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0925 MAIN STREET (COTUIT)
_ _ ,;. - �4 4 1 Y � i rr win..Y,M•�i,-,• ,_j�..�,,,,...._.. .. ..:� �it"F'r.., ..;...�r.r..T:..�,-,�"'r.({..'""`'�_.,,.,,{,i,u: ..,_--�s'"�&s'r„°rRer"'l�_..',::^'tnty`!°t!-v�{� 'y.dry.Cy`^'^tan,7'".;ry.:t�r•'�r��`�" �-.;,,,}Y,,. y , - x..-r-may..,. _.. ;,� �� OJoF a TOWN OF BARNSTABLE Permit No. ..30022 BUILDING DEPARTMENT TOWN OFFICE BUILDING ' Cash HYANNIS,MASS.02601 Bond .. CERTIFICATE OF USE AND OCCUPANCY Issued to Cotuit Inn Partnership Address Suildina A, Unit 1. . 923 Main Street Cotuit. Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE: R 44ZL December .9s......., I9...87.......... . ....... .............. ..� . Building Inspector ':LY'•''§T •.wn?.v,? "'9{+1"'r.9'..,,.�„ yrc— *µ.,w"1 t•:: � .�'��) F•$vrN+?!4'TM' n,T}.Te! T'w t , � y, ' .,. + C THE �e TOWN OF BARNSTABLE Permit No. .39.9?2 BUILDING DEPARTMENT neaisr Castel ` rwa TOWN OFFICE BUILDING ,EpY� t J . HYANNIS,MASS.02601 Bond .... ...�.y CERTIFICATE OF USE AND OCCUPANCY Issued to COtuit Inn Partnership Address Building A, Unit 2, 923 Main Street .,...- Lotuit, Massachusetts USE GROUP = "FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING,_INSPECTOR"`UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF.THE MASSACHUSETTS STATE BUILDING CODE. ..... .. December..9......., Building Inspector s -.-ram.-,y- �•...,.w..-..wa.�.e.�.,yr.Tw-s...es...ti�..;a r-.-^.,r ��o-r..�p:7r.,w,svrw,wiah€: ��'�..b :.w�'t��J�$4;<'.".:"'xSS'+7,,r,.@$'°'qvY",�'Mit�,.4xas_-.-.,...-.q.o- F..�... a '.+.�'w Y TOWN OF BARNSTABLE Permit No 3 ?.? • BUILDING DEPARTMENT aearx Cash .... "...I .... ■a.. TOWN OFFICE BUILDING (( .63q. .....` �f� r �t,■�rr� HYANNIS,MASS.02601 Bond ....... -.. CERTIFICATE OF USE AND OCCUPANCY Issued to Cotuit Inn Partnership Address Puilding A, Unit 3, 923 Main Street Cotuit, Massachusetts USE GROUP = FIRE.GRADING ` OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL { SIGNED BY.THE BUILDING_INSPECTOR`UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. December 9, G{il, 19 A T.......... . ............... Building Inspector .zl"g ,,.,,_.,;<.. .,r..-.- .s�;6a-.,.. ,+ -v---` .,,:r-. ..p.,...,,y.'g{'; ,.griWw+nsa„ .*.`"n„r�1i""'t t + y yoFtxero• TOWN OF BARNSTABLE Permit No. ..30022 BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash .a. ' f6;q ` .. ... .. �t,�r► .HYANNIS,MASS.02601 Bond . I � CERTIFICATE OF USE AND OCCUPANCY. Issued to Cotuit Inn Partnership Address Building A, Unit 4, 923 Main Street Cotuit, Massachusetts : n USE GROUP FIRE.GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL ' SIGNED BY THE BUILDING INSPECTOR UPON ,SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. December............, 19................ ........... Building Inspector sqr---:«...w--�.......ry...-r�•?y.'i,,,.r.�j.-....:Ynsa:R•'M7'.-."�i•'T`-"^---^ems='-..--++ ,F"^':=:c.:.y¢;.�_�w`,�*Tyela+":ty^'."8'�C"��s',,'i.$xat"`4;=�':'.n'.�.^"•v -r+e..;yw-.... .^m'„y'....'.'y:;�:-r"' _A,t{. .�...�� P� ,, ofTHE�o TOWN OF BARNSTABLE Permit No. 30022 0� BUILDING DEPARTMENT 1 D°8:aa TOWN OFFICE BUILDING Cash HYANNIS,MASS.02601 Bond ...............:. CERTIFICATE OF USE AND OCCUPANCY Issued to Cotuit Inn Partnership Address Building A, Unit 5, 923 Main Street r 6otuit, Massachusetts . USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND.IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. December...........; 19.....$.?..,.... Building Inspector p -4•. w-r.ar .ten�-: za•,p.r r`ykl ._„ y_.: # ""fix' " y s.,I }k�. av r�Vy- THE t1v. ,� �of �►� TOWN OF BARNSTABLE Permit No. .. 30022 BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash HYANNIS,MASS.02601 Bond ................. t CERTIFICATE OF USE AND OCCUPANCY Issued to Cotuit Inn Partnership Address Building A, Unit 6, 923 Main Street r 9 Cntuit, Massachusetts USE GROUP FIRE GRADING" • ` ` OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL �€ SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. i ' December 9, 87 19................. • ......... ... ...... .................. Building Inspector ,Ve!...-',.r__r^"^.'�r��-...^+--s..-�'..v+r.y.�a,._:ry,...r-m...,rv-.F-_.-.. ,,,,,..yFy�,.,.,-._r.'rt,��,,.�.....,�-�,,.�,.�...e•n„i• _-R.y�ga�+* t:""',�,N{�.M3"r"'�.*Rr.z.-anrsstc?;afrn3TR: .�•+.+^ .r. .:� ,,fi..r. - ��'— ;-�..� fj ,fTNE>, TOWN OF BARNSTABLE 30922 Permit No. ................ BUILDING DEPARTMENT :: I TOWN OFFICE BUILDING Cash f6S9 HYANNIS,MASS.02601 Bond ................ CERTIFICATE OF USE AND OCCUPANCY Issued to Cotuit Inn Partnership Address ,Building A, Unit 7, 923 Main Street° 'Cotuit, Massachusetts ; USE GROUP' FIRE GRADING OCCUPANCY LOAD 4^ n THIS PERMIT WILL`NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL '+ SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. December 9, 87 19................. ..... . ........... ................. Building Inspector i �,,r.�......:,. -,-...� .-�,•��...z .....-...,.,..,:v��.. "'vim .`-rmyj �r*-*-'.*'"g►^a�t-"°k'°.:'��•,w.,�ah:5 '7..y.�.Cr�4�'x'�.�.+F�"`�+r."'""�° "�!''"1�".�`aRae.'. -;v s�,�':::a+. o ..,F.._. ..r: ,. fTME� TOWN OF BARNSTABLE 300Z2 0 n ., ` Permit No. ................ BUILDING DEPARTMENT F aeea i TOWN OFFICE BUILDING Cash HYANNIS,MASS.02601 Bond ................ CERTIFICATE OF USE AND OCCUPANCY Issued to Cotuit inn Partnership Address ,Building B, Unit 8, 923 Main Streea Cotuit,, Massachusetts. . . USE.GROUP FIRE GRADING OCCUPANCY LOAD THIS:PERMIT WILL:NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY-THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. ......Dege.mber..9.,...., I9..A7........... . Building Inspector A P y0f 1NE� TOWN OF BARNSTABLE 300.22 P e ermit No. ................ BUILDING DEPARTMENT TOWN OFFICE.BUILDING Cash °Four HYANNIS,MASS.02601 Bond ............. CERTIFICATE OF USE AND OCCUPANCY Issued to Cotuit Inn Partnership 'Address Building B, Unit 9, 923 Main Street , 4 ' Cotuit, Massachusetts : USE GROUP~ FIRE GRADING OCCUPANCY LOAD 4: THIS PERMIT :WILL,NOTfBE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. December 9, 19 87 fit. ................. .................... Building Inspector s s. �, •y` oF�r�• TOWN OF BARNSTABLE Permit No. ..30022,,... BUILDING DEPARTMENT Cash TOWN OFFICE BUILDING ' oriv HYANNIS,MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued'to Cotuit Inn Partnership "Address Building C, Unit 10, 923 Main Street - #Cotuit, Massachusetts USE GROUP - FIRE GRADING OCCUPANCY LOAD . THIS PERMIT WILL NOT BE VALID; AND THE BU DING SHALL NOT BE'OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. Dec.ember..9, 19.....57........ v .......... .... ........ ........ Building Inspector r HERITAGE ASSOCIATES I 21 Cochituate Street i V d `' NATICK, MASSACHUSETTS 01760 DATE JOB NO. Phone 651-0688 3 10 87 ,a ATTENTION _ >I TO Maureen Cullen RE Cotuit Inn Cotuit Partnership 10 High STreet --------------------------- Boston, MA. WE ARE SENDING YOU1 Attached ❑ Under separate cover via the following items: ❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples_ ❑ Specifications ❑ Copy of letter ❑ Change order ❑ COPIES DATE NO. — _ DESCRIPTION 1 _ Mortoaqe Survey THESE ARE TRANSMITTED Its checked below: ❑ For approval ❑ Approved as submitted - ❑ Resubmit copies for approval X1 For your use ❑' Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ — ❑ FOR BIDS DUE 19-- ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS i cc: Joe DeLuz� , _ _ Hyannis- Bui__ldin___ g Inspectorf COPY TO SIGNED: PRODUCT 2402 E85 I.,Croton,Mass 01471 If enclosures are not as noted, kindly notify us at once. El F W.0 �-e4 N `h1 s L L ` h GONC ►� ' FodaDAno'� � 3S� 90 3 *1 MORTGAGE SURVEY I certify that the buildings and lot lines as shown on this plan have I certify that the lot and structure been located on the' ground and that they have conformed to the Zoning shown on this plan are not located and Building laws of the in the special flood hazard area as Tawv of delineated by the Housing and Urban DD Development Division of the F.H.A. �7C-= J certify that this inspection was when constructed. performed in accordance with the technical standards for mortgage inspections as adopted. by the Mass. OF M , Association of Land Surveyors and �� E Civil Engineers, Inc , E. BENKART H R do I ASSOCIATES No. 9742 Registered Land Surveyors ! 9FCISTERw 338 Brigantine Circle q�� SUR,�'y� Plymouth, Mass, Q23�0. - r 1'. r November 20 1986 Barnstable Town Hall 367 Main Street Hyannis, MA .02601 RE: , COTUIT INN. - REHAB Dear Mr . DaLuz ;. , We have recently evaluated the structure of the Cotuit Inn . This planned .evaluation 'was made possible , by the current state of demolition and in-fact was anticipated since th e projects R ,1 conception P What was not anticipated was the deleterious condition of the existing framing. Many of the main support members have been either notched beyond repair , been made discontinuous, or been totally removed at some time during the life of the Inn . ,a These shortcomings, coupled with. the lack of a .foundation , the potential risk to public safety in terms of fire , and the exceptionally high cost of repair have been the catalyst for our recommending to the Owners, a.k .a. The Cotuit Inn. Partnership ; that this structure be demolished in its entirety except for the ', majority of the front facade . Our purpose in preserving . the front facade except .for minor changes, is fundamental . We feel the character of this portion of structure is important to the .area in which it sits. The new construction will not change the density nor in our opinion affect the zoning district in general In fact , new framing will assure adequacy of support , and 1 consequently assure public safety. It will allow complete fire i blocking,' thereby minimizing risk . r i IL Further , construction can proceed more rapidly, thus minimizing_ the inconvenience to neighbors and abutters. We believe this recommendation to be in best interest of all parties involved with this project . If you should have any questions or require further information , please feel free to contact me . Very truly yours, (Willia L. Snow nt WLS/bn cc : M. Cullen , Cotuit Partnership i THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) IA M �c� C DATA a TOWN .' OF BARNSTABLE f Zoning Board of Appeals Forrest A. Davie Zs Deed duly recorded in the Property Owner County Registry of Deeds in Book Scene - Page --- Registry Petitioner District of the Land Court Certificate No. Book __ . : Page 1984-72 Appeal No. 19 FACTS and DECISION Forrest A. DanieZs A'ay 14', 84 Petitioner, _._ filed petition on _ 19 requesting a variance-permit for premises at _ ' C' in the .village (street) _ w CoMit of. __ .____... : __ , adjoining premises of (see attached list) Locus under consideration: Barnstable Assessor's `lap. no. _ lot no. 12 Petition for Special Permit: fl Application for Variance: ❑ made under Sec: :_ .of the Town of Barnstable Zoning by-laws and Sec. Chapter 40A., Klass. Gen. Laws for.the purpose of To _Zi-ncte the a rtments. Locus is presently zoned in M Notice of this hearing was given by mail, postage prepaid, to all persons deemed. affected and by publishing.iu 0-a�Ze 1Pa ram ne-vi-spaper published in Town of Barnstable a copy of which is attached to the record of these proceedings filed with Town Clerk. A public hearing by the Board of Appeals of the Town of Barnstable n•as held at the Town Office Building,. HyAnnis, Mass., at `� _:L.�f.' P.11. u)xln said petition under zoning- bylaws: Present -at the hearing were the following members: - � ... .._........._ —_ �=—_.Chairman •— AAXNDSL Lc::ISION At a regular meeting of the Barnstable Board of Appeals, the Board reviewed its decision of July 5, 1984 in the application of the Cotuit Inn for a Special Permit, being Appeals No. 1984-72, and found that the decision did not adequately set forth the findings and intent of the Board -in granting the special permit, and therefore, in order to clarify and supplement that decision, the Board voted unanimously to amend the decision of July 5, 1984 by adding the following language The Board of Appeals found that the subject parcel, consisting of one acre, located in an RF zone, contains at present five buildings which have been inexistence .for several years prior to the adoption of zoning in. Barnsta ble. , These buidings consist of.a main building, three cottages and a bunk house, being building numoered 1 through` 5 respect.ivelry, 'aZl as shown on a pZan of Zand dated November 28, 1944, which was submitted with the application. These buiZdings contain a mixed-aggregation of cock: aiZ Zounoe, cottages, single rooms and housekeeping suites; and have been known ard. oneratcd. as t%e Cotuit Inn. The premises are licensed as an inn and are Zicensed ror the saZe of Food and aZco+,oZic beverages. Due to changing conditions in the economy and rile rapid epar.sicr ar-_; rorc s `- ir: `i:c nz,mber cf modern establishments which are availa,�le to transient visitors_. and travellers, the Cotuit inn has gradually ceaced to be a vid�Ze operatic"?, a an Ir.n. SOS$. Of revenue i2aS resulted in the Znab2lit 0.- rtl^ .Stile ' rOprieLc2's :Lr LC be »Gre2'L? 1 aZi:t: ne; a}:a ti e t Yctire t., h i, "� ' j"2CZGZ 25 a;1(Q L. azZen� into d; 02e.aZr L/: c*t,. in tU�'n has re0-:4ZTed :in ria-tr?cr dccZine Of t} c �rGTiSES... Continued ov�ratLcn of ti:C r_ro c�:t r'rGn: SC S as an Inn C J c ri n to try i:S�Ci :u:':r, Zc not eCcncr:1. }: it e cc;tc-1i'a pOs L. Ze tC oper^` crcr,,Oc as an inr, ea r: fit U ^+' }i t ' c .'�:Ors "'! 2. ._?'^ L: Z� Cc, a r • is _ :` ..:. 0CY. :!n}:L 2'c':i. Y. }: �2'G:�� :•�' a}?.'r. 72'C?.' ✓I:c ::reT.Z:_. CX Cn 7 PC i? - -.or- Io w Page 2. Amended Decision Coturt Inn Appeal No. 1984-72 in terms of size and style, but the external features of the main building wiZZ be greatly improved and preserved. The alterations of the building will result in a great improvement of the safety of the buiZdings- for habitation, and an upgrading of property values. The stablization of the property for residential use only wZl be more in keeping with the residential character of the district generaZZy, although the immediate neighborhood contains a- number of non-residential uses at the present time. Therefore, the change z711Z not have any detrimental effect .c7:. the ir7nediate neighborhood.. _%ize overaZZ _and tong range considerations involved warrant a change in the ,uo'e Of the property. Trze plans and application, establish that, on balance, the- ,roposed use Will erinc a✓Out beneficial. chap;es !:h-ch far outweigh the da'.aers innerent in prolongation of the present use: . Accordirgly, .the Board finds trot the morose aSc_will, not onZ: .not ce sur. .. startiaZla more aetrimental or o�jectionable to �;_e 7. i-72borhood than 'kc p»cscnt use, cut. L:il�, in fact, grina about an improvemen. a7:d EubBtartia� u.r�1' dingy ati:c� w�?Z be mere in 'keeping with the district's c0sc7::iaZ-7, residentiaZ c;,.a r et_r, a ti:ci�efore in i-:ee2- in,7 With tine spirit ana n. c.= tre zcnin_g 7 -Z� C:3c Of; Ll: =crt: o2n;,, trc COG" -- W.a?::,:i'..� z7O r ra l. . ti At the conclusion of the hearing, the Board took said petition under advisement. A view of the locus was made by the Board. Appeal No. 1984-72 Page 3 of 3 on. 19 The Board of Appeals found 1. The petitioner surrenders the aZccboZic beverages Zicense and innhoZders license prior to commencement of alterations of the premises. 2. There shall be no short term rentals. 3. The green spaces `indicated on 'the pZan submitted are to be maintained. 4. The permit is granted for. ten (10) residential apartments, which sbaZZ . be shown on a new p Zan:. 5. The new pZan shaZZ show the Zocation of the office/maintenance. area L�hich shaZZ not contain Ziving quarters. I, �_.�.__�.r....____......__...._ .....__ _._._.,.:__.._.___........, Clerk 'of .the Town of Barnstable, Barnstable County, 'Iassa,ehusctts, hereby certify that twenty (20 days have elapsed since the &card of Appeals rendered its decision in the above entitled petition and that zio appeal of said decision has been filed in the office of the Town Clerk. &Ined and Scaled this _..._._.. day of under the pains and penalties,of perjury. Distribution:— Property Owner Town Clerk. ];,yard of Appeals Applicant . Towu of Barnstable Persons interested Building Inspector _ Publie 'Information Board of Appeals. Chairman' ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # 'tf w op Health Division Date Issued Conservation Division ' Application Fee Al1. Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/Hyannis Project Street Address • � L.° \ r Village Owner a> ���e L, `�fl o lk Address go V L410 '' �eo#"14gz Telephone Permit-Requests ' A S' e Y' Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new - Zoning District Flood Plain Groundwater Overlay ProjecfValua o CO Construction Type �--- Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No : Fireplaces: Existing New Existing wood%coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size Pool: ❑ existing ❑ new size _ Barn: ❑existing O:ne4- 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) VName ``�"� M �� ti Telephone Number J� ^� Address ? Zr License # 00 e�L,_,4 t, vu. Home Improvement Contractor# � lWorker's Compensation # 14 ,C C. S6 US 7 01� ALL6ONSTRUCTION DEBRIS RESULTING FROM THIS PROJEC WILL BE TAKEN TO SIGNATURE DATE l : L � FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. F ADDRESS VILLAGE OWNER DATE OF INSPECTION: 7 FOUNDATION;['. I FRAME 1 INSULATION - FIREPLACE ELECTRICAL: ROUGH FINAL i. PLUMBING: ROUGH FINAL i� GAS— ROUGH ' 1 FINAL i FINAL BUILDING .` ; l t DATE CLOSED OUT (a ASSOCIATION PLAN NO. ,r, r The Commonwealth ofAfassachusetts Department oflndustrial Accidents Office of Investigations + 600 Washington Street Boston, MA 02111 ,�•�'� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/EIectricia.ns/Plumbers Applicant Information n I Please Print Le ibl Name (Business/Organization/Individual): / l ���- ��� ��� o&./ f • Address: .ram L f(A-q Axe y�employer? Check the appropriate bog: Type of pioject(required): 1. I am a employer 4. ❑ I ama general contractor and I: employees 1 and/or part-fim. L * :have hired.the stilb-contractors 6. ❑New construction 2.❑ I am a sole jumpne or or p er listed on the'attached sheet T.❑Remodeling ship and have no employees These sub-contractors have g. ❑ Demolition workin for me in an capacity. employees and have workers' g Y P tY• 9. ❑Building addition [No workers'•comp.•insurance comp. insurance.$ required.] 5. ❑ We are a corporation and.its 10.El Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their i L❑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 flit out the section below showing their workers'compensation policy infornution_ t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors.and state whether or not those entities have employees. If the sub-contractors havepmployces,trey-must provide their workers'comp.policy number. 1"am an employer that is providing workers"comp ensation insurance for my employees: Below is the policy and job site information Insurance Company Name: a L � � Policy#or Self-ins. Lic. #: C—C ��UCI��,rs�od f 1>10 j 0 Expiration Date: � / � L/• Job Site Address: 9 �3 t'✓d City/Statdzip: ejl-"j I PUA. 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 crimirisl penalties of a fine tip to$1,500.00 and/or one-year impri onment, 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 certi nder e pains penalties of perjury that the information provided above is tru and correct. Si ature: Date: _ L/ Phone# U L CJU Fi al use only. Do not write in this area to be compteled by city or town official r Town: 'Permit/License# g Authority(circle one): rd of Health'2.Building Department 3. City/Town Clerk .4.Electrical Inspector S. Plumbing Inspector errf PPrcnn: ._Phone.#: Information and Instruction 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." Au 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 tiustee 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 to cal 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 I"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"ith 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-conkactor(s)name(s),-addresses)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 licensees 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' atio policy,pleas e call the De 'artment at the number listed below. Self-insured companies should enter their compensation p Y�P � P , self-insurance license number on the appropriate line. City or Town Officials .Please be sure that the affidavit is complete'aud 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 pr,=*t/lieense number which will be used as a reference number. In addition, an applicant that must submit multiple permit/Ecense applications in any given year,need only submit one affidavit indicating current policy information(if necessary) and under`lob Site Address" fhe 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 roof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each PP P tune 'tizen is obtaining a license or permit not related to any business or comet ercial ven •year:Where a home owner or ci, using (i.e. a dog license or permit to btirn 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 Depaztrnent of Industrial Accidents Office of fayestigat-ions, �-g 6GQ Washington Street Boston, N A 02111 Tel. # 617-727-4900 ext 406 or 1-877-MAS.SAFE Fax # 617-727-7744 Revised 11-22-06 www.mass.gov/dia I xb1101 b6 b9 07 '5M297680}>5999035331 P VI Y ` own off"Bazastahle Regulatory Services Thomas K Geiler,Director Building Division Tom Fcrry,Building Comzzumione►- 200 Main Stzcct,Fiyaunis,MA 02601 • wSv�t+.town.�arnstaGlr,-tna.us • Office: 508.862-4038 Pax: 508MO-62: Property Chv'riermusE Complete and Sigzx'S is ,Sec ior� Tf T_Is inz A,BWide I, 1 k�J� ,f�: /�'19�M.Q1 � ,as 0-fter of die subjcct.property, TJCLiST�"E' 7`/QA•I1VDR L�v�wG- TRus7- laetrby to act on my behalf, ira 41 x tters rd tive to work authofimed by this buil&g penuit application for, 7-1 (Addirs4 of,ro -� _. . i r — atc �gaatVire of C?wnr . Priff Name If Pry e _c time ir is applying for peg- lit please complete t&- Homcowaci-s Licemc Excnyption Form on the revetsa'side. F i Cotuit Inn Condominium Trust 925 Main Street Cotuit, MA 02635 January 5, 2005 To Whom It May Concern; The Cotuit Inn Condominium Trust, on behalf of owner Colleen Trainor, approves the installation of new windows in Mrs. Trainor's unit. Appleton Construction has been approved as the contractor to install said windows. Any permits needed to complete this work should be granted to the contractor. Trustees of the Cotuit Condominium Trust: Alfred Wohlwend George Marino Karen Megathlin Signed: . Karen Megathlin, Treasurer, a NOTICE NOTICE TO TO EMPLOYEES r 3 EMPLOYEES The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 600 Washington Street, Boston, Massachusetts 02111 617-727-4900 As required by Massachusetts General Law, Chapter 152, Sections 21, 22 &.30, this will give you notice that I(we) have provided for payment to our injured employees under the above mentioned chapter by insuring with: ASSOCIATED EMPLOYERS INSURANCE COMPANY NAME OF INSURANCE COMPANY 54 THIRD AVENUE P.O. BOX 4070 BURLINGTON, MA 01803-0970 ADDRESS OF INSURANCE COMPANY WCC 5005786012010 03/16/2010 - 03/16/2011 POLICY NUMBER EFFECTIVE DATES Malcolm & Parsons Insurance 6 Freeman Street- P O Box 527 Agency Inc Stoughton, MA 02072 (781) 344-3200 NAME OF INSURANCE AGENT ADDRESS PHONE Peter Appleton dba Appleton Construction 37 Baird Way Centerville, MA 02632 EMPLOYER ADDRESS 02/05/2010 EMPLOYER'S WORKERS COMPENSATION OFFICER(IF ANY) DATE MEDICAL TREATMENT The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services provided by the treating physician will be paid by the insurer,if the treatment is necessary and reasonably connected to the work related injury. In cases requiring hospital attention,employees are hereby notified that the insurer has arranged for such attention at the NEAREST AND BEST MEDICAL FACILITY NAME OF HOSPITAL ADDRESS TO BE POSTED BY EMPLOYER e u Massachusetts- Department of rUnlitanda� Board of Building Re!gul.ttions and S h` Construction Supervisor License License: CS 5414 , Restricted to: 00 PETER J APPLETON 37 BAIRD WAY CENTERVILLE, MA 02632 Expiration: 6/8/2012 .. Tr#: 26907 ('ummissiuncr f \ i el TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # � Health Division Date Issued 1 —1 Conservation Division Application Fee U� Z Planning Dept. Permit Fee :?2 Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address Village Owner Address Telephone � Z- �� 9 L Permit Request 7 , Square feet. 1st floor: existing floor: existing proposed 0: Total new .Zoning District Flood Plain Groundw ter Overlay Co Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach sup orting docume`•'r1-tation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: Yet❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Pp 7 Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing_ new _ Half: existing © new Number of Bedrooms: a- existing One'ew/ ram, Total Room Count (not including baths): existing new y First Floor Room Count Heat Type and Fuel: Vf6as , ❑ Oil ❑ Electric ❑ Other Central Air: WSes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number Address License # 5 Home Improvement Contractor#E m 0 o UU// r-, o_,r_-vr9" Worker's Compensation # crm*il C144- ALL CONSTRUCTION DTBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO A,9 (AZ 4 t SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED ` MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: t ,:F�FOUNDATQN1;1L ARRI 1►PRU1 ni!),A—li 4 FRAME i iINSULATION ► ..�..� Sri a i FIREPLACE ELECTRICAL: ROUGH FINAL -- PLUMBING: ROUGH FINAL GAS: ROUGH FINAL : FINAL BUILDING.( F DATE CLOSED OUT ASSOCIATION PLAN NO. 37ie Canon MPedlth ofmamickuseft Departmmt rrf Inds sft ial Accidmts _ d fue oflnvestigadons .•60@ Waddagfou SYreet . Workere Cot pensatiunlusurance AffidavitR=I&rs/Cbnhwftwsfil'fi►r4ricians0n=ben _ Ayq3hcaA Infarm11iku PIM5e Print Name(Bvsmessr Address: �,0,ACV(_ (®ffo ciylstateg* , Phone I%- l tr-}a��a�€mglofer?Cherk the app¢alariate ba=: Type of p'°]ed('eq�d)= 4nd 1•�amaemp 4 am it enema/contactor and I ❑ 1. t�pemployees(fall sudlorpatt#�me).* ❑I a have hued the sub-c�trackin G. New on 2❑ I am a sole proprietor orpartner- fisted wi the attached sheet �- 9 ship and have no employees These nab-ountractfln have g- ❑�tifion wcddng for me in any capacity- empbyees and bane wa 5mm' I 0 Building addition INo WO&M'comp.insurance coop. 1 xeqaired-I 5. 0 We area corporation and its 10.0tricai repass or additiom I n I am a homeowner doing all work officers have emrdsed their 11-0 Plumbing repairs or sditions snpseU[No worlrers camp rigbt ofemmWtion per MGL 12.0 Roafrepairs insurance required.]t c-152,§1(4�and we have no employees-[No wmk=' 13.0 Other camp-insurance=qn red j *Aa WL3m±6trched�sbazalt®st�IsofiIlo�thesecfio¢bdowsh¢xia5thra�a�s' t Homeowners vdo sabmit this tfrdt4rt i¢dloaml they&M amag allwakm d&mhim outside camtr c rs mmst submit awv afdwk i¢dicetin soda. tL—=Wtc=1flW cbect thisb=mast attached rot additin¢atl sherr sbm�g then:me of t5e nab o�xtna and rusts whether ornotthose erati<ties7n employees. If tin sd?-c rtaahsrte mWjgw%theym¢srp made ftw!w warms'wmp.yorcyaumhez " I not cm Ranplvyer filtrrtisprovidirr�ftrorkers'camperrsrrlian ursrirturce for>nyT etrzpl�oyees, �elorr is i#ispaticl,tub job srtg fr formatiram Insurance Cgmpauy Name: 4/d Policy 4 or Self-inn Iie.4k "c �r FxgiratioaDate: Job Site Address: Aftzch a copy of fie woricers'compensation policy dedaration page(showing the pow number anal erpu-atian datej- Failure to sew coverage as required under Section SA of hdGL.c-152.can lead to the imposition of criminal peaaldes of a fine up to$1,50Q.00 and/or one-year impdso-t as well as rivA pen RIEea in tine foua 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 maybe foawarded to the Office of hwestigatiom of the DIA for,.,smanre coverage verification- I do{eereby ecrg y er theptuins and penawas eafperfiuy thatthe iruforata rwa proyfiW ahme is true ante correct lureA&t Dater: Phone 4' owwhd use mljs Do me wiita inthis area,to he camp&ad by do arlum aft City or Town: PermitUcense i Bsuing Auffwr4(circle ane)r- L Board of HealEtir 2.Ong Department I+L,.tyl%MM Clerk 4.Electrical Inspector S.Plumbing Easgecte r *Other Contact gersou: Phu= 6 . � � DATCts;tr�ruw,:T,r I CERTIFICATE IS ISSUED AS A MAATTER OF IMFOR&IATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS tFiCATB DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND tfJ UND OR ALTER THE COVERAQE AFFORDED BY THE POLICIES BELOW.CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A COf�ITRACT BETWEEN THE ISSUIN�G INSURER(S),AUTHORIZED REPRESENTATIVE RODUCIER.AND THE CERTIFICATE HOLDER. 11TANT:N the cl+rtRleate holder le>Irt dDDfTIONALINSURED.the poDgeag)must be endorsed.B SUBROGATION IS WANED,subject to the tem alaiconditions pottey,chin paflclea msy rcqutss en endorsement A i3latellleid an this cmdeeate dam natcorNer Apt►t8 to the eetWlaete holder in Hsu of V m►tlo>sest:ert(a).OrUCER YAR1 PHONE bal FAX d R3 I®k xim=awo +o® SB r A. AN%Fxtl: 877 238- S20 'NO-Not B 7 3 -4 31 Los2S Old Dill Rd EdMll s 168134 ADDRESS: PRODUCER CUSTOMER ID a {877)B3�®Cri�a 0 INSURERM AFFORDING COVERAGE NA1C D INSUREDINSURERA: Coating t:a'1 lvLd9vait C cuw INSURER& 1n ts-wvw Buil&M &AQ R=0&aft6 USURER 0 PO am 1080 MURER 0: wY:uit. m 02635-2080 wsu>aER E CTL 1273 767949 INSURER F-- I � COVERAGES CERTIFICATE NUMBER: REVISION 9ER: TNIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIREMENT.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 POLIGIC3 DE GRIBED HEREIN is SUBJECT To ALL THE TERMS.EXCLUSIONS ANO CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. men ADDL SUBR UMRa LTA TYPE OF INSURANCE INSR WVD PO Y UtdBER M� Y t GENERAL LIABILITY i EACH OCCURRENCE 5BAWG _ COMMERCIAL GENERAL LIA04M !I (� PREMIS TO RFMED u L—J PREMISESS(Eeooa+rmns) $ CLAIMS MADE D OCCUR MED EXP lAm ace Icon S _ R PERSONAL 8 ADV RUURY S GENE AGGREGATE S GENLAGGREGATE LIMIT APPLIES PER: PRODUCTS•COMPIOP AGO S POLICYPROJECT r--ILOC , ❑ A COMBINED SINGLE LIMIT UTOMOBILE LIABILITY I B +L M $ ANYAUTO ODILYUJURV Pnr mean S ALLOWHEDAUTOS BODILY INJURY 1pm t S SCHEDULED AUTOS PROPERTY DAMAGE i HIREDAUTOS I (pm°xd°°II S NON-OWNED AUTOS S i � g i UOABRELLA LIA8 OCCUR EACH OCCURRENCE S EXCESSiJAB CU1aAS MAADE ^ AGGREGATE S DEDUCTIBLE S S RETENTION S I WC5TATU an OTH WORKSASCOMPENSATION fmfffi AND EMPLOYERS'LIABILITY E.L.EACH ACCI ANY PROPRISTC"ARTNSWY/ N/A 6-805700-01-06 08/31/2D]3 /311209,4 8 100_000 E.LOISEAS EA1IMPtOM s 100,000 (fdsmiato►Y to NIt) nye�aeacetraumsar E.4.DI�ASEPou�ruM[r �s SOO,OOO 8PECIALPROV►810NS t-Iow El D cescHIPTION OP OPERAnOW/IODATIONS/VEMOLES{Arab Aeard tat,Addlltanal RDmerke 8ahellIft It=M epsno H regldred) CERTIFICATE HOLDER SHOULD ANY OFTHS All0a DESCRIBED POLICISe 80 CAti1�LLED 8L'OOABTNE Qwvw swidim Qlmd palladollmEXPIRATION UM THEREOR NOTICE WILL BE DELIVERED U ACCORDANCE WITH X30 1108 1020 THE POLICY PROVISION& C*tuitr M 02635-1080 AUTHORIZED REPRESENTATIVE Attua psedeft b2m=Gw 1783118 r ACOAD 25(aOH199} the ACORO nanm sMld WOO arts rcgtatercd melt of ACORD ®tsiiic zoas ACORD CORPORATION.All rights i I it Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supen isor I &2 Family License:'CSFA-077754 " CAREY C GROVER PO BOX 1080 COTUIT MA 02635 .i Expiration Commissioner 11/22/2015 ,, ��e rza,ecrll� _ Office of Consumer Affairs&Business Regulation License or registration valid for individul use only gME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: istration: 144322 Type: Office of Consumer Affairs and Business Regulation V-11—Epiration: 9/23/2014 -'DBA 10 Park Plaza-Suite 5170 Boston,MA 02116 - GROVER BUILDING+REMODELING CAREY GROVER 56 BOWDOIN RD MASHPEE,MA 02649 - --- Utlersecretary Net vaAd without signature M Cotuit Fire/Rescue Department, ,. FIRE DEPARTMENTS OF THE.TOWN OF BARNST=ABLE Fire Prevention Office - Hinckley Building 200 Main Street, Hyannis; MA 02601 (508) 862-4097 . BUILDING CODE COMPLIANCE FORM-:-' Plans dated IZI for the property located at, 9 2-S Kka 1, V\! S I-u''e 'f also known as CAO -x-o\�'J Co J d- have been reviewed by C ri°Fd w jw(ci bb:5 V of the ❑. Barnstable ❑ Comm Cotuit ❑ Hyannis ❑ West Barnstable Fire Department. THE CHART BELOW INDICATESTHE STATUS OF THE REVIEW: IL TYPE OF CONSTRUCTION DOCUMENT ; N/A ;RECEIVED-.'- REVIEWED. COMPLIES . 1. Narrative Report 2. Firefighting& Rescue Access 3. Hydrant Location &Water Supply 4. Sprinkler Systems 5. Sprinkler Control Equipment �( ' 6. Standpipe Systems' 7. Standpipe Valve Locations " 1( 8. Fire Department Connection' 9. Fire Protective Signaling System, r ✓'' f -- 10. F.P.S.S. &Annunciator Location ✓" J 11. Smoke Control/Exhaust k X 12. Smoke Control Equipment Location `• 13. Life Safety System Features ^ ' ✓ - . ✓ 14. Fire Extinguishing Systems' I.s ✓ J J 15. F.E.S. Control Equipment'Location F �( 16. Fire Protection Rooms f �C 17. Fire Protection Equipment Signage , t 18. Alarm Transmission Method a I 19. Sequence of Operation Report 20. Acceptance3esting*Criteria `r r {. We believe this document to be complete and,`compliant for the issuance of a building permit. We have complet d the cceptarice' t ting for the occupancy permit�and believe that within the,scope of the{building per it, th above is s are incompliance: Cotuit Inn Condominium) Trust 1046 Main Main Street,#i 1 Telephone: 509-420-0299 Osterville,MA 02655 Fax:509-420-0789 December 20, 2013 Stephanie Wall PO Box 840 Cotuit MA 02635 Dear Stephanie Wall, Your request to have Grover Custom Builders perform renovations at Unit 04 of the Cotuit Inn Condominiums .is approved Sincerely, 00 A r er A A Pr ident, First Proper t Ma ement =s Agent for the Trust "" w ca CD a rT(V : 10 �► / Cotuit Inn Condominium Trust 1046 Main Main Street,#11 Telephone:508-420-0299 Osterville,MA 02655 Fax:508-420-0789 December 17, 2013 Stephanie Wall PO Box 840 Cotuit MA 02635 Dear Stephanie Wall, Your request to have Grover Custom Builders perform renovations at unit#4 at the Cotuit Inn Condominiums is approved provided that the Anderson Sliding glass door has the same dimension and appearance from the outside of the unit as the others in- ' the building including mullions and white hardware. Sincerely, Andrew Witter ARM,AMS, CMCA 4 n T Town of Barnstable 0 Regulatory Services MASS. $ Richard V.Scali,Interim Director 1639. ♦0 �& _ . - 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 as Owner of the subject property hereby authorize ��.�'L`� O(��: to act on my behalf, in all matters relative to work authorized by this building permit (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. S' atu e of Owner Signature Applicant Ap Print Name' Print Name Date OTORMS:OWNERPERMISSIONPOOLS 10l13 4 Town of Barnstable Regulatory Services BIKE Tp Richard V.Scali,Interim Director ti Building Division * sAxrtsrnsr E t Tom Perry,Building Commissioner 16 3F ����. 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB.LOCATIOM number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. 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. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures 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. QAWPFILES\FORMS\building permit forms=RESS.doc Revised 061313 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION i` .(0Map Parcel ® . Application # Health Division Date Issued `� l d Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board 0 Historic - OKH _ Preservation / Hyannis P-r-ojeet Street Ad ess Village'" ,0 t � �`� ZL44 Y � Address. l St 442ao A Tele-hone CP-erffiit`_Request�q yea GEC F-. lo a41D' din L' f 'Y1,5 /m h le,®v Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation...._, Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes,'attach supporting documentation. Dwelling Type: Single Family_ ❑ Two Family ❑ Multi-Family (# units) " , ={ Age of Existing Structure Historic House: ❑Yes ❑ No On Old King`'s Highways ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) w uq Number of Baths: Full: existing new Half: existing g ROW a. 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 i APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Nam.e._.= ��1 GI/ /? Telephone Number: rtLicense # . vallimQtAlka,3z� & ®� 7 i _.•Home l provempnt`Contractor I 111e17ZT Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE " ' ---wDATEy' �� '/� I i 4 FOR OFFICIAL USE ONLY ,f a APPLICATION# ? DATE ISSUED _ MAP/PARCEL NO. ADDRESS VILLAGE OWNER . t DATE OF INSPECTION: ; 4 FOUNDATION' " FRAME INSULATION - i� _ 'i FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL iGAS: � ,'Wk" " ROUGH FINAL :,`-FINAL BUILDING`. Iv ® : l °y4/Qo`lt-- DATE CLOSED OUT ASSOCIATION PLAN NO. t The Commonwealth ofMassachusetts Department of Industrial Accidents Offlee of Invesfigd1ons 600 Washington SYreet Boston,MA 02111 www.massgov/di?a Workers' Compensation Insurance Affidavit: Builders/Contra.etors/Electricit ns/Plumbers Applicant Information: Please Print Legibly AA Dame(Business/OrganizadonMdividual): /�j� j�S � r� Address: Rota lr113ID City/State/Zip: Qy 0 Phone#: a��� c����77�1,71�3 Are you an employer?Check the appropriate box: 1.ElI am a employer with 4. ❑ I am a general contractor and I Type of project(required): employees(full and/or part-time).* have hired the sub-contractors 6• 0New construction 2A I am a sole proprietor or partner- listed on the attached sheet.t 7• ❑Remodeling ship and have no employees 'These sub-contractors have S. 0 Demolition working for me m any capacity. workers'comp.insurance. g- Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10. Electrical q � ❑ repairs or additions 3.❑ I am a homeowner doing all work right Of exemption per MGL I Q]Plumbing repairs or additions myself.[No workers'comp, c. 152,§1(41*and we have no 12.❑Roof reLil��QW airs insurance required.)t employees.[No workeW �' 14 comp.insurance required] 13.b Other *Any applicant that checks boot 91 most also till out the section below showing their worioert'oompantion policy imformtadoa Homeowners who submit this affidavit indicating they are doing all work and then hire offside eontractats must submit a pew affidavit indicating such. 4Ontractors that check this box must attached an additional sheet showing die name offlo subantrac6on and their workers'comp policy humstiom lam an employer that Is providing workers'compensation Insurance for my employees. Below is the po&7 and fob site Inform dOIL Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address City/State/Zip lr+t Aa 0a 63,} 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 MOL 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 cert(Jy under the pains and penallles of perjury that the!r{formation provided above is due and correct: Sign Phone .; S'04P 774K /e;46 . Official use only. Do not write In this area,to be completed by co or town of Icial City of Town: Permit/Lfceusell f Usufng Authority(elmle ones! 1E.Board of Health 1.B'uildingDepartmt nt 3.City/Town;.other . �lClerkd,>�tt trfEal Inspector IPdumbing Inspector. ` Contact Peraont Phone#t Information and Instructions Massachusetts General Laws chapter 152 requires an employers to provide workers'compensation for their employees. Pursuant to this statute,an earployee is defined as ...every person in the service of another under any contract of hire express or implied,oral or wd to " ' 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 8 P deceased employer,or the receiver or trustee of an individual,partnership,assoc` P rp, ration or other legal entity,�mployhrg 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 construc tion or repair work on such dwellin house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,f 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 h�aur-ace 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-contractors)name(s),address(es)and phone number(s)along with their certifiers)of Insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(UP)with no employees other than the members or partners,are not required to carry workers'compensation Insurance. Iran LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of hsdust W Accidents for confirmation of insurance coverage. Also be sore 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 Lndustrial Accidents. Should you have any questions regarding the law or if you are requiredd to obtain a wort=1 compensation policy,please cuff the Department at the number listed below. Seif4isured companies should enter their self-insurance license mnaber on the apprqxisto 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 permittlicense number which will be used as a reference number. In addition,an applicant that must submit multiple perraMicense 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"off 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 pewits or licenses. A now 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 bur leaves etc.)said person Is NOT r equi W to compete 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 Commoner ofMassetfi�tsetta Depafnent of WNW Aoddonts Office.of 1nves*#0Rg 600 Wes ton Strut Boston MA 02111 Tel.#617-727* 490oAWor 1-87 7-MMSA Raised S:Z6-o FU#617-?2777749 • .m=govMh OF THE t a� s EARNSPADLE, • - - _ - . MASS. Town of Barnstable i679� 1� plEp Mp.�a Regulatory Services Thomas F. Geiler,'Director Building Division Thomas Perry, CBO Building Commissioner- , 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-700-6230 Property ®weer Must Complete and Sign This Section If Using A Builder Iwill as Owner of the subject property hereby authorize 1�r119 dea to act on my behalf, in all matters relative to work authorized by'this btuldingperrnit application for: o n 3 (Address of Job) Signature of Owner Date ro � i SSA Print Name . Ir Property Owner is applying for permit, please complete the Homeowners License Exemption Form on the reverse side. t a P�otHETo Town of Barnstable Regulatory Services i ia3LAI srAet.E, ` Thomas F. Geiler Director .T, tASS. $ ', � ,bJg. A15y raµ�d Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis, MA 02601 wim town.barnstable.ma,us Office: 518-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "FIOMEOWNER" name home phone N work phone H CURRENT MAILNG ADDRESS: i cty/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 OFHOMEOWNER 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. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements, Signature of Homeowner Approval of Building Official Note: Three-family dweiling�s'containing 3,5,000 cubic feet'or larger will be required;to-to`mplywith the State,BAu.i?Ldtn'g 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 ofcon.5truction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,thaf.such Homeowner shall act as supervisor." ,t ` . r'�j. , r• Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Reg'ulations-�ror iF R 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.. puff" Massachusetts- llejru trnenfof public Sateh 4 } Board of Buildin(F , Re'„ulations and Standards :onstructi01 Supervisor License Licens. cS 42539 CHARLES J MAURO 203 UNION ST YARMOUTHPORT, MA 02675 41:. Expiration: 6/10/2012 ('unnni.�sliFner Tr#: 27830 F ` ISTEM MUST BE gsses¢or's offioec(lst floor): { _ ( .�, ' '01STALLED IN COMPLfA Ero Assessor s"map':and lot n1.umber. ...:...... ... Q� �♦ .Board of HOalth (3rd floor): ' Sewage Permit number ....... (>'J..r..� ��. r .'.... '"'"" �;' ENVIRONMENirn c AU Engineering,Department (3rd Yfloor): ^� �Jf `, ,�` TOVU[�{ REQ TIO 9 LE B 9pi 3 r 1639 ' r House number '..:.:..:..........................:... ........... .... t DESIGNING ENGINEER Mt:�o�aY;a +VISE t APPbCATIONS PROCESSED 18:30-9:30 A.M. a'nd� 1:00-2.00 =P,M.,o y INSTALL:AT10N AND,CERTIF RITING THE SYSTEM WAS INSTALLED IN' STRICT TOWN 'OF` - STAMIJILA �"� - BARN RUI.LDIN.G . LNSPECTOR _ :. - . . . APPLICATION .FOR `PERMIT TO . ...... ....... ... ..;,.,,,,,,,,,.................... TYPE'OF CONSTRUCTION ......................... ............................................. ........... V ,, ......................... t _]_O E• c ,�. TO THE INSPECTOR OF BUILDINGS: +� The undersigned hereby applies for a permit,.according to the. following information: - - Location �� .......� 0o...l.�<.�.7.. ...... ..................................... ............................... �. .... �. - , Proposed Use ................./Q........ ........ .............. ......... Zoning District .......Fire District ! ................ Name of Owner �.. o - ' ........................... :..........`...Address ......................................................... Name of, Builder ..... •... ....Address ../0.......jy-01.Yw�.?,0,..,*C•`..... /�d1•j. y`v/���� _ Name of Architect ../.71' /.T� .:.'. sS�� 1 :� Address 1l7 Number of Rooms ... L........................:.................. .....:...Foundation :...��O.11 �/�. ....... �CR � , Exterior .......INQ.Q.b.....C✓44p.,R ...... ..................Roofing ....:. ....... ......................: Floors ....... � ... .........:..........................:.................. Interior` ........ Heatin ............ ........ g <�� ..e'..........................................................:.:.Plum . bing ..... �.. �- .................... ............................ 50 Fireplace ... r� Approximate Cost ........ ..... Definitive Plan Approved 'by Planning Board __ _____ ___ ____-_-_s___19 -____ 4.................. _ .. . Area Diagram of Lot and Building with Dimensions d .. Fee '"t"Db Y - ............................................ F SUBJECT TO APPROVAL,OF BOARD`OF, HEALTH J s OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules-and Regulations of the Town of Barnstable regarding the 'above construction. -9f IVT- Nam ,1�(,..... t ' Construction Supervisor's License DANIELS, FORREST A.� `' C�tad ���� �"���/e>-'s�.� _ _ - - • ry P �o .. ..�22... Permit for REMODEL « RECONSTRUCT = �.J2 Story,)••,Multifamily,•Dwelling.. - N923 Main Street r.. � ... .. r , �• - �- S Location ......,,... ........................ ........ T • ..i3 � _ e CO tlllt �` , I .. a c+ ww A. 4 .!' - ,pti � .. • • ............................ Owner .... Forrest;A. Daniels ` Type of Construction Frame 7 �„ ...................... ......... M .................................... ........ .............. ;............ � PlOtl....... :?_ • ... Lot ` ......�.................... ` _ �,•. `_ _ ,y � .. • �_ �, -. _ � e;T - { ' : t yOctober 9'. 86 Per"mit'•Granted :..... 19 ` Date of'Inspection .. 'Z., �... . .... ........ �ayY.. Date Completed 1�.-........ . ... ..... J19 E�k(0417 N CF. 0 10, sit •! - ho Assessor's offioe (1st floor): ?NE Assessor's map and lot number � :~-....� Board of Health (3rd floor): _ /� Sewage Permit number ...... .. ..� � ?:.(./..'....t ' i BAHII9fADLE, S .... Engineering Dep r artment (3rd`floor): 9a r—J f Boa rb 9. 0� Y House number i APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN OAF BARNSTABLE - BUILDING INSPECTOR �� APPLICATION FOR PERMIT TO . ....,.;...,.... �(. �,................- Gf:`:.................................. ................... �= TYPE OF CONSTRUCTION �� ..�. -.. !..A. />I'1d, •••................................. �.. x. �... .. ... 's .......... 19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location °{ ............... ..... .......,/.(..V .................................................................. J� . /� l.L/. J ..... /��.T. .............................................................................. Proposed.Use ................../..0........ q Zoning District .............. ....................Fire District ...................�.� �" ............................................. Nameof Owner ' ..............Address .................................................................................... r fJ , Name of Builder ....C�9 /i/.�.... �°f1�1�ZC......... ..10 V7�.dl /. ....6........,:'` 11)...�f'VE.-(� -.........Address ' Name of Architect ..,/T /T/9GE,,,,//•,S, G (47r,..3 -Address ST.. c-r.... Number of Rooms ... .....................................................Foundation ......, rJ / F ...... � rl/C/4 �} Exterior ..... t�nO. .....(...,... /�;9f�0 ?.! ..........................Roofing ......./.. �L�T...... F..........:. Floors G�1 � ...........:!f...........................................................lnTerior .................��Ck�+!'fG................. IF Heating sc^5.................................................................Plumbing ---2n r S ti...:.............................................................. Fireplace .................../ .......................................................Approximate Cost ........-?` .r!�r.R. .......................I............... Definitive Plan Approved by Planning Board ________________________________19-------- , Area .d� !- -'.... Diagram of Lot and Building with Dimensions Fee 'bU SUBJECT TO APPROVAL OF BOARD OF HEALTH ;;Pj / 0 .Y . OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .................................................................................. • Construction Supervisor's License DANIELS,- FORREST A. A=35-12 30022 / REMODEL & RECONSTRUCT No ................. Permit fo{� .................................... (2 Story) Multi Family Dwelling Location`/) ' Main Street Cotuit .....................................................................I......... Owner Forrest A. Daniels ........................................................... Type of Construction .....Frame . .......................... ............................................................................... Plot ............................ Lot ................................ October 9, 86 Permit Granted ........................................19 Date of Inspection ....................................19 Date Completed .......................................19 f x y A,A Assessor's map and lot number s 17 � OF THE Sewage Permit number ... ............................... d�Q� ♦� Z BAUSTADLE, i House inumber ..The...C.otuit..Inn........No...numb.e ''" 9 ""'a �p 2639, TOWN 'OF BARNSTA;BLE BUILDING INSPECTOR 9,—,e_4 --L � APPLICATION FOR PERMIT TO reI1oSt'ate.Akizting...facility.....................:. TYPE OF- CONSTRUCTION ...Clas.S..A..W..0.Qd............................ r� TO THE INSPECTOR OF BUILDINGS: t" r The undersigned ihereby applies for a permit according to the following information: Location Q.tIda:t.1...M.As. A................:....:. i ProposedUse ...ApAX'tfQ9.t1fia.....................................:......r................................................................................................... r Zoning District .N�?. •�!ro #'Q 'IC► XIg.................................Fire District Co.tuft.......................................................... ....... Name of Owner ..FOX' �St... .�..'. �,7 .� e.�,. �.,. X'.nAddress G.0tU].t..Inn/..Vieke.rsQn..Ea.Yle,...C.otuit e Nome of Builder IV,oY 4.0...Cr9.t.a...IAC:............................Address • 5.5... � �7,..r�. t.►. .We.S.w0.0.d Mass 020 1 Name of Architect Tellage)a/.mormac...........................Address same..............:........................................................... Number of Rooms 4.5... ]..ri!GI81_1..3...bathr.00 ndation e-ancrete....................................................... r s 0 } 4 Exterior ..Existing � ......Roofin "RE lace...ex.iS.tin-...aS. h31ta.I�'l�ir�� FloorsWQCd...eAS. Y) . ....tia. e...bathSc4kk].tl;klQnSnterior Dry. Wall. ................................................................... Heating Eie.ctri,a,`,.heat...p3um.pa...... ......... .... Plumbing ac•candance....with...plumbibg...c.odes , Fireplace .Firebr•iGk.. ....................................... ......APProximate Cost ..$375-*.Q0.0............................................. Definitive Plan Approved by Planning Board ____________ _____'------- _`_______. Area��..e �. ... (( A' .. Diagram of Lot and Buildiri with Dimensions 9 9 Fee ........`��..+.1).............................. SUBJECT TO APPROVAL OF "BOARD OF HEALTH �_ '•,` --� r Ail r i s. I hereby agree to conform to all the-Rules and Regulations of the Town of Barnstable regarding the above construction. -�-- Name . �.it:, `.. ............... Daniels, Forest A. , Jr, ' vA=q5-l2 ` - � No --23762 Permit for —. l................ ----' ................................................ . ' . . . Location Mai a..,9 tree t........................... ~ � - ............................Co.Wit....................................... - Owner --�—.3�oze�t.�L...I��i��l�..�r.—.. ' � ' ' Type of Construction ..................fzaun. - ' --------------------------. , . _ Plot ............................ Lot ................................. � ^ ^ - ~ . . ' — | Permit Granted ---- . —'lg 82 / Date of Inspection ---------...--l!9 \ � Dote Comp|ete6 ...................................... � . � � | PERMIT REFUSED ~ ^ ----.------.-----' 1p Y . . � ..�,�.+«'���:/�==—.. ^�' ---.. / . . A - ................ ................. ............. ^^� ...'......'..........................'. ' �����'' , � ----..--~----------------.— � ` Approved .................................................. 19 ` . . - --------------.—.----------. � ' ------------------'--~^--'^—' r q �t1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 1 lMap � Parcel (_-l/� -Permit# Health Division {= _1ARN-6 i ABLE Date Issued ?�63 Conservation Division ? P,3 F P _ Application Fee 8 A19 g: 4 Tax Collector Permit Fee Treasurer q1 fa �i�JIS10f� Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address .}�nyt 5 YYl�� Village cb O)l.> qq 1 Owner O_Ai It cbndb TVIA Address 3 vd— Y-n01 h b Telephone 61S `4 a o -? 0 ,y Permit Request Z- '�6 d Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: 0 Yes 0 No Basement Type: ❑Full ❑Crawl O Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:O existing ❑new size Other: Zoning Board of Appeals Authorization q Appeal# Recorded❑ Commercial O Yes = ❑No If yes,-"site plan review# Current Use Proposed Use BUILDER INFORMATION JO9,71o2 7 Name Telephone Number 6D 4c`3� LnC9 1 Address 36 '�eG 1�Ac1 Q License# Home Improvement Contractor# t a to Worker's Compensation# (9 F a,I e b IQ 10 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY P / PERMIT NO. DATE ISSUED MAP/PARCEL NO. 1 • ADDRESS VILLAGE OWNER r • DATE OF INSPECTION: F FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL ti GAS: ROUGH FINAL s ' FINAL BUILDING DATE CLOSED OUT f ASSOCIATION PLAN NO. t _ ti _ f The Commonwealth of Massachusetts Department of Industrial Accidents Office onflyesti9atfons 600 Washington Street Boston,Mass. 02111 Workers'�� ensation Insurance Affidavit nemec �� � ��'C7 � • ocatlon: hone# ®�S `� rmin all hark myself. am a homeowner pelfo g ca aci (] ;am a sole rietor and have no one workit ees working on this job. / d have no Oiii�iii iiir�irrrit/l/1,/�%y/%/%%/ %/%%�///�%%/a/�/%//iii % ensation far my em �Y^ xw.YYY �// }� workers' CO ::. •.;: }':z:;:::t:>fok:z'.'•!. y'•zi".•:•rrf,',za';'cc•`{•}f;:;�;7"+:{;<ti�+3:;ti;;t"','sad;'+••':r{iF?'•'%'%sr«n,;,:i•r,•,rx%:};. }JIQvidlnb'w°r r, {,4} :;x+t{?Si2;4Yfiz<t#;:+{S:Y;:;:,}:'} iG.t:•a••;? :x{;•Grr.4 N . 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''•:t'i+`•:z4:•:„•.v.{.f::a 3�ir'':r:. '+l'` f;;'c;++:R•'::}%';;i::++:;!):::}ifr£+'?i!'.;fYb'n.`!•.fiiii 'aJ,cY;{}„{:•r,•.4S+rY{iiS %fi!>>:.f:.r ZS3at8Bce:cQ >:YS^ eaalties of a Sne up to 51,500.00 amd(or ositlon of czb �P Fame to a ecva a coverage as tired under Section 25A,of XGL 152 can Lead to the imps ER a Gnu of 5100.00 a.day against me. I TIMA tmd{hzt a iat risonmeot as wen as Civil penalties in the form of IL g asp jowO DIA for cove ge veri�csfion. RK 0 one years P be forwarded to the Office of Inve3iii copy of this statement may _ the p ' an, P �'°fP�1w7'th I do hereby cerd at the information Provided above is truf and correct, R � signature Phone# �� Li print name pv- f'-��� do notes ita in this area to he completed by city or town of Idol offidaluse only . Building Department peradtaicense# Clucemin:Board dty or town: C3sd ctcnen!%Office ! 0He9lth 1)epart=aent ❑ cbeckifirnm 11te sponseisrequired - �ciher phone#; contact person*. (rayed 9195 PJA) r. r C Information and Instructions for Massachusetts General Laws chapter�I52 section 25 re�esdall�emloy rs to ersonprovide m the service eof another under any coetract employees. As quoted from the 'law", an employee is de every p of hire, express or implied, oral or written. An employer is defined as an individual, partnership, association, corpora�trves other d gal temployer,a wo or the morecre or ed in a iciat enterprise, and including the legal representatives engaged ] rP the foregoing g 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 app errant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or'renewal of a license or permit to operate a business or to construct.b uildin gs in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,nertherthe 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 till in the workers' compensation affidavit completely,by checking the box that applies o yafuda��� be and supplying company names,'address and phone numbers along with a certificate-of u�uan Y 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 ygu have any questions regarding the"law"or if you compensation policy,please call the Department at the number listed below. are.required to obtain a workers' City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permitllicense number which will be used as a reference. number. The affidavits maybe retnrned•tn the Department by mail or FAX unless other arrangements have been made. 'fie Office of investigations would like to thank you in advance for you cooperation and,should you have any questi=. Please do not hesitate to give us a call. TjoeP D ariment s address,telephone and fax number: . The Commonwealth Of Massachusetts Department of Industrial Accidents Office of fuYestigaugns • J 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 ❑hone#: (617) 727-4900 ext. 406, 409 or 375 MARK HERBST 35 Peep Toad Rd. Centerville MA 02632 (508) 420-6216 PROPOSAL SUBMITTED TO: WORK PERFORMED AT: Cotuit Inn Condominiums CIO Al Wohlwend SAME 923 Main St Cotuit MA 508-428-7908 We herby propose to furnish the materials and perform the labor necessary for the completion of the following; New RoQf Remove existing shingles Install ice &water shield at edge in valley areas Install 151b., elt paper Install certainteed shingles Qf chot�e Replace plumbing boots Counter flash sAylights &chimney Vent all ridges with cobra vent '" .� All debris%vill be cleaned daily Re-nail loose plywood x# 30yr. ArA tectu s, hingle S22.100,00( W I 4Qyr. 4rchitectual shingle 23,330.00( *'lease check& initial cchoice above, Thank You '' All materialis guarnateed to be as specified,and above work to performed m �-- accordance with specifications submitted for above,and completed in a substantial *" 4 workmaAliikeanner_for the sum of as specified above& verified wI your initials Dollars ! ith a ments as follows- `Yet At ��� `"��'��� �`� �Q1� 4 payments _ 1 Any allteN above involving extra costs will be added under written agreement"" bec � n extra h r e over and above signed estimate/agreement RESPECTFUL S _ Signature ACCEPTANCE OF PROPOSAL w The above prices sp fication & conditions ar satisfactory,we herby accept you are authoriz o't o , and pay nts will ecifie above. Signature(s) C 'I Date: * osal may a withdrawn by said company if not accepted within 30 days �I . .. . � �* - , , . lee-�om�inoozcuea� o�✓�aQaaclucaelta R • -4 BOARD.-,OF BWILDING REG L-ATIONs License GSTRUCTION SUOERVISbFt ' g ± Num_bej�G 0418546 t 69 hdate 1/21 R53 k �Xt y • Tr.no: 2926 Resrtr W& 14! MARK D FIERBS � OF TWERVILLE, MA 06632 Administrator I: I , , w ✓7e i�anvrhaizcuea a��/l�Caaoac�i��ael� r Board of Building Regulations and Standards HOME IMP,ROIVEME-NT CONTRACTOR Re1strtann26480 i n APT t�4n _li§,'-004 ± , e n'dwidmal i MARK HERBST p a I ' 4 MARK HERBST 35 PEEP TOAD RD. CENTERVILLE,MA 02632 Administrator. i r 109345 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # Health Division Date Issued (9 "1 t L Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address Main Street 10 Village Cotuit Owner Alfred Knight Address 51 Forest Ave #15 Old Greenwich, CT 06870 Telephone 203-698-3064 Permit Request air sealing, duct sealing, attic insulation Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 1303 Construction Type Lot Size Grandfathered: 0 Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: 0 existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ = w Commercial ❑Yes ❑ No If yes, site plan review# _ NO Current Use Proposed Use ILn u -.A -- APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name RISE Engineering Telephone Number 401-784-3700 Address 1341 Elmwood Ave, Cranston, RI 029fl�ense # 100459 Home Improvement Contractor# 120979 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE4/7 DATE 512,1110 Erik Nerstheimer for RISE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. r The Commonwealth of Massachusetts - Depart in of ndustrial,9ccidents Office of Investigations 600 Washington Street Boston;Mass. 02111 www.mass:gov/dia Workers' Compensation Insurance Affidavit: Builders/.Conira.ctors/Electricialls/Plumbers Applicant Information 'P➢ease)Print Legibly Name(Business/OrganizatiofAndividual): RISE Engineering; a division of Thiel chi-Engi n i ng Address: 1341 Elmwood Avenue _. City/State/Zip: Cranston, RI '02910 Phone#: (401)784-3700 or .1-800-422-5365 Are you an employer? Check the appropriate box: 'Type of project(required): 1. N I am an employer with 4. 0 I am a general contractor and I 6:❑New construction employees (full and/or part time).* have hired the sub-contractors 7 ❑Remodeling 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. ship and have no employees - These sub-contractors have '8. ❑Demolition working for me in any capacity. employees and have workers' . 9: ❑Building addition [No workers' comp.insurance comp.'insurance.$. required] 5.❑ We are a corporation and its 10. 0 Electrical repairs or additions 3. 0 I am a homeowner doing all work officers have exercised their myself [No workers' comp. right of exemption perm MGL 11. ❑Plumbing repairs or additions insurance required] t c. 152, § 1(4),and we have no 12. ❑Roof repairs employees. [no workers' 13. N Other Insulate comp.insurance required.] *Any applicant that checks box##1 must also fill out the section below showing their workers'compensation policy information. tHomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a iew affidavit indicating such. $Contactors that check this box must attach 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 thepolicy and job site information. Insurance Company Name: The Preston Agency r Policy#or Self-inss ic.#: 3730961-00 ) Expiration Date: 1/1/11 Job Site Address: Ci /State/Zi :.dl ri P 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 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 $250.00 a.day against violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certi and 'the ins enalties ofperjury that the information provided.above is true and.correct. Sign lure: Date: Z/ 1, Print Name: Erik Nerstheimer Phone#:(401)784-3700 or 1-800-422- 365 ext131 Official use only Do not write in this area to be completed by city or town official City or Town: Permit/license#: IssuingAutbority(circle one): I.Board of Heath 2. Building Department 3.City/Town Clerk 4.Electrical Inspector " 5.Plumbing"Inspector 6.Other Contact person: , Phone#: ACMD CERTIFICATE OF LIABILITY INSURANCE OPID 97 DATE(MM,DDlYlYY) THIEL The 09/13/YO eucER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION The Preston Agency Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1350 Division Rd Suite 303 HOLDER'.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR PO Box 810 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, East Greenwich RI 02 8 18-0810 Phone: 401-886-8000 Fax:401-885-1700 INSURERS AFFORDING COVER AGE NAIC IIJSURED INSURERA: Zurich—American Ins Co. -- Thielsch Engineering, Inc INSURER B:. wer Lc,n tom,r,ntoo c Ltebl.,l.ty Thielsch Group Inca INSURERC: North American Capacity Hi Tech Raalty Inc, 19S Frances Avenue INSURERD: Cranston RI 02910 Hartford,AInsurance Company — .INSURER E'' - - COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED To THE INSURED NAMED ABOVE FOR THE Pa ICY PERIOD IFJOICATED.NOT V TIHSTANDNC'" ANY REOUIREMENT,TERM 09 CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH'HIS CERTIFICATE MAYBE ISSUED OR _ WAY PERTAIN,THE INSURANCE AFFORDED BY'rHE POLICIES DESCRIBED HEREIN IS SUBJECI TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MA,Y HAVE BEEN REDUCED BY PAID CLAIMS. LTR JNSR r?PE OF INSURANCE - POLICY NUMBER DATE(MIN/DOM') GATE(MMp �^ LIMITS. " GENERAL LIABILITY _ _ e' EACH OCCURRENCE 2 1,O O O O O A X. COMMERCIAL GENERA-LIA8ILITY 3T30962-500 04/01/10 " 'O1/O1/'11 30 0,0 0 0 �rE PREMISES(Ea occwenca) S _- CLAIMSMaDE'.a OCCUR' - MEDEXP(Any.oneperson) g 10,.000 ' PERSONAL S ADV INJURY S 1 1000,000 • GENERAL AGGREGAIE 5 201 0 0 0,0 0 0 s GENT AGGREGATE LIMIT APPLIES PER PRODUCTS-CGMPh�PAGG $ 2;00 0,O 0 0 POLICY X JET LOC ,r. -- - Emp Ben. 1,000,000 i AUTOMOBILE LIABILnY - - A X ANY ALTO 3730963-00 0"4'/O1/10 O1/O1/11 CbMBINED"SINGLE LIMIT s'2 .600,,000 ' (Ea accident). ALL OWNED AUTOS ----'— ,S. SCHEDULED AUTOS 80DILY INJURY-(Per person).. - HIRED AUTOS - . BODILY INJURY'" NON-OWNED AUTOS _ (Per accident) , ,. -• I PROPERTY DAMAGE ; . (Per accident).,. 'GARAGE LIABILITY - L. AUTO ONLY-EA ACCIDENT q' ^ ANY AUTO OTHERTItAN EAACC I . AUTO-ONLY: AGG $ EXCESS7UMBRELLA LIABILITY _ EACH OCCURRENCE` . ; 10.,000,000 B X OC•UR CLAIMS MADE U.MB 92 6 38 3 7—0 0 A 4/01/10' O T/O 1/11' AGGREGATE $10,0 0 0,0 0 0 RDEDUCTIBLE X RETENTION F 10,000 y WORKERS COMPENSATION AND - k„ K-TORY 1-IMITS EP,. EMPLOYERS'LIABILITY - P. ANY PROPRIETGR/PARTNER/EY.ECUTtVE 3730961-00 04/01/10;, 01./01/11. E.L.,EACHACCDENT 41,000.,000 OFFI CERMEMBER EXCLUOED7 -- '"—` E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,aescribe under - SPECIAL PROVISIONS befoN - EL DISEASE-PdLIC'P CIht1T :f,1,0 0 0,-0 0 0 OTHER - C Professional Liab DVL000026.8.00 "04/01/10 09/01/11 Prof Liab 2,000`,000 , D � Leased/Rented Eqp 02UUNTD56_78 04/_01/10:-, 04/01/11 Equipment 100,000 DESCRIPTION OF OPERATIONS 7 LOCATIONS 1 VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER `CANCELLATION' SHOULD ANWOF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE*EXPIRATION , _ DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 OAYS.WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO 00 SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER."ITS AGENTS OR - s -REPRESENTATIVES, 3. AUTHORIZED R�EV - t ACORD 25(2001/08) V (DACORD CORPORATION 1988 tg �. s r e t i k r 7 Ira ��tf�kt h 9 }t1`st r.L,THIEL 1 PAGE 2 A, Also INBU�tED 51TdAME!;Th'ie1�a�,�h�i�aeet ing � ,�Lg,�„r � f ,t,, Also for,;c RISE Engineering, a"division .of Thielsch,Engineering,, Inc. Gaskell Associates_, a division of Thielsch Engineering, Inc. BAL Laboratory; a division of Thielsch Engineering, Inc. ESS Laboratory, .a division of. Thielsch Engineering, Inc. ALCO Engineering, -a division of Thielsch Engineering, . Inc. Water Management Services, a division of Thielach Engineering, Inc. , i 000\ 91te Off o �nsmer fait; an us1ness - e u anonO e g 10 Park Plaza - Suite 5170 M Boston, Wssachusetts 02116 Home Improve& ontractor,Registration - - 'Registration: 120979 Type: Supplement Card Expiration.: 3/25/2012 THIELSCH ENGINEERING ERIK NERSTHEIMER 1341 ELMWOOD AVE. CRANSTON, RI 02910:` A Update Address and return card.Mark,reason for change. Address 0 Renewal Employment Lost Card DPS-CA1 is 50M-04/04-GGIO1216Q . .. ,.tom ✓ite Z/7G✓77/I)2002c!/CCLG/.iL Oy i/l�CllllOpCft(.t6C�6 , •. \ Office of Consumer Affairs&Bu iness Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation Registration 2 p�79 Type: 10 Park Plaza-Suite 5170 Expira oft-={ '12 Supplement Card Boston,MA 02116 THIELSCH EN&t� ERIK NERSTHE 0__ 1341 ELMWOOD� - ��-� ° CRANSTON; RI 029f�c_p: Undersecretary Not valid without signature agt10I1 The Official Website of the Executive-Office of Pub lid Safet y,and Securify (EQPS) - Mass. Gov Home r Public Safety Department Of Public Safety Licensee COriiplaints"' License Type Construction Supervisor,N License#! 100459 Restriction WS,IC Name Erik Nerstheimer City, State, Zip North.Scituate, RI,-02857 r Expiration Date 3/28/2012 Status Current r No complaints found for this Licensee. Back_ To Search ✓/7�. V[1jj L7j'1�iLj7�G(fP�/L Vy�Y/_.,L4� - .. - I _ "_. .-. Board of Biiildino Regulations Ind Standa71't3 License-or registration vah d-for individul'use only ii HOME IMPROVEMENT CONTRACTOR i. before the expiration date.. If found return to: !' Registraiioh: 12097g Board of Building Regulations and.Standards' Expiration 3/25/2010 One Ashburton Plate$m 1301 Type Supplement Card 'c?st�31,Ala. 027.08 IELSCH ENGNE;ERING= IK NERSTHEI�IR= 11 E L M W 0 0 D RVE'` ANSTON, Rl 02910 .T,,...... — _ r Admmisti �tor - ---- Not valid without sign . i.- 'a'"F'' http://db.state.ma.us/dps/licdetails.asT)9txtS earchI.l\T—rQT 1 nnA cn RISE ENGINEERING Federal ID n 06-0406629 RI Contractor Registration No 8186 A division of Thielsch Engineering MA Contractor Registration No 120979 CT Contractor Registration No 620120 1341 Elmwood Avenue,Cranston,RI 02910 r x�, (401)784-3700 FAX(401)784-3710 CONTRACT Page I S E S c 1, - � r„�'" Y � THIS CONTRACT IS ENTERED INTO BETWEEN RISE `n .� ENGINEERING AND THE CUSTOMER FOR WORK AS IeNC.INEERING ��Ag�� �� :j DESCRIBED BELOW CUSTOMER WWWW^"lll w w YYY!!! _ PHONE DATE Client# Alfred C Knight (203)698-3064 04/16/2010 109345 SERVICE STREET r BILLING STREET 923 Main Street 10 51 Forest Ave#15 SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Cotuit,MA 02635 Old Greenwich,Cr 06870 44 (0,0 JOB DESCRIPTION , I RISE Engineering will provide labor and materials to seal areas of your.home against wasteful,excess air leakage. Thiswork will be performed in concert with the use of special tools and diagnostic tests to assure.that your home will be left with a heal 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 attics,basements and other unheated areas(windows are not generally addressed.) This work will be performed at the rate of$66 per man per hour,which includes materials and testing. 12 man hours.This measure is available for 100% rebate from the Cape Light Compact. $792.00 RISE Engineering will provide labor and.materials to seal heating and/or cooling ducts within designated unheated areas. This work will be performed at the rate of$75 per man per hour,which includes materials. 1 man hours.This measure is available for 100%rebate from the Cape Light Compact.Basement supplies and retums. $75.00 RISE Engineering will provide labor and materials to install a 8"layer of R-30 Class 1 Cellulose added to 374 square feet of open attic space. $411.40 RISE Engineering will provide labor and materials to install insulation and weatherstripping to 1 attic.access hatch(es). $25.00 RISE Engineering will apply all applicable,eligible incentives to this contract. You will be billed only the Net amount..Currently,for eligible measures,the Cape Light Compact offers 75%incentive,not to exceed$2,000 per calander year. -$1,194.30 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***One Hundred Nine&10/100 Dollars $109.10 UPON FINAL INSPECTION AND APPROVAL SY RISE ENGINEERING.CUSTOMER AGREES TO REMIT AMOUNT DUE IN FULL INTEREST OF 1%WILL BE CHARGED MONTHLY ON ANY UNPAID BALANCE AFTER 30 DAYS SEE REVERSE FOR IMPORTANT INFORMATION ON GUARANTEES,RIGHTS OF RECISION,SCHEDULING,AND CONTRACTOR REGISTRATION. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES t - C AUTHORIZED SIGNATUR RISE ENGINEERING CUSTOME CCEPTANCE r NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE G, ACCEPTANCE OF CONTRACT-THE ABOVE PRICES,SPECIFICATIONS AND CONDITIONS ARE y SATISFACTORY TO US AND ARE HEREBY ACCEPTED.YOU ARE AUTHORIZED TO DO THE WORK DAYS. n AS SPECIFIED.PAYMENT WILL BE MADE AS OUTLINED ABOVE �. �O ��