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HomeMy WebLinkAbout1221 MAIN STREET (COTUIT) IZ z � INI� NSI - 4 ''elephone 508/563-6049 . COLONY INSULATION;INC. 28 Jonathan Bourne Drive, Pocasset, MA 02559 CLOSED-CELL FOAM INSULATION SPEC SHEET CONTRACTOR: JOB SITE ADDRESS: DATE: V0 AREA THICKNESS : R-VALUE _ Ceiling — Cathedral Ceiling Garage.Ceiling. — Basement Ceiling-- Slopes - - Exterior W al.] — Garage H-se. Wall' — W alkout W alh• — Cathedral W all " B lockers S tair/Risers . , All R-values and thickness easurements are deemed to be accurate by the following installers: r TECHNICAL DATA FOR MATERIALS IS ATTACHED�TO T.HIS-FORM - ' - Town of Barnstable _ 3 _ _ F Buildn °Post'Ais Card So-T__hat rt is Uis�ble From=the Street; A droved Plans Must b'e Retained one ob and this Cartl Must:be_Ke t `_ g. nn�LE, • �. � - . :. �t � �Epp � ,� � � P Pasted=Until Final,lnspection Has=Been.11[lade s a ' ' Whe_re a Certificate of Oecupancy'�s Required;rsuch Building shall;Not be O copied until a F�naLlnspect�on has been matle :; Permit ems. .�, a.�.. .. -s. ,. ..�. :.. F.. .. .�� .� , '. �..:. *..... . .' ....E�. .. Permit NO. B-19-3379 Applicant Name: A I ENTERPRISES INC. Approvals Date Issued: 10/29/2019 Current Use: Structure Permit Type: Building-Addition/Alteration=Residential Expiration Date: 04/29/2020 Foundation: Location: 1221 MAIN STREET(COTUIT),COTUIT Map/Lot: .018-061 Zoning District: RF Sheathing: Owner on Record: 1221 MAIN STREET LLC Contractor Name: Al ENTERPRISES INC. Framing: 1 MX Address: 7905 FOXHOUND ROAD Contractor License 109606 2 MCLEAN,VA 22102 Est Project Cost: $ 100,000.00 Chimney: Description: Remove and rebuild existing sunporch, replace(8) existing,windows Permit Fee: $560.00 and window trim.Add 8' new sliding door. Strap and reside existing z Insulation: Fee Paid? $560.00 house. Remodel existing(1)floor full bath Final: Date 10/29/2019 - - Project Review Req; R h Plumbing/Gas f _ Rough'Plumbing: 77 7 `,Building Official: Final Plumbing: This permit shall be deemed abandoned and invalid Unless the work authonied bylithis permit is commenced within sik months after issuance. All work authorized by this permit shall conform to the approved application and the approved construction documents#or whieh this permit has been granted. Rough Gas: All construction,alterations and changes of use of any'building and structures`shall tie in compliance with the local zooirg by laws and codes. This permit shall be displayed in a location clearly visible from access street or,road and shall be maintained open for public mspection for the entire duration of the Final Gas: work until the completion of the same. r ' •a q n et. ,Electrical The Certificate of Occupancy will not be issued until all applicable signaturesby the Building and Fire Officials are provided on this permit. Minimum of Five Call Ins ections Re wired#orAllConstruction Work: t; Service: 1.Foundation or Footing 4 ,p 2.Sheathing Inspection ;. S a R 22 Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage.Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. - Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site v All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT 6A, Final: Application Number.................................................... Section 5—Detail s� Cost of Proposed Construction/M.O®©-ed Square Footage of Project ` a Age of Structure //C1 le'9 25 Dig Safe Number # Of Bedrooms Existing Total#Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ( Design Section 6—Project Specifics Wiring ❑ Oil Tank Storage ❑ Smoke Detectors ❑ Plumbing ❑ Gas ❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney El Add/relocate bedroom i Water Supply 0 Public ❑ Private. S Sewage Disposal ❑ Municipal ry On Site g P P Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: G'G�c%��./�'�/` � I am using a crane ❑ Yes No Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No IN Section 8—Zoning Information Zoning District Avc Proposed Use/��f�✓� Lot Area Sq. Ft. Total Frontage Percentage of Lot Coverage a'�� �� # of Dwelling Units (on site) Setbacks Front Yard Required Proposed Rear Yard Required /5 Proposed Side Yard Required ew Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes No Last updated: 11/15/2018 Application Number........................................... r Section 9- Construction Supervisor Name /�� h/. ;-SX4&7T Telephone Number Address X Zc95 City <7— State lt4f Zip 026,3 License Number6S -6;50�5 7 License Type66A2E—,x,4zb Expiration Date Contractors Email ;Dome-1711:C41P ,1l474 Cell# 60�� --776, I understand my responsibilities undWthe rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required b CMR a Tows of Barnstable.Attach a copy of your license. / Signature Date Section 10—Home Improvement Contractor Name_�1^' iG � /�• Telephone Number r; Address /7/�gG&t city aFc&/ State �� Zip Registration Number lD�l Oy Expiration Date 7�,A��a y. I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required 80 CMR the Town of Barnstable.Attach a copy of your H.I.C... Signature Date o 9 / Section 11 —Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the-Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date ,,,APPLICANT SIGNATURE Signature Date /o g/� Print Name T Telephone Number E-mail permit to: Last updated: 11/15/2018 Section 12 —Department Sign-Offs { Health Department ❑ Zoning Board(if required) ❑ Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ : Conservation - ❑ For commercial work,please take your plans directly to the fire department for approval Section 13 — Owner's Authorization / i I, 4Jo dtn W0_ c,0—H— , as Owner of the subject property hereby authorize �G- / 1,E777 to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of j ob) Signature of ne `l date Print Name Last updated: 11/15/2018 Town of Barnstable, MA Page 1 of 1 Town of Barnstable, MA Friday, October 25, 2019 Chapter 240. Zoning Article VI II. Nonconformities § 240-92. Nonconforming buildings or structures used as single- and two-family residences. , A preexisting nonconforming building or structure that is used as a single- or two-family residence may be physically altered or expanded only as follows: A. As of right. If the Building Commissioner finds that: (1) The proposed physical alteration or expansion does not in any way encroach into the setbacks in effect at the time of construction, provided that encroachments into a ten-foot rear or side yard setback and twenty-foot front yard setback shall be deemed to create an intensification requiring a special permit under Subsection B below; and (2) The proposed alteration or expansion conforms to the current height limitations of this chapter: B. By special permit. If the proposed alteration or expansion cannot satisfy the criteria established in Subsection A above, the Zoning Board of Appeals may allow the expansion by special permit, provided that the proposed alteration or expansion will not be substantially more detrimental to the neighborhood than the existing building or structure. https:Hecode360.com/print/BA2043?guid=6559881 10/25/2019 r ACoMODN 10/02/2019 CERTIFICATE OF LIABILITY INSURANCE °ATE(M /2019"' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsemengs). PRODUCER NAME:CONTACTAllison Petkiewich-Sousa RSC Insurance Brokerage,Inc. PHONE (781)9864400 (781)963 4420 A/C No Ext: JC No 15 Pacella Park Drive ADDRESS: apetkiewich-sousa@risk-strategies.com Suite 240 INSURER(S)AFFORDING COVERAGE NAIL tl Randolph MA 02368 INSURERA: AIM Mutual Insurance Company INSURED INSURER B: A I Enterprises Inc INSURERC: P.O Box 2056 INSURER D: INSURER E: Cotuit MA 02635 INSURER F: COVERAGES CERTIFICATE NUMBER: CL1910233615 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TR TYPE OF INSURANCE INSD WVD POLICY NUMBER MIWDD/YYYY MMIDDNYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR (Ea PREMISES a occurrence) $ r MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'LAGGREGATE LIMIT APPLIES PER: _ GENERAL AGGREGATE $ POLICY ❑JE Q F LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident _ ANYAUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTYDAMAGE $ AUTOS ONLY AUTOS ONLY Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DIED RETENTION$ $ WORKERS COMPENSATION X PER STATUTE ER AND EMPLOYERS'LIABILITY YIN N _ ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 A OFnCEPJMEMBER EXCLUDED? N/A WCC-500-5017622-2019A 07/18/2019 07/18/2020 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER " CANCELLATION SHOULDANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main St. AUTHORIZER RREPRESENTATIV9 Hyannis ? MA 02601 , E O 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts Department of IndustridAccidents. Office of Investigations 600 Washington Street ' Boston,MA 02111 www mass gov/dia' Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leeibly, Name(Business/Organization/Individual): ������` �f •c/C Address: City/State/Zip: Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1. I am a employer with �Z 4. I am a general contractor and I 6. New construction employees(full and/or part-time).* have hired the sub-contractors ❑ 2.❑ I am a sole proprietor or partner- wed on the attached sheet. 1. Remodeling ship and have no employees These sub-contractors have g• 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.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.[1 Plumbing repairs or additions m sel£ o right of exemption per MGL y [N workers'comp. 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees.(No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. 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-contracbms have employees.they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lie.#:�,4J�C-5��$O/7loZ2—a4/4fja Expiration Date: 7��/0 Job Site Address: �� til/t7�'/ City/State/Zip: C-dTy�T,/��d' ✓ Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi der th and penalties of perjury that the information provided above is true and correct: Signafore: Date: Phone# " Official use only. Do not write in this area,to be completed by city or town gfj-iCia1 City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone M Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public-work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for conformation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the mniber listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials , Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would lice to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents trace of Investigations 600 Washington Street Boston,MA 02111 - Tel.#617-727-4900 ext 406 or 1-877-MASSAM Revised 4-24-07 Fax#617-727-7749 www.maw.gov/dia r 9 �.vnni�unwemui v� maaoa�nwcua Division of Professional Licensure Board of Building Regulations and Standards ConstrgC � tf>�r �iS' rvisor �. � CS050457, ti' .h' L empires 04/19/2�020 PETER M POMETTI PO BOX 2066�: i COTUIT MA 0165 N• -0 Commissioner .T�,e �.,.,�,aoper,�reo.�..�g�✓//6o.�1¢cr�;deCf, ;:_............_..----- --. _ . 1 . Office of Consumer Affairs&Business Regulation HOME IMPROyEMENT CONTRACTOR j TYj-4---�Corooration a Registration valid for individual use only Re i ri x ratio before the expiration data. If found return to: E Office of Consumer Affairs and Business Regulation 09/20/2020 A I ENTERPRIS�-.__ 1000 Washington Street-Suite 710 � _-�'�; Boston,MA 02118 PETER M.POMETToo 140 LITTLE RIVER`R ` COTUIT,MA 02635 j Not valid Without Signature Undersecretary � g i Town of Barnstable tits a�tt�s Planning&Develapment'Department', ""r Barnstable Historical Commission: . ,�ssrAetE. aas.a .2 ,Hyaruus,,Massachusetts 02601 s� .'� Phone'n 0o8)a862-4787 Fax(50.8)862-4734 Maul Street' _ e a town:barnstable.ma us t p s .C'OMMISSION.MEMBERS:- Eli abeth Jenkins,Direcxor; • Erin K.Logan,:Adminislrattvc Assistant t 'Laurie Young Chair. ancy Clad:.Vice:Chair' Marilyn Fifield Clerk'. Gcorgc Jcssop,AIA ,`•�•�;::� ;f Cl Nancy;Shoemaker ; 'Eliiabcth-Muntfurd' }t r r,.17 M ?;j�r .:.-:..,•� DECISION Summary: Demolition Delay NotImposed Pursuatit�to.Chapter t 12;Historiekroperties; Section;l 12-3 E' =Y Applicant/Property Owner:; 1221 Main Street L`LC c`SubjectProperty: 1221 Main Street,Cotuitix }ti Assessor's Map1Parc'e&- 018T061 ,. He i..ng.Date:: September.l92017 Pursuant to,the.:Barnstable Historical'Commission rece iving.your nonce of intent,on August 1.7, 2017, :duly '.advertised and noticedpubLe,ltearing was field on September 19,2017 to determine whether the signiftban structure. identified as.a single family stricture'on this property;isApreferably, preserved significant building and whether "demolition delay would be imposed for the partial demolition of this structure on the parcel-addressed as 1224 Main. Street,Cotuit;Map 018;P.arce10..1 After rexiew;and:.consideration of;publicaestimony, application and rccord;:file,`the;,Commission by"a'unanimous t' 4'. rote, found that=in accordance with Chapter 112E the par ial dctriolition of ahe•sin le family. structure is:nota M prefecably`preseryed significant building. 'in accordance with Chapter 112-3 F,the Commtssion deterrnined bya unadimous vote that:the partial d-mblition of; the single fare ly,dwelling;:would not be detrimental;:to tiie.historicat culturalor architectural heritageor.resouices;of' the Town. t #_ UdIdue, .Chr' Dute cc: Brian Fiorcncc,.Building Commissioner '? Ann Quirk_Tawn>Glerk:. • I 200 Main Suvct,:Hyaunis,NLN 0260111))30"62 l787(0:508462-1784 367-Maia.Street.I1'umis,:NIA 02601,Ui)5UB-8ii2-1678(f)50M62478 r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION pap Parcel— Health placation # Health Division Date Issued Conservation Division Application Fee S v co�3 Planning Dept. Permit Fee ` Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address 1499%1 4447``-1 Village, 6�0 4F Owner Z�/ ��iJ�� GLG 7 ®9 �novs+e' xz f Address j/�fi o'� -"/®z Telephone 703 ' & Jpf 4permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay V . ;Project Valuation `Ss 0011`b Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family IS( 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 rya —y Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor o r m Courild Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other U Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood , oal stole": ❑As ❑ 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) Avef Name Telephone Number Address _ / d10 License# Home Improvement Contractor# i Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE �• `� FOR OFFICIAL USE ONLY APPLICATION# I DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: ,FOUNDATION. , FRAM (i l))Its INSULATIONS FIREPLACE ELECTRICAL: ROUGH FINAL } PLUMBING: ROUGH FINAL GAS: ROUGH FINAL f FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. VMassachusetts -Department of Public Safety .Board otBuilding Regulations and Standards Construction Supervisor License: CS-050457 PETER M POMEf3I PO BOX 2056 COTUIT MA 026:35 Expiration Commissioner 04/19/2014 C X e own&&.uuealt/z a�C�/�cuaachadetfa License or registration valid for individul use only Office of Consumer Affairs&Business Regulation g Y rOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration; ,:T09606 Type: Office of Consumer Affairs and Business Regulation xpiration: _912:1J2014. Private Corporatio-.i 10 Park Plaza-Suite 5170 I PEWERPRISES Boston,MA 02116 A t: PETER POMETTI 140 LITTLE RIVER RD....... g I COTUIT, MA 02635 Undersecretary Not valid without signature ., x N1-1 2/2.712013 5: 49:58 AM PAGE 2/002 , Fax Server CERTIFICATE OF LIABILITY INSURANCE DATE(MMr 491" Y) IFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICAT S CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. �- THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER. U IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require and endorsement A statement on this certificate does not confer rights to he certificate holder in lieu of such endorsements . PRODUCER CONTACT NAME: HORGAN INS AGCY INC PHONE FAX PO BOX 2S0 (AIC,No,Ext): (AIC,No): E-MAIL HYANNIS,MA 02601 ADDRESS: 28XBF INSURERIS)AFFORDING COVERAGE NAIC 9 INSURED INSURER A: CONTINENTAL CASUALTY COMPANY A I ENTERPRISES INC INSURER B: INSURER C: INSURER D: PO BOti 2056 INSURER E: COTMT,MA 02635 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS 15 TO CERTIFY THAT THE POLICESOF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT;TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THEPOLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAM. INSR ADD SUB POLICY EFF DATE POLICY EXP DATE "it TYPE OF INSURANCE L R POLICY NUMBER (MNIIDDIYYYY) (MMSODIYYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGETO RENTED CLAIMS MADE OCCUR. PREMISES Ea occurrence) $ ED EXP(Any one person) $ RSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER' ENERAL AGGREGATE $ POLICY 0 PROJECT❑LOC RODUCTS-COMPIOP AGG': $ AUTOMOBILE LIABILITY COMBINEDSINGLE S ANY AUTO LIMIT(Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Per person) HIRED AUTOS BODILY INJURY $ (Per accident) NON-OWNED AUTOS PROPERTY DAMAGE. $ (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE s EXCESS LAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ A WORKER'S COMPENSATION AND X L M STATIIrORY OTHER EAVLOYER'SLIABILITY YIN UB-C^_76M142-12 07/18/2012 07/182013 OMITS ANY PROPER rrORIPARTNER/EXECUTIVE a NIA E.L.EACH ACCIDENT $ 500,000. . OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L DISEASE-EA EMPLOYEE $ 500,000 1 yes,desr:ribe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 560,000 .. DESCRIPTION OF OPERATIONS!LOCATIONS/VENICLES/RESTRICTIONSISPECIAL ITEMS THIS REPLACES ANY PRIOR CERTEICATE ISSUED TO THECERTIFI�SATE HOLDER AFFECTING WORKERS COMP COVERAGE. CERTIFICATE HOLDER CANCELLATION TOWN OF BARNSTABLE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 200 MAIN ST BEFORET PIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORD J( E WITH THE POLICY PRO N . AUTHOR E�1 R RESENTATIVE HYANNIS,MA 02601 ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 1988-2010 ACORD CORPORATION..All rig eserved., / i Tom.of R�.rn.st���e . ���e�ry,Bti?ldiug fia,nmfs�inner - �?� C4#Fice:':5t18 gQ4038 xo e (�mx -us. Co�p1ct6 ai Sy .'1' iis This-Section 'V V e' cs� � r7 1 ��der of>ttse su�je�.pzap '. �,caz�t, �oa1s aye.z�o��Q�e f��d•�r us�ized.:�:'.b��xe cc�az�t�l�d auci:�.f n�1. ri ec�lotis. te::j� riec ..ad acceCed.. i' f�wncr I ; mtvxe.o�.Agplit.�at . - taze o • . mtt n r I a"�.t r'� 4 .s •w,,.,,. if f. In�i .at• t '.i,�� •�'` � }�a:��. a._ .I �cs„� ti `f�' '� x..��d t""'L C.'�''i..• � ,nyp,�,y ��s. -i`2'v,C'a. _ S` � � ?'��'. -II< jy� �'L.v � �i' ��F �T •�"� '�` e? j nk hyi� snr � w < -.i� �, S': 7js•P.•52 -e4;r�+, �:�4 z:�,. itSW. `kr 'K%� r �i.'r 3� n,�•Mc"fi. .��y ;.�`r, �• y �„a n , �r �.. �'3�o y.F^+Y��' , �q�..�;'x, y k x Vie:: r '9ii��hr��.. - :.a,e -" �-r�� ��•:�- a� per -1` ..- �. nii V, r", A.YiF ^ l�-. 6� �� y�v�,� . R�'� � '`,�,�_ � Y�,'�'a. '�`r,�y �� $ , �'�. .✓k�fr` _ u ����-i � i �'-M, a. Sri�` .�`_'_'ai�'�„t`�Y+ � �nE'z�,••�'^�r,:F rf �4,� n.�t .+$:� �-,1.'l Svc�.1� <i }-., _ i-�- �p�.v. •w �.- `.+* y -.. "r _)_._ 1 ,. .d` .it.---tXv` 'nq,� xrt ^��'`e{1'_. a• r-. < - +T - :. •n � c 'fir FP, - I � :' . `; �•frFn + ���7�t d .�vT ,i���a-�j' ��z� .� �r � �ti .1F� a" �C' _ �+ `c�. ��'�"a:-x � .<• ' � r-{ &. y :„r." S1 ti-� �"tea�k _ - � yy..v"s•Y Is-. 't _ ``' -Y�o'}' „`.�- <- `�'N t• sue- _ y I -. f�.r`;r���`� .y�S � �+'' ,yaScz lib. tc }�t `"'�r• ��,,tdb'� ,J. � �.� � w,.y �1�,tip,.. -.+ u _ ` ti� -s.. i V i t r4a0' <. �'���c pp�i�' Cam` -f,. .?�"ir•.. ''�i'�.,. �� F � '4 'i w. s`.`� t ,�{� jT�:r _ S �+h-�� �+BC"rfi�F ��� i h� - '.vJ. _ :.T y..�Jy 4i[Y•, � t l � ��y�.,,. d'�rL"4� $ �� 5 �+{ � ���err.,— 1 �`T�r '`IK'W � �'.� +� •� �S - �'s�, .y:�y .i •q •-ii utr , ... �'rSg. "�.7 ,�+� �� '�� K{��� "4c ��� W .�„�,sy �-: �.i1 1 ��, 'X;.�.�. ' 3 x '� '�' - �' .- '„��'�'a •r�r +. r f rw�.� ?T7.'t' - -,-+ r'^•u 'C` Y r. v-r-.i;,.vY ,F Jgo ,�aw1 'y. ,a�,rr�,��r r .y. y a- -5 ��' F -w •y .r. ; _ syoia ' _ r Y• 3 e yx•- '}„yi?+ d ... -,_ t '!br„ '`J r'.r- 9E' �1x' -�z" v.7 -'ftaNX - w•a.n .�s '}..r ,"1"�.` _-z k '�' '�„ '� ?� +: }_ .n -. r J v -4. k._li`T-'r 1 n'_ �' Sx+•'f.�'r<`.ayr�t veh` ��"`� -a��'�xt �� ; s S � ! �` a�?, ���r�� iJ• �"¢:� mow, `�C��,. �.�.�l.`'� o �,,[T. - 1 �'.� n�. � � l�`�� .rt•. 7`aM±.y/^4� ice., elt � � .�.y�.•,,fir'�. �'� '``l -u 4` i •t �►`f ram. � -�i. h rid+ M•y # ram : r OA=DETECTOR ,, .- 4= SIAOKZ:tig P/E O , �o RIDGE BEARING WALL - N Z 0 EXIST.2X8 RIDGE c\I ° NEW DBL 2X8'5 @ 16°O.C. m aD EXISTING 2X8 RAFTERS @ I G"O.C. ., 1/2°CDX PLYWOOD _ N V Q Z _. -NEW 2X8 CEILING J015T5 @ IG'O-C. - Q W O U)X z a < 0Q Zcr F 12 — —— 1 2 LA Lt 4 3/4(+/-) — _ —— a 3 112 w O * o Q ¢ U EXIST.TOP PLATE LINE OF EXIST.FLAT CEILING o �+ O - ------------------ -----——————————— EXIST.TOP PLATE .. EXIST. - .EXIST- �N BEDROOM o LOFT u cn- x- N f -VAULTED CLG. - co VAULTED CLG- - _ W C) m -- N Co 14'-0 3/4" NEW SECOND FLOOR EXIST.SECOND FLOOR _ EXISTING TOP PLATE R EXISTING FLOOR JOISTS EXISTING EXISTING LIVING RM. REAR ENTRY LV _ 27'-8" EXISTING FIRST FLOOR - - Lu —III EXISTING EXISTING FLOOR JOISTS Fla I I 'w _IiI=II. CRAWL SPACE ElIlEilll=- o EXISTING CONCRETE i1I I II I I � N U) 'JO FOUNDATION WALL ' EXISTING /- BASEMENT ? r G PRELIMINARY ZtL CROSS SECTION ` wa 9 94-Aft, tce a. o TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 0/4 Parcel o�O� Application 11 ? �O� Health Division Date Issued QJ , Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address /°��/ ��'i�✓ �T Village CW7_111i1 _ 06 Owner �/��i✓ /V.4�✓G}� Al�C077- Address,16 egZ'W/ (✓ �o" O� Telephone 7dJ f'�✓� �� Permit Request Square feet: 1 st floor: existing AW proposed/700 2nd floor: existing /D proposed//00 Total new Zoning District Flood Plain Groundwater Overlay ' Project Valuation ol�QVO•v0 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 //� yam° Historic House: W/Yes ❑ No On Old King's Highway: ❑Yes M/No Basement Type: YFull Q Crawl ❑Walkout ❑Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing 3 new d Half: existing c'_? —new , �O Number of Bedrooms: 1 existing Onew Total Room Count (not including bathe): existing 1? new 62 First Floor Room Count Heat Type and Fuel: ®"Gas ❑Oil ❑ Electric ❑ Other YPentral Air: ❑Yes m No Fireplaces: Existing / New Existing wood/coal stove: ❑Yes 2 No Detached garage: Ciexisting ❑ 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 site,es Ian review# Y plan C> Current Use Proposed Use =t APPLICANT INFORMATION (BUILDER OR HOMEOWNER) ' �E7f��®r+=e�Gs7'77 Name d��L Lj ��G�i � Telephone Numbers °g e2a`'�!g Address �� 'k License Geri '`�'� `� 1375— Home Improvement Contractor# /096e9<9 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TOw'� SIGNATURE GrYy DATE /2/J I FOR OFFICIAL USE ONLY } APPLICATION# DATE ISSUED k t t ' MAP/PARCEL NO. f ADDRESS VILLAGE OWNER 't i DATE OF INSPECTION: i FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL ' r , PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. ' The Commonwealth of Massachusetts - - Department oflndustriidAccideists Office of Investigations 600 Washington Street- Boston,AM 02111 fvww.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Address: City/State/Zip: corcllr, PhoneA. Are you an employer?Check the appropriate box: Type of project-(required);, 1. I am a e Io with 4y 4. ❑ I am a general contractor and I �P Y� 6. ❑New construction . .. employees(full and/or part time):* - have hired the soh-contractors. 2.❑ I.am a-sole proprietor or partner- listed on the'attached sheet' 7. Remodeling These sub-contractors have slop and have no employees '8. Demolition workingfor in an capacity. employees and have workers' y, p ty. 9. ❑Building addition [No workers' comp.insurance comp.fioi ance.t required] 5. ❑ We are a corporafion'and its 10.❑Elect ical repairs or additions officers have exercised their 11. Plumb'' r airs or additions 3.❑ I am a homeowner doing aII work ❑ i eP , myself. [No workers' comp." right of exemption per IVIGL .:' 12.❑Roof repairs '. c.152 1 and we have,no ra insunce required.]t. § 4),: e employees.[No workers 13.❑ Other camp.insurance required:) *Any applicant that checks box#1 must also fill out the section below.showing their workers'compensation policy information. t HomeDwn=who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavitindicating such, $Contractors that check this box must attached an additional sheet showing the name of the sub-contracto]s and state whether or not those entities have employees. If the subcontractors have employees,they must providb their workers'comp.policy numbcr. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job,site information Insurance Company Name: Policy#or Self-ins.Lic:# y�3�O'2�7/ 7 °� /`L Expiration Date: ��FAXO`✓? ' Job Site Address: City/State/zip: � . Attach a copy of the workers' compensation policy declaration-page*(showing the policy number and expiration date). Failure.to secure coverage as required under Section 25A of MGL c. 152 can Lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as-well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be.advised that a copy of this statement may be forwarded to the Office of ' Investigations of the DIA for insurance coyera�e verification I ito hereby certffy apd9r the pa'!. d penalties.ofperjury that the informaton provided above is true acid correct Si tore: G,/% .. Date: c�.✓/ ./✓ Phone# c 0' _11A& —TA/ Official use only. Do not write in this.area,tb be completed by°or town official 'City or Town. Permit/License# Issuing Authority(circle one): 1+Board of Health 2.Building Department 3.City/Town Clerk 4:Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person:. Phone#: . Rightfax N1-1 2/27/2013 5 :49:58 AM PAGE 2/002 Fax Server CERTIFICATE OF LIABILITY INSURANCE DATE(nnMrDD'vvrn TUA.PWIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE . THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require and endorsement. A statement on this certificate does not confer rights to he certificate holder in lieu of such endorsements . PRODUCER CONTACT NAME: HORGAN INS AGCY INC PHONE FAX PO BOX 250 (AIC,No,Ext): (A/C,No): EMAIL HYANNIS,MA 02601 ADDRESS: 28XBF INSURER(S)AFFORDING COVERAGE NAIC it INSURED INSURER A: CONTINENTAL CASUALTY COMPANY :F A I ENTERPRISES INC INSURER s: INSURER C: INSURER D: . i PO BOX 2056 INSURER E: COTMT,MA 02635 INSURER F: 'COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POUCIESOF INSU NCE LISTED ELOW HAVE BEEN ISSUEDTO THE INSURED AMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN.MAY HAVE BEEN REDUCED BY PAID CLAM. IISR ADD SUB POLICY EFF DATE POLICY EXP DATE t LTR TYPE OF INSURANCE L R POLICY NUMBER (MMIDD\YYYY) (MMIDDIYYYY) LIMITS GENERAL LIABILITY ACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ CLAIMS MADE r7 OCCUR. w1REMISES(Ea occurrence) HIED EXP(Any one person). $ RSONAL&ADV INJURY $ GEN'L AGCREGATE LIMIT APPLIES PER ,ENERAI_AGGREGATE $ t ' POLICY PROJECT❑LOC RODUCTS-COMPIOP AGG $ x AUTOMOBILE LIABILITY COMBINED SINGLE ANY AUTO LIMIT(Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ A WORKER'S COMPENSATION AND h WC STATUTORY OTHER EMPLOYER'S LIABILITY YIN LJB-0276M742-12 07/18/2012 07/182013 LIMITS ONY PROPECERIME BERlEXCLUDRlEXECl1TIVE M NIA E.L.EACH ACCIDENT $ 50.0,000,;? .OFFICERIMEMBER EXCLUDED (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,descritm under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES/RESTRICTIONSISPECIAL ITEMS y , THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. CERTIFICATE HOLDER CANCELLATION TOWN OF BARNSTABLE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 200!MAIN ST BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORD!( E WITH THE POLICY PRO N . AUTHOR EI R RESENTATIVE HYANNIS,MA 02601 ACORD 25(2010105) -The ACORD name and logo are registered marks of ACORD. 1988-2010 ACORD CORPORATION.,All rig hWeserved- Massachusetts -Department of.Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-050457 , C_ PETER M POME T-TI PO BOX 2056 COTUIT MA 02635 Expiration Commissioner 04/19/2014 e2e�po�nrrao,uvea�C/d C�/�aJacrc�c�eCta . - License or registration valid forindividul use only Office of Consumer Affairs&Busi�ss Regulation g y OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:. egistration: ,.1'09606 Type: Office of Consumer Affairs and Business Regulation xpiration: 9/21/2014 Private Corporatio°i 10 Park Plaza-Suite 5170 VP�EERP Boston,MA 02116 ARISES ItC PETER POMETTI f; 140 LITTLE RIVER RD< g lL j COTUIT,MA 02635 ' "` - Undersecretary i Not valid without signature . i t Town of lR stabl eg Building Dion,: ' �'om Per..ry,Bu�ldin��ornnxfs�inner , i` �a6ltlfttin.:a"Free�H5+2mm�e�,A.4260T' - . vv�rlr:t9irF.burhsin�Ia.ra�..�, - 508462 4038 P'tPperty owner-must. ,ecti 1 �. fi`�1.18 S. �, CO�7Ct. t�� If Using A.Build= o owner csft suject, xaprxty m.:Al r=t V=xeiadSQe. -."Ol .pth6I ed by,this bixta:ag pE�t�t, y /�•l �!h •., ca-�,14'� DES k a (Ad&ess of.ro�) ¢oi;£ rites: d s.ire the �t s ons bi ity.s :tote Pp ica t,. Fools aye a6f to be fa: .d r u ed:bef6 re fire Is instaRed=d aR,Ping x irYs eG#Iotis.a e:p orn?�d..aud�cccptcd.. • v f�w3�cr 5igaawxe.o€Applk=t . - oh� �alc�, �• q. DmtG • �FQF•.k�fjPffiin7LS.�LS:6t�fl�z. . "rQ4f�� Q BAR lS TA EXIST.WDVJ: FILL IN ST.'WDW. EXIST?'.WD4V. � I � I D"CU5BIE5 RENOVATED Q-I I I ' EX15T. s BATH t .Z N DEN I _ Z I ii o CENTER bOOR.BETWEEN FILL IN EX15T:.DR, TUB.AND SINKS EXI5TING HALL --------------------- k' DATE: 01 J 30!2013 Walcott {Ren0va 0 n s SCALE: 1/4"= V-0° SECOND FLOOR PLAN # w i t a t airy YY !d elr Nan t o v 6 •�f'r" ~ '�-y��,�,t�Y Yf �4� `.W"T,g t"- ��' �`i N� ,,,t��� t���i .AS �� R'�S''�5� #r r'"�.• �E'--�x e-� � ��''� ���������roT -'=s+.:yt, � .� � 3i4�''.tij �k 2 �' ��4 A4r}�` - W� AF. m' ,�eY" u � 4 •"'' 21 4"�a c + .;,71ua 'w, sS+Irk, ri �i„ rm t IY rl � '•:` w :'�q t h° 4 :,•,� r y ,.,h,,. � Y�"I,rv.�P�' r�,'. a y u -. � '.,� .'�� 1'tf'_as rl a WI L.•,��,�^t,�"IYl'Nu, E r '#Ei W t •,eS. w ,1p 6 t`< ',,�. � �- ^rr,°"t X �o"` W �41 N,�-.�._ a��' , iW'.�"µI �4 r i�^a�I a t tiril..w +'� "�Pxr� r �'E �+._¢ �,•'�b .`fix F ' 7 v r� '"4:.- ,. � I d � y �,, �, �I II a �' �, .t '.d �'�, � �_ �>M r''� �• IG8 ++ .-:`t ,�y�C.h -� e� R T �,�. 7, T � ..i d 1 i',P a ,� u 'i....;v�� �w��;+..t &r. $'•"y €'�'}_ , t i�w�� ,4 � � � J 3 t - + > � r�,'. 'lT yi 5`r r �_ � r�. ,lt � ,,�c�''j r� r, 3 +F.. .:.•_ - ,er sew sf_ 4+g`� _ : ,� ."U. ��� -�� ~� 4- ,w • tW y`7"h',4 A S ,���$Tr�q.^^ x hw � .+ ..,+ '^3�k°l�i� i� -i ,. .,Y rali4 ... �S S^ -� •• �' .,..i yn a°'��°,,WIVV II c+'�.;`r�r'y{f '"eiyy',I�,k'4-�°r4`!4 r Ii,I�Yl�,u I*ah b o-,M.,., '',1yg".,.xl r-wt .r.. ,`°'-,-,"i' ° �'yMR.6�,r a,r€W v^ r c.tl.�,ee sv I I oa,f•;.y.r-' tiv'I I �'w""wy Iy 1W4I'Y Iaw, :4 Y e n r,,".p',I r�f!V,7"i c p Ilwi d�ft'ar1 I�II Lr,-N ." i t +Mul„It, , i r. r,t! •''� �^ W° :ru "k.'k;.r� i' it"i<�rW ,��it � o�s- W" .:.. � i�w I ` a� r � � �,°w��.i�b�^"�'+I '� -':�i, a ti': t,4 -f 'W t w y+ s+ ..�&°+^ry .'t• - - �Yw � s'�'S 4•ram R i- ` '�` -- _-. `,_ ,•,.... . I v r"'?� t��N l�gl,. Y�NI+�[� V ,�I I`h1Cy� t'Sir ��' - a � h�N"rlirvr�y ht'� � �uW n y� •�I !i�' II Ih +II I - Iv4-ap4., t { '_ ,�-.^• �`'w^l ii''\ f ! w�kk ,y� ti+IlAur # \ _ + i"F ,II �I� 1w , 5E DRO i 1 s f �, CrL. Cmt. CL. 141 -01 tf. �� - rs �'"�k1•. . tot,. .t� ti# v - c. � ' iC ) f i FLOCS R, ( Ito i5c" ;o TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map_NU U Parcel Application# c�� � Health Division Conservation Division Permit# Tax Collector Date Issued Treasurer Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis C7 Project Street Address Village otu Owner W t Address t22--1 m CLA Y_� st Telephone `1� Y) Permit Request Any 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. (welling Type: Single Family Two Family ❑ Multi-Family(#units) o 0 Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highw y: ❑Y ❑,ylo Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other ' ' Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) t Number of Baths: Full:existing new Half:existing new © c*� Number of Bedrooms: existing new co 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 Cl new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name 0k-0122-� Q �� '� Telephone Number Q28, ` S tC Address�� _x�lN� 120 'License# c.-- Home Improvement Contractor# �� Worker's Compensation# ALL CONUBUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATUR 0\ Q DATE Y i + FOR OFFICIAL USE ONLY a PERMIT NO. r DATE ISSUED MAP/PARCEL NO. x ADDRESS VILLAGE t OWNER f }(3 1 DATE OF INSPECTION: f FOUNDATION t FRAME 1Li INSULATION E FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL i GAS: ROUGH FINAL FINAL BUILDING t � I DATE CLOSED OUT ASSOCIATION PLAN NO. P E Page 7 ot7 CAPIZZI HOME,IMP ZOVENIENT NC. SPECIFICATIONS AND ESTIMATES STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT I,HENRY WALCOTT, OWN THE PROPERTY LOCATED AT 1221 MAIN STREET,IN COTUIT, MASSACHUSETTS. I HAVE AUTHORIZED CAPIZZI HOME IMPROVEMENT TO ACT AS MY AGENT TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE I GIVE MY PERMISSION TO LESSEE TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. SIGNATURE OF OWNER(S): OWNER'S ADDRESS: OWNER'S TELEPHONE: 508-428-6832 LESSEE'S SIGNATURE: LESSEE'S ADDRESS: LESSEE'S TELEPHONE: APLLICANT'S SIGNATU ' Cic APPLICANT'S ADDRESS: 5 Newtown Rd., Cotuit,MA 02635 APPLICANT'S TELEPHONE: 508-428-9518 RESPONSIBLE OFFICER: RESPONSIBLE.OFFICER ADDRESS: RESPONSIBLE OFFICER TELEPHONE: "� Clisnti?:d?298 CAPIiHONI AQGRDr CERTIFICATE 4F LIABILITY INSURANCE DATE(,4LMr*_OrYYYY, ` FRODUCER Oit`a9r07 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Rogars$Gray Ins, Agency,lnc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 434 Route 134 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXi END OR P. 0.Box 1601 ALTER THE COVERAGE A FORDED 9YTHE POUCiFS MLOW. South Dennis,MA 02660-1801 INSURERS AFFORDING COVERAGE NAIL INSURED INSURER.: National Grange Mutual Ins, Co. Cap zzi Home improvement,Inc, Capzzi En�rprisss, Inc. INSURER 3: American International Gr 1645 Newtown Road INSURER C: Cotult, MA 02635 INSURER o; - INSURER E COVERAGES 7HE POLICIES OF INSURANCE LIS'0 BELOW HAVE BEEN ISSUED TO 7HE INSURED NAME A&O'!E-0R T He POLICY PERIOD INDICATE].NOT`aVIT4STAND NG ANY RSQUIRE�41E NT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUVEUT WITH RESPECT'•O WHICH THIS CERT IF!CATE MAY 9E ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED SY THE POLICIES DESCRIBED HEREIN IS SUBJECT TOA'!THE TSRPAS.EXCLUSIONS AND CONOITICNS OFSUCH POLICIES.AGGREGATE LINTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN t LTR 7: TYPE OF INSURANCE POLICY,NUMBER POLICY EFFECTIVE POLICY EXPIRATION __QA7E(MG/ ' Y AT''MIA! iYY I 'LIMITS I I cenE2AL uA3IUTY MP010707 MOS/06 106i108I07 EACH OCCURRENCE si 000,000 X MMERCtAL GENERAL LIABILITY FZN,GE TO RENTED I PREMISES(E3 OC rt �SOa ow' CLAI}AS fMOE a OCCUR - MED EXF(Anyone pers:n:' $10 000 PERSONAL a Aov av vRr 31,000 OQO GENERAL AGGRECA.7E $2,000 QQ0 GFtI'l AGGREGATE UTAIT APPLIES PER:RO• .PRODUCTS•CONP/CP AGG S2,000 600 PGLCCY PE LGC AUTOMOBILE LIABILITY ANY AUTO •-CMSINFQ SINGLE LIMIT $ jEz accident) ALL OWNED ALTOS SCHEDULEDAUTCS BODILY INJURY S (Per person) HIRE)AUTOS NON-OWNED AUTOS BODILY INJURY $ fP=r amd:ra) - PROPERTY DAW.4--E $ 1 (P-r ern deN) GARAGE LABILRY Al,?O ONLY•EA ACCIDENT $ I ANY AUTO 1 1 I OTh ER THAN EA ACC S i AUTO ONLY: AG $ I EXCESSiUMBREL.LA LIABILITY j EACH OCCURRENCE - $ 1 OCCUR CLAIMS MADE - AGGREGATE $ DEDUCTIBLE $ It RETEN T ION $ Y7CR(ERS COMPENSATION AND- 1764953 $ 12125t06 12`25/O7 r sraru- GTH- ENPLOYERS`L1AB(LITY TORY AI IT' F AIRY PROPRIETORAPARTNEA/EXFCUTIVE E.L.EAGH ACCIDENT $5aa,aaa CFF!Cc'� VEVSER EY,CLUDEG? If yes,dews.under E.L.DISEASE-:a EMPLOYEE $500,000 SPECIAL PROVISIONS ce cw -OTHER E.L DISEASE.•FOUCY UMIT S500,0GO DESCRIPTION OF OPERA IONSf LOCATIONS!VEHICLES/EXCLUSIONS A;C 3YENDORSE(AENT I SPECIALPROVISIONS CERTIFICATE HOLDER CANCELLATION - SHOULD ANY OF"rHE ABOVE OESCRISED POLICES BE CANCELLED BEFORE THE EXPIRATION DATE THERSOF,THE ISSUING INSURER WILL ENDEAVOR TO MA0. 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NA,M ED TO THE LEFT,BUT FAILURE TO DO SO SHALL [IMPOSE NO OBU GATION OR UABILITY OF ANY KIND UPON THE INSURER,iTS AGENTS OR REPRESENTATIVES. - AUTHORIZED REPRESENTATIVE ACORD 25(2001iC8) 1 of 2 #26435 4 ()Mf `•' `O ACORD CORPORATION 1988 \ i ne uommonweatrn of massaenusetts �A Department of Industrial Accidents +,+ Office of Investigations 600 Washington Street Boston, MA 02111 , www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Conn-actors/Electricians/Plumbcrs Applicant Information Please Print Legibly Name (Busmens/organization/Ind vidual): `.. Address:, 1645 Newtown.Road eotu , NIA City/State/Zi-p: Tel. 428 9518 j one# 5D60 one e you an empiayer? Check the appropriate bog: Type of projeet(required): T am a eiaployer with 4. Q T.am a general contractor and 1 6 Never constriction employees (fii]I and/or part-time).* have hired the sub-contractors 2.CQ !am a.stile proprietor or partner- listed.on the attached sheet � 7 O TZeniodeIing ship and hati�rio employees Thesesub-contractors Have 8. .Q.Demolition woricm9.for ire in any cap acity. workers' wrap insurance. 9. 0 Building addition Iwo workers' comp.msuran.ce 5: Q We are a corporation and its requrred] officers have exercised tlieir 10.0 Electrii al repairs or additions 3.0 I.am*- ahomeowner doing.all'work 41tbf exemption perMGl I l.0 Plumbing repairs or additions myself`jNo wo=keis':.comp. c 152,:§l(4),and we have no 12 Q Raofrepairs msiirance requirecLl# • .employees {No workers' - I camp arcl,ran ce r Hired; 13 [� Other *P;ny agplicantthatchecks,Uox�l must also fill:out the section below showm theuwor�czis co g m�ensatton pahcy mfq�stYon Homeowners who subnntthis s£ndavat mdicaiing they ate doing an wain and then]nre outside contractors must submit a uew affidavit mdcatdng,such ntractors that cfieck Eros bog must attached an addifiorral sheet showing�e name ofdre nab contracfors and fhea.woilters coin.po7icymforMat201L I izn cm ein�layer that is proviriang workers'.compensafion_lazsurance far my Employees Below'is the policy m zd j n�'site cnformmzon_ 1 �:l ,/� rCc Trt ,BP r1\Tfnr t :,; �. a ` Tr r) .1 1 # Policy g or.Self ins. Lic. : : o Egp .,.lion Date. rob site Address;. . City/Slate/zip: 41tach a copy of thevorl;ers' �ornpensation"policy declaration page showingthe.policy number and expiration datej, ailiire to secure coverage as required under Section 25A ofMGL c. 152 can lead to the imposition of crihiinai penalties of.a rue.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_fne P.to$250 OO a:day:against#re�io3ator .Be:advised That A copy ofthis statement maybe forwarded to the Office of nveshgatons ofthe'DTA for in ,rarice coverage verification do hereby.cE rq r' thepains andpend es if e iy thritYhe irzforrnation provided above is true and correct - : attire` Date: hone : — Official use only. Do not write in this area,to he completed by city or town official. City or Town: Permit/Licease n issuing Authority (circle one): L Board of Health 2.13uilding Department 3. City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6. Other ' -u. -....._..... .... _.. \ ,.//2 U/69rvYI20�ZGU2CLIA.ia 0�✓/�GCLI�QCJ2CL6P.�6 Board of Building Regulations and Standards License or registration valid for individul use only y HOME IMPROVEMENT CONTRACTOR before the expiration date. If found returil to: Board of Building Regulations and Standards Registration: 100740 One Ashburton Place Rm 1301 Expiation .'6/23/2008 Boston,Ma.02108 Type: Supplement Card CAPIZZI HOME IMPROVEMENT, I bARY GUSTAFSON / 1645 Newton Rd. C, Cotuit,MA 02635 Administrator t valid with t Sig ture Board of Building Regula ions and Standards One Ashburton Place - Room 1301 Bostori, lVlassachusetts 02108" Hom e m r vem ent�-Contracfor Reg istration ation Registration: 100740 Type: Supplement Card Exp i Kati o n: 6/23/2008 CAPIZZI HOME IMPROVEMENT, INC GARY GUSTAFSON 1645 Newton Rd. COtUIt, MA 02635 Update Address and return card.Mark reason for change. Address Renewal Employment ❑ Lost Card ✓�ze Larrumaruue¢`� a���� r�tuvP,�6 . Board of Building Regulations and Standards Construction Supervisor License License: CS .74640 Birthdate: 11/29/1975 Expiration: 11/29/2008 Tr# 6430. Restriction: 00 GARY GUSTAFSON 8 SHORT WAY SANDWICH,MA 02563 Commissioner 1 F G ��- 21 Home Improvement F ji1C t . yL Y I, Gary Gustafson,.Production manager Of Capizzi Home Improvement, Hereby authorize Lisa Haworth, to sign on.my behalf for ifdrtlit.4pphcations'filed through the town.- t In r. f :Signed Gary G stafso` Date: -A�7 F Date: 1645 Newtown Road Cotuit, MA 02635 (508) 428-9518 (800) 262-5060 FAX (508) 428-1547. I� �y ID C j� ki Al v// 4 F �. °FIHE Town of Barnstable P ~ Regulatory Services » BMWSTABLE, « r MASS. Thomas F.Geller,Director 039.MAr� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the`reconstruction, alterations,renovation,repair,modernization,conversion, -improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: 9__ r(yo- t--t Estimated Cost Address of Work: Owner's Name: Date of Application: L'o.. \.A - V—i- I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied []owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: S f ) U T Date Contractor Name Registration No. OR Date Owner's Name QIorms1omeaffidav Engineering floor) Map , Parcel (0f `Permit# �O g , P House# as I s Date'Issued Board of Health(3rd floor)-(8:15 -9:30/1:00-4-30)�?_Y- Fee - �/• o-� Conservation Office.(4th floor)(8:30-9:30/1:00-2:00) A- - r SEt C S` UST 8E or/School Admin. Bldg.) t lanning Board 19 v . MD TOWN OF B ;fARN.STABLE' s �. Building Permi"t,Application ," Project Street Address 1-23-1 s r- i Village Owner Pie j 2.y .A A-c--r r• Address Telephone! Permit Request TO T v� ;>/ti A'D' 20-17 re-O a 2. y3Z-V.Za Sz- E f_ ac, 1 Vr tI I -7 5 14 W-0 First Floor; 12 S'n t4& square feet Second Floor Lo o E r l e T7-4& square feet Construction Type W o 0 0 r 2R —.- Estimated Project Cost $ to,0 00 " Zoning.District Flood Plain J.j Water Protection o Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family U. Two Family p Multi-Family(#units) Age of Existing Structure 1 So Y F_5 Historic House ❑Yes $No On Old King's Highway ❑Yes JNo Basement Type: p Full ❑Crawl ❑Walkout J60ther Co '3• -• A-'�a J - Fu� C_ r C Q A-0 Basement Finished Area(sq.ft.) 9 Basement Unfinished Area(sq.ft) b Number of Baths: Full: Existing I New © Half: Existing I New 0 No.of Bedrooms: Existing New o Total Room Count(not including baths): Existing New e, First Floor Room Count s Heat Type and Fuel: Ll Gas W.Oil ❑Electric ❑Other Central Air ❑Yes ; No Fireplaces: Existing I New 10 Existing wood/coal stove ❑Yes �J[No Garage: ❑Detached(size) sv o Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization p Appeal# Recorded❑ Commercial ❑Yes %No If yes, site plan review# - Current Use Proposed Use Builder Information Name A R.o✓ex s tn,r-e`1 mg`( Telephone Number Address IN, 3 .to er0 License# o4-7 GA I i Home Improvement Contractor# I b 48 S Worker's Compensation# ovoo '3 a o .a a NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO L44- 1 L_L 3 o&A.lZrd ;E_ SIGNATURE v V` DATE re 4 4 BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY o 4 PERMIT NO. Is DATE ISSUED �. MAP/PARCEL NO. a ADDRESS `' VILLAGE OWNER ` 4- DATE OF INSPECTION: r FOUNDATION FRAME INSULATION •- -//T/ FIREPLACE - ELECTRICAL: ROU FINAL ; r PLUMBING: U . FINAL - W S: •FINAL' NAL BUILDI v, $ _ _ v f , ]SATE CLOSED ` co ASSOCIATION N ( t °F SHE l°�� y` The Town ,of Barnstable 7 ,AxxsrAsie, 9$ MASS. � Department of Health Safety and Environmental Services plED n�'t" Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only Permit no. Date ; AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT'APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. Type of Work: l koZ1. Est.Cost K1 e,v&o" Address of Work: 17-2.1 C o r tia. Owner's Name WE 14 R-Y w k t.C.srT r Date of Permit Application: 'I t!o �4•� f hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under$1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR Date Owner's Name +� The Commonwealth of Alassachusetls Departrtrent of Industrial Accidents r _ l Office 8/10yeslfyal/OQs 600 Washi►i torr Street Boston, Alas. 02111 Workers' Compensation Insurance Affidavit i lic:tnt information• Please PR(NT Ie�'''`, V.,- name: C e_ao,�2 locitiom �;O r- cin• phone# vs I am a homeowner performing all work myself. I am a sole proprietor and have no one worktns in anv capacity .. .•..........L.-. .......... ..-r..._..ar.rz•.R�S}�a+ 17s'pa+;,:��+ Rm►l�.n+s. .,ow.w..ggs....... •.n.+-n+'.+.�.•...._�.w�•,,��.�._�••.�.� I am an emplover providing workers' compensation for my employees working on this job. contltanv n• rne• C7 ttdr r—X r M JE L H7-^L�f 'jse►.lrt��+�S address: t7c l C> Ca��` city: phone#: insurance co. policy 00 O 1 am a sole proprietor, general contractor, or homeowner(circle one) and have hired the contractors listed below who have the followin= workers' compensation polices: cominny n•tmc• address: city: ahone#• insurance co onlicv# compnnv name: address- cin•• phone#: insurance co policy if Attach additional sheet ifneeessa - .,__.;..,,;....:. ":-T a..,K>r .:.c:a....=t ..c.•r—..»•»•... .. . ._r3:'.isr..�_.....�..:�.-...o.•..+,e.t:._•::.:�:,•_r'e� -.__..:,...,..._,,;u,�__,..,..._.-,.o. Failure to secure cowcr:tgc as required under Section 25A of NIGL 152 can lead to the imposition of criminal penalties of a line up to S1,500.00 andior one wears*imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. 1 understand that a cope of this statement mac be forwarded to the Office of Investigations of the DIA for coverage verification. 1 do herehr ccrrif}}�unr/rr the prr^irr-s and nnitirs ojperjun that the information provided above is true and correct. Si_nature ' 2V `—t. d '�/ Date I 16 ? Print name Phone# ¢Z 0 `S 3 L3 y wYL".tY . �.''ofGcial use only do not write in this area to be completed by city or towwn official y� ,K city or town: permit/liccnse# rliluilding Department [ CLicensing hoard E check if immediate response is required ❑Selectmen's office F ollealth Department contact person• phone#; I'•1Uther �.: Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law an enrploree is defined as every person in the service of anc►theF under any contract of hire. express or implied. oral or written. An enrl)lol-er is defined as an individual. partnership, association. corporation or other legal entity. or any two or more the foregoing engaged in a joint enterprise. and including the lei-al representatives of a-deceased emplover. or the receiver or trustee of an individual , partnership, association or other legal entity, employing employees. However the owner of a dwelling house haying 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 hou: or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states,that,cwcry statc.or,local,licensing agency shall withhold the issuance or renewal ofa 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. v h nor any of its political subdivisions shall enter into any contract for the ither the commonwealth Additionally. neither _ performance of public Nvork until acceptable evidence of compliance with the insurance requirements of this chapter h� been presented to the cbi'tracfing authority. : • , :, ; Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names. address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested. not the Department of Industrial Accidents. Should you have any questions regarding the "law" or if you are required to obtain a workers compensation polio•. please call the Department at the number listed below. City or'I'owns 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. Plea be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned v the Department by mail or FAX unless other arrangements have been made. Tile Office of investigations would like to thank you in advance for you cooperation and should you have any question, please do not hesitate to give us a call. 5 �^•k..•�•-........ ..._...�..�i....•.. .-�v..�.O..r•I�..:`��'^'v5�-.�.�w.r..i-_........7...tV/��..�+�f�'awv-.RnT�^:.�T.�.�-'r1,-...�.1.-�Y.'...•w.n+1w.1'+en�.i'Yf.aMt'i 1T....T'V 1�.�•wOfiw/c�v� The Department's address. telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of investigations 600 «`ashington Street Boston, Ma. 02111 fax #: (617) 727-7749 phone 4: (617) 727-4900 ext. 406, 409 or 375 .s�A F i3 ._ ; ..S�ras;` :.> .:} .c M•Y- ,.+-r'ryd-fEV.. a. i F..S.r„�F. +'gcw,p `:7p.v tea"• •i,�i�»'p`•', wvY E. ;q.,,,,.rrdbxr+.w+,/a� "�q"'^Yj.-i .`�,z.., s ­IA .f _~ z�, y. ? ry. •' .�- t Sr 4. 9a 'C a Z n q v C Wit_. •�t h S ,�. �.., e > ` ¢L 1r u ..in„ t_ s:' ^' i 5 a 7-,� -k.''" 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A.. rt e j,' n i ,p + ' 3 k a r d ws. :. ,� ,� - x ,� r ,7 f r`.�i-So- r a s. 'j Y a r �.° 11-11 r t ; r`� s ; rty'3' na .. I 0 t �i.� i s ivy c,E R�` f', l,A N A:?C Kl.� C_1 A l P+ �. .�BP_ - . i „` _.__.._ _ .,_ _ v _ _ . _ _ - - r _ ._ .... .. ...r.. _._ ...... ._ ._. .�..._ . - .. -_ - ! RA.L Ta..r ie I f _ NIEvJ S•.wr4 E<. -- - I [iL TbzcN WEST CL&vAT.sN - - - tbRTN rLEK.."r,*4 .. . ` .Yf�• TZD Ci�vY6 - R-3i0 I ' 1 I El. f n 4 b— I W i CARPET I II 4 �w LD••aD• SFGT.—L q WALCOT^' Do,T1"I 1121 MA-4 97. Co�.,.•T .,.,:+� o Z L.b 5 .we.oi Yea i p � Restricted To: 1G :.DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE 00 - None Number Expires: t, 1G - 1 & 2 Family Homes �) ' »Restricted Tay -iG STEVEN P MCELHENY ; Failure topost0asassrravt aX P0, 80% 282 Massachasauttz tiz>�&�sv�s�erop COTtlfT, . MA 02635 care Is eav*a',ar revocattora ' f� a!t!r!s fJcnnsa. ' "'NIC O Poomrnraou a/euaelld HOME�bMPROVEMENT GONTRAC,TOR Rr: } �istarat�on 110480. 5 72 , �, Te IPlU1IVI++DUAl.4; 1 f E'll, xatiron 1P0/3'0�/9'8 GROVER & MONWHENY BUILDERS S°T1fiVEN�P zMcEIH�NY a. � `"" � � .- �� • n��n+wsrRnroa .� � OTl1fIT MA 026535' �� �� �" ;Since 1955 GAco WEsTERN Insulation:Certificate Date installation completed Building address a , City/State/Zip Application Contractor,(company name) Address 411 City/State/Zip Phone Areas Insulated Exterior stud wall Average thickness ",R-Value Ceiling. �=A& Average thickness R Value ' Roof deck Average thickness R-Value Crawl space/basement Average thickness R-Value . Additional areas insulated I*(print name) as an independent contractor,certify that the GacoWestern insulation installed on this project was a in accordan ewith the GacoWestern recommendations and specifications as stated on the product data sheet and the. o estern Application Spe ica in the amount as indicated on this certification. . : (signed) Date GacoWestern Aged R-Value Chart Dimensional Lumber 1n p, 3- 4n :5„ 6„ 1n. „ 8 9 3.5 5:5 115 GacoGreen 4.2 8 12 16 20 24 28 32 '36 14 22 29 Gacdirdtop 3.7 7 11 15 19 22 26 30 _' 33 13 -20 18 6.4 13 20 21 33 40 0 53 60 13 37 48 184' 6.1 13 20 27 3 34 40 47 54. 60 24 7 49 193 _ 6.2 13 20 27 34 41 47: 54 61 24 37 49 'Based in initial measured K•values. - GacoWalIFoam. SPRAY POLYURETHANE FOAM INSULATION www.gacowall oom-.COm 800.456.4226 b PRODUT Gaco Western WaliFoam 183M is an HFC-blown(zero ozone-depleting)liquid spray system that cures to a medium-density rigid polyurethane insulation material.Gaco Wall Foam, .183M contains polyols derived.from naturally renewable olls,post-consumer recycled plastics,and pre-consumer recycled materials.Gaco Wal]Foam 183M does not emitain.CFC'S, " HCFC's or other gases harmful to the environment.This system can be sprayed on clean,dry substrates down to 3S'F(2°C).GaEO WaliFoalri 183M is a class I fire rated foam that. meets the requirements of ICC-ES AC377 Acceptance Criteria for Foam Plastic Insulation.6aco WailFoam183M meets the requirements of AC377 Appendix X for use in attic and crawl spaces without an additional ignition barrier. s a TECHNICAL INFORMATION To ensure optimum performance,a minimum pass thickness of 3/4"(1.9(m)is recommended with the maximum not to exceed 2"(5.1 cm)per pass.for typical equipment settings,Consult Gaco Western's GacoFoam Splay Guide. PROPERTY TEST TEMPERATURE ASTM TEST UNIT VALUE d Nominal Denslfy(Sprayed;ln Place) r 77°F(25°O D 16Z2 03 Ibslft' 18' 2 2 ° 1tt °F/Btu h RZ33at35 rt (ompresswe Strength(Parallel to Rise) 11°F(25°O D 16Z1 04a psi; 31 Tensile Strength 71°F(25°C} �'; 23 ` Psi: 64; rz D16 Water Absorption ` :; Water VaporaTransmisslon 11°F(25°O ' Y E-96 05 , perm m 1]2 OLmenslonal Sfabihty(10ays) " 158°F(7D°C)/95%RH D Zl6 99 °�linear change L`6% W 5% T 3% ; Recommended;Servue Temperature Range `, � 7I°F(25°C) °: � . , � ;-, °f/�°C + 40°F,to Z00'f{40°(to 93°C) Closed fell Content ,r, � 71°f(25°C) , + , D 6116 05 % 97:8 Au Permeance @ 75Pa{Infiltration/EX6ltratlon) 11°F(15°C) s F E 183 04 l/s/mt 0 Q00/0 000'4t l thickness) �tiOtEFedelalTtade(epi A {nrF'� �� T-ayWOl�77�T f�j SURFACE BURNING CHARACTERISTICS ASTM E84-05(Also known as ANSI 2.5,NFPA Z55,UBC 8-1(42-1)and UL 723) �h 1''meantesttempe�a"1ia �F�r�;.. �..�.- _ _ �... _�� .::4r �• .•�� � ��� SYSTEM THICKNESS - FLAME SPREAD INDEX SMOKE DEVELOPED INDEX WaIIFoam 183,M ROOM CORNER FIRE TESTING NFPA Z86(AC377 Appendix X) LOCATION FOAM THICKNESS fa 9 5'(1413 cm) Ceiling ' s a Up Coll"(2194ucm) d. TYPICAL LIQUID CHEMICAL PROPERTIES "A"Component Contains polymeric isocyanale."B"Component(ontainspolyol,Catalysts and blowing agents. PROPERTY TEST TEMPERATURE ASTM TEST UNIT VALUE. Viscosity A [omponelit 11 F(25 q ; D 2196 68 cps 180+ZO y B Viscosit ,Coponnt r v 0* n. _ m e�._. `` -75 .5. 0 Speafic GTaVi(y 'A (omponent „ h 71°F(25°O F, D 1638 70 S G ' 1 Zt Specific Gravity..,.-.,-.,'B-Component 120 Weight/Gallon- A Component 77°F(25°C) , IbsLgal 10,2 Weight/Gallon,-`6.Component 10:0 Mixing Ratio '.A & B .Ctimponeni 17°F(25°C) h:' By volume 11, Stability WhemStdiid 6t50°F to 70°F,, r ` r Months `A"Component 1 year, to. to 21°C) s r ' 'B` [omponent 6 months EQUIPMENTPRODUCT" R, - SETTING VALUE CHARACTERISTIC VALUE x Pre=Heat ream Time° 0 1 sec Pre.Heat Poly(B) '115°F 130°F(461'( 54 4°C) Rise Time' 3 5 sec Hose Heat 115"f ']30°F(461°[ 54 4°O . '`Tack Free Time`:- 3 5 sec, r Recommended;5pray Pressure 800 1000 psi(dynamic) ; Cure Tlme ' 4 hours The infemuUon herein Is beNeved to be reNable but unknown risks may be presenL ALL WARRAPI TIES OF ANY KINq EXPRESSED OR IMPUED,[MCI DOING WARRAIMES OF FiiNESS FOR A PARFICULAR PURPOSE AND THAT GOODS ARE OF MERCHANTABLE QUALITY,ARE SPECIFICALLY DISCLAIMED.See GaroWesteAforinfonmUon concerning Its Nndbedwara and its n4a.blN .. 5 6 .,7F�,.• yr t Mt�s54F'tF' i. 3.7�`uez��.,�rsr+ yhr',!#','4i ?.E',� ..�+ s.:rm` fipi.rkS�xD;...Ti1•{t .itf .Y"t '�1s ':€1 ..�. .. s• 3 i� � ou .. c Y �+ co Wxzv p�� - ENERGY STAR - ...L .'�� wa"�6^s•^d!6nesw.W..V4Ir«./U,u nso..N.gbbe6ed 1 i 4; PARTNEfl ', i, iF! G.,Me aap.Qv d.n8MEM 1.....N..seGalmu. Toll-Free:877-699-4226 www.gaco.com Product=GWFosi 0212 rIle -71� �oF �E Town of Barnstable *Perinit# 28 19 y HP ti� Expires 6 mouths from issue date Aq �© * BARNSrABLE. = Regulatory Services Fee r� 6�S. 'Thomas F.Geiler,Director �A� ArFDN1°'`a Building Division fts TonrPerry, Building Commissioner 18 200 Main Street, Hyannis,MA 02601 '►o CT 2, �T Office: 508-862-4038 �^lQ,�.e �QQS Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIA.L ONLY R�S�,�e Not Valid without Red X-Press Imprint Map/parcel Number ' Property AddressT MIA y�j� _ EE Residential Value of Work �/ '9 �'� Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address / Q n Contractor's Name (�i 1 P Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) '(Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner [1I have Worker's Compensation Insurance Insurance Company Naive )AM Workman's Comp.Policy# O 411 lot?- Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris-will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ e-side Replacement Windows. U-Value--- (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. Home Improvement Contractors License is required. Signature PIA Q:Forms:expmtrg Revise063004 Performance Data MAndersen° NFRC Certified Total Unit Performance Andersen windows and patio doors meet or exceed the fallowing standards:WDMA,-LS.-2,W.D"M.A-I.S.-4(WDMAlicenso No 129)Hallmark certified.Independent testing laboratories have } �ompliancc with these standards is confirmed by ongoing testing in Andersen Laboratodes.lhese products are covered by one or more of tt,e following 5,582,445;5,097,629;5,740,632;5,199,234;D312,565;D397,604;and D417,831.Other patents pending. Performed all required tests on selected sizes. Patents:4,999,950;5,595,409;5,775,749;6,055,786;5,544,450;5,566,507; 400 Series Windows tWithout Grilles Andersen°Product Type HP 3HP SSon HP HP Sun Without Grilles Low-E Low-E Low-E Low-E 400 Series Doors Casement U Factor I Andersen°Product Type Luw E T HP Sun HP HP Sun 0.33 p_35 0034 0.36 24"x as"size SHGC2 ) "" --- Frenchwood° ----0 Low-E LOw-E I Low-E 0.33 0.24 0.30 J 0.22 U-Factor' 0.33 �' 0.53 0.29 -f----- Glidin Patio Door -_w_ 0.31 _0.3_5�-0 3g Awning 0.'48 0.26 SHGC" .0.29 g U-Factor p 3-.,_.;0 35 '"r -•� - -- 72"x 82"size .0 29- h 0.21 0 26 -" 0.20 48"x 24"size SHGC 0.34 0.36 V1. 0:44 a 0.24 0.39 .` " 0.32�_0.24 0 300 Frenchwoode U-Factor' 0.21 .` 0.52 Hinged Patio Door 2 0.33 0.34 0.34 '1 0.36 CasemenVAwning U-Factor' 0.28 `0.47 0.26 SHGC �=7 0:30 0.32 _ 0.34 38 x 8 _ VP 0.20 ;' 0'25._ 0.16 Picture Window , - ` 0.32 0�41 ; 0.22 SHGC ,_0:36 1_0.26 0.33 Frenchwoode 036 ' 0.20 48"x 48"size 0.24 U-Factor' 0.34 0 36€` VP 0.59� 0.32 Outswing Patio Door 0'36 F 0.37 Woodwright'" 0`53 0.29 SHGC 0.27' 0.20 U-Factor r 0.33 1 0.35 0.34 0.36 38"x 82"size VT, r 0.25" 0.19 Double-Hung SHGC' ,Q,32 Frenchwood° 0:41 'f 0.22 # 0.6 0.20 36"x 60"size 0.24 0.29 0.22 U-Factor' ' " �' r -0..51 1 0•28 _ Patio Door Sidelight SHGC2 t- 0.35 0.36 4 0.35' J 0.36 Woodwright'" 0.46 0.25 0.20 ' 0.15 U-Factor' ,_0.30 l 0.32 0.32 16"x 82"size ! 0.19 ` 1 0 15 Picture Window SHGC' , 0.34 VP i 0.27 '1 0.15 F'0:26 0:33`''I 0.24 Frenchwood® 0.14 48"x 48"size - 0.31 0.22 U-Factor' r .,0.34"- 0.35 1 0,35 �' # 0.54 0.34 Woodwright- 0.29 0;48�-- 2fi- Patio Door Transom SHGC2 ro ,.0.16 U-Factor' s 0 30:'', ( 0.32 -"+"0 38"x 1a"size 0.13 0.15 +I 0.12 Transom 0.32, I p 34 VP # 0.20. 0.11 SHGC2 r 0 35 0.25 0.32 �_ fi_0.19.: 0 1i p 48"x 48"sizeVP 0.23, Without Grilles Tilt-Wash I 0.57 ,'� 0.31 0:51 0.28 200 Series Windows&Doors Clearer-- U-Factor' # 0 34 0.36 0.35. Andersen°Product T e ( Clear Double-Hung SHGC' r 0.35 Type Dual-Pane Low-E Duaear Low-E 36"x 60"size 0 32 0.24 '0.29 .'. 0•22 y Casement VP 0.51' U-factor 048 i0:49 Tilt-Wash 0.35 0.45 0.25 24"x 48"size SHGC' 0:52 - U-Factor' i 0.33 Double-Hung Picture SHGC' #� 0.25 035 1 0.37 VP '0,59 _ i - 0 35 Q s2 6.24 Awning , 054 48"x 48"size VP # 0.56 U-Factor, # 4.48 - /Tilt-Wash 0.30 0:50 p 48"x 24"size , °0.49 -r _ U-Factor' � , : - SHGC �"`,,0.56 - 0.52 r. Double-Hung Transom 2 0.35 0.34,y# 0.36 VP � _ - SHGC � 0 35 .,.' 0.25 + rift-Wash 0.58„ _ - ko 0i53 r 48"x 48"size 0 32"' 0.23 U-Factor' $ 0.49 -VP 0 56 . 0.31 0.50 0,27 Double-Hung 2 _ 0.34 0.50 0.35 Gliding Window U-Factor' i! 0 36 w SHGC 0.38 0.56 0.33 0.51 ;;'" 0.30 60"x 36"size 0_38-,` F39 36"x 60"size SHGC2 ? 0 30 0.23 V' D 0;58_ 0.51 0:52 0 281, : Narroline® U-Factor' r 0.46 VP '' 0.46".". 0.25 0.50 0.35 0.50 0.36 Elliptical Window 0.4Y 0.22 Double-Hung SHGC' 0:58 .) 0.33 0:52 U-Factor 48"x 48"size # 0.30 '•{ 0.32 0 32';- 0.34 36"x 60"size _ �' d._0.60 ''I 0.53 0.31 SHGC2 0 36 0.26 0 33` Narrolinee Transom '0.53 0:47 VP tt1;W 0 59"' 0.24 U-Factor , 0.47 i 0.31 Circle To '" 0.32 0 53 ; 0.29 48"x 48"size , 0.48r 0.33 P U-Factor' SHGC - r.. 0.30,. t 0.32 0 32 •. 0.59, 0.34 0.54 0.31 Casement SHGC' 0.34 ; VP p 0 62 ' 0.55 #.-0 36 0.26 0 33:''; 0.24 Gliding Window 0.56 0.49 48"x 48"size VP #a.0.59. U-Factor 0.50 0.35 Circle/Oval 0.32 0 53 0.29 } 60"x 36"size SHGC2 i "0.57 0 50 I 0.35 48"x 48"size U-Factory - 0 3_ p 0 32 0 32` 0.34 0.33 Ot51 ,: 0.30 SHGC # 0:36 0.26 } �: VP t, 0.58 0.52 Of52 0.46 0 33 0.24 Foxed,Transom, U Factor' #t 0.47�' k'0.59 0.32 0$3 0.29 Circle Top.. 2 0.3.1 . t 0:148 0.33 Arch Windows U-Factor' '«`0.31 0.33 k . SHGC ,' 0 60 �.4 - 48"x 48"size 0 32 0.34 48"x 48"size -- SHGC' , '0 36"; �' 0 62 0.32 0.34 0 5,4�' 26 .. 0 33 ,' .0.24 .. _ Narroline® U Factor' r 0 49 0.55 0.5 6.L _.0.49 0.32 e �' r'-0 59 ,,j' 0 32 0 53 0.29 Gliding Patio Door , "� 0:50 0.35 Flexiframe U-Factor' SHGC 0.60. 0.35 0 30:;' 0.32 0 32 >' 0.34 72"x 82"size 0.54 0.32. 48"x 48"size SHGCz .0:36� V' 0.62 .' 0.55 _ 0.49' ( 0 26 0 33 '; 0.24 Perma-Shield® U-Factor' .0.47 I 0:56' �' I:' 0.59-' 0 32 0 53 0.29 Gliding Patio Door z 0.31 0.48 . 0.33 Springline'"Window U-Factor' j 0.34 I SHGC Q.60 0.34 - 0 36 0 36 0.38 72"x 82"size 0.54 48"x 48"size t,, 0.32 SHGCz ` 0 35,` 0.26 062` 0 32 t 0.24 0.56 0:56 0.50 65 '.' 0.30 0.50 .. :(_0_27 ' Grilles"Fmehght or Full Divided light. Skylight Tempered U-Factor' --- - High-Performance"(HP Low-E)and"High-Performance Sun"(HP Sun)are Andersen trademarks for"Low-E'glass. 48"x 48"size 0.46 0 44 I 0.46 SHGC2 t `0 42 'I O 31 1 U-Factor defines the amount of heat loss through the total unit in BTU/hr sq.W.-F.0 42 Q,81 } The lower the value the less heat is lost through the entire product. r 0.67 '� 037 :'065 `Venting ' 0.36 ( 2 Solar Heat Gain Coefficient(SHGC)defines the fraction of solar radiation admitted through U-Factor, 0.42 Q 44 -"a �- the glass both directly transmitted and abso bed and subsequently released inward. Roof Window 0 42, 0.44' SHGCz y"6'40 '1 0.29 -0 39 The lower the value,the less heat is transmitted through the product. 48"x 48"size �, 0.29 i; 1r # 0:620 34 0 60 0.33 3 Visible Transmittance(VT)measures how much light comes through a product(glass and frame) Stationary U-Factor' z The higher the value,from 0 to 1,the more daylight the product lets in over the product's total unit area. ' Roof Window SHGCz -- -- -v0 42 0.44 Visible Transmittance is measured over the 380 to 760 nanometer portion of the solar spectrum. 48"x 48"size C 40=��-0 3O O 3g 0.29 This data is accurate as of August 12,2003.Due to ongoing or new industry standards,this data may change over time.g product changes,updated test results, 0.33 239 CAPIZZI- HOME IMPROVEMENT INC. SPECIFICATIONS AND ESTIMATES PAGE 6 OF 6 STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT I, OWN THE PROPERTY LOCATED AT IN MASSACHUSETTS. I HAVE AUTHORIZED CAPIZZI HOME IMPROVEMENT TO ACT AS MY AGENT TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. I GIVE MY PERMISSION TO LESSEE TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE ' MASSACHUSETTS STATE BUILDING CODE. SIGNATURE OF OWNER: i OWNER'S ADDRESS: OWNER'S TELEPHONE: LESSEE'S SIGNATURE: LESSEE'S ADDRESS: LESSEE'S TELEPHONE: APLLICANT'S SIGNATURE: APPLICANT'S ADDRESS: 1645 NEWTOWN RD. , COTUIT, MA 02635 APPLICANT'S TELEPHONE: 5081428-9518 RESPONSIBLE OFFICER: RESPONSIBLE OFFICER ADDRESS: RESPONSIBLE OFFICER TELEPHONE: ACCEPTED BY - DATE THIS PAGE IS PART OF AND IN CONFORMANCE WITH PROPOSAL # l.. ; ��� ��. -� �•�fe.7 tl`i,l:i .cl�•L 33cl `iC)11_ Mass'a•C1-1us 021 () "�()II1C• �.I]lprOVf T?1L'•I3�, oil irat;tC)I- 1",e(' t_1`aiioil Reaistration: 100740 iype;: Private Corporation Expiration: 612312DD6 CAPIZZI HOME IMPROVEMENT, INC. Thomas Capizzi, jr. — - 1645 Nevwion Rd. — COiUii, MA 02635 Update Address and return card.A'lark reason for change. ❑ Address Renewal D Employment ❑ Lost Car, m ✓/tl; 7JCN71i17t.0 , 00�llLdP,�d \ Doard of Building Regulaiious and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date, If found return to: Regist Epp Board ofBuildinb Regulations and Standards hu Exp One Ashrton Place Rm 1301 iration: 6/23/2DD6 Boston,Ma.02708 Type: Private Corporatio CAPIZZI HOME IINPRO '!'Fiomas Capizzi,jr. , 1645 NevAdon Rd. Cotuit, IJiA 02635 Administrator Not valid without F ✓/ie Vr om�noaaus� a�� 9.�czewa:c�zuae�l i I BOARD OF BUILDING REGULATIONS License. CONSTRUCTIONS ^ - �1.. 1 bee: CS 0 ` �Exp,res 09/26/20D7 Restricted DO i + r 4> � i THOMA CAPIZZI-.R' laaj commissioner �oFE t0ti 4 Town of Barnstable * 0"� j , ' cT Permit# 6 I lJ" - Expires 6 month issue date S^ MA"SS M regulatory Services r Mass. Fee 1639. Thomas F.Geiler,Director �AIF�MA'S a ® Building Divi&ion ` °* ry, Building Commissioner Office: 508-862-4038 FEB 12 200 Street, Hyannis,MA 02601 Fax: 508-790- QVN ExWms PPLICATION - RESIDE NTIAL ONLY 6W Not Valid widlout Red X-Press Imprint Map/parcel Number Property Address L l , T Residential Value of Wor Minimum fee of$25.00 for work under 60$ 00.00 Owner's Name&Address VD Cc4u t+ Contractor's Name C, Z� ��L� �' ` Telephone Number Z �- 9 l8 Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) 0�51 :71 ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor - ❑ I am the Homeowner I have Worker's Compensation Insurance nsurance Company Name Vorkman's Comp.Policy c>V^L-- =opy of Insurance Compliance Certificate must be on file. 'ern-it Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side AReplacement Windows. U-Value maximum.44( *Where required: issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign property Owner Letter of Permission. Ho Improvement Contractors License is required. gnature ,orms:e mtr xp g vise063004 i Page 7 of 7 CAPIZZI HOME IMPROVEMENT INC. SPECIFICATIONS AND ESTIMATES STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT I,HENRY WALCOTT, OWN THE PROPERTY LOCATED AT 1221 MAIN STREET, IN COTUIT, MASSACHUSETTS. I HAVE AUTHORIZED CAPIZZI HOME IMPROVEMENT TO ACT AS MY AGENT TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR,THE MASSACHUSETTS STATE BUILDING CODE. I GIVE MY PERMISSION TO LESSEE TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR,THE MASSACHUSETTS STATE BUILDING CODE. SIGNATURE OF OWNER(S): , OWNER'S ADDRESS: OWNER'S TELEPHONE: 508-428-6832 LESSEE'S SIGNATURE: LESSEE'S ADDRESS: LESSEE'S TELEPHONE: APLLICANT'S SIGNATURE: APPLICANT'S ADDRESS: 1 Newtown Rd., Cotuit,MA 02635 APPLICANT'S TELEPHONE: 508-428-9518 RESPONSIBLE OFFICER: RESPONSIBLE OFFICER ADDRESS: RESPONSIBLE OFFICER TELEPHONE: Client#:4T298 CAPIHOM A 6.PORM DATE(MMIDOlYYYY) CERTIFICATE OF LIABILITY INSURANCE o1109107 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION r Rogers$Gray Ins,Agency,lnc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 434 Route 134 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR P.O.Box 1601 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. ..z South Dennis,MA 02660-1601 INSURERS"AFFORDING COVERAGE NAIL# INSURED INSURER a 'National Grange Mutual Ins.Co. Capizzi Home Improvement,Inc.Capizzi Enterprises,Inc. NsuRER B: American itttsmational Gr 1645 Newtown Road I'NSURERa .,,.Cotult,VA 02635 ».,.�., »..,..;.z-......+.,_..:Vr,, INSURER 6 .<. _.. INSURER E COVERAGES _ , THE POLICIES OF INSURANCE LIME BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATE'].NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUNENT VVITH RESPECT,TO WHICH THIS CERTIFICATE MAY.BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED,BY PAID CLAIMS. LTR. TYPEOF INSURANCE "POLICY NUMBER POLICY EFFECTNE POLICY EXPIRATION 'LIMITS A GENERAL LIABILITY MP010707 06108/06 06/08/07 EACH OCCURRENCE S1,000,006 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $5OO O00 MAIMS MADE i OCCUR - - bIED IXF(Any one person, $10 000 PERSONAL d'ADV INJURY... sl_000,000 GENERAL AGGREGATE s2.000.000 "GEN'L AGGREGATE L1Pd1T APPLIES PER: - - PRODUCTS•COMPiw AGG $2,000 000 POLICY 'PRO- - - . 1EC7 LOC .z AUTOMOBILE LIABILITY. ' - :0OMBWEDSINGLE LIMIT ANY AUTO - : (Easwident).. $ .. . ALL OWNEDALTOS BODILY INJURY SCHEDULED AUTO filer person) .. - HIRED AUTOS - NON-0WNEDAUTOS BODILY INJURY $:; {Per am dtid} - PROPERT7.DAM4 E $ IPerafsdant}.GARAGE LIABILITY - -AUTO ONLY:.EAACCIDENT $ ANY AUTO EA ACC $ - OTFERTHAN - - AUTO ONLY: "4GG $ i EXCESSAIMBRF_LLA LIABILITY _ EACH OCCURRENCE.' $ j OCCUR 0 CLAIMS MADE - .AGGREGATE i s DEDUCTIBLE $ RETENTION B WORKERS COMPENSATION AND 1764953 12125/06 12125/07 •lYC SLTArU- oTH• EMPLOYERS"LIABILITY ER - .... ....._ ._-.,_. _ - 'E:C EACH ACCIDENT .- $50O 000 ... .: 'ANY PROPRETORIPARTNERIEXECLITIVE.. ,` . ._. _. -_ .. _..... .;"Z,d m be u d8IXCLUDED i E.L.DISEASE-EA EMPLOYEE $500 000 If yae,desvlm under - - SPECIAL PROOSIONS t8 m EL DISEASE-POLICYUMIT 400,000 _,OTHER .: . DESCRIPTION OF OPERATIONS i-LOCATIONS!VEHICLES I EXCLUSIONB ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER 'CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE:CANCELLED BEFORE THE EXPIRA"CION.- DATE.THEREOF,THE ISSUING INSURER W LL ENDEAVOR TO.MAL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL' IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. - -^--_____..,— ---`::AUTNORIZED REPRESENTATIVE.""'....""."'".""..`...""""_ .. '"". "."""`W'""•'. "..`_-`.'."""-. �_� ACORD 26(2001108)1 of 2� ..DMW ___®ACORD CORPORATION 1988---•-- � 1 ne �ommonfverurn of nxassaenusetts Depa hiiMt of Industrial Accidents 1,�ce.f stzgatwns 600 Washcngton Street J` Boston -AM.0211.1 nassgov/dia Workers'Compensation Insurance A ffidav�t Bi lde`rs%Contractors/Electricians/l'lumbers Applicant-Information t . ' .. `� Please Print Leibly Name(Bnsmess/Organtzahon/Indivdual) c al Address e on an em io er?Check the. ' ro hate bug. R :' P y 1`_ _ �P p. � r4 Type of prn�ect(r�gmr•ed): I an le m}iloyer ►rtk 4 ❑.I am a general contractor and i 6 New construction employees(fall and/or part tamej* Have died the sub-coi�actois y 2 D I a sole proprietor or partner- bsted on the attached sheet 7 D R- 6hwelmg- ship and Faye no'employees T#�es�sub-rontradors have Sl. 3eim6lifion for me m any capacity. workers'comp raisuiance {' 9 $udd-4"addrtton {No workers'comp insurance 5 D we areacorporationand its. , �gTed) �: o#ticers have exercised t�ieii IO D l✓lecthcal tans.or additions 3''❑ I am a hoineovvrier damg all work ?ilk cif egenr tid, per M T l Phunbm -repairs or additions C 1 mysel£ o worms' comp: 153, 1(4},and we. ave 12 Q Roofepans ' I J 1nSliTaIlCe ed. � w � _ c� ce requiea.j *An applicant that cliedcs bog#i must also fll,out#he section helow showing their workers'compensation policy moon t.Homeowners who snbmit this affidavit mdicng�eysie dom�Tail work,sad then 7nre otttgde contractors must submit a new effidavitmdicat ing such �Coutrscxors that c�ieck 8ns box must attached sn addfional sheet showmgthe name offfie stib�ira�tors end then-workers'comp policy mfoixnahon I urn an employer flint>s�nrovidirzg workers'rom�v :ensatr-ft r�csuranee for.my einpTo�ees. del w the Jrokcy and all sate mformatton. >.f �a 1 r _ t 77 insurance:Company Name �� Policy#or Self ias Lic Job:Site Address City lS,atq Attach a copy of the workers'<compensation policy declararon page(s6owuig ffie policy number,and expiration date). Failure to secure coverage as required under Seehon25A of MGL c l52 can lead to the>nnpo'S1 on of cnminai peualti of a fine up to$1,Sii0 ancUor ane-year'mpnsonment,as well as c�vi7 penalizes in,the form'of a STOP�VORK{3RD R _ _.. off m5a 9U:a da3' aasteoiator` clv�sd ffiat a cop3►of flits:statement may fie forwarder to the"bifice o y . • . • : e mformatron: rovded ubove.is rue and:;correct t do'hereb' undertlu Tans and enalbes o thatch f S Date: D f�`icial use only Do not w zte m thrs area,to be completed:by city or town gf�`icid it Permit/License# ~ Issuing Aatliority(circle one)_ 1.Board of Health Z.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other A ------------....___._.-____..-------_.____-------- ----- 76romw wwelve�111 Board of Building Regulations and Standards f" One Ashburtoxl Place - Room 1301 Bostola, Massachusetts 02108 Dome Immovement Contractor Registration Regfstratfon: 100740 Type: Private'Corporation OAPIZZI HOME IMPROVEMENT, -INC. Expiration: 6/23/2008 Thoma's CaplZzi,Jr. 1645 Newton Rd. Cotuit, MA o2635 Update Address and return card,Mark reason for changp. ors-GAI to soM-o�os pcesee 0 Address [j Renewal �rfl to [] P yment ❑ Lost Card ' -�ie•too�a.�iaoourrreal� d�'�Qaoliu�et�$. - I Mard of Building Regulations gild Standards ' License or registration valid for individuI use only HOME IMPROVEMENT CONTRACTOR before the expiratlon:date. If found return to: Registration: 100740 Board of i3tiilding Regulations and Standards • Explrafioh: 8I23/2Oo8 One Ashburton Place RM 1.3 Type: Private Corporation Boston,Mn.02I08 CAPIZZI HOME IMPROVEMENT, INC. Thomas Captzzi,lr• 1645 Newton Rd. —= £ Cotuit, MA 02635 Deputy Administrator Not valid without signature t f 6G%GYut6Z(� . 130ARC►rJF 13UiLDING.ig(t31- ON f®r < Nuinbe�6 057o32 ;f121 i117ZI THOMAs X CAP! 4� W I 16 N 7'OVV Nf "' ryry K� , Assessor's map and lot number ....�.1.4�.......�.(° .� i �FTNETD Sewage Permit number a�l� � ... Z BAMTABL4 i House number ............................ 9 IA"& 0 16}9. d• TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .. U.1 4.(,?.........19.... ...................... ................................ TYPE OF CONSTRUCTION ......�! ? .Q.....J- 2. G=.................................................................................... ,.........199A. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..... ....... .� �1"�i.. ............ ..... '........................................................ Proposed Use .I..QPr1J�(Q.................................................................................................... ...... ........... ........... ZoningDistrict F ! �......................................Fire District .61 U�..................... ........... .................. . .. ... ................................................. :.� Name of Owner .:......../11) 1.C.{j.. ......Address ......I Q 2:(...VK .)�"'....S�T..... QT.......'............... C Name of Builder,-...01p!..ZZ.f.......dON`,C... Address ....�.b ..... \Q(,�!Y�? i�� .... Nameof Architect .......................:..........................................Address .................................................................................... Number of Rooms ...............0....................... ........Foundation ........ Exterior �N1.%::........Oc—rq? ......fir/r" t ...........Roofing ..... .X-xx,r?rG4�e j Floors ................4C.....:.............. 4. interior .......�. J........ ... . ......................... Heating ..................................................Plumbin ..... s..... ....... O0 Fireplace .....lti". (.rj�.:../.[^�.`�.............................................Approximate Cost .....� Definitive Plan Approved by Planning. Board ________________________________19________. Area .�:......' ..d................ Diagram of Lot and Building with Dimensions Fee � SUBJECT TO APPROVAL OF BOARD OF HEALTH IF 1 lao �P L---------- OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the. Rules and Regulations`of the T n of Barnstable regarding the above construction. Name ........ ...... ................. Construction Supervisor's License .�A�. ..�............ WALCOTT, IfENRY. F. A=018-051 No .3. 56.6... Permit for ....Build Dormer Sinle Family i lyDweg ,,. ... l l ng............ Location ...... 2,21„Main...Stre,et................ Cotuit Owner ....Henry,,.F.....Walcott................... Type of Construction ....Frame ........................... ................................................................................. Plot ............................ Lot ............................... Permit Granted ......March 15, 19 90 Date of Inspection ....................................19 Date Completed ......................................19 PERMIT COMPLETED 1/1/ Assessor's map and lot number ....6.l. '.......... . �c SYSTEM �L � �. n1 pp pppaaa ��C� THE T Sewage Permit number l..J�.�j. .. ............... VJ P�� d�Q� ♦� WITH TITLE EWZ%E ®NMENTli6.C� 7 ar. BJflBSTADLE, i House number .........................:.: ./....,���.............. TOWN REGUL�►Ti®NS 9 MaeB 00 039. 9• aMAIa TOWN OF BAR.NSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .....��.1..4.o........1 .. .l........2 iN1 t...�.............. ....................................... TYPEOF CONSTRUCTION � .................................................................................. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..... ........ 1 ....... ..! ............... 0'�.!..!.............� .5:....................................................... ProposedUse ........ ....................................................................................... ..................................... Zoning District f ` 2/l/g f.....................................................Fire District .................. /.............�......................... k. Name of Owner 9.......... .....Address ...... .... tA.14^.....S�:C:.....4�:?:: ............... Name of Builder ... 19 ....... .......Address ..... .. .....Y \V(W '......2 4..0...... 1� . Nameof Architect .................................................Address ...................:................................................................ .................. np 11 Numberof Rooms ..................................................................Foundation ........IV� ............................................................. Exierigr n C ............. ............�f.�.%�....4..�!'t!�:.....:�.N: ��..........Roofing ...... ��j.:�.......,.f..Lf..!v`:G G� .1.. Floors. ..........X.!.St.:.�!!�.�../. U4v �. ,5..............��.. ...! ........................ � ........�............................Interior ....... .....�� HeatingI.�f..�..............................................................Plumbing ... . ............................................. Fireplace ....`...� n/ C h.;P Q �,�-- p -? ...5. ...l.t:...........:..........................................Approximate. Cost ...... .. }.. ... �.oej ...IQP8...4411 � Definitive Plan Approved by Planning Board --------------------------------19-------- . Area .................. Diagram of Lot and Building with Dimensions Fee � ��.. ........... .... ...................... SUBJECT TO APPROVAL OF BOARD OF. HEALTH ISO OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the.T of Barnstable regarding the above construction. Name ....... ��.lJ /.......� ........... Construction Supervisor's License ..(,.!.`l ..I. ......... WALCOTT, HENRY F. cw Permit for ,...B -il.d...D.o r.i.n.e r ..... .. .. .... . ...... . .........S.i ag e v f-�...�!'��mil Dwlli�n ......................... ...Ci............ Location ..1221 Main Street . .............................................................. Cotuit ............................................................................... Owner ....qgAKY..F.....Walcott.................... .. .. .. Type 'of Construction ....F.KA]Aq .................... ................................................................................. Plot ............................ Lot ..................... .......... '-ch Permit Granted ...j�l�kX......... ........19 90 ,Date of Inspection ./.....F.... ...............19 :Date Completed ...... ad............19 % U:- 131 17 I LEI - ?ATE CAPO HOME W.PROScFlT ri: �.YLl_._ SrtcFT 1645 W—t'R7M 6 ---- qEm�;VIA c��--Trpp:•�,==-�—_-' �:Z: Z tnGC'rJ � jit.h. T _ - - CAPIZZI kd'NE AI+PRW"Ek" 1645 HEVYIW ROADMori,VIA o2nm � R 2�5�tFi n y2 2-1 CD`/ v Z lltis�nr�E K`� R-3o � I I •__ zL1D� �y 11 0 L L`{,l5`�1`�)lt'"� � II TYoec� • I I �;, • _ - e, w�,10 fL o . ni'�L24toxt2 :. - _ j • i ?ATE:_ r CAPIZZI HOME IMPROVEMENT IN . 1645 NE14' M%' ROAD COTU►T, VIA 02635 — SLI.�Ft [ p q• ^" .3'k'R t;-1 - K?:. 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THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO D BE USED FOR LOT LINE STAKING OR ANY OTHER Bay PURPOSE. err 3 pf 3. CONTRACTOR SHALL BE RESPONSIBLE FOR CALLING Locu DIGSAFE (1-888-344-7233) AND VERIFYING THE Pine LOCATION OF ALL UNDERGROUND do OVERHEAD UTILITIES 9e PRIOR TO COMMENCEMENT OF WORK. 4. EXISTING SEPTIC LOCATION PER TIE—CARD ON FILE WITH TOWN. I i Nantucket Sound LOCUS MAP SCALE 1"=20100't ASSESSORS MAP 18 PARCEL 61 I i ZONING SUMMARY ZONING DISTRIICT: RF DISTRICT MIN. LOT SIZE 87,120 S.F. MIN. LOT FRONTAGE 150 K A O A MIN. FRONT SEETBACK 30' ri MIN. SIDE SETBACK 15' 0 32 MIN. REAR SETBACK 15'- _ BUILDING HEIGHT 30' PARCEL A o 130.00, BENCHMARK: 10797± S.F. 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