Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0222 EISENHOWER DRIVE
a�o� �is�ho�- Qr, `i CAM P) -a - TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION C'"MA I Map �✓ Parcel Application # Health Division BUILDING DEFT. Date Issued Conservation Division Application Fee Jul 2 4 2017 Planning Dept. Permit Fee S Date Definitive Plan Approved by Planning Board TOWN OF BARNSTABLE Historic - OKH _ Preservation/ Hyannis Project Street Address 1 2 Z /� ,i�1i 0 w &YZ J?A Village /Ip Ii./ Owner_./e'e 121 CIMJZ c0 Address Telephone Permit Request ,1&,_4z;g&� .Lev /'T Square feet: 1 st floor: existing proposed 2nd floor: existing - proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 'tea®� D Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family )6 Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes 0No On Old King's Highway: ❑Yes ,dNo 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 n Board of Appeals Authorization ❑ Appeal # Re corded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 4,4 t4'e �, � ,jij5 Telephone Number Address License# /e,"o q,-4 tgeoloo 7-1c Home Improvement Contractor# Email �SLI r-� Z 4W Worker's Compensation ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE�� V_/Z FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE e� OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street,Suite 100 Boston, MA 02114-2017 www.mass,gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Leeibly Name (Business/Organizatior4ndividual):Cape Cod Insulation Address: 18 Reardon Circle City/State/Zip: South Yarmouth,MA 02664 Phone#: 508-775-1214 . Are you an employer?Check the appropriate box: - Type of project(required)- employees 48 a e employer I. i m to r with Y em to � •© P p yees :till and/or art lima ( P ), 7. ❑Now construction ' 2.[]1 am a sole proprietor or partnership and have no employees working for me In $, E] Remodeling any capacity.(No workers'oomp,insurance required,] 3.F1 I am a homeowner doing all work myself.(No workers'comp.Insurance required.)t 9. Demolition 4. I am a homeowner and will be hiring contractors to conduct all work on my property. i will 10 ❑ Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.[]Electrical repairs or additions proprietors with no employees. 12. Plumbing repairs or additions 5.[1 am a general contractor and I have hired the sub-contractors listed on the attached shoot, These sub-contractors have employees and have workers'comp,insurance.: 13.❑Roof repairs 6.[]we are a corporation and its officers have exercised their right,of exemption per MOL c, 14.21 Other Weatherization 152,11(4),and we have no employees,(No workers'comp,insurance required.) `Any applicant that cheeks box#1 must also fill out the section below showing their workers'compensation policy Information. t Homeowners who submit Ods,Affidavit indicating they are doing all work and then hire outside contractors must submit a now affidavit indicating such, :Contractors that check this box must:=hod an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. if the sub-contractor:have employees,they must provide their workers'comp,policy number, . lam an employer that is providing workers'compensation Insurance for my employees. Below is the policy and job site Information. Insurance Company Name: Atlantic Charter Policy#or Self-ins,Lio,#; WCE00431902 Expiration Date- 06/30/2018 v . Job Site Address: Z 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 MOL c, 152, §25A is a criminal violation punishable by 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,A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification, 1 do hereby certify under the pains andpenalties ofperjury that the information provided above is true and correct: Signature: Henry Cassidy ."'"'.""4�M...w,-. -..,- - ,M a..,:L"��,4«.. Date'' 7/2 3117 Phone#: 508-775-1214 E only. Do not write!n this area,to be completed by city or town ofjiclaln; Permit/License hority(circle one): Health 2,Building Department 3,City/Town Clerk 4. Electrical Inspector.,54 Plumbing Inspector sons Phone#: Massaghuselts Department of Publlo Safety I,, ,�` board of 8ullding Regulatlons and standards Lloenset Cs•1oo888 ' Oanatruotlon 8upowllsor, / rr HENRY E OA881DY; 8 SHED ROW WEST YARMOUrH 11 11 111 0 , (�1/'`—�. Expiration) Co missloner 111111201T It , l - . � p ! Office of Consumer Affairs and Business Regulation. 10 Park Plaza • SUlte 8170 Boston, Ma t�.�i'usetts 02116 Home Improveme. :�T.v�l rector Registration g tion ;t'.;' y "Oorporatlo Cape CG latlon, In0 `'�;` ' ' �' ;: ';:='}' ;� Re Istratlo n 18 Rear '' •:�..'; m 163687 Clrole �� "1i'y;'ir; �rfeld'1, xplratiCnl 12/1rt/2A18 +yy ;j'�ice„I�•i 1 '.'.».`.''s�' So,.Yarmouth, MA 02ee4 �9�4•,r Ih eoM,oant Update Address and"'• ' '+�'-•••--,.----._.»._...,, return Card. Mark reason for Change, O�v �p491N160940v01l�G�o��iG`rt�orro%cwatta' �"'���''•��''ta'...n.,ll,sxui.11;n1_(�,q,,.rt;plc,/m',nt,.�1-J,.�•9.k.C,�r�}... offloo of Consumer Aneirs&Business Reyulatlon HOME IMPROVEMENT OONTRAOTOR T' Regletretlon veild for Individual use only r' 3''e,i Oorporatlon before the expiration date. !15 , � , t?xplratlon Ottloe 01 Consumer Affalro and un al urn t l I;; e, 170 12/14/2016 10 Park Plain a e 6 gulatlon I, Boston,M•• Cape Cod Inswlit' 11 HenryCassldy' y1 18 Reardon Olrol �� , ��� VccG So.Yarmouth,M�' ; • Undersecretary t al hout si atu , t I 27 CO/�l7" CAPECOD• JZS �.,.•- CERTIFICATE OF LIABILITY INSURANCE CATC(MM/DD/YYY 03/30/2017 THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RI0HT8 UPON THE CERTIFICATE HOLDER,TH CERTIFICATE DOES NOT AFFIRMATIVELY OR NEQATIVELY AMEND EXTEND OR ALTER THE COVERAQE AFFORDED BY THE POLICI BELOW, THIS CERTIFICATE OF INSURANCE: DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSVINQ INSURER(S),AUTHORIZE REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANTI If the Certificate holder Is an ADDITIONAL INSURED,the polloy(lea)must have-ADO ITIONAL INSURED pprovlelona or be endorsE If SUBROOATION 18 WAIVED, subject to the terms and conditions of the policy,certain poiloiva may require an endorsement, A statement this certlfloate does not confer rights to the Certificate holder in lieu of such endorsements , PROOVOER AOJ 194 ore&3O4ray Ineurenoe Agency,Inc, south Donnie,MA 02800 ' S o e ma ro era ra ,Com Not 877 818.215E 8 NAIC INIVRINGRID E r 0 a 24198 Safe u Com an 39454 Cape Cod Ineulatlon, Inc, wousys o Endurance American Specialty Insurance Company 1s Reardon Clrole4 718 South Yarmouth,MA 02064 tlaV I u n n 144328 INSURER P t THIS 19 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERT( INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH TI , CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLIOIE9 DESCRIBED HEREIN 13 SUBJECT TO ALL THE TERM EXCLUSIONS AND CONDITIONS OF SUCH PODLIOIESR LIMITS SH WN MAY HAVE BEEN REDUCED BY PAID CLAIMS, VIN TYPO OF INBVRANOC POLICY NUMBER X COMM OROIAL OeNeRAL LIABILITY LIMITS OLAIM9MAD6 I V000VR R/0 CBP8283083 1,OOC 04/01/2017 04/01/2018 A ° T o 1maw 0C o h 5 L AoOR LIMIT APff PEf 1,OOC X POLICY J Lo')? 2)OOC auroMoelle LIABILITY P P 2,000 ANY AVTO 6232707 COM 01 co s e ° ��y�J gg ss HgJpVLtED 04/01/2017 04/01/2018 s RP AVT08DONlY X AVooTNN03y�.�gp IL N e r n $ X AUTOS ONLY X AViO�CNIY nI 1,000 pPBR AOE X VMBRCLCAWAS X OOpUR CXCE88 LIA9 OLAIMB-MADE R/O EXC10008836001 2,000 1 tleo RETpETNpTINONS 04/01/2017 04/01/2018 J • �'r�����to°�r�P9�CIA,1l�� N ., AggiE0Q ecunvWCE00431902 X d� f yi e��Ctd64' ` NIA OVOO/2018 OW3012017 Ily�� dlwrlb,vn vr D 1,000 8 ISE E ,000, 9 •P L II—MI 1,000, pE90AIPTION OP OPERATIONS/ OCATI4Ns/VEHIOLP�a (A09R0101,Addlllonal Romarko 8ohodulo,moy be elleohod(I more op�o�Is roqu►rod) Yorkore Oompeneal on Ino udea Oltloers or roprletore, 1ddlllonal Insured status Is provided under the Qenerel LlBblllty and Auto Liability when required by written con iraot or agreement g eement with the Certlfloate Hold OEFITIFIQATE-HOL SA For Informational Pur osse THE 8 ANY OF THE ABOVE DE90RIBED POLICIES BE CANCELLED BEF0R1 ' p THE gXPIRATION DATE THEREOF NOTICE WILL 9E DELIVERED IP ACCORDANCE WITH THE POLICY RROVISIONS, AUTHORIleD Alp go ACORD 26(2018/03) The enns.. �____' .- .. ®1088 2018 Annom nnen..,,...._.. ... . . To of Barnstable _ w Regulatory Services rt&ard'V.ScaU,birwtor Building Division Tom YerrN Building Commissioner 200Mam Street,%v=is.MA 02601 wwwAcwn barnstabie nia as Office: 508-862-4038 Fax: 50849.0=6230 Property Owner Must Complete and Sagn'�'his Section ifUsm eABuilder T, as Ovner of the subject prop My. herebyauthaiize Le►ae cd� 1�nSV � dAi 0 V� to act onmpbel a�f, in Z Mau=rdativc to work am&iized by this budding pemm application for f Adciress'af'Joii) **Pool fences and alums ate the respowlgity of the applicant.Pooh are motto be:fAed ar ldn - d before fence is installed and all final' Mpecuons are performed and accepted. Signature o€ a S quire of Appkcwt � 49 0. rq CIA Prkt Name Print Name Date Q FORM&OWTtFRPSRtMIONPOOTS }, TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel -2- Application # Cl Health Division Date Issued Conservation Division Application F" , ✓ Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic- OKH _ Preservation/ Hyannis Project Street A�dr dress. 2i1Z ��- Village C. Owner_ (omt, XL Lee. IZ�e�.� Address ;tz Z ffisov,_Leu t>v. Telephone SD -- Permit Request i Lo X tie OV% — � v (L64'wL Square feet: 1 st floor: existing /15D proposed Z9 1 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Lf bFack> Construction Type Lot Size 2p,qcn� / Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family.(# units) Age of Existing Structure 37 Historic House: ❑Yes LJAo On Old King's Highway: ❑Yes LirNo Basement Type: Dull ❑ Crawl ❑Walkout ❑Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing r) new Number of Bedrooms: 0 existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: alias ❑ Oil Cl Electric ❑ Other Central Air: Q'es ❑ No Fireplaces: Existing I New Existing wood/coal stove: ❑Yes G7-Ko Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: existing ❑ new size _Shed: ❑ existing ❑ new size — Other: i CD CD Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes 2lo If yes, site plan review# Current Use Proposed Use ~_ 03 APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name AV k1b &Abr Telephone Number S®9P Address P�1[7 j.w.Ur License # _yt)�s Ntv�etws Home Improvement Contractor# l l Lf Email --f'ee p ee oA," A�� u o-D C ova.- Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE /® FOR OFFICIAL USE ONLY APPLICATION # BATE ISSUED .MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION •\� FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL 4-iq-1 FINAL BUILDING F j N4l o DATE CLOSED OUT ASSOCIATION PLAN NO. Tlie Connuorrivealth ofMassachusetts ; Departure(ofrrtdarstrialAcciderdi*r f� -c a l'nt�estigadens 600Iiasiringtou,;�`_eet y Baston,AfA 02.UI spri n1 rnamggovIdia Nttnrkers' Campensaf ffnInsurance Affidavit:Builders/ContractarsJEIectdcians/Plumbers Applicant Inf n-matiou Please Print Legibly Naine(Mushie�minfim lnduidnal)_ v ,.,4 it Address: .t city/sta,&Zip- M&VSI 00 Phone,' Are you an employer?Cheekthe appropriate bow . Type of project(regniied).: I. I am a genetalconfiactor and I El I am a employer u7th ❑ - , loyees(full andlor part-time).* have hired.the sub-contractors 6_ New consizuctiun: 2•.�'I am a sole propmetor orpartner- Mted on the attached sheet 7. ❑Remodeling slop and bane no employees. These sob-connlractors have g_ ❑D HEM wodrino forme in any capacity employees andbave workers' uildin additioir [No v,-orlaers, comp.insurance comp:insurance-I g required-I 5_ ❑ We are a coxpomtion and its 10,❑Electrical repairs or additions; 3.❑ 1.am a homeommer doing all work officers have exEircised their 11.❑Plumbing or additions nVmlf,[No workers'comp_ t right of exemption per MGL insurancerequir�edj i ` . c.152,§1{41 and we have no 12.❑Roof repairs employees.[No workers" 1313 Dther comp.insurance required.] *Any appf[caattfiat checks box Plustalso fill outthe section below dvwing their ww teas'compensatinupalicyinrocmadao Homeowners who submit this af5da[a inducting they am drains all wol sad tbea bae outside contractors nmst submit a new affidavit iadica#iag such_ tc'ontractorsthst chectihis boat must attached au additional sheet showmgthe naiueof the sub-cmUscfiaa.and state whether ornotthese entitiesbave emp➢ayees.I€the sub-caatractooshace empIopees,theymustpmuide their workers'-romp.policy number. lain an eiiiplojYrr f7icit is prm�i+trirg ivorkcrs'conilrertsafiari irisiirarica fbr Sri}�tanipLoy�es $eto�v is t7te policF ated jab cote fifarmaiiirts . Insurance Company Name: Policy,45,or Self-ins..Lic.;k F—kpiratiost Date: Job Site Address: - CitylStaW- Zip: n A tach a copy of the workers'compensationpolicy declairation page(showing the policy number and respiration'daite).. Failure to secure coverage as requuedunder Section 25A of MGL m 152 can lead to-the imposition of criminal penalties of a fine up to$1,540.00 andlor one yearimprisDrtment,as well as chil penalties.in flee farm of a STOP WORK ORDERand a fine l of up to WO-00 a clay against the violator. He adtrised that a copy of this statement maybe forwnded to the Office of Investigations of the DI,i4 for insurance coverage verification. - I do hereby c Under the is and ponabYes afpr.7'A a that the irrfarrriaftort proi*W a.bmw is.true and correct Date- phone i€: ✓O�- sZ O kw L/O t)Qfsiid use oral.Do not avrke in thft area,ter be completed by city ar<tamn afficcaL City,or Town: PernritUcense# Enuing Authority(circle one): 1.Board of Health. 2.13uil ing Department 3.CityfTown Clerk 4.Electrical Inspector S.Phimbmg Inspector 6.Other Contact Person: Phone#: f Information and Instructions 7vfassar-h cs tts Ge)aeral Laws chapter 152 raquirm all employers in provide workers'compensation for their employees. pursaanttD this ,an empkgme is defined as."-.every pessdn in the service of another under any contract ofhire, =%press or implied,oral or wrifiru." An ezrpfoyer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged m a Joint enir,rp a,and including the legal representatives of a deceased employer,or the receiver or trustee of an iadividu A 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 aaofher who employs persons to do made aan ce,construction or repair work on such dwelling house or on the grounds or building appUtfenaatthereto shallnotbecanse of such employment be deemedto 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 corrrpliaum with the iasnran ce.coverage regwored_" Additionally,MGL ehaptrr 152,§25C(7)states=Neither the commonwealth nor any ofits political subdivisions shall enter into any contract for the perfoumaac6 ofpoblic worIcumtl acceptable evidence of compliance with the i„SUrance rr?nrem ent s of this chapterhave been presented to the contracting anfhOxxty." Please fill oil the worker'compensation affidavit completely,by checking ffie boxes that apply to your sitaation and,if necessary,supply sub-contractor(s)nan e*), address(m)andphonenumber(s) alongwiththeircertHicate(s)of „carance. Lfi iti-,dLiability Companies(LLC)orLimitr-dLiabr7ity-Partnerships(LLP)withno employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have empIoyees,apolicyusrei,irtA Be advised that this affida d maybe submitted to the;Depa-ime t o Industrial Accidents for confirmation of in mane coverage. Also be sure to sign and date the affidavi t The affidavit should b Dr etiumed to tine city or town that the application for the permit or•license is b eiag requested,not the D oP arum ant of Ln-dnstzial`Accidents. Should you have any questions regarding the law or ifyou are regoaed to obtain a workers' compensation policy,please caIl the Department at the number listed below. Self-insturd companies should enter their self-i sm7an ce license number on the appropriate lime. City or Town Officials Please be sore that:the affidavit is complete and priated legilbly. 'Ili=D eparimeat has provided a space at the bottom of the affidavit for you to f M ourt in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fr71.ia the pemiidIicense number which will be used as areference number. Iu addition,an applicant that must submit unulilple pemlitllicense applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"lob Site_4ddress"the applicant should write"al I6catiDDES it (may 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 citiT.eu is obtaining a license or permitnot related to any business or commercial vents= (i.e, a dog license or permit to buzm leaves etc-)said person is NOT required to complete this affidavit The Office of Inveshgaiions would at to th=k 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. Thu CamMMwe ala of Mnmchnsetfs ' Degaitmeat of lndustzal Aooident t f)f C:e atTnveSVnf io---= �Rtl T�ashin�tan�'t:�t Boston,MA Oi l l l Tf1.4 617' 7-49QO cxt 406(Dr 1-977 MMS� Fax It 617'27 7m Revised 4-24-07 WW �ag f °pry Town of Barnstable of Regulatory Services s @ 4ilFACP(T1fF. s s_ Richard V.Sad4 Director BuRdi g Y}I WOII • tom Perrp,Em Conomiss«aner 200 Main Street Hyaams,MA 02601 www:town-larnsfiable ma_ s Office: 508-8624038 Fa= 608-790-6230 PrageAy Owner Must Complete•and Sign This Section- if Using ABuildex' CJ b le ,as Owner of the subject property ben:by auiizouze (/ C� cD to act on my bebA. in all mattm mlaf=to work authorized bythis buUding permit application for.. . (3%174 61 , (Address of Job) tPOolfences and alarms are the responsl&7 Of the applicant Pools are not to be filled or 4i&d before feace is installed and all final ' j6ff- ns�are pesfomsed and accepted. Sa a =e of Owner Signature of App Prior Name Prim Name Dke � . �Fox�rs:ow�.��smr�oozs TGNM.of Barnstable Regulatory Services ,f oFVMME r � Rich rd V.Sczli Diredar Commissionrx . ��,,era� f Tom Perry,BJ d S �a 200 Maim Stcat Hyanais,MA 02601 ��� W4P�f-{D�YII.IT2Mcfa�jjr ma� • Office. 508-862-4-038 Fay 508-790-6Z30 3101M NM LUZarc EOMR-MN . 'PNersePrint IJAIE: JOB LOC AIIUrt n"M CC sfi e -110 FA "ER : - y®cphonc#- wo�cPbonc#r namr_ . 7 ��••� CURRENT MA]LZNG ADDRBSS: _ citplcuyru _ ¢� zip code ' The r*,r'-'-aPt exemption for`homeowners"was ex i-ndrd to include owner-occupied La-29t es of sk=its or less and to aI10w homeowners to engage an individual for HT-Who does notpossess a license,provided tbatthc owner acts as sanetvisor_ MFMuTIOX OF$aMY-owNE2 P ason(s)who o-wns a parcel.of land on which he/she resides or mtmnds to reside,an which these is,or is intended to be,a one or two- foray ciWvI iag, afiacbtd or detached stractr¢es accessory to m=h use and/or farm sttuetraes. A person who constucts more,than one homy in a tWo-ye=period shall nntbe cansidered.ahomcownrr. such`homeownee,.sbaII submitin the Bmildmg Official ' a fo= acceptable to theBnr7d'mgOfficial,tbatheshasbaIlbeMMonsible for aIlsachwo$cQerfarm.edmcimllmbmldmL-yezmit (Section 109.L1) The undersigned`,homcawnet'ass= responsib�7rty for cauzpliaace wifhthe State Bu77 ding Code and other applicable codes, bylaws,tales and regalafions_ - The undeaigned`homeownci"cedffies thathcr she undc=tands the Town ofBamsiable Bulling Departmcatm:mim fiISP=ffiM procedures andrmlairemeenfs andfmthclshewffi complywith saidprocedmcs and regn¢eme�s- sipnahaa ofE[==w= ApproPal ofBmMdmgOffidal • Note. Three&mi[y dwellings containing 35,000 cubic fbet or Luger wMbe rDqafi-edto comply wrth.tbe Sta,Bm7ding Coda Section 117.0 Caneraction Contml- HON�sowrN=,S Corr The Code sf xtrs that: aAuy hotaoowner performingworkfor which abulZdtag permit required Shall be exempt from the provisions of this section(Secfioa I09.1.I-T j=jsmg of consirad3on S¢pervisors);provider/that if the homeowner engages a person(;)for Titre to do such Mork,ghat such Hameowner Shall act as supervisor." Many homeowners who use this exemption are unaware.thatthey are ssommgfae responsffitTifies of a supervisor (se`gppendi3c QRules Br Regulations for Licensing Construction SIIpervisors,Section 215) This lack of awareness often results in serious problems,parficularly when fhehomea-ymer hors unIlcensed persons. In this rase,out Board cannot promed against the unUcensed pmsoa as it wouldwith a licensed Supervisor. The homeowner acting as supervisor is ulfrmateiy responsfIble. To easiu e'th:at file homeowner is fuIIy aware of his/her responsibilities,' many communities require,as part of the e undersEands the_ nnsibiTidies of a Supervisor. On$ie lastpage pF��•aPPh�°u, that the box—owner crstrfy that helsh resp of this issue is a form cmrrendY tsed bp,se+eral towns. You may,rare t amend and adopt such a formlt=ti adDR for use is your community. � peanitfias�A'BFs�dCe . Revised 061313 Generated Dy RE5cnecK-weo Sottware r - ;' y Compliance Certificate Project - Energy Code: 2015 IECC Location: Cotuit, Massachusetts Construction Type: Single-family Project Type: Addition Climate Zone: 5 (6137 HDD) Permit Date: Permit Number: Construction Site: Owner/Agent: Designer/Contractor: -S_ Compliance: 17.3%Better Than Code Maximum UA: 75 Your ILIA: 62 The%Better or Worse Than Code Index reflects how close to compliance the house is based on code trade-off rules. It DOES NOT provide an estimate of energy use or cost relative to a minimum-code home. Envelope Assemblies Gross Area Cavity Cont. Perimeter Ceiling: Cathedral 240 45.0 0.0 0.023 5 Skylight: Wood Frame, Single Pane 18 0.400 7 Wall: Wood Frame, 16in.D.C. 384 15.0 9.8 0.042 12 Window:Wood Frame,2 Pane w/Low-E 47 0.300 14 Door: Glass 60 0.280 17 Floor:All-Wood JoistlTruss Over Uncond. Space 256 38.0 0.0 0.026 7 Compliance Statement. The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application.The proposed building has been designed to meet the 2015 IECC requirements in REScheck Version 5.5.0 and to comply with the mandatory require ents liste in the REScheck Inspection Checklist. cG��v�(A4 cS d ue saw. Name-Title Signature Date Project Title: Report date: 10/28/16 NfKescneM software version .5.5.0 Inspection Checklist Energy Code: 2015 IECC Requirements: 100.0% were addressed directly in the REScheck software Text in the "Comments/Assumptions" column is provided by the user in the REScheck Requirements screen. For each requirement, the user certifies that a code requirement will be met and how that is documented, or that an exception is being claimed. Where compliance is itemized in a separate table, a reference to that table is provided. Section Plans Verified Field Verified # Pre-Inspection/Plan Review Value Value omplies? Comments/Assumptions & Req.ID 103.1, :Construction drawings and 19Complies ;Requirement will be met. 103.2 :documentation demonstrate ❑Does Not [PR1]1 ;energy code compliance for the j :building envelope.Thermal ❑Not Observable tenvelope represented on ❑Not Applicable (construction documents. ; 103.1, !Construction drawings and ❑Complies 103.2, documentation demonstrate TNot oes Not 403.7 energy code compliance for[PR3]1 ;lighting and mechanical systems. Observable ; ;Systems serving multiple ❑Not Applicable ;dwelling units must demonstrate ; compliance with the IECC ; :Commercial Provisions. 302.1, Heating and cooling equipment is;, Heating: Heating: ;❑Complies 403.7 sized per ACCA Manual S based Btu/hr Btu/hr ❑Does Not [PR2]2 on loads calculated per ACCA l81 Cooling: Cooling: :,[]Not Observable Manual J or other methods approved by the code official. Btu/hr Btu/hr :❑Not Applicable - 1 r Additional Comments/Assumptions: 1 I High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Report date: 10/28/16 # Foundation Inspection Complies? Comments/Assumptions & Req.ID 303.2.1 A protective covering is installed to ;❑Complies ;Exception: Requirement is not applicable. [FO11]2 protect exposed exterior insulation ElDoes Not J and extends a minimum of 6 in. below i grade. ❑qot Observable fi�of Applicable 403.9 Snow-and ice-melting system controls;❑Complies [FO12]2 installed. ;❑ ,oes Not ;❑ of Observable: of Applicable Additional Comments/Assumptions: 1 High Impact(Tier 1) 2 Medium Impact (Tier 2) 3 Low Impact(Tier 3) Project Title: Report date: 10/28/16 aec�lon- Plans Verified Field Verified r # Framing/ Rough-In Inspection Value Value Complies? Comments/Assumptions & Req.ID 402.1.1, ;Glazing U-factor(area-weighted U- . U- TYComplies ;See the Envelope assemblies 402.3.1, i average). :❑Does Not ;table for values. 402.3.3, i 402.3.6, UNot Observable 402.5 i ; ;❑Not Applicable [FR2]1 1 1 1 303.1.3 U-factors of fenestration products Ekomplies ;Requirement will be met. [FR4]1 !are determined in accordance ❑Does Not :with the NFRC test procedure or [-]Not Observable ;taken from the default table. ❑Not Applicable ; 402.1.1, Skylight U-factor. U- ; U- ;❑Complies ;See the Envelope assemblies 402.3.3, :❑Does Not ;table for values. 402.3.6, I 1 1 I 402.5 i;❑Not Observable ; [FR5]1 ;❑Not Applicable 1 1 1 1 1 1 1 1 1 1 402.4.1.1 ;Air barrier and thermal barrier 19complies ;Requirement will be met. [FR23]1 installed per manufacturer's ❑Does Not instructions. $) ; ❑Not Observable ; ❑Not Applicable 402.4.3 Fenestration that is not site built Elcompnes ;Requirement will be met. [FR20]1 !is listed and labeled as meeting ❑Does Not IAAMA/WDMA/CSA 101/I.S.2/A440 ka I or has infiltration rates per NFRC ❑Not Observable ; '400 that do not exceed code ❑Not Applicable I limits. 402.4.5 IC-rated recessed lighting fixtures Complies ;Requirement will be met. [FR16]2 sealed at housing/interior finish ❑Does Not and labeled to indicate :52.0 cfm leakage at 75 Pa. ❑Not Observable ❑Not Applicable ; 403.2.1 ;Supply and return ducts in attics ❑Complies [FR12]1 !insulated >= R-8 where duct is ❑Does Not >= 3 inches in diameter and >_ ❑ t Observable R-6 where < 3 inches.Supply and return ducts in other portions of of Applicable ; ;the building insulated >= R-6 for ;diameter>= 3 inches and R-4.2 ; for< 3 inches in diameter. 403.3.3.5 Building cavities are not used as ❑Complies [FR15]3 'ducts or plenums. []Does Not 4❑ of Observable j of Applicable 403.4 HVAC piping conveying fluids R- R- ;❑Complies ; [FR17]2 above 105°F or chilled fluids ;❑Does Not below 55°F are insulated to >_R- 1 v 3 ;❑ of Observable ; �IlNot Applicable 403.4.1 ;Protection of insulation on HVAC ❑Complies ; [FR24]1 piping. ❑Does Not 1 ❑Dot Observable Not Applicable 403.5.3 Hot water pipes are insulated to ; R- R- ;❑Complies [FR18]2 >R-3. E❑Does Not I k i 1 ;❑q�ot Observable of Applicable 11 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 1 Low Impact(Tier 3) Project Title: Report date: 10/28/16 f Plans Verified' Field Verified # Framing/Rough-In Inspection Value Value Complies? Comments/Assumptions &Req.ID 403.6 Automatic or gravity dampers are ❑Complies ;Requirement will be met. [FR19]2 installed on all outdoor air ❑Does Not intakes and exhausts. I ❑(`lot Observable ; of Applicable Additional Comments/Assumptions: 4 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Report date: 10/28/16 �ec�iun Plans Verified Field Verified r # Insulation Inspection Value Value Complies? Comments/Assumptions & Req.ID 303.1 All installed insulation is labeled 19Complies ,Requirement will be met. [IN13]2 or the installed R-values ❑Does Not provided. ❑Not Observable ; ❑ of Applicable 402.1.1, Floor insulation R-value. 31 ; R- ;Ekomplies ;See the Envelope Assemblies 402.2.6 ;[ Wood ;❑ Wood ;❑Does Not ;table for values. [IN111 ❑ Steel ❑ Steel ;❑Not Observable ❑Not Applicable 303.2, ;Floor insulation installed per Complies ;Requirement will be met. 402.2.7 ;manufacturer's instructions and ❑Does Not [IN2]1 in substantial contact with the underside of the subfloor,or floor ❑Not Observable :framing cavity insulation is in ❑Not Applicable contact with the top side of sheathing, or continuous ; I insulation is installed on the underside of floor framing and I extends from the bottom to the ; Itop of all perimeter floor framing members. 402.1.1, ;Wall insulation R-value. If this is a; R- R- ; Complies ;See the Envelope Assemblies 402.2.5, mass wall with at least 1/2 of the ❑ Wood ;❑ Wood ;❑Does Not ;table for values. 402.2.E ;wall insulation on the wall ;❑ Mass ❑ Mass UNot Observable [IN3]1 ;exterior,the exterior insulation requirement applies(FR10). ;❑ Steel ❑ Steel ;❑Not Applicable ; ; 303.2 ;Wall insulation is installed per 11compnes ;Requirement will be met. [IN4]1 I manufacturer's instructions. ❑Does Not ❑Not Observable ❑Not Applicable Additional Comments/Assumptions: 11 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Report date: 10/28/16 Plans Verified� Field Verified_ # Final Inspection Provisions Value Value Complies? Comments/Assumptions & Req.ID 402.1.1, ;Ceiling insulation R-value. R- A ; R- : Complies ;See the Envelope Assemblies 402.2.1, Wood ;❑ Wood ;❑Does Not table for values. 402.2.2, i ❑ Steel ❑ Steel ❑Not Observable �ij 2.6 ;❑Not Applicable 303.1.1.1, ;Ceiling insulation installed per QMComplies ;Requirement will be met. 303.2 I manufacturer's instructions. ❑Does Not [F12]1 ;Blown insulation marked every 300 ft2. ❑Not Observable ❑Not Applicable ; 402.2.3 Vented attics with air permeable ❑Complies ;Exception: Requirement is [F122]2 insulation include baffle adjacent ❑Does Not :not applicable. to soffit and eave vents that extends over insulation. of Observable aot Applicable 402.2.4 ;Attic access hatch and door R- R- ;❑Complies ;Requirement will be met. (FI3]1 :insulation >_R-value of the QDoes Not :adjacent assembly. got Observable ; of Applicable 402.4.1.2 ;Blower door test @ 50 Pa. <=5 ACH 50 = ACH 50 = ;,[]Complies ;Requirement will be met. [FI17]1 ;ach in Climate Zones 1-2,and E❑Does Not <=3 ach in Climate Zones 3-8. :El t Observable ; of Applicable 403.2.3 ;Duct tightness test result of<=4 cfm/100 cfm/100 ;❑Complies [FI4]1 cfm/100 ft2 across the system or ft2 ft2 :❑Does Not <=3 cfm/100 ft2 without air handler @ 25 Pa. For rough-in ; :❑ of Observable (tests,verification may need to ; ; ot Applicable ; ;occur during Framing Inspection. 403.3.2 1 Ducts are pressure tested to cfm/100' ; cfm/100 ;❑Complies ; [FI27]1 (determine air leakage with ft2 ft2 :❑Does Not ;either: Rough-in test:Total ;leakage measured with a ❑Not Observable ;pressure differential of 0.1 inch ; ;CJI(lot Applicable " ;w.g. across the system including ;the manufacturer's air handler ,enclosure if installed at time of ;test. Postconstruction test:Total leakage measured with a :pressure differential of 0.1 inch I w.g. across the entire system j ;including the manufacturer's air handler enclosure. 403.3.2.1 ;Air handler leakage designated ❑Complies [F124]1 !by manufacturer at <=2%of ❑Does Not design air flow. ❑ of Observable ; El Applicable 403.1.1 Programmable thermostats ❑Complies [Flg]2 installed for control of primary ❑Does Not heating and cooling systems and initially set by manufacturer to nyQot Observable code specifications. MNot Applicable 403.1.2 Heat pump thermostat installed ❑Complies [FI10]2 on heat pumps. ❑Does Not ❑ of Observable LJNot Applicable 403.5.1 Circulating service hot water ❑Complies [FI11]2 systems have automatic or ❑D 'es Not accessible manual controls. ❑ of Observable ; Not Applicable 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 1 Low Impact(Tier 3) Project Title: Report date: 10/28/16 # Final Inspection Provisions Plans Verified Field Verified Complies? Comments/Assumptions & Req.ID Value Value 403.6.1 All mechanical ventilation system ❑Complies [F125]2 fans not part of tested and listed ❑Does Not HVAC equipment meet efficacy and air flow limits. : Not Observable Not Applicable ; 403.2 Hot water boilers supplying heat ❑Complies [F126]2 through one-or two-pipe heating ❑Does Not systems have outdoor setback control to lower boiler water El Observable temperature based on outdoor of Applicable temperature. 403.5.1.1 !Heated water circulation systems ❑Complies ; [F128]2 'have a circulation pump.The ❑Does Not system return pipe is a dedicated of Observable return pipe or a cold water supply pipe.Gravity and thermos- Not Applicable syphon circulation systems are not present. Controls for circulating hot water system pumps start the pump with signal for hot water demand within the occupancy. Controls automatically turn off the pump when water is in circulation loop is at set-point temperature and no demand for hot water exists. 403.5.1.2 Electric heat trace systems ❑Complies [FI29]2 comply with IEEE 515.1 or UL ❑Does Not 515. Controls automatically adjust the energy input to the ❑Vot Observable ; heat tracing to maintain the of Applicable desired water temperature in the piping. 403.5.2 Water distribution systems that ❑Complies [F130]2 have recirculation pumps that ❑Does Not pump water from a heated water supply pipe back to the heated ❑�`�of Observable ; water source through a cold IJNot Applicable water supply pipe have a demand recirculation water ; system. Pumps have controls that manage operation of the pump and limit the temperature ; of the water entering the cold water piping to 1049F. 403.5.4 Drain water heat recovery units ❑Complies [FI31]2 tested in accordance with CSA ❑Does Not B55.1. Potable water-side pressure loss of drain water heat El Observable ; recovery units < 3 psi for of Applicable individual units connected to one or two showers. Potable water- side pressure loss of drain water heat recovery units < 2 psi for individual units connected to ; three or more showers. 404.1 ;75%of lamps in permanent ❑Complies [F16]1 fixtures or 75%of permanent []Does Not :fixtures have high efficacy lamps. ii Does not apply to low-voltage ❑Not Observable lighting. ❑Not Applicable 404.1.1 Fuel gas lighting systems have ❑Complies [F123]3 no continuous pilot light. ❑ oes Not ❑ of Observable of Applicable 11 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 1 Low Impact(Tier 3) Project Title: Report date: 10/28/16 i Plan s Verified Field Verified & Re ID Final Inspection Provisions Value Value Complies? Comments/Assumptions 4• 401.3 Compliance certificate posted. ❑Complies ;Requirement will be met. [FI7]2 ❑Does Not ❑Not Observable ❑Not Applicable 303.3 Manufacturer manuals for ❑Complies [FI18)3 mechanical and water heating ❑Does Not systems have been provided. ❑Not Observable ❑Not Applicable Additional Comments/Assumptions: 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Report date: 10/28/16 2015 IECC Energy Efficiency Certificate Insulation Rating R-Value Above-Grade Wall 24.80 Below-Grade Wall 0.00 Floor 38.00 Ceiling / Roof 45.00 Ductwork (unconditioned spaces): D.. Window 0.30 Door 0.28 Skylight 0.40 Heating .. Heating System: Cooling System: Water Heater: Name: Date: Comments F-- .I� � 4v 'v q. _ abt i231 _ 3z bee Q `qq4 1 9 L� y ' 12.S-00:_ I' li Ot,}I RKHARD \� JAMES a y& � CERTIFIED IE►D PILOT LAN /$Tv 04 MASS .1 CERTIFY THAT THE tl� �—-��� I0*�j O�HEARN, lNC.4RLS, R5 SHOWN ON:.. THIS PLAN-: HAS BEEN 1348 ROUTE 13 LOCATED ON THE.. .GROUND: A$: INDICATED. EAST DENNIS ; MASS. ,�nr� ©oniFo2r'.5 7 ��y' S T�FiC� DATE: `r_3-��. SCALE-'. 3d` ;7/�1�'.:i4rr'+n°rle^•, �s. '; JOB N O. ' et7:; CLIENT: /at f/ lI�t.E DATE i:RGISTEREb �ND SURVEYOR DR. BY : ;: •"' SHEET. OF Massachusetts Department of Public Safety �= Board of Building Regulations and Standards License: CSFA-057540 ` Construction Supervisor 1 & 2 Family w, a DAVID J GADY , 217 A TIMBER LN. MARSTONS MILLS MA 02648 Expiration: { Commissioner 12/28/2017 # Q �anvnzdrausecclC�a��caaac�urteCt'_t Office of Consumer Affairs&Business Regulation a Lrcense or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR t}efore the expiration date. If found return to: f {' ` Office of Consumer Affairs and Business Regulation ` i Registration: 1.14561 Type: g Expiration 10/4/201,7 DBA , 10 Park Plaza-Suite 5170 Y•_ �"�'" Boston,MA 02116 x` . DAVID GADY CARPENTRY �r r ` David Gady ;T IN -f 217A Timber Ln t { ' Marstons Mills,MA 02648 � ' "xj - Undersecretary Not valid witho signature CA- 1 FASTENMASTER TECHNICAL BULLETIN RAFTER TAIL 1 TOP PLATE CONNECTION DETAILS The minimum fastening requirements for the rafter to top plate connection in the 2006-2012 International Residential Code (IRC) and International Building Code (IBC) include a wide range of nailing options. In all cases, these codes can be met by installing the FastenMaster Timberl-OK when the guidelines on this technical bulletin are followed. In many cases where increased wind or seismic conditions require a stronger rafter to top plate connection, this fastening method may also be used to replace the use of metal ties or straps. t ' CAN BE USED WHEN RAFTER IS ALIGNED OVER OR BETWEEN WALL STUDS a f j �. SIDE A VIEW TimberL®IC• Heavy Duty Wood Screw • Use a b"FastenMaster TimberLOK. • Drive fastener through double tap plate at an angle between • Where the rafter is directly over the wall stud,insert fastener point 15'and 30'and into the center of the rafter. between the bottom of the top plate and the top of the stud. • Fastener must be driven into the center of the 1-1/2"rafter edge • Where the rafter is located between two studs,insert fastener point (+/-1/4")with the threads fully embedded into the rafter. on bottom surface of the top plate no greater than 1/2"from the • Bring the fastener head flush with the wood surface. inside edge of the plate. P Effective August 1,2014. Please reference our website to ensure that you are using the most up to date version. lnstenM®sbr. FASTER EASIER STRONGER 153 BOWLES ROAD,AGAWAM,MA 01001 413•789.0252 800.518.3569 WWW.FASTEMMASTER.COM FASTENMASTER TECHNICAL BULLETIN FASTENER DESIGN LOADS The FastenMaster TimberLOK load values in Table 1 can TABLE I be used by a design professional to determine suitability of these fasteners in a rafter to top plate connection. TimberLOKDesign - • Where the uplift and/or faferat design toads have to Top Pll.ate,Connectia 7 been provided on the building plans,the allowable Wood Species SPF/HF Douglas Fir Southern Pine loads in Table 1 can be compared to the plan values to make sure they are met or exceeded by use of this Lateral/ Lateral/ Lateral/ fastening method. Load Type Uplift Shear Uplift Shear Uplift Shear • If ties or straps have been called for to resist uplift Allowable Load 420 320 540 380 620 410 and lateral forces,the allowable loads in Table 1 should be compared to the manufacturer's published • TimberLOK values above are based on ICC-ES Report#1078 and independently verified values for the specified connector to ensure that this throvgh testing to ASTM D-1761. fastening method meets or exceeds these loads. • A standard wind load duration factor has been applied to these values per NDS Table 2.3.2. • In cases where the above two methods are not Other applicable NDS adjustment factors are at the discretion of a design professional. available and the wind speed from IRC Figure • These values apply only to the top plate to rafter connection and assume that the fastener is 301.2(4)equals or exceeds 100 mph in hurricane- properly installed per the instructions on this bulletin. prone regions,or 110 mph elsewhere,the design loads of this connection can be determined by a design professional from one of the following three sources and compared to Table 1: 1. American Forest and Paper Association(AF&PA)Wood Frame Construction Manual for One-and Two-Family Dwellings(WFCM). A sample of this chart is shown below. 2. International Code Council (ICC)Standard for the Residential Construction in High Wind Regions(ICC-600). 3. Minimum Design Loads for Buildings and Other Structures(ASCE-7). Sample Wind Loads Table 2 below represents common design wind loads on rafter to top plate connections taken from the AF&PA Wood Frame Construction Manual, High Wind Zone Exposure 6,Wall Connections at toad Bearing Wolfs. TABLE 2 Roof Framing Span.(ft.) 12 16 20 24 28 32 36 WIND ZONE RAFTER LATERAL SHEAR (MPH) SPACING (LB.) (LB.) 90 16"o.c. 82 96 110 125 139 154 168 119 52 90 24"o.c. 123 144 165 187 209 230 252 178 78 100 16"o.c. 124 147 170 193 217 240 264 145 64 100 24"o.c. 186 220 255 290 325 360 396 218 96 110 16"o.c. 170 203 236 269 303 336 370 176 77 110 24"o.c. 255 304 354 404 454 504 554 264 116 120 16"o.c. 220 264 308 352 397 441 486 209 93 120 24"o.c. 331 396 462 528 595 66) 728 314 140 130 16"o.c. 275 331 386 442 499 555 611 247 109 130 24"o.c. 413 1 496 580 664 748 833 917 370 164 This chart is used as an example only and should not be the sole source to design the connection. Fostenftterd and limberLOK�are trademarks of OMG,Inc. Copyright®2014 OMG,Inc All rights reserved. � 1 �,�" �� TOWN OF BARNSTABLE Permit No. ---------_- »n,n, Building Inspector Cash - ------------ °"""�` OCCUPANCY PERMIT Bond ----__ _ "No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Address Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. .....................................................1 19......__ ...................................... ........................................................_._.._._._ Building Inspector i`�„�•;`'.e TOWN OF BARNSTABLE Permit No. 1 ��nsrr.nr Building Inspector Cash _-___--- �'°"``~� OCCUPANCY PERMIT Bona No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to �ltit;�0i1 I�orl�ll Address Lot #19 222 Li.Benhatmr Drive ,U, a i t Wiring Inspector Inspection date ` f Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date F THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. r .....................................:.........„, 19».»....... .......................................... ........................ Building Inspector V Y rE.+K j 2 i s r t > 1 1 tea.©0 i t 5 ' y JUCHARO .Ne 2YM, °' CERTIFIED PLOT PLAN AMASS ar p 1 'K ! •CERTIFY , THAT T.HEo�i�2- �d_ R.. .✓ O�HEARN /NC..; RLS, R5 SHOWN ON . THIS PLAN; HAS BEEN.. 1348 ROUTE v 134 .LOCATED SON THE ';GROUND: A$; . INDICATE=D: - EAST DENNIS; i' q.ura-.r:r + 4 DATE ``r 3='7 SCALE JOB N0 ; ,. CLIENT Ptrl� ��i PATE -R GISTE Et ;ND SURVEYOR DR. . BY : ,p. SHEET. OF , / 7 ,,.'.Aslosspr% map and lot number-3-?:�/,;;;,?,/... 7. ....... .. ....... gTHE Sewage Permit number ..... /........................ STABLE M House number ............... ............................................ IN CO P 5 TOWN OF BARNS ft- 4L CODE REGULAT101NS BUILDING INSPECTOR APPLICATION FOR PERMIT TO ....Ik11kkzan4......rl�.1'2 .............. ........................................... �zg TYPE OF CONSTRUCTION 1V ...1010. ...... ........................................... 1�. ........................1917. ............... . TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..... ...... ........ A1,9 UJ-67VL_,....L2#f,1...L1-C...........coiv . l-r.............I..................I ........................................ .... ......... .................. .......... .... ...... ProposedUse V.......A)O"W.-F............................................................................................................ Zoning District ........fiJ.......................................................Fire District .... .......................................... Name of Owner ............................Address A/CEV/14 W,4 7-C"t Z,&A,1E .............................................................. Name of Builder .......................Address4l .......GrJlGligk. ............. ...... ..y ..... ..... . 'It XD. OCAl"VI ................. Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ...6...........................................................Foundation Pao &VC 1167 Vj I-IV ;1 0,b Ir/A)J-J ................................................ ExlerioVkY ...—XP�TT... ��PMI&.1E�...Roofing A ......................................... Floors ..&q6q:L................................................................Interior ...e.ll.j�.kJa...>'...depchry......................................... Heating ....... O/� ....................................Plumbing .......................................... Fireplace .......WS112f...... .......................Approximate Cost .... .............................................. Definitive Plan Approved by Planning Board ----------------------------- Area Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name i�, .................................. 21434 Howell,, Hutson _ oo N6�21434 ..... Permit for •oiae••story--dwelling �`�' , ............................................................................... , • *' 4 i t7_ �_- r—' e Location lot..#•1.$••22a...Eisenhower..Dr.; ..... CF- Cotia...................... 7.t�............................................ C) UD Owner ...........Hutson,•Howe•1.1. ........................ �- Type of,Construction .......fr e.... ................... , .............. ............... ................... ±E tr Plot ............................ Lot ..........:..................... u ._ Permit Granted ' ....... 9Jul 6. r 79 Date of Inspection . . ......19 ... Date Completed ( ...Dv19 j ..... s cr PERMIT REFUSED .......................... .................. 19 c ,. ................. t' t+y tr j .. ........... ..................... r/ ........... 4 ...................................... tF o .� �.. i Appr'o d�, ....... .......... 19 ' r x� /! / .................. ? ................................. b7 Assessor's map and lot number1!!..+ :°"/_-?1.1 �.� rr '� Qy�F THE TQ� Sewage Permit number ...... ........................ Z BAR33T4i1kE, i .House number ............... .�..IQ .......:..................................... r rb s TOWN OF BARNSTABLE BUILDING INSPECTOR � r�c�r � ��� A�f�n� APPLICATION FOR PERMIT TO ............................................................................................................................. TYPE OF CONSTRUCTION `. !�'''��...r1410 /�/'6 b /1 ktV°-t c/' 1 ......................19.E r , TO THE INSPECTOR OF BUILDINGS: i The undersigned hereby applies for a permit according to the following information: Location ........................................................................................................................................................................................ ProposedUse .S/rlr t ..... ...Lam/�t. t...........1iWW�............................................................................................................ ZoningDistrict ....... fi-E................................................Fire District .... ............................................................... Name of Owner P/11FS�3!V....../✓DbVCk.`.........................Address �y� ...Lr.-06C &u.A7'C...L.....b9l\,E........A/C 0iJr 1,V1 Name of Builder LUJd Ifs �' ;'<f n✓ 6.A .......................Address � f�'�! ......... r................... . . . .Name of Architect ..................................................................Address ........f............................................................................. Number of Rooms 6 Foundation .�l�v�2�'v �Unrtkf�r� ,(llri"' ....................................................... ........................................ .......................... Exterior'. ...:""�'(k1r4c .. �U/ 1 S/JINF?fb P'...Roofing ....��.......• .......�.....:(���.1.. . ....................................................V �- i• a . Floors ... '....................................................................Interior ... i�`1= 'C3C f ::....................................... Heating 1i ....... n .............. Plumbing ' ... .......................... ...........� .. Fireplace �.?✓. .��". tllil ........ ���:�.....f.tI.11C........................Approximate Cost . .............................................. Definitive Plan Approved by Planning Board -----------___________________19_______. Area - ....:.. .W..:S.�..�.:...... � S d r1 Diagram of Lot and Building with Dimensions '"""""° Fee .....:....................................... SUBJECT TO APPROVAL OF BOARD OF HEALTH CJ a _ I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .. !.9 � �1�4'!.t' ,` ,:; ............................. .. ..�..,i.n._.a.s. :�...s.tr tee:�"L4� "...r,t::::a ... .-...�::... u. r_ � ....'�.r:..- i. .;..:,:..�.�.F. .... ... ...i..... ... +.-... ..�...... .,z_ .... .... .. ..... �..�.,..... ........ ..�.... .... 21434 Howell, 1utson Na1.434......... Permit for .. t2e••6• Dry—d ,+e-1-1•ing ~ y ; r .................. .......................................................... Location ......lot *19. 222„•EjgeLjhQwex;.Dr... _ cotult........... n wi Ci 'S Owner .......... utsn owl Type of Construction .....f aMe = � " < ............................ .................... ................. _ a Plot ............................ Lot................................... - Permit Granted ..,...... "u ';b 19 79 J 3 ' Date of Inspection ..........19 Date Completed ...............19 '.: Y _; �._ PE IT REFUSED { .................. 19 .............. .r.. ....... ........ _ R�........................... . ............................ w ... ............ ........� ......./............. .............. F A, r Approvedr ,�: 19-,...'., a • ?)ll�13 , f . L = Town of Barnstable *Permit# �T Expires 6 nro jro date ' NMOL Regulatory Services Fee 1659. `0� Thomas F.Geiler,Director 1 Building Division Tom Perry,CBO, Building Commissioner � �7��� 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma us Office: 508-862-403 8 Fax: 508-790-6230 EXPRESS P RMIT APPLICATION - RESIDENTIAL ONLY ^ � Not Valid without Red X-Press Imprint Map/parcel Number O Property,Address 2-ZZ i-1 S et1 kauj to Z(Z >,�v Residential Value of Worl 67-0o Minimum fee of$35.00 for work under$6000.00 t Owner's Name&Address 13ftm's ks Contractor's Name ��.L/ *A-� 1�t tt� , , tl t`'1 Telephone NumberL5�") 716 `((O qSP Home Improvement Contractor License#(if applicable) to 2 9)27 Construction Supervisor's License#(if applicable) 0(t0 5 s'0 i ❑Workman's Compensation Insurance ICheck one:7 ❑ I am a sole proprietor ❑ I am the Homeowner V( I have Worker's Compensation Insurance Insurance Company Name fJ'�S°G• � Q� � -�'�` . Workman's Comp.Policy# f/.Tec-. Copy of Insurance Compliance Certificate must accompany each,permit. Permit Request(check box) Fz'Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to 2au tZN '1)i/1 ❑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 regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Ho Improvement Contractors License&Construction Supervisors License is requi d. SIGNATURE: Z:IWPFILES\FO S\ ilding permit fomuT7PRFSS.doc (Zevised.053 2 r The CommonweaM ofMassarhaisetts Depwhnmt of Industrial Acdden& Office of Investigations 600 Washington Stmet Boston,M4 02111 wrvrumas&govldia Workers' Compensation hm.u once Affidavit BuiMers/Confimchw.sTkct6cimvJPhmbers Apulic,=t Information Please Priest Lel r`Irly Name � wS ✓cL7r�,� Address: YK 0-(d C1t3/ tabedZap_ (�Vt/ i� P W 02� E f 77 2-!% i Are you an employer?Check the appropriate boa: Type of project(required): I_❑ I sm a employer with 4. ❑ I am a general contractor and i employees(full andlorpar"me)_* have hued the sub-s hactora 6- ❑I+iew construction.2_ i.am a sole proprietor or partner- listed on the tfached sheet. 7- ❑Remodeling sMp and have ao employees These have8- ❑Demolition working for me in any capacity. employees s' 9- ❑Budding addition (Apo t udmrs'camp.insurance comp trrsaraacI I requied-] 5. ❑ We are a.cmpom ion and its 10-❑Electrical repairs,or additions 3.❑ I am a honxmvner doing all wm k offcers have emercised their ll_❑Plumbing repairs or additions mywH o workers' right of exemption.per MGL sus ce repain reqnha&]I c 152,§1(4),and we have no 12. of employees- [No w =' 13. Other comp inmmce required.] •Any appt r mar dmdEs boa#1 umst also ffi1 out flee section beb w d w1nsth�vmdete canpe�napolici MfutmaEiad Hnooeaaoers who mbmit tbis affidwit wAk2tmg Ybey sze doing all woody and men hirte outside cmtactum mast submit a now affidavit indicating such jCmitacgus that chwl this baoc must attached au additional sheet shoaring tbE name of the sub-connx&m and date whew a not those enfities hme employees-If the aabtonnctars lave employees,mey emtst Amide their wwkets'rmnp.policy member- I am an emp4vr that isproviding workers congmusaden insuran a for my emplajmm Befosv is Its policy aged job site informadva Insurance Company Name: "S o c, !ELUV`'"y tq Policy#or Self-ins-Tic.#: e C'' �CJO `r 5 t)U 8 ( r 7,wF3xp a Date: Job Site Address: �!�� ��S Yw w 1�lL. City/State 4: l��`''•� `�Nt' , dZ�P� Attach a copy of the workers'compensafm policy declaration page(showing the policy m, er 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 andfor one-year imprisonnum,as well as civil penalties in the form of a STOP WORE;ORDER and a fine of up to$250.00 a day against the violator_ Be advised that a copy of this statement miry be forwarded to the Office of Investigatiow of the DIA for insurance±coverage verificadioa- I do hereby cert&render thepains 9ponabUs trfpet7ury t &do iRfor providad above is bus and correct . Sr Date: / 3 Phone [5-00) Y7? t) I use enfy:. Do not write in this area,to be completed by city ar town offic&L City or Town: PermitH icense# Issuing Anthority(circle one): I.Board of Health 2.Building Department 3.CStyfrawn Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phase t!: BARNMABM �,�MASS, ' Town of Barnstable Regulatory Services Thomas F.Geiler,Director Building Division ` Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as.Owner of the subject property hereby authorize ���'� to act on my behalf, in all matters relative to work authorized by this building permit application for. ZZZ �e S�v�h O t.�eft, �(Z• lm`��� (Address of Job) Signature of Owner Dat " Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. QAWPHLESTORMSNbuilding permit fb=\EXPRESS.doc Revised 051811 N1 t1 ! •husctt - b p l-tnunt of Public SafetN ✓!e �O""j2O11P��z �JZ1���a tit 4 Board of, Surltlin� Re�uLttton, and Stand (Is . � Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Construction Supervisor License �Et Registration: 102827 Type License: CS 40858 a'Expiration: 7/2/2014 DBA FELLOWS BUILDING&HOME IMPROVEMENT DAMES D FELLOWS r 5 MAIN ST �� i = James Fellows MASHPEE, MA 02649 5 Main Street Mashpee,MA 02649 Undersecretary Expiration: 9/30/2013 ("uronui�siuni r Tr#: 1812 License or registration valid for individul use only , Failure to possess a current edition of the ' before the expiration date. If found return to: Massachusetts State Building Code ' Office of Consumer Affairs and BusinessRegulation egulation ,- is cause for revocation of this license. 10 Park Plaza-Suite 5170 Boston,MA 02116 Refer to: WWW.Mass.Gov/DPS Not valid without signature a R_ SHE ram, Town' of Barnstable *Permit# S�-_i Expires 6 ingn� t�o+n ivs�e date BAMSPABM Regulatory Services Fee 039.SS Thomas F.Geiler,Director s6g9 ,��' ,,rEO �a Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 47 Office: 508-862-4038 ®P ..,t�,P Fax: 508-790-6230 �.AY EXPRESS PERMIT APPLICATION - RESIDENTIAL ONL Y Not Valid without Red X-Press imprint TOWN OF BARBS iL Map/parcel Number 1 9� Property Address 2!2 lJtr:AVl, S" .o 02X0_S5_ Residential Value of Work?(&90, d0 Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address �Sfa•P_ 1'S�C`nsl,� p �.�C�l���1'l� �`ZZ �1�-�i.�ze�.�•et/' 1JV". �LSD��.i 1�' Contractor's Name YAat_�, Telephone Number 93 /cj(1 Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: 'Ellarri a sole proprietor. ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance 96 l I LI,+ Insurance Company Name 4 CJ1 tC(_W1 Zd 2 Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) _ ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side Replacement Windows. U-Value 3�J (maximum.44) *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. Home r ement Contractors License is required. Signature awltl� 6//)5.d�,n Q:Forms:expmtrg Revise063004 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street, 7`h Floor ?' Boston,Mass. 02111 Workers'Compensation Insurance Affidavit:Buildin lumbin lectrtcal Contractors R. name: u1•e address_P city � \N state 1� zip��oCs t'� phone# work site location MH address): 2.2 2 Ei So A"aa-6r t>L CcT6.t_--V wtk a—,-w S ❑ I am a homeowner performing all work myself. Project Type: ❑New Constructiotr.®Remodel J;aarn a sole n ro netor and have no one worktng in any capacity. ❑Building Addition t 7tc •.'�;'9.F� ; '.7 w. . 'a.8':: �ck�ffi :wxt -r�.y:, •,.a• �;;x: ,r ax ,Ni '.c';+r' +.;•'d•.., :+•' ,. .,..':�'Wr't a'�Y � y -�, 1i<y. .:i...,}..e.. .; �:r c�,1•r..}`�... • ..3•..OK+,'4•.; '•.. 6� .. 4.. r I am an employer providing workers'compensation for my employees working on this job. company name• V,�Co �u`�Q �4�rtlXul address: yV l c r' - -..._..C� CoI"�.................... phone#: 'SOS ���.. rg� city 1 o tr1�S VB`l � insurance co. ❑ 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: co .name• address:- city. Phone#: insurance co. oli # Company name: address: city: Phone#• insurance Ca oII # <e xeg� vs„t7T.itdi# Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. 1 understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. i do hereby c t under the pans and penalties of perjury that the information provided above is true and correct. Si afore Date �f' O S Pant name k IV Phone# 5—a 3�i� /S�/ official use only do not write in this area to be completed by city or town official city or town: permittlicense# ❑Building Department ❑Licensing Board" ❑check if immediate response is required ❑Selectmen's Office _ ❑Health_Department . contact person. phone#; ❑Other (mv'iscd Sep.2003) r. r 'J 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. Please supply company name, 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. =31 Sam 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 permit/license number which-will be used as a reference number. The affidavits may be returned 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. 91 The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street,7te Floor Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617)7274900 ext. 406. pcoo �0 UASCO NUNEZ CARPENTRY 79 Mayfair Rd SOUTH DENNIS, MA 02660 H I C, #124793 (866);:398=1511 •.Toll Free (508) 398 1511 • Dennis; MA ]_�PHONE DATE TO. ,M/M George Richard 508-420=6997: 3/21/2005 01 BOX° 1974'`; JOB NAME/LOCATION P idin g DoorC Andersen Gl 222 Eisenhower Drive Cotuit, MA 02635 JOB NUMBER. JOB PHONE 6997 SAME We hereby submit specfcatlons,and esbmates.for: � 1 Remove one fifteen lite exterior door, one casement window and one air conditioner .from kitchen ar.ea,... ( all ,,the. above are grouped together on rear wall of house ) .. 2 Install::..one Andersen >Pe:rma-Shield gliding door in same :location;. and..relocate air conditioner to ahe.:right, ( v `eiaiti from:interior.g: ) of. new; gliding door 3 Supply interior/exterior trim and. framing `materials .where needed 4 Supply''town building.`permif: .5 Take all debris from this job to 'town landfill 6 Make arrangement for delivery of new Andersen �U��llO s40Prl/[1e�I" * This proposal::does not include:.any painting or staining y/v vsr All Andersen.products described above will be prepaid by;.owner ** If: this proposal is satisfactory, please sign the YELLOW copy and return with payment schedule �oTetlo � . ** Customer has already:.received quote for new Andersen door from Center, and will make arrangement, for payment with. them directly. *** WE ACCEPT CASH, CHECK OR VISA/MASTER CARD BY SWIPE ONLY FOR..PAYMENT *** We Propose hereby to furnish material arid labor—complete in accordance with the above specifications,for the sum of: Ohe Thousand One Hundred Eighty and 00/100 Dollars dollars($ 1, 180.00 )• Payment to be made as follows: 50o Down payment to start. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$590.00 50% Upon completion, at time of completion. . . . . . . . . . . . . . . . . . . .$590.00 All material is guaranteed to be as specified.All work to be completed in a professional manner according to standard practices.Any alteration or deviation from above specifications Authorized involving extra costs will be executed only upon written orders,and will become an extra Signature charge over and above the estimate.All agreements contingent upon strikes,accidents or delays beyond our control.Owner to carry fire,tornado,and other necessary insurance.Our Note:This proposal may be workers are fully covered by Workers Compensation insurance. withdrawn by us' not accepted within 30 days. Acceptance of Proposal—The above prices,specifications and con- FU ditions are satisfactory and are hereby accepted.You are authorized to do the work as l specified.Payment will be made as outlined above. ignature �.✓� ` nature at of Acceptance: �J PRODUCT 13128M USE WITH 771 ENVELOPE NEB$ To Reorder:1-800-225-6380 or www.nebs.com PRINTED IN U.S.A. AB x'.�g i BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 069680 Birthdate: 10/03/1948 Expires: 10/03/2006 Tr.no: 2545.0 Restricted: 1 G VASCO E NUNEZ III 79 MAYFAIR RD G— S DENNIS, MA 02660 Commissioner '7 i • ��e L�a�iz»z4�zu+ealr�, cf llrs.:.;r.rirr.reld: Board of Building.Regulations and Standards HOME IMPROVEMENT CONTRACTOR ' Registration: 124793 Expiration: 8125/2005 Type: Individual Vasco E.Nunez, III Vasco Nunez,III 79 Mayfair.Rd. � S.Dennis,MA 02660 Administrator iFrom:Donna Seviour At:Drake,Swan&Crocker FaxID:2077750339 To:Vasco Date:05/02/05 02:09 PM Page:2 of 3 ., ,.. ACORD CERTIFICATE OF LIABILITY INSURANCE S DATE( 1DDIYYI'Y) VASCOSCO-2 05/02/05 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Drake Swan & Crocker ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Insurance Agency, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 14 Lots Hollow Rd ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Orleans MA 02653 Phone:508-255-3212 Fax:508-255-9864 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Norfolk & Dedham Mutual INSURER B: Vasco Nunez INSURER 79 Mayfair Road INSURER D. South Dennis MA 02660 INSURER E'. COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN POLICY EFFECTIVE PULIL I=XFI-lIUN LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YY) DATE(MMlDD/YY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $1000000 A X COMMERCIAL GENERAL LIABILITY R0207202 09/12/04 09/12/05 PREMISES(Eaoccurence) $50000 CLAIMS MADE F-IOCCUR MED EX.P(Any one Gerson) $5000 PERSONAL&ADV INJURY $1000000 GENERAL AGGREGATE ,6 2000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $1000000 POLICY PR0. JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSlUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR F—ICLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND TORY LIMITS ER EMPLOYERS'LIABILITY ANY PRIOPRIETOWPARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICEWMEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ It yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER I: DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Carpentry-construction of residential property not Richard Job: Cotuit CERTIFICATE HOLDER CANCELLATION BAMT01 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Barnstable Town Hall 200 Main Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Hyannis MA 02601 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Small Business ACORD 25(2001108) ©ACORD CORPORATION 1988 IH OF MA`rS ERIC J. ER h ; CED HOLM m \` .,�~ O STRUCTURAL �', ��rt�.� C > I t -PLY �'r,— t✓ �� ''t' j :!=3• :e . --� l u U Ni 38962 co �.I ,i — f • 4 t 1 rc {� � e�n I c -ram — � f _. Pe- -vw �e l 3� ""C►h e� pNl t t a� P ka -x—e b-l c��, 31 y r w , +NG T ( �f lflYlr� __ _.. ._._.._.... - . ......._. .. ,_...-..._ _._........ ........._-..__.�..._...... _ .._ �, BU p , - � J E Vill • � � NOV m 0 9 2016 �c r�` a } t TOWN OF BARNSTABLE `. E • I t 1t 1 c�. • - - L � Ijsl lilq,� ., 1 _ V 1.1 II ( i �'i jiE � I( ' .. • if In o f1 , , 1 I !, i OF } ! N Mess , l I i O ERIC J. CEDERHOLM P I STRUCTURAL y f No. 38962 ! iM I 1 S r I i i I I . _ t 0 tZ-1 l-+ l�F V W.._s l D KA t r � t • r ! b iy.: 3 f ;i t k t - i t + JI r o 'T M L Fz1 J 0 T to L H �Ffw—ql S /o � ERIC J. I •'� .�7 t` — X CEDERHOLM fn� I �� \ ��p� �:, �Ofzr I�,y PLt o ijo` STRUCTURAL .J t`.J:...= v\ No. 38382 Lo _ • I i • L - r ' 1 t 1. CIl��lr� �� I 1 tD �pCJlcP6 Vc }-le, � r j t o.l I I � I -. BUILDIfV G DEPT. - -- -_ . .� NOV 0 9 2016 1_ . TOWN OF BARNSTABLE `�`F ��u G(o - �'c-•tom S�� ��s� �... j � �-- G��,�•`.- ..I.� ' � f i i i jE ' I j ( ;1 _._.._.. .-.._ - � I � ` I --...................... I I I II i I , I , t care ERIC J. 'z C`DE;t!-IC UTA URAL �• ! i I I l i :l I � � I i� j � i I III i I 1 Ii � � � I ' I fi� I � � I isl II II i • I IF I � I II I, • __ I Ii, I �r , • - - - - - - - - - - - - - - - - - - - - �- - g - - ` - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - i ; wig « cE-t,A IT- _ _ G i i i i L iffti1 A_r / i i i 1 �! E ZT t-1 f . i � CIF i`q u Imo;/r�._.• .� - o .`•� —�J I C=ED, RF4C_f� �ttt I -;\ ��✓t-o•.„� r'^�� l� l.f STRUCTURAL 33962 e All i i� : . t I 1 (Itill - r �-gQ:, 51� I .Y ''jam• „i I EACH ea ij t oil I\ � •� 1 ` I l 1 t � � � `k-t �4�C�ta>,.$ �-I�� ���f�.�e'�:�®�,. t1V�-•�'+� l��• �L� j I t i � • 1 I i I t , i I ( 1 ( I '1'� ( IIj i � `•' ; , � I ; I ,s4,rsG���-- �I,1��� ���•��i@: .13.]� .__---.^�.. I i .�I = .... } ` — BUILDING DEPT I � i F _ 11It� t lL7 _....:_ ._,__ , NOV 0 9 2016 J_ i TOWN OF BARNSTABLF A5u(o( r I i t I _ III I I , 14 I 1 i it tt -17 i OF i I i ERIC J. CEDERS OLI A Mrl 6 mu or I I ' I i I+ i IIi ! � •'F�.� �a� ' � i I I I I I Ii � � I ' i i � � !•; i II i1 I � j i I! I i ! : I 1II li III' I 111 i 11 I I 'll I ; I i ! '( Ifl; � � I II I ' li I , • ; I fll A - I I ( - - - - - - - - - - - - - - - - - - - - - - - - -� I- - - - - - - - - - - - i - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - f i - - - - - - - - - - - - - - - - - - - icE-LAt 2;2-2-, .fit-cUA 1'r��J C; i E d, f � r - - - - - - - - - - - - - - - - - - - - - - - - - ........ _ - -- - - ... - -- - --..._... ----._ ..__ .._._..------- _ - r A� fyl. i 1 t i I i i I i i II I i f 1r 1 _ I � ' I i i I' �•y