded areas as shown below. Storm Nailing(all slopes):If weather conditions Position nails vertically between the upper and lower are such that sealing of shingles may not occur prior to I, nailing guide lines.For low and standard slopes,it is a significant windstorm,then it is recommended that the slope po- acceptable to nail between either the middle and lower shingles be attached using the`Steep Slope'nailing i (02wieztrP) lines or between the upper and middle lines. instructions above. L iaa M2) r�T`o —CAUTION:Excessive use of roofing cement can t'r wJa• t2 AnA. 3305( —1-� (-5 —r r-(2a5 mm} LOW '-I cause shingles to blister. sm,�rnrtaion i t.�g,g (tale::�t2t LS.S ISM t•-^� 11r;Yn�tina o_Kail IeK ^� �{ i Lo'(e 2) Slope Restrictions Mdigng ales form"ana smaaam ropes(fmm-n2to 2m2) The roof deck must be at least:318"(9.5 mm)thick plywood, N2kt6_n rQ a a v es sv m o e or 7/16"(11 mm)thick non-veneer,or 1"(25 mm)thick nominal wood deck For UL fire rating underlayment may be required.Apply flat and Roofing Over an EXISTING Roof (Roof-Over) unwrinkled. Cut old shingles back flush to rakes and eaves. 9 1 St Course:Cut 2"(50 mm)off the bottom of the Standard or Steep Slopes:CertainTeed recommends Apply drip edge along rakes and eaves,if desired. full Landmark PRO shingles and apply remaining DiamondDeck7l'Synthetic Underlayment,Roofers'SelectT`1 11-1/4"x 38-3/4"(286 mm x 984 mm)pieces.For all High-Performance Underlayment,or shingle underlayment meeting The"5-Course Diagonal Nesfing"method of ASTM D226,D4869 or D6757.Always ensure sufficient deck application described below is suggested for roofing courses,align top edge of shingle to be applied ventilation,and take particular care when DiamondDeck or other over square-tab asphalt roofing shingles of 5-518" with bottom edge of old shingle in next course. synthetic underlayment is installed.Follow manufacturers application -d-118"(143 mm d-3.2 mm)exposure. , 2nd Course:Cut 6"(152 mm)off the left end of a instructions. Starter Course:The starter course consists of full shingle and apply remaining 32-3/4"(832 mm) Low Slopes:One layer of CertainTeed's WinterGuardil 5-518"x 38-314"(143 mm x 984 mm)strips formed piece.Exposure of 1st course only is reduced to Waterproofing Shingle Underlayment(or equivalent,meeting ASTM by cutting off the top 2"(50 mm)of CertainTeed's 3-5/8"(92 mm). D1970)or Mro layers of 36"(914 mm)wide fell shingle underlayment Swiftstart self-sealing shingles,or equivalent 3rd,4th,5th and Succeeding Courses: (Roofers'Select or underlayment product meeting ASTM D226, Cut 6" 152 mm off the(eft end of the first starter ( ) Apply as described above in`5-Course Diagonal D4869 or D6757)lapped 19'(483 mm)must be applied over the shingle only.Apply the remaining 32-314'(832 mm) Application Method"section. entire roof,ensure sufficient deck ventilation.When DiamonclDeck piece to the lower left corner of the roof,overhanging or other synthetic underlayment is installed,weather-lap at least the rakes and the eaves 112"(13 mm)if drip edge is ; 20'(500 mm)and ensure sufficient deck ventilation.Follow used,or 3/4"(19 mm)if no drip edge is used. sp C1111. manufacturers application instructions. Continue with full lengths along eaves. %vfi ate° -mn i ,•arh � •'Oi Cold{(heather Climates(All Slopes): / �'i r co"e - dRooi IMPORTANT:When the first course shingles 1)gT Application of WinterGuard or its equivalent is strongly recommended are applied,ensure that the end joints of the starter i whenever there is a possibility of ice build-up.Follow manufacturer's i1?v• application instructions. roC shingles and the first course shingles are NEVER nps "'Se ;,us• '"�/ i-_ -. LESS THAN 3-1/2"(90 mm)apart.Either plan the �� �Za2•!e� i add Flashing:Corrosion-resistant flashing must be used to help prevent starter shingles'application to avoid end joints getting leaks where a roof meets a wall,another roof,a chimney or other closer than 3-1/2`(90 mm)or cut back the affected ' objects that penetrate a roof first course shingle to.ensure the minimum / !--rsrCb Sealing:Shingle sealing may be delayed if shingles are applied in 3-112"(90 mm)end joint spacing. cool weather and may be further delayed by airborne dust accumulation.If any shingles have not sealed after a reasonable time period,hand sealing may be necessary. CAUTION:To prevent cracking,shingles must be sufficiently warm to allow proper forming for hips,ridges and valleys. co o o • a:,y � I 8 i 6 Course Diagonal Application Metal Step Flashing Method (6'" (152 mm) and 11" (279)} Pm Gommu ne flst over crap ILn'ry.' r(so758(t94 min) Minimum (MEW Root or Tear-Oft) ,l minimum Underlayment:Apply as required,following manufacturer's instructions. T Diagram"A"illustrates application of Roofers'Select and standard felt r(76 mmn main underayment,for standard or steep-slopes only.Always ensure sufficient deck ventilation,and take particular care when DiamondDeck or other synthetic underlayment is installed.Follow manufacturers application instructions. _ Flh Alignment:Snap horizontal and vertical chalklines to assure shingles %7 '•' will be correctly aligned.Expose all shingles 5.5/8"(143 min). `A� 71 Starter Course:Use applicable CertainTeed StarterT'a product,such as Swiftstartlu,with a minimum height of 7-5/8"(194 mm)or its equivalent / / - Apply with sealant at eaves edge.Cut 6`(152 mm)off the left end Fa oaprmg bp ano rings, of the first starter shingle only.Apply the remaining piece to the s daP4='.ceama sp?N CeGinTaeG. ad-.M— Ridge-�ngM`ora like mlor. - i' I �z}0YmtM°�9 lower left corner of the roof.Use full length starter shingles for rest of the course.(See�). IMPORTANT:When first course shingles are applied, ensure that the end joints of the starter shingles and unae,Uym�r the first course shingles are NEVER LESS THAN 3-112"(90 mm)apart Either plan the starter �\ shingles'application to avoid end joints getting closer than 3-112"(90 mm)or cut back the 5 affected first-course shingle to ensure the minimum 3-1/2"(90 mm)end joint spacing. t� Air Fla—,^` Through SOFT 'AGagaal2 2nic veNilatmn 0EZIr5 e cooL^.r alao ai the Somm&anG a Grim alliC in that.It elTO helps pre—u Starter shingle orm l r fz uraofsh ngl s,root°eck ———————————J —ammNGalmi--ion.a-bmation of I 1. I I _'________Ir_______— ire Dens Shuaye Coinage oriLtara I I R e m o v el these p,lo r ti o n s I resellinghminzG&varulelionsnol l' - 'l ________-I________1 raser�d by CanainTeea'S Lintitcd EnmaL= l WEnzmy.eomrarlam only.br iaMs ` II I 6JenG Jtvdjl� 6 a6a - I eaa"s r>1L IMPORTANT:Do not align end joints of shingles inlomla6Gnab0malg[v nx .P1— 2t5o nml" , tin,r(3dsmml: —.11 the'Carhinleal Shugla closer than 3-1/2"(90 mm)from one another. A* tasklanuVicall t.¢8D404-9M ' tor_xPy)•antliar'rha Principles olAluc I l - •�� Ertdedam 1st Course:(See(D).Apply full Landmark PRO wntia�'bn ua( too-ARVE r �,sr� srungkm%'jwmm) fora ropy). - - N°� cM'� I. i shoal rooting cdrr_m shingle at the lower left corner of the roof,flush with e h�eycJ� I l the starter course. r ° r6C9a Cum=( nun) Hung. 2nd Course:(SeeQ).Cut 6'(152 min)off the left end of a full shingle and apply remaining 32-3/4"(832 mm)piece over left edge of 1st course. a� ceU i � 3rd Course:Cut 11"(279 min)off the left end of a full A shingle and apply remaining 27-3/4'(705 mm)piece over left \ rrsu edge of 2nd course. 4th Course:Apply the 11'(279 mm)piece over left edge W-e \�'' of 3rd course. p6pe6se �m seams t0. T , 5th Course:Apply the 6"(152 mm)piece over left edge of 4th course. \ w 5>� Apply a full shingle against the right edge of each shingle in courses b through 5.(See(M). Succeeding Courses:Beginning with a full shingle,repeat the 5-course gla j0srml' ��� saner a-' diagonal pattern up left rake(See(9).Apply one full shingle against each shingle in courses 1 through 10(right side of sections and(0). .>5 ) Proceed up the rake in 5-course sections and fill in diagonally with full shingles,unfil the roof is covered.Diagonal application is important to assure proper finished appearance. ssw �aes�yQ fig. ;a„w I E*�mml a�c6oe t I �i\\,91nmti ALTERNATE METHOD:An approved alternate method of y application is the 5-5/8'(143 mm)and 11-1/4"(286 mm)method .. ....��.. .— — , , . . ..P..--:.,.—�; ...,.,.. —,�:�. - - , -, , :. -'. - , - - , . ,.: _�:� :-�...I.. �41 1, :, .. . . � � � - ..: - .- . ,: � . . ::� I . .., -1: !� ., 11 . � ,, , .. - :�, -�:��- _ - .�..-. . :'. *. - : �: -��. -�... -: �.� ""'::,.,;�:- . .. �:.!I.: .,.. - - - -, , 1. � . � .....;. _A:. .. : —..:- . ..- - : - --, - ��, �, : .:. - M . . -:0 - ,,�.--,.� �� ;_-.Q. . :. - . . I , % : - 4 � . � . ."..:, .. .���.�, .., -... .. .. ��.-..`,.-- ,., ,--.-" ". . . .%. m � I .�; . - . I I I W. -. .. .. . . . . - Landmark Pro is designed speafcally fqr the'professional roofing contractor that takes ,pride in providing rri®re to their customer Landmark Pro improyes upon the CertamTeed Lanemark shingle, a leading consumer .. publication's "B.est Buy" for the past five years We Started by adding more wpq:enng asp. alt to ahe mdustry's toughest fiberglass gnat to provide.more protection; Theri.}.we in corpo;rated:our Maximum De..fmrtion color blend technology to give the product more vibrancy on the roof Included is the proven performance ofour NailTrak feature, enabling faster installation Landmark Pro offers the industry's strongest warranty Protecting your reputation and, safeguarding homeowners frorn.manufactunrig and,aesthetic defects Landmark Pro Standard ltNarr, .. Lifetime Limited UVarran;ty , 1.0 years of SureStart protection .: 15- year 110',,, wind warranty (Up.grade to 130 MPH avarlable)- (CertanTeed starter and.CertainTeed hip and edge required) 15 year algae resistance warranty Add:it all up and what you get is the opportunity to offer a lot of additional value for the money „and today that means more than eXer �T F .'' ti`vi'r -=5� rYr-�r ""`�4"5.. 3�-s t , y `z'` a.a „i:v ... ro� '1. >lf�&kh� 1 'X`h `1• eH 1' ry �v�a' R`� ,k�� t� _tYt "e�('. �` ' s ua:d z �, f ni .a� F '- n +a � $`' tXr`:as s ��-' iT,'(rt,. �=•S.l•' "f .S - .. I 15::. :,J M .a 3�` g y,_ s . �— d �a t� - -1 f® I IM 'I '. ��i s®:_ — aril . n. ,>;: f E ial `. .. _ .: r: - . - -..-. " . _::. . .., Landmarkp, specaficataons landmark specmcataon`.s 250IbP!s.. re 2, Ibs/square Premium Max`.Def color palette Traditi na! o1or palette NailTrak' for faster installation • NailTrak :for faster installation Lifetime:limited warranty Lifetime limited warranty 7 b yearSureStart protection includes • 10 .year SureStart protection includes - Matenals labor, tear offand disposal cost IVlatenals and::labor costs 15 year:algae;resistance 10-:year algae re.'sistance 15 year 110 MPH wind warranty with • 15:,year 110 MPH wmd,.warranty with {; upgrade to`13.0 MPH:available upgrade.to 130MPH available " eallC< o��/l�,Caaaaclluaelta d= ,per ✓1ze �roownza�uu \ 7.1 Office of Consumer Affairs&J3 siness Regulation; I License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the.expiration'date. If found return to: i Registration '1,28778 Type Office of Consumer Affairs and Business Regulation Expiration Sl16/2013 Individual . 10 Park Plaza-Suite 5170 Boston,Iv1A 02-116 >. SE 'E.ANDERStOFN r SEAN ANDERSOIv,, 50 TROWBPIDGE P7rTf� F� I W.YARTMOUTH, MA 0270: — Undeisecretary --- a Not vd"Without srgna q '" IVI tssachusetts - Dcpar trnent of Public S:tfch tift7]� Bo.trd of Building Re, .. r ulation•�and Standai is Construction Supervisor License - License:, CS 74101 ,. BEAN E ANDERSON , 50 TROWBRIDGE PATH r• 1 WEST YARMOUTH:, MA 02673 f . .. Expiration: 2/24/2013 _ (uuuin,siuner Tr#: 9749 ; ' The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations + d 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl f d d� "� Name(Business/Organization/Individual): Address .t City/State/Zip4 — V,4~J_Rt fi I — Phone.#: Are you an employer?Check the appropriate bog: Type of project(required):. 1 a employer:with 4. ❑ I am a general contractor and I ' � 6. ❑New construction . . employees(full and/or part-time).* have hired the sub-contractors 2.❑ 1 am a sole proprietor or partner- listed on the-attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition workingfor me in an capacity. employees and have workers' Y P t3'• 9. ❑Building addition o workers' comp.insurance comp.insurance.t [N mP _ 10. Electrical repairs or additions 5. We are a corporation and its ❑ P required.] 0 � 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp.insurance required.] . *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy.information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: l 2 g� 51 Policy#or Self-ins. Lic.#: �35-a° 7— 1� Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the for insurance coverage verification. I do hereby certify n er the p and penalties of perjuiy that the information provided above is tr a and correct signafore: Date: .,D /l Phone#: � � + Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town CIerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more 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, §25C(6)also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"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 out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary, supply sub-contiactor(s)name(s),address(es)and phone number(s) along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit 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. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials 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 applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in__(city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call.. The Department's address,telephone-and fax number: The CommonwWth of Massachusetts Depart meat of Industrial Accidents Office of luvestigations 600 Washington Street Boston,MA 02111 Tel. 617-727-4900 ext 406 or 1-977-MASSAFE Fax#6.17-727-7749 Revised 11-22-06 ' www.mass.gov/dia ANDER-5 OP ID: KG CERTIFICATE OF LIABILITY INSURANCE , DATE ,, THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS �RIGA f-' FON�THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER y E 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., nn, nrT — I N 3` IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pol)cy(ies) must b"hcl&sed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER ONTACT Phone:508-771-1632 NAME: Northwood Ins.Agency,Inc. PHONE 540 Main Street, Suite 9 Fax: 508-393-2955 A/C No Ext: r+x�r< C a7"'at' FAX No: Hyannis,MA 02601 E-MAIL W u, ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC A INSURERA:Generat Casualty Insurance CO. 24414 INSURED Sean E Anderson Const, LLC _ INSURERB:-Hartford Insurance Co _ 50 Trowbridge Path INSURER c W Yarmouth, MA 02673 INSURER D INSURER E INSURER F COVERAGES CERTIFICATE NUMBER- REVISION NUMBER: THIS IS TO CERTIFYTHAT 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. I�TR TYPE OF INSURANCEAUUL POLICY EFF POLICY E P INSR WVD POLICY MMIDDIYYYY MMIDDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A. COMMERCIAL GENERAL LIABILITY CCX0396093 04/13/12 04/13/13 AMAG 0 RENTED PREMISES Ea occurrence $ - 100,000 CLAIMS-MADE FX_1 OCCUR !MED EXP(Any one person) $ . 5,000 X Business Owners - PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ .2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: - PRODUCTS-COMP/OP AG $ 2,000,000 POLICY PRO- 17 JECT LOC $SL 1,000,000 AUTOMOBILE LIABILITY - " - - COMBINED SINGLE LIMIT - Ea accident $ ANY AUTO BODILY INJURY(Perperson) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS - Per accident) $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE t $ EXCESS LIAB CLAIMS-MADE - AGGREGATE DED RETENTION$ $ WORKERS COMPENSATION - WC STATU- OTH- AND EMPLOYERS'LIABILITY TO Y I I S ER B ANY PROPRIEfOR/PARTNER/EXECUTIVE YIN CERT WILL FOLLOW FROM 05/21/12 05/21/13 E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? N 1 A (Mandatory in NH) CO W/IN 5 DAYS E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space is required) - CERTIFICATE HOLDER CANCELLATION TOWN BAR SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town Of Barnstable THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 230 Main Street : Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE O 1988-2010 ACORD CORPORATION. All rights'.reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD YOU WISH TO OPEN A BUSINESS? - For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must_do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St.,'Hyannis., Take the completed form to the Town Clerk's Office, 1 st Fl., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. Ptlrzillgj - DATE: t� Fill in please: APPLICANT'S YOUR NAME/S: ScR-P� S BUSINESS YOUR HOME ADDRESS: o a Ga,-tS-M� IZtdc s„ Go Tv �T Mfk 011p3S TELEPHONE # Home Telephone Number 5 0 — 4 —oo O —1-1 IUAME OF`CORPORATIt]N. TJm F ; NAME OFNEW BUSINESS SE -t. S`t'ia=�2 1�r t- 5- i✓- �gTYPE OF BUSINESS I�.'f.Cl Ls r IS THIS A TION ,. 'Ai" OF BUSINESS._ e GzJI!�ILXP/PARCEL:NUMBER � e `�C:`� .. "(Assessing) When starting a new business there are several things you.must do'in order to be in compliance with the rules and regulations of the Town of v Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd.-& Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S OFFICE i This individual has been informed of any permit requirements that pertain to this type of business. ) _ Authorized Signature*_* C COMMENTS: 2. BOARD OF HEALTH This individual has n informed of the,perm t rerrientsthat pertain to this type of business. MC Authorized Signature* COMMENTS: ;. 3. CONSUMER AFFAIRS(LICENSING AUTHORITY) This individual has nfor ed of thp licensing requirements that pertain to this type of business. Au horized Signature** , COMMENTS: lb�.cr� (��'e.�1z_ -^�- ���-� �� . � � � ��. � �� .R ' I � '�� ^ .� � �` ,S ,, .� k. - �m a -a �f ) ... ,. � '1 - '� TOWN OF BARNSTABLE CERTIFICATE OF OCCUPANCY PARCEL ID 056 002 X18 GEOBASE ID 40973 ADDRESS 96 CRYSTAL RIDGE DRIVE PHONE �. COTU IT ZIP — LOT PART LO BLOCK LOT SIZE p DBA DEVELOPMENT DISTRICT CT I PERMIt 29311 D SCRIPTION PERMIT TYPE BCOO TILE CERTIFICATE OF OCCUPANCY I CONTRACTORS:ARGHT,TE�C L S:: Department of Health; Safety .-, j and Environmental Services TOTAL FEES:'. ZNE BOND; $.00 Ox CONSTRUCTION, COSTS $.00 1�01 s SINGLE FAM HOME DETACHED 1 PRIVATE P BARNgrABM 4 MAW t BUILD IO DIVIS. �N DATE I�SUED 03/09/1998 EXPIRATION DATE Ty k IV "i _ ��{-AR �E;e�LrtvI.b, " CM ain)y���eul }"fir[ y� � � � 0 R"s.11D�1,iS�.�S, , l,�i�T'.k,`lJ s'�'3".L�.T, dSiIU"�'3.['r• DRNE+` ZIP LOT SIZE FFM IT 26 4B DESCRIPTION Ii,3G FA «7?WFIEI,l t�j S PT IC NO 97-5"��i P amIT TYP�T�? f. 'TY D TITLE NE14 RRSID NTrAL--BL G P I.a 'QONTRACTORS BAY$ID,E T:Qg NO, NC Department of H1RCHITECTSealth, Safety and Environmental Services TOTAL- FERS: ? $.GC) THE CONSTRUCTION C0,13TS S. I C . *=Ut C � � � a >ARNSTABM MASS. . ' 1639. BUILDINK IV.ISIONf BY " ON DATE ` THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN. CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE'OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS •ARE REQUIRED FOR 2. PRIOR TO,COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU= t• (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ELECTRICAL;PLUMBING AND MECH- 3.IN OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. ANICAL INSTALLATIONS. 4.FINAL INSPECTION BEFORE OCCUPANCYJim BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS Z7�j 2 4�f L/ Y . V 3 1 HEATING INSPECTION VROVALS ENGINEERING DEPARTMENT / I 2 d1 BO D OF HEA T OTHER: SITE PLAN REVIEW APPROVA t) c\ ` WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND.VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED'WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELF.PHONE OR WRITTEN NOTIFICA TION. - NOTED ABOVE. TION. '' s '���<.' j ';-'" ak�C.'�.<'�-..�t;��} Iti"?q.� �►� � � ;'�r' ^"`'w.t. �1".t'.�i '��'a � ���,��1 �°i L BUILDING PERMIT to T l �f ST / ' ) Map Parcel ev r clpqfm�it# d� House# - Date Issued Q Board of Health(3rd floor)(8:15=9:30/1:00- T� / 7— Fee �„_ l�; �a� ',�* D Conservation Office(4th floor)(8:30-9:30/1:00 2:00) Liy/�Q ��A� A6v�+�,� d � � Planning Dept.(1st floor/School Admin. Bldg.) O,;�°y;� ANce . �h�e fe^ W�a Definitive Plan Approved by Planning Board 19 a 9ARN y��� STARLE,'• MA95. F 5 "'3 E TOWN OYBARNSTABLE lE° '� Building Permit Application Project Street Address Village z ' Owner c L� Address 'I Telephone ^Permit Request cC'•! c d jC.64 ,,First Floor square feet Second Floor _7 square feet Construction Type ® :�/144--1(-� Estimated Project Cost $ �. �— 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 Old King's Highway ❑Yes per_ Basement Type: ull ❑ rawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) �— Number of Baths: Full: Existing�v = 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: as ❑Oil ❑Electric ❑Other Central Air d les ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ttached(size) ❑Barn(size) ❑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 ' r� yot- Name. Telephone Number / a U U91' Address 7 A. n--7,�A �L, ,. License# � o oxi 11 Home Improvement Contractor# 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 i SIGNATURE DATE 1X21 J/, BUILDING PERMIT DE D FOR THE FOLLO ING REASON(S) 0 6 A _ FOR OFFICIAL USE ONLY PERMIT NO. - - - DATE ISSUED - - MAP/PARCEL NO. .t ADDRESS C <t VILLAGE OWNER t w DATE OF INSPECTION: FOUNDATION FRAME INSULATION' c FIREPLACE ELECTRICAL:': ROUGH FINAL , PLUMBING: ROUGH ' FINAL { GAS: ; ROUGH FINAL FINAL BUILDING t • 5 . ' i DATE CLOSED OUT ASSOCIATION PEAN NO. w } �F"E r . . . ; The Town of Barnstable • s�cxsrneie. - 9�A MASS, �m�' Department of Health Safety and Environmental Services 1659. ram" Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner 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 wititfi other requirements. -/ Type of Work:✓2'[d�fi ���Qd'�/—��'�Z Est. Cost (�y Address of Work: Owner's Name �[�iic 1 4:44 Date of Permit Application: a All 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 age t o the owner: a r /tea 7.91 Da a ontractor Name Registration No. OR Date Owner's Name -------------- The The Commonwealth o Massachusetts Com f M ssa husetts 11= - Department of Industrial Accidents -:. --- _ Office of/nrestigations 600 Washington Street Boston,Mass. 02111 Workers' Co m ensation Insurance Affidavit name: ei location: city �� phone# `Zr y ❑ I am a homeowner performing all work myself. am a sole ro rietor and have no one workin in any ca acity %N/ %%%%%%%//////%/l%%%%%%/%/%%��%%%////%//%%///%//////////%//%/%%%%%%%/�/%�%%%/�%/�%%%%%//, ❑ I am an employer providing workers' compensation for my employees working on this job. comaanv::name. address.:? city. phone#. insurance co. olcv# .. ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: company: . address: city. phone#: insurance co oliev# camaanYname. address: city: phone#: insurance co. Wig.# ��. Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a tine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a tine of$100.00 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 verification. I do hereby certify under the pgid penalties of perjury that the information provided above is trap and correct Signature Date y4A� Print name i ��/ i�oru Phone# e d 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 Office ❑Health Department contact person: phone#; ❑Other (revised 9/95 PJA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a . dwelling house having not more 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 renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions 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 applicant. Please be sure to fill in the permitJlicense number which will be used as a reference number. The affidavits may be retmrned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. FEE The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of lovesullatlons .. 600 Washington Street Boston;Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 MQNR Appeoft Table JS=b(continued) prescriptive Packages for One and Two-Family Residential Boildlup Heated with Fond Fuels MAXIMUM MINIMUM Glaang (Hazing Ceiling wan Floor Bas meat Slab 'Heating/cooling Amy(%) U-value= R-value' R value' . R value' Wan Perimeter Equipment Efficiency' IPadmp I I I I R value' R valuc 5701 to 6500 Headug Degree Days' Q 1 12% 0.40 38 13 19 10 6 Normal R 12% 0.52 30 19 19 10 6 Normal S 12% 0.50 38 13 19 10 6 85 AFUE T 15% 0.36 38 13 25 WA WA Nomad U 15% 0.46 38 19 19 10 6 Nomad V 15•/. 0.44 38 13 25 N/A WA 85 AFUE W l5'/. 0.52 30 19 1 19 10 6 85 AFUE X 19% 0.32 38 13 25 N/A N/A Nomad Y 19% 0.42 38 19 25 WA N/A Normal Z 18% 0.42 38 13 19 10 6 90 AFUE AA 19% 0.50 30 19 19 10 6 90 AFUE 1. ADDRESS OF PROPERTY: 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: y xa,,jD ius 4. %GLAZING AREA(#3 DIVIDED BY#2): 5. SELECT PACKAGE(Q—AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-080303a 0 �,- 14 As, ,1 . - ����; AIRED PLOT PLAN SHOWN CERTIFY THAT THE FOUNDATLO:`� SHOWN ON THIS PLAN IS LOCATED ON Tti", FOR GROUND AS SHOWN HEREON AND THAT V i' 14 "��� `s TA6 lf$I.DC;�; k$�,, 4.'�TI_Il lr, MA. CONFORMS TO THE MINIMUM SETBAC?` LC'1P 237,17 B REQUIREMENTS OF THE TOWN PRV.PARVD FO V BARNSTABLE. -." vo j r , s;: l i F. r f Pee -- _- f �� - 4. 1 fi 1` 1 ;', a a - w I � f 1 { K' t a J j Mt' r , l y ..(-"•?r�� HV.R]�r.[C' Laa44..-��'3s'%•�s�d`: } �. � +. ` x 1 r tr} q 0/ fib` p HOME IMPROVEMENT .CONTRACTORS REGISTRATION t Y Board of Building Regulations 'and :Standards Vq.", _ One Ashburton Place Room13b1 ..Boston -, Massachusetts 02108 `.t .y ,y; -y'r �S7}'"' ; � .,.•h Ikd' qq k-+ t� v� ,�d atii4 r�.,,,,,i`' ,�a �3�yrr �,.2p 7 rc�", v HOME IMPROVEMENT CONTRACTOR y - a q«.,y"y i'er�o °fi+!'f .c "�rr}p��t••'��"ps:•s.. ,',y-q, �;;. Registration 113239 Expiration 05/27/99 Type - ,INDIVIDUAL F _ s • '} L r 5 � 'T+"tot x 1N .,nr�,c" j'ys mot. =r z�r HOME IMPROVEMENT CON TRACTOR q `g Registration '113239 I-MYPe YINDIVIDUAL' yy iMICHAEL J . DINOIA11VrEzplratton } 05/21/99 -32 OUTPOST LN j. :,� 1 9 rr 43" �•- �F•��6 P"r� �3'd, c r^Ir s FK f,t`� d-�"� ^a CENTERV I LLE MA 02632 .MICNAEL J: DINOIA UTPOST LN ,, ADMINISTRATOR eP ENTERVILLE MA 02632 4 � ( ray r a- q ar Y � 01 ............ iAfie eat i yfi^`, ad j § TDanznwouueaz a�✓ awac�iu:ell DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE Number Expires: — Rest icted'r o ; 00 MICNAEL J OINOIA 32 OUTPOST A CENTERVILLE, NA 02632 Engineering Dept.(3rd.floor) Map 50 Par , q Permit# House# 'TsT> Date Issue Board of Health(3rd floor)(8:15 =9:30/1:00-4:3.0) ee Conservation Office(4th floor)(8:30-9:30/1:00:'2:00) x Yi Planning Dept.(1st floor/School Admin. Bldg.) -- SEPTIC EM MUST BE / MPLIANCE Definitive Plan Approved by Planning Board (� a- 19 �3 t CODE AND TOWN OFF BARNSTABt o ������� Building Pe 't Applicati n ProjectItreddress �1 t Village Owner Address Telephone -711 14 6 Permit Request 4 First Floor 30 square feet Second Floor square feet Construction Type �f Estimated Project Cost $ Iola, Zoning District Flood Plain [ Water Protection Lot Size !J , 717 Grandfathered ❑Yes ❑No Dwelling Type: Single Family R"' Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes UrNQb On Old King's Highway ❑Yes UrRo Basement Type: W ruull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) c2 02 30 Number of Baths: Full: Existing New Half: Existing New — No. of Bedrooms: Existing t New Total Room Count(not including baths): Existing New -7 First Floor Room Count Heat Type and Fuel: Leas ❑Oil ❑Electric ❑Other Central Air IB'fes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) 1 112 Xo2 ❑Barn(size) ❑None ❑Shed(size) r---• ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# � Recorded❑ Commercial ❑Yes f1No If yes, site plan review# Current Use 11acax'l, Proposed Use Builder Information ,/ Name `� Telephone Number 77l—�Q Z Address 5 License# ®z J Home Improvement Contractor# Worker's Compensation# &JC l 3/z Z 0 /7 Y0/3 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 r-- DATE L7 BUILDING PERMIT DENIED FOR TH FOLLOWING REASON(S) __- - q i 7�rN 'J J.: {�+ ..'Ji4• + 8 'i'i i4ppy FOR OFFICIAL USE ONLY - ' ___,x.,. ! ' - -• n •• y ' - . a -' PERMIT NO. - - DATE ISSUED MAP/PARCEL NO. a ADDRESS ` "� , - VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION hREPLACE ELECTRICAL: ROUGH FINAL PLUMBING-',,' ROUGH FINALr GAS: '. N U FINAL :FINAL BUILDII �'� Cam.' 7 � � ! _ + }1 - . • ' !. », 0)to DATE.CLOSED►� ++�s _ .• .A ' ASSOCIATION"P., ; I. O \ i __� �-JC.R.F ENen \V .'LOUVER vENT'jl -------- COIL::,.15U-1 LOW G.,-Co Iwo: CEMTr V-V I LLC ram+ l� tlti0 JuN.9, .w.m a i FQ�sG usu�u�,Y I I /..AS �►Sr( -A Ut SM INf,LE j _ — - .R1C-eHT SsQE'ECEVA7�ON. JABPHAI_'1 Roof sHIw1G6tS / s \V:G.9Hsr_It.LCt........ ® ' ❑ ❑ D ❑ 0 'El ❑ L i I EDDLI LI:El.El ❑ LC-1 � 0 Ll � nr=r _y I j - i«� r 1� O ..-Le FT SsOE ELEVATSON sIL•�1•-O o !z i i FALSc cw lxw cf i I SEAL='f APB-A-jp"AL-r SW%WGLE4 / I i I i =L1win GU-T STL ^IDF- 32 -,.Z�,e - - J EF I" III pj� j ELL- J-1 ! I ' .BAYSIOE..BUILOING.:.C. l"d 2BNTEctvrcL:E.. K"`�'y4�sf=0' •r�onm w� arww R. !1 u.6 11 11 l __400._So.TT-":PAT 10_:' Pcc 1S lj-2 � d IPA I 1 .. -ss•4',,.�.4,, . V is m 4 8 4•a G'- 4• f.'.L !g' 2" 6• g IPcc ae.e9 �3 ._. _ .-... ._._ .... .. ._ .. .--.- -__ __.._. - ._--_--.-.. --_ ,__- .. .•,_; l V Pe.e.. 1S'ISN' ORS`r•8t sl k4 7S-s' 19'7_- ? �VA'r 1ss/4+•Af/4 1tr YL. -L%W4v f --PCC. %-3 i c. IB�Y4 r lg%4 - eb.•`a \ w' Rcc. K1 F-lia- r TGM� 11d 'j 1 0. o.. A I I I .9ATu V I: OAS(-FIAT.Cell. I 1 J 1I �{ Oi BCO20O/A -1 OOI4_ _.-.._ "JM 9TEIL ,�Et7 PJn 'Ctscol•ect L�.-�TId 0 CI c— WALK w F Its!If --. .. Y RL^T C�II ARV . I• I —_ _ -_ _.__ .. _ -.. { PTO oeAs P! I 9 I . -t, 1'e•c � `2-B I I � �� -- � p1L�61CJt - - _ .- - - 1 � -� TIDE ® Z9�i4—+-699'q I �I L / �I 1 0• NI O ,1+� I 1 1.•0'• �I({t N.G TJlJO7n FAll { 1r ,A2ACeE •; _HO •a^_o Q..[ N Gfi.p ALA(j-3[ACL s` - ( I PITCH L- .000R N 1AU 40C ,I Fv1reR `� I - 1 1 5/8 F.tc. Styr.z2Oc:.ti , =2lI-c PTO 2 f.S Isi19 6S1 In! vt Q1� a I I r 1-14 : 7�s'+�i:- I - I i Q 4 r W4 ISly4r i I p 4w 1 I " 4'b 4'•3• 7 p ,�. 7�- o---'�--- -} 4'4• `T_ '1 •c 4-4��_ � � � I 14 0 8-`--- ---..._14`. o- � 7''!o^ �• I fn'-ar 1 PT*. aJ4.1+� a I o= rum Rum Division = T B4YSIpE._.BuILOING_.C�(�+e i e P.O.Box534 Hyannis,Massachusetts 02601 =I 1 /�•� � ` /�•"' FIa61r.FLO PM::. PLAN.. 1 666 f '1• =�_z.{6_eva,TT.r4����a�7 � i I 1 pt-yw000 3T oR.A GE I I i .PTO i9 41 i9'4/4• i �AYSIQ6 P.�UIL�7�MG.41�+�-_. - �ur����4r71ye rwwmn� arwn 2 _J -- ---- - - - - I I I I I I L _ —•-- - -..._ __ J 1 r, I I I I -tl.�ti to^ F'ovTl wKa• I I I i 6.7 6'_C. .-.I ��-8 I 18" ms ' ! r 1 r I I L_j is),"as+, r 1 - - J --8•<T'-9•'GO.+C^� w t S -. il I ! j -I i •�'1!a:DECK COIU/A M S 1 cro-•.�,••`. I {! .. I i 24'�24'•r t1" FOOT-"=+•- j 4'_0•• I -�F- jjjr �. --.— -. - ! walL i$rSP•o� i I 1 I_ ( _ I. 'I �I I L+GA. — —I� I I' ! _ I 0' - J I -�- I 'LL - - - - - - -- - - yi �I� _...._. 12•'� !o" roc-�.�c,-, -- - - - - -.- - =-� „� I L — — J I 4.Co j eAY510E_ PDutl.O!"In, Co 1wc. ! ...--- rrat�Ir4.-1:0 •r�wovmw� awww onto Jur•. 7� � av� ' BASEJAE'NT. -Fou►-r.�q-'Sr�rJ R.00v vcuT ..__ 2.11L Rloac pl-AI+1d." " \ _—.riAL--TAFb ASPNALT 5wINGL -5 11 _ -- tolL".cow -bb4cibl"ri"W C. ... .. .v.ace:c tucq,Caa-aa�r��_•�F,rSrrax:._.. z.. o � 4. I = i i it I• wood Fu22rn.p.t r..f .. ♦. �'� �• • �' � j I! o.ia Fr -i A' tou. t _ .SpAt.S j . i I� I ', ;! � - is { �• ! j u i I C ', j ::vF1.5jr1YG D¢1 coCSG IL 4Lu r n TT 2 L4 cC tl.__I - i—_ to 'All - iad — s 2x:c sTV - �' ir►�rs6 _J c-OY - .'SHCA7r1i1NC- .YJCC tVrCAP'-_ y Stf2c;s REARbo _... Cf`cn&c _. of � 4' 'Cow A..Lt n - �� - �I � OEto♦v w^j RAq r Pj o I J -.__Ifo..,!Acr- 14' T PLAY 9{o E._:fSU1L17\NG-_Ce twe':._.._. ' ecui:Ik'sl'•O r'.o+mwr ve�www Q oew:JuN O"1 M'� -C-T—►O _.�6 TA IL ' 4-p/dT�RPQ2Q�l —— 01"4 J 0 o 4+,-71� 5f w CERTIFIED PLOT PLAN I CERTIFY THAT THE FOUNDATION SHOWN ON THIS PLAN SLOCATED ON THE FOR GROUND AS SHOWN HEREON AND THAT IT LOT 14 CRYSTAL RIDGE RD., COTUIT, MA. CONFORMS TO THE MINIMUM SETBACK LCP 23747 B REQUIREMENTS OF THE TOWN OF PREPARED FOR BARNSTABLE. BAYSIDE BUILDING INC. �o���```���G STEVEN W. MBA y SCALE: 1" = 50' OCTOBER 27, 1997 R s�f ��O"ess1b qH� SUNVO�Q Weller & Associates 1645 Falmouth Rd. —Suite 4C Centerville, Ma. 02632 (508) 775-0735 c�'✓j�a;;ac/useft s DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE Rumber: Expires: Restricted fo: 00 BRIAN T DACEY 62 FERNBROOK LN CHfERVnH, HA 02632 c COMMO TH OF MASSACHUSETTS --`=P DF1'AI ;MENT OF LNDUSTRIALACCIDE.NTS 600 WASHINGTON STREET BOSTON, M SSACHUSETTS 02111 games-, Ganooei: �rn:5stone' WORKERS, CONTENSATION INSURANCE AFFIDAVIT (licensee/permiacc) with a principal place of business/residence at: _ �AA-� i i �,2 6 3 (CitylS mtemp) do hereby certify, under the pains and pcnalrics of perjury,that [] 1 am an employer providing the following workers' compensation eovenge for my employecs working on this job. Insurance Company Policy Number ( J I am a sole proprietor and have no one working for me.. ( J I am a sole propricror, nenl contractor r homeowner (circle one) and have hired the eontraaors lined below who have chc following wor c:s compensation insurance politics: Namc of Concracror Insurance Company/Poliry Numbct Nime of Contractor Insurance Company/Policy Number N2me of Contnczor Insurance Company/Poliey Number 0 1 am a homcownc. performing all the work myself. NOTE. Plcaic 6c ,mare test wbilc bornco men wDo crooioypcnaoos to do ms.intenancr. construction or rrpair—o x on a awriiinc of not roorc tnxz three untu to wntco the n �ormev ncr aiso resiau or on the Frouocu appurtenant tbercto arc Clot icncrssJ�' constacrrd to be cmmovrn untirr t:hc 'Z'orXcn' Corancnssuoo Act (GL C 152, sect_ 1(5)). appiication by a bomeowaer for a br--ac or permtt Msv MGtOcc tl)c IcpJ sutus of an cmpioyrr unacr the Workers' Compensation Act 1 uno'cntand :nat : CODN'of this statcnent •rill be forwuded to the Deoar-rsent of Industrial Aeddena' OFriee to Insurintr tot oovc'-3pr rr^:i ::ton ant :;ss: :aiiure to secure em•rrare a recuiree unoer Section _'5A'of V1Gi. 15= can lead to the impnnuon of e :�iv ?m-;iJ rim Mnsts"t or: f,nc of ue to Sl 500.00 and/or impruon=cni of up to one era: and aivi penaicies in the form or a Stop Wo:x Orb et and a fine of S100.w a day 2TLns-. mc. t 01 i1 r i SUBCONTRACTOR'S INSURANCE ENGINEEER: BAXTER & NYE ENG: (L) FIREMENS FUND - S30MXX80564866 (W) LIBERTY MUTUAL - WC1312595563023 WELLER & ASSOC: (L) NAT'L GRANGE MUT.- MSP45246 EXCAVATION & SEPTIC: ROBERT J. OUR (L) U S F & G - 1MP30109550901 (W) U S F & G - 771521695 DECO CONSTRUCTION (L) TRAVELERS - 660364K8342 (W) LIBERTY MUTUAL - 312446298044 FOUNDATION: BAYSIDE FOUNDATIONS: (L) COMMERCIAL UNION - ABR406267 (W) LIBERTY MUTUAL - WC1312201785044 WELLS: DENNIS SCANNELL (L) TRAVELERS - 660873E5627COF92 (W) WAUSAU - 151300062926 CELLAR/GARAGE FLOORS: MICHAEL BROWN: (L) AETNA - MP0023672849 FRAMERS: ROBERT DORRER: (L) TRAVELERS - W680526K991TIA9 (W) AETNA - 006C0023972416C MICHAEL DUFFLEY: (L) COMMERCIAL UNION - NBF821356 (W) LIBERTY MUTUAL - WC1312492127024 MASON: SHERMAN, WAYNE: (L) COMMERCE INS CO - N60685 (W) WAUSAU INS - TO BE ASSIGNED ELECTRICIAN: CHAVES ELECTRIC: (L) HANOVER INS. - LHN2964649 (W) MISCELLANEOUS INS CO. - 0708878 91 1 PLUMB & HEAT: WHITELY PLUMBING: (L) TRAVELERS - 660365K1782COF9 (W) EASTERN CASUALTY - POLICY IN MAIL ALARM SYSTEM: BALTIC SECURITY: (L) FIRST FINANCIAL - FF0131 G400831 (W) COMMERCIAL UNION - CB0743379 CENTRAL VAC: VACUUM HOUSE: MERRIMACK MUTUAL - SBP1608045 i ' t INSULATION: MAP INSULATION: (L) AMERICAN STATES - 02CC326435-3 (W) U S F & G - 7711099932 SHEETROCK: MEL REED: (L) WORCESTER INS - CB817530 (W) COMMERCIAL UNION - CBH557387 INTERIOR TRIM: DAVID'S REMODELING: (L) COMMERCIAL UNION - NB F821442 M & R CARPENTRY (L) MARYLAND INS. GRP- SCP30235965 (W) CIGNA PROP & CAS.- C80049997 OAK INSTALLER: ROBERT BUDDEN: (L) NORTHERN ASSUR. - NBF528652 PAINTING: CAMPBELL PAINTING: (L) TRAVELERS - 1680251K4083COF (W) AMERICAN POLICY - WCC 186604 GARAGE DOORS: ALL, CAPE GARAGE DOOR: (L) U S F & G - BSC14667590301 (W) COMMERCIAL UNION - CBH573757 STORMS & GUTTERS: ALUMINUM PRODUCTS: (L) AETNA - MP0021014146 (W) AETNA - JC89258880 OAK FINISHER: AMERICAN FLOORS: (L) TRAVELERS - 680 342W754-0 CARPET, VINYL & TILE: CARPET BARN: (L) VERMONT MUTUAL - SBP6507393 (W) PHOENIX INS. - 6NUB476J652794 5^ TILE INSTALLER: TONY AVERINOS: (L) ASSURRANCE CO. - CFP26528977 (W) HARTFORD FIRE - 77WZCY2409 WIRE SHELVING: CAPE COD CLOSETS: (L) U S F & G - BSC146983441 APPLIANCES: KITCHEN APPL MART: (L) FIREMENS FUND - AZC80453098 (W) HARTFORD INS CO - 77WZNB1603 MIRRORS & SHOWER DOORS: L & M GLASS: (L) COMMERCIAL UNION - CBR409003 (W) U S F .& G - 0071439933 LANDSCAPE & SPRINKLER: COY'S BROOK: (L) COMMERCIAL UNION - ABR345850 (W) CIGNA COMPANIES - C41138178 DRIVEWAYS: NORTHERN SEALCOAT: (L) MARYLAND CASUALTY- EPA18716945 (W) THE PHOENIX - UB387K530 A TEST HOLE LOG DATE: SEp T, /3� 198� /� 21 / SOIL EVALUATOR: ,OOP-J �cE WITNESS: PERC RATE: �J o � . / Q /L/ p GO.C> W1 7/7�r �T cc •`� 00 v GZ O 1�a � DESIGN DATA _ Ga DAILY FLOW: (3)BDRMS.a 110 GPD= 33o GPD oSEPTICTANK: 3 3-GPD z 200%= Edon GPD io USE: /Sa c>GALLON PRECAST SEPTIC TANK LEACHING FACILITY: l USE: Cz�,s SxZo�S s/ CAPACITY: 1 \S3 SIDEWALL: 7G -yZ 2�1 BOTTOM: \ ( a TOTAL: o ,D �i 4^ ;• , qC'/NOTES: O BRAMt N t // 1. ALL PIPE TO BE 4"DIA.SCI140 PVC. " ea CIVIL G,n �TLNEN l 1. o twit 2. PIPE TO BE LAID LEVEL FOR V OUT OF DISTRIBUTION ; V No.32686C y BOX. 3. RAISE ALL APPLICABLE MANHOLE COVERS TO WITHIN i0n AFC 6"OF FINISH GRADE 4. SEPTIC SYSTEM IS NOT DESIGNED FOR THE USE OF A �D GARBAGE DISPOSAL. 5. SEPTIC TANK AND DISTRIBUTION BOX TO BE INSTALLED ON A 6"LAYER OF STONE. 6. INSTALL GAS BAFFLE IN OUTLET TEE. 2* Ay OF"*PEASTONE OVER 314•-1 ld•WASHED STONE ALL AROUND TOP OF FOUND. EL. to yoo to, 14" $9• z o Goa \ lvo,ofl\5983 100. so foo, zS S8, So SEPTIC SYSTEM PROFILE SITE SEWAGE PLAN GENERAL NOTES FOR 1. CONTRACTOR TO BE RESPONSIBLE FOR THE LOCATION OF ALL UTILITIES,ABOVE AND UNDERGROUND,PRIOR TO ANY EXCAVATION OR CONSTRUCTION. G G Z 3,2 Y,;; 2. SEPTIC SYSTEM TO BE INSTALLED IN COMPLIANCE WITH PREPARED FOR 310 CMR IS.00:TITLE V. 3. DIUS ETERMINATION 15 NOT TO BE USED FOR PROPERTY LINE DATE: �.cJ[ /9�2' SCALE: / G ya 4. ALL DISTURBED AREAS TO LOAMED AND SEEDED. S. CONTRACTOR TO PROVIDE 24 HOUR NOTICE FOR ANY - - REQUIRED INSPECTIONS. WELLER & ASSOCIATES 1645 FALMOUTH ROAD CENTERVILLE, MA. 02632 TEL: (508)775-0735 FAX: (5'08)775-0754 APPROVED BY: