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0048 PINQUICKSET COVE CIRCLE
t, 'l" I Nov 04 16 04:05p R.T. Bowman LLC 5085488758 p.2 D G INSULATION INC. P.O.BOX 2193 E. FALMOUTH,NIA 02536 CLOSED CELL INSULATION SPEC SHEET November 3, 2016 JOB SITE ADRESS 48 P.NQUICKSET COVE CIRCLE._ COTUIT MA.. . ATTIC RAFTERS 7" R-49 CLOSED CELL FOAM EXT WALLS 3" R-20 CLOSED.CELL FOAM INSTALLER NAME JOSEPH DROLETTE fi Nov 0.416 04:06p R.T. Bowman LLC 5085488758 p.3 SINCE ,1955 . GacoOnePass F1850 September 2016 Supersedes 8/16 GacoOnePass F1850 CLOSED CELL SPRAY FOAM INSULATION DESCRIPTION GacoOnePass F1850 is a two component HFC-blown (zero ozone-depleting)liquid spray system that cures to a medium- density rigid cellular polyurethane insulation material.GacoOnePass F1850 contains polyols derived from naturally renewable oils, post-consumer recycled plastics,and pre-consumer recyded materials. GacoOnePass F1850 is a Class A(Class 1)fire rated foam that meets or exceeds the requirements of ICGES AC377 Acceptance Criteria for Foam Plastic Insulation. See Intertek Code Compliance Research Report CCRR-1043 for code compliant application information.GacoOnePass F1850 is a Type II foam in accordance with ASTM C1029. GacoOnePass F1850 is designed to be installed in up to four(4)inch passes when insulation instructions are followed. This dosed cell foam is designed to provide:excellent thermal performance; air impermeable insulation;and,an integral part of an air barrier assembly. RECOMMENDED USES GacoOnePass F1850 will provide excellent performance in a wide range of residential,commercial and industrial applications where in service temperatures are between-40°F and 200OF including: Walls Attics Concrete Slabs Cold Storage Storage Tanks Ceilings Crawlspaces Residential Ducts Freezers, Flotation Floors Foundations Plenums Piping - Industrial Applications' GacoClnePass is FEMA Class 5,the highest rating for flood-resistant materials PHYSICAL PROPERTIES The following physical property tests were conducted by independent certified laboratories with traceable samples in accordance ICC-ES AC377 and ASTM C1029 for Type ll foam. _ PROPERTY* ASTM TEST VALUE UNIT Care Density D1622 2.1 t 10% Ibs/113 Aed R--Value g ,, C518 R 6.5 at 1"' f h•ft2•'F/Btu C518 R 25 at 3.5""' h•ftz•"F/Btu Compressive Strength(Parallel to 01621 28.5 psi - Rise): Tensile Stren th D1623 39.7 psi Water Vapor Permeance E95—Method A 0.44perm-in Dimensional Stability At 158OF and 97% RH D2126 L=4.20/6,W=5.1%,T=1.2% % linear change At 1580E and ambient RH L=0.8%,W=1.1%,T=1.5% % finearchan e At-20OF and ambient RH L=0.1%,W=0.1% T=0.2% % linear change Open Cell Content D2856 4.4 % Air Penmeance @ 75Pa " 2 Jnfiltration/Exi�tmtion F2178 0.00 at 1 Lis M Air Barrier Assembly 75Pa 2, Infiltration/Exfiltratlon ' . E2357 0.007 at 1" Us•M Crack Bridging -15°F -26'C C1305 "` Pass No-cracking- Water Absorption(96 hours,Z, D2842 2.76 %by volume head,.70-74-F 21-230C ' Water Resistive Barrier ICGES AC71,AATCC Pass Method 127 Made in the USA • gaco.com 877.6999..42�26 �::- Nov 0416 04:06p R.T. Bowman LLC 5085488758 p.4 GacoOnePass F1850 Page 2 UV Weathering AC71 Pass No blistering or delamination Accelerated Aging AC71 Pass No blistering or delamination Hydrostatic Pressure—55 cxrl(2151 water column AATCC Method 127 Pass No water leakage Adhesion DensDeck D4541 39 psi Concrete D4541 48 psi OSB D4541 44 psi Fungi Resistance C1338 Pass no growth Hot Surface Performance C411 Pam No flaming,charring, or smoldering VOC Emissions UL GREENGUARD Pass No harmful effects UL GREENGUARD Gol ` Pass No harmful effects 'These items are provided for general information. "Federal Trade Cormmlssion regulaitions published in the Federal Register 16 CFR Pal 460 require that R value testing of polyurethane loam Insulation must be conducted on aged samples at a 75"F mean test temperature.Failure to comply can result In substantial fines by the FTC. "`To detemune R values for Nckness not listed: a. between 1 inch and 3.5 inch can be deterTined through Linear interpolabor►;or, b. greater#=3.5 Inches can be calculated based on R 72inch SURFACE BURNING CHARACTERISTICS GacoOnePass F1850 meets Class A(Class 1)requirements when tested in accordance with ASTM E84(UL 723)as defined in NFPA 101 and Section 803 of the International Building Code(2009, 2012,2015). SYSTEM THICKNESS FLAME SPREAD INDEX SMOKE DEVELOPED INDEX GacoOnePass.F1850 4°(10.2 cm) 5 350 LARGE SCALE FIRE TESTING " TEST PERFORMANCE LOCATION FOAM THICKNESS/COATING AC377 ignition Barrier Vertical surfaces Up to 8.0-(20.3 cxn)/No Coating Required Horizontal or sloped surfaces Up to 10.0'(25.4 cm)/No Coating Required NFPA 286 Thermal Barrier Vertical surfaces Up to 7.5'(19.1 cm)/DC315-18 mil wet Horizontal or sloped surfaces Up to 9.5'(24.1 cm)/DC315-18 mil wet GacoOnePass F1850 meets or exceeds the IBC requirements for exterior walls in type I, II, 111, IV and V construction. This includes NFPA 285 and NFPA 259 testing with Intertek Listings (GWUFIP 30-02;GWL/FIP 30-01). VAPOR RETARDER GacoOnePass F1650 meets the requirement of one perm or less tor a Class II vapor retarder per the Intemational Code Council and ASHRAE when installed at 0.44 inches in depth.However,minimum installed thickness recommended by Gaco Westem is 0.75 inches.Water vapor permeability,at various thicknesses is provided below: Thickness WVP 0.44' 1.00 perms 1.0" 0.44 perms r 2" 0.22 perms 3" 0.15 perms 4" 0.11 perms ' AIR BARRIER PERFORMANCE GacoOnsPass F1850 is an air impermeable insulation and an air barrier material based on testing in accordance with ASTM E2178 at one4itch depth or more and has passed air barrier assembly testing in accordance with ASTM E2357 ' and.the Air Barrier Association of America ABAA D-115-010. . Made in the USA 0 gaco.com • 877.699.4226 Nov 0416 04:06p R.T. Bowman LLC 5085488758 p.5 GacoOnePass F1850 Page 3 INDOOR AIR QUALITY GacoOnePass F1850 is a low VOC emitting material and is GREENGUARD Gold Certified(29167-410,29167-420) (formerly known as GREENGUARD Children &Schools Certification)by Uf_ Environment This program demands strict certificatlon criteria and considers safety factors to account for sensitive individuals(such as children and the elderly),and ensures that a product is acceptable for use in environments such as schools and healthcare facilities.It is referenced by both the Collaborative for High Performance Schools(CHIPS)and the Leadership in Energy and Environmental Design (LEED)Building Rating System. , FLOTATION PERFORMANCE GacoOnePass F1850 meets the requirements of US Coast Guard requirement for flotation materials for both bilge and engine room applications in accordance with Code of US Regulations, Navigation and Navigable Waters Article§183.114 by testing from an independent laboratory. LEER INFORMATION ` GacoOnePass F1850 has a minimum of 9.7%recycled content based on weight,including 1.8%pre-consumer material and 7.9% post-consumer material. It contains 8.5%rapidly renewable content.GacoOnePass F1850 raw materials are blended in Waukesha,WI.Actual polyurethane foam end product production is done on-site by the applicator. TYPICAL LIQUID CHEMICAL PROPERTIES "A"Component contains polymeric isocyanate."B"Component contains polyol,catalysts,fire retardants,surfactants and blowing agents. PROPERTY TEST ASTM TEST VALUE UNIT TEMPERATURE Viscosity-"A"Component: 77°F(25`C) D2196 200±50 cps Viscosity-"B"Component: 1080# 100 cps Specific Gravity-"A"Component 77-F(25-C) 131638 1.24 S.G. Specific Gravity-"B"Component: 1.235 S.G. WeighttGallon--A"Component: T7-F(25-C) 10.34 Ibs/gal Wei ht(Gallon-"B"Component ' 10.3 lbs! al Mixinq Ratio-"A"&"B"Component: 1:1- By volume Stability When Stored at 50-17 to 700F A Component-12 Months 10-C to 21-C : B Component 5 Months APPLICATION To ensure optimum perfomtance,a minimum pass thickness of,314"(1.9 cm)is recommended with the maximum not to exceed 4"(10.16 cm)per pass.To obtain optimum results substrate temperature should be within the ranges as stated below.All substrates must be dry at the time of application.Do not apply to wood surfaces with a moisture content of above 18%. Material Substrate Temperature GacoOnePass F185OR 30°F to 120-F -1-C to 49"C GacoOnePass F185OW 20OF to 80'F -70C to 27-C EQUIPMENT SETTINGS REACTMTY TIME Pre-Heaters-Iso(A): '105'F to 135°F(41`C to 57°C) Cream Time: Isecond Pre-Heaters-Poly(By 105-F to 135-F(41-C to 57°C) Rise Time: 3-6 seconds . Hose Heat 105"F to 135-F (41-C to 57-C) Tack Free Time; 4-8 seconds Recommended Spray Pressure: 1,000 to 1,200 psi(dynamic) Cure Time: 24 hours The Information herein Is believed to be reliable but unknown risks may be present ALL WARRANTIES OFANY KIND,EXPRESSED OR IMPLIED,_ ; INCLUDING WARRANTIES OF FITNESS FOR A PARTICULAR PURPOSE AND THAT GOODS ARE OF MERCHANTABLE QUALITY,ARE SPECIFICALLY DISCLAIMED.See Gaco Westem for information concerning its rmtited warranty and its availabildy. For specific Safety and Health information please refer to Safety Data Sheet ''. Made in the USA • gaco.com • 877.699.4226 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Oil Parcel 6Z3 Application # �® Lo ��z' ' . 1 b Health Division Date Issued, �� C Conservation Division AUS2016 Application FEM TJ yr y OF O,�p�N�TAB�� Permit Fee Planning Dept. Date Definitive Plan Approved by Planning Board led �( Historic - OKH _ Preservation/ Hyannis - at led . MI I�p " Prod Street Address Q i Nci+ Co .Ci r Ca Village Owner Cj1���'GWl }- ��`G,1,,,jr JR d 1 I`S Address Telephone Permit Req est 14G� r oev e 0 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) L T Name !�� � �Telephone_Number � e A dress license-# Home.lm rovernent Contracto## !0 � T-Em--iF� 97'��tUMAV 91VG O)CICIP (QM-- Worker's Compensato ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO G ATURE +. w DATE '' - - FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH t FINAL FINAL BUILDING © DATE CLOSED OUT ASSOCIATION PLAN NO. r vAassachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-058154 t 'Lvn5S7 U.^.iIC?rS ROBERT T.BOWMAN,JR � PO BOX 706 , y H MA 02574 WEST FALMOUT Apiration: 031031201$ f�ommissioner �1;�^�:`i `.J - J✓ l�tf�:.: v'�S{lL-��T/VL �V'•JCLs'P..' �.f� �./ �� I�I,�/C�'✓.l'i/fi� + - �` P, : `` Office of Consumer Affairs and Business Regulation. _ `1=_ 10 Park Plaza- Suite 5170 Boston,Massachusetts 02116 Home Improvement Contractor Registration Registration: 102829 l Type: Individual Expiration: 7/3/2018 Tr# 288900 ROBERT T. BOWMAN Robert Bowman P. O. Box 201 W Falmouth, MA 02574 Update Address and return card.Mark reason for change. sca, c_ 201r,-05n, Address 0 Renewal n Employment ❑ Lost Card �l/....-t�f[;:rlatnlvr•'nrrf/�C!�='-r�rc;•:Cr(�rr:ielf. '. . . �--.----- --- Office of Consumer Affairs&Business Regulation License or registration valid for individual use only . expiration before the date. If found return to: HOME IMPROVEMENT CONTRACTOR Registration: fi02829 Type: Office of Consumer Affairs and Business Regulation Expirat►on 7/3/2018 Individual 10 Park Plaza-Suite 5170 Boston,MA 02116 ROBERT T.BOWMAN....- Robed Bowman >` 649 Brick Kiln Road , �� x _�_:_.,_z=�.r.>.�_ _ a e ` l-- •ter;f°.��-' W Falmouth,MA 02574 Undersecretary Not valid without signature p Tize C'oinmonivealth of Massachusetts , g; Department of Industrial Accidents Office of Investigations 600 Wasizington Street Boston,AM 02111 www mass gov/dia Workers' Compensation.Insurance Affidavit: Builders/Contractors/Electricians/Plumbers A licant information Please Print Leflibly Nan1e(Business/Organization/Individual): s Address: t �� City/State/Zip: Are you an empl,wer.,Check the appropriate box: ' 9{ Type of project(required): 1. I am a employer with_ { , `1• ❑ 1 am a general contractor and l employees(full and/or partTT-time).* ha�tc hired the sub-contractors b- E]New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. W Remodeling ship and have no employees These sub-contractors have S; Q Demolition working for me in any capacity. employees and have workers' [No workers' coiiip.insurance comp.insurance.' 9. ❑Building addition required.] 5. We are a corporationand its I O.E].Electrical repairs or additions 3.❑ 1 am a homeowner al doing a work officers have exercised their 0 i 11.Fl Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL ` insurance required.] '" c. 152, j 1(4),and we have no 12.[] Roof repairs employees. [No workers' 13•[] Otltcr comp. insurance required.] Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that isproviding workers'compensation insurance for my employees. Below is thepolicy and job site . information. Insurance Company Name: 6 N'S' Policy#or Self-ins.Lic.,#:W CONS i 1J, Expiration Date:O Job Site Address: b c k ef�av�e e1r-�t�e City/State/Zipi 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 maybe forwarded to the Office of lnvcstiaations of the DIA for insurance coverage verification. Ida hereby certify under the ainsapilpenalfte of perjury that the information provided above is t ue acid correct Signature: Date: Phone#`. Offrrial it se only: Du not write in this arett,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): I. Board of llealth',2. Building Department 3.Citv/Town Clerk 4.Electrical Inspector 5. Plumbing g Ins ect�t P b:Other - - Contact Person:' Phone# RTBOV MA-01 CCOSTA {/A1COR", DATE(MMIDDA'YY1) �..�: CERTIFICATE OF LIABILITY INSURANCE 517912016 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(les)must be endorsed. If SUBROGATION IS WAIVED,subjectto the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in-lieu-of such-endorsement(s). _:_-..._ ---.--...---------....__...- --------_-----_--_---- PRODUCER CONTACT NAME: Mason&Mason Insurance Agency,Inc, HONE �,(781)447-5531 FAX 458 South Ave. Arc No:(781)447-7230 Whitman,MA 02382 ADDRESS:info@masonandmasoninsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Main Street America Assurance 2— INSURED INSURER B:Star Insurance Company 00006 RT Bowman LLC INSURER C: 'PO Box 201 INSURERD: West Falmouth,MA 02574 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,-THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD W ID POLICY NUMBER MMIDD MMIDWYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE 1XI OCCUR MPSIO587 05/01/2016 06/01/2017 DAMAGE TO PREMISES R occurrence)FNTEEF $ 600,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY• $ 11000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 POLICY❑JECOT- LOC PRODUCTS-COMPIOPAGG $ -2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS AUTOS ( ) NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident $ k $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE + AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION SPE AND EMPLOYERS'LIABILITY - TATUTE ER B ANY PROPRIETORIPARTNERIEXECUTIVE YIN CO220514 06/18/2016 06118/2017 E.L.EACH ACCIDENT. $ 600,000 OFFICER/MEMBER EXCLUDED? N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 500100 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ -; 600,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Falmouth THE EXPIRATION DATE THEREOF,- NOTICE WILL BE DELIVERED IN ACCORDANCE VVITH THE POLICY PROVISIONS. 59 Town Hall Square'' Falmouth,MA 02640 AUTHORIZED REPRESENTATIVE 9zl- @ 1988- ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD f Permit Form Page I of I ' I� i' !0 t �v PAMnStraet H nee s,PviA 62£a{J3 5tJ8 8 a ...ES jford2l @verizon.net(Business) v C:PEr7q��Jjec—t#: B-16-1514 Location: 48 PINQUICKSET COVE CIR,COTUIT Status: Issued Balance-Due:_-$0.00! PERMIT INFORMATION . Occupancy Type Building Type Date Submitted Date Issued Permit For Residential Single Family 6/1/2016 6/22/2016 Addition/Alteration-Residential . Project Cost Permit Fee Additional Fee Total Fee Total Paid 90000.00 $459.00 $50.00 $509.00 $509.00 OWNER APPLICANT PYNCHON,JANET M TR KENNETH VONA CONST INC C/O DAVIS,MALM&D'AGOSTINE PC 11 FOX RD. BOSTON MA 02108 WALTHAM MA 02451 CONTRACTOR f KENNETH VONA CONST INC Ill FOX RD. IWALTHAM (781)890-5599 matt@kenvona.com 111,6519 06/22/2016 Attach Documents / Photos 3 � I +REVIEW STATUS +INSPECTIONS https://www.viewmypermitct.org/Secured/Permitview.aspx?tid=67&PermitTypeID=O&Per... 8/4/2016 Town of Barnstable Regulatory Seiwees UAM R3ebard V.scab,Director •tea, Building Diviion, Pa.al Roman Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstabie.ma.as Ofre: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If 11 jigg A-D. I. .. ,as Owner of the subject property hereby sutho to act on myy belsal>y in 0 matters relative to'work authorized by this building permit application for. -pt"tj U �,b (Address of Job) **Pool fences°and alarms are the responsibility of the;agplicant Pools are not to be filled of utilized before fence is installed and all'final inspections are performed and accepted, fir r jts�}' Comic aG f "�' ignaweovZer o Applrcant Print Namc , � 18 aolG Date q:FoR W'0WNERFER sstor MLS 8 Town of Barnstable Regulatory Services Richard V.Scab,Director Building Division Paul Roma,Building Commissioner 200 Main.Street,Hyannis,MA 02601 Office: .508-862-4038 Fax: 508-790-6230 NOTICE TO THE BUILDING DIVISION OF CHANGE OF LICENSED CONSTRUCTION SUPERVISOR -�Q "01V{�, owner of property located at Lj 'os,-4. j rfo �.hereby certify that �UQy%�CoraS kdG)A lKis no longer Construction Supervisor listed on the application for the projeiyt under construction as~authorized by building;permit# I. 4 ,issued on _ ] 201 10L. I understand that the project under construction must cease until a successor licensed Construction Supervisor,is submitted on the records of the Building Division. Pi t4 ck,�,c. Cove , UC.. 11kO1sE 0 DA:,,.. III(INM 'i Ur. (net\ q/forma/ncrvcp�r . reference R-5 780.CMP, rvw 07/18/16 I I TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # (D Health Division Date Issued 6Z G Conservation Division LA� Application Fee Planning Dept. Permit Fee Cj Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis '�Aru S Erg T Project Street Address qJ IP �ku-� C a� �i r Village C0+4�� MA Owner 1"1 �� � Gott . L L C A dress(l nr.e DD��.1 PL. STD 3�b1 IS�-Fo� Telephone C 0 �4-1 AJB f O ® � Permit Request a 7L Q4 l u hlIQl Pgo,' Z 11' sr L O Square feet: 1 st floor: existing ` proposed 2nd floor: existing $Gd proposed %(00 Total new Zoning District Flood Plain Groundwater Overlay Project Valuation ® Construction Type Lot Size_ 65 ACNS Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) J / � Age of Existing Structure ���� Historic House: ❑ mYes No On Old King's Highway: ❑Yes �J No c7 0 Basement Type: 4 Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing of new Half: existing new V Number of Bedrooms: existing® n�ew c Total Room Count (not including baths): existing D new First Floor-Room Count Heat Type and Fuel: ❑ Gas '�Oil ❑ Electric ❑ Other Central Air: ❑Yes *o Fireplaces: Existing 3 New Existing wood/coal stove: ❑Yes �JNo Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage:`Xfexisting ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # 1 r Current Use �5 �r`� ( Proposed Use �S j 'A I&N ' - a APPLICANT INFORMATION , (BUILDER OR HOMEOWNER) w n Name 45"416-111 i/dM+ raUrxik 7)611 Telephone Number Address ( �-Dk 4AQ License # C5F4 -051385 017'72f Home Improvement Contractor# Email y�ya �ke,A%/VAQ . CQM Worker's Compensation # Wa 52-1&$44(0-P ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY t APPLICATION # DATE ISSUED MAP/ PARCEL NO. , ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME - INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL ,PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. J f { Town of Barnstable Regulatory Services Building Division Tom Perry Building Commissioner• . 200 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 AGREEMENT FOR ACCESSORY KITCHEN IN BUILDING RESIDENCE I(We), the undersigned, being the owner(s) of property situated at 48 Pinquickset Cove Circle, Cotuit, MA, holding title under a deed recorded with the Barnstable County Registry of Deeds in Book 29543, Page 169, being shown on Assessor's Map 017 as Parcel 023, hereby agree, certify, warrant and'represent to the Town of Barnstable that the accessory kitchen to be located in the principal dwelling is to be used accessory to that dwelling and is.not intended for and shall not be used to create a permanent,or separate.apartment for year-round or summer occupancy, for.rent in any fashion. The intended and authorized use is for an accessory kitchen within the residence. The accessory kitchen shall not be used to create a"Family Apartment" (as defined in the Zoning Ordinances) which would require application and approval of a special permit and compliance '...� with the Family Apartment Rules and Regulations. This accessory kitchen within the residence shall not be used to create a rental apartment or a single room rental, or in any fashion, which rental would be a violation of the Town of Barnstable's rules, regulations and zoning ordinances. This agreement shall be recorded or filed at the Barnstable County Registry of Deeds for the purpose of alerting future owners of the property of this binding Agreement concerning the use of the property as herein stated, which shall run with the land and binding future owners. The consideration for this Agreement is the issuance of a building permit and/or certificate of occupancy by the Town of Barnstable Building Department. WITNESS our hands and seals this day of G 201'6. TOWN OF BARNSTABLE Owner(s) . �tNc��tc r!-st✓T coves' u.-c.., By: W'll f ate, Building Commissio er THE COMMONWEATLTH 0 'MASSACHUSETTS BARNSTABLE COUNTY, SS Date Then.personally appeared the above-named (owner), G taw. �-t • ' and made oath as to the truth of the forgoing instrument, before me. Notary Public C��� My Commission Expires: Oft, b, avb6 ,�NINIIIINh►7j, I CHR/ST'''% •�Y C mil'• '�t,+��+ iP 2 Town of Barnsable • �^ ReguLa�u Sea�tces - � $mod<v ,Building Dvisfron • `�'omPe�crp.BCoaner . aoo Main sal sT=ui8;,MA 02601 . Officc: 509462443$ Fas SOV90-WO Pmpe y OvmerMust complete aad Sigg:'This SectionXfUsing-A i lder ,i�}►���crw► :�lIi.�vJ � 11�G. as C?wnectbe'�ubjtt'propety 1t�Q4' t,4Cf, C' , besbpoaze �D;r.� :)C1 'Cor1S}Ai�C � . .to aetan 1 , 2r1 aIl:,m�ts rye m vvo�t,a�nuzed b �ildmg E gP °u f.��., , ' Is_ (Add x 46s'nflab) *P061 fences and ala n;,z are the resporlsj y-of the applicant f ool are not to be filled or iA e befozre fence is insulduand all f nal . inspe=ns•are pedonned and accepted. Pwou Pn�Nanac'°:� Pratwa�.. 1 I Damt. I , �.gaaaas:o: ' I o� T Town of Barnstable Regulatory Services • . - MAFM lzfrhard V.Sc4 Dhmator Bid 3g Division `romPerry,ETdIdmg Commoner 200 Mum Street Hyamr*MA 02601 WWW tDWnl stable ma_us , Office: 508-862-4.038 Fa.= 508-790-6230 Property Owner Must . Complete and Sign This Section If Us in.g A Builder j, LJ, 1 C4 uh T, G(�I i wY u�: MG�►� ,as Qwner of the subject property aLL heml3y azai3iori?R w u0J-3 CK_ Co tS<_4 ail to act on niy bgml& in all matters lalliM to work=:ho&_ed bythis bm[ding pemit application for. c►r cG_ cam;� m (Add=s of Job) "Pool Pool fences and al:;tm are the responslfl yof tbn applicant Pools. are not to be ed or used before fence is installed and all final ' inspections f 11 .are peifozmed and accepted , of Ownes S of ApFEcaat . /`�rr'�� I/� fie• 'T1�,rx�yi�i Priur Name _ Pert Name Dam. QFo�s� oors . 'down of Bamsfiable Regulatory Services RirTm V.SCO-Director BuHdlfmg Division F _ Tom Ferry,B47dmg Commissioner • `U , `a� 200 ISM Stmet Hyaas,MA Q2601 WW4P.fII VIMd'bTn ma US - Of 508-962-4038 - Fmc 508-790-230 - HDIMOWNM LitMM Mama EON .PT�2MPI'l� Jps 3a)=UbL- ' nrmtbrr' street IIam- 11®ephaw eF vca3cpB=# MRRENT MAILIZIG ADDABSS: _ ---- e9/tea - s zip Code The c n-mt exemption for`5iomeownnf was eDd=rl to inclpdc owner-occ�ied dweIIm�s of six or Less Odin aIIoW possess yidedthattheowneractas ervisor_ b.omeoprners to engage an individual for hn-ewho does notp q pro sou DAMMN ORHOriD;OWNM ,P ensan(s)wiio ovens a parcel of Landon which helsha resides or inteds n to reside, do which t�is,or is intended to be,a one or two- famay dwalIing, aiiacTlbd or detached sttact res accessory to such use and/or faLm stuctures: A peason Who constmcts m=a than one home in a two-year period shall notbe cousidrredAhamrown= Such hommwnce.shall mgnakto the Bmlding Official on a form ' acceptable to the B-m1dmg Oifitial,ihathelshc shall be responsible,for an sash wo3icperE=ed nndcrffim bm aoz pit (Section 109.L1) The n dersigaed`homeown=-assumes rmsponssbs7$y for complim=wi{hthe State Big Code and otfier appHcabIo codes, bylaws,roles and regmbtions_ - 'I]1e tm.de�.gned`.�ioracownea?'ceatities ihatheJshe ffid�ds t3ie'Tom nf$arnstable Bty7ding Depazimcot�inspetiion proce,dmesmdregaemenfsandffiatbrlsbewMcomplywith.saidprocedrarsandrNlPirc�- • 5iga�aeofHnmcoW= - Approval eB;@d-m905ci2d • Note- lore-family civmMng*s confat 35,000 cubic feet or In m wMbe req atdtD coyly withthe Stafr Bim7dmg Code Section 127.0 C.onsta�n CmtmL RDhODWN>s s EXEMrMN The Code states that a9np homeowner performm" 'g Work fur Which a bnildiag permit is required shah be exempt from the prvvtsions of this secfinn(Section I09_U-Licrasing of consirudion Supervisors),provided that if the homeowner engages a person(;)for Tice to do such work,that such Homeowner shall act as sap ervisor." Many homeowners who use ffils e=mpt ion are are!wss=mg the responsibi0i of a supervisor (See Appendix Rules Bc fe�n?iioas for T Sir ConsCt IIcnn SIIperPisors,Sectnn Z.15� 'This lark of awareness o$ra results in serious problems,pariicnlady when ffie hOmeaw=hires mTweused Pe OmTri this case,am I Board cannot proceed against the muceased person as it would wiffi a Hcensed Supervisor- The homeowner actmg as Supervisor is ulf=tely responsz'ble. To eusure txat the ho--wnrr is faLLg aware of his/her respoasfrTiiu'es,many eommuaf =require,as part of ffie er=it a n,Mat the homeowner cerUy'fiiat helshe undersbm s ffie responsffiiTtir'es of a Supervisor. On the lastpage p PP�o - a rmfeer�ou for me in of ffiis;sue is a farm rn rrenffp wed by several towns. You may rare t amend and adopt such fn your cammuaitp • fr,n„e1F4PRFCC ifnp Q� p� Revised D6 U 13 f td r!im E srr state ma us( Ch!nrp i nrz nspx FEN 11'I 9)],�•,EA�2CN tf�t + i Y ' tre. �,z�ki31"lahs a,,,,„gNlas3�orow_ e ins r � �r s: -_.,� sTp f T!g '' °i „� 3 ,. >v'q� -�Jv� - !y...IT!Ire:� ��"�,,�,.�,,,1....:...�:::k�. �r Mill s Search the Secretary's website , .> ✓ r«'s Corporations Division Business Entity:Summary ID Number..D01213971 ;. 5 � Summary.for-PINQUICKSET COVE-LLC / _......... .......................................- _......... ....... ........ ..... ........ ew........ ; The.exact name.of It e.DomeOIC.Limited Liabili Cem a LLC .PIN UICKSET COVE.LLC c. r t Endty�type: Domesdc Llmited.Liability' m Copany((LLC), �z , Identification Number:061213971 j. y x Date of Organization in Massadiusetts: 0341-2016 - -Last date:certain: I �y .. ... ` � c The location oraddress.'where the records are maintained(A PO:box is not a valid location or address):' 3 Address: DAVIS,MALM&D'AGOSTINE P.C.,C/O.WILLIAM'F.GRIFFIN ONE BOSTON PLACE„37TH FLOOR r ' City or.town,:State,Zip code,Country:: :805TON; MA '02148 -USA AV yF � '• The:name and address-of:the Resident Agent: •s r' Name: WILLIAM F.GRIFFIN,'JR. Address: DAVIS,.MALM&-D.'AGOSTINE,P,C.ONEBOSTON PLACE,37TH>FLOOR Y l City or town,State,Zip code,Country:: BOSTON, MA 02108 USA The name and.business address.of:each Managein ,, 5 MANAGER WILLIAM F."GRIFFIN)Rc� DAVIS,:MALM&DAGOSTINE,'P.C.,ONE�BOST.ON PLACE,FL ! � 4 -� 37 80STON MA 02108.USA '.d ..... ... -........ ......... ........ ........ ......,_ .... .... ....... .......-- ........ . ......... ....... '_ t in addition to the manager( ) the:name and business address of the person(s)authorized.to execute documents to bellied with the Corpo rations:DiVision: + .ti a MENEM T 07 w RO The name and business address of the person(s)authorized to execute acknowledge deliver,and record' �Sta r�� � �f ' � 11 s _ k x �r„,tj.k � r it�;�1'� F<��j�3 � ��r�y ° w..... 3 �•�«E,� �. F ltrryy,, t 4 .`""7i vs r1��sdztry a r.` a{�a n;Farr.a Hx�a 'I:i tt ....... .. ov- w� N � tS h1:M1.h5kt3tZ r mz vrad eo 617-023 o.yoow ens FUNNUM LOT - txueni48-PINOUICKSETCOV PHF S.av a ._,,,,_.„.,_;,_,„.,..,. ,......_.�.... �...._��....�.... 1 � � Y61aga-0O2111I Faa DisvktCOTUIT �•,<�,•••,••,••.••�.�•,�. - . Town�v.�ct5su ntfili ama.INo '�� Raid md-1274�� . Asbuilt Septic Scan: meeseay.M,v o— YNCHON;JANETMT 0,l%PINOUICKSETCQVE sneeze r6WE BOSTON �y BOSTON I s—Fm _....,.,.,I?ro:3 21D8. �j�apolnflli� �a. J�3 �(Nosr✓�7al 3 Ail,.<. . � :g 9 3::" r !„t 13 y' Rue:--2 05'. ..<.._..____-- I Uee.Single-Fam MOL-0t �.zwa�y .. ......._ �NOW 10.113 TW,gmPhy,Level: Rvaa,Pav'ad.,.,. umm l5ept d, s,Pubk—Watet� >ow a a vn.1985 - e„ar� s�: w.13, AC u�,2282 IWoodSh3ngle Tya;None --- 'Massachusetts Department of Public Safety i Board of Building Regulations and Standards `License: CSFA-057385 Construction Supervisor,1 &2 Faintly KENNETH B VONA 11 FOX ROAD o WALTHAM MA 02451 t ""^ Exp'iration: miss ioner o7/19/2017 • r i Construction Supervisor 1&2 Family Restricted to: Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this,license. DPS Licensing information visit:WWW.MASS.GOV/DPS ��U c(>ryaa�i2nruu�tc�lf u��il�i!taaeac%cioeC1.�. - ..:4ffiice.of Consumer Affairs&Business Regulation. License or registration:valid for individul use only before the expiration date.-If found return to: OME IMPROVEMENT CONTRACTOR = registration 016519 Type: Office of Consumer Affairs and Business Regulation xpiration kZ%2016 Private Corporation 10 Park Plaza-Suite 5170 _ Boston,MA 02116 KENNETH VONA CONST,INCS 7— ,-''' d KENNETH VONA. r�c 11 FOX RD, WALTHAM,MA 02451 Undersecretary Not valid without signature a E f i 1TIe Comrn'orrivealth of-Massachusetts Departtrnevnt afrndostrid AccideFzts - - @,},due of Imwstigations 600 WaslizngioFn,gireet Boston,M4 02MI. t�x�mrrss_g�frlin , Workers' Campensaf un Insurance Affidavit:BmidersiContractursiEIectr cians!Plumbers 1 Applicant Infmrmatian Please P'sint f.egibly Name ���P�nr�aniraGiout nd�ay} KE NIJ`c.TK 1/6�1�} ndl►l Si Iii+4iT1� /�C Address: lI f;Vk IUAO M444 -MAM 44,1- 4/JJY City/S ate(Zip � -2f ,44A D/77� Phone-,rk- mire you an employer?Ghech.the appropriate bow Type of project(regmretl}: I_MI am a.employer with 7e 4. ❑I am a general contractor and I employees(full anrctfor part-time. * Have hired the sub-contractors 6. [-]New construction 2.❑ I am a sole pmpaietar or partner- listed on the attached sheet 7_ ❑Remodeling slip and have no employees. These sob-contractors have. $. ❑Demolition waiting forme in any capacity. employees and have workers' [No w-rsrkers'comp.r mm-ance comap.msuranc-,l 9. ❑B.uilding addition required-] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions' 3.❑ I am a homeoumer doing all work officers have exercised their 1 L❑Flumbiagrepairs or additims myself':[No workers'camp- right of exemption per MGL 12.❑Roofrepairs . ins ancerequired-]l c.152,§1(4� and we have no employees-[No wod=s' 13.0,{)ther comp-insurance required.! 'tray WEc gut chedmbcm AFl maxi also fM ootthe swdoabeIowsheuiag the¢nrorkere ca®pmsatioa policy idbmsti= 1 Homeowners who submit xhis affidavit indicating tb--Y axe doing all wol sad then him ou=de conmictors mast mbmit a nem affidavit indicating mcb- fCaatcactorsthat ebecki i;box xnmt attached ant addiriansl shed sho dng tbemaneof the sub-cemdxscnimsad statewhether ornot4wse entitinhwe employem I€the sub-c=bxct=shm exapIayms,they=tstgmuide thews trarkeW wmp.policy number- lam an etixploywr tfsat is pr4nid rtg ivarkers'comperesatiati inmirance for my enrpfoyees Below is iftepolicyy rued jab site ir�fot rrrafian. .' Ins urance Company Name: �T14[l./� IzdM1�Nl A-0rA- ��✓Sdi2,q t/te_CO ' Policy 4,or-%Mins.Lic.;g.: I NC A-J21 b#1#b.11D E�piratioa Date: •7/11!L h Job Site Ad&e= Yj Pin/XQ,ISXS15-:r CA4&C,1. L,&` Citylstatdz�p: &d y►.r— Attach a copy of the workers'compensation policy declaration page(shewiag the policy number and expiration date}. Failure to seeuce coverage as requbA.under Section 25A of MGL c.1.52 can lead to the imposition of criminal penalties of a fine up to$1,50D 00 andlor one-year imprisonment,as well as earn!penalties.in the form of a STOP WORK ORDER and a fne of up to$250-00 a stay against the wiolatcr. Be adt iced that a cagy of this statement=nay,be forwarded to the Office of ` Imvestigations oftlhe DIA for insurance coverage verification. Ida ker-eby c xider tTg 'i andpenafties a/per, ut y'thattlie in/brmadw;pnv i&d abme A bw and correct SiEmature: Q ])ate: 5-11--146 Phoneik7B1- D 0,0kial use only. Do not write in dds area,to be completed by c4 ortaicn ojpdat City or Town.: PermitlLicense# Issuing_mthar€ty(circle one): 1.Board of Health 2.Building Department 3.C ltyffown Clerk 4 Electrical Inspector S.Plumbing Inspector 6.Other- Contact Person: Mane#: _ ormation and lnstructio-us Massa irrmeffs General Laws chapter 152 regaires 0 employers in provide workers'cotsipensaiion for their employees. employees. this sf#Lte,an anpIoyee is defined as-`-.every person in fhe service of another under any coatrart of byre, express or implied oral or wrhem" An�IT2plvyer is defined a3"aa individual,pazinership,assoQafion,corporaion or other gal etrtdy,or a�two DI more of the foregoing engaged is a joint uprise,and including the legal represenisfives 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 horse having not more f3�three apartraml s and who resides therein,or file ocaapant of true - dwelling house of another who employs persons to do ma>man m.,contraction or repair work on such dWeIling house or on the grounds or building app therein shall not because of snch employment be deemed to be an employer." MGL chapter 152,§25C(6)also sues that"every state or local licensing agency shall withhold the issuance or renewal of a Iicense or permit to operate a business or td construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of cdmpIian.ce with the insmrance.coveirage required-" Additionally,MGT,chapt-z 152,§25C(7)states¢Neither the commonwealth nor Ly ofits poIi tkal subdivisions shall mtr,r Ito any cont act for the p erformance ofpublic wow umf11 acceptable evidence of compliance with the fimum„ce.. regzm:enients of this chapter haves been presented to the conirarE,v Thor fy:' APplican-t s , Please fill out the woricras'compensation affidavit completely,by ch=Icing the boxes that apply to your situation and,if necessary,supply sob-contractors)nam(-,(s), addresses)and phone numbe(s) along with their cerlifi-cate(s)of insurance. Llmitrd Liability Companies(LLC)or Limited Liability Partamships(LLP)with no employees other than the members or partners,are not requii-ed to curry wort ms'compensation issuuance If an LLC'or LLP does have employees,a policy is rmp a-ed. 13 e advised that this a$lda:vh maybe snbmitii--d to the;Department of Industrial Accidents for confnmation of ivance coverage. Also be sure to sign and data the affidavit. The affidavit should be refrmmed to the city or town that the application fur the permit or license is being regae:sbA not the Department of h2dost of Accidents. Shouldyou have any questions regarding the law or ifyou are reqo:ired to obtain a workers' compensation policy,please call the Department at the nombr-r isisd below: Self-insared companies should nit x their self-i �ce license amber an the appropriate]me. City or Town Officials Please be save that the affidavit is complete and prinied-legibly. The Department has provided a space at the bottom of the affidavit for you to fill out mole event the Office ofInvestigafions has to contactyouregmiagthe applicant Please be store to fill in the pemit/ Corse number which will be used as a reference number. In addition,an applicant that must sabmiL multiple pennitfIicrose applications in any given year,nee,only submit one affidavit indicating dent p olicy 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 officia stamped or marked bythe city or town may be provided to the . applicant as proofthat a valid affidavit is on file for future permits or licenses. A new affidavit must be tilled oi±each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venttire e. a dog license or permit to burn leaves etc.)said person is NOT reg�to complete this affidavit The Office of Investigaiious would Itke 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 C0MMMWWItIE of chus5t:s , Degar mt Gf JaAutd l Aocidents woe of�.ve�fzg�fioa� Bodon,MA EM IT 'T�1.4 61'-'27-490O Cmt 4€6 ar l-g77-ILA.SS Fax 9 617 727 7M Revised 4-24-07 M ego ldia ACORO® DATE(MM/DD/YYYY) 11101� CERTIFICATE OF LIABILITY INSURANCE 7/6/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTNAME: Construction Eastern Insurance Group LLC PHONE (800)333-7234 FAX No: 233 West Central St E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC# Natick MA 01760 INSURERA:Union Insurance Co INSURED INSURER B Acadia Insurance CompanV 31325 Kenneth Vona Construction Inc INSURERC:Libert International Und 11 FOX Road INSURER D: INSURER E: Waltham MA 02451 INSURERF: COVERAGES CERTIFICATE NUMBER:NASTER 2015 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR I ADDL S BR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE D POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ 300,000 A CLAIMS-MADE ❑X OCCUR PA0296259-1B 7/1/2015 7/1/2016 MED EXP(Any one person) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 2,000,000 POLICY X JECT PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 B ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED /1/2015 7/1/2016 BODILY INJURY Per accident AUTOS X AUTOS 0300197-16 ( ) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS Per accident $ Medical a menls $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 20,000,000 L. EXCESS LIAB I CLAIMS-MADE AGGREGATE $ 20,000,000 DED I X I RETENTION$ 10,00C 100005374005 7/1/2015 7/1/2016 $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N X TLIMIJS ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 ED? OFFICER/MEMBER EXCLUD N/A (Mandatory in NH) CA5216446-10 /1/2015 7/1/2016 If yes,describe under E.L.DISEASE-EA EMPLOYE $ 11000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) RE: EVIDENCE OF INSURANCE CERTIFICATE HOLDER y CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION ..DATE THEREOF, NOTICE •WILL BE DELIVERED IN FOR INFORMATIONAL PURPOSES ONLY ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE John Koegel/PMA — ACORD 26(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INSn25rgmnnsini Tho Aroon nnmo onrl Innn orn ronieforcrl morlre of Arinpn Yr. + + / EASEMENT 1 I / 1 + + Np o + NPROPX F \ 129'tJANET M PYNCHON / \\ —' Ot7/02348 PINOU:CKSET CO`JE CIRCLE DDITION / i z f + 'YA c2 ! rrr) -m-, Now ra$byMamhReWyrnaY Ped dNo.: ,4a48sosi-,40M c = 0 20' 40' 80' ®TETRA TECH 48 Phgafaore,aria a se Dare: May+B.2o,e . 1 I CowK MasaaCametlB 02835 _ Br. h1V,RA www.LeUateUi.can Plot Plan _ I scuE:I._40. ,� C-101 � wrmaown.naa,Ts Plgre:(Wa)T86.�a Fmc(509)]96Z1a, - I�aaaaaaa� Bar MBeaueellnd, ° J q Town of Barnstable *Permit# doo9 L,6 i Expires 6 month ,ona,iss e date y Regulatory Services Pee � � 1�t' Thomas F.Geiler,Director �, OCT r Building Division ®W/ 9 200 Tom Perry,CBO, Building Commissioner ®p ,9 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - I2ESIDENTUL ONLY r '' Not Valid without Red X-Press Imprint Map/parcel Number. J� V Z Property Address residential Value of Work 0 0 d_ Minimum fee of$25.00 for work under$6000.00 c Owner's Name&Address Contractor's Name F- 6,� Telephone Number:50 S— Home Improvement Contractor License#(if applicable) P S 3 Construction Supervisor's License#(if applicable) 101workman's Compensation Insurance Ched one: ❑ I am a sole proprietor ❑ I am the Homeowner ZI have Worker's Compensation Insurance Insurance Company Name T Workman's Comp.Policy# U... Copy of Insurance Compliance Certificate must be on file.. Permit Request(check box) aRe-roof(stripping old.shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. 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. A copy of the Home Improvement Contractors License is required. SIGNATURE: " Q:Forms:expmtrg Revise061306 —�" The Commonwealth of Massachusetts v Department of Industrial Accidents Office of Investigations -- 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legiblv Name (Business/Organization/individual): FA a,44. C 1fY�� .(� , L LG Address: �P D 9 9X l g8 City/State/Zip: C�`v�� MA- oa63s Phone #: 5 0 9—Yag c�?oQ- 9o`Z Are you an employer? Check the appropriate box: Type of project(required): 1;,,I am a employer with _ 4. ❑ 1 am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. ❑ New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance. # 9. ❑ Building addition 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 I L Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp. insurance required.] Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: pv h Policy#or Self-ins.Lic. #:U Q -y 3 Ll l M 5'5 6 -'A ,)✓x�tratiorl Date- C - — _ Job Site Address: ` OA6 - �'� City/State/Zip: (164tLl� Attach a copy of the workers' compphsation 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 7* hfe ,* ndpe tiesof perjury that the information provided above is true and correct. Si ature: Date:Phone#: 54 ' Yoeg' 0 2 02�� Official use only. Do not write in this area,to be completed by city or town official City or Town: PermitALicense# 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#: Old Skaudlwds mass OW IM , :.:gin.. yo XA11• To 9668 MEAN •FMWr;R, 1.04 TMNNvVIEWf�� - EAST Fa411WJJTH.:I%WSSS (t mmSEn T1 Board Of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR License or registration valid for individul use only before the expiration date. If found return to: Regist►�a4�orc 112536 Board of Building Regulations and Standards lug r;Eg'P't1"00�:0/23/2011 Tr# 281021 One Ashburton Place Rm 1301 Type: DI Boston,Ma.02108 FRASER CONSTR110I0 N C.O. DEAN FRASER �i f 104 TWINN VIEW LANE E FALMOUTH,MA 02536 Administrator Not re a� r oar�i of u,l�mgeojla4s an tan ar s One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Horne Improvement-C®ntractor Registration Registration: 112536 Type: DBA FRASER CONSTRUCTION CO. Expiration: 3/23/2011 Tr# 281021 DEAN FRASER P.O. BOX 1845 COTUIT, MA 02635 Update Address and return card.Mark reason for change. Co 4oM-08/08-DBSUFORMCA108212008 Address Renewal 1';mployment El Lost Card FT • L t is �- - RightFax C2-2 9/29/2009 5 : 35: 22 AM PAGE 2/002 Fax Server ACORD. CERTIFICATE OF INSURANCE DATE(MM100\YY) 09-29-09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE WISE&QUINN INS AGCY IN HOLDER. THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 449 PLEASANT ST ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE BROCKTON,MA 02301 COMPANY 24WCB A HARTFORD CROW INSURED COMPANY B FRASER CONSTRUCTION LLC COMPANY P.O.BOX 1845 C COTUIT,MA 02635 COMPANY D COVERAGE 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 CERTIFICA-TE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER DATE(MMOMYY) DATE LIMITS GENERAL LIABILITY GENERAL AGGREGATE $ COMMERCIAL GENERAL PRODUCTS-COMP/OP AGO. $ CLAIMS MADE OCCUR. PERSONAL&&ADV.INJURY $ OWNER'S&&CONTRACTOR'S PROT. EACH OCCURRENCE $ FIRE DAMAGE(Any one fire) $ MED.EXPENSE(Any one person) $ AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ ALL OWNED AUTOS BODILY INJURY(Per Person) $ SCHEDULE AUTOS BODILY INJURY(Per Accident) $ HIRED AUTOS PROPERTY DAMAGE $ NON-OWNED AUTOS GARAGE LIABILITY ANY AUTOS AUTO ONLY-EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGREGATE $ EXCESS LIABILITY UMBRELLA FORM EACH OCCURRENCE $ OTHER THAN UMBRELLA FORM AGGREGATE $ WORKER'S COMPENSATION AND A EMPOLYER'S LIABILITY UB-0341 M556-09 09-26-09 09-26-10 STATUTORY LIMITS X THE PROPRIETOR/ EACH ACCIDENT $ 500,000 PARTNERS/EXECUTIVE INCL DISEASE-POLICY LIMIT $ 500,000 OFFICERS ARE: X EXCL DISEASE-EACH EMPLOYEE $ 500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/RESTRICTIONSISPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE,'. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE FRASER CONSTRUCTION LLC EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TOTHE LEFT,BUT PO BOX 1845 FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NOOBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. COTUIT,MA 02635 AUTHORIZED REPRESENTATIVE ACORD 2"(3/93) Raman Ayer �u Fraser Construction, LLC ' CONSTRUCTION P.O. Box 1845, Cotuit MA. 02635 ROOFING Email: fraser_constructiongverizon.net www.fraserroofing.com FAX 1-508-428-0123 508-428-2292 MCL#112536 CS#97668 RE-ROOFING PROPOSAL DATE: September 9, 2009 PHONE: 508-428-0509 NAME: Janet Pynchon (Mrs. David) Off Cape: 413-256-1769 MAIL ADDRESS: 15 Country Corners Rd. Amherst, MA 01002 JOB ADDRESS: 48 Pinquickset Cove Cir Cotuit, MA 02635 FRASER CONSTRUCTION hereby proposes to perform the following services in a neat and professional like manner and in accordance with the manufacturer's specifications and local building code. -Remove and Haul away all of the old roofing material -Re-nail all plywood sheathing as needed. Supply and Install - CERTAINTEED LANDMARK /WOODSCAPE AR 30: 30 -Year Warranty, 5 year Sure Start Protection, CLASS A FIRE RATED, ALGAE Resistant, Extra Heavy Weight, Self Sealing, Multi- Layered, Architectural Style, Fiberglass Based Asphalt Shingle with New England's Exclusive COPPER/CERAMIC Stones with a Full 10 Year Warranty against ALGAE Containment. 5 year 110 mph wind- resistance warranty with six nails in common bond area, Fraser construction includes six nails in common bond area at NO additional cost. See actual warranty for specific details and limitations. Color: Partial Front & Garage PRICE- $9,000 Initial Complete Roof PRICE- $12,775 Initial Supply and Install - CERTAINTEED LANDMARK /WOODSCAPE PREMIUM: Limited Lifetime Warranty, 10 year sure start protection, CLASS A FIRE RATED, ALGAE Resistant, Extra Heavy Weight, Self Sealing, Multi-Layered, Laminated Architectural Style, Fiberglass Based Asphalt Shingle with New England's Exclusive COPPER/CERAMIC Stones with a Full 10-year Warranty against ALGAE Containment. 10 year 110 mph wind-resistance warranty Wind warranty upgrade to 130 mph when CertainTeed starter & CertainTeed hip & ridge are used. See actual warranty for specific details and limitations. Fraser construction includes six nails in common bond area at NO additional cost. Color: Partial Front & Garage PRICE- $9,600 Initial Complete Roof PRICE- $14,000 Initial SupRly and Install - CERTAINTEED LANDMARK ULTIMATE: Lifetime Warranty, 10 year sure start protection, CLASS A FIRE RATED, ALGAE Resistant, Extra Heavy Weight, Self Sealing, Multi-Layered, triple-layer thickness, Laminated Architectural Style, Fiberglass Based Asphalt Shingle with New England's Exclusive COPPER/CERAMIC Stones with a Pull 15-year Warranty against ALGAE Containment. 10 year 110 mph wind-resistance warranty, Wind warranty upgrade to 130 mph when CertainTeed starter & CertainTeed hip & ridge are used. See actual warranty for specific details and limitations. Fraser construction includes six nails in common bond area at NO additional cost. Color: Partial Front & Garage PRICE- $10,800 Initial Complete Roof PRICE- $15,750 Initial v Add for Copper Valleys PRICE- $500 Initial Supply & Install - CertainTeed Winter - Guard: (ice & water shield) Waterproof Underlayment System (3ft. on eves and valleys, 18" on rakes, walls, and skylights) SuRply & Install - Roofer's Select.Underlayment Paper (as recommended by CertainTeed) Supply & Install - (Soffit Venting) Hick's Ventilated Drip Edge or 8" Aluminum Drip Edge with existing soffit vents SURRIV & Install -Aluminum & Neoprene Soil Pipe Flashing SuRply & Install- Ridge Vent - Shingle Vent II (as recommended by CertainTeed) Clean 8s Remove - Debris from work area daily. X4 Star Warranty Upgrade will be applied if proposal is signed and returned within 10 days. (see enclosed brochure) 2% Discount if paid by check immediately upon completion NO MONEY DOWN- NO Payment at the start or part way thru _ Payments accepted are: CASH - CHECK- MASTERCARD -VISA-AMERICANI EXPRESS * Any payments not made within 30 days of completion will be charged 1.5 %for every 30 days the payment is late. Possible Extra -After the shingles are removed from the roof, we will lift one sheet of • plywood to make sure that the insulation is not up against the plywood sheathing preventing ventilation from the eaves to the ridge. If it is, ventilation panels will be installed by; removing the plywood sheathing, installing the panels, turning the plywood over and then re-installing the plywood. If needed, this would be charged for as an extra at the rate of$6.00 per panel including Materials & Labor. There are 6 Panels per sheet of plywood. Possible Extra-Any rotted or otherwise deteriorated trim boards, plywood sheathing, lead flashing, or other carpentry needing replacement will be done and charged for as an extra at the rate of$60.00 per hour, plus 15% mark-up materials FRASER CONSTRUCTION Warranties the labor for 12 years FRASER CONSTRUCTION Warranties the shingles against Blow-Offs for 10 years. CERTAINTEED Warranties the shingles and labor 100% through the Sure Start Warranty duration. CERTAINTEED Warranties the shingles to be ALGAE resistant for the duration of the Sure Start Warranty depending on the shingle that was purchased. Any deviation or alteration from above specification will be executed upon written orders and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays are beyond our control. Owner should carry fire, tornado and other necessary insurance upon the above work. We, if not accepted within thirty days may withdraw this proposal. FRASER CONSTRUCTION, LLC: Carries Workman's Compensation and Public Liability Insurance on the above work, certificate available upon request. DATE OF ACCEPTANCE: �V YY6 H eowner Fraser Constr ction, LLC r Assessor's map and lot number . ......:..J.7:-........ :...... .. *THE Sewage Permit number .. .P., ... . ....... . House number v 2 BAHMAO&Ar LE, t ff" A 411 Ero -VA k A1 " _ 0MAI TOWN OF RNSTBLE DAVIRONJIVIEN BUILDING . 1K$,PECT0R APPLICATION,FOR PERMIT TO .....5. ... ..........7..... .. TYPEOF' CONSTRUCTION .... �............................................................................. ... `. .4)................19XX7, TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .. .. �. ./.G. .,fib`'...... ......................................v.... ... ................................... �. . ... ..Pro Proposed Use .. .S ..... : .................................. Gv T!� ' f Zoning District .......... .. .. ..y..................................................Fire District ................. .... ................................. T l Name of Owner A2 ...... U.................Address`.. .... �s bu t s�- Name of Builder . 1'h..t....aD...!.�t���.�.�'r.�'.°.....................Address ... P..A.w).e .N.4?��..d�l.. Nameof Architect ..................'.............................................Address ...........t' ................................................................... Number of Rooms ......... Foundation ....a.. . < <' F. .................................................... . ............................... i M Exterior ..( L.�P �«'r^d ....................................................Roofing ... !!...............!�' �C 1. ... .............................................. Floors �.......................................................................Interior t � .. ° ............ ................... ........................ S13Heating `.. . l .!`..........�....................................................Plumbing ......?G! . ' .................................................. U � V V- t Fireplace -..................................................................Approximate Cost ....... ... ........ �.................. , y�y . rig 0 Definitive Plan Approved by Planning Board ________________________________19________. Area �. „ ......` .z"... Diagram of Lot and Building with Dimensions Fee f... . ........... SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name4k........................ ..........&........................ Construction Supervisor's License 0.04-1 3........... OLSON, VERNON 28071 SINGLE FAMILY DWELLING -----------'--------------- . / . 'Location _ PI��8. ..00VE______. C0TUIT ' --''~—'------'----^—^--------- , .,~ . VERNON 0�S00 . - " Owner ----.----.--.—._-------. Type of Construction ---. .------- ^ ` —_^.--.----.------------..�---' , . ~ . . ^ Plot .�--------. Lot ............................. JU0E '24 85 Permit Granted ---------�—_—]g ' ^ / Date of Inspection .-----lA DoAa o| �y � . . ' ^ p ~ — ` � ` - / . . ' ^ ' . � . . ` Assessor's map and lot number ....Lq.-�:.... ,,3 v v THE Sewage Permit number ..........35.'"A..1.4...................... BARNSTADLE, House number ..................... ..... '.. ........................... 90o Mb 9 0� p, TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...... !` �'C^ P" r'' "�..F;„ '�1"" : ". .... .......... . `' ................................... TYPE OF CONSTRUCTION ....... qi� .........` .. ':. . .................191" ... . TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..�?�( � .:`�.!'.-:.�'t" C......',..�........................9...........�".... ....:......... .......... ................................... ProposedUse ......... r .E�i 4....!` ."�E �`: �, ,. �...... ................................. .. ................................................. Zoning District j ` ...............................Fire District ...�'o.. f Name of Owner e-;2.d"I'J'�'f......41"5 0 .................Address ........................ ................. ...... ...... ........ Name of Builder Wn%—t...' .'.. ��,I f®�" ..... .......................Address .. f ? � h ' ra "��., E `A.. � ..' .... ...... , Nameof Architect ..................................................................Address ...........r '..................................................................... Number of Rooms .......................................................Foundation ..t�I—,:Q >i t €� -x ............ ...........................j................................. Exterior ..................................................Roofing ........r .. Ia.. a„."` Floors ......................................................................................Interior ....!t. ..�......=...-..................te:r............................................... Heating . ...........................................Plumbing ................................................... . ...... . Fireplace ......................................................... .Approximate. Cost - +,!. ty", .. � . C� Definitive Plan Approved by Planning Board ________________________________19________ . Area ..?�.::..:.�-^�...... ) . . .... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH r i OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ,t f..:kv& Construction Supervisor's License r r I '... ........... OLSON, VERNON A=17-23 No ...2HZA... Permit for ..1z...STORY................ ............SINGLE„FAMILY DWELLj�VC�................... 48 PINQUICKSET COVE CIRCLE Location ................................................................ COTUIT ............................................................................... Owner VERNON OLSON .................................................................. Type of Construction FRAME .......................................... ............................................................................... Plot ............................ Lot ................................ Permit Granted JUN.. 24, ....................................19 85 Date of Inspection .............................:......19 Date Completed ......................................19 IL } E TOWN OF BARNSTABLE Permit No. ------- -_-___-_____ Building. InspectorVAIM cash ----- — —w 0I � � fOCCUPANCY PERMIT N Bond ___ _-- _ Issued to Vernon Olson { Address 48 Yinquickset Cove Circle, Cotuit Inspector Inspection date Wiring Plumbing Inspector'— Inspection date. 0 Gas Inspector Inspection date XEngineering Department7 S - Inspection date 'f^ Board of Health , Inspection date �`� THIS PERMIT WILL',NNOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL ,t SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MAS$ACHUSETT$ STATE BUILDING CODE. / � s --e.4 ....................................................... 19..._ _ .. . .......Buildin ..Inspector ._------- ._.. •: a, j,4: .� J3$` a TOWN OF BARNSTABLE BUILDING DEPARTMENT Z 2 STAU = TOWN OFFICE BUILDING mat erg' i6J9' �� HYANNIS, MASS. 02601 MEMO TO: Town Clerk ?' FROM: Building Department DATE: An Occupancy Permit has been issued for the building authorized by Building Permit $ . .. � ��. 1........_................................................................................................ ........................... _. issued to ......1!-v4A4tA �........ ...._........................................................................ ...................................... � Please release the performance bond. i 0 40 UN h 6� .Iv ►� o t 40C. - oo t 1 � Z ,�0' 0 � W OF l#Ar�D C\ -O 1i � E. Z- o KELLEY N Q 1 No. 26100 CERTIFIED PLOT PLAN 0 r LOCATION SCALE DATE PLAN REFERENCE ICERTIFYTHAT THE �"X./.S.T. .!Co4!!?!Q•. SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON AND THAT IT CONFORMS TO THE SETBACK REQUIREMENTS OF THE TOWN OF CONSTRUCTED. DATE G%2•eif*'�f '' REGISTERED LAND SURVE�OR