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Home My WebLink About0079 GUIMQUISSETT ROAD f r Town of Barnstable _ � � �.� , Building Posh:°This Card So,That it_is Visible From the Street Approved Plan"s Must b`e Retained orrJob and this Card Must be Kept '4 twttnsrwetE { ill p "� ` ' Posted Until Finalµlnspection Has Been Made s a- M1 4j �y�m�� x.. a .. .- .. 1 1 r ° ,Where a Certificate,of-Occupancy is Required;such.Buldmgshall Not be Occupied until a�Final Inspection has<leen rriade. _. Permit NO. B-18=3157 Applicant Name: MAHONEY, BRENDAN &CELINE Approvals Date Issued: ' 10/03/2018 Current Use: Structure Permit Type: Building Alteration INTERIOR Work Only- Expiration Date: 04/03/2019 Foundation: Residential Map/Lot: 019-085 Zoning District: RF Sheathing: Location:. 79 GUIMQUISSETT ROAD,COTUIT Contractor Name; . Framing: 1 to`ZCt �,c Q —o Owner on Record: MAHONEY, BRENDAN&CELINE 'Contractor License`._ 2 Address: 79 GUIMQUISSETT ROAD Est. Project Cost: $5,000.00 Chimney: COTUIT, MA 02635 Permit Fee: $85.00 Description: 'Finsih portion of basement to create playroom N Fee Paid: $85.00 Insulation:.u Project Review Req: Date 10/3/2018 Final �� ►(z��r q d�-=------- Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: Rough Gas: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six'months afteri"ssuance. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Final Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or.road and shall be maintained open for public inspection for the entire duration of the Electrical work until the completion of the same. 3 F' Service: The Certificate of Occupancy will not be issued until all applicable signatures by the.Building and Fire Officials are provided'on this permit. Minimum of Five Call Inspections Required for All Construction Work Rough: 1.Foundation or Footing - 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Final: 6_Insulation 7..Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Final: Work shall not proceed until the Inspector has approved the various stages of construction. Fire Department "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: - Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT 0 Application N=ber............... ......— + �. ` TOM OF 3LF.......5 .......... .: ...:.. ' otberFee.................:...... 3MAB ' BUIZDIIVG DE):C r 7018 Fu 'i gToth"Feed' ..........................t TOWN OF B�A�RNST�.. LE Permit App by..................................oa........................ ... WIN,0"-- BUII�DINO PERMIT„ 1i"��IS �.. � .................. ..... .................... LSE �.. ..P�1.. APPLICATION Section 1 —Owner's Information and Project Location 71 6-,j I (1va5 Se:?� � rI {verge �G?vi7 Project Address "Owners Namer�1 Owners Legal Address rty� v v 7 �-Srate - /�' Zip-, U26 Owners Cell# \ - Section 2—Use of Structure Use Group ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet ❑ Single/Two Family Dwelling Section 3—Type of-Permit ❑ New Construction ❑ Move/Relocate . ❑ Accessory Structure ❑_Change of use ❑ Demo/(entire structare) � �Eu Basement' Family/Amnesty El Fire Alarm Rebuild ❑ Deck Apartment ❑ Sprinkler System ❑ Addition ❑ Retaining wall ❑ Solar `❑ Renovation ❑ Pool ❑ Insulation Other—Specify r7Sction 4-Work Description �e A i' T act nndsrted_2J9r2018 Application Number.................................................... Section 5—Detail w Cost of Proposed Construction :5�UU 0' Square Footage of Project Age of Structure Dig Safe Number # Of Bedrooms Existing Total#Of Bedrooms(proposed) 110 MPH Wind Zone Compliance Method MA Checklist WFCM Checklist Design Section 6—Project Specifics Wirier ❑ Oil Tank Storage ❑ Smoke Detectors j ❑ Plumbing ❑ Gas . ❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney ❑Add/relocate bedroom - 1 Water Supply ❑ Public El Private Sewage Disposal ❑ Municipal ❑ On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway 1 Debris Disposal Facility. I an using a crane ❑ Yes ❑ No Section 7—Flood Zone Flood Zone Designation j Within or adjacent to a wetland, coastal bank? Yes ❑ No ❑ a Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq.Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) s Setbacks Front Yard Required Proposed Rear Yard Required Proposed ' Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No i Last undated:2/9=18 - r The Commonwealth of Massachusetts Department of Industrial Accidents — --_ - ;Office of Investigations ' 600 Washington Street - _ Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lezibly Name(Business/Organization/Individual); !' y<G•^ Address: °, (ry l Gl: S �7 ,�►'� City/State/Zip: Cy (u/7 �� G?G3Y Phone#�- r'�:5 30r-- Z? Z6 Are you an employer?Check the appropriate boat: Type of project(required): 1.❑ I am a employer with 4. I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. 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 g, 0 Demolition working for me in any capacity. employees and have workers' # 9. ❑Building addition [No workers'comp.insurance comp.insurance° . quired,] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3. 1am,a-homeowner doing all work officers have exercised their l LEJ 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: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify u der the pains and penalties of perjury that the information provided above is a and correct -- n Signature: � ' - Dater-- � � c.. 7(—, Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4,Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 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, 625C(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-contractor(s)name(s),address(es)and phone numbers)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 lice 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 Commonwealth of Massachusetts , Department,of Ihdustriat Accidents Office of Investigations 600 WmhW9ton Weet Boston,MA 0211.1 Tel. 4 617-7274900 ext 406 or 1-977-MASSAFE -. Fax##617-727-7749 Revised 4-24-07 www.mass..gav/dia Insulation would be fiberglass. Can you confirm if RI is acceptable? I intend to use a water resistant sheetrock for the covering. 2) Ceiling Intent is to have a drop ceiling. 3) Door There is a weather stripped door in place at the bulkhead. Do not see any other need for doors at this time. Regards, Brendan From: "Carter,Jeff'<Jeff.Carter(Wtown.barnstable.ma.us> Date: October 2,2018 at 10:11:58 AM EDT To: "bcmaeamac.com'<bcmae()mac.com> Subject:ViewPermit, Permit No:TB-18-3157 Good morning Brendan, 7 As a follow-up to our conversation yesterday can you submit a supplemental description to add to you permit request that addresses the full scope of the project. Please describe the materiall you will be using to frame walls with(ex 20 studs) and that you will be using a pressure treated bottom plate if that is your intent. Include what you.will be using to insulated the walls with and what you will be using for wall covering. Is the ceiling being covered and if so how? Description of doors being installed, any door the separates conditioned and unconditioned space needs to be weather-stripped and insulated. You can email it to me directly. If you have any questions my contact info is below. Thanks, - Jeff Carter Local Inspector Building Department . Town of Barnstable 200 Main Street Hyannis, MA 02601 508 862-4035 2 Carter, Jeff From: Brendan Mahoney <mahoneybj@icloud.com> Sent: Wednesday, October 03, 2018 3:09 PM To: Carter,Jeff Subject: Re:ViewPermit, Permit No:TB-18-3157 I Jeff, - That is doable. Regards, Brendan On Oct 3, 2018, at 3:01 PM, Carter, Jeff<Jeff.CarterOtown.bamstable.ma.us> wrote: Thanks for the description, Just want to let you know that the current code will require either R19 fiberglass or R15 of continuous insulation which can be accomplished in a couple different ways. You also need to make sure that any doors that go from heated to unheated space are weather-stripped and have a sweep on the bottom.. Let me know if this will work for you to continue moving forward From: Brendan Mahoney [mailto:ma'honeybi(abicloud.com] Sent: Wednesday, October 03, 2018 9:26 AM To: Carter, Jeff Subject: Re: ViewPermit, Permit No: TB-18-3157 Jeff, Good morning, below are the answers to the questions below. Supplemental Description Intent is create an additional work space/play area in the basement. We plan on using 2*4's that are pressure treated with a treated bottom plate to frame"the area. Wall covering would be water resistant sheetrock with n RI fiberglass insulation. Electric heat would be leveraged as well. Flooring would be painted supplemented with area rugs: Ceiling would be a drop ceiling. Please share if there is any other additional items that need to be added into the description. Below are the points of clarity requested in your previous note. 1) 2*4 - Pressure treated with pressure treated bottom plate 2)_ Wail covering&•Insulation 1 �v ✓ / .000 77771 F. o / f V (, ka,delot _ . ` ' tit , 7z (-f!( olAc-1 -�X 5711UG' t.. IV , v J l c,C. ' Carter, Jeff From: Carter,Jeff Sent: Tuesday, October 02, 2018 10:12 AM To: 'bcmae@mac.com' Subject: ViewPermit, Permit No: TB-18-3157 Good morning Brendan, As a follow-up to our conversation yesterday can you submit a supplemental description to add to you permit request that addresses the full scope of the project. Please describe the material you will be using to frame walls with(ex 2x4 studs)and that you will be using.a pressure treated bottom plate if that is your intent. Include what you will be using to insulated the walls with and what you will be using for wall covering. Is the ceiling being covered and if so how? Description of doors being installed, any door the separates conditioned and unconditioned space needs to be weather- stripped and insulated. You can email it to me directly. If you have any questions my contact info is below. Thanks, Jeff Carter Local Inspector Building Department r Town of Barnstable 200 Main Street Hyannis, MA 02601 508 862-4035 } 1 ------------- . Application Number........................................... Section 9—.Construction Supervisor Name Telephone Number Address City State Tap License Number License Type Expiration Date, Contractors Email Cell# I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your license. Signature Date Section.10—Home Improvement Contractor Name Telephone Number Address City State Tap Registration Number Expiration Date I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your EUC... Signature Date Section-11--Home-Owners-License Exemption- -� (J f e^ c,.. 144t.��a�� Home Owners Name:_ ' ) Tel hone Numbe �� 2 2 6 ep ��' Cell or Work Number ```�Q I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and F docomen aiion required by 780 CMR and the Town of Barnstable. CSignamre__ _ DaIDaD a SAP-PLICANT SIGNATURE -Signature Date t N�Prin _ Telephone Number �cJ. E-mail.permit to: __ Y-�C*1 G l @ M O�C e CUB%-" Section 12—Department Sign-Offs Health Department © Zoning Board(if required) Historic District ❑ Site Plan Review(if required) ❑ �� Fire Department ❑ Conservation ❑ For commercial work,please take your plans directly to the fire deparbnent for approval Section 13-Owner's Authorization I 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: (Address of job) Signature of Owner dad I Print Name 1 i i j i y�y f Last undated:2/92018 f�da 3 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Q_m"r BUILDING DEpT — > jl Map Parcel O �� Application'# 17 Date Issued Health Division MAY O 12017 - Conservation Division -'OWN OF13ARNS1ABLE Application Fee Planning Dept. Permit Fee 615 .00 Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address 104 Gu,"u,'%Srt E'�- K d Village- Owner Ceu,&L f'Is-kcno� 4'(3reA MaAmy, J Address Ad ('a HA a)�lo3S Telephone �f 7-losa-o3��f Permit Request A,L 6 ► �z�: � sk�PP `� E� 2�� Il�la a a4 — (•�qi�`u Tbt r►�-��` 6.a d 1zs a f i c 4ti4-,,1, 0) V-e,�- (37 -exX aus�- tsR 4-, 44 F , LO Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuat* 3:1b%,T- Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 9f 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 r 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 b""a Telephone Number Sb 8 -5'&7- 206 Address License # 10390 Home Improvement Contractor# 1-80"?y7 Email�1e Worker's Compensation # X�,✓S 57nt//87y/ ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO (WAhc_ �5 I V&-U At0aU R,'✓-t! MA. D)-7,)-b SIGNATURE DATE 0()T/7 j FOR OFFICIAL USE ONLY APPLICATION # t DATE ISSUED MAP/ PARCEL NO. a Is ADDRESS VILLAGE i � OWNER DATE OF INSPECTION: If FOUNDATION Z FRAME ` 4 INSULATION ` FIREPLACE !T ELECTRICAL: ROUGH FINAL K PLUMBING: ROUGH FINAL I 'r GAS: ROUGH FINAL FINAL BUILDING 'r DATE CLOSED OUT f. ASSOCIATION PLAN NO. T The Commonwealth of Massachusetts x Department of Industrial Accidents I Congress Street,Suite 100 0 Boston, MA 02114-2017 r www mass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information .t Please Print Legibly Name (Business/Organization/Individual): IASUId•(e-Isar yomhG Address: t1/l0 Grove S-f City/State/Zip: ![�a11 0y-7'>-o Phone #: SO Fi- 7 ' 2 y� Are you an employer?Check the appropriate box: Type of project(required): L�I am a employer with employees(full and/or part-time).* 7. []New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in $• Remodeling any capacity.[No workers'comp.insurance required.] In t 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 Q Building addition ensure that all contractors either have workers'compensation insurance or are sole 1 I.E]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 sheet. 13.[:]Roof repairs These sub-contractors have employees and have workers'comp.insurance.- 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.�C Other �Z, ns(J614-76� 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. 1 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. i Insurance Company Name: m4v?u Policy#or Self-ins.Lic.#: kW C S(�tf l e 7 4l Expiration Date: l a/I Ott 7 Job Site Address: �� by issue VC/�1 • City/State/Zip: Co}�n�� P O2(o36" Attach a copy of the workers' comfensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL 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 forth 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 rlo hereby certify under the aias andAena ies of perjury that the information provided above is true and correct. Signature: / ► Date: I Phone#: 567- (D706 Official use only. Do not write in this area,to be completed by city or town official. City or Town: . Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Office of Consumer Affairs"and Business Regulati6n 10 Park Plaza- Suste 5170 Boston, Ma usetts 0211,E Horne lmprovern tractor Reglstrat l r7 Type: Coparatfbn INSULATE 2 SAVE , INC. � �, Reglsyr tion . 180747 Expiration:: t 2/20/2018 410 Grove St Faltrver, MA 02720 � scA 1 _) 20M-0st>> "_r' ` Update Address arSo rctum Qard. Marie r , son for chant®' .CLAdies � 1' en®oval C7 Ernimen CJastrtl /a tmsrratvrx{crtcrlri rfC3rzi�tcrisc - - - :, ,.-, _:m 4fltco of consumer Atfstrs 8.Business Regulation ` HOME IMPROVEMENT C6NTRACTQR Registration valid for lndivtdual uee"on}i - TYPE:Gorparatfan before the 6*ratlon date. If tourid rett rri to: Syr jr q office oi.Cortsumer AffaPrs and,8uslne Reguietton 8p 97 12128/2018 40 Park Plata'-Sufte 5170 Boston MA 02116 INSULATE 2 V .i ,A Roland Langevr5 00 Grove St �G Faliriver,MA 02720 � lndersecretary [d€ft vatic!-witttitt st gnat ure- W �( z Massacf% artment of'Pubfic Safety oaf f uIttlirt i ogut ttaris anr# t66darde x - � l Lite l C(u) :tructio rt'S+i 41sor _ t . tT43LAND CANGeVW ' FA LL;twmM4 61 V M. CA— C:cn�r�%ss i�rt t'fr' 081�4t2017 I , J ® CERTIFICATE OF LIABILITY INSURANCE 7(MMIDDIYYYY) ACORO L...�'" 12/8/16 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 endorsement(s). PRODUCER CONTACT NAME: Anthony F. Cordeiro Insurance PHONE (508) 677-0407 ax No; (508) 677-0409 IAC.171 Pleasant Street ADDRESS: hsouza@cordeiroinsurance.com Fall River, MA 02721 _INSUREws)AFFORDING COVERAGE __ NAIC# INSURER.A Lib,ertX„-,Mutual Insurance,,. INSURED INSURER B: Insulate 2 Save, Inc. INSURERC: ...-._. ...__.... - -- ------- .—_.. 410 Grove St. INSURERD: Fall River, MA 02720 INSURERE: INSURERF: , COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRj ADDL SUBR ; POLICY EFF POLICY EXP LTRI -TYPEOFINSURANCE INSR WVD POUCYNUMBER MMIDDNYYY MMIDDIYYYY LIMITS A i GENERAL LIABILITY Y Y BKS 56418741 i 12/10/16 12/10/17 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED i X I COMMERCIALGENERALLIABIUTY PREMLS.6:S_(Eao�curr� ...._$. 3„00,000-....... :. ..1----- ---.... � ............. CLAIMS MADE u OCCUR ME EXP(Anyone person) $ 5 000 PERSONAL&ADVINJURY $ 1,000,000 LlGENERAL AGGREGATE $ 2,000,000 GENTAGGREGATELIMITAPPUESPER PRODUCTS-_COMP/OP AGG $ . 2,000,000 j PRO X POLICY LOC $ AUTOMOBILE 12/10/16 12/10/17 COMBINED SINGLELIMn A Y Y BAA 56418741 �Eaacciderit $ 1,000,000 ANY AUTO BODILY INJURY(Per person) $ —..- ....... ... — .... ALLOWNED SCHEDULED BODILYINJURY(Peraccident) $ AUTOS X AUTOS NON-OWNED PROPERTY DAMAGE $ X_ HIRED AUTOS X AUTOS A X UMBRELLA LIAB X OCCUR Y Y USO 56418741 12/10/16 12/10/17 EACH OCCURRENCE $ 2,000,000 ~ EXCESS LIAB - CLAIMS-MADE AGGREGATE $ 10,000 - --.... ..... ._._. .. ._.-_.... _. 1 DED RETENTION$ $ WORKERS COMPENSATION 12/10/16 12/10/17 IWCSTATU- IOTH- A ! XWS $6418741 _X.1T..O.R.Y.LIMITS-........ .i..ER......._ _..- ......AND EMPLOYERS'LIABILITY YIN I _ ------ ANY PROPRIETOR/PARTNER/EXECUTIVE t ' E L EACH ACCIDENT $ 500,000 OFFICE RIMEMBER EXCLUDED? N I A (Mandatory in NH) — ,_E_L,DISEASE-EA EMPLOYEE $ 500 000 If yyes describe under 1DESCRIPTIONOFOPERATIONSbelow E.L.DISEASE-POLICYLimrr $ 500,000 I DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is regui red) "For Insurance Purposes Only" 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 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Phone: Fax: E-Mail: RISE-Engineering RISE 5 Dupont Ave,South G Yarmouth,MA 02G64 CONTRACT' .r�i� l � �� ENGINEERIN 508-568-1926 FAX(401)784-3710 �y Page 1 PROGRAM THIS CONTRACT IS ENTERED INTO BETWEEN RISE - CLC`RES ENGINEERING AND THE CUSTOMER FOR WORK AS DESCAISEO BELOW CUSTOMER PHONE DATE CUENT4 WORK ORDER CELINE MAHONEY (61.7)650.0324 02/02/2017 233058 26102 SERVICE STREET DIIUNO STREET 79 Guimquissett Road 79 Guimquissett Road SERVICE CITY,STATE,ZIP - - BILLINO CITY,STATE,ZIP Cotuit,MA 02635 Cotuit,MA 0263.5 JOB DESCRIPHON HEALTH&SAFETY:We have noted there is Vermiculite insLilat ion in your home.Vermiculite Inig►itcomnin,dsbestos fibers,which:iis a known carcinogen.Weatherization measures,such as'nir.'sealing and insulation,cannot be installed in the areas of your.home where vermiculite is present.To.prevent disturbance"of the vermiculite,a btower door test will not be conducted at your home: HARRIER:We have discovered what appears to be a mold/'mildew-like substance.in.your home:This is being brought to your attention to identify it as a pre-existing condition to the insulation and airseal.ing work planned for your home.;Your signature is your acknowledgement of these conditions and agreement to proceed. AIR SEALING:Provide labor and materials to seal areas of your home against wasteful,excess air leakage:This work will be performed $924.00 in concert with the use of special tools:And diagnostic tests to assure that your home will he left with a healthful level of air exchange and indoor air quality.Materials to be used to seal your home can include caulks,foams,weatherstripping and other,products. Primary: areas for sealing include air leakage to.attic's,basements,attached garages and other unheated areas(windows are not generally addressed.) (12)working hours. A reduction in cubic feet per minute(cfm)of air infiltration will occur,but the actual number of cfm.s not guaranteed, 0. HEALTH&SAFETY: In order to maintain healthy indoor air quality and remove exec.&.-,moisture,every kitchen should have an exhaust fan vented to the outdoors to provide at least 100 cubic feet per minute(CFM)of ventilation.Your home's kitchen ezhaustfan is not currently vented to the outside:and it is our strong. recommendation you consider venting this,in the near;future. This is being brought to your attention to identify k as a pre-existing condition to the weatherization work planned for your home.Your signature is your acknowledgement of.these conditions.and agreement to proceed. AiR SEALING:Provide labor and materials-to install Q-ton weatherstripping and a doorswcep to(2)door(s)to restrict air leakage. $1,54.00 ATTIC FLAT:Provide labor and materials to install a 10"layer of R-37 Class.I Cellulose added to(1080)square feet of open attic $1.,447.20 space. ATTiC ACCESS:Provide labor and materials to insulate the back of(I).attic,batch with2"rigid Thermax board.Weatherstrip the $42:50 perimeter.. _ VENTILATION:Provide labor and materials to install(3;)8"diameter mof vent(s)to,increase ventilation in attic areas. The vent $261.45 can be supplied in(circle color)black VENTILATION:Provide labor and materials to install(1).insulated exhaust hose to.existing bathroom fan(s)'. $50.00 VENTILATION:Provide labor and materials toinstall ventilation chutes in(76)rufter bays to maintain air flow. S2OJ,l F. t RISE Engineering IS E 5 Dupont Ave,South G Yarmouth,MA 02664 CONTRACT �� pf,�� ENGINEERIN - 508-56A-1926, FAX.(401)784-3710 Page. 2 PROGRAM e THIS CONTRACT IS ENTERED INTO BETWEEN RISE: CLIC-HES -ENGINEERING AND THE CUSTOMER FORWORK.AS OEseRISEO BMW CUSTOMIYt PHONE DATE CLIENT If WORK ORDER CELINE MAH©NEY (617)650-0324 02/02/2017 233058 26102' SERVICE STREET .BILLING STREETe 79 Guimquissett Road 79 Guimquissett Road - .. SERVICE CITY,STATE,ZIPBILLING ......._._... ..,, _._..._.,.__.__.... ................_.._._,._._..w..._..... ...__�_._-- -&LLIND CRT,STATE,ZIP Cotuit,MA 02635 Cotuit,MA 02635 JOB-DESCRIPTI€IN INCENTIVE:RISE Engineering will apply all,applicable;eligible ince'ntives to this contract. You will be billed only the Net amount: $165.00 Currently,for eligible treasures,the Cap;Light Compact offers 75%incentive,not to exceed$4,000'per calendar year,antian incentive of 100%for the Air Sealing measures. For the safety and health of your home's indoor air duality,we might be conducting a blower door diagnostic of the available air flow in your home both before the work is begun,and after the weatherization work is complete(not to be conducted if asbestos is present).We will also conduct a diagnostic assessment of the combustion fumes in the exhaust flue of your heating system and water beater.This has a value of$90 and is if(no cost to you. 'The Permit will be secured by the insulation contractor.This has a value of$75 and is at no cost to you.It is the homcowner'si responsibility to close out this permit by contacting their municipality at the completion of this work. Total: $3,309.39 Program Incentive $2,7,92.79 r : Customer T'otai:`' _-".$516.60 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF "*Five.Hundred Sixteen&601100 Dollars $516:6d UPON FINAL INSPECTION AND APPROVAL BY RISE ENGINEERING.CUSTOMER AGREES TO.REMIT AMOUNT DUE IN FULL INTEREST OF IX WILL DE CHARGED MONTHLY ON ANY UNPAID BALANCE AFTER JO DAYS.SEE REVERSE FOP-IMPORTANT.INFORMATION ON GUARANTEES,RIGHTS OF,RECISION,SCHEDULING.AND CONTRACTOR REGISTRATION. AUTHORIZED SIGNATURE•RISE EAgln l.g CUSTOMER ACCEPTANCE NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHRI DATE OF ACCEPTANCE f .._...�.J_:.,_.. .... / ACCEPTANCE OF CONTRACT-•THE ABOVE PRICES.SPECIFICATIONS AND CONDITIONS ARE 30 DAYS, SATISFACTORY TO USAND ARE HEREBY ACCEPTED.YOU ARE AUTHORIZED TO 00 THE WORK AS SPECIFIED.PAYMENT YALL BE MADE AS OUTLINED ABOVE r Town of Barnstable Regulatory Services Rithard v':-Sc i i,Diredor v� i639. ♦� Building Division Toni Perry,Building(onunissiontr 240 fain Street,Hyannis,'-AA 02601 wmv:town.ba rnstable.maxs Office; 508-862-4038 Fxx. 508-7,90-6230 Prope:ty { wtie.r Must C o plete and, Sip 'bis Sec.tior : Alu as C)cmer of the subject ppr1;y l cn,b :aurlacari7e w acr.on.my behalf, in aI.1,tz mrs relative to work authonwd by this bu% p; er ut application for: U 1 K! 6'77 O. COT o n% M,4 0-26 3S .�{A.d.dress oE;�o�).. _ "Pool fences and al<ariw are the responsibility of dle appl cam. Pools are not to be filled or utilized before fence i� nstalled and,all final ad ,"Ml.poliormed and accepted. 'All Sigh tarm"Of Ovmer ,. S#at"Ure.Of''Appl wlt Punt wine PninG Nam, Da tte Q:FORiti']S:O��I':'F_}2�'�ti'�]SSIONPWLS f . � i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Q n , Parcel Application # / Health Division _ Date Issued Conservation Division Application Fee ` Planning Dept. Permit Fee �lv� Date Definitive Plan Approved by Planning Board Historic - OKH �_ Preservation / Hyannis . Project Street Address I �� +'� IV) rou'C>S e, RA Village Owner i PCenj V_� Address D nAdc S si'� S (CA Telephone I• 3 - r Permit Request e-ct S GM _ r Ci-a\ +' s4rorforp Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation v Construction Type_'rroorr-41, Lot Size Grandfathered: ❑Yes ❑ No If yes, attach w porting�4pcurontation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) c _ Age of Existing Structure ek Historic House: ❑Yes U/No On Old King s0Highwayar❑Ye`� allo UJ Basement Type: VFull ❑ Crawl O.Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq. ) rn Number of Baths: Full: existing new Half: existing n' `w Number of Bedrooms: -existing�L new Total Room Count (not including baths): existing newC First Floor Room Count Heat Type and Fuel: O/G as - ❑Oil ❑ Electric ❑ Other Central Air' ❑Yes Vo 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 XNo If yes, site plan review# Current Use Si6etlt - cgwxtkq fit, Mcneo. Proposed Use Scx(101, APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name a. Telephone Number Address qGu i'C-rrr i' e 9" T ' License# n co Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO , SIGNATURE l ` DATE i { e FOR OFFICIAL USE ONLY b � APPLICATION# DATE ISSUED t " MAP/PARCEL NO. • y F ADDRESS VILLAGE r OWNER DATE OF INSPECTION: `3 FO,UNDATIONICA D-14,N0 .,A_ FRAME y :i,INSULATION,L,' t FIREPLACE ELECTRICAL: ROUGH FINAL e PLUMBING: ROUGH FINAL j k. GAS: ROUGH FINAL E ; - FINAL BUILDING,, 1 DATE CLOSED OUT ASSOCIATION PLAN NO. s The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 600 Washington Street Boston,MA 02111 www.mass.gov/dhz Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Address: 94 TG� City/State/Zip: I Phone #: yo I ZGs J 64_? Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑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 g• ❑Demolition workingfor me in an capacity. employees and have workers' Y P tY• # 9. ❑Building addition [No workers' comp. insurance comp.insurance. required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 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: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Si ature: �-=, �� Date: CMG l7 Phone#: y U Official use only. Do not.write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: I I ' 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-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited LiabilityTartnerships(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 subrnif ne 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 Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 4-24-07 www.mass.gov/dia Page 1 of 3 Lauzon,Jeffrey From: Celina Mahoney[bomae@me.coml Sent: Tuesday,June 11,2013 12:05 PM To: Lauzon,Jeffrey Subject:Decking for Permit&Heating Item for 79 Guimquissett,Cotuit Jeff, First,thanks for time to introduce yourself yesterday. I am sure this time of year becomes a circus with the out of town traffic all looking to do work around the same time. I believe I've covered the items of concern in the attached re-adjusted specs for the deck. Please-advise if the attached drawings work for you. Concerning the breezeway,I was incorrect on the current heating. There currently is heating within the current breezeway so we will not need to bring any from the kitchen area. If you need some pics I can have my wife take some.Since the heat is already there and we are doing less than a 50%rehab in the breezeway will this satisfy the heating issue we discussed. Thanks, Brendan k Slm_psom rger P N �Ed'' - fi4W JKCR 4 If,Wz ", �#Ziff PT ,. �� •, � ��' '.t ��`�"' ,� � �� t � �a � � �,r � ♦S�"r °`$.'. (f'f �8ar � a�`-- �' � �J % t x��ys;.� "—r aa` � fi �� ;� .. `� �.�1�n`� `z"� fia,ar' '�S x�t ` - ��.�•,.:�Y �,�+ F pS d�c`� �a'*4�, �.�,- .. N'S .. zt O VIA +' ,... 6/14/2013 Page 2 of 3 `: k`f:o-• fir, *' ""- :,, 3 j .' �4.• {a b, .. �. .,* rah I F �� 2�v 6a ter + � 2#gypfi" " a F k4 `E � . VID "s£ "iSrM1t.'.E'j� 49U€�nttSOnt?17 IYIID d5 y -M 1 rS11 s�'dap t f'. y; `` y?,r A 41,ss�' r,�2a £�x�°2 I"'.4 •"fi AF`?8'..f&z� '� Y4L Y��J'•, 5 i� C" i-�i 3pp'£ ^��` �{s+;?S �' #'. Ac y, �tAiZ 2 �s3• �a9`�J r`.Fag R ry s`x. ET �y .e .& »�ISO,` AN b.f '„V rr , d 8 p + '�'� � IN e. �' " 'yf` �.��+ssx�, ~�Alum Flashing SDs screws , 101, rrr tou9h��5n0 Noa7 > b 1g � 6/14/2013 Page 3 of 3 �. V, m.k rpm 4A F blocks as needed t. 7 w u '^t c q N&I Pol, 71 s * g� " a n �Sr a " �dCrui .'��' t,�;.,`,, ,k.,,ay.a "-yak: -',✓; a T€ a"Ta e'§ fe n ✓d`m"f d+§a x ��,NINA { �5t ., -F a " sMrc? Vol vim e `'�` �� 5,9 �` ry t r w G2K ' #is M, 7 "fit, -got N a4 `a}`;� ?^, pax c '�� & � ra 1i <`16 7p vR¢kX WAN $ � s 2 ro t 3,( ep e t #s r�$ F IA i �` r�+wu $, � its" t '�' �-.a0.� za, t r' x 7 y. �' x4 ��§'�� i �"e�,'u��, S'$ate� �^6�� J j �E '-s �j'�.`{xp�l .#� p F S` f,y_ ��rf '^'t$ ��w ^'4.� '•'r 'e.'.11 'Y 'h" &�L j'. r IN 6/14/2013 The Commonwealth of Massachusetts = Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): � 4C Address: City/State/Zip: Phone#: Are you an employer?Check the appropriate box: Type of project(required): L❑ I am a employer with 4. a/neral contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. U24t'emodeling ship and have no employees These sub-contractors have g• ❑Demolition workingfor me in an capacity. employees.and have workers' y p �'• 9. ❑Building addition [No workers' comp. insurance comp. insurance.t quired.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3. 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 n employees. [No workers' 13.❑ Other l— comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an.additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lie-#:- Expiration Date: -Job Site Address City/State/Zip:' Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for.insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided ab ve is a and correct Si ature: A-. A2 14,AA Date: Phone#: Official use only. Do not write-in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: 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-contractor(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 Commonwealth of Massachusetts _ .. Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 4=24-07 wwvv.mass.gov/dia �tH Town of Barnstable Regulatory Services '"jtj'bT MASS. Thomas F.Geiler,Director —39. Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION �O Please Print DATE: Pd, � � � �JOB LOCATION: U number i 1 q.�I Js_treet village ..HOMEOWNER": ' 0 T r"trKflfd&�1 rYA11 name home phone# work phone# CURRENT MAILING ADDRESS: - Lanwisfor Law �/� ¢ H 1 Ifft(V /`-1�'I• 0,Q l fJ city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor: DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, - bylaws,rules and regulations. ' "homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection The undersignedg P P pro dures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content0utlook\QRE6ZUBN\EXPRESS.doc ''l Revised 053012 of rti Town of Barnstable �+ Regulatory Services ,Thomas F. Geiler,Director i � Mass. . '°rFnrr►a�° Building Division Tom Perry,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 L Y , as Owner of the subject property G -C hereby authorize_1�➢�JQ; K rr _ r,<'�Y ft = to act on my behalf, in all matters relative to work authorized by this building permit. -7 Col"ermis-Noif (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Ca. MIL4 Signature of Own r Signature of Applicant I'. e. 9 Cp—I- CZ one Print Name Print Name Date Q:FORM&OWNERPERNSSIONPOOLS 6/2012 irk MASSACHUSETTS ASSOCt ATION or REALTORS• STANDARD PURCHASE AND SALE AGREEMENT 1#5031 (With Continoeticies) The parties make this Agreement this (9 tu day of k, , c� (� This Agreement supersedes and replaces all obligations made in any prior Contract To PurchaS o� r agreement for sale entered into by the parties.- 1. Parties. Robert F. Hayden IV 2009 Trust and Mary Ellen Hayden 2009 Trust,60 Cheoh Road Cotui. MA 02635 [insert nante], the"SELLER,"agrees to sell and Brendan Mahoney and Celine Mahoney 9040 Byron Avenue, Surfsid FL 33154 [insert name), the "BUYER,"agrees to buy,,the premises.described in paragraph 2 on the terms set forth below. BUYER may require the conveyance to be made to another person or entity ("Nominee") upon notification in writing to SELLER at least five business days prior to the date for performance set forth in paragraph 5. Designation of a Nominee shall not discharge the BUYER from any obligation under this Agreement and BUYER hereby agrees to guarantee performance by the Nominee. 2. Description Of Premises.The premises(the"Premises")consist of: (a)the land with any and all buildings thereon known as 79 Guimquissett Road, Cotuit MA 02635 as more specifically described in a deed recorded in the Barnstable Registry of Deeds at Book 24803 ,Page 99 ,[Certificate, No. ],a copy of which ❑is 0 is not[choose one]attached;and (b) alI structures, and improvements on the land and the fixtures, including, but not limited to: any and all storm windows and doors, screens, screen doors, awnings, shutters, window shades and blinds, curtain rods, furnaces, heaters, heating equipment, oil and gas burners and fixtures, hot water heaters, plumbing and bathroom fixtures, towel racks, built-in dishwashers, garbage disposals and trash compactors, stoves, ranges, chandeliers, electric and other lighting fixtures, burglar and fire alarm systems, mantelpieces, wall-to-wall carpets, stair carpets, exterior television antennas and satellite dishes, fences, gates, landscaping including trees, shrubs, flowers; and the following built-in components, if any: air conditioners,vacuums systems,cabinets, shelves,bookcases and stereo speakers,and all appliances seen by Buyer dLwinq home in tion but excluding N/A [insert references to refrigerators, dishwashers,microwave ovens,washing inachines,dryers or other items,where appropriate] 3. Purchase Price.The purchase price for the Premises is$ 321,000.00 dollars of which $ 2,000.00 were paid as a deposit with Contract To Purchase;and $ 10,000.00 are paid with this Agreement; $ are to be paid NIA ;and S 309,000.00 are to be paid at the time for performance by bank's,cashier's,treasurer's or certified check or by wire transfer. S 321,000.00 Total , 4. Escrow. All funds deposited or paid by the BUYER shall be held in a non-interest bearing escrow account, by REIMAX Classic , as escrow agent, subject to the terms of this Agreement and shall be paid or otherwise duly a counted for at t1w time forHarformance.If a ram..- BUYER'S Initials BUYER'S Initials BUYER'S Initials SELLER'S Initials S LE 'S Initials SELLER'S Initials MASSFORMS" 01999,2000,2002,.200b,2007,2008,2010,2012 MASSACHUSETTS ASSOCIATION OF REALTORSO SW COICSIOWW4 Rtd W tt Foram wm Fonn No.503 Setiatt..04009.606126.7624709 1,61.1 11 s 1111])[I C i t)v PtCparedhy:D9bOtahSc3u'Cing I RFJA+AXCtass}C�dobQonest0phomes.com� stjft arises between the BUYER and SELLER concerning to whom escrowed funds should be paid, the escrow agent wApt retain all escrowed funds pending written instructions mutually given by the BUYER and the SELLER. The escrow agent shall abide by any Court decision concerning to whom the funds shall be paid and shall net be made a paTty-*-a w gent shall pay the 5. Time For Performance. The SELLER shall deliver the deed and the BUYER shall pay the balance of the purchase price at 1 o'clock P. m. on the 7 day of June 2013 ,at the Barnstable Registry of Deeds, or at such other time and place as is mutually agreed in writing. TIME IS OF THE ESSENCE AS TO EACH PROVISION OF THIS AGREEMENT. Unless the deed and other documents required by this Agreement are recorded at'the time for performance, all documents and funds are to be held in escrow, i pending prompt rundown of the title and recording (or registration in the case of registered land). SELLER'S attorney or other escrow agent shall disburse funds the next business day following the date for performance, provided that the recording attorney has not reported a problem outside the recording attorney's control. 6. Title/Plans. The SELLER shall convey the Premises by a good and sufficient quitclaim deed running to the Buyer or to the BUYER'S nominee, conveying good and clear record and marketable title to the Premises, free from liens and encumbrances,except: (a)Real estate taxes assessed on the Premises which are not yet due and payable; (b)Betterment assessments,if any,which are not a recorded lien on the date of this Agreement; (c) Federal, state and local laws, ordinances, bylaws, rules and regulations regulating use of land, including building codes, zoning bylaws,health and environmental laws; (d)Rights and obligations in party walls; (e) Any easement, restriction or agreement of record presently in force which does not interfere with the reasonable use of the Premises as now used; (f)Utility easements in the adjoining ways; (h) N/A (insert in(h)references to any other easement, restriction,lease or encumbrance which may continue after title is transferred) If the deed refers to a plan needed to be recorded with it, at the time for performance the SELLER shall deliver the plan with the deed in proper form for recording or registration. 7. Title Insurance. BUYER'S obligations are contingent upon the availability (at normal premium rates) of an owner's title insurance policy insuring BUYER'S title to the premises without exceptions other than the standard exclusions from coverage printed in the current American Land Title Association ("ALTA") policy cover, the standard printed exceptions contained in the ALTA form currently in use for survey matters and real estate taxes (which shall only except real estate taxes not yet due and payable)and those exceptions permitted by paragraph 6 of this Agreement. S. Closing Certifications and Documents. The SELLER shall execute and deliver simultaneously with the delivery of the deed such certifications and documents as may customarily and reasonably be required by the BUYER'S attorney, 2 Z7161 9UYER'S Initials BUYER'S Initials BUYER'S Initials SELLER'S Initials SELLER'S I rtials SELLER'S Initials MASSFORMS" 111111,2000,2002,2006,2007,2008,2010,2012 MASSACHUSETTS ASSOCIATION OF REALTORS0 a*= SmnwtEesu aedr�uueercu Form No.503 .............. serielx 640469-60013e-7624705 �t3r111SI1111S1C11y Prepared by:Oebwah SclOng I RFJMAX Classic I cob@onesiophomes.com r BUYER'S lender,BUYER'S lender's attorney or any title insurance company insuring the BUYER'S title to the Premises, including, without limitation, certifications and documents relating to: (a) parties in possession of the premises; (b) the creation of mechanics' or materialmen's liens; (c) the HUD-1 Settlement Statement and other financial affidavits and agreements as may reasonably be required by the lender or lender's attorney;(d)the citizenship and residency of SELLER as required by law;and(1)information required to permit the closing agent to report the transaction to the Internal Revenue Service.At the time of delivery of the deed,the SELLER may use monies from the purchase to clear the title,provided that all documents related thereto are recorded with the deed or within a reasonable time thereafter acceptable to the BUYER and, provided further, that discharges of mortgages from banks, credit unions, insurance companies and other institutional lenders may be recorded within a reasonable time after recording of the deed in accordance with usual conveyancing practices. The SELLER'S spouse hereby agrees to release all statutory, common law or other rights or interest in the Premises and to execute the deed,if necessary. 9. Pon—talon And Condition OLPre,mises.At the time for performance the SELLER shall give the BUYER possession of the en ire Premises,free of all occupants and tenants and of all personal property,except property included in the sale or tenants permitted to remain. At the time for performance the Premises also shall comply with the requirements of paragraph 6, and be broom clean and in the same condition as the Premises now are, reasonable wear and tear excepted, with the SELLER to have performed all maintenance customarily undertaken by the SELLER between the date of this Agreement and the time for performance, and there shall be no outstanding notices of violation of any building, zoning, health or environmental law, bylaw, code or regulation, except as agreed. The BUYER shall have the right to enter the Premises within forty-eight (48) hours prior to the time for performance or such other time as may be agreed and upon reasonable notice to SELLER for the purpose of determining compliance with this paragraph.At the time of recording of the deed,or as otherwise agreed, the SELLER shall deliver to BUYER all keys to the Premises, garage door openers and any security codes. Until delivery of the deed, the SELLER shall maintain fire and extended coverage insurance on the Premises in the same amount as currently insured. 10.Extension Of Time For Performanee. If the SELLER cannot convey title as required by this Agreement or cannot deliver possession of the Premises as agreed, or if at the time of the delivery of the deed the Premises do not conform with the requirements set forth in this Agreement or the BUYER is unable to obtain title insurance in accordance with paragraph 7,upon written notice given no later than the time for performance from either party to the other,the time for performance shall be automatically extended for thirty (30) days, except that if BUYER'S mortgage commitment expires or the terms will materially and adversely change in fewer than thirty(30)days,the time for performance set forth in paragraph 5 shall be extended to one business day before expiration of the mortgage commitment. SELLER shall use reasonable efforts to make title conform or to deliver possession as agreed, or to make the Premises conform to the requirements of this Agreement. Excluding discharge of mortgages and liens, about which the SELLER has actual knowledge at the time of signing this Agreement,the SELLER shall not be required to incur costs or expenses totaling in excess of one-half(1/2)of one percent of the purchase price to make the title or the Premises conform or to deliver possession as agreed. If at the expiration of the time far performance, or if there has been an extension, at the expiration of the time for performance as extended,the SELLER,despite reasonable efforts,cannot make the title or Premises conform, as agreed,or cannot deliver possession, as agreed, or if during the period of this Agreement or any extension thereof,the SELLER has been unable to use proceeds from an insurance claim,if any,to make the Premises conform,then,at the BUYER'S election,any payments i 3 ROMS nrtra s BUYERS n3 r alsBUYEWS Initia s L 'S nitsls SELLERTInd—laTs SELLEWS Inch .. i IvWsFoRmsm ®1999,2000,2002,2006,2007,2008,2010,2012 MASSACHUSETTS ASSOCIATION OF REALTORM s..enaameu aKm. Form No.S03 s so 04GM4M3W624 s 1(31'lllsllllnliClC\' PdY� hs9 1 N&AAA7tCmsak i dan�onasto�apesoom{ t� I, i i i i i made by the BUYER pursuant to this Agreement shall be immediately returned. Upon return of all such funds, all obligations of the BUYER and SELLER shall terminate and this Agreement shall automatically become void and neither the BUYER nor SELLER shall have further recourse or remedy against the other. 11. Noneoy-Onrmance Of Premises. If the Premises do not conform to the requirements of paragraph 9 because they have been damaged by fire or other casualty(occurring after the date of this Agreement) that is covered by insurance,then the BUYER shall have the right to elect whether or not to proceed to accept the Premises and take title.If BUYER elects to proceed BUYER shall have the right to elect to have the SELLER pay or assign to the BUYER, at the time for performance,the proceeds recoverable on account of such insurance, less any cost reasonably incurred by the SELLER for any incomplete repairs or restoration. If the SELLER, despite reasonable efforts, has neither been able to restore the Premises to its former condition nor to pay or assign to the BUYER the appropriate portion of insurance proceeds, the BUYER shall have the right to elect to have the SELLER give the BUYER a credit toward the purchase price, for the appropriate amount of insurance proceeds recoverable less any costs reasonably incurred by the SELLER for any incomplete restoration. 12. Acceptance Of Deed. The BUYER shall have the right to accept such title to the Premises as the SELLER can deliver at the time for performance and if extended, shall have such right at the time for performance, as extended. The BUYER shall also have the right to accept the Premises in the then current condition and to pay the purchase price without reduction of price. Upon notice in writing of BUYER'S decision to accept the Premises and title, the SELLER shall convey title and deliver possession. AcceptanAr l;eMUC1#%he BUYER or BUYER'S nominee, if any, shall constitute full performance by the SELLER and shall be deemed to release and discharge the SELLER from every duty and obligation set forth in this Agreement, except any duty or obligation of the SELLER that the SELLER has agreed to perform after the time for performance.Notwithstanding the foregoing, all warranties, if any, made by the SELLER shall survive delivery of the deed. 13, Adjustments. At the time for performance of this Agreement adjustments shall be made as of the date of performance for current real estate taxes, fuel value, water rates, sewer use charges, collected rents, uncollected rents (if and when collected by either party), security deposits, prepaid premiums on insurance if assigned. The net total of such adjustments shall be added to or deducted from the purchase price payable by'the BUYER at the time for performance. If the real estate tax rate or assessment has not been established at the time for performance, apportionment of real estate taxes shall be made on the basis of the tax for the most recent tax year with either patty having the right to request apportionment from the other within twelve months of the date that the amount of the current year's tax is established.flf tenants will continue to occupy the Premises, use of the Rental Property Addenthan to Purchase And Sale Agreement should be considered] 14.Acknowledgment Of Fee Due Broker.The SELLER and BUYER acknowledge that a fee of 16075 ( Sixteen thousand seventy five dollars )for professional services shall be paid by the SELLER to REIMAX Class ,the"BROKER",at the time for performance. bev,veee"4@mr, of this Ag;88FAM ARd 8 PFiGF feg 148FOOFAGIA With BROKER, thS WFMS of(lie prier fee agreement 1 -eentVal..fire"" RRrrr~nn has a sl , eed W " change itiA . The BUYER and SELLER acknowledge receipt of a notice fi•om BROKER,pursuant to 254 of the Code of Massachusetts Regulations Section 3.0(13),regarding any agency BVJ1'�nitials BUYER'S Initials BUYER'S Initials SELLERS Initials SELLER'S Initials SELLER'S Initials MASSFORMS- rr&+1999,2000,2002,2006,2007,2008,2010,2012 Iv1ASSACHUSETTS ASSOCIATION OF REALTORSO sti;ehwesunavd 0ed rants serau Form No.503 Satiaw:0d0609•G0036.7626700 t 'PrMred by.Debamh SchMng(RERAM ClaWc►deb@onestophomes.com I �c w n S I I I I I]I I C;I N i relationship of the BROKER with the BUYER and/or the SELLER. The BUYER and SELLER understand that Keller Williams RE [insert dame],a real estate broker,is seeking a fee from RE/MAX Classic 50/50 split [name of listing broker, seller or buyer, if applicable]for services rendered as a ❑seller's subagent buyer's agent ❑fac,ilitator (nan-age-- [choose one]. The BUYER further represents and warrants that there is no other broker with whom BUYER has dealt in connection with the purchase of the Premises. 15.Buysr's Default. If the BUYER or BUYER'S Nominee breaches this Agreement, all escrowed funds paid or deposited by the BUYER shall be paid to the SELLER as liquidated damages. Receipt of such payment shall constitute the SELLER'S sole remedy, at law, in equity or otherwise, for BUYER'S default. The BUYER and SELLER agree that in the event of default by the BUYER the amount of damages suffered by the SELLER will not be easy to ascertain with certainty and, therefore, BUYER and SELLER agree that the amount of the BUYER'S deposit represents a reasonable estimate of the damages likely to be suffered. 16. Buyer's Financing. (Delete if Waived) The BUYER'S obligation to purchase is conditioned upon obtaining a written commitment for mortgage financing in the amount of$ 258,000.00 at prevailing rates,terms and conditions by 5/31/2013 The BUYER shall have an obligation to act reasonably diligently to satisfy any conditions within BUYER'S control. If, despite such diligent efforts, the BUYER has been unable to obtain such written commitment the BUYER may terminate this Agreement by giving written notice that is received by SELLER or SELLER'S agent by 5:00 p.m. on the calendar day after the date set forth above. In the event that notice has not been actually or constructively received, this condition is deemed waived. In the event that due notice has been received, all monies deposited or paid by the BUYER shall be returned and all obligations of the BUYER and SELLER pursuant to this Agreement shall cease and this Agreement shall become void. In no event shall the BUYER be deemed to have used reasonable efforts to obtain financing unless the BUYER has submitted at least one(1) application to a licensed mortgage lender by 3 days from the signing of thisa` NNAeasonably promptly in providing any additional infonnation requested by the mortgage lender. 17. Tnsoections/Survey. (Delete if Waived) The BUYER has had an opportunity to conduct all inspections and accepts the condition of the property as is, subject to any work expressly agreed in writing to be performed at the expense of SELLER. Notwithstanding the foregoing, the BUYER has 0 days from the date of this Agreement to complete inspection of by consultant(s) regularly in the business of conducting said inspections, of BUYER'S own choosing, and at BUYER'S sole cast. If the results are not satisfactory to BUYER, in BUYER'S sole discretion, BUYER shall have the right to give written notice received by the SELLER or SELLER'S agent by 5:00 p.m, on the calendar day after the date set forth above, tcrininating this Agreement. Upon receipt of such notice this Agreement shall be void and all monies deposited by the BUYER shall be returned. Failure to provide timely notice of termination shall constitute a waiver. In the event that the BUYER does not exercise the right to have such inspection(s) or to so terminate, the SELLER and the listing broker are each released from claims relating to the condition of the Premises that the BUYER or the BUYER'S consultants could reasonably have discovered. IS. Lead Paint Laws. For premises built before 1978 BUYER acknowledges receipt of the "Department of Public Health Property Transfer Notification" regarding the Lead Law, acknowledges verbal notification of the possible presence of lead hazards and the provisions of the Federal and Massachusetts Lead Laws and regulations, including the right to inspect for dangerous levels of lead. Occupancy of premises containing dangerous levels of lead by a child under six years of age is prohibited, subjected to exceptions permitted by law. BUYER further acknowledges that neither the SELLER nor any real estate agent has made any representation,express or implied,regarding the absence of lead paint or compliance with 5 BUR'S Initials BUYER'S Initials BUYER'S Initials SELLER'S Initials SELLER'S Init' Is SELLER'S Initials yn, eid-- MASSFORMS'" C01999,2000,2002,2006,2007,2008,2010,2012 MASSACHUSETTS ASSOCiATION OF REALTORS@ Sretr..fde9uadW Rw1Line Fare Fomi No.503 121 x� Sedalg:040469b00136.7E2A709 1'1?lti�l?? ��1C111' Prepared by;Oebomh SchiVing 1 RFJMAX Classic I deb@cneslaphomes.com f any lead law, except as set forth in writing. BUYER assumes full responsibility for compliance with all laws relating to lead paint removal, if required by law,and related matters(in particular,without limitation, Mass. G.L.,c. 111,§ 197),and BUYER assumes full responsibility for all tests, lead paint removal and other costs of compliance.Pursuant to 40 CMR 745.113(a),the Property Transfer Notification Certification is attached to this agreement. 19. Cerocate of AWaay-d Installation. The SELLER shall equip the residential structure on the Premises with approved smoke detectors and carbon monoxide detectors and furnish BUYER with Certificate of Approved.Installation from the local Fire Department at the time for performance to the extent required by law as well as any wood stove permit, if any,required by law,regulation or ordinance. 20.W-arraaties And Representations. The SELLER represents and warrants that the Premises ( ❑is not[choose one] served by a septic system or cesspool. Of yes, a copy of the Title 5 Addendum is attached.] The SELLER farther represents that there ❑is an/ ❑is no or El has no knowledge ofan[choose one]underground storage tank or an unapproved and abandoned septic tank. The SELLER further represents and warrants that SELLER has full authority to enter into this Agreement. The buyer is not relying upon any representation, verbal or written, from any real estate broker or licensee concerning legal use. Any reference to the category (single family, multi-family, residential, commercial) or the use of this property in any advertisement or listing sheet, including the number of units, number of rooms or other classification is not a representation concerning legal use or compliance with zoning by-laws, building code,sanitary code or other public or private restrictions by the broker.The BUYER understands that if this information is important to BUYER, it is the duty of the BUYER to seek advice from an attorney or written confirmation from the municipality. In addition, the BUYER acknowledges that there are no warranties or representations made by the SELLER or any broker on which BUYER relies in making this Offer, except those previously made in writing and the following: NONE i [If none,state "none",•if any listed, indicate by whom the warranty or representation was made.] 21. &Mg All notices required or permitted to be made under this Agreement shall be in writing and delivered in hand, sent by certified mail, return receipt requested or sent by United States Postal Service overnight Express Mail or { other overnight delivery service, addressed to the BUYER or SELLER or their authorized representative at the address set I forth in this paragraph. Such notice shall be deemed to have been given upon delivery or, if sent by certified mail on the ? date of delivery set forth in the receipt or in the absence of a receipt three business days after deposited or, if sent by overnight mail or delivery,the next business day after deposit with the overnight mail or delivery service,whether or not a signature is required. Acceptance of any notice,whether by delivery or mail, shall be sufficient if accepted or signed by a person having express or implied authority to receive same. Notice shall also be deemed adequate if given in any other form permitted by law.[If there are multiple buyers, identify the mailing address of each buyer in paragraph 23.1 BUYER Brendan Mahoney and Celine Mahoney 9040 SELLER Robert F. Hayden IV 2009 Trust and Mary Byron Avenue, Surfside Ellen Hayden 2009 Trust,60 Cheoh Road Cotult Address: Address: 22. Counterparts / Electranic Delis m t Construction Of Agreement. This Agreement may be executed in counterparts. All documents related to this transaction may be delivered electronically, including by encrypted email or facsimile,and shall have the same effect as delivery of an original.This Agreement shall be construed as a Massachusetts contract;is to take effect as a sealed instrument;sets forth the entire agreement between the parties; 's binding upon cxd- TV- 6 B 'S Initials BUYER'S Initials BUYER'S Initials SELLER'S Initials SELLER'S Initials SELLER`S Initialss MMSFORMS" ®t999,2000,2002,200G,2007,2008,2010,2012 MASSACHUSETTS ASSOCIATION OF REALTORS@ Form am3 1 w i SOrid�W06696aWSW8ttT09 1 J's Pq-ddhr.D MMhSdMV I RS/M"CUM�1 d�oneMph6M88=m I lorniSinipl1C1ty j f and is intended to benefit the BUYER and SELLER and each of their respective heirs, devisees, executors, administrators,successors and assigns; and may be canceled, modified or amended only by a,written agreement executed by both the SELLER and the BUYER.If two or more persons are named as BUYER their obligations are joint and several. If the SELLER or BUYER is a trust, corporation, limited liability company or entity whose representative executes this Agreement in a representative or fiduciary capacity,only the principal or the trust or estate represented shall be bound,and neither the trustee, officer, shareholder or beneficiary shall be personally liable for any obligation,express or implied.The captions and any notes are used only as a matter of convenience and are not to be considered a part of this Agreement and are not to be used in determining the intent of the parties. Any matter or practice which has not been addressed in this agreement and which is the subject of a Title Standard or Practice of the Real Estate Bar Association for Massachusetts, formerly known as the Massachusetts Conveyancers Association, at the time of performance shall be governed by the Standard of Practice of the Massachusetts Real Estate Bar for Massachusetts. 23.Ali ditiond rm4sions. Seller to install 3 BR septic system in compliance with Title V regulations, as per engineerlm plan provided to buyer for review.Work to be completed in workmanlike manner with Certificate of P Compliance to be presented within 5 business days of completion of work, but no later than 5 business days i prior to closin .Grad ma—to be done in disturbed areas,but no loam or seeding. BuXers acknowledge that they have had opportunity to conduct inspections of premises prior to signing Purchase and Sales,and are are purchasing premisT is condition,excepting Septic Installation. I See Rider A Attached hereto and mft a P= hereof. � I i UPON SIGNING,THIS DOCUMENT WILL,BECOME A LEGALLY BINDING AGREEMENT. IF NOT UNDERSTOOD,SEEK ADVICE FROM AN ATTORNEY. Signature: B:anCen Date Email: bmahoney@emc-corp.net Signature: SE ER,or spouse t/ ate C,,-ble 9ahcneyiWa'r 2L'7".i Email: bcmae@mac.com 4 i BUYER Date SELLER,or spouse Date draw Aggat By signing below, the escrow agent agrees to perform in accordance with paragraph 4, but does not otherwise become a party to this Agreement. ESCROW AGENT or representative Date b� cnCat_ ' BUYER'S Initials BUYER'S Initials BUYER'S Initials SELLER'S Initials SE L.ER1 Initials SELLER'S Initials MMSFORW 01999 2000,2002,2006,2007,2006,2010,2012 MASSACHUSETTS ASSOCIATION OF REALTORS@ se,UWft s=,a RAd Bum Farm. Yo m x- seem ik odoecc.sOt ivrsum fornisimplicity. _ i RIDER"A" PROPERTY: 79 GUIMQUISSETT ROAD,COTUIT,MA 1. NOTICE: All notices required or permitted to be given hereunder shall be in writing and delivered by hand or mailed postage prepaid,by registered or certified mail,by facsimile with proof of transmission addressed to the stated respective representative,or by electronic mail In the case of Seller to: SELLER In case of Buyer to: Bryan W.Reardon,Esquire Dubin&Reardon 1645 Route 28 Centerville,MA 02632 Tel: (508)771-0330 Fax: (508)778-7624 email: breardon(@dubinreardon.com or in the case of either party to such other addresses as shall be designated by written notice given in such manner to the other party. Mailed notice shall be deemed given upon deposit in the United States Postal Service so long as notice is faxed to the representative stated above,or sent by electronic email,or if given by hand, at the time of delivery or receipt . Each,party hereby appoints their respective representative as stated above to be their lawful attorney-in-fact for the purposes of the execution of extensions to time limitations set forth in this Agreement. 2. TAXPAYER CERTIFICATION NUMBER: At the time of the delivery of the Seller's deed,the Seller shall execute and deliver to the Buyer and any title insurance company insuring title to the premises(for the Buyer or for any lender granting mortgage financing to the Buyer with respect to the premises)either(i) affidavits setting forth that the Seller is not a foreign person or foreign corporation and providing the Seller's United States Taxpayer Identification Number,or(ii) such other documentation.as is required by Section 1445 of the Internal Revenue Code and any regulations promulgated thereunder that would exempt the Seller and/or exempt the sale of the premises from the provisions of said Section.1445. The Seller agrees to execute and deliver to the Buyer's attorney a certification, signed under the penalties of perjury,of the Seller's taxpayer identification number and of the Seller's present and/or future mailing address. I 3. REBA STANDARDS: Any matter which is the subject of a title or practice standard of the Real Estate Bar Association of Massachusetts at the time of closing shall be governed by such standard to the extent applicable. 1 1 l r 4. TITLE REQUIREMENTS: Notwithstanding anything herein contained,the premises shall not be considered to be in compliance with the provisions of this Agreement with respect to the title unless: a. no building,structure,improvement,property,way,or prescriptive rights or easements,belonging to any other person or entity, encroaches upon or under the premises from other premises; b. all structures and improvements on the premises and all means of access to said premises shall be wholly within the lot lines of said premises and shall not encroach upon or under any property not within said lot lines; c. title to the premises is insurable for the benefit of the Buyer,by a title insurance company,in a fee owner's policy of title insurance at normal premium rates,using the American Land Title Association form currently in use,subject only to the printed exceptions to title normally included on the`Jacket"to such form or policy and such other exceptions permitted under Paragraph 4 hereof; d. the premises shall abut and have legal access to a public way or way or ways over which the Seller shall have an expressly granted right of way to a public way,which right shall be transferable to the Buyer and included in the deed to be delivered hereunder. 5. TITLE INSURANCE: At the time of the delivery of the Seller's deed,the Seller shall execute and deliver affidavits and indemnification forms regarding the following:mechanic's liens,materialman's liens,and parties in possession sufficient to eliminate any title insurance exceptions for these matters. The Seller will execute a survey affidavit as is commonly accepted by any title insurance company providing title insurance with respect to the premises and any affidavits and certificates as are customarily required by a lender granting mortgage financing to the Buyer with respect to mortgage loans for transactions of this type. The Buyer or the Buyer's lender will provide said affidavits,indemnifications and certificates. 6. DELMRY OF THE EREMISES:At the time of closing SELLER shall deliver the premises to BUYER in broom clean condition with all rubbish,debris,or other items of personal property not otherwise conveyed or remaining at the Premises,removed by SELLER. SELLER shall also deliver to BUYER all keys to the premises and any warranties for appliances,fixtures or improvements. BUYER shall be allowed to inspect the premises immediately prior to the closing to confirm that the premises comply with this paragraph and Paragraph 9 of this Agreement. 2 �� 7. ACCESS TO PREMISES:Upon reasonable notice to SELLER or the broker (which need not be in writing)and in the presence of Seller or Seller's representative,the BUYER and/or the BUYER's designees,agents and representatives,shall have the right to enter upon the Premises from time to time and make such investigations,surveys,tests,examinations and the like as the BUYER deems necessary or appropriate in connection with the performance of this Agreement. BUYER shall indemnify and hold SELLER harmless for all liability arising out of such entry upon the Premises. 8. BINDING SIGNATURES: This Agreement may be executed in multiple counterparts,and may be executed by facsimile or electronic(scan and email) signature and as so executed shall constitute one document. 9. REPRESENTATIONS OF SELLER: SELLER represents to BUYER that,to the best of SELLER's knowledge,information and belief,and without undertaking an actual investigation;(a)there are no underground fuel storage tanks on the Premises;(b)there is no asbestos present on the Premises;(c)there is no litigation or proceedings,pending or threatened,against or relating to the Premises;(d)there are not now,and will not be,any outstanding agreements with any party pursuant to which any parties have or could acquire an interest in the Premises(other than outstanding mortgages),including any tenancy and occupancy agreements which affect the Premises and which will survive the closing,and(e)the Premises and the present uses on the Premises are not in violation of applicable zoning,building and subdivision laws and regulations.The representations by Seller in this paragraph shall survive the delivery and recording of the deed. Seller further represents that Seller is not the petitioner in any bankruptcy proceeding,presently or in the past. 10. The Buyers' obligation to perform is contingent upon the bank appraisal equaling or exceeding the purchase price noted herein. INTENTIONALLY BLANK �G 32 �" 10. Seller hereby authorizes conveyancing attorney to obtain payoff information, from Seller's mortgage(s)or other security holder(s)listed below and in connection therewith hereby authorizes any equity mortgage lender(revolving line of credit)to freeze the equity account. The Seller hereby authorizes the mortgagee(s),upon receipt of the payoff funds, to close the account and forward a discharge of the mortgage in accordance with the instructions provided with the payoff check. 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JL" _3 A PIG"Cms ex S 1p froW�6 o . 5z '7z t ��' C5-:A BoTrONA 97 K'zTG��t� t3 Pic-2 �L CI& 9c POST nit T t.tP 0 Spit"-' Z--Cy �Osr "(U ex eztab <- w zl" WwLeb 'N4brn `L GILL, PputS-'Vest WALL, �s�p ��- c' 2�, ado p��ar.�to 51 a� r, N�S r� 16 D C�DhM0�.1 tv�lls' . ` 1 � a lbx -- �� E 1. LA& 1} fl 2at0 yw� Wc-�.sic. ` t7t:a1 OLD AW; RIr acOVL ALI, POSt'S i G t \ - �� r ll:sa�,PI -ISV TOWN OF ISARNSTARi 4 7- Assessor's map and lot number ...�.(..—... s D _ "�� ' SEPTIC SYSTEM MUST 6 pFTNET�� 2 INSTALLED IN COMPUA `Sewage Permit number ....:�..../f�1 .:..........................' _�i . VM "• A 11 Z B9SH9TYDLE, i House number Q ENVOMMENTAL CODE "A°a . .: ............................................. 1 639. 00 TOWN AEGULATlO 0 TOWN BARN-STABLE BUILDING -11"NSPECTOR APPLICATION FOR PERMIT TO . a . .. .... ........ TYPEOF CONSTRUCTION ....... ........................................................:............................................ ............................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: yam^ Location .... ..........! .........Y-4fl..f . .. . :�. £.�....Proposed Use ....... ................................................................. ..L................................,......................... Zoning District ..... ............................ ....Fire District ....C 0.� ........................ ................................................................ Name of Owner <... ...-4,. X-Address ..../...�. aiu�� i�:.....`' iz ev Name of Builder ...� �� ............... Address ....1Q.u��. �iG... :... �. Nameof Architect ..................................................................Address .................................................................................... Number of Rooms Foundation 11 Y��""' Exierior ....................................................................................Roofing .... 't- Floors ......................................................................................Interior ............................................. Heating ........Plumbing.......................................................................... .................................................................................. Fireplace ..................................................................................Approximate Cost .. .... Definitive Plan Approved by Planning Board ________________________________19________. Area o aU.!�'.......................... ® O Diagram of Lot and Building with Dimensions Fee . SUBJECT TO APPROVAL OF BOARD OF HEALTH i _ r J I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name 21436 MacEwen, Dorothy W. i t No 4436...... Permit for ......Addr..te-garage. ................ ........................................................... Location ......7.9..1;zuimgLti.SSet.-Rd.o. ................. ................... aton............................................... f, Owner .............D0Mthy..W.. .Mac"EWen............ .f yi I Y Type of Construction Wood......................... ................. .............................. Plot ......................... Lot ............................ < i Permit Granted .................Ju1Y....6.......19 79 Date of Inspection ..........................." °.19r - Date Completed � .1,7 ....t....19 }. - x .yraPtipiAd;' � r PERMIT REFUSED ✓'" . .. ................................ 19 .............................t f. ................. t �" v G 4y a w,..i. .................................. ............. .� . . i. .................................................... ri . 4y t`f:+r Ap rived ........ ............. .... t .. ............................................................................... , ' h - 74- Assessor's map and to number ...;��... ../....,� .... l- Q��F THE Tp�y Sewage Permit number .......... '.:............................ ti BARISTADLE, i House number r MAl6 t639- j� D MA a' TOWN OF BARNSTABLE L ._ ,n. a1 • BUILDING . INSPECTOR APPLICATION FOR PERMIT TO ...... r ; TYPEOF CONSTRUCTION .......—e;, ..................................................................................................... ..............................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .....�. ..-- ! strc.Gr �f-�• ;...�r�.'.......... � ........... t'/td!l.. �`.....� .�.. .....�t'f� ProposedUse ..... . .......................................................................................... .............Fire District U Zoning District .....'..................................................... .............................................................................. Name of Owner ... ...&� �=:Address .... -:.. .<f ;rar ...... 16 .. f/ Name of Builder .... !t.. , ,r :........!" Address ...../. ?..:. ,!�, :,. ,....�� :..../.. ate•' Nameof Architect ....................................................:.............Address ..................,,...........�........................................................... Number of Rooms ..................................................................Foundation "'E , %t ,dtc�. , ` Exierior ....................................................................................Roofing .... n2e�,—� .-........................ Floors .....Interior .............................................:...................................... ................................................................................. Heating °............ a......'.Plumbin.g................................... ` .............................. r .......�...... Fireplace ..................................................................................Approximate Cost ... � <?. ......................................... Defin'itive'Plan Approved by Planning Board ---------------____-----------19--------. Area ............................ Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH I I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. �s Name ....�Az4.;�............. ............... • :=.:�:c., ., ..r_�,:.,. ...:,�...ie'c. ...:.mt':.:... .. -:�i..a...o-..19...3:.+ Fir .:.,,r,.��. -.',.�.......l .<,.,_...:.... .. .. ..... r ..-.., .. ,.. ....... ..a-.,i ..,- ........ ... ..... ,. ..... �.. 21436 MacEwe51,-.Do-roth Y 'A=19-85 No �1�36.... Permit for A4�L...�Q.gara&e.... ............................................................................... 79 Location ....................... Cotuit ..................................................................... ............Dorothy..W..--MaeEwen.............. Type of Construction ........Wood......................... ............................................................................... Plot ............................ Lot ....... ....................... Permit Granted ........ZJ�4Y............. ..6........19 79 Date of Inspection ....................................19 Date Completed ......... ..................19 PERMIT EFUSED ................................ ....... . ... .. .. . ..... 19 ......... ... .. ... ..... .......... . . ............................... ................................................................................ ..........................\.................................................. ............................................................................... 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