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Home My WebLink About0069 STUB TOE ROAD I Application number................................................ Fee ..................................................... .. ................... MAn� A Building Inspectors Initials............ Date Issued........................l.a.l. . .�:t,� Map/Parcel................................................................. TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOW S/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: BOG S'ty1�J Tc}e (Lp api NUMBER STREET j VIL AGE Owner's Name: �AC C C_conn pw t Phone Number (SO Q, 4 0 — (D 5 q Email Address: Cell Phone Number Project cost$ S I O — Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize } yt CLt&r—(\tA to make application for a building permit in accordance with 780 CMR Owner Signature: Date: t TYPE OF WORK Siding Windows (no header change)# ® Insulation/Weatherization Doors (no header change) # Commercial Doors require an inspector's review ED Roof(not applying more than 1 layer of shingles) Construction Debris will be going to - fit r 00 1A$ ft�) fYjQ AA Q_.d& CONTRACTOR'S INFORMATION Contractor's name p dl y/1 EyujM LA [,I,f, Lek V IV— Home Improvement Contractors Registration(if applicable)# i g g 9 O S (attach copy) Construction Supervisor's License# �_SS L— I0 b 1(2 (attach copy) Email of Contractor 5( y& ti10&"eX e _q�w .La Phone number (So l}t{q 04 4 ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC4PPROVAL BEFORE A PERMIT CAN BE ISSUED. t APPLICATION NUMBER'............................................................ *For Tents Only*, 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. Purpose of Event - Check one: this event is a: for profit non-profit event Check one: Food served Yes No T 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-4:30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLETjSTOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowners Name: Telephone Number Cell or Work number I understand,my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT'S SIGNATURE Signature Date All permit applications are subject to a building official's approval prior to issuance. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Modern Energy LLC DBA Jeff Vlk Address: PO Box 88 City/State/Zip: Northborough, MA 01532 Phone #: 508-449-0449 Are you an employer? Check the appropriate box: Type of project(required): 1. ✓ I am a employer with 3 4. 1 am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. New construction 2. I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have g. Demolition workingfor me in an capacity. employees and have workers' y p �' 9. Building addition [No workers' comp. insurance comp. insurance.: , required.] 5. We are a corporation and its 10. Electrical repairs or additions 3. I am a homeowner doing all work officers have exercised their 11. Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12. Roof repairs insurance required.] t c. 152, §1(4), and.we have no employees. [No workers' 13.✓ Other Insulation comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Traveler's Prop. Casualty Group Policy#or Self-ins. Lic.#:7PJUB-iK07706-5-17 Expiration Date: 12/6/2019 Job Site Address: 69 Stub Toe Road City/State/Zip: Cotuit, MA 02635 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the D1A for insurance coverage verification. I do hereby ce under the pains andpenalties ofperjury that the information provided above is true and correct. Si TAA ature: Date:9/25/19 Phone#: 50 449-0449 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#: � l ® A�v CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYI� 02/13/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Laurie Scully Hometown Insurance Center,LLC HONo Egli: (508)347-9394 FAXNe: (508)347-5852 IAIC590 Main Street E-MAIL s: lscully@htownins.com PO BOX 541 - INSURER(S)AFFORDING COVERAGE NAIC N Sturbridge MA 01566 INSURER A: Maxum Indemnity Company INSURED INSURER 8: Commerce Insurance Co. 34754 Modern Energy LLC,DBA:Jeff Vlk INSURER C: Nautilus Insurance Company P O Box 88 INSURER D: Travelers Prop.Casualty Group TPCO01 INSURER E: Northborough MA 01532 INSURER F: COVERAGES CERTIFICATE NUMBER: CL18112902736 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. TR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DID Y MM DD/YYYY LIMITS x COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE �OCCUR PREMISES Ea occurrence $ 100,000 MED EXP(Anyone person) $ 5,000 A BDG3024078 12/06/2018 12/06/2019 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PEA7 LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident ANY AUTO - BODILY INJURY(Per person) $ B OWNED x SCHEDULED LP6939 - 11/09/2018 11/09/2019 BODILY INJURY(Per accident) $ 'AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ x AUTOS ONLY x AUTOS ONLY Per accident PIP-Basic $ 8,000 x UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,000,000 C EXCESS LIAB HCLAIMS-MADE AN045789 12/06/2018 12/06/2019 AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION OTH- AND EMPLOYERS'LIABILITY STATUTE ER YIN x PER 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ D OFFICER/MEMBEREXCLUDED? NIA 7PJUB-1K07706-5-17 12/06/2018 12/06/2019 (Mandatory in NH) - E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Jeffrey Vlk is exempt from Work Comp coverage CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Thielsch Engineering Inc ACCORDANCE WITH THE POLICY PROVISIONS. 195 Frances Ave AUTHORIZED REPRESENTATIVE Cranston RI 02910 ( @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ACo 02/1 CERTIFICATE OF LIABILITY INSURANCE °ATE'M3// 0192019 Il`� THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER - CONTACT Laurie Scully NAME: Hometown Insurance Center,LLC HCNN Eid: (508)347-9394 AX No: (508)347-5852 590 Main Street E-MAIL Iscully@htownins.com ADDRESS: PO Box 541 INSURER(S)AFFORDING COVERAGE NAIC tl Sturbridge MA 01566 INSURERA: Maxum Indemnity Company INSURED INSURER B: Commerce Insurance Co. 34754 Modern Energy LLC,DBA:Jeff Vlk INSURER C: Nautilus Insurance Company P 0 Box 88 INSURER D: Travelers Prop.Casualty Group TPCO01 INSURER E: Northborough MA 01532 INSURER F: COVERAGES CERTIFICATE NUMBER: CL18112902736 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AUULSUBK POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDD MM/DD LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE 7 OCCUR PREMISES Ea occurrence $ 100,000 MED EXP(Any one person) $ 5,000 A BDG 3024078 12/06/2018 12/06/2019 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: - GENERAL AGGREGATE $ 2,000,000 POLICY ❑JECT ❑LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: PRO $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident ANYAUTO BODILY INJURY(Per person) $ B OWNEDX SCHEDULED LP6939 11/09/2018 11/09/2019 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY I� AUTOS ONLY - - Per accident PIP-Basic $ 8,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,000,000 C EXCESS LIMB HCLAIMS-MADE AN045789 12/06/2018 12/06/2019 AGGREGATE $ DED RETENTION$ $ v� WORKERS COMPENSATION - /� STATUTE ORH AND EMPLOYERS'LIABILITY Y/N D ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? NIA 713JUB-11<07706-5-17 12/06/2018 12/06/2019 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below - - E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Jeffrey Vlk is exempt from Work Comp coverage CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Cape Light Compact JPE ACCORDANCE WITH THE POLICY PROVISIONS. 261 Whites Path AUTHORIZED REPRESENTATIVE Unit 4 South Yarmouth MA 02664 @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD i Town of Barnstable • Building Department Services sna�rsrnsi€, �' 'o ��Q Brian Florence,CBO ;., �fb #��` Building Commissioner ' 200 Main Street,Hyannis,MA 02601 www.towmbarnstable.ma.us Office: 508-8624038 . Fax: 508-790-6230 e ! a t Property Owner Must Complete and Sign This Section If Using A Builder I,, Marc F Campbell as Owner of the subject property hereby authorize CAPE SAVE to act on my behalf, in all matters relative to work authorized by this building permit application for: 69 Stub Toe Road Cotuit i - (Address of Job) i Signature of Owner Signature of Applicant I Print Name Print Name to i RISE Engineering RISE 5 Dupont Ave,South Yarmouth,MA 02664 ENGINEERING CONTRACT - WZ 508-568-1926 FAX 508-568-1933 Page 1 PROGRAM THIS CONTRACT IS ENTERED INTO BETWEEN RISE CLC-HES EN GINEERING AND THE CUSTOMER FOR WORK AS DESCRIBED BELOW CUSTOMER - PHONE DATE CLIENT CLIENT# WORK ORDER MARC F CAMPBELL (508)740-6259 01/10/2019 265584 26102 SERVICE STREET BILLING STREET 69 Stub Toe Road 69 Stub Toe Road SERVICE CITY,STATE,ZIP BILLING CRY,STATE,ZIP Cotuit, MA 02635 Cotuit, MA 02635 DESCRIPTION QTY COST INCENTIVE TOTAL STORAGE-BASEMENT Homeowner is responsible for the removal of the stored itemsTttials) blocking the installation of weatherization work in the basement. Removal must occur prior to the scheduled work start. STORAGE-GARAGE Homeowner is responsible for the removal of the stored items blockingthe installation of weatherization work in the garage. 9 9 Removal must occur prior to the scheduled work start. DROPPED CEILING TILES „, Homeowner is responsible for the removal of any ceiling tiles—T' itia�s) blocking access to the basement sills being insulated. ATTIC DAMMING-R-38 FIBERGLASS 310 $762.60 $762.60 Provide labor and materials to install a 12"layer of R-38 unfaced fiberglass batts for damming purposes. ATTIC FLAT-11"OPEN R-40 CELLULOSE 1,000 $1,620.00 $1,620.00 Provide labor and materials to install a 11"layer of R-40 Class I Cellulose to open attic space. PULL DOWN STAIR:THERMADOME BUILT-UP 1 $237.65 $237.65 Provide labor and materials to install an easily moved, insulating cover for the attic access folding stair. A small flat surface of plywood will be created around the opening within the attic. This will allow the cover's integral weather-stripping to restrict air leakage. VENTILATION CHUTES 70 $244.30 $244.30 Provide labor and materials to install ventilation chutes in the rafter bays to maintain air flow. VENT BATH FAN THRU ROOF 4 INCH 2 $237.50 $237.50 Provide labor and materials to install an insulated exhaust hose with roof mounted flapper vent to exhaust existing bathroom fan(s). SOFFIT VENTS 4 X 16 12 $346.92 $346.92 Provide labor and materials to install 4"X 16"rectangular aluminum soffit vents to increase ventilation in attic areas.Specify color:White HOME AIR SEALING 14 $1,120.00 $1,120.00 Provide labor and materials to seal areas of your home against wasteful,excess air leakage. Materials to be used to seal your home can include caulks,foams and other products. Primary areas for sealing include air leakage to attics,basements,attached garages RISE Engineering RISE5 Dupont Ave,South Yarmouth,MA 02664 ENGINEERING CONTRACT - WZ 508-568-1926 FAX 508-568-1933 Page 2 _PRO V RAM THIS CONTRACT IS ENTERED INTO BETWEEN RISE CLC-HES ENGINEERING AND THE CUSTOMER FOR WORK AS DESCRIBED BELOW CUSTOMER - PHONE DATE CLIENT 9 WORK ORDER MARC F CAMPBELL (508)740-6259 01/10/2019 265584 26102 SERVICE STREET BILLING STREET 69 Stub Toe Road 69 Stub Toe Road SERVICE C Y,STATE,ZIP BILLING CRY,STATE,ZIP Cotuit, MA 02635 Cotuit, MA 02635 DESCRIPTION QTY COST INCENTIVE TOTAL and other unheated areas(windows are not generally addressed.) A reduction in cubic feet per minute(cfm)of air infiltration will occur, but the actual number of cfm is not guaranteed. At the completion of the weatherization work,and at no additional cost to the homeowner,a final blower door and/or combustion safety analysis will be conducted by the sub-contractor. WEATHERSTRIP AND ADD DOOR SWEEP 2 $160.00 $160.00 Provide labor and materials to install Q-Ion weatherstripping and a doorsweep to door(s)to restrict air leakage. BASEMENT SILLS R19 FIBERGLASS BATT 145 $317.55 $317.55 Provide labor and materials to install R-19 unfaced fiberglass insulation to the perimeter of the basement ceiling at the house sill. OVERHANG R13 FG AND RIGID BOARD 12 $63.00 $63.00 Provide labor and materials to install 3.5'R-13 kraft faced fiberglass plus rigid board insulation to an exterior overhanging floor. All seams will be sealed. Y RISE Engineering RISE 5 Dupont Ave,South Yarmouth,MA 02664 ENGINEERING CONTRACT - WZ 508-568-1926 FAX 508-568-1933 Page 3 PROGRAM THIS CONTRACT IS ENTERED INTO BETWEEN RISE B ERING AND DBELOW E CUSTOMER FOR WORK AS CLC-HES DESCR CUSTOMER PHONE - DATE CLIENT# WORKORDER MARC F CAMPBELL (508)740-6259 01/10/2019 265584 26102 SERVICE STREET BILLING STREET 69 Stub Toe Road 69 Stub Toe Road SERVICE CITY,STATE,ZIP - BILLING CRY,STATE,ZIP Cotuit, MA 02635 Cotuit, MA 02635 DESCRIPTION QTY COST INCENTIVE TOTAL I-INCENTIVE: 100% RISE Engineering has applied all applicable,eligible incentives and you will be billed only the net amount. Currently,for households where total income is less than or equal to 80%of median income, the Cape Light Compact offers 100%incentive toward eligible insulation measures,with no limit on the amount,and an incentive of 100%for the Air Sealing measures. Total: $5,109.52 Program Incentive: $5,109.52 Customer Total: $0.00 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***00/Dollars $0.00 UPON RECEIPT OF YOUR RISE ENGINEERING INVOICE,CUSTOMER AGREES TO REMIT AMOUNT DUE IN FULL.INTEREST OF 1%WILL BE CHARGED MONTHLY ON ANY UNPAID BALANCE AFTER 30 DAYS.SEE REVERSE FOR IMPORTANT INFORMATION ON GUARANTEES,RIGHTS OF RECISION,SCHEDULING,AND CONTRACTOR REGISTRATION. NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE �'IGR'IlAT�-C 30 DAYS ACCEPTANCE OF CONTRACT-THE ABOVE PRICES,SPECIFICATIONS AND CONDITIONS ARE SATISFACTORY TO US AND ARE HEREBY ACCEPTED.YOU ARE AUTHORIZED TO DO THE WORK AS SPECIFIED.PAYMENT WILL BE MADE AS OUTLINED ABOVE t - _ Cornmonwreatth of Massachusetts division of.Professional Licensure, Board of Ouilding Regulations and Standards Constructi r,Specialty ° CSSL-106112: n,P* Upires:0312012021 JEFFREY Yit » t] ' 40 RRESCOT'!STRi: CUNTON MA 01 4S Commissioner ./" - C;� - ola4 Office of Consumer Affairs and Business Regulation 1000 Washington Street- Suite 710 Boston, Mass%chusetts 02118 Home Improvern"e,000Ntractor Registration Type: LLC MODERN ENERGY LLC " ; Registration: 188905 n Expiration: 09/14/2021 1,2 HYCREST RD CHARLTON,MA 01507 t r a a'� } t Update Address and Return Card. SCA-1 C 2W4WI7 G5/is r�'o�u'�a7eu .lfi�i oQ/��imac%uGslre _ , Of en of Consumer Affairs&Business Regulatlah HOME IMPROVEMENT CONTRACTOR T Registration valid for Individual use only _ - - - - - — ,�s ,E:.LLC_ry, __ .before the expiration date. if found return to: Rag stratia I Office of Consumer Affairs and Buslnese Reguletton- _ -- ° �' t 09/,14/2021 1009 Washington Street-Suite 710 MODERN ENE RQ u=" --- Boston,,M1A..02118 JEFF VLK 12 HYCREST9RD CHARLTON,MA.01.50 Id0 lid,Without signature Undersecretary. �- �oF11HE ram, Town of Barnstable *Peru# % 05I P ® Expires 6 mo dlis from issue date BARNSTABLE, * Regulatory Services Fee �r v MASS. Thomas F.Geiler,Director s639, 4 "A 6,4 Building Division Tom Perry, Building Commissioner . 200 Main Street, 'Hyannis,MA 02601 JU Office: 508-862-4038 / 1 2005 Fax: 508-790-6230 `��OF BAR 0(� EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY NS7ASLiEF g� Not Valid without Red X-Press Imprint Map/parcel Number 04® 1 10 3 Property Address [Residential Value of Work 4 4i w-1 5 O(Limum fee of$25.00 for work under$6000.00 Owner's Name&Address Contractor's Name Telephone Number ` ®` Home Improvement Contractor License#(if applicable) .3;10 Construction,Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Ch one: � I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name { Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request heck box) Re-roof(stripping old shingles) All construction debris will be taken to rI R D 6A ` ' ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maxinium.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property wner must sign Property Owner Letter of Permission. Hom mpr ement Contr ors License is required. Signature Q:Forms:expmtrg Revise063004 The Commonwealth of Massachusetts Department of Industrial Accidents Office of investigations 600 Washington Street, "Floor Boston,Mass. 02111 Workers' Compensation Insurance Affidavit;Buildin lumbin /Electrical Contractors name. v` address: �'O• ✓�y` � I� _ 01 --] ci � s La tate: 1 11-1 zi : agkp hone# I �" work site location full address : ❑ dam a homeowner performing all work myself. Project Type: []New Construction 0—Remodel I am a sole proprietor and have no one working in any capacity. ❑Building Addition.35"g~ .aEiw�� - i7d' �u'.:.''° .r `'' Ss%9L. �7.`�3.:.C�.a"'�!i:'�a�=':� ,}�'.v..:'i:..>r'%.a� ..�'.�.`: .. ❑ 1 am an employer providing workers' compensation for my employees working on this job company name, address: city photie# insurance co. D0lJCJ# ❑ I am a sole proprietor,general contractor,or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: F company name: address: city Phone#: insurance co. volic # company name: address: city phone#: insurante to. . 011 # tee, + sstr — — — Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties.of a fine up to 51,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day against me. l understand that a copy of this statement may be forwarded to the Office of investigations of the D1A for coverage verification. I do h rebp-c'ertrjP�ndee sins and malt es ojperjury that the information provided above is true and correct Signature Date1 Print name ��`1' W Phone# q o— Its ofricial use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Building Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; € ❑Other (rmssd Sept 2003) i F r T ..of_Barnstab e .� Regulatory Services ,s, =Thomas F:.Gefler,-Director �'►�' �' � ��. . . . ion .. . . . .. ib 9• �� 'D1v15 � 1�C11ri �Bu -Tom Perry; Building Commissioner , - 200 Main Street, ]iyannis,.MA 02601 Www.toWn.barnstable;mama Fax: 508-790-6230 Office: 508-862-4038 Property Owner Must Complete and Sign This Section If Using ABuilder . s as Owner of the subject property onze:'. to act on nVbelialf, hereby auth in all matters relative to work authorized by this building permit application for, (Address of Job) k U � Signature of Owner Date r. r Print N=e i V s J ;/fie�ammzaruuea� a�,/�pgapcfitise�b Board of Building Regulations and Standards I. HOME IT-1 OVEMENT CONTRACTOR Re istlug ''-'a o 2007 �z�idual James Curiey James Curley 287 Fuller Rd. Centerville,MA 02632 Administrator 2 &lessor's map and lot number .....f,� ....../ Sewage Permit number ................ ,................ row o� Z BARNSTABLE. i House number 9 Maas ................... G`C ...................... �p 039• 90 i TOWN OF BARN'. TA;.RL-rE,1�, ' U ",gNICE ENVIR1Ie1;wIIAL CCY r;— BUILDING IHSPECTOROKNI PY(-;ULAT"C;,j APPLICATIONFOR PERMIT TO ......... ............................................................................................ r Wood Frame TYPE OF CONSTRUCTION ........ ............................................................ l ..........................19....G.� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location Lot 35 Stub Toe Road, Cotuit, Ma. .............................................................................................................................................................. Residential ProposedUse ............................................................................................................................................................................. Zoning District RC.......................................................Fire District Cotuit Theo Construction Co Inc 24 Great Pond Dr S Yarmouth Ma Name of Owner ...........:Address ' Nameof Builder ..............se...a..m.................................................Address .................................................................................... Nameof Architect .................NZA.........................................Address .................................................................................... Number of Rooms 5...............................................Foundation ,poured concrete .................................................................... Exterior cedar shingle .Roofing .,asphalt shingle ................................................................ .................................................................... FloorsPly^'ood.................................................................Interior ...sheetrock.......................................................... g 1 H4 . as g 1 l -Z bY�s Fieatin g....................................................�............Plumbin /.............at...:.................................................... Fireplace ......one....................................................................Approximate Cost .....2.5.r.0.0: .....,............('.....((................P�.. Definitive Plan Approved by Planning Board -SeP-t,-__21----------19-13-_, Area /.3.4 ......g:�... ...... 0 Diagram of Lot and Building with Dimensions Fee ........ .... .............................. SUBJECT TO APPROVAL OF BOARD OF HEALTH � M \fir f r\d (V- I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. CONST.SUP. LIC. 016681 Name. �''`, .:fir.... ... ................ ATHBO CONSTRUCTION CO. ~ 364683 one � � �� —..----. Permit for ---..�� --.-- ` ' .-.��.�.��..��A!N............... --.- . Location' ..I��..3S.—..83..Stob..9�oa.l�o:d__ ^ ^ ' - . � ----_..====,=---------------- ' . Theo.. Clz � C��o�er -----.��.��!�!�.!--.�-----. ' Type of Construction —. --.------ � ! —.—.—�---------------------- ' 4^ ' ` Plot ...............................� Loi ~^ ................................ [ , ` Permit Granted ......May..22*................... P 84 [5ate of Inspection ..................................... ` . Dote ' � PERMIT REFUSED ' ^ . ^ l� 'r—'------- -'----'' ----'-'' ' ~.—~--.---..—.---------..---.�/...~ L -~~ . ~:_~.-_-.—.----.-----,--------�� ^/ ' . � �.._-----.--.---.—~------.—'.--.._.. ' " —..--..--.----,----~---....~---.. � � � .Approved ________________ 19 � - ---.----_-----__—.---.---.--. � /~^ � ©r�' X"Ax- fL . Assessor's map ard. lot number .....�d.'t.�..,. ........ + / f Ii�TC i �I`/ / d ��\ �.0*TNEr�� Sewage Permit number ................ -. -1 `- .................. d - Z House number ...................'.. BJHB9TLDLE, i ............. G ......................... roo M6& is CEO mxf TOWN OF BARN-STABLE BUILDING INSPEWOR APPLICATION FOR PERMIT TO ........00.WC x kIG.t...................................:........................................................... TYPE OF CONSTRUCTION ................Wood Frame.............................. .. l ..........................19.....a . . TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...Lot 35 Stub Toe Road, .....Cotuit..: a...................................... .............. ................................... t Proposed Use Residential Zoning District ............RC.......................................................Fire District ..........COtul.t.................................................... tf4`. Theo Construction Co Inc 24 Great Pond Dr. S. Yartfiouth Ma. • " Name'of_Owner ........................................................�............Address ..............................................!.................................. Name of Builder same Address N/A Nameof Architect ..................................................................Address .................................................................................... 4 Number of Rooms 5 .........................Foundation „Poured concrete ......................................... .................................................................... Exterior cedar shingle ,.......Roofing „asphalt shingle ......................................................... .................................................................... Floors plywood • ......Interior ...Sheetrock .................................................. ................................................................................ ........................ t ,y Heating U ..... q,a .... Plumbing 1/2 hatEh!e ......... ......... .. ......... .. .................................................. Fireplace ......One..............................................`.....................Approximate Cost .....25,000............z .............................. Definitive Plan Approved by Planning Board _Sept. 21----------1q_73_, Area Diagram of Lot and Building with Dimensions Fee .. ...•................:-z....................... SUBJECT TO APPROVAL OF BOARD OF HEALTH*, 6..1r 4 Nl • I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. 01 CONST.SUF LEC. 016681 r ................ � F y THBD CONSTWCTION CDJ A=40-103 No ...2-64-8- -.*'. Permit for � � . ��----- _. � �� SingleFamilyDwelling----�.�� ..�� ..�� -----.- LocationIo��_35 69Stob �_. .. ..]�oy_.I�xsd__ OotuLt ' -'-'--'---------'-----'-^----- ` Theo {��. Owner ______________________ � , Frame T"oa of Construction ................................ ----.-----.----------------. ^ . Plot ............................. Lot ................................ - - May 22, 84 Permit Granted ........................................ � , Date of Inspection ------------lQ � ' r Date ' Como|a�e6 -l� . �----'----... .� . . . . ^ - . / PERMIT REFUSED � -----_-...-.._---------.. 19 � .......................................... ................ ---.---.--.~~--./.------------ � ' -^-----^^-------^^^-~--'-'--^- � -.---,-----~--~.---------.~..~. � � . Approved ................................................ lg � , � ----.----......-------~.--.-..--- � � '~- ----.-'.----.-.------..-.--..-.. . | | | | ' -� ' TOWN OF BIMNSTABLE Permit No. ----------------------------- Building Inspector VA"3TAX Cash ------------- OCCUPANCY PERMIT Bond -------------------- - Issued to Teo Corigtrwtion Co. Address 10- fir, 60 qf7i11'j Tc,.k-- ?rv-1. Crtiit Wiring Inspector Inspection date Plumbing Inspector 6 e Inspection date Gas Inspector Inspection date Engineering Department Inspection date Board of Health Q"c Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIQNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. 311 ...... .................... 19.......... ..............v............... ................................. Building Inspector • - FROM TOWN OF B Mr. Francis Lahtelne � , ,�. , .,,�.. . �4 BUILDING DEPARTMENT Town Clerk 367 MAIN STREET HYANNIS, MA ''O2W1 Phone. 775A 120 SUBJECT: .. FOLO HERE .y DATE .. - August 3,' 1984 .A SSAGE Work has been ccopleted under Permit #26468 (7heo donstructionACo�} - +R-�♦�'f!.�sys•r ilp-.h"P.fb♦ +R'P`:wYM�vy^R"�4+v.R- �.Y�F f�v-�' 4•a y r Please��!�4-}re sler�se $t?Ild. • - y KMV R'iY fi.+!'a.'.r+s.#.r'�ip"YM�'�.9!N.W ri'+R - +�1Y+R{Y��O to 5$"•�'R'^�tb'a'.Y a; . ♦ _ •. SIGNED DATE - REPLY SIGNED: ,N87•RMI RECIPIENT: RETAIN WHITE-COPY,RETURN PINK COPY • PRINTED IN U.S.A. SENDER: SNAP OUT YELLOW COPY ONLY.SEND WHITE AND PINK COPIES WITH CARBON INTACT. j r l! _� ' y LS !'._._ . 1 �'' :.✓ ✓' Tom; � �:1 u.; s �n All WY0 Z U-Z CL. Z ul IG` c 10uj if < p PI._At,j E(-47)vv ; ��i F© UNDATKoti UOCATION Lnr 35 5Tu i -tw- f�oA o C) ikke -I"OCO GOOS-reUCTio=.) C-<) t..,c. SCALE t"=.30' vNOV g83 . UaINL -R 1 _ L rV`i �` L�'� (\\� �. �/r G �.