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HomeMy WebLinkAbout0039 ROSEWOOD LANE �� �S��/UU � � �` i r Cape Save Inca 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 8/10/17 Thomas Perry CBO Town of Barnstable Building Division 200 Main St. Hyannis,MA 02601 RE: Insulation Permit 17-2149 Dear Mr. Perry This affidavit is to certify that all work completed for 39 Rosewood Lane, Cotuit has been inspected by a third party Certified Building Performance Institute(BPI) Inspector. All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCluskey BUILDING DI=P 1 AUG 24 2017 T011N Orr,9QfiKlc sA0LE I-31- 13 ��� ' �� `"� P�r �. o., Town. of Barnstable MAW 200 Main Street, Hyannis MA 02601 508-862-4038 Application for Building Permit PP , g Application No: TB-17-2149 Date Recieved: 7/10/2017 Job Location: 39 ROSEWOOD LANE,COTUIT Permit For: Building-Insulation-Residential Contractor's Name: WILLIAM J MCCLUSKEY State Lic. No: CSSL-102776 Address: West Yarmouth, MA 02673 Applicant Phone: (508)398-0398 (Home)Owner's Name: FRIEDMAN,JEROME&SUSAN Phone: (508)428-5531 (Home)Owner's Address: 39 ROSEWOOD LN, COTUIT,MA 02635 Work Description: Add 2" rigid insulation to the crawlspace.Air seal the crawlspace with expanding foam.General weatherization. Total Value Of Work To Be Performed: $3,500.00 = Structure Size: 0.00 0.00 0.00; Width Depth Total ea r,° I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to " accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: William McCluskey 7/10/2017 (508)398-0398 Applicant Date Telephone No. Estimated Construction Costs/Permit°Fees Total Project Cost: $3,500.00 Date Paid Amount Paid Check#or CC# Pay Type. Total Permit Fee: $85.00 7/10/2017 $85.00 XXXX-XXXX-XXXX- Credit Card .......................... h 0299..:. Total Permit Fee Paid: $85.00 Lu:^" < aa.�....a ..... a,_....x c.�....... -m.t.. �.uW..,..oa�`� w ix.......w3ia��� a,•' aka '_ AW Ar ,,. w. ,. Con ► , r svv on Y j ._ to � 41, Mel, 11114/14 Thomas Perry, CBO Town of Barnstable BdIding Division 200 Main St Hyannis, MA 02601 RE: Insulation Permits Hear Mr. Perry, This affidavit is to certify that all work completed for insulation work at 39 Rosewood Lane (application#201300745) has been inspected by a certified Building Performance Institute(BPI) Inspector. All work performed meets or exceeds Federal and State requirements. Sincerely, Conor McInerney ConserVision Energy CID co 376 ROUTE 130,SUITE C SANDWICH,MA 02563 508-833-8384 WWW.CONSERVTODAY.COM i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # Health Division Date Issued i Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis okf 2AZ//3 Project Street Address - 29 RIO&C 773CA LWVL Village Owner 7Te-y-wva_ -er-1eAw. w Address R bock UaNl L Telephone Permit Request -Lf-k o i�2 4� Z l Square feet: 1 st floor: existing posed d fl : existing proposed Total new Zoning District Flood in Groundwater Overl Project Valuation Constructi Type Lot Size andfa hered- ❑Yes ❑ If yes, supporting documentation. Dwelling Type: Single Family ❑ Two amily ❑ Multi-Family # u ' s) ® y Age of Existing Structure Historic House: ❑Yes ❑ o On Id King's way: ❑ es Clo Ba ent ❑ Full Crawl ❑ out ❑ Other " C) d L" asement Finishe rea(sq. fini Ba ment n d Area (sq.ft) umber of Baths: Fu existing ne alf: existing new C tio Num of Bedrooms: existing new Total Roo bunt (not ncluding baths): existing new First Floor Room Count Heat Type and I: 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"ORHOMEOWNER) Name NAC'1 h,"-,-VQM Telephone Number Address ' to I nge 13 C) License # b2.1`1$ SA VICA Wt cA ✓ " 1A 0-2-S L 3 Home Improvement Contractor'# Worker's Compensation # ill C l'i f1 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO - &V '°� SIGNATURE Lla 6 Aefl DATE Z I 1-3 I f 3 FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL N0. ADDRESS VILLAGE ~ '� OWNER 1 DATE OF INSPECTION: FOUNDATION FRAME f • i INSULATION t' FIREPLACE r ELECTRICAL: ROUGH F INAL a PLUMBING: ROUGH FINAL f GAS: ROUGH FINAL 1 FINAL BUILDING Lo _ —- DATE CLOSED OUT ` ' =a ASSOCIATION PLAN NO. • lY 4 ,j TOWN'OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # Health Division Date Issued r r Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address ��: os i�ib;oc4-' ,L'ov Village Owne'�'. �,rl�.atv,.��„� Address 311 Rnewback Uavu Telephone /� Permit Request A Aok e \,cN Ce l l ut o W 4,0 2�� �' �� �r ✓J1 uS S A( ss- � Square feet: 1 st floor: existing proposed 2nd floor: existing - proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation I SM Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Q-� , Age of Existing Structure Historic House: 0 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 x 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 ,HO OW T. . Name D Y ML I r W Telephone Number U' 3 Address P—OvAP— 13 License # J bri"1 SA ytCA Wt CAn ✓ " , U�S�O3 Home Improvement Contractor# Worker's Compensation # &V C S 6 S S_'7 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �ovV-k,.k M � SIGNATURE +. DATE Z I rk JI FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. OWNER AUTHORIZATION FORM I, "'tic- F-A�C�'�°1✓ (Owner's Name) owner of the property located at 3 ( OSPc orb Lane , (Property Address) MA Cap 35 (Property Address) hereby authorize C "V- 0 k (Subcontractor) an authorized subcontractor for RISE Engineering, to act on my behalf to obtai a building. permit and to perform work on my property. --------------- X Owner Signatur X Date I Massachusefts -Delaarfrner'Yt of Public Safety of B ild � +ard, an Rteguiations and Standards 4:uni:�tictjafn tiuper�'i,ta-Slk;ri:71i'� - License: CSSL-1027.78. - CONOR D b1CINRNEY 39 SIASCONSET.DRIVE SAGAMORE.BEACH'htA}02562 Corn aissioeler 08/19/2014 y ` 01'ficeii� oNt>ens rw ar rk a'lk rrczc_ toosuruer �Itairs �3v Bess egu{a Ion h. tsh ' HOME IMPROVEMENT CONTRACTOR ' Registration ti171254 Type: K' Expiration: 311/2014 Partrersh.p x Ca SERVE ENERtGY ; y CONOR MCINERNCY 376 ROUTE 130 SUITE C SANDWICH;MA 02563 wk i f Undersecretary I � i The Com nrotatueulih (ry( `14as.9`ac•ltttsert Prinf o rrt " DepartttJem o/'1ndustrtal Acc ielents, t — Office o rfta t':4tifyttlddJa " ` t .1 Congress.vn-eet; Suitt, 100 Boston A1.4 0 21.14-2017 1vW 11).of ass..;tJVI((t(d Workers' C�'ttrr�pensatioti 11Stii_all cc Affidavit. lit,:EtJ rs�CFJwltr�tcrt�r /f .teat yca�a y.il'1!rYstf�e°�s Applicant Information _ Please 1'ritit Le a lb° Name.(,f3usin.ssiOrg.tnicationrint6vit1uaI1:CONSERVE ENERGY INC. d.b'a C ONSERVI,SION ENERGY Address: 376 ROUTE 130, SUITE C City/Slate/LI SANDWICH, MA 025G3 , . , I? i hur z.. D-08-833-838�f Are e you an employer? Check the appropri ttc bux �--� d 1'ypr of Protect(required): � I.� 1 am a e.Illpioyel With, 6 4. �I i am a uClrClstl Gt:)l,CraLC+'?r aajcf � ! 6. ❑ Ne,;v con_to'cf[;tlUi enlployees(ttlll 111CI101"�alC Cifflef." ti(t`t I't1CL tltl �LLb UilltartC!r" = i ] 2.❑ I am a sole proprietor of partner- lit l aft u c tt a'll ct;n�ct I �� } eniodelinw 1 ti I shlp and have rio ecc etn la 1"'��� u c tita iorS It_cc ( t p � L,}i i icillttc}.? � I working- for tile ill ink` C ipacity I - ty t 13t�Jci si t.;ritt.itJn a�t13 1111 N llt�e_ t i [Na workers' comp. in;uraiicc ((`��� required.) 5 1 ��r't rk t cr!)Nt luihl '111d.J'5 I-� ii7.d j Ef'r-1 trical rcpa- 4Or it; cttUl'Y u S ! 1.atn a hurneuwnc doing all w-urk JifU r, !1 r`e t:x cts .d their d i.IJ i'l+lnibnism ref "ji U3'addiiUCCs I _ I j myself. [fNo workers' cortip, ,I I I ouf repair j t" s Ii4i -it tnc uv: !to an�ua<in�e rac(tlirecI.I � { 1 r+?ibrJ�k iS 3C C ! �' NEATHERll A!l(jN t.'nflilttvCC, � � i � I,.•. �� ( ?r,�---- —_- t UillCtf,7 inyt rat ilc rtyLLtfC I I 'Any applicauft that checks box irl must thu tutt)ut the secuui't bdo,v oao.t ut ih�•t t•:r 11..i; Ctn ipcit.raru;r r+iLr..y uir-Ctn.uaon. i lUstteuwners WItU Submit thisatPid li tt Intlica(m_'the-t"art doitte,all ic�urk and thoi hIrt!owsido col,i acior„mu'.'t:rib: lq'-t ucy a i'ilrjayt indicating;tteh. Contractors than check this;bux rniui unachcd uu urtchtion I Sheet sliu vt w'tiv nn.t.c of ut4.,t,:.�-c:aait acturs.Ind state whcilier wit :tot t.`u)sc cntilie hsrvc rnipiuyees. f dwr sub-cu,itificwr;have cniployccs,litey tttu'S!piv,idu the.1! ;, 4c :unit}.policy iwitttbrr 1 am an employer ilttit is prut�idt:tr wvrhers'eomperrsct[i irr an.i.tritnc-e fiir rill;enplti3 ee ., Beloi,i is'tlae pol i'y aticf(rrlj_rite its formation. Insurance Company Name: SELECTIVE INSURANCE COMPANY OF THE SOUTH Y I'oflcy r ur Self-iris. Lac, a:WC7938539 xn ration L,UI .::3r!fir' 3 Jab Site Address. Attach a copy of the workers' cotnpeitsation lioiicy decIaI a i0i1 1)attn)e(slIo W itoi the poiie: au n i be r acid expiratitata rtatet.: Failure to `eCUI-e C:OVer1ge Lis reyuii'ed U.nc,er ',3ectlon 25 A i.Q can to the anpos!ticln i71 ciimir_al pemd ties of a fine up to $1,500.00 and/or one year miprisull lilt, <,. Well ,!. Cit it nctlahiL!s !Il tht f0l"'! of WORK ORDER.and tinc of up to S250.00 a dui aka ast the viula[or. Bc advtY :c! that tt copd� ul !nay be Cur o airded to (lc;10hic: (,:1" Investicfatio►ts uf'the DIA for irl,ul`aQeV cutidra c te.riiic lciott, y 1 er the p pains and ►enaliies,o f ei fury+tlrr r the tr,jr�t rrrrtttritt lrrr i=rl[r!«hroirc a►rite r►rttt t r��tcet; rtu twilit certr ij urcr! _ . ._ Signature: Da UCE 1:'hc)ne.fx: 508-833-8384 Qjjic•ial use orfly. Do.nof lurite in this area, to be cuniplea3l b)"e11t7 fir lowly. ojfleiitl City or Torvrl: I � Issuing Authority(eirde ou ): i, Tetaeac$cif"rt;Ja�ftf} 2. L;ie1tlinv.lei'{irt'Cnt;Nd :Y. ( ,tw`' bts�si C fir 1: d. h r trtc.;a' rn3pc:e{z.!r' `i. b'3i.t-tlalsssa -?,, „1rs� %:rJ,r 1 { F ��.`€;rrE,at't f'#�r�,€rtae iota .�.._� r. ._.,. v..«....r.n.,. ...«..„.s..........._-. ......u .............._.«w..m..n..:....,....a., w._..._......_s........v. .... ..n...nw.....n. r Client#'68880 CONSER ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE{EA1201Y2 Q3175i�Qia 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 TH.EZOVERAGE 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 1NSURED,,the policy( dorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement'.A statementon this certificate does not confer rights to the. certificate holderin.lieu of such endorsement(s). PRODUCER CONTACT NAME Rogers&Gray Insurance.Agency;Inc. ;PHONE 508 398 7980 FAX - (A1G,,No Ezt�—., ---- 434 Route 134 I&MAIL`- South Dennis,MA 02660 _INSURER{SI AFFORDING COVERAGE 1 NAIc 0 ; 508 398-7980 _....- INSURERA:Selective Ins.Co.of the South --_ _................ .._-. INSURED i INSURER,6 - _ Con-Serve Energy;Inc. 376 Route 130.STE C I INSURER C. ._.: _. _ Sandwich.,MA 02563 INSURER D I INSURER E, 7 a INSURER F —1 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 CONTRACTOR 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 - ,IDOLSU8 - _ _ POLICY EFF POLICY EXP'' LTR TYPE OF IN D POLICY NUMBER jMMlDD .,. MMIDDlY1'YY) LIMITS A GENERAL LIABIUTY X S2011299 3/14/2012 0311412013 EACHOCCURRENCE 191�OQQ,QQQ 1t E RENTED Xj COMMERCIAL GENERAL e f iPRE DAMAMiSES'TO anccurrn $10.Q,006 �,_u CLAIMS-.MADE OCCUR + MED EXP(Anyone person. $; 1�0 000! &ADV INJURY -I S 1000,000 __ _ GENERAL AGGREGATE i 0000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 1 .� PRODUCTS comp10PAGG s3 PRO- ,OUO,OOO 1-1 XI POLICY i JECT 1 �LOC I S AUTOMOBILE LIABILITY COMBINED SINGLE LIM �IT L - I - ANY AU�O " BODILY INJURY(Per person) $ I—'-ALLOWNED ��SCHEDULED I - --1 ...... .._ AUTOS AUTOS } { ) ,BODILY INJURY(Peracadent)I$ HIRED AUTOS �AUON-OWNED PROPERTY ueceY DAMAGE is A UMBRELLA LtAS OCCUR —x 9201.1299' O3i14t2O12 0311412013 EACH occuRRENCE 1p 0 000,000_ _ .EXCESS LIAB. I CLAIMS-WADE I A FGRTE - CRETENTION$0__ WORKERS COMPENSATION -- 1• - aye WC STATU !OTii I - A WC7956539 03/1412012'0311412013 X i AND EMPLOYERS'LIABILITY �..,....-,.S.QRY�.iMITS ANY PROPRlE70RIPARTNER7EXECUTIVE Y 1 N { E EACH ACCIDENT $1 OO O0O OFFICER/MEMBER EXCLUDED? �) NJ A IMandatary In NH, - "—'j I E_L.,.DISEASE EA EMPLOYEE i$100,000. II yes deswbe under € ......____...._ DESCRIPTION OF OPERATIONS below i E.L.DISEASE-POLICY LIMIT i$500,000 DESCRIPTION OF OPERATIONS ILOCATIONS f VEHICLES(Attach ACORD 101;Additional Remarks Schedule,if more space is required)" Excluded officers under'Workers'comp=Conor:an,d Courtney McInerney. Blanket additonal insured'coverage applies"fonder:CGL. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE'ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Thieisch Engineering',Inc, THE EXPIRATION DATE THEREOF,, NOTICE WILL: SE DELIVERED IN 195 Francis Ave. ACCORDANCE WITH THE POLICY PROVISIONS; Cranston,R1 02910 AUTHORIZED REPRESENTATIVE t ©198 -2010 ACORD CORPORATION.Ali rights reserved'. ACORD 25(2010105) 1' of 1 The ACORD name and logo.are registered marks of ACORD #S788991M78898 DD R I • t TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 0 to Parcel bsl�� Application Health Division 'Date Issued o�ZI Conservation Division Application Fee �y Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board . Historic - OKH Preservation / Hyannis �f�i3 — Project Street Address Village CO:)[1A\�- Owner ;Se--00N\-C. C�P,(� n rw Address �� SeWT � r_rni�gd Telephone Permit Request 6 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 00 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 T c7 � a Total Room Count (not including baths): existing new First Floor°14m Count' Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other "' Mai Central Air. ❑Yes ❑ No Fireplaces: Existing New Existing wood coal stogie: ❑Os ❑ No Detached g1trage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ xisting "0 new-i' size_ J L!w Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: v Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number Address �Lt�J� ��aU �;�� License SCMAL.)SCA, :AAA Home Improvement Contractor# Worker's Compensation # \19— S---L S-3 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE ���a t- =' FOR OFFICIAL USE ONLY APPLICATION# DATEISSUED MAP/PARCEL NO. i s ADDRESS VILLAGE f OWNER DATE OF INSPECTION: ^t FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL ' PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING r> DATE CLOSED OUT ` t ASSOCIATION PLAN NO. i OWNER AUTHORIZATION FORM (Owner's Name) owner of the property located at ...................l c �ac� (Property Address) _ MA dad 35 (Property Address) hereby authorize v (Subcontractor) an authorized subcontractor for RISE Engineering, to act on my behalf njtaia building permit and to perform work on my property. X ---------------- Owner' Signatur xDate S r, The Cominonwealth of Massachusetts Pr1s�iFarm Department of Industrial Accidents Office of Investigations I Congress Street, Suite.100 Boston,MA 02114-2017 www.mass.gov/ilia Workers' Compensation Insurance Affidavit: Builders/Conti-actors/Electricians/Plumbers Ap2licant Information Please Print Legibly Name(Business/OrganizatioMndividual):CONSERVE ENERGY INC. db.a CONSERVISION ENERGY Address: 376 ROUTE 130, SUITE C City/State/Zip:SANDWICH, MA 02563 Phone#: 508-833-8384 Are you an employer?Check the appropriate box: Type of project(required): 1.® I am a employer with 6 4. ❑ I am a general contractor and I have hired the sub-contractors 6. ❑New construction employees(full and/or part-time). - 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' 9. [] Stilling 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 I I.[]Plumbing repairs or additions myself, [No workers'comp. right of exemption per MGL 1 ❑ Roof repairs insurance required.)t c. 152,§1(4),and we have no employees. [No workers' 13.®Othet-WEATHERIZATION comp,insurance required.]' "Any applicant that checks box#t must also fill out the section below showing their workers'compensation policy information. 9 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-conuactors.and state whether or not those entities have employees. if the sub-contractors have employees,they must provide their workers'comp.policy number. 1 am an employer that is providing workers'compensation insurance far my employees. Below is the policy and jab site information. Insurance Company Name: SELECTIVE INSURANCE COMPANY OF THE SOUTH Policy#or Self-ins.Lc.#:WC7956539 _ Expiration Date:3/15/13 Job Site Address: City/State/Zip Attach a'copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and afine 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.. 1410 hereby certd under the ains and enadties o er°ur�Ihallhe�inorm�arovided �,bove true and c©rrect.Si nature: Phone#:508-833-8384 Official use only. Do not write in this area,it)be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical inspector 5.Plumbing inspector 6.Other Contact Person* Phone#: A' Client#:68880 CONSER ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIODNYM 1 03/15/2012 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 be endorsed,If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsemengs). PRODUCER I CONTACT NAME: Rogers&Gray Insurance Agency,Inc. Rditt—­- _`KX__ 508 398-7980 434 Route 134 E-MAIL South Dennis,MA 02660 ADDRESS: ............... AFFORDING COVERAGE NAIC 9 508 398-7980 INSURER A:Selective Ins.Co.of the South INSURED Con-Serve Energy,Inc, r INSURER 8: I INSURER C: 376 Route 130.STE C INSURER D: ........... Sandwich,MA 02563 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. WSR AODLISUBR NO L.I.C­Y.EFF LTR TYPE OF INSURANCE POLICY NUMBER ICY EXP LIMITS - _g'—--- Mmioomyn A GENERAL LIABILITY S2011299 03/1412012 03/14/2013!EACH OCCURRENCE $I A00.000 X COMMERCIAL GENERAL LIABILITY 1 RAM61JTO ENTED CLAIM&MADE S"T It (.,_PREMISES —BLE 1 S $I0,0000 L_2j OCCUR MEDEXP(Amone ...) PERSONAL&ADV INJURY f$1,0001000 _�!LtERALAGGREGA`Ifi $3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGO 1$jQAQIq00 PRO. POLICYLOC $ F JECT COM INED SINGLE LIMIT'AUTOMOBILE LIABILITY ANY AUTO INJURY(Per person) ALL OWNED SCHEDULED ------- AUTOS AUTOS OILY INJURY(Per arcicem).$ NON-OWNED PROPERTY DAMAGE­T HIRED AUTOS AUTOS .......... $ .........._H UMBRELLA LIAR A — i X OCCUR IX IS2011299 03/114/2012[0311412011 EACH X EXCESS I" CLAIMSAADE AGGREGATE I s3,000.000 $DED X RETENTION$0t_ ------------7------------- .............. C7956539 11412012 031114120131,:�_j"T'CQ` i ANY PROPRIETORIPARTNERIEXECLiTiVE, LLL�E�C I�ACCIDtl� OFFICERIMEMBER EXCLUDED? iNIA1 _T_ 1$100000 (Mandatory In NH) Lyi ...........T I E L DISEASE-EA EMPL2YL�l$100 A WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN �M(14=11114,under RIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1000,000 l � � IlilIi _ � , DESCRIPTION OF OPERATIONS I LOCATIONS IVEMCLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Excluded officers under workers'comp-Conor and Courtney McInerney, Blanket additonal insured coverage applies under CGL. CERTIFICATE HOLDER CANCELLATION Thicisch Engineering,Inc. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 195 Francis Ave. ACCORDANCE WITH THE POLICY PROVISIONS. Cranston,RI 02910 AUTHORIZED REPRESENTATIVE 010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) 1 of The ACORD name and logo are registered marks of ACORD #S78899IM78898 DDR ke Massachusetts Department of Public Safety Board of Building Regulations and$tandards C`unvructu,n Suprr�i�,r'��easlt� 'License,CSSL 102778 CONOR ID 111CINER EY 39 SIASCONSBT DRI4rL'.Ar7 SAGAIMORE BEACH MA.02562 , `l.,G,.•�J��t f 'n Expirat+on Oomrnfs susner 08/19/2014 Om. AVoo umer'r'r�t�fa,rsf�kiness tufaion #, License or registration valid for individul use only -HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 171251 Type: , Office of Consumer Affairs and Business Reputation Expiration: 3/1/2014 Partnership " 10 Park Plaza-Suite 5170 x' Boston,MA 021,16, CO°ti SERVE ENERGY , CONOR MCINERNEY 376 ROUTE 130 SUITE SANDWICH,MA 02563 t, Undersecretary ' Not valid without signature r \ .moo, Town of Barnstable *Permit# ro9,3615 �Qy Expires 6 montl s from'Sue date y Regulatory Services Fee * BARNSPABLE, 9c� i639. � Thomas F.Geiler;Director AlFD MA't A , Building Division �� Tom Perry,CBO; Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bastable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address _ �] Residential Value of Work I cam. 3 P -O .-.Minimum fee of$25.00 for work under$6000.00 Owner's Name&AddressM �� Contractor's Name (��>,1 Y2 S'Trq U c.� �V15 i 1Z Telephone Number CZ- ,S3"1 . It 2--4^ Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) C�� :. , 4workman's Compensation Insurance "PRESS T Check one: ❑ I am a sole proprietor J U N "L 1 . ❑ I am the Homeowner ; 1 ❑ I have Worker's Compensation Insurance TOWN OF BAR.NSTABLE insurance Company Name 1 �4 iZ l t�lS y �Z.,Q 0C=—t, , Workman's Comp.Policy# �1.1G )2_2 C D q t 6� Copy of Insurance Compliance Certificate must accompan.y:each permit. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to El Re-roof(not stripping- Going over existing layers of roof) ❑ Re-side #of doors :Replacement Windows/doors/sliders.LJ-Value (maximum.44)#of windows-J .. *Where required:Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. . . , a A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE:. 6`.Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\4STGU5QO\EXPRESS.doc Revised 090809 e Commonwealth o,f assachuseft Department of Indirstra it Accidents Office of Invm4tz6ons 600 JVai ington Sttmet Boston, M4 02111 }L'1mT,Y asmgov/dia Workers' Compensation Insurance Affidavit-,Builders/Con,tr�ctDrs/EledticiansMumbers: Applicant Information Please Print Lewbly' ' Name sinEW0rgM3iZ3ti0nllndividua1): M:1 Ad/rears.. '�F. O CitylStateJZig: - t-N.A�t- A. ,Phone# . Via$ . b3� ( 124 Are you an employer?Checkthe appropriate boss T e of reject(required):: �.. I am a general contractor and;I -: `� y� P J 1.gI am a employer with ❑ g 6- ❑New construction employees(full and/or part-time.)_* have hired the sub-contractors 2.❑ I am a sale proprietor or paw listed sari the attached sheet ?. ❑.Remodeling � ship and hate no employees ,Thee sub-ccstziractors have .g ❑Demolition, w for me:icr am c cl employes and have wodc&s'' °fig y tY 1 9..❑Buildingadditiiacc. [No workers'comp.insurance , corup_.insuranm required.] 5_ ❑ are a corporation and its ' MEl Electrical repairs or additions . 3.❑ I am a:homeowner doing all work offic5ers have exercised their l 1.❑,Plumbing,repa or additions self o workers right of exemption,per MGL m3' [N '�mP- 12.❑Roof repairs ' - insurance required_]T � ` ', e.I g §I(4 lo ), have no workers' coo comp insurance required-] �vJ t�Ws *Any applicant that checks box#1 moist also fill out the section below shoe r ng,their workers'compensation policy information. Homeowners who submit this affidavit hidic tang,they are doing all wdk and then hire outside contrRaors malt submit a near affidavit indicating sucb_ tCoutmactors f ist check this box.must attached an additional sheet showing the name of the sub-cou=tors and state whether or not those entities hzve employees. If time sub-contractom have employees,they must provide,their workers'comp:.policy number..: lain an employer that is proW&ng workers'compensation inssrance for my entployeem Below is the poUcy and job site inforrrration: r t. Insurance Company Name: �sf,�cf � ►J6���.5 — Policy#or Self--ins.Lic.:# Z : 'W G Y? 2_C:�n t- Expiration Date Job Site Address: 26-t V 1��os�—�.t :. �T'� CitWstste/zip Ot:' v tom[" ,A �2ic35� Attacha copy of the workers'compensation policy declaration page(showing the policy,, and exgu=anon date). Failure to secure coverage as required under:Section 25A of MGL c 152.can lead to the imposition of criniiatal penalties 6f a fine up to$1,500.OD and/or one-year imprisonment,as well as ci%ril penalties in the form of a STOP WORK ORDER and a finer of up to$250.00 a day against the violator. Be advised that a copy of this statement may be:' tin the Office of Investigations of the DIA.for niastmance coverage verification- I do here1q,certifjs nlyder tide pains and penalties of per crry that the inforina€a'on,gro Aed above is true and correct Signature-. A Date:' . ' Phone : offiFial use only. Do fiat write in this area,to be completed by city or town.Irlciat City orTaaa►: Permitfucense# Issuing Authority(circle one). r' 1.Board of Health 2.Building Department 3:City/Pov%m Clerk. 4.Electrical Inspector S.Plumbing infector 6.Other Contact Person: Phone , 6 antuvsrnsLE, 9� r Town of Barnstable Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CBO Building Commissioner . t.. 200 Main Street, Hyannis,MA,02601 , `www.town.barnsta ble.ma.us Office: 508-862-4038 - Fax: 508-790=6230 Property'Owner Must Complete and Sign This ;Section If.Using A Builder. I, 1zots,t,F—= '�11✓1h N as Owner of the subject property hereby authorize~M1t— -r— ,'���G.x_ Gol `1 to act on my behalf, in all matters relative to work authorized by this building permit,application for: (Address of Job) S ature o wner Date. r Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on"the reverse side. . C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Intemet Files\Content.Outlook\4STGUSQO\EXPRESS.d6c Revised 090809 DATE(MMIDDNYYY) • M. CERTIFICATE OF LIABILITY INSURANCE 04/05/2010 P �DUCER ;781)447-5531 FAX (781)447-7230 'THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Mason & Mason Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 458 South Ave. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Whitman, MA 02382 Kimberly Wood INSURERS AFFORDING COVERAGE NAIC# INSURED Miller Starbuck Construction, Inc. INSURER& Star Insurance 000204 PO BOX 726 INSURER 8; Falmouth, MA 02541 INSURERC: ` INSURER D: INSURER E: COVERAGES 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:AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POUCYEXPIRATION LIMITS GENERAL LIABILITY DATE IMMIDWM EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY r. - DAMAGE TO RRENNT-PRFMIRFS(Ea r ED C- $ CLAIMS MADE OCCUR MED EXP(Anyone person) $ r PERSONAL&ADV INJURY $ + GENERAL AGGREGATE- $. GEN'L AGGREGATE LIMIT APPLIES PER: ' PRODUCTS-COMP/OP AGG $ POLICY PRO• e JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO K r (Ea acddentj ALL OWNED AUTOS BODILY INJURY SCHEDULEDAUTOS i (Per person) $ HIRED AUTOS BODILY INJURY NON-OWNEDAUTOS (Peraccident) $ 5 PROPERTY DAMAGE - t t $ (Peraccident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ r ANYAUTO OTHERTHAN EA ACC $ AUTO ONLY. AGG $ EXCESSIUMBRELLA LIABILITY +;: EACH OCCURRENCE $ OCCUR. CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE t - $ RETENTION $ $ WORKERS COMPENSATION AND WCO220915 O3/27/2010, O3/27/ZO11 WCSTATU- OTN- EMPLOYERS'LIABILITY OFFICER INCLUDED E.L.EACH ACCIDENT $ �1,OOO,OOO A ANY PROPRIETORMARTNER/EXECUTNE OFFICEMMEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE 1,000 000 If yes,describe under SPEGAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 OTHER , DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEF.ORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Totem Of Barnstable BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 200 Main Street X OF ANY KIND UPON THE INSUR rr8 AOENTS OR REPRESENTATIVES. Hyannis, MA 02601 AUTMOR17ED REPRESENTATIVE' ACORD 25(2001108) .` ©ACORD CORPORATION 1988 a � v' 11.►a;tchii, tt• D:cp t►t itiL.;i�t rrt Riiblitatciti Jy. Bt>a:it 6t BuiIdiWL Rc"ul lta+�n. ttid st►tvi1 it tl� Construction;Supe rvtsor Li-en 1 : r License CS: :43338 _ Restncted fo. 00 F PHILIP M MILLER ,. . w PO.BOX 72g t FALMO.OTH IVIA 0254.: _ y Ezpiratio'n 31142"0.- Tr,T..11'806: ' . f. • a a { Y � ' . r ] g, - ':.G M r t sqf mgµ. •. r w « - _ —•-----�._ 9s..f-•" e fit" a�' �" 011 : ME IMPROVEMENT,a HOC ONTRACTOR A' 9lstr4ti6n r Explratrort .~t 10373 rz . Q ff t 0/20/2010 Tr# 275249 ` ' TYhe Ppvate Corporation r MILLER STARBUCK GfjNgRNCTION,INC,PNILIP MILLER �4. R 0 MILLPOND WRY i r k EAST FAIMOUTH MA 02536 r 3 Administrator } , w" t 3 p ,4 , � t x n " n r t� . �L � ;,� ,., .P� •�, '` 'Y _ r '�, s� n'Abe r ..•.� : u s a - r .. t- e o r . :9 F _ Assessor's map and lot number ..?, . !�.....�� .y.,b,. ,,,,,,,,,,, �FTHET� l S f, Sewage Permit number ......... Z BASBSTADLL House number ...:...........................................................:. r rasa p�1639. 'F0 Jul a TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO t . .. ?. ........................................... ....... TYPEOF CONSTRUCTION ...................................................::................................................................................ . ...... ............................. TO THE INSPECTOR OF. BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..... . .°........ C?'N.. ....,......... ProposedUse ....� :.�......f�. V)tq....................................................................................................................... 1 f Zoning District �< ...Fire.District ( o 7(1' ....... Name of Owner xFC� ..cjUStA1.1 ,1 ...Address .. Ca t9aC �:. L:. .:....... Name of Builder- ................ ;Address ..`, .... , ........................................... Name of Architect .........Address ........: ....................... C �CtQ �. U v, Number of Rooms .......................... ^. ......... Foundation-:d CC)............................ ` ,.... �S................ Exterior ? �1 � .ti; �;1� h.�:«..... ... ......... Roofing ...... ..` ..... .......................................... ................ 't Floors � .Interior s .............................. Heating.......,C `'a�......................................................Plumbing .... ......... �f A �'t �..`....... Fireplace ... ..... N��"y .:.Approximate Cost S i Definitive Plan Approved by Planning Board _ _________.______________,_19_______. Area .... ��.. ... Diagram of Lot and Building with Dimensions .. g g Lv`T PCB' Fee ......� ... SUBJECT TO. APPROVAL OF BOARD OF HEALTH 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. � Name ........... ti FRIEDMAN, JEROME & SUSAN 24264 permit for ....................................ADDITION No ................ Single Family Dwelling ...............:............................................................... Location 39 Rosewood Lane ................................................................ Cotuit ............................................................................... Jerome & Susan Friedman Owner .................................................................. Type of Construction .......Frame ................................... ............................................................................... Plot ............................ Lot ................................ Permit Granted .....Augus t„A ............19 82 Date of Inspection ....................................19 Date Completed 19 1 V V ��`' Assessor's map and lot` number . ; ....... ,.. - / .......... Cf THE t0 /tom Sewage Permit number j SEPTIC SYST M MUST BE IPSTALLED IN COMPLIANCE Z BASa9TAMLL i 9 House number .....................:.........:..............:........::......... WITH TITLE b rues ENVIRONMENTAL COOE AND : . TOWN OF SARI '° ' s BUILDING : INSPECTOR' E.. -�APPLICATION F -� . r �OR PERMIT TO .........................1.�?�1.....................:�.�'�..................................................... TYPE OF CONSTRUCTION ........................................ 4 .................. ......................19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..... ....... ?Q. pqj?..L-A4.......<�.. .......�................................................................................... ....... Proposed Use 4�............. ...... 1.7 Zoning District ...:.....:..0.`.. ....:...........................:................Fire District ............ ...?(/. .............................................. KJ Name of Owner 9�t? °.. �?511Q� Address ...-�" ......�` ....L ......1 Name of Builder" . . ...........................................1� Address ...........og)..If V.* .:",...�.:�m Nameof Architect ..................................................................Address ................:......:.....:.....:......................:....:....:. Number of Rooms ......................... ...........:......................Foundation ...CC? .....................................P,(!Z { �................ Exlerior ,I..........................:....Roofing ...................... ........................................................... Floors ......................Interior_ Heating ..............................................................Plumbing ...�^ .`... //` - ........... Fireplace .............. U .................................................Approximate Cost :y. 1S?:.1��.......... .......... Definitive'Plan Approved by Planning Board ---------------_—-----------19________. Area .... tom ..5:................ Diagram of Lot and Building with Dimensions `� Fee / P ............................................. 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. Name .�...... ..:.. ... ...... ...... .............. ..................... FRIEDMAN, JEROME & SUSAN 24264 ADDITION No ..... ............. Permit for .................................... SiMgle Family Dwelling . ............................................................................... 39 Rosewood Lane Location ................................................................. Cotuit , ............................................................I..............I...... . Jerome & Susan Friedman Owner ................................................................... Frame Type of Construction .......................................... IN ............................................................................... Plot ....n....................... Lot ................................ iPermit Granted .......August j.r. ......�19 82 , ,Date'of Inspection ....................................19 Date' Completed ........ ............­19 7 . • � �.r.. 2.�,.—r.,,„•r .•..♦ :..y. R�...:� .'. J 4 Y.iv r �.r,j _ .,.4 n .• �a ,�. 3( ate- D %,�, 7 7 n Assessor's map and lot-.number .... ... ...... r Sewage Permit number °f7HET°� TOWN OF BARNSTABLE ;r Z BAUSTL E, i "b 9 BUILDING r INSPECTOR °�E0 MpY a 1 .„ APPLICATION FOR` PERMIT TO ....................�R��•�f!u� � ......................................................................... TYPE OF CONSTRUCTION ................!.t? .......:r/`G W7 e ................................................................... ..................19. r' TO THE INSPECTOR OF BUILDINGS: The undersigned hhereb�y} applies forma /permit according t0 00lthe (following information: Location / �` / 1/!/f fj .. 1/. /fl{/:.Arr...Jn,ryl. . C! .......C 87 i .!...... Proposed Use art............................................. ........................... 'Zoning District ...................../1 .......................................Fire District ......... .t.t .................................... Name of Owner ? .��P�a�?�+ �"'r�✓T a Assoc r/r' d �7 �P�� P r ✓.............. ..... ..P......:.............. ........Address ....................................,...........: ?�...� 11Q Name of Builder ......./, /C' . 0!::, n .........................Address %CI�� i /............/ .. ..:.................................................. Name of Architect ....../„e%/ l�/r z�l� Address .......................... G r>..:�............................................................. Number of Rooms ............Via.................................................Foundation /4� x Exterior 5v ��1.... ...! .../�'v P oofing o7 3-5- 1,4 � 1c�/ .................... Floors ......r'��... ..............Interior ......''A Heating, / Plumbing' �t�+ i C L� .....................................:�.<........................................... .................. Fireplace .....f!f�l�` 5��/1 � pp ................. 0 Q�U �_.........................A Approximate Cost .....�......�................ Definitive Plan Approved by Planning Board -------_------------------------19--------- Area ....... .`�....................... ,`Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH Ll r rA f _9 4-- I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction; Name . � i s f/r ...... c r T/::/l... Tellegen & Fervone No19714....... Permit for ...P".4 Rg.............. .................................... ... Location ...LQ t.. VttkaV...... ..............................CQ I't.................................... Owner ....Tellegau.. ....................... Type of Constructio ........Moto d..F.r.awls........... ............................... ................................................ Plot ................... ........ Lot K.IQ..L..3.6........... P C io.... ....... ove Permit Granted .............................. ........19 77 Date of Inspection ................ ...................19 Date Completed PERMIT IFUSED . ................................................................ 19 .. ........ . . ......................................... .................r...... ........................................... .. .................................. ................................. ............ ...... .. ................... .............................. .. ........... - -- - Approved .......................... .I................... 19 .................................... ..................................... ................. ............................................................ Assessor's office�(lst floor): ' .. �.a. .. .o .�.�.. apne r Assessors map and lot number .... 9""m jaE ��♦ Board of Health (3rd floor): ' Sewage Permit number 1AIRis E. Engineering, Department (3rd floor) „ v' . ;:,. rasa House, number. .: . i�!OC% ECG � �f1t'E:wL �O t6}9• Definitive Plan Approved,by Planning Board °-------------------------------19--------- " TOWN REGAIN AWsp APPLICATIONS`;PROCESSED 8:30-9:30, A.M. and 1:00.2:00 P.M. only' TOWN, OF BARNSTABLE BU�I.LDING INSPECTOR , APPLICATION FOR PERMIT TO .... 1.d.,•l1It.. .gyp .. -` .TYPE OF CONSTRUCTION .......W �Fra ....................... ......... ......... ......... ... ..................... - TO THE INSPECTOR OF BUILDINGS: The: undersigned hereby applies for a permit according to the following in Location .........��'...!..:R0, U-VgGA.'(,l 11-0L.......:...C;O Lei.�"..... �..M�:.....���'5... :....:..... ..... ......... Proposed WUse ... . ...........................r ..... , Zoning District ..... .:. .. ....... ......... ..............................Fire District ..... .......................................... Name of Owner �e ... .... ... . l�Sf��. .ell. 1c VL-Address ....��-1... 5?. r iC.IG,...... �,t ?a..�'............... Name of Builder ....... .r......... .........Address ..:............................ Name of Architect .... [XA r.0.001A .......... ......Addr.ess .....Maf1{!1(ahj(lA�...!`!�S Number of Rooms ..... f.:..::.......... ...........................:.............Foundation ............................................................ Exterior '.S .ih !�C.,....�.. "..1..'..I :.............: :Roofing ..'..:.. ..... QS.Pi.. .........................................14 Floors ................ ......................:..............................................Interior. ........ .(!.Cr... ........................................... Heating ............Plumbing,........../.N..0n ..-.`......`.. -f ( .: ?o�"....W-4..c :..................... Fireplace .......... :............................................:...........::...ApproximateCost'.. f.Q.0.0........... ................ 1 Diagram of Lot and Lilding,with Dimensions Fee!�( ,.. ' • _ r y , 1. � � .4 � � .. • a 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 , • Nam/e ..... Construction Supervisor's License :................ FRIEDMAN, JEROME & SUSAN No 32482 Per for ..$4ljrld„Addit.ion , _ T ' . Sin 'le Fimil Dwellin r' f Location 39 Rosewood„Lane a Owner Jerome &»`Susan Friedman ; �,,, TYPe of-Con ? 1 .... '.................... `•, � w ;' Wk ...tip. .. .�t....I.... ... ..1.. r ..'.. .. ..... -..................... •=' r a � '^4. � _ , ' Prot ' ' ........ Lot'..` -, � ..r. _ r• �—t Cam"' _ � �" �e, fig, .Y o ' December 5 88 3- Permit Granted ..........................�..L.,,......19 Date'of;-Inspection ��y� }..c..� �9 r �. " _' } �? x DateR Completed � .. .. ...41 _ I 6 it 1 R,::• j,,,. - [" 7• �<: •� y9. , .... - ' may. `y,•`. ,...- r- . - �• • � ,w - ti '�- Yam,• .. - r / i . . . • j �' .,a..+:.r✓' - .Nr..✓+X .. N+' �a." *. ,..,.� .'e > h.. ,,;�:i;k�.:�e^. .. "`Ruthf." .sV_ f� µ .�.; r;. ,y�: - - .. ,. Assessor's office (1st floor): Assessor'slmap and lot number . ,.. j� ��..., 1G_- o� ?O!.A� v ... .O n y THE Board of Health (3rd floor): r f� y1f� Sewbge Permit number .0... ..�....�F.....: 6 " Z BARNSTABLE, i Engineering' Department (3rd floor): so NAB& House number J / .... o lb q. , ...................................................�................. �0 MAY d\ Definitive Plan Approved by Planning Board ------------------------_-------19-------- . APPLICATIONS PROCESSED 8:30:-9:30 A.M. and, 1:00-2:00 P.M. only. TOWN OF BARNSTABLE BUILDING INSPECTOR a APPLICATION FOR PERMIT TO ..I....I`. TYPE OF CONSTRUCTION ...:...YU�) .(,. .....:d �..!6^. ......................................................................................... ....................... ........19S. � I TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...1 .. �a. t?( /�'...•I,lk`.lr:,, ...:............ s?h ).k.......y..!A.A......�??.�.�✓'`.............................................:... ProposedUse J( 1!t"Its .Z ...! . 1. . ................................................................................I......................... Zoning District ....... �.:..� .: 3f �11 ...................................................Fire District .........�...................................................: Name of Owner ...: f�.(�1'Y'!. .S.�.!. c A.51.P�.A!.,�.V.,� Address ....` .. c�� )G .. C........ �� ter. f�............... Nameof Builder .......ALt; ............................................Address .................................................................................... Name of Architect ..... ,. :1r; .. .� W,(lGt,�J`(�...................Address ....me.et((N,h�i•l:�`?c'..�.�........ : .. . Nu fiber of Rooms ........I..........................................................Foundation (240.(K.r'.( -, .................................................. Exiej for !.i'a,.::....J...: ......).....1.1..........................................Roofing �(I a� d,t ..*.. . ............................I.................. Floors ................::1.....................................................................Interior ......... .Y?+'t~� l 1;G�L • Heating fi,A..C. .. 14:'. ... �,: J..!f...✓.................................Plumbing f�,ox).r,....................................................... Fireplace .............N'.................................................................Approximate Cost ......... t', � , C) s Area�....>f� Diagram of Lot and Building with Dimensions Fee 1e? (/ 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. Construction Supervisor's License P - if;_.7'LO. -�'"'` FRIEDMAN, JEROME & SUSAN A=010-036 r ` No .....�.4.82.. Permit for ..,.Build Addition _r 3 Sing le Family Dwelling ............... ....................................................... Location ..39..... osewood. . . . ...La. ne ..................... .... .. .... .. .. ....... Cotuit ............................................................................... Owner ...Jerome & Susan Friedman .................................................... Type of Construction ..,Frame ............................................................................... Plot ............................ Lot ................................ Permit Granted ., December 5 , 19 88 ...................... Date of Inspection ....................................19 Date Completed ......................................19 , f D , J z r t u t ♦♦f � AIL t p7 t t r .I1 t •ti 1 .� '�1,�,�;,1, tt/S_ r 7'1�,.X r'.L,r��`i L�7 � /`�_ 1 z' �ti �,> ` ''°'' x 1 1 C ?Ti TA�AT"T�/ �U�J�A T/OA./ /.5 �. °U . l T U ,61 '0 n� Tq- L.P r.off' .. CA > C >;3 k k'� y��7"�! '�.o1�/lrJ� 'i�'_;�..!s'C�J/.����l�r✓T�; a a 7 A.d 41 ?" 7r. y # 1 m i `f s�'e�"' �.e ' �+�..� /�J L�©Q R�`' 4—c.-� �: r--Jf"1...• �. y..., 1 i 1 , 1 Yi y r,. cu` as. rAt;:>L d �' � SeG1�'Na i c l rt-1�,t G G y">OF 'J,.,,F � � Tu�`T� i t 1 � t' sIOW 4 1 f A °" !/L/ �t s J� ,�1� 'Z� ,S I C3 A-14 Tom.U 7C L 0o�7 jr3� t J�� @y f� 1�MVI- �..+� �Y"��Iv �'�w✓'/'�.�� 4 �* .� �. £ J. �'� t 'y�ff ;'A t f' 1-11- 77 Assessor's map and lot ,number . SEPTIC SYSTEM -MUST 11 711 i INSTALLED IN COMPLIANCE . 7 Sewage Permit number '......... ..............C.. :.....:.......................... p,qT CLE 11..STATE , WITH ?' SAPJITARY "CODE AND. T4�11N �FTHET R TOWN OF BARTNSIT.sA-LE:.. i HAR II IFST 9 "�` 0 •BUILDING ' INSPECTOR Apo,163q. "'00 ? RFD MAI a` 4� APPLICATION FOR, PERMIT TO . ..:.......:.......... . ..................... a TYPE OF CONSTRUCTION .................. a......... . . .!:........................................................................... ....................1<112...............19.�.7 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...... ..�E. .... �.....:...... � ?.I�%t .1......U...�.1.1.� ...... ,c�?� ....... 1. .... ProposedUse ..............C..2'..//.e. /.��?. ................... ............ ....................................................................................... Zoning District ..................... .......................................Fire District .:........C6. ?.!.�.............................................. Name of Owner I.ZRe E'Gf�o!, tie. : 3.a�E'.... SSo �.Z�Address ...1...�. ........... ...... Name of Builder .......�..��. ��'.c .. .r�...........................Address .......................... ,i2.f..�...................................... Name of Architect .::.../..��<../C� ..Z°l!I.............................Address ..........................�Q. ?..P..................................... Number of �Rooms ............P......................:..........................Foundation S ......... Exterior ......�/`<...... ..�....,Wy...5..k � oofng ......a ........ /1 . ................:.. Floors 1 ..............Interior ...... ......................... IHeadings!. ...:..:.....: ./........::..`.`....................::..,-Plumbing .... 4f.. ........ 0 ............................... Fireplace �s�� gSC��/' Approximate Cost .....:....>�� ®©�................... ............. .. . .. ......./Y............... . .................. ............... - Definitive Plan Approved by Planning Board ________________________________19________. Area -Cv-/. .. ....................... Diagram of Lot and Building with Dimensions Fee 7 SUBJECT TO APPROVAL' OF BOARD OF HEALTH-, \�0 Pd I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .'/�% ..... .....�.. :�L. ..... • Tellegen & Ferrone No 19710 Permit.for. ......Dwelling........... • 4 + ' Location ........ lot :27 O'.a--...^.......it y�... ..... ......... . . ............................ .................... r �f Owner ..Tellegen:.&..Ferrone........... Type`of Construction ..............Wood--tame...... .... . ........................................................................ Plot `Lot ...........MAO....L3.6. . r Permit Granted'..............:.Nov..::....1....19 77 b Date of Inspection ...... ..... ....:.............19. Date Completed / ) �! _7 ... .... .......19 `' f PERMIT REFUSED USED r.......................... ........ ...................... 19 .................. .............. .. ................................ ......................; ,................................................... +.- ' • • ,. "'. p lYl "` ' , ` ; r 4r. ........................ ................................................... • � ��- � - � � ry: r�� • r, ' , i � � 4 A 'Approved ............. .......................... 19 i Fj ............ ............................................................... f . lo i A • T TNT :7-11WE' , AJ �,,f i rP r Tr dye`aJR a I � fiw. x.�^ ^`'•*' •i o- y'- "FF a t: � {y yS �• � x �, ;iF. 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