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HomeMy WebLinkAbout0019 CONANT LANE �o .. J ., � i t - • ., rt n �. .t ,. ... u .lti ., t11 � � � ..W X ,. - ,. Town of Barnstable R#EcEi -r 200 Main Street, Hyannis MA 02601 508 862-4038 �6 'Application for Building Permit 2- `= Application No: TB-16-3428 Date Recieved: '41/21/2016 Job Location: 19 CONANT LANE,CENTERVILLE' Permit For: Building-Insulation Contractor's Name: Elwell H Perry State Lic. No: CS-1Q4088 Address: Acushnet, MA 02743 Applicant Phone: (508) 992-5770 (Home)Owner's Name: HALFORD,NOREEN E Phone: .(508)428-8212 (Home)Owner's Address: 19 CONANT LANE; CENTERVILLE,MA 02632' -.. Work Description: Install 10"Cellulose to 196'open attic. Install 2" FSK fiberglass board insulation to 412' of common Wall area.. Install 196' of 9"•R-30 fiberglass insulation to exterior_ overhang and install 2" poly iso to bottom of joists. Total Value Of Work To Be Performed:. -$2,720.00 Structure Size: 0.00 0.00 0.00 Width Depth Total Area ` I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568): I understand that pursuant to 31-275 C:G.S.,officers of a corporation and partners in a partnership may electto be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. ' All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: Elwell'Perry 11/21/2016- (508)992-5770 ' Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $2,720.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $85.00 11/21/2016 $85 00" XXXX XXXX XXXX- Credit Card i... .... 4419 ...................................... . . ...... .......... l... Total Permit Fee Paid: $85.00 .Zo `0 Q �{ S �'S 0F1HE Town of Barnstable' *Permit# O Expires 6 n�onthsfrom is ate Regulatory Services Fee y BARNSTAaLE, /J MASS. S �' Thomas F. Geiler,Director OK C6/to �X pIFD MA't A Building Division Tom Perry, CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 ' www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without.Red X-Press Imprint CAS c� t� � Map/parcel Number Property Address P Residential Value of Work sw nirrirrru,ii iee m a--ccnnn nn Owner's Name&Address k)o r PG'N 0a l 1'r F Aj Cl 4 c�( ^0 co KI T or t11 r �i� (!t-(A Contractor's Name FG '��+� cof U I'(0 N) Telephone Number s�Clt?'_9_ .O�i,5 r� Home Improvement Contractor License#(if applicable) �3 Construction Supervisor's License#(if applicable) /0a3 C o _ . ESS❑Workman's Compensation Insurance P Check one: ❑ I am a sole proprietor v ❑ I am the Homeowner P ARNSTABLC I have Worker's Compensation Insurance TOWN O Insurance Company Name (c N i i° sQ Workman's Comp.Policy# (,6 iq ?S(� Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) KRe-roof(stripping old shingles) All construction debris will b�c taken to �19 ❑Re-roof(not stripping. Going over existing layers of roof) Re-side #of doors , ❑ Replacement Windows/doors/sliders:.U-Value '(maximum .44)#of windows *Where required:-Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required SIGNATURE: ` Q:\WPFILES\FORMS\building permit forms EXPRESS.doc Revised 090809 4 The Cornmonwealth'ofArassachusetts <� 1 Department of Industrial Accidents Office ations fl"ce of I .t dOO Washington Street ' ti Boston, MA 02111 fvwiv.mass.gov/dim Workers' Corhpensation,Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lel4ibly Name (Business/0rganization/Individual): &r")V C Ue'- lc ly Address: 7 CM Id S.� City/State/Zip: ( p4s LS Phone Are an employer? Check the appropriate box: Type of project(required): l.icy 1 am a em lo,Dyer with y 4. 0 I am a general contractor and I P y 6. New construction employees (full and/or part-time).* have hired the sub-contractors 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. y• 9. ❑ Building addition [No workers' comp. insurance comp:insurance.$ required.]. . 5..,❑-We area corporation and its 10.❑ Electric al repairs.or addition officers have'exercised their '11.E]Plumbing repairs'or addition 3.El I am a homeowner doing all work myself [No workers' comp. right of exemption per MGL 12:E]Roof repairs insurance required j,i C. 152,§1(4),and,we have no employees'[No workers' 13.❑ Other comp, insurance required]. *Any applicant that checks box 41 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their worker's'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy andjob site information. Insurance Company Name: OD R? t p S44 Policy# or Self-ins.Lic #: (O f Q�� Expiration Date: s' t' 9 ,to Job Site Address. C� Cato INPf LfV City/State/Zip: l.eNTc�wt��io 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 fin of up.to$250.00 a day,against the_violator. Be advised that a copy of this statement nay be forwarded to the Office of Investigations of t DIA for insurance coverage verification. I do'hereby cert under he p ins and penalties of perjury that the information provided above is trite and correct. Signature; , Dater �l / /0 Phone#: soit? 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 S. Plumbing Inspector 6. Other . Contact Person _ Phone#: 'Information and. Instruct tins t Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, l 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, constriction 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, §25C(6)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." s shall Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivision enter into any contract for the performance of public-work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the*'contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s), address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies (LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage, Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line: City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department 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 permitllicense number which will be used as a.reference number. In addition, an applicant that•must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address" the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture. (i,e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's'address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 4-24-07 www.mass.gov/dia a �zHE r Town of Barnstable ' Regulatory Services BARN STABLE, � +. � '' � Thomas F. Geiler,Director ;A� Building Division y: . } Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.towmb arnstable.ma.us Office: 508-862 4038 " Fax: 508-790-6230 ~ Property Owner'Must Complete and Sign This Section . If Using A Builder I, ©✓tam �qYJ , as Owner of the subject property hereby authorize f r�e o to act on my behalf, m all matters relative to work authorized by`this�building permit application for T' (Address of Job)' Signature of'Owner a .. Z�- Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse 'side. k - oF��ram, Town of Barnstable o Regulatory Services " satwsrABLE. t Thomas F. Geiler,Director Y 9� t� Building Division 059• PTFD �a Tom Perry,Building Commissioner i 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Officer 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER work hone 4 name home phone If P CURRENT MAILING ADDRESS: 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. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,oh"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 Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official 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 Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that hdshe understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may caret amend and adopt such a forrn/certification for use in your community. Q:\WPFILF-S\FOR.MS\hometxempLDOC I - las�achuutts- 'eDcpartntent of Public Safct% gourd of Buildin�� ' Re�iidations and Standards Construction Supervisor License License: CS 102260 Restricted to: 00 MICHAEL MEAGHER JR � 97 EMERALD LANE MARSTONS MILLS, MA 02648 Expiration: 11/5/2012 ( uumis.�i„��er Tr#: 102260 Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 162938 Expiration 4'/27/2011 Tr# 283438 TYPe DBA MEAGHER BROTHERS CONSTRUCTION MICHAEL MEAGHER JR:;_:.. 97 EMERALD LN �g,�Q-��d-` MARSTONSMILL,MA OZ648 Administrator i i - License or registration valid for individul use only before the expiration da e. f found return to: ' Board of Building R jations an tandards # One Ashburton Pl 'e Rm 130 Boston,Ma.0 • _g N valid withou s------- ' From:EriCa Barrett FaxID:OLDE CAPE COD INSURA _ Page 2 of 2 Date:6114/2010 10:04 AAA Page:2 HIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND GONFERS NO R1GHT8 UPON THE ERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED Y THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN HE ISSUING INSURERS AUTHORIZED REPRESENTATIVE OR PRODUCER' AND THE CERTIFICATE HOLDER. MPORTANT: If the Certificate holder is an ADDITIONAL INSURED, the polICY089) must be endorsed. If SUBROGATION f S WAIVED, subject to the terms and conditions of the policy,certain policies may require and endorsement A statement n this certificate does not confer rights to the certificate holder in lieu of such endorsement. PRODUCER Old Cape Cod Insurance Agency Inc.. , 296 Winter Street r Hyannis, MA 2601 COMPANIES AFFORDING INSURANCE COMPANY A GRANITE STATE INSURANCE COMPANY INSURED Michael Meagher F 97 Emerald Street MEimtons Mills, MA 02648-0000 t . THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOT WITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTHE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED 15Y PAID CLAIMS. ao LTR TYPE or WaURANL! POLICY NUMOER POLICYEFFEC"A DATE POLICYIWIRAT1ON DAT8 A AN ODEMPLO ERSELIABILITY LINT$ E PROPRETOR! PARTNERSJEXECUTIVE OFFICERS ARE: INCL 0 EXCL 0 6619858 11/09/2009 11/09/2010 ATUTORY LlMrrs OTHER Covarago AppIkw to MA Oparatlm•O*. S 100,00 CH ACCIDENT •' � ISEASE POtICY LIMIT ' � �� iSEASH-EACH EMPLOYEE S 100 00 DESCRIPTION OF OPERATIONSIYEHICLEB/SPECIAL r1rams RE:THE WORKERS COMPENSATION POLICY DOES NOT PROVIDE COVERAGE FOR MICHAEL MEAGHER• CERTIFICATE HOLDER CANCELLATION " TOWN OF BARNSTABLE SHOULD ANY OF THE ABOVE DESCRIBED POLICIESBE CANCELLED BEFORE THE' BLDG DEPT. W IRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE 200 MAIN ST WMTE THE POLICY PROVISIONS. HYANNIS, MA02601 y. AUTHORIZED REPRESENTATIVE A a- RI S E Division of Thielsch Engineering,Inc. 1341 Elmwood Avenue i ENGINEERING Cranston,Rhode Island 02910 May 1, 2013 Thomas Perry, CBO ` Town of Barnstable c� Building Division 200 Main Street Hyannis,MA 02601 � e 6 Re: Insulation permits Dear Mr. Perry, This affidavit is to certify that all insulation work completed for 19 Conant Lane has been inspected by a Building Performance Institute (BPI) certified Professional. All work performed meets or exceeds Federal and State requirement. Sincerely, Erik Nerstheimer Supervisor of Installations, BPI certified Building Analyst Professional and Envelope Professional, RISE Engineering, a division of Thielsch Engineering, Inc. 1341 Elmwood Avenue Cranston, RI 02910 401-784-3700 •800-422-5365 •Fax 401-784-3710 Assessor's. map and lot number ., .........✓............:a) 7NE TO Sewage Permit number .... � �!� BAR33TADLE, i House number MAO& .�!.:.......................................................... . o wava\0� TOWN OF BARNSTABLE BUI`LDIHG IHSPECTOR ' _ a APPLICATION FOR PERMIT TO .. u// j .! ..*.. ................. .....................................:.......:.. TYPE OF CONSTRUCTION .........Lb d.d................................ ..................... .................................................... ................................................fG� 19 � �. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location s /� �4 � �u• �.<�.(�jC.t"�`e+C7.i..(l d.........................:................................................... ±'' ........................................ ............. ProposedUse .... ...!t................ ,. .................................................`........................................................................ ZoningDistrict ............::................`..........................................Fire District ............................................................................... Name of Owner ! ......t.'?.t ' .. ................Address ... !9 .114t ! (;... .. ............. PY ty ' Name of Builder l.- fr 2 3„ 9►"/t�1 1 Address ........ tea' � s-���I�..V/... i ................ \� .......... .. ....... .... r. ........... / Nameof Architect ..................................................................Address .........................................r........................................... Number of Rooms ........................../.......................................Foundation ........t..�4 1(#? C�i� 1.+n , .... .Y ...................................................... t Exierior ......f. !y ..... ...r. .�.! � .s. Roofing ..... �rl er'.- . ......................................................... ... .................... . .:y, ,.. t Floors Y............................Interior .......� .....V .............,........................................... Heating ..................................................................................Plumbing .................................................................................. Fireplace .......................................................Approximate Cost ......... n ........................... ....................................... 4.... Definitive Plan Approved by Planning Board -----------_-------------------19________ . Area .....Z... ........................... Diagram of Lot and Building with Dimensions Fee .............._ -- SUBJECT TO APPROVAL OF BOARD OF HEALTH t t _ . LA I u I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. �� � Name .... .... .. ..... ..... ................................... C z GUE-RTIN-f—A-Mlif K=171-56 No 22.4�: B.... Permit for AD-D...FAMIL.Y...ROOM §iaglP..Famil-v...D.Welling................. Location ..19...Cnas.tan.t..,L-ana.................... .................Q.011ter.Ville................................. Owner ...ATUI...Q.-uertiri............................... Type of Construction Fxame............................ ................................................................................ Plot ............................ Lot ................................ Permit Granted ........§.ep.temb.er....10.jq 80 Date of Inspection ....................................19 Date Completed ......................................19 PERMIT REFUSED ................ ................ ............ ........ . 19 2 ..... ............... ............................... ........... ......7.......................... ............................................................................... ............................................................................... Approved ................................................ 19 ............................................................................... ............................................................................... Assessor's map and lot number ............................... b�QyOf 7H E Sewage Permit number PrIv 5YMM (� � TADLE, i q ST House number ...4aJ ALLEY �JV y ............................. IVE WITH T CoTO 5 : v.a�e� �. TOWN 'OF B A R N.S T ' �L coy ��o BUILDING INSPECTOR a _. APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION ... C6®Q`�...... 1e'4- .:.......................................................... .......... ........... .............19 . TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for-a permit according to the follo wing information: Location ......./.(?..:.. ..... ..! '............�d i�.... '' d:.:.......................................................................... Proposed Use .... ! .! . ....... .� s......................... ....................... ZoningDistrict ........................................................................Fire District ......... ............................ Name of Owner !'A.. . . .....f. .. .r!.. �...............Address ......... 0'�ameof Builder ... ......Address �.,.,,, 4Z�O Name of Architect ..................................................................Address _ .............................................................................:...... Number of Rooms ........................�.......................................Foundation ... ........4�.�i.......................�. . Exleriord..... ... . �r ........::...................Roofing ....................... ............................... �qq .Interior ;....... � Floors ... .................................................................. Heating ..................................................................................Plumbing ...........:................................................................. ca . .... Fireplace ..:.................................:............................:..............:.Approximate Cost .......X80.0.. ....... ............................... Definitive Plan Approved by Planning Board __ ------- - 19 ---. Area Diagram of Lot and Building with Dimensions Fee r ``............�.�.......... SUBJECT TO APPROVAL OF BOARD OF HEALTH 0 6 db a LA 1 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .. f� .................................... GUERTIN,- AMIL ' . 3 No .22 .$... Permit for .AD.D...FAM1,Ly.. GOM .......SiA37.a.. �l�r. welling.... ......... Q rl R. Location 1LA--m. ! ?.t;...Laarle...... ........... f ++ .A it G.l�a7�'.�.a,Yl. . ...Owner .... ... ... ............... y = -•- � of Type of Construction ....Fxame ... . .-- .., Plot ....... ................... Lot ..................`.............. -`'• 'h' -- t�"'� �1 � ., - -- ___ { i - r September TO 80 Permit Granted ................ .. .�...19 - -� Date of Inspection .. .. .....:...19 -� ra •- i Date"Completed .............. Q .: :19 PERMIT REFUSED %"- '� �3 ✓ ,, .� - ,�. ...........i. ........... .................................... 19 .......... ..k............................................................. A r '` ........*1*.S.:.1. `.................................................. ............... ..�.'� .... .......................................... Approved` . . ............................... 19 4 - ......................... .................................... ; ...................... ......................................................... . - Assessor's map and lot number .. . ;"� y�F THE Sewage Permit number ..........................:............................. Ii STAB House number ^+ --� ro mm&'- .......:................................................................ po�i63q. 9� 'Fa MAY a` TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .... .!?f 1k Neal v Tr.��st. ... ................................................................... TYPE OF CONSTRUCTION ......: :.nl,e f ami lv rps�c7pnt a t ,...... ............................................. Ju1v 17 1 �..:....... ........................19.� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .':°t...:...3.:�....Conant Lane Centerville.,...rA........0263.2............ .....:... Proposed Use ....s... ..... ... ..........a.. inctle Family..:residential................................................................................................:..... .. .......................... J Zoning District ... .....................................................................Fire District .....Centerville Csterville Name of Owner ...Emil Guertin Address 325 Wheeler ::oad, Marston I-Ali.; Name of Builder ,Suffolk Realty Trust Address P..�. BOx .. 0s Centerville .. .......... ................... ........................................................... t _ Nameof Architect ..................................................................Address .................................................................................... Number of Rooms eight .............Foundation ........poured concrete ..................................................... ...................... Exterior cedar shingles ,,,,,,Roofing ........asphalt shingles .............................................................................. ...................................................................... Floors ca.rpet. . skim coat plaster ..... . .. .....................................................................Interior .................................................................................... Heating .:'.... .'�'`.....:....4: ►.....?.!..............................1 Plumbing ......... . V,.C............................................................ Fireplace br ic;, ana block................. Approximate Cost $35,000 00 ............................................. ...........:........................................................ Definitive Plan Approved by Planning Board ---------------____-----------19_______. Area .:... � .. ................ Diagram of Lot and Building with Dimensions Fee .......:f...:`4P............. .................. SUBJECT TO APPROVAL OF BOARD OF HEALTHG, • „3 ¢ f Suffolk Realty Trust P.O. Box 308 Centervi;le 6 X`ID ! 2 z-fi 2 �- i I , a, fI t jClr I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .. .... ."..:`::. . : .........: ..:.tt.�.�.. ............... Emil Guertin No2O453-- Permit for .......I.waIlixun........... ' --------------------------. ' Location ..Lct..36`'—''Cwnaut-'La...................... ' ...................Cantmrm-i11. *-----------'' owner Emil �nar.tin ' Type of Construction � � . - -_` Permit Granted . Dote of Inspection ` � Date Completed � P RMIT REFUSED . __.. —. lV ' --'' '' -------'' ---.---... .—~—... ......................................... - —^-----'---^~^— ^^'--^''----^—' ------^^------^'r''^'—~--^---^—' � � p � Approved---------------- 19 -------.—.------~.^--~..—.---.. ' ~ -------`---^---------^--~—^' . . ��� � TOWN OF BARNSTABL ?04 • Permit No. -----=---- -------/I-/3-78 »n,� Building Inspector 7 "YL Cash OCCUPANCY PERMIT Bond "No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Emil Guertin Address 325 Wheeler Road, Marstons Mill lot #36 19 Conant Lane, Centerville Wiring Inspector Inspection Plumbing Inspector/( L Inspection date r V Gas Inspector X--- Inspection date r AA,, ,,t�Engineering Department ,� +l��A Inspection date/j Q THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR` UPO.N SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. -� ... ................. 19� . /�C�G'/ ��.%a��� .......... �... Building Inspector / I r� Assessor's map and lot numb �. � Qi(✓ �C '. . -3-7� THE T0� Q Sewage Permit number .......? ..l���f'J�.:............................. SEPTIC SYSTEM PJIUS y y'► # INSTALLED IN COMPIL 9TADLE, House number .'' .... 9....................................:........ WITH ARTICLE II STA 9a rues t639. 9� T �Y CODE AND TOWN. 9F ,,,,,,,BARNSTABLE. • - ""', to, BUILDING. INSPECTOR 7y t APPLICATION FOR PERMIT TO ..:. uffol,k„Re lty„Trutt,,,,,,,,,,,,,,,,,,,,,,,,,,,,;I ...... ....................... TYPE OF CONSTRUCTION ....... .................l............ July..�2?....1...................19.78.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .Lot # 36 Conant Lane Centerville, MA 02632 .. .... ...... ... ....... .... .......... Proposed Use ....single family.. .. ...............residential ... .................................................................................................:.... ..... ..................... ......... Zoning District .....S.F.R.......................................................Fire District Centerville — Osterville Name of Owner .,,Emil Guertin ....Address ., 325 Wheeler Road, Marston Mills Name of Builder ,Suffolk Realty Trust Address P.!.O. Box 308 Centerville ................................ .............................................................. Nameof Architect ..................................................................Address .......................:............................................................ Number of Rooms eight poured concrete ..........................................................Foundation ........ ?................................................................... Exierior c.edar shingles ••,,.Roofing ........asphalt shingles................................. .. .... .......... Floorscarpet ..........................................................Interior ......skim coat............................ ...... ................................. Heating ..forced:hot water , 1.......... Plumbing ......... ................... .:. ........................ Fireplace ....bri. ... ... ck and blo. ck.....................................Approximate Cost ......... .5.,.000.,00................................. .. ..... ....... ..... ........ Definitive Plan Approved by Planning Board ________________________________19________. Area .....�.b.. D,.. ................... Diagram of Lot and Building with Dimensions Fee ........ .. SUBJECT TO APPROVAL OF BOARD OF HEALTH �� •3,3 19 1 ` Suffolk Realty Trust P.O. Box 308 Centervi �6 40 .2-Z/'2- St. 0_04//V I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ... s .. ............................................... Emil Guertin l %No&453........ Permit for ...I...Dwell2T a } ................. ...................................... Co Location* ..........Lot 36...................... nt..Latzs......,..... ......Centervil.p.............................. Owner .. Emil Guertin..... Type of Construction ....... rame................ $ ...'...................... ................................... ......... , Plot .. 1.72.....56 ..: Lot ........................... Permit Granted August`.....3..................19 78 Date of Inspection ,. Date -Completed ..... 19 , PERMIT REFUSED , ............................................................ 19, _ Y :........ .r ...................................................... ......... . ... .. ....... .. .............. .. .... ... ,,. ,. -Approved ........................ . . ter.19 ( r # x ..} ...... ...............................i.... ............ ..... ......... f 1, i TOWN OF BARNSTABLE'BUILDING PERMIT APPLICATION Map 0 r13 Parcel' 0,546 Application Health Division Date Issued oZI I Conservation Division Application Fee Planning Dept. Permit Fee 4� Date Definitive Plan.Approved by Planning Board ok 2J141 Historic = OKH _ Preservation/Hyannis Project Street Address '/ q C on�Yl�— Lan L Village Owner N aa Yl 44i rpy-d Address S r�m C Telephone Ll Z 71 — Z 1 7� Permit Request r r S uAb_Y)G 5(,(,LC" DU I-f_Ld �( ' (� —2'� W2 el l y� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 353 a- Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ;❑ Two Family ❑ Multi-Family (# units) ram, 4+ Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway:.,,0 Yes, ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing U new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing 0 new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name RISE Engineering Telephone Number 401-784-3700 Address 1341 Elmwood Avenue License # 100459 Cranston, RI 02910 Home Improvement Contractor# 120979 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE Erik Nerstheimer for RISE Engineering 7 S FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED i MAP]PARCEL NO. ADDRESS VILLAGE OWNER i DATE OF INSPECTION: t FOUNDATION j FRAME INSULATION:: FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH Y<�_�` '� FINAL 'iFINAL BU'ILD.ING, iR,l - tF .T . . F t a .DATE CLOSED OUT ASSOCIATION PLAN NO. I . 14 RISE ENGINEERING !Federal ID#05-0405629 RI Contractor Registration No 8186 A division of Thielseh Engineering MA Contractor Registration No 120979 CT Contractor Registration No 620120 1341 Elmwood Avenue,Cranston,R102910 gy�pp°�++ ®®�/� (401)784-3700 FAX(401)784-3710 O ®NTf[l1�� � Page ' 1 R I S THIS CONTRACT IS ENTERED INTO BETWEEN RISE ENGINEERING AND THE CUSTOMER FOR WORK AS ENGINEERING - DESCRIBED BELOW CUSTOMER PHONE { DATE - Client# Noreen Halford (508)428-8212 08/2010 11346 SERVICE STREET BILLING STREET 19 Conant Lane 19 Conant Ln D SERVICE CITY,STATE,LP - _ BILLING CITY,STATE,ZIP i Centerville,MA 02632 Centerville,'MA 02632 �'0V 1 2. 2010 ., JOB DESCRIPTION RISE Engineering will provide labor and materials to seal areas of your home against wasteful,excess air leakage. This work will be performed in concert with the use of special tools and diagnostic tests to assure that your home will be left with a healthful level of air exchange and indoor air quality.Materials to be used to seal your home can include caulks,foams,weatherstripping and other products. Primary areas for sealing include air leakage to attics,basements and other unheated areas(windows are not generally addressed.) $792.00_ RISE Engineering will provide labor and materials to install a-7"layer of R-23 Class 1 Cellulose added to 108 square feet of floored attic kneewall band joist space. , $118.80 RISE Engineering will provide labor and materials to install a 9"layer of R-30 Class 1'Cellulose added.to 182 square feet of open attic space in the kitchen area: $200.20, RISE Engineering will provide labor and materials to install a I V layer of R-38 Class I Cellulose added to 680 square feet of open attic space - in the dormer . Z . . ;$816.00 RISE Engineering will provide labor and materials to install FSK foil faced rigid insulation board across the face of the rafters,behind the knewall. Seams will be sealed with FSK foil tape. 411 square feet of area. $1,109.70 RISE Engineering will provide labor and materials to insulate the back of 1 existing kneewall access hatch(in the kitchen attic)with 2.5"rigid fiberglass board insulation,and seal the edge of the hatch with weatherstripping. r $85.00 RISE Engineering will provide labor and materials to install a new,finished plywood,attic space access hatch.The hatch will be insulated, weatherstripped and held closed by eye hooks. (Wood surfaces will be unfinished. Prime coat and/or paint is not included.) . �$100-00 RISE Engineering will provide labor and materials to install 8/4"X 16"rectangular aluminum soffit vents to increase ventilation in attic areas. $136.00, RISE Engineering will provide labor and materials to install 158 square feet of R-19 unfaced fiberglass insulation to the perimeter of the 1: a P1 Lf f RISE ENGINEERING Federal ID#05-0406629 RI Contractor Registration No 8186 A division of Thielsch Engineering MA Contractor Registration No 120979 CT Contractor Registration No 620120 ` �. 1341 Elmwood Avenue,Cranston,R10291.0 = , (401)784-3700 FAX(401)784-3710 Page 2 CON 1 RMC 1 g i - THIS CONTRACT IS ENTERED INTO BETWEEN RISE ENGINEERING AND THE CUSTOMER FOR WORK AS ENG1NEERiNG DESCRIBED BELOW CUSTOMER - PHONE DATE Client# Noreen Halford (508)428-8212 11/08/2010 113466 SERVICE STREET •-,BILLING STREET - j� 19 Conant Lane 19 Conant Ln `� 0 V L� F ' D Centerville,MA 02632 Centerville,MA 02632 NOVSERVICE CITY,STATE,ZIP 4 .BILLING CITY,STATE,ZIP- r i 1 2 2010 JOB DESCRIPTION basement ceiling at the house sill. $173.80 RISE Engineering will apply all applicable,eligible incentives to this contract. 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 measures(not to exceed$2,000 total incentive.). -$2,000.00` RISE Engineering will apply all applicable,eligible incentives to this contract. You will be billed only the Net amount. Currently,for air sealing measures,the Cape Light Compact offers a 1.00%incentive,outside of the$2,000 per calander year limit. -$792.00 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***Seven Hundred Thirty-Nine&50/1.00 Dollars $739.50 UPON FINAL INSPECTION AND APPROVAL BY RISE ENGINEERING.CUSTOMER AGREES TO REMIT AMOUNT DUE IN FULL.INTEREST OF 1%WILL BE CHARGED MONTHLY ON ANY UNPAID BALANCE AFTER 30 DAYS.BEE REVERSE FOR IMPORTANT INFORMATION ON GUARANTEES,RIGHTS OF RECISION,SCHEDULING,AND CONTRACTOR REGISTRATION. - DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES . AUTHORIZED S RE-RISE ENGINEERING - CUSTOMER ACCEPTANCE - - NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE 3 ACCEPTANCE OF CONTRACT-THE ABOVE PRICES,SPECIFICATIONS AND CONDITIONS ARE SATISFACTORY TO US AND ARE HEREBY ACCEPTED..YOU ARE AUTHORIZED TO DO THE WORK DAYS. - - AS SPECIFIED.PAYMENT WILL BE MADE AS OUTLINED ABOVE . 'W The Commonwealth of Massachusetts Department of Industrial.A,ccidents Office of Investigations ` 600 Washington Street Boston, Mass. 02111 www.mass.gov/ditz Workers' Compensation Insurance Affidavit: Builders/Contract®rs/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): RISE Engineering a division of Thielsch Engineering Address: 1341 Elmwood Avenue City/State/Zip: Cranston, RI '}02910 Phone#: (401)784-3700 'or 1-800-422-5365 Are you an employer?Check the appropriate box: Type of project(required): 1. N I am an employer with 4. 0 I am a general contractor and I 6. 0 New construction employees(full and/or part time).* have hired the sub-contractors 7. 0 Remodeling, 2. 0 I am a sole proprietor or partner- listed on the attached sheet: ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers'comp.insurance; comp.insurance.$ ' required] 5.0 We are a corporation and its 10. 0 Electrical repairs or additions 3. 0 I am a homeowner doing all work officers have exercised_their 11. 0 Plumbing repairs or additions myself [No workers' comp. right of exemption perm MGL insurance required] t c. 152, §.1(4)'-and we have no 12. 0 Roof repairs employees. [no workers' 13. N Other Insulate comp.insurance required.] -*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. tHomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contactors that check this box must attach 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: The Preston Agency Policy#or Self-ins.Lic.#: �37330099/61-001 Expiration Date: 1/1/12 Job Site Address: L G W 1 l.l�l,r I1� L_l�J I a City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration(date). Failure to secure coverage as required under Section 25a of MGL'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 $250.00 a.day against violator.Be advised that a copy of this statement maybe forwarded to the Office'of Investigations of the DIA for coverage verification. I do herby certi and Me ins enalties ofperjury that the information provided above is true and.correct. Si nature: '` Date: Print Name Erik Nerstheimer Phone#:(401)784-3700 or 1-800-422-5365 ext131 Official use only Do not write in this area to be completed by city or town official L6. or Town: Permit/license#: ng Authority(circle one): ard of Heath 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector her act person: Phone#:. �!1 OP ID: 31 A�oRo� CERTIFICATE-OF'LIABILITY INSURANCE UATE, 12/30/YYYY) /30/10 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. F, . 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 endorsements. PRODUCER 401-886-8000 CONTACT - NAME: The Preston Agency,Inc. 401-886-1700 PHONE FAX 1360 Division Rd Suite 303 A/C No. xt AC No): E-MAIL PO BOX 810 - ADDRESS: ' P East Greenwich,RI 02818-0810 cRo°ucER THIEL-1 LIST ER iD#: INSURER(S)AFFORDING COVERAGE NAIC# INSURED Thielsch Engineering,Inc INSURER A:Zurich-American Ins Co. Thielsch Group Inc. INSURER B:American Guarantee&Liability Hi Tech Realty Inc. 195 Frances Avenue INSURER C:North American Capacity Cranston,RI 02910 INSURERD:Hartford Insurance Company + INSURER E: INSURER F: - .COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR - 'POLICY EFF .POLICY EXP - LTR TYPE OF INSURANCE -POLICY NUMBER MMIDD/YYYY MM/DD/YYYY '^ LIMITSx GENERAL LIABILITY - EACH OCCURRENCE $ 1,000,000DAMAGE TO RENTEry— - A X COMMERCIAL GENERAL LIABILITY.. 3730962-01 01/01/11 01/01/12 PREMISES Ea occurrence $ 300,00 CLAIMS-MADE OCCUR MED EXP(Any one person) $ 10,00 PERSONAL&ADV INJURY $ 1,000,00 - GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: } PRODUCTS-COMP/OP AGG $ 2,000,00 POLICY X PRO- JECTLOC jEmp Ben. $ 1,000,00 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT A X ANY AUTO 3730963-01 01/01/11 01/01/12 (Ea accident) $ 2,000,00 ALL OWNED AUTOS BODILY INJURY(Per person) $ SCHEDULED AUTOS BODILY INJURY(Per acddent) $ - ` ' PROPERTY DAMAGE $ HIRED AUTOS (Per accident) NON-OWNED AUTOS $ $ UMBRELLA LIAB X OCCUR - EACH OCCURRENCE $ 10,000,000 EXCESS LIAR CLAIMS-MADE AGGREGATE $ 10,000,00 8... AUC-4857188-00 01/01/11 01/01/12 HDEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N - ' X T Y A R A ANY PROPRIETORIPARTNER/EXECUTIVE 3730961-01 01/01/11 01/01/12 E.L.EACH ACCIDENT $ 1,000,00 OFFICERIMEMBER EXCLUDED? NIA (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 1,000,00 If yes,describe under • _ DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,00 C Professional Liab DVL000026800 04/01/10 04/01/11 Prof crab 2,000,000 D Leased/Rented Eqp �02UUNTD5678 01/01/11 01/01/12 Equipment 100,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION TOWN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE< THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Y - AUTHORIZED REPRESENTATIVE w44,t ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD NOTEPAD THIEL.-1 PAGE 2 INSURED'S NAME Thielsch Engineering,Inc OP ID:31 DATE 12/30/10 RIK gr,. nggineerinfq,a division of Thielsch En ineerin9,`Inc. �a kell Associa es ad' f Thiel h en ineen 9,.Inc. A Laboratory,alvlslon o � lelschn Inperin ,Ir�c. qE� LL orato ,a rvi iqn o igg sch n meenn�'Inc. W O ngmeermq division offff T�iglsch 1 ineei`im Inc. ater a ageme ervices,a division of TTTThhhhieisch Engineering,Inc. 91te MeP W ice o resumer A(an usmesa s on O o _ g 10 Park Plaza- Suite 5170 ,M Boston, ssachusetts 02116 Home Improve ontractor Registration Registration: 120979 Type: Supplement Card z f w Expiration: 3/25/2012 THIELSCH ENGINEERING ERIK NERSTHEIMER fi > 134'1 ELMWOOD AVE. a CRANSTON, RI 02910 Q Update Address and return card.Mark reason for change. Address Renewal Employment Lost Card DPS-CA1 Q 5OM-04/04-G101216 p� ✓fie TDammwoziueallf /�aaeacfzuaelt6 L\ "Office of Consumer.Affairs&Bu iness Regulation License or registration valid for individul use.only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation Registration 979 Type, 10 Park Plaza-Suite 5170 Expira 12 Supplement Card Boston,MA 02116 THIELSCH ENC&Cus ERIK NERSTH a 1341 ELMWOOD %l CRANSTON, RI 02911 i —r Undersecretary Not valid without signature Licensee Details Page 1 of 1 The Official Website of the Executive Office of Public Safety and Security(EOPS) Mass.Gov Home Public Safety Department of Public Safety Licensee Complaints License Type Construction Supervisor License# 100459 R Restriction WS,IC Name Erik Nerstheimer City,State,Zip North Scituate,RI,02857 Expiration Date 3/28/2012 ; Status Current No complaints found for this Licensee. Back To Search http://db.state.ma.us/dps/licdetails.asp?txtSearchLN=CSLI00459 1/7/2011 r zt NAT-2453171 Control No: 134244 THE COMMONWEALTH OF MASSACHUSETTS DEPARTMENT OF LABOR 8 DIVISION OF OCCUPATIONAL SAFETY 19 STANIFORD STREET,BOSTON,MASSACHUSETTS 02114 LEAD-SAFE RENOVATION CONTRACTOR LICENSING WAIVER RISE Engineering A Division of Thielsch Engineering;Inc. 1341 Elmwood Av enue Cranston, R102910 WAIVER: LW000672 EXPIRES: _April 15,2015, IN ACCORDANCE WITH M.G.L. C.-I §_197(B)(b)AND 454 CMR 2103(3)(b), THIS LEAD-SAFE RENOVATION CONTRACTOR LICENSING WAIVER IS ISSUED BY THE DIV._..OF OCCUPATIONAL SAFETY TO THE CONTRACTOR ABOVE FOR,THE PURPOSE OF PERFORMING LEAD-SAFE RENOVATION WORK: THIS LEAD-SAFE RENOVATION CONTRACTOR LICENSING-WAIVER MUST BE MAINTAINED BY THE CONTRACTOR IN ACCORDANCE WITH M.G.L. C. 111, § 197B(b)AND 454 CMR 22.04'WHEN PERFORMING LEAD-SAFE RENOVATION WORK. HEATHER E. ROWE,ACTING COMMISSIONER L, Printed on Recycled Paper - -