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HomeMy WebLinkAbout0133 RALYN ROAD 3 3 eo� a00001-0000005 Alarm MonitoringCertificate For Eligible Homeowner's Insurance Savings The security system currently installed in your residence may entitle you to savings on your homeowner's insurance. You should check with your insurance agent or mwj broker to determine if you are eligible. BUILDING DEPI Date Monitoring Services Started: 02/25/2015 NOV 3 0 2020 Name: REED, BARBARA - TOWN OF BARNSTABLE Address: 133 RALYN RD City: COTUIT State: MA ZIP: 026353032 Tel, 5084201762 The customer above, is being provided Central Station Signal Receiving and Notification Service, seven days a week, 24 hours a day, by a U.L. Listed Alarm Service Center for the service(s) checked below: ❑x Burglar Alarm ❑ Fire Alarm ❑ Cellular Communicator ❑ ADT Pulse ❑ Video Surveillance If you have any questions regarding this installation or services provided, contact ADT LLC dba ADT Security-Services at 800-238-2727. This Security System Installation Certificate is subject to the terms and conditions of your ADT Residential Services Contract. xlqz,� 6 11/18/2020 Jamie Haenggi, Chief Customer Officer Date Requested ©2019 ADT LLC dba ADT Security Services.All rights reserved:(06/19) ST9JF001 Town of Barnstable Building Post=Th�suCard So That�t:Tis�/isibleFrom:the St ee FA rouedPlans Must a Retairnec;l.on Job and_#h&is Catl MustbeKe�t . M"� Posted Unt I Final�l pectiori Has Been Mader"£ _ � � y ; Permit W he e a Certificate of O,ccu anc, .,�s Re ulred,:such`B;a�ldm shall Not be Occu ied.unt�l a Final Inspection has been�made I Permit NO. B-18-2334 Applicant Name: ROGER E BYAM _ Approvals Date Issued: 07/19/2018 Current Use: Structure Permit Type: Building-Addition/Alteration-Residential Expiration Date: 01/19/2019 Foundation: Location: 133 RALYN ROAD,COTUIT Map/Lot 022 059 Zoning District: RF Sheathing: Contractor Name£' ROGER,E BYAM Framing: 1 Owner on Record: REED, BARBARA L TR g Address: 133 RALYN ROAD 'Cont'r`actor-License CS-075376 2 COTUIT,MA 02635 x EstYProiect Cost: $7,500.00 Chimney: Description: replacing boards on house and garage due to nsq,-ct damage. )Permit Fee:. $88.25 Insulation: Replace double hung window in garageFee�Paid $88.25 Project Review Req: Date 7/19/2018 Final: 1 Plumbing/Gas # Rough Plumbing: r.�.. Building Official 41 Final Plumbing: Rough Gas: . This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months afterissuance. All work authorized b this permit shall conform to the approved a lication andthe'a roved construction documents4 which this ermit has been ranted. Y P PP PPS„� PP , P g Final Gas: All construction,alterations and changes of use of any building and structuresshaI[be in compliance with the local zonmgby laws and codes. This permit shall be displayed in a location clearly visible from access street or rod�a and shall be maintained open,fo�public inspection for the entire duration of the work until the completion of the same. ,.. P • _. Electrical Service: i nil II applicable si n r res-b the Buildih S;nd1FFite Officials are,; rovided'on•this permit. The Certificate of occupancy will not be issued until a atu, ,.•, P Y PP g Y g p P Minimum of Five Call Inspections Required for All Construction Work:' P, R, "' Rough:. 1.Foundation or Footing 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level vel before firest flue lining is installe d 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Final: Work shall not proceed until the Inspector has approved the various stages of construction. "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Final: Building plans are to be available on site All Permit Cards are the property . p p rty of the APPLICANT-ISSUED RECIPIENT 0 �� 0 oi;�, Pemut Fee.....T1.. n....................Other Fee........................ Mla � Total Fee Paid............. .. . .. ................ ................... ...... . . ......: TOWN OF BARN T� �a:, ABLE Permit Approval try..... . . ................orl.. ...� -. ..w BUILDING P RMIT Map.....D@.........................PerceL......a .............................. APPLICATION - Section I—Owner's Information and Project.Location Projef Adaress-} Z Owners.Name' A&A Own Hers Legal Addiess 41- c�� City State' . - ���� Ismail' Owners Cell# Section-2---Use of Structure Use Group ` ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet Single/Two Family Dwelling Se tion3=1`ype of Permit n ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment ❑ Sprinkler System ❑ Addition ❑ Retaining wall [] Solar ❑ Renovation ❑ Pool ❑ Insulation Other—Specify �Se tion 4--Work_Description AW(- T Act andFAed:2/9/2019 i Application Number.................................................... Section 5—Detail Cost of Proposed Construction Square Footage of Project Age of Structure 'L Dig Safe Number 1 s #Of Bedrooms Existing 1 Total#Of Bedrooms(proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics ❑ Wiring ❑ Oil Tank Storage 4 ❑ Smoke Detectors ❑ Plumbing ❑ Gas `"❑ Fire Suppression ❑ Heating System Masonry Chimney ❑Addhelocate bedroom Water Supply ❑ Public Private Sewage Disposal ❑ Municipal ❑ On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: I an using a crane ❑ Yes ❑ No Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No ❑ Section S-Zoning Information Zoning District Proposed Use Lot Area Sq.Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front'Yard Reequired. _ Proposed ' Rear Yard, ;-: ,Required Proposed ; Side Yard -"Required,-' Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No _ 1 Last undated:2/9/2019 Byam Construction Roger E. Byam P.O. Box 1793 Hyannis Ma. 02601 Ph. 508-364-4499 HIC License # 132560 MA. C.S. License # 075326 Proposal and Contract July 3`'d , 2018 Submitted to: Barbara Reed 133 Raylyn Rd. Cotuit , Ma. 508-420-1762 The following are the specification and terms for the project at the above address. - Remove 55 ft. (approx.) of damaged lower courses of siding shingles, and install a new PVC water table trim board. - Remove 4 existing wooden corner boards on garage , and replace with new PVC trim boards. - Remove decayed ends of 2 back garage and 1 front garage Rake boards and replace with new PVC trim. - Remove 1 existing wooden double hung window on back garage wall and install 1 new Andersen double hung window of similar size. Install new PVC trim to the exterior of new window and pine interior moldings to best match the existing detail - Remove the existing main front overhang soffit plywood and install anew PVC soffit . - Remove the existing 1x5 horizontal frieze board trim on main house front wall and install new PVC trim. - Install new PVC bed molding to to front wall soffit , including around the top of existing entry door trim. - Remove the decayed end of 1 Rake board on left end gable wall and replace with new PVC trim. - Remove the gutter on the back deck wall and set aside. - Remove the decayed sections of the wooden facia and soffit trim, install new PVC trim in its place, then re- install the aluminum gutter back into place. - Remove all 3 pieces of the wooden trim on the breezeway sliding door, and install new pvc trim boards. r All new door , cornerboard, and water table trim will have adhesive backed moisture barrier underlayment applied to the wall surfaces prior to installation. Materials total — 1,500.00 $ Installation labor including debris disposal — 6,000.00 $ Project Total — 7,500.00 Payment terms : 1,500.00 $ deposite due at acceptance of contract to supply materials . 2,000.00 $ payment due at 1/3 of project completion. 2,000.00 $ payment due at 2/3 of project completion. 2,000.00 $ payment due at full completion of the above described specified scope of work. Any unforseen corrective work deemed necessary (repair /replacement of damaged plywood sheathing, framing members ect . ) , above and beyond the specifications described above , shall be performed upon a time and material basis of 55.00 $ per hour labor rate plus the cost of materials. Barbara Reed a-ci JAC, Roger ByamByam Construction --`v -7 J 09Z� t1W SINNVAH (.£6LL XOS Od WVA13 3 M30021 ' ai"•:.i sue.,...;�:..+ - A. � !� � . 6l,0Z/£0/L0 :sajid�>€� � ', 9L£5L0 SO t; `A . JosiA! ��ylii'�;suo0 spiepuelS Pue suogein6ab 6ulpllnl3;o pjeoi3 ainsuaai-I leuolssa;oJd 10 uolslAla sllasnUoesselN to ylleanmuowwo0 ,3 ��e Tpo�rnmorccueaLtli o�6�/�aaaacic�el� . � Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE: Individual before the expiration date. If found return to: €_.__;Registration Expiration Office of Consumer Affairs and Business Regulation —§-6D 10 Park Plaza-Suite 5170 _ y1325 02/26/2019 Boston,MA 02116 I ROGER E BY ROGER BYAM`'c •tiWo ME-" � ,,;124 Sea St. Hyannis,MA 026&1i;,�z `' " Undersecretary Not valid without si nature i I. s l i The Commonwealth of Massachusetts Department of IndustrialAccidents 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 Leziblv Name(Business/0JIA gamzationdndivi ual): A `Address: V. City/State/Zip: , Phone#: �F Are you an employ r? heck the ap opriate box: Type of project(required): 1.❑ I a employer with 4. ❑ I am a general contractor and I mployees(full and/or part-time).* have hired the sub-contractors . ❑ w construction 2. 1 am a sole proprietor or partner- wed on the attached sheet. 7. [ Remodeling ' .These sub-contractors have ship and have no employees � 8. ❑Demolition workingfor me in an capacity. employees and have workers' Y P h'• 9. El Building addition [No workers' Comp.insurance Comp,insurance# �! required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions I, myself. [No workers'comp. right of exemption per MGL 12.❑Roof repairs 152. , 1(4),and we have no insurance required.]t c § 13.❑Other employees. [No workers' comp,insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. 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!!or 'compensatio urance f my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: ' ? Expiration Date: Job Site Address: A City/State/Zip: 53Attach a copy of the workers' compe satin policy declaration page(showing the policy num er and expiration date). Failure to secure coverage as required under Section 25A.of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify u er the pains penal' of perjury that the information provided above' ue corr cL [Signature. Date: Phon#� '� WQ!q Official use only. To not write in this area,to be completed by city.or town official a {- City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." 1 S c 'V_ i s MGL chapter 152,§25C(6)also states that"eve'ry state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct,buildings in the commonwealth'for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public-work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority;" Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation inswance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. -The Department ha's,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. 1n addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy`informatioi (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 like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. . The Departments address,telephone and fax number: The Commonwealth of Massachusetts - Department of Industrial Accidents Ouse of Investigations 600 Washington Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MA.SSAFE Revised 4-24-07 Fax#617-727-7749 www.maw.govaa Application Number......................................... Section 9_-Construction,Supervisor NameA Telephone Number ��0 1 Lq Address City State c Tap License Number Q License Type Cis Expiration Date Contractors Email 6 AA (well# /0 r —6 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 by 780 CMR and the To of Barnstable.Attach a copy of your license. Signature ,41AM Date ! f Section--10-=Home Improvement Contractor— ` Name Telephone Number City State • — �' Address p Registration Number Expiration Date 7/ f r 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 requir/d by 780 CMR and th&4rown ofBazastable.Attach a copy ofyour H.LC... Signature f Date Section 11 Home Owners License Exemption Home Owners Name: Telephone Numbe Lj l?(� � Cell or Work Number I understand responsibilities under the rules and my resp regulations for Licensed Constriction S ervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation re by 78r and the Town of Barnstable. Signature ( Date / D G APPLICANT-SIGNATURE Signature ( Date J` �- Print Name Telephone Number - E-mail permit to: T...h.....3 n/flPIA10 Section 12—Department Sign-Offs Health Department ❑ Zoning Board(if required) ❑ IFistoric District ❑ ,Site Plan Review Of required) ❑ Fire' Department -`Y E 0 Co nservation ❑ 4 -CA, c rovak, For commercial wor1�please take your plans directly to the f re deparbnent fot app Section 13—Owner's Authorization I, �� T , as Owner of the-subject property hereby authorize \r '�to'act on my behalf, "Mall matters relative to work authorized by this building permit application for: (Address of job) } ' Signafore of Owner � t ;, Print Name - I o � t. i Last uDdited:2/92018 t4vili ,PE. COS INSULATION �._... IIIIB OtAN 1YApµH /YRFY Igh4 lulring 1 IFIIY OVrIY91 IN1Y'A'0 CYItIXq ,_/ TO 'OF 8 kegulatory Services RVS?A�� _ . 13uildit�b l.�ivisior� _ r \cldre;ss - ` - - • Address ? Dear Building 111speetor I11et15e accept this Afftdrivit''t's documentation that Cape Cod Insulation, lac'.-pe"L"Ibrnled u1Tieted the insulation raid weathar•izatlon work at the property listed below. Cape Cod InsutaLion did this in accordance to the specifications listed on the building poi,mit application. All work has-been inspected by a certified Building Performance Institute; 4 (Bill') inspector. ; AcldreU , Villa" /-a PA-ly4 RID ;Cry f 111,uWuLion 1118M]led: Fiberglass Cell ilos ' .1 Value estrieted Unrestricted Cc;i1i111;5 � . be 3,v • Mopes l'lours Walls ( ) ( ) ( ) i l mry assldy Jr, President Cape Cod Insulation, Inc. ti TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map o Parcel T;^,f 9r,1 �. "�, N _ E Application # Health Division p11 Date Issued `L 15- Conservation Division Application FeeU Planning Dept. Permit Fee �5• �V Date Definitive Plan Approved byF1Inning Board Historic - OKH _ Preservation/ Hyannis Project Stree ddress Village I� Owner,-�lCV Gl. Address Telephone �2-63 - 0 Permit Request 4-o p Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation �� -� Construction Type Gam/ 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) t Name Telephone Number ✓" y 'C 21 Address > I VW(/l V d-e-, License # I b a l 0 U&van f"L Home Improvement Contractor# 16 3 5'h Od Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESUL G FROM IS PROJECT WI L BE TAKEN TO SIGNATURE DATE r FOR OFFICIAL USE ONLY APPLICATION# DATEISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME r INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. F Massachusetts Department of Public Safety Board of Building.Regulations and Standards License: CS-100988 Construction Supervisor. HENRY E CASSIDY 8 SHED ROW - 4 _ WEST YARMOUTH M ..' '' ` CA— Expiration: Commissioner 11/11/2017 Office of Consumer Affairs and Business Regulation 10 Park Plaza Suite 5170 Boston, Massachusetts 02116 Home Improvement Co:i tra..etor Registration Registration; 153567 Type,- Private Corporation Expiration: 12/15/2016 Tra 259188 CAPE COD INSULATION, INC HENRY CASSIDY 18 REARDON CIRCLE - SO, YARMOUTH, MA 02664 Update Address and return card, Mark reason for change, KAI .± 2OM•05/11 Address 0 Renewal Employment �� Lost Cat ........... cTQj .. .... .._. ..... ........ ...... .. V/ee cpoa�yraovuuerr.���a�C/���u1J«o�cc�eGZ`J Of(lee of Consumer Affelrs& Business Regulation License or registration valid forindlvldul use only ITA OME IMPROVEMENT CONTRACTOR before the expiration date, If found return to, eglstratlom A..53567 Type; office of Consumer Affairs and Business Regulation j xpiretlon;;.1:2715p2Q:p6 Private Corporallon 10 Park Plaza-Suite 5170 Boston,MA 02116 CAPE COD INSULA1;I;b;N.`;:;INC`: iJ. HENRY CASSIDY 18 REARDON 50, YARMOUTH,MA 02664 ' ' Undersecretary N valid wi ut sign e The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www,mass,gov/dia ' Workers' Compensation Insurance Affidavit; Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name (Business/Organization/Individual); Address:_ 1 ,<1 G�lO 0 0t✓%�G ✓ City/State/Zip;!)MA4 Phone #: 1� Are you an employer? Check th appropriate box; . Type of project (required): I• ,I am a employer with 4• ❑ I am a general contractor and 1 have hired the sub-contractors 6, ❑;New construction employees(full and/or part-time).* •v 2•❑ 1 am a sole proprietor or partner- listed on the attached'sheet• 7, [] Remodeling , shipand have no employees' These sub-contractors have employees and have workers' g' _� Demolition working for me in any capacity, p y ees [No workers' comp• insurance comp, insuranc 9, Building addition e,t• ❑ required,) 5. ❑ We are"a corporation and its 1 Q.0 Electrical repairs or additions officers have exercised their 3,❑ I am a homeowner doing all work l l• ] Plumbing repairs or additions. myself, [No workers' comp, right of exemption per MGL 12,❑ Roof repairs insurance required,) t c, 1'52, §1(4), and we have no employees,[No workers' 13, Othermila comp, insurance required,] p q ] *Any applicant that checks box ff 1 must also fill out the section belowshovoing 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 atta.9hed an additional sheet showing the name of the subcontractors 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 >vorker•s' compensation Insurance for my employees, Below Is the policy-and job site ,,Info.rmation, insurance Company Name; C,,_,,k0JAJw �,h '[/AW. , Policy # or Self-ins, Lic. #;� �il� ' 1J _ Expiration,Date; / Job Site Address: h R City/State%Zip: WL Attach a copy of the workers' corh7pe sation policy declaration page (showing the policy number and expiration date), Failure to secure coverage as required under Section 25A of MG.L,c, 152 can lead to the imposition of criminal penalties of a- fine up to $1,500.00 and/or one-year knprisonment, 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 insuran. coverage verification, I do hereby certify d the pat an penalties ofperjury that the Information provided ab ve Is ue and correct, Si nature: ` - Date: Phone#: Official use only, Do not write In this area, to be completed by city or town offlcial, 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 rnntart Parcnn• CAPECOD•27 BDELAWRENCE ACORO`° CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) I - 6/30/2015 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(les)must be endorsed, If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT NAME: Rogers&Gray Insurance Agency,Inc, PHONE FAX 434 Rte 134 Alc No):(877)816.2156 South Dennis,MA 02660 t E-MAIL DDREss: INSURERS AFFORDING COVERAGE NAIC p . INSURER A:Peerless Insurance Company•see LIBERTY MUTUAL INSURED INSURER B:ATLANTIC CHARTER INSURANCE GROUP. Cape Cod Insulation,Inc. INSURER C 18 Reardon Circle INSURER D South Yarmouth,MA 02664 INSURER E: 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,TR TYPE OF INSURANCE POLICY NUMBER ADDLISUBR MMIDDIIYEYYY MM/DDT P LIMITS LTR ' A X COMMERCIAL GENERAL LIABILITY - EACH OCCURRENCE $. 1,000,000 DAMAGE TO RENTE17- CLAIMS-MAD_ OCCUR CBP8263063 04/01/2016 04/01/2016 PREMISES Ea occurrence ' $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIN11T APPLIES RER: GENERAL AGGREGATE $ 2,000,000 X JECT LOC PRODUCTS-COMP/OP AGO $ 2,000,000 POLICY❑ OTHER: $ AUTOMOBILE LIABILITY o 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 $ - UMBRELLALIAB d OCCUR EACH OCCURRENCE $ F4 EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH• AND EMPLOYERS'LIABILITY STATUTE ER B ANY PROPRIETOR/PARTNER/EXECUTIVE Ya NIA E WCE00431901,. 06130/2015 0613012016 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED (Mandatory In NH) .L.DISEASE•EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE•POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES ( CORD 101,Additional Remarks Schedule,may be attached If more space Is required) Workers Compensation includes Officers or Proprietors, Additional Insured status is provided under the General Liability and Auto Liability when required by written contract or agreement with the Certificate Holder. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cape Cod Insulation,Inc THE EXPIRATION DATE THEREOF, NOTICE WILL BE-DELIVERED IN 18 Reardon Circle ACCORDANCE WITH THE POLICY PROVISIONS, South Yarmouth,MA 02664 AUTHORIZED REPRESENTATIVE G 1988.2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD f Town of Barnstable o Regulatory Services senrrsres� Richard V.Scab,D'iiector .➢Q 3MASS. `0� ,ra<° Building Division 'Tom'Perry,Building Commissioner 200 Main Strut,Hymnis;MA 02601 }vivw.,toiVn.barg.5table.m'a us Office:. 508=8624038 par.: ,508:790.6230. Property-Qwner Mush Complete--and Sa gnIhis Section zf U.M.� ML�lde�r I` as Omer of the subject propcny ' to.act 6n in behalf heebyaurhorim nu n Y , in all matters related to rk authorimd'by this building pu�ux application for of soli) «„ Pool fences and alarms are the responsi'bRiLyof the applicant. Poo 1s axezot_to be filled or"utilized before-fend:as'installed-and ail Pima] inspections are pelf-o med and accepted.. r Signature of Owner sipature of A.pplicanx paint Name a Pint-Naze bl Date QXOItMOWA'F."ERMISSIOWOOLS TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map, ��'`� . Parcel 2 Permit# Health Division w w Date Issued Conservation Division Fee fT75.Cx- Tax Collector ` SA 'Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board f Historic-OKH Preservation/Hyannis , Project Street Address X V1feo-?A C(n Village Cn /4 Owner Address -Telephone " Permit Request Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Estimated Project Cost �600 Q Zoning District Flood Plain Groundwater Overlay 'Construction Type Lot Size Grandfathered: U Yes U No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family 0 Multi-Family(#units) - Age of Existing Structure Historic House: ❑Yes U No On Old King's Highway: O 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:U existing U new' size Pool:U existing ❑new size Barn:U existing ❑new size y `Attached garage:U existing ❑new size Shed:U existing ❑new size . Other: Zoning Board of Appeals Authorization U Appeal# Recorded O Commercial ❑Yes U No If yes, site plan review# 3 Current Use Proposed Use BUILDER INFORMATION e Name FRASER CONSTRUCTION Telephone Number ' Address 71 TARAGON C1R. License# Home Improvement Contractor# Worker's Compensation# Gc._113/S %7D S d 3 60 I ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO X---in f-i;t ew I SIGNATURE DATE _ FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL'NO. ADDRESS VILLAGE 01 c ow OWNER „" + DATE OF INSPECTIOM FOUNDATION FRAME INSULATION r FIREPLACE ELECTRICAL: ROUGH a: FINAL a PLUMBING: ROUGH FINAL' GAS: ROUGH FINAL' ! FINAL BUILDING-- t a 4 i ca: DATE CLOSED OUT ASSOCIATION PLAN NO. - • �( ��Ic�x 'f• 11 A A r 1 A A o I 1 I I I I t I I '• 1 I l/i/ %(/!y�%1G'r/,./!`iuL61Yy/ // // %i6% / j•f/ r.��„ -. / r / / 1 • + ' f 1• 1 1 :" 1 . IAA � I 1 1 ■ 11 • • . • • 4� 1 1 1 r • I I II �l I - V / 1 • 1 1 �• 1 • 11• • :y• • • . 1 . 1 - • • • .• 1 1• 1 • - u I� /%%/////./�///i/'%/�%�///%�%//%?T//,%%!%%///////,!OJ/%,.�._�r/%'/r%/%//1�7J"%.:%%'%�'%,%"%"/. '%2 ///,'"!%'/%/!i%//%///a/"%%%'�//'%////%!lid/,%%%/%%/%%/%i%%'%!✓// I 1 y 1.� ai'////r' ,bra /;/• ///.,/,, / ,// ; ;/ , ; . ;///,, /%/,,,,/// ,./,i/,///„/%%/�/,//i//////%G/%%//% 11 I t 1.r-777, I I I '• l f ' I 1 li .1 I � • ■ . 11 1 H ":va aN.a.-��::;:- -Moccr,�'�:i. �.:.irM.C:?• r.FCPY>i r.�cv,;n�6:'b. ...':'.:: `.-. �.:i<..., �.k .sP.FK";:S'.� `�'�^�`�'�M' .-�J�*.M"!,�,•.vwia i HOME IMPROVEMENT CONTRACTORS REGISTRATION Board of Building Regulations and Standards One- Ashburton Place - Room 1301 Boston, Massachusetts 02108 HOME IMPROVEMENT CONTRACTOR j Registration 112536 Expiration 04/06/01 "1----------------------------- - -- TYPe - DBA ` HONE INPROVEHENT UHTRACTOR Registration 112536 FRASER CONSTRUCTION co i Type - D8A DEAN C . FRASER t Expiration 04/06/01 71 TARRAGON CIR COTUIT MA 02635 FRASER CONSTRUCTION co DEAN C. FRASER TARRAGON CIR ,D9M ��TUIT NA 02635 I The Town of Barnstable Deportment of8ealth Safety and Environmental Services Bnilding-Division 367 Mein 38t+sat,Hymds MA M60.1 Office: 508462-4038 Ralph Cressen Fax: 508-790-6230 Builds ng'Commissioner Permit Date AFFIDAVIT SOME 04PROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MOIL c. 142A requirm dwt dw"won,aloetadons, . .m converw aiernizadon, on, buprovanwg,Mao*denolklc%orconammtin ofan addldon to my p x-gx sthtg owueFoccupied building contsiniag at least one but not mom then ibur dwelling units or to strucmm which ere 04acent to such residence or building be done by registwW=fteaM wilt cwtWn exceptions,along wi8t other requirements. Type of Work: Bd m ud 4 Address of Wodk: Owner's Name: Gc,lam ' M Date ofApp on: I hereby certify that: ° Rqistmdon is aot required for the followlq nuou(s): Mork nab"by law (Yab Under$1,000 QBuilding not owaeaoccu�ed OOww pugbtg own P=k Nodes H hereby given Wat: OWNERS PULLING THEtR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME LVIpwvmw TT WORK DO NOT LAVE ACCESS TO TIDE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permh as the Mw ofdw owner: Difie Conn wrName Regisaadort No. OR Date Owmr's Name Assessor's office(1 st Floor): , 1� Assessor's map and lot number 0 a°�-- Q Ir9 EEP710 SYSTEpj MUST a P�O�THE TOE`. Board of Health 3rd floor.. INSTAU DIN CQEmp °A Sewage�Permit number e d� WITH TITLE 5 : aALU FAME : Engineering Department(3rd floor): �'/�'I CODE roes House number TOWN °o �a�p.d. Definitive Plan Approved by'Planning Board 19 ' �Fo rav APPLICATIONS PROCESSED 8:30-9W A.M.and 1:00-2:00 P.M.only, TOWN OF BARNSTABLE BUILD-ING INSPECTOR APPLICATION FOR PERMIT TO &h TYPE OF CONSTRUCTION TQ�IgN1G 21 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 3-6 ��'V r COW A NVA Proposed Use /TO VnA4 'r-60w\- Zoning District Fire District Name of OwneaVI& Address r31S M JA Name of Builder�OV 57�00� �-M' Address.2A a6" 6 Ave So. Name of Architect Address Number of Rooms cane. Foundation k011 � « Exterior �`�-^ �`�^�\'�� /vkV.41L Roofing �^�� Floors 50, me tr e. Interior --ty "Lik�1 Heating T • �- Plumbing Fireplace AU(3N 4 Approximate Cost Area m-0 s ` Diagram of Lot and Building with Dimensions Fee ®a _ ty 0 OCCUPANCY PERMITS R FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of BarnPre?gard6Aghe above construction. Name Construction Supervisor's License() REED, RONALD & BARBARA No 33258 Permit For BUILD ADDITION - Single Family Dwelling Location 133 Ralyn Road Cotuit Ronald & Barbara Reed Owner _ r. Type of Construction Wood Frame ` Plot {{{ Lot Permit Granted October 3 19 89 F Date of Inspection 19 - Date Completed 19 4. S IT dad , r� ,z JOB ^�Ofx 4 ��� bCA� '2e � COTS BROOK INC. �Environmental Designers and Builders SHEET N0.l33 -?prt ^ ..P OF 24 Forsyth Avenue ( �. SOUTH YARMOUTH, MASS. 02664-1814 CALCULATED BY DATE (508) 394-8442 (508) 362-2820 CHECKED BY DATE_ SCALE ...... . .... ..... .. ... . i .. ....... ...... ....._' ....... 1 R.O- � Why' .... . 14�G11....... 4 ......... ........ .... ......... ........................... ............. .. ....... : ..... ... ....1 .. ... .. .. . .. .. -c1 ,_ ly .... ... :... ..:. ..... . ... .. : . P.- a . rs .... .. 1 C ti'�'o?e 4� v . . .. p � 1 . .... . . ..... .. . . : ... .. ..... 3 .. _ .�. : .............:...........................:...........:..............:..............:_............;.............:.......... ...... ............. ............................ .... ................,.. i PROWG7204.1 a Inc.,Groton,Mass 01471. -r COTS BROOK INC. JOB got') �3 '� 6 oj�( - ee". Environmental Designers and Builders SHEET NO. OF 24 Forsyth Avenue SOUTH YARMOUTH, MASS. 02664-1814 CALCULATED BY DATE (508) 394-8442 (508) 362-2820 CHECKED BY DATE__ SCALE � ;.Y 14 adadt'1.J .. ..... ........ ..... ... 4 �. ........ :... ......... rr ......... ........ ..__; .....__. '_...``>. L.. ._ .. ..._ ...__ ._... .......... .i.. ......._ _....._ _.,. ......,..„ ... .. .._. .. .. .. .. .... ...._ ... .... .... .. ..... 2�ci r� ...........w1��n r"> � �1C�U` Z� c T�X w,-4 W'l.�c C;�1\.1` ..... z ` t �wa1� Y1 �� K�01.: � �'�°rt a?�� `iCslaiil '�Q, 'r t t ... 1, � V ...... LL`. �< .._ ....... �. ...�I , .._....... .. ' ...... .. r Z .... ....... ....... ...,.. ., Ap ..; ... r . ... `S ....... ......... - ..__ ........ .. ....... ... ..... / ..... s� ...... ' _ pViC. 1\c- ...... i J U 8 . Lj .............. r .. .... ... .. .. ... ...... ............. . .. ...... .... .. ..... ...... �t t N a 1.+ h a�L 'T L........� .-j ' PROO1101204.1 ems Ia.,Gwtw Mass.01471. 5 'l Assessor's office(1st Floor): Assessor's map and lot number a°� Pyoi THE toy♦ Board of Health(3rd floor) -(� � ` 1 122 / / Sewage Permit number 0, � �17 v Z BAH39TGDLL i Engineering Department(3rd floor): �/� '� s rasa House number 1 %%��-� �" °° s639. \e�' Definitive Plan Approved by Planning Board 19 �0 Mav d APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OF,- BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO (33+�� ��t X ��` NsA.Awy (cm e- TYPE OF CONSTRUCTION W �IIVI( i eJ�f 1 21 2 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 33 R,g Vyr, C� NVA Proposed Use 2>t hY 1 i1c 'fi�o'Wt /T un 1 Zoning District ' Fire District �-©w 1 Nar`ie of Owner flora& 16aona' t f Address MA -Name of Builder I *CS:I Address 2-4 Ave' Name of Architect Address Number of Rooms ynQ- Foundation �� �OVf "fay-,«c=i(! Exterior �'C, 5`"`rc�e's Roofing Floors -P(nr0_- Interior 1 Heating U- Ilk) Plumbing AlGN&-7 Fireplace /UG rU Q Approximate Cost �� 0oC r � Area tok Ste, Diagram of Lot and Building with Dimensions Fee +o �;✓ �CK r _4 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS • I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regard' g the above construction. Name Construction Supervisor's License �� REED, RONALD & BARBARA A=022-059 No758 Permit For BUILD ADDITION y Single Family Dwelling Location 133 Ralyn Road Cotuit Owner Ronald & Barbara Reed Type of Construction Wood Frame Plot Lot Permit Granted October 3 19 89 Date of Inspection 19 Date Completed 19 a