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HomeMy WebLinkAbout1400 SANTUIT-NEWTOWN ROAD a_ 4 n i d i� ��� �" �` } r' t d j J VV ® i pht A /yp,M Application number 5 Date Issued........ I.13 nA 263 �0�' /� 1'3 1®J� Building Inspectors Initials.... . i0rsn�• o.. l os?1...................... � s Map/Parcel... ............ ........ . TOVVN OF BA STABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: /V00 3q11-tv, AI,W oale? Co f411 NUMBER STREET VILLAGE Owner's Name:Chn's -f L yam/ for?e- Phone Number 5 D8i - q20- 7 3 Z L4 Email Address: Cell Phone Number Project cost$ -S 17 — Check one Residential v11 Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: .5e, A-d tea 06 A4 Date: TYPE OF WORK El Siding ErWindows (no header change)# . 1 Insulation/Weatherization ❑. Doors (no header change)# Commercial Doors require an inspector's review Roof(not applying more than 1 layer of shingles) Construction Debris will be going to GPI sfe-Ir7ang I P.4P4 - 2,, '(d l I R L COl'Q 11 RACTOWS INFORMATION OR1V' ATIOlV Contractor's name &pan SoAecn Ale-1 ccrj a J./)JOW S Home Improvement Contractors Registration(if applicable)# !7 3 LPL 5 (attach copy) Construction Supervisor's License# 01 S 7 01 (attach copy) Email of Contractor Phone number 'V0l L 2:$ -1900 ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUtD. i APPLICATIONNUMBER............................................................ *For 'Tents Onbyx Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Check one:this event is a: for profit non-profit event Check one:Food served Yes No Flame Spread Sheet of each tent must be attached.Provide a site plan with the location(s) of each tent If food is being served at your event please obtain a health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4.30pna Commercial events may require Fire Department approval *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles:front back left side right side HOMEOWNEW S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities tender the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures;specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date PLICAN 9 S SIGNATURE Signature Date 6 `1 3 _d All permit applications are subject to a building official's approval prior to issuance. Rehewal Agreement Document and Payment -Terms Andersen. dba:Renewal By Andersen of Southern New England-.• Chris &Lynn Jones ���� Legal Name:Southern New England Windows,.LLC 1400 Santuit Newtown Rd p��i RI #36079, MA#173245,CT#0634555,Lead Firm#1237 ' Cotuit,MA0263s WINDOW ae LAcEMrsr 10 Reservoir Rd LSmithfield-,RI 02917 - - - H:5084207324 - . . - .. Phone:866-563722351 Fax:401-633-6602 1 sales@reriewalsne.com Buyer(s)Name: Chris &Lynn.Jones Contract Date:05/29/18 Buyer(s)Street Address: 1400 Santuit Newtown Rd,:Cotuit, MA_02635 • Primary Telephone Number: 50.8420732.4 Secondary Telephone Number " clskmcast.net Primary Email: 1 Secondary Email: Buyer(s)hereby jointly.and severally agrees to purchase the products and/or services of Southerm'New England Windows,LLC d/b/a Renewal By Andersen of Southern New England("Contractor"),in accordance with the terms and conditions described in this Agreement' Document and Payment.Terms,any documents listed in the Table of Contents,and any.other document attached to this Agreement Document,the terms of which are all agreed,to by the parties and incorporated herein by reference(collectively,this "Agreement"). Buyer(s)hereby agrees to sign a completion certificate after Contractor has completed,all work under this Agreement. Total Job Amount: $5,487. " By signing this Agreement,you acknowledge that the,Balance Due;and the Amount Financed must be made.by personal"check,bank check,credit card,or cash. Deposit Received: . $p Balance Due: $5,487 Estimated Start: Estimated Completion: 8 to 10 weeks> 8 to 10:weeks Amount Financed: $5,487'+ Method of Payment. Financing We schedule•installations based on"the'date of the signed contract and secondarily on the date in which we complete the technical measurements.The installation date that we are providing at this time is only an estimate..We will communicate an official date and time at a later date:Rain and extreme weather are the most common causes for delay. Notes: Depo gsky bal gsky tax are in Barnstable. Buyer(s)agrees and understands that this Agreement'constitutes the entire understandings between the parties and that there are no verbal understandings changing or modifying any:of the terms of this Agreement.No alterations to or deviations from this Agreement will,be valid without the signed,:written consent of both the Buyer(s) and Contractor.Buyer(s)hereby acknowledges that Buyer(s) 1)has:read this Agreement, understands the terms ofthis Agreement;and has received a completed,signed,and dated copy of this Agreement,'including the two attached Notices of Cancellation,on the date first written above and 2)was orally informed of Buyer's right to cancel this' Agreement. NOTICE TO BUYER:Do not sign this contract if blank.You are entitled to a copy of the contract at the time you sign. _ E YOU,THE BUYER,MAY CANCEL THIS TRANSACTION AT ANY TIME NOT.LATER THAN MIDNIGHT: OF 06/01/2018 OR THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION, WHICHEVER DATE IS LATER.SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT Legal Name:Southern New England Windows,LLC dba;Renewal }'Andersen'oFSouihern New England Buyer(s) w' Signature of Sales Person Signature Signature z " Cory Scanlon Chris Jones _Lynn Jones' Print Name of Sales Persona Print Name Print.Name. - UPDATED: 05/29/18 . . .. Page 2 / 10 . � gee of Consumer Affairs and Business Recrldlation 10 Park Plaza - Sete 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 173245 Type: Supplement Card SOUTHERN NEW ENGLAND WINDOWS LL Expiration: 9/19/2018 BRIAN DENNISON 26 ALBION RD -- LINCOLN, RI 02865 Update Address and return card.Mark reason for change. Address Renewal Employment — Lost Card =�3ffice of Consumer Affairs&Business Regulation Registration valid for individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. if found return to: -- Office of Consumer Affairs and]Business Regulation Registration: 7-3245 Type: 10 Park Plaza-Suite 5170 Expiration: 09j201 8 Supplement Card Boston,MA 01-116 >OUTHERN NEW ENGLAND WINDOWS LLC. IENEWAL BY ANDERSON � IRIAN DENNISON 16 ALBION RD l a� .INCOLN, RI 02865 Q-"dersecretary Not valid without signature L s9rl ct a' i i d nQ R e q :daiIU' C Gr;d viGi ia•' s, CS-095707 BR,IAN D DENNISON 7 LAMBS POND CIRCLE CHARLTON MA 01507 I '.G^"tn iiSSiG:'��ff 09p$;`2C�� The Commonwealth of Massachusetts h us Department of Industrial-Accidents 1 Congress Street,Suite 100 Boston,Mf4 02114-2017 www.mass.govldia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Le 'bl Name (Business/Organi=ion/lndMdual): e t ) '� Address: Z& A MOO li J . City/State/Zip: p Phone 4k Are you an employer?Check the appropriate box: Type of project(required): 1,XI am a employer with Z0 t,employees(full and/or part-time).7mee T.Q New construction 2.[]I am a sole proprietor or partnership and have no employees workinforany capacity.[No workers'comn..ansurance required.] g•.�Remodeling 3.Q I am a homeowner doing all work myself.[No workers'comp.insurance required-] 9 ❑Demolition 4.�I am a homeowner and will be hiring contractors to conduct all work on m property,. I will 10[]Building addition P ' ensure that all contractors either have workers'compensation insurance or are sole I I.[]Electrical repairs or additions proprietors with no employees. 5.❑I am z general contractor and I have hired the sub-contractors listed on the attached sheet 12.❑Plumbing repairs or additions These sub-contractors have employees and have worker'comp.insurance.! 134—IRoof repairs �J 6.❑We are a corporation and its officers have exercised their right of exemption,per MGL c. 14.FE Other lJ t/1Q'o-rn/ 152,§1(4),and we have no employees.[No workers'tromp.insurance required.] /�`J�li<fi►s �— 'Any applicant that checks box#3 must also fill out the section below showing their workers'compensation policy informatiorr. Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. (Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy Ad job site information. Insurance Company Name: `ire Pl a t)S Policy#or Self-ins.Lie.#: C 31-:�7 Z q _ Z.0 Expiration Date: t 1 Job Site Address:_ /1/0 0 �an�v�f Nc�✓�nw•-1 City/State/Zip: 7u,'l- 1q Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation ptlriishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification_ I do hereby certify under th ains andpenalties ofperjury that the information provided above is true and correct Sianafore: a D2te: tle- 13 Phone#: QD t-2Z e-T f-s' Official use only. Do not write in this area,to 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#: AC Rom® CERTIFICATE OF LIABILITY INSURANCE FDATE(MM/DD"YYY) 12/29/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCERCOITI'ACT CoBiz Insurance, Inc.-CO NAME: PHONE 1401 Lawrence St, Ste. 1200 303 988-0446 a c N,:303 988-0804 Denver CO 80202 ADDAIL : COMaiI Cobizinsurance.Com INSURE S AFFORDING COVERAGE NAIC i INSURER A:Acadia Insurance Company 31325 INSURED ESLERco-01 Southern New England Windows, LLC. INSURERS:Firemens Insurance Company of WA,D.C. 21784 dba Renewal by Andersen of Southern New England INsuRER c:Homeland Insurance Company of New York 34452 10 Reservior Rd INSURER D Smithfield RI 02917 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1252851165 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. INTR LTR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP WVD POLICY NUMBER MMIDD MMIDD LIMITS A X COMMERCIAL GENERAL LWBILITY CPA3158728 1/12018 1/12019 EACH OCCURRENCE S 1,ODD,DOD dLAIMS-MADE a OCCUR PREMISESocncu e PR nce $300,000 MED EXP(Any one person) $10,DOD PERSONAL&ADV INJURY $1,00D,0o0 GEN'L AGGREGATE LIMIT APPLIES PER: I GENERAL AGGREGATE $2.000,000 X POLICY IRO-7 LOC - PRODUCTS-COMP/OP AGG $2.ODO,000 OTHER: $ A AUTOMOBILE LIABILITY N CPA3158728 1/12018 11,2019 COMBINED SINGLE LIMIT Ea accident $1 DDO 000 X ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS I Per accident $ I $ A X UMBRELLA LIAB N OCCUR CPA3158728 1/12018 1/112019 EACH OCCURRENCE $10.000.000 EXCESS LU16 CLAIMS-MADE AGGREGATE $10.000.000 DED I X RETENTION$n S B WORKERS COMPENSATION WCA3158729-20 1/12016 1/12019 X AND EMPLOYERS'LIABILITY Y/N STATUTE ERA ANY PROPRIETOR/PARTNEPJEXECUTIVE OFFICER/MEMBER EXCLUDED? ❑N/A E.L.EACH ACCIDENT $1,000,000 (Mandatory in NH) E If Yes describe under L DISEASE-EA EMPLO $1,000,000 DESCRIPTION OF OPERATIONS below I EL DISEASE-POLICY LIMIT $1.000.000 C Pollution Liability 79300733400DO 1/12018 1/12(T19 Each Occurrence $1000,0D0 Clams-Made Policy Aggregate $1:000.000 Retroactive Date 06202013 Deductible $10,001) DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. For Informational Purposes AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25:(2014/01) The ACORD name and logo are registered marks of ACORD Town of Barnstable, v`. FSHe Regulatory Services .Thomas F.Geiler,Director • B"NSTASLB, 9� MAS& 1639. Building Division ♦0 iOrEv '�a Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 ,Fax: 508-790-6230 &—W-® � Pk PERMIT# Sr l 7 6 FEE:$ �i a SHED REGISTRATION 120 square feet or less C6� I L k� Location of shed(address) Village - �t Property owner's name Telephone number " / 07 Size of Shed _ Map/Parcel# }.. 05 Signature Date . Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? of Conservation Commission(signature required) PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE - ' COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEETHE APPROPRIATE COMMISSION FOR DETAILS. ti .. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN aN Q-forms-shedreg REV:121901 - BUYER: r.>!ES r21sToPI- 2. JUN 2 9 2005 - ,x BARNSTABLE CONSERVATION I\N• I �'-IC5 110 e-1) v TO THE AND ITS TITLE INSURERS. , MORTGAGE INSPECTION PLAN I CERTIFY THAT THE BUILDINGS SHOWN do D�( CONFORM T` O SETBACK REQUIREMENTS �©TL I.E. (FRONT, SIDE, REAR SETBACK ONLY) OF•'PS � �-�- WHEN CONSTRUCTED. OR ARE EXEMPT FROM VIOLATION ENFORCEMENT ACTION UNDER MASS. Gl- - I TITLE HI, CHAPTER 40A. SECTION 7. UNLESS,,OIITHERVASE NOTED. MASSACHUSMS I FURTHER CERTIFY THAT THIS PROPERTY IS ND LOCATED IN THE ESTABLISHED FLOOD HAZARD AREA.COMMUNITY PANEL NO.: 2 DEED �JI�',1�Op1/G DATE: 8•I�- 85 /3Q25 THIS COMPANY IS NOT RESPONSIBLE FOR ANY INDENTURES MADE SUBSEQUENT TO THE RECORDED BooK DATE OF THE LATEST DEED OF RECORD. PAGE 330 WFIENEVER BUILDINGS ARE SHOWN LESS THAN ONE FOOT FROM THE PROPERTY LINE IT IS ADVISED THAT A MORE PRECISE SURVEY BE MADE TO VERIFY THESE MEASUREMENTS. CERT. NO. _ N 0 THIS CERTIFICATION IS BASED ON THE LOCATION OF SURVEY MARKERS OF OTHERS, D DOES NOT PLAN BK. 533 PAGE REPRESENT A PROPERTY SURVEY. VERIFICATION OF SURVEY MARKERS US r~~' S SHOWN, MAY BE ACCOMPLISHED ONLY BY AN ACCURATE. INSTRUMENT SURVEY: D YS'AR DEPICTED PLAN �3 DATED ON THIS PLAN. THIS CERTIFICATION TO BE USED FOR MORTGAGE PU ES' OFFSETS AS. SHOWN ARE NOT TO BE cI ROUQICUlt USED FOR THE ESTABLISHMENT OF PROPERTY 1 Nn^F'' SCALE: 1'040 BRADFORD � � NQ 3UF�fc �_ ENGINEERING CO. P.O. BOX 1244 JAMES W. RpUGI(111KAC p I c 1tAq�n HAVERHILL MA. 01831 I ucsic UNITED CASUALTY AND SURETY INSURANCE COMPANY LICENSE AND PERMIT BOND For County,City,Town or Village Only. Not Valid for Contract,Performance,Maintenance, Subdivision,Agent to Sell Hunting and Fishing Licenses or Utility Guarantee Bond. KNOW ALL MEN BY THESE PRESENTS: BOND NO: 001664 That we,JACQUES MORIN,300 Bearses Way of the Town/City of Hyannis, State of MA 02601,as Principal, and UNITED CASUALTY AND SURETY INSURANCE COMPANY,a corporation duly licensed to do business in the State of Massachusetts; as Surety, are held and firmly bound unto the Town/City of TOWN OF BARNSTABLE, State of Massachusetts, as Obligee, in the amount of FIVE THOUSAND DOLLARS ($5,000.00), lawful money of the United States, to be paid to the said Obligee, for which payment well and truly to be made,we bind ourselves and out legal representatives,jointly and severally. THE CONDITION OF THIS OBLIGATION IS SUCH, That whereas, the Principal has been licensed and/or issued a permit for.the Purpose of opening arid/or occupying a public way located at: Lot#2 Santuit- Newton Rd.;Cotuit, MA-02635 by the Obligee. NOW THEREFORE, if the Principal shall faithfully perform the duties and comply with the laws and ordinances(including all amendments),pertaining to the license or permit,then this obligation to be void,otherwise to remain in full force and effect for a period commencing on the 5th day of May 2000, and ending on the 5th day of May, 2001, unless renewed by continuation certificate. This bond may be terminated at any time by the Surety upon sending notice in writing to the Obligee and to the Principal, in care of the Obligee or at such other addresses the Surety deems reasonable,and at the expiration of thirty-five days (35) days from the mailing of notice or as soon thereafter as permitted by applicable law, whichever is later, this bond shall terminate and the urety shall be relieved from any liability for any subsequent acts or omissions of the Principal. Dated this 5th day of May, 2000. " JA QUE MORIN-Principal Witnessed UNITED shall AND TY I CE COMPANY B y THOMAS P.CARRIGAN,JR. Vice-President and omey-in-fact ss: ACf NOWLEDGETV:IENT OE St31iEI'Y STATE OF MASSACHUSETTS County of Suffolk On this 5th day of May, 2000, before me, the undersigned officer, personally appeared THOMAS P. CARRIGAN,JR.,who acknowledged himself to be the aforesaid officer of UNITED CASUALTY AND SURETY INSURANCE COMPANY, a corporation, and that he as such officer, being authorized so to do, executed the forgoing instrument for the purpose therein contained, by signing the name of the corporation by himself as such officer. IN WITNESS WHEREOF, I have hereunto set my hand offici e - Carol A.Carrigan, Notary Public Expires 7/6/2001 - - . dp UNITED CASUALTY AND SURETY INSURANCE COMPANY No: •• 17.7 3 5 5 BOSTON,MASSACHUSETTS POWER OF ATTORNEY Principal:(Name and Address) _ KNOW ALL MEN BY THESE PRESENTS: JACQUES MORIN That UNITED CASUALTY AND SURETY INSURANCE 300,13earses Way . - COMPANY;a corporation of the State of Massachuse[ts,does Hyannis,MA 02601 - hereby make,constitute and'appoint - = ............................................ ... .. ...... ..... ..... .. Thomas P.Carrigan,Jr.of Quincy,Massachusetts : - Bond No:001664 its true and lawful Attorney,in-Fact,with full power and authority,° _ Obligee:Town/City of Barnstable- - for and on behalf of the Company as surety,to execute and deliver i and affix the seal of the Company there to,-if a seal is required, Effective Date: bonds, undertakings, recognizances, consents of surety or other Immediately written obligations in the nature thereof,as follows: Any and all bonds,undertakings,recognizances,consents of surety or other written Contract Amount: N/A - b obligations in the nature thereofand to bind UNITED CASUALTY AND SURETY INSURANCE COMPANY,thereby,and.all of the'acts of said Attorney-in-Fact _ Bond Amount: $5,000.00 pursuant to these presents,are.hereby ratified and confirmed. This power of attorney,is signed and sealed by facsimile under and by authority of the following Resolutions adopted by the Board of Directors - of UNITED CASUALTY AND SURETY INSURANCE COMPANY at a meeting duW called and held on the 1st day of July,1993 which Resolutions are now in full force and effect: Resolved that the President,Treasurer,or Secretary be and they are hereby authorized and empowered to appoint Attomeys-in-Fact of the Company,in its name and as its acts,, to execute and acknowledge for and on its behalf as Surety any and all bonds;recognizances,contracts of indemnity,waivers.of citation and all other writings obligatory in the nature_ - thereof,with power to attach thereto the seal of the Company.' Any such writings so executed by such Attomeys-in-Fact shall be binding upon the Company as if they had been duly executed and acknowledged by the regularly elected Officers of the Company in their own proper persons. - - - - ° t . Tl>is power of attorney is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors _-of UNITED CASUALTY AND SURETY INSURANCE COMPANY,at a meeting duly called and held on the 1st day of July,-1993:-, That the signature of any officer authorized by Resolutions of this Board and the Company seal maybe affixed by facsimile to any power of attoriiey or special power of attomey or certification of either given for the execution of any bond,undertaking,recognizance or other written obligation in the nature thereof;such signature and seal,when so used being` .. hereby adopted by the Company as the original signature of such officer and the original seal of the Company,to be valid and binding upon the Company with the same force and effect as though manually affixed. ' IN WITNESS WHEREOF,UNITED CASUALTYAAND SURETY INSURANCE COMPANY.has caused these presents to be signed by its proper officer and its corporate seal to be hereunto affixed this 29th day of October 1997. - .. ?• ± UNITED TY-INSURANCE COMPANY Vill Todd S:Can'ig State of Massachusetts,County of Suffolk ss: On this 29th day of October,in the year]997 before me personally.came Todd S. Carrigan to me known,who,being by me duly swum;did depose and say:that he resides in the State of Massachusetts;that he is President(Surety)of UNITED CASUALTY AND SURETY INSURANCE t ; COMPANY,the corporation described in and which executed the above instrument;that he signed his-name thereto by the above quoted authority;` that he knows the seal of said corporation;that said seal affixed to said instrument is such corporate seal,and that it was,so affixed by authority of his office under.the by-laws-of said corpora ' - Notary Public-Dona J.Hernberg My commission expires:08/03/01 1,Todd S.Camgan,President(Surety)of UNITED CASUALTY-AND SURETY INSURANCE COMPANY,certify that the foregoing power of attorney,and the above quoted Resolutions of the Board of Directors of July 1, 1993 have not been abridged or revoked and are now in full force and effect. - 5th May. , 00 Signed and sealed at Boston,Massachusetts,this day of 20 - -Todd S: _ COMMONWEALTH OF MASSACHUSETTS DIVISION OF INSURANCE 470 Atlantic Avenue•Boston,MA 02210-2223 (617)521-7794-FAX(617)521-7771 a - TTY/TDD(617)521-7490 CONSUMER HELP(617)521-7777 ARGEO PAUL CELLUCCI DANIEL A.GRABAUSKAS GOVERNOR DIRECTOR,CONSUMER AFFAIRS& BUSINESS REGULATION LINDA L. RUTHARDT COMMISSIONER OF INSURANCE NO: 1999080 CERTIFICATE OF COMPLIANCE Effective: January 1, 1999 NAIC#: 36226 This is to Certify that Federal ID#: 58-1847495 UNITED CASUALTY AND SURETY INSURANCE COMPANY is duly organized under the laws of this Commonwealth, and that it is authorized under the Sections of Chapter 175 of the General Laws of Massachusetts and amendments thereto described by the following designations: DESIGNATION CODES- 1 Fire 15 Reinsurance(Reinsurance Companies Only) , 2A Ocean&Inland Marine 16A Life-All Kinds 2B Inland Marine Only 16B Group Life Only 4 Fidelity and Surety 16C Variable Annuity Authorization 5A Boiler 16D. Annuities Only 5B Boiler(No Inspector) 16E Variable Life Authorization ' 6A Accident-All Kinds 17 Repair-Replacement 6B Health-All Kinds 19 Legal Services 6C Group Accident&Health' 20 Credit Involuntary Unemployment ' 6D Non-Can.Acc.&Health 51 Stock Companies >(Extension of coverage 6E Workers'Compensation 54 Mutual Companies >not specified in Section 47) 6F Liability other than Auto u 54BX Reinsurance except Life 6G " Auto Liability 54BY Nuclear Energy „ 7 Glass 54BZ Special Hazards _ 8 Water Damage and Sprinkler Leakage 54C Comprehensive M.V.&Aircraft 9 Elevator Property Damage and Collision 54D Personal Property Floater 10 Credit • 54E Dwellings x 11 Title 54F, Commercial Property 12 Burglary,Robbery,Theft 54G Reinsurance-Life Companies Only 13 Livestock .. This certificate shall remain in effect for an indefinite term unless said authority is amended or revoked in accordance with law. s Linda Ruthardt Commissioner of Insurance LOVELL'S LOT 1 q�'S' �- F`O POND 0,� EDGE OF -- ( WETLAND 4 �o 109.0!'� LOT 2to I 4t N 56,820 SFf ��0 IY( 0 LOT 3 000 r. I b s JOB # 98-248 L-2 CFR TIFI ED PL 0 T PLAN LOCATION SANTUIT—NEWTOWN ROAD COTUIT, MA SCALE : 1" = 60' DATE : JULY 19, 2000 PREPARED FOR REFERENCE LOT 2 PB 582 PG 63 JACQUES MORIN. 1 HEREBY CERTIFY THAT THE STRUCTURE SHOWN O ' IS GROUND AS SHOWN�HEREON.��O ON THE TIMOTHYs9cy G oM 50�-362-4341 R c tm�60q 3e2—�°° z COVELL Down cape engiaeeriag, ina s No.3W3S .. Qv crvm ENGINEERS 1 z-f�CTU LAND SURVEYORS --i----- — — --- -- 939 mein sL ycm,outh, ma 02675 DATE REG. D SU TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 001 Aaiftg) Mapl6irT Parcel Permit#Ot, L l Health Division " �"a l �/t�,�3 Date Issued // Conservation Division 6 lZO Z,_�- �D 6 Application Fe Tax Collector (��� O ►G AA, t�Q f f o��� - Permit Fee 1 Treasurer 0 {G 1��— _ �� t 0 b� ' �— SEPTIC SYSTEM MUST BE Planning Dept. INSTALLED IN COMPLIANCE Date Definitive Plan Approved by Planning Board yU1Tf1 TITLE 5 ENVIRONMENTAL CODE ANC Historic-OKH Preservation/Hyannis T01M4 REGULATIONS Project Street Address 600 SAI1M ! T IV EI. 7Z LdAl i Village DTU IT— Owner C_10 US Td)6-5 Address 096 so`y l r A)Ek)70 W Telephone-L5V 9) q 2,0 73 Z�Ll Permit Request -0 -D A 5101 R1+L S-Mk Qas[a V) )Wr Jgat<i Z mk' 0 tE 'P E, T ri�i/�cA—�('� kd LL, B L /Ay FOB VoKr 4 /(�/ 7— Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuatio TO WO Construction Type ML.-T#L dA.) S0 Nv'TiX96_ Lot Size 1 0 3 14CAL-� Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family O' Two Family ❑ Multi-Family(#units) Age of Existing Structure �2- 2 YAS Historic House: ❑Yes allo On Old King's Highway: ❑Yes A No Basement Type: 0 Full ❑Crawl 9 Walkout ❑Other ' Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing l new Number of Bedrooms: existing 3 new Total Room Count(not including baths): existing new First Floor Room Count / Heat Type and Fuel: 1@ Gas ❑Oil ❑Electric ❑Other ;,Central Air: QYes ❑ No Fireplaces: Existing I New Existing wood/coal stove: ❑Yes J&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 BUILDER INFORMATION NameWME70 W A)ek Telephone Number Address License# v Home Improvement Contractor# `O rn Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE A n,41 DATE 5 _ FOR OFFICIAL USE ONLY ` r PERMIT NO. DATE ISSUED MAP/PARCEL NO. ` ADDRESS r VILLAGE DATE OF INSPECTION: FOUNDATION ` t� FRAME , INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL- , PLUMBING: ROUGH4• €:.. " FINAL r - t ` --i L� GAS: ROUGH;•i M •' FINAL ` FINAL BUILDING ''� _ � .yr�•jwQy -y�q •� �•Y i i \ DATE CLOSED OUT' r, x • ASSOCIATION(PLAN NO. hWP��F'IHE Ip��O� Town of Barnstable r Regulatory Services saxxsrwst.�, ' Thomas F.Geller,Director ass. 9�pTF .19. a`�� Building Division D MP Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-403 8 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the`reconstruction,alterations,renovation,repair,modernization, conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-'occupied building containing at least one but not more than four dwelling units or to structures which.are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. Type.o f Work: zw OF .5)010L rS 2 • -r Estimated Cost -* D 4 Address of Work: 800 54P T'l T_" �JEW IV OV Owner's Name: PiC S Date of Application: I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law ❑Job Under$1,000 OBuilding not owner-occupied &weer pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE -_ ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner:. Date Contractor Name Registration No, �O C R 3 T,,+e 0 er's Name y � J The Commonwealth of Massachusetts Department of Industrial Accidents Of/fce oflatrestfg.Jff _ 600 Washington Street -_ Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit location: //' '� � hone 77 �`( ci Y11 _. I am a homeowner performing all work myself. 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I understand that a one years,imprisonment as weII dull rwarded to the Office of Investigations of the DIA n. for coverage verificatio copy of this statement may be fa I do hereby c th auxs d p perjury that the information provided above b true and c rrect — Date Signature /�// 3 Z, Print name ��15/ (�f/'��2 /q o DNC-S phone#( omc al use only do not write in this area to be completed by city or town official perndttiicense# CIBndiAing Department city or town: ❑Licensing Board ❑SelechmeWs Office. check if immediate response is required ❑Health Department contact person: phone#; _ ❑Other UrAsed 9/95 PJA) 1 , f I Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct.buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,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 r Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits maybe submitted to the Department of Industrial Accidents for confirmation of fimuanCe 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 cy,please call the Department at the number listed below. are required to obtain a workers' compensation poli City or Towns _ Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the pernut/hcense number which will be used as a reference number. The affidavits may be=tarned'to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. FIN The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600'Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 The Town of Barnstable Regulatory Services Thomas F. Geiler, Director Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: r2J(� JOB LOCATION: J I00 number, J _ street village "HOMEOWNER 1�1 JTD Y� �' �YI �n�s 57e8-yap 7_3a IU14 name /I home phone# ..)) J •work phone# CURRENT MAILING ADDRESS: / ()0 SQ'1/1 ri l r°C/)TQ(Uf'l A city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFIlYIITON OF HOMEOWNER Persons)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more.than one home in a two-year period shall not be considered a homeowner. Such"homeowner"'shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable.codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of B arnstable Building De eat minimum inspection procedures and requirements and that he/she will comply with said p Ce =quig, en ignature of H eowner Approval of Building.0i icial Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors),provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed•Supervism The homeowner acting as Supervisor is ultimately responsible. Tn—eiirP thnr rhP hnmenwner is fully aware of his/her responsibilities,many communities require,as part of the permit . e , o LOVELL'S F LOT 1 POND�� . ��,� EDGE OF I -l- � WETLAND ?.0 r ►� � � LOT 2 ' N 56,820 SFf o 17I I Y p CC �`� ' LOT 3 co JOB # 98-248 L-2 CER TIFIED PL 0 T PLAN LOCATION SANTUIT—NEWTOWN ROAD- - COTUIT, MA SCALE : 1" = 60' DATE : JULY 19, 2000 PREPARED FOR: .REFERENCE ' LOT 2 PB 532 PG 63 JA CQ UE S MORIN i 'HEREBY CERTIFY THAT THE STRUCTURE SHOWN ON THIS PLAN IS LOCATED ON THE tNOFMgS GROUND AS SHOWN HEREON. TIMOTHY tiG te n so9-3e2-4s41 K 1 scQ -mog COVELL dolma capeeriag, iaa S No.3803Sv: CIVIL ENGU4EiE:RS 939 rt� � yonoutn, ma 02675 DATE REG. D SU (Right)View from upper level showing matching custom yoUpd well railing. ' Ii � Fe R� (Above)67' Diameter Custom Welded Steel Unit with custom design treads, cherry tread coverings, custom nickel silver handrail with banded-twisted spindles & spindles with stainless steel ball &forged scroll ends, and custom sandblasted wire-brushed i clear coated finish. i r (Right)TO" Diameter BOCA Custom Welded Aluminum Unit with included triple in-between spindles, 1'/a" aluminum handrail, optional custom design treads (G-4), alternating aluminum center collar castings on spindles & landing railing, and custom verdigris powder coated finish. _ lqoo S�'J"V b'l —' ��I�t/`�lo+/h/ ►r91 .�.. �.UM A _ fill 4 �C d)A.) i � s 7't�J2.wA'Y ROD COi V)T ML ,)- • TOWN OF BARNSTABLE CERTIFICATE OF OCCUPANCY PARCEL ID 025 011 001 GEOBASE ID DRESS 1400 SANTUIT-NEWTOWN ROA PHONE COTUIT, MA ZIP - 1B0B T 2 BLOCK LOT SIZE A DEVELOPMENT DISTRICT ERMIT 50368 DESCRIPTION 3 BEDR. SINGL: FAM. DWELL. PERMIT it46154 ERMIT TYPE BCOO TITLE CERTIFICATE OFOCCUPANCY CONTRACTORS: Department of Health, Safety ARCHITECTS and Environmental Services TOTAL FEES: BOND $.00 Oki CONSTRUCTION COSTS $.00 756 CERTIFICATE OF OCCUPANCY 1 PRIVATE P E � * BARNSI'ABLE, • MA$$. 039. A� ED Mpl BUILDIN D VIS N BY r L DATE ISSUED 12/05/2000 EXPIRATION DATE ire TOWN OF...BARN STABIJi, BU1 .1 I LV l yPERM I S' PARCET'. Ill- 025 01.1 001 CROBASE ID ADDRESS 1400 SANTUIT--NEWTOWN RQU . a t e PlIONE COTUIT, MA ' ZIP149T 2 LOT SIZE �- 1 DBA DEVELONENT DISTRICT—— P.17.RMI.i 46I,v94 DESCRIPTION 3 BEDROOM fiaIN FAM-DVIELLING SEP-,R0.2000._2{7 1 PERMIT TYPE BUILD TITLE NEW RESIDENTI L WE �CONTRA TORS: MORIN, JACQUES NM Department of Health, Safety ARCHITECTS: and Environmental Services 101 SINGLE :FAM HOME DETACHED 1 PR1. ATF, PJ *e Fa"_:.. ; � MRN3TABLE, • MASS.. �► �1639. • ED MO'I► A� BUILD Ni D AISION DATE ISSUED 05/17/2000 EXPIRATION DATE THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. - MINIMUM OF FOUR CALL INSPECTIONS REQUIRED > FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL,PLUMBING AND M FOR (READY TO LATH). PANCY IS REQUIRED,.SUCH BUILDING SHALL NOT BE CH ANICAL INSTALLATIONS. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4.FINAL INSPECTION BEFORE OCCUPANCY. VISIBLEPOST THIS CARD SO IT IS BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 2l��4`Wl a,jtia(ot� 2�����' `�� 2 I� 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT yl `1 del 2 I-11 OF HEALT W 0,C) OTHER: SITE PLAN REVIEW APPROVAL WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN+NOTIFICA- TION. NOTED ABOVE. TION. BUILDING PERMIT TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map d�� Parcel 6//0 0 / � Permit# Health Division j� '�� i � Date Issued Conservation Division - rJu rGCvi ')3 Fee ��N, 1 Tax Collector r SEPTIC SYSTEM MUST BE Treasurer � '��� ,IN'STALLED IN C®MPLIANC Planning Dept/Un � � � VATH TITLE 5 V0GiMEVTAL C®®E ,ND Date Definitive Plan Approved by Planning Board —/Q _S7 NRE0ULAT11ONS Historic-OKH Preservation/Hyannis Project Street Address Village Owner �//4-�Q`'�' /� mot-la Address 3 00 eA--ye.s Telephone -77-5- $$Zz Permit Request -101 '4 �,Z, cam" Square feet: 1st floor:existing / proposed /-37a 2nd floor: existing proposed -s Total new /9 Estimated Project Cost 7 Zoning District Flood Plain G Groundwater Overlay Gr/° Construction Type A/,&off% Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure & 14- 07 Historic House: ❑Yes No On Old King's Highway: ❑Yes MNo Basement Type: Tf 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_ newer Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: a-6as ❑Oil ❑Electric ❑Other y, Central Air: CJ 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 d"new size;WIZ Shed:❑existing ❑new size Other: Zoning Board of Appeals Auutt orization Cl Appeal# A Recorded❑ Commercial ❑Yes Q No If �es site plan review# Y Current Use Proposed Use BUILDER INFORMATION Name A v� Telephone Number :7 Z Address , License# CS d.,;'2 17 10 0/ Home Improvement Contractor# Worker's Compensation# as o / U1 F J0 6 9 ,n ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE _ �Pr L FOR OFFICIAL USE ONLY J PERMIT NO. s DATE ISSUED MAP/PARCEL NO.. ADDRESS VILLAGE " OWNER ' DATE OF INSPECAN: FOUNDATION FRAME 9 h-,2 La) mnuE INSULATION FIREPLACE ELECTRICAL: ROUGH t.. FINAL - PLUMBING: ROUGH '• '' FINAL �Y S GAS: ROUGH■ Z - FINAL _ 1. �. FINAL BUILDING ' S r � 1 DATE CLOSED OUT ASSOCIATION PLAN NO. , t ter... ,. � .•. '.. ... � s .,+. +rr. .,. .. ._ .. � w�'•'••r ^1 r ' .. •P`OptHElp�� The Town of Barnstable - - - aAR 6. MASS.ASS. Department of Health Safety and Environmental Services Ti � n- i679• �0 , •'" prEDMA��� - Building Division / 367 Main Street,Hyannis, MA 02601 ' Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice ,., •ate- Type of Inspection EL M(/ Location L� ►UPLcI 'J�TT,c/7? xPermit Number Owner Builder d One notice to remain on job site, one notice on file in Building Department. The following items need correcting: 4 r uA ;a)44!e,-s lima a/� m .. v f-Irek)ar, 4A-1Y-5 oy\ ckAY ' Please call: 508-862-4038 for re-inspection. Inspected by Date N MAScheck COMPLIANCE REPORT Massachusetts Energy Code Permit # . MAScheck Software Version 2.01 Checked by/Date CITY: Barnstable STATE: Massachusetts HDD: 6137 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) -. DATE: 5-4-2000 PROJECT INFORMATION: 108 Statice Lane F Hyannis, MA 02601 COMPANY INFORMATION: Bayberry Building Company, Inc. 300 Bearses Way Hyannis, MA 02601 NOTES: Lot 18 Bayberry Place - Subdivision # 701 COMPLIANCE: PASSES Required UA = 420 Your Home = 412 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 1372 30.0 0.0 48 WALLS: Wood Frame, 16,, O.C. 2168 13.0 0.0 178 , GLAZING: Windows or Doors 364 0.300 "109 GLAZING: Skylights 25 0.410 10 DOORS 19 0.055 1 FLOORS: Over Unconditioned Space 1372 19.0 -" ' 0.0 "`65 HVAC EQUIPMENT: Furnace, 0.8 AFUE COMPLIANCE STATEMENT: The proposed building design described here is - consistent with the building plans, specifications, and other calculations, submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building; and the cooling load if appropriate, has been determined using the applicable Standard Design Conditions founds, .., in the Code. The V L125% ment selected to ,heat or cool the building, . . shall be no greater th of the designload as specified in Sections 780CMR 1310 4. Builder/Designer Date O ; a -... ,'.. •- ,a; %..^ '� a ., „ .. e MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2.01 DATE: 5-4-2000 Bldg. Dept. Use CEILINGS: [ l 1. R-30 Comments/Location WALLS: [ ] 1. Wood Frame, 16" O.C. , R-13 Comments/Location WINDOWS AND GLASS DOORS: [ I 1. U-value: 0.3 For windows without labeled U-values; describe features: # Panes Frame Type Thermal Break? [ ] Yes [ } No Comments/Location SKYLIGHTS: , [ ] 1. U-value: 0.41 For skylights without labeled U-values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ J No Comments/Location DOORS: [ ] 1. U-value: 0.055 Comments/Location FLOORS: [ j 1. over Unconditioned Space, R-19 Comments/Location HVAC EQUIPMENT: [ ] 1. Furnace, 0.8 AFUE AIR LEAKAGE: [ ] Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. When installed in the building envelope, recessed lighting fixtures shall meet one of the following requirements: 1. Type IC rated, manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned, space. 2. Type IC rated, in accordance with Standard ASTM E ,283, with no more than 2.0 cfm (0.944 L/s) air movement from the the conditioned space to the ceiling cavity. The lightingfixture shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. VAPOR RETARDER: [ ] Required on the warm=in-winter side of all non-vented framed - ceilings, walls, and floors. MATERIALS IDENTIFICATION: [ ] Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. Insulation R-values and glazing U-values must be clearly marked on the building plans or specifications. DUCT INSULATION: [ ] Ducts shall be insulated per Table,,J4.4..7.1. r•.` DUCT CONSTRUCTION: [ ] All accessible joints, seams, and connections-of supply and return ' ductwork located outside conditioned space, including stud bays or joist cavities/spaces used to transport=.air, °shall be sealed using mastic and fibrous backing tape installed according to the manufacturer's installation instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not, ° permitted. The HVAC system must provide a means for balancing air and water systems. TEMPERATURE CONTROLS: [ ] Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone •or floor shall- be provided. HVAC EQUIPMENT SIZING: [ ] Rated output capacity of the heating/coolingsystem is not greater than 125% of the design load as specified in Sections 780CMR 1310 and J4.4. [ ] SWIMMING POOLS: ; All heated swimming pools must have an on/off heater switch and require a cover unless over 20% of the heating energy is from non-depletable sources. Pool pumps° require a time clock. 4 [ ] HVAC PIPING INSULATION: f, HVAC piping conveying fluids ab6ve"120 F or chilled fluids below 55 F must be insulated to the following levels (in. ) ; a PIPErSIZES (in. ) HEATING SYSTEMS: z TEMP (F•) `27--RUNOUTS 0-l" 1.25-2 2.5-411ay r Low pressure/temp. 201-250 l-0 1.5 ,1.5 2.0 Low temperature 120-200. 0.5 1.0 1.0. 1.5 Steam condensate any �+ 1.0 16.0r "l.•5 2:0 COOLING SYSTEMS: Chilled water or 40-55; 0.5 : ., 0' 5 ;. 0.75 refrigerant below 40 �1.0 1.0 1.5 1.5 [ ] CIRCULATING HOT WATER SYSTEMS: + Insulate circulating hot water pipes to the following .levels (in. ) : PIPE SIZES (in. ) NON-CIRCULATING I CIRCULATING MAINS-& RUNOUTS v . HEATED WATER TEMP (F) : RUNOUTS 0-1" 0-1.25" 1.5-2.0" 2.0+11 170-180 0.5 1.0 1.5 2.0 ' 140-160 0.5 0.5 1.0 1.5 100-130 0.5 s 0.5 0.5 1.0 ----NOTES TO FIELD (Building Department Use Only)-------------------7- . a The Commonwealth ufMassachusetts Department of Industrial Accidents - 9/l�cee/Indesu�arloos 600 Washington Street Boston,Mass. 02111 Workers'Compensation insurance Affidavit cat city phone#(Lon 7 7 S — ��-- ❑ I am a homeowner performing all work myself. p I am a sole proprietor and have no one working in any capacity 0811110 I am an employer providing workers'compensation for my employees working on this fob. ..•L'o.1 ...ail:' `;.i•' wades xm l� ^ .v a�ltf"e A'Y : -d1'1'�-'C l . . . 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I uoderstand that a copy of this statement may be forwarded to the Office or investigations orthe DIA for coverage verification. /do hereby cerr6 under the pains and penoldes of per)ary that Ihe'ftyorntntlort provided above is true and correct Signature _mate Print name VYLO-/0- Phone 0�� _ S k82"L 1Z Cchcck y do not write lu als area to be completed by city or town official pertnit/license a sBuilding Department pLicensing Board mediate response is required j]Seleetmen's Office Cliiealth Department : phone N; pother t�:ca sros atn) • a: .Jfie "Lo��vnw��rr,�leaul2 o��.i��ar�icule�d ' BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR, ` Number,CS 057770 , Expires: 02/16/2002 Tr. no: 17122 ix Restricted To _1 G W 9 JACQUES N MORIN 300 BEARSES WAY HYANNIS, MA 02601 Administrator y `s TOWN OF BARNSTABLE BUILDING'� PERMIT PARCEL ID 025 011 GEOBASEID 1374 ADDRESS 1400 SANTUIT-NEWTOWN ROAD PHONE COTUIT ZIP - 1 LOT BLOCK LOT SIZE . DBA DEVELOPMENT DISTRICT CT PERMIT 37947 DESCRIPTION DEMO COTTAGE PERMIT TYPE BDEMO TITLE DEMOLITION PERMIT CONTRACTORS: CONTRACTOR Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: $25.00 BOND $.00 CONSTRUCTION COSTS $.00 645 SFH DETACHED. DEMOLITION 1 PRIVATE P•,c+ �&4RN3fABLE. MASS. 039. Al I Ep Mpl BUILW BY 1 --Y------ -DATE ISSUED 04/21/1999 EXPIRATION DATE r 0fT STb7A.t - y L u x.. LL'�pp�q pp 7fi'D a P ry't PARCEL ID 025e03 " ¢ . GE0BASE ID 137 _ADDRX&S ��y ;� rat � ZIP �j r✓✓EITV A } j e 1?� ?y � q ZIP •gLO`.' ��' vv��yyrr'� ,LOT SIZE �^�v �v�yy ' i.JVELOP.i#.GLYJ... ,: i.. `, ', "9.JT1Lr.t til� EIRMIT_ 37947 DESCRIPTION .'DEMO CO' TALE EMI`, TYPE BltkO t-�—�'I'rk. E 7�EM LITTIO�t ' I' ' CONTRACTORS: CONTRACTOR � � �� '� Department)f Health, Safety "A2GHITS= j((/ and Environmental Services TOTAL FEES: V2.6.00 THE BOND , • $,.'00 1 . CONSTRUCTION COSTS $.00 � �► 6'45 : . Sm4 DETACHED:DEMOLITION ` 1 PRIVATE PTt ]> ABLE. • MA83. BUIL BY DATE ISSUED 04/21/1999 EXPIRATION DATE THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF;EITHER TEMPORARILY OR PERMANENTLY.EN- "_T'ROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR j ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS i PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS:. - MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS' ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE'OF'OCCU (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ELECTRICAL,PLUMBING AND MECH- ANICAL3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN,MADE. INSTALLATIONS. 4.FINAL INSPECTION BEFORE OCCUPANCY. } VISIBLEPOST THIS CARD SO IT IS BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 2 2 2 3 1 HEATING INSPECTION'APPROVALS ENGINEERING DEPARTMENT 2 BOARD OF HEALTH OTHER: SITE PLAN REVIEW APPROVAL WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL.AND VOID IF CON- INSPECTIONS INDICATELFOR HIS THE INSPECTOR HAS APPROVED THE- STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE.ARRANGEBYVARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTENCA VON. NOTED ABOVE. TION. BUILDING PERMIT THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR , QUALITY ORIGINAL (S) I M DATA EST/MATED PROJECT COST WORKSHEET Value LIVING SPACE (high end construction) square feet X$115/sq. foot (above average construction) S square feet X$96/sq. foot= (average construction) square feet X$57/sq. foot= GARAGE (UNFINISHED) 5'sa square feet X$25/sq. foot 13, rO—O PORCH square feet,X$20/sq. foot= DECK o-a square feet X $15/sq. foot= 3�D-U-o OTHER square feet X$??/sq. foot Total Estimated Project Cost ZED Z 6 For Office Use Only /nc/usionary Mbrdab/e Housing Fee residential Commercial" Property Owner's Name �:2 oti, d�( Project Location �� I — c7,1,1 t,�� � • 4�< / Project Value ���f 7� Permit Number "Existing Sq. Ft. "Proposed New Sq. Ft. Fee$ o2e © 76:3 BA.YBERRY;B UILDING CO ZINCr JACQUESN MORIN / ## es or. _ ` i "TIM,;MW MORIIV � Y ?� rzsf 0 s —SPH..508 775-8822 w 300 BEARSES WAY � � y ORDEROFE rbT aTa "v " a4� aR g p 1 .� Y,r c..ti�'I$atm y 1< •. x., ^ .Y �� �y, . ��TM""� S` $ r � �i 1e Ewai�` •/ � k, _i 'P,R BOX IOJ.' ,?,+�� ��` 'M— 3� §�" "s f.. - Y • tY�lv1 �•N ��f� �` "a '� Y ��C�"fi4.i� �.y,� .Crt+�z Nr 1. 2-L 13 ? 1 7Ri_ ann r 3d11. n ,1, „ =_ TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 0 ' ` Map Parcel 660 JS 65 P0 Permit# L "ter c .. Health 6iv ision • Date Issued '02�� Conservation Division J ' Feen2S'•r�o Tax Collec ✓C y/� � Treasur ' Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address Village Cd Owner Address Telephone Permit Request sk A\Xw � CG`\ Cel Square feet: 1 st floor: existing�oposed,,_�2ndfloor:existing proposed Total ne Estimated Project Cost / Zoning District Flood Plain ''' Groundwater Overlay---' Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes,attach supporting documentation. Dwelling Type: Single Family ed Two Family ❑ • Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No. -On Old King's Highway: ❑Yes ❑ No Basement T ull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new / Half:existing _; ew Number of Bedrooms: existing new Total Room Count(not including baths):existing new /f First Floor Room Count Heat Type and Fuel: ❑Gas Q,61'1 ❑ Electric Q.Other . Central Air: ❑Yes ❑a Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:,❑existing ❑new size Attached garage:0 existing Cl 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 . BUILDER INFORMATION _ Name �`% `� Ccr. c s 1 Telephone Number 5 A 74\71 3 0 0`1 Address License# oaS so Z�(c65 �S•�J�r.�e� y�-"� 'Z Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO C L , OnLs v_ SIGNATURE DATE - FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. r < ADDRESS VILLAGE t ga. •. - 1 ��... ,F y.t. 'F a - ! r _- 1 .. f • -.- t f _ OWNER00 DATE OF INSPECTIONL FOUNDATION - 'FRAME INSULATION IT FIREPLACE - ELECTRICAL: ROUGH FINAL• PLUMBING: ROUGH FINAL f { + r GAS: ROUGH FINALE _ t FINAL BUILDING - - DATE CLOSED OUT f 1 ASSOCIATION PLAN NO. - - i'• i PU1 TOW lF 11 V, ' s , lkpol 13. 1 999 , 4 A r�: on Pc €���}} yy rram�. �. - � , .. •. . s hi- ` e y:sY i?3'ii4 e L °ad' cottage, l �_ '° at 1400 q isuwi x oza d. C ttuil. has been mrn-e-l -ate kv Z..'ri�a -tpp'S r':f 33�aa' ? :q: a• i-y:.ulli `on G. :, F v v; a E s water r ... -N 3& d tf3 3T i-3•'f. 4oI i.f !-�°�.:.5 f` S.a - 3'}�: s�1•lL.'r lip A:i X, _ 00 UK44 Emus 999 9368 5108 I�j001 "y��r '^ 1 . m ICtric matt ZA 121 , yi We- sa, WreFqurr- Wss_::.hrssetts 02571 9,0 t � . 'RO�� Sri"L Lam.`, -f,.a • "- f v °�•-<- a ti {.{ knt i= u � r ? 7= lii _ ,Y ? + . Sept. 1``�. l'N! Tiat thePrior Ole J" - n time, .)f�� j" f r at I ti 1, 3plt '��zi' �t t -• .a yy 41, - �aAN J y,. Ire- �= _ � 1 yz *���,`.`�, _ 4 .�4y�,F�'�Z1`�Isy�'°#'y�,N"h�l•+ } 1."�1� 't 4:i 'ipt - a•.f trr {fWI r j' ti Y �, c3y „m� �Y•,v � 4 - � r APR-15-1999 155. 71�- COL GAS MARI:ETIhIa P C!1 ! a ray- F Y w n.a ri s ' hlr Don r'em r y" jets 508-2731-0096 1 0 ti - a.1� - r �;r -h E:u$4*z ''ta3 xli M'` To Whom 1-twN a pp�� ((pp -yam. � FF�yy''�.)s;;!�(y� E — �'3Y€`q wis�+'"! •{'1 ! F'9+3c R'� cx` R'._3a 'x�w3slot s:bdvatHF �l.a {�_ ,. .._ - rs3a S�L+&+�'M 7 3-l�—+.6 x nSz.�._.,-.m, d-s 0' =vc_.-'. — _ _ NOv `!f'.E €y`=_ � _ . on y u.s ryi e i 7.3��,'yI 9�ID ty'4xg'-aF i8z kna . l TOTAL P.C-11 Property Location:.;134tPSANTUIT-NEWTOWN RD MAP ID: 025/ Olt/// /l.q/ ' Other ID: Bldg#: 1 Card 1 of 1 Print Date:04/08/1999 =a„- - ` :..., « .a^r�-..0 ,� z;.. ,.:-- x ., �.._`�. o air,,. ``;�„�, saa,r�ri-✓,r: ,..:� �::��..._.� -s .,--..a�.,v�i �-�� .,,�' �: ..�s"' ,.. MuRIA ,JAUk2ULb IN escription Code Appraised value I Assesseda ue 00 BEARSES WAY 801 ANNIS,MA 02601 BARNSTABLE,MA ccountPlan Ret. - ax Dist. 200 Land Ct# er.Prop. #SR VISION Life Estate DL 1 LOT 1 Notes: DL 2 ota 70,80 , `sa JVb F r; r. code Assessedvalue r. Code Assesseda ue r. code ssesse a ue AVID,�SANDRA M 7051/250 02/15/199 U I 1 IA , IMMERMAN,JEANNE H 4871/097 01/15/198 U I 1 IA IMMERMAN,JEANNE H 3881/311 09/15/198 Q t ota. ota. Totaljkjar . is signature ac now a tines a visit Ty-a Data Collector or Assessor �.. �< .. .„ter. , ear yp escriptton mount Code nTDescription Number Amount Gomm.Int. Appraised Bldg.Value(Card) 0 Appraised XF(B)Value(Bldg) 0 Appraised OB(L)Value(Bldg) 0 ota (Bldg) 7 00 ,,.. w, .• z., Special L d Value Va lueo8 Total Appraised Card Value Total Appraised Parcel Value 70,800 Valuation Method: 70,800 Cost/Market Valuation fk 1 Net TotalAppraised Parcel Value 70,800 G: z ermitIssue Date lype Description Amount Insp.Date o Comp. Date omp. Comments Date ID c7d. Purposelmesult P1•':\: 1.. :� ...r ...... :.�.. ........ . ��.: •. .. .:,,& =R �. .,.«�' � ..a:��.,�v�,. Use Code Description one ronta e Dept nits \ nit rice actor . . .F actor f. Notes- ecia °riC u p g p s- � p ing j. unit rice an a ue I 1JUU Vac Land 1 1300 Vac Land RF 2 0.01 .0 A 100,000.0 1.0 5 1.0 11WC 0.7 70,000.0 �70 1 1300 Vac Land RF 0.0 A 1,000.0 1.0 5 1.0 11WC OM WETLANDS 700.0 10 Total and Vin�t Lu Ak.i ota an au Property Location: 1374 SANTUIT-NEWTOWN RD MAP ID: 025/ 011/// - Other ID: Bldg#: 1 Card 1 of 1 Print Date:04/08/1999 guiv OW z- : 'a '• ' r 'S ement escr:ption ommercia Data ements ty e ype Vacant99 an Element Description Model 0 Vacant eat Grade Frame Type tones aths/Plumbing Occupancy Ceiling/Wall a ooms/Prtns Exterior Wall 1 /o Common Wall 2 Wall Height Roof Structure Roof Cover nterior Wall l ' 2 Element Gode Vescription Vactor Interior Floor 1 Complex 2 Floor Adj Unit Location Heating Fuel Heating Type Number of Units C Type Number of Levels /°Ownership Bedrooms Bathrooms 1 t Total Rooms na I. ase to UU ize Adj.Factor .00000 Grade(Q)Index .00 ath Type Adj.Base Rate Kitchen Style Bldg.Value New Year Built ff.Year Built mil Physcl Dep 100 uncnl Obslnc con Obslnc pecl.Cond.Code :., N u„ _ : IC ond Code Description ercenta"a verall%Cond. ac an eprec.Bldg Value " uv � ME, .: Y, Code Description LIff Units Unit Price Yr. Dp Rt Yo(-na Apr. Value I, Code Description LivingArea ross rea EJJ.Area UnitCost Undeprec. Value t ross iv ease rea fflag a Inc Ummuawcuuls dyluxyucauseus r_ 'vy --_ Department of Industrial Accidents OflICC Ol/Ayesffoa affs - 600 Washington Street Boston,Mass. 02111 Workers'Co m ensation Insurance Affidavit name: -,J� location: ` l�U �r•�•+��s- ,y C',�•.���,.,� \��- city phone# ❑ I am a homeowner performing all work myself. ❑ I am a sole etor and have no one worldn in anvca p/%// ////////%//// /�iO//%///%/d0%%%/%/�//////////%/////O///a/ "�� m an employer providing workers'compensation for my employees working on."job. m an name::. ::::. .............1j. .. : ::..::.:...... .. .:.:.......::.::.: ...... .. i0 e ' ... ;;';:;•{: .::.c:.::c:':..' address.. .. -» �. .. . ... atv . .... Ct5 ... : . . W� nsnran ce co . ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who k have the following workers'compensation polices: v,.. a name.: comp nv .: .. ::.::":: ...... ....... ........... ... ... :.:::.;:.;::{:::.:>::>:.>::::::>::::::. . .:.....:::...... address. ::'..::. :::::::" -::.;;:.>.... :..: :.::::::.....................;::::::.....:..............:..::;:;:;:•::::.;•:::::::::::::.:::;:•:::..::;. yisY:<:.::.iris:.iris:4iiiiiiii:.:�iiJii:v::vv::>ii }iii :.:..:..........::v::......... ::::::::.�::::::::::::i:ii:.:.i:!.i:{.:{::ii:::.�:.�:::.:..:::•:::.�::::::::: ................ V:::: :':.:':.:i!i::j:.:..'{::i:.:::'.i:'.::::}:;:::::::.si::: <;<2?%.:.:i:.:j`.:.:.i:ii:"''::i�:?.:. : .:. sj:.:i:::?{:i:^:::i:::::::4:i:4: j :. �, .... ...... .............:.. .... ..v.�::::..:::::.:::. ....... .: :.:.:. ii: ;i:;i:; ; ii:isiiiii:issisii:.w::Jii::ii::{ii:-::ii'Liii:flti�i�4i::y':iiv::::i::::??i:jjiv::}.'�:?;'+,':i::i::{`::jj(: ......................................... ................. .................. :i:::::::::::::::::::::: :::•::ii:ii}ii :-:{•i;{•:�):.i:{C}�.;4.rj6iii:4iiiii'::�- ....................................:.:....:.:.:.:n..n:::::::::.�:........................................y... ..........::............... ......{.vy.:n,:-ilii:.ii::i iii:v:ry•�..::::: ::n}v:::;.:�•{{.:'{:.iij:::v.:N:: ................ ...r.........:.. ttill ..::::;:::.::.::::::::;:.,:;::::.::>:: :::::::::».-> p i:;::i:_:::: :ii�:4:i::'? .iTii}:............................ <:!...:.:...........? .'.;}i..........:.i. ':?;:} :;:;:j':};:i<ii:i :;iiiii:ii:•iii ii::^:isvi:fi:;iii:i:ii:iiy'.:"o;�:;y.%::6 vi•:;::;iii ii::::: ...:...........................................:.�::::::::: ...::••:Ci::i::>.<i:iiiiiiiii;.... ..'!:iiiiY.}.'::.iii:::::::{ lnnlDenv RBnIC ::'.':.:,.<i•is t;:r•;:i:'x:x::;;:;;i;:::::;.a:.::<.:<:i:...:.....:;< ..::v.::.:::•:::..::-v::::::::::::::::::::.:,n ,m- \..::::-:::: ...::: v............ .....�.::::.. ....:... ...::.::..:: ..............: ......... ::.�:.......:n::::.�n::.n:n.. .......................................................................:.:::::::::...............................:............:.::::::.:•iii....ii...........:.:�:. ... .�.... i'. ....is i::- .. '•:ii:';.:::.:::.•�. cl tVtX. lieeelE.b ........ <{.........::.::::::::.:.....................::::..............::::...:.... . ...:::....: nmrance.co. .,..__ . . ....... ...., ...:. olicv�>:'<:;>< > ,.. :....:::,:.;•.:.:.:.:>:;;•::�:,».:i.:;>;:: :;•>::: FeBms to seems coverage as required under Section 25A of&a 152 can lead to the impesitlon of criminal penalties of a Hoe up to$1,500 00 aad/or one years'imprisonment as wen as dvii penalties in the form of a STOP WORK ORDER and a fine of i100.00 a day against me. I understand Brat s copy of this statement maybe forwarded to the OMce of Investigadons of the DIA for coverage verification. I do hereby certify under the pains and penalties of perjury that the infornudon provided above is trru7coffect Signature Data Print name 6m Phone# SU y, official use only do not wrtte in this area to he completed by city or town official city or town: perudocense# ❑gunding Department ❑checkifhomediate response is required ❑L�g Board ❑Selechnra's Office ❑Health Department contact person: phone#; _ ❑Other (rm"9/93 PJA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers�to provide workers' compensation for their employees. As quoted fim the"law",an employee is defined as every person in the service of another under any comr - 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 a.:, the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the rc=ve: 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 cr building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renews: 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,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 in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names,address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of IndusaW Accidents for confirmation of insurancecoverage. 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 Departrent at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of hrvestigations has to contact you regarding the applicant. Please be sure to fill in the permitlliceose number which will be used as a reference number. The affidavits may be maid io the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have-any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents 8mce of Investloatlons 600 Washington Street Boston;Ma. 02111 fax#: (617) 727-7749 phone#: (617) 7274900 eat 406, 409 or 375 NOTE: OKH District approval required prior to issuance of permit for propertylocated --in the Historic District(north of the Mid Cape Highway) In Hyannis - Check to see if it's included in the Hyannis Historic Waterfront District, if so, it needs approval from the Historic District. Assessors Office: Obtain a field card showing date of construction. Take this to Historic Preservation(4th fl. School Administration Building) open 8am- 12 noon. { � Sign-Off from Historic Preservation(this is required no matter where house is located) Sign-off from Treasurer Sign-off from Tax Collector Specify on permit where demolition debris is to be disposed of. Certification that the following utili 'es a e shut o e��66 Gas5,� Electric !���,x� �`\e\� �,�,�`'t,` G ya Water If on town sewer- sign off from Engineering that sewer has been capped S e If septic system-no certification required Worker's Comp form must be submitted if more than one person will be involved in the work. _ (Minimum) Fee inimum c>o �� Lrf c}c,of NOTE REGARDING DUMPSTERS: (527-CMR-34) TELL APPLICANT THAT A DUMPSTER OF 6 YARDS CAPACITY OR LARGER REQUIRES A PERMIT FROM THE APPROPRIATE FIRE DEPT. K6- �' 3U g4brms-PERMITS 1 Rev 12/14/98 71 noOD (o (Xi O 00 00 Y J N X Z N C7 � CEDAR CLAPDOARDS ® -.— •4•TO WEATHER TTP. 'rROM ELEVATION ONLY, LLl LLJ _ _ _ L 1171 LILIF CEDAR SMGLES . 5' j - - , To wEamcR TYP. SIDE + a a - REAR CLEVATIONS a H a u FRONT ELEVATION - W s , . SCALE,1/4• -1•-0' - q - RIGHT SIDE ELEVATION -- - Z . SCALE- 1/4• - V-O' Z w SMOKE DETECTORS O.K. A A* AR/NSTABLE WILDING DEPTLo d I � v _ 1 p 11 Ln >_ p El d d l9 w d ITU-1 Z:nZ Wd) In Z ; 1Z: ..1 QL O d 1 _ p 0 LEFT SIDE ELEVATION REAR ELEVATION SHEET NUMBER- SCALE, 1/4• - V-O' SCALE- 1/4' - V-O' FILE NAME- 92113A1- — 14•-4 7_2• 14'_11• 13_10• D.-4' 7._2• 7.-2. no m ....- --------- -- -- -. ..------ ,D ~ .¢ 0 Y DECK 'LT 12' a 2 B' Q - CO F- N .._. -. _.-.-_ CY.m- FAMILYn n �s , ROOM � o , 2i 4 LIVING DINING a MASTER BEDROOM T S 6 - 12-2 1'2 -G_7 y/t �-57A t Ll 70 (7) III J rrr!cox�c f 5" 1 WAll!-N 1 11 LtCN DN. I--- I ,; A7 ra CO VON 1 r --.,, 515TT- LAV. � f wC1L5 ECT wCCN 1 - - O A Dt 'Crt SC/ --- N 4�: o`1 I Wm �coNrtt—.I� - - —� LLMiG 9r�5 o qp o Z O Ul `— O N GARAGE MASTER ------- CA) , z Y BATH FOYER 2-0.I KITCHEN 4 i a o H A cl 0 1 - - _jj I (( ll LJ To l 7'-2' a 7-2• �y h, Li 6ci; • _-- '-O---- 2-d' r-s 4-y 4-c• _-.t�• _ _4��• y.:.1O: y-10- -�c-0_-- - u'-0•— c� �� I � - -- 11-0• 11•-0• o-0 - -7-S' zs-o• CCAMrDRAL FIRST FLOOR PLAN 7-' y'• " 1O y"'---- 1y-10 a/5, -- c-o 7/5, Cn-HG OVER r-_- ---�---- - -- --- .--T------- rdlir RIL 5;ALE• v4-- r-o" BELOW) :... - I I I Lic Or CWKET In B=ovER/rRovmc W - L_J L_J KTDRANE AUND OD BEDROOM Q ccw.N 7o eE:aw) � r� 14-1 3/4' — -- -15-10 1/4• '--12 — \ I O - BEDROOM q 0 BALCONY S _� - i Q Q O r f or ant• P�" CC AM Aemlr Di -- to to Lt/ 11- \\\\ w � O I Q oe — BATH Q acctss r W Q PANEL -J •— r o�ctow� C " TO. S AGCr55 Q` . BELOW) a r_ rANEL / i O O < f ® � COVEN TO allow c5TcoAcE) /// STORAGE _ Y m L_J SHEET NUMBER+ ,, y c• y L y c•� `.�. 4.�. 4.�. 4.�. • 7_6 —. AID SECOND. FLOOR PLAN vim• "{• (( FILE NAHE. 9?11 in? cl N Z(U ?c �O r I C3 c. R]m 9 c� MOTE• G.G. r /OLNDAnON - o. ;04 " - CONTINUOUS RIDGE VENT -. - CONiRAGTOR TO VCRifY - % TYMAL BLLD-OVER - •. - LOGAnO!Vs Of SONATLBLS q 12' N TYPICAL ROOF COCONSTRUCTIONO J -------------- p 4 ATTIC i n`;�$oSFICOTHNG/2`[e 81 _ - ___ __ 9' FIBERGLASS NSLL. - - RAr TORS AT 1G' OL./PROVVE -rROPLRVCNT- QQ� O OR EQUAL STYRA►OAM INSULATION TO N 0 I MM4TAIN VENTING AT CAVES Alm SLOPED a i i 1!4 FOR WALL —— ON 1G, 6 * CONTCTC WALL L - - NSIAATED CCLNGS/PROVIDC CONTTUOUS - - Q BUU ICADBLC 'C' - ON CR x 8' CONTINUOUS - '-0 u SOFFIT VCNrnG/PROVDE RIGID INSULATION _ r a a o 94 _ BUJo1caD CONCRETE roornc AS Rcouem AT VAULTED cE1.Ncs N _ l _ q 12 WALK-IN BEDROOM. a TO MELT E►CRGY..GODC RCOLRtKT1T9.C1tJ0)�. a vui o u f FULL BASEMENT �— o L G G_ _ S - _ 1- 2x10'. • IG• O.c. 2 ■ 10. et 1G' o.c. ain • G_ G_ G_ G__ G_ TYPICAL CXTCRIOR WALL CONSTRUCTION- H W i 4 rrL f 1 f 1 -1 f r 1 r -1 °r 11 c WEATHER CEDAR niVAnon ain/ Q t p __ S LAV. DINING RM. WtiTE CEDAR SNNGLES AT TO WEATHER -f—-—+- -+ -—i -t—--+ --�- SHEaTHD RE ■ 4 sn10s AT 1G rLy. . L_J L---J - _J L J L—J L—J of smc AND ROAR uevanons/1/z rLY. Z 0) 2 x 10 CRT(Tyr-) I. - f` - 3 1/2, rotxGLASS NSU-AnON UIL I TTT. .)o' x 30' ■ 10'CONE. COL.?AD - L J S/B' rLY. SLBFLOoR GLUED .. _ AND NALfD TO JOISTS GARAGE I_ O 2 x 10'. et•IG• O.C. 2 x 10'6 at 1G• Oc. 00060 - o (4• CONC. 5LA8 W/ ,. - 1 ? c3) 2 x 10 GRT 2 x G TREATED SU M r W.W /PTTCtl TO p G 1/4' /BCRGLASS NSLL. TYP. OVERHEAD DOORS) I - � IN BASEMENT CEILING 4 I FULL BASEMENT CONCRETE WALL u - - 3 1/2' GONG.-FUED STEEL w - - Lt_J I - LAITY COL" - ... 4. .4'- CONIC. SLAB _ - Bm BM. Ll a� 0 Q Y PKT. PKT. i Q - IG• r B' GOHT. CONC. FOOTING - ' STAR p -L_ J _ .^ FAD I Q Q Q DROr WALL FORD t s - 30' x 30' x 10' • V/ 1'--1 l `` s� r-0 3 c -_- __ CONCRETE COL. PAD ------ ------ < O 14'-0• 4--O' S-0' 2'-0• 9'-O• 7'-B• (2' CONCR T AFRON)- I _ 0+ .. _ �OUND 8''C ONGRENCPETICC - • 9'-G' - - >_ w FROST WALL ON IG• x B• 23'-0* GROSS SECTION - F-- CONT.CONC. FOOTING - - " - SCALE, 1/4• - V-O• OLWj) FOUNDATION PLAN z m z E O Z Q . 00 � / (/l - SHEET NUMBER, I FILE NAME- y - — - 928SA3 T.O.F. AT EL. 65.0' SEPTIC P.;R0F1LE TEST HOLE LOGS : COVER TO WITHIN 6" OF FIN. GRADE (NOT TO SCALE) /-ACCESS ACCESS COVER (WATERTIGHT) To - ENGINEER: RICHARD LEARNED WAKEBY RD. • MINIMUM .75' OF COVER OVER PRECAST WITHIN 6" OF FIN. GRADE WITNESS JERRY DUNNING 2% SLOPE REQUIRED OVER SYSTEM 65.0' 6t26yjEZj RUN PIPE LEVEL 2" DOUBLE WASHED PEASTONE DATE: 4/17/97 FOR FIRST 2 < 2 MIN/INCH 3' MAX. PERC. RATE -1.,81' CLASS SOILS P o62.0 # LOVEIL'S POND AS 61.29 Z AFFLE 61.46' �«� IO CI 71 C7 0 F-1 I1 17-1 C] 2 q SLOPE) 61.17' 0 0 0 M 1-) 0 0 0 O o V AROUND LOCUS ( ) �6" CRUSHED STONE OR MECHANICAL 0 a 0 = O 0 a C7 0 ELEV. ELEV. a $ 4, COMPACTION. (15.221 [2]) 0�8 2' 0 00 0 0 (� 0171 0"0 59.17' IV Q � 2 DEPTH OF FLOW ( 1 % SLOPE) ( 1 % SLOPE) O 66.0 OVA TEE SIZES: „ 3/4 TO 1 1/2 DOUBLE WASHED STONE ' q Q R, INLET DEPTH = 10 LS LOCATION MAP NO SCALE OUTLET DEPTH 14" 5.17' 810 1OYR 4/3 FOUNDATION--- 14' SEPTIC TANK 35' D' BOX 14' LEACHING B FACILITY ASSESSORS MAP 25 PARCEL P/0 11 LS ZONING DISTRICT: RF ,. 10YR 5/6 YARD SETBACKS: NOTE: EXISTING DISTURBED AREAS ON THE WETLAND 38.7 EL. 54.0' 26 66.83 FRONT = 30' SIDE OF THE WORK LIMIT LINE SHALL BE RECLAIMED IN #10 #11 -1 SIDE = 15' NATIVE SHRUBBERY IN CONSULTATION WITH CONSERVATION AGENT 38' REAR = 15' M `` 38.0; 38.5 40<1 ,�, 8.3#12 C PLAN REF. -- 532/63 A e LOVELL'S POND MS FLOOD ZONE: c tio# .5 2.5 Y 6/8 LOT 1 L 38 C3 .2 0.7 38. EDGE OF WETLAND � K \\ \ 39.3 v'9 D #15 8,8 N WA NOTES: LOT 2 0 TER ENCOUNTERED I 56820 SF (TOTAL) --� 39 33 6 _1_ -��--`' - 40- SEPTIC DESIGN: BASED ON BARN. GIS 49096 SF (UPLAND) �8 --- 4j (GARBAGE DISPOSER Is NOT ALLOWED ) 1 . DATUM IS LOTf 2 0 3 .1 ✓' 42 kESIGN FLOW: 3 BEDROOMS ( 110 GPD r 30 GPD ._� -- 2• _M_l1_NICLPAL...WATER IS AVAILABLE ��_ w. _ `42.1 J 39 7 3Z5 �� 44 USE A 330 GPD DESIGN FLOW 3. , MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. UTILITY ��' \ �- -' "� ;------ 45- SE:.PTIC TANK: 330 GPD (?) - 660 4. DESIGN LOADING FOR ALL PRECAST UNITS 70 BE AASHO H- 10 POLE / / 3 I� ---' - -- 4� 5. PIPE JOINTS TO BE MADE WATERTIGHT. USE A 1-00 GALLON SEPTIC TANK ___ __ 48- --- 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS. 1.5 .6 C ) - - 49- LEACHING: ENVIRONMENTAL CODE TITLE V. 1. ---� FILI WITH 3AaD' �� '"" - -- 51- SIDES: 2(25 + 12.83) 2 (.74) - 112 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO BE „BY HAND \ _.S-TA USED FOR LOT LINE STAKING. oa d T- 52 _ - 25 x 12.83 (.74) = 237 srun N- -\✓ FEN E -- BOTTOM: 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4 PVC: 54- TOTAL: 472 S.F. 349 GPD 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED WITHOUT INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED 1` s� s PROP. HEDGEROW g USE (2) 500 GAL. LEACHING CHAMBERS WITH 4. FROM BOARD OF HEALTH, 11 �S 5�� STONE ALL AROUND 5 ^ 58 10, CONTRACTOR SHALL BE RESPONSIBLE FOR VERIFYING THE 62 LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIES PRIOR Iz TO COMMENCEMENT OF WORK. 56.4 PROP. 3 BR ��� LEGEND TITLE 5 SITE PLAN DIRECT LOW 62.9 DWELLING �`•\�'�` _ 100.0 PROPOSED SPOT ELEVATION OF V LOT 2 SANTUIT- NEWTOWN ROAD ►� 11 ' Y FROM 6 10 M1N• FOUNpATION TF = 65.0' � MO _ / GARAGE W l 100x0 EXISTING SPOT ELEVATION IN THE TOWN OF: 11\ RES LOT 3 PROPOSED CONTOUR (C 0 TU I T) B A R N S TA B L E II .ao . � 100 EXISTING CONTOUR PREPARED FOR. BAYBERRY BUILDING CO. C 3.8 CO 30 0 30 60 90 IL / 64.5 BOARD OF HEALTH 65.7 APPROVED ' MA SCALE: 1" = 30' DATE: FEBRUARY 25, 2000 DATE ALL ROOF RUN-OFF TO BE DIRECTED TO REMSED 5/3/00 (CONCOM) / G / DRYWELLS, OR STONE TRENCHES ALONG DRIPLINES off 508-362-4541 r '1 C fox 508 362-8880 Uf 66.0 I �L��01 nr�� t ARNE H. Cis Q down cape en gin e ering, In c. �� ARNE OJALA rl H. $ CIVIL v ►""" / fro OJAL.A 1Vo 30792 CIVIL ENGINEERS Na 26348 ,o EGlSTERE� �4 - BENCHMARK CTR OF CATCH LAND SURVEYORS rn BASIN' EL. = 67.85 (ASSMD BARN. G.I.S.) 939 main st. yarmouth, ma 02675 �` 1 ARNE H.~OJALA, lllE., P.L.S. DATE