HomeMy WebLinkAbout0096 GLENEAGLE DRIVE � ��c��
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COD 5111 Ili
Cape Save Inc.
7-D Huntington Avenue
South Yarmouth, MA 02664
Tel: 508-398-0398 Fax: 508-398-0399
4/15/15
Town of Barnstable
Thomas Perry CBO
Building Commissioner '
200 Main St. Hyannis,MA 02601
RE: Building Permit#201501438
TO: Building Inspector(s),
This affidavit is to certify that all work completed for 96 Gleneagle Drive,Centerville has been
inspected by a third party Certified Building Performance Institute(BPI)Inspector.
-A
All work performed meets or exceeds Federal and State Requirements. '
Sincerely,
5�1-
William McCluskey
R TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map Parcel Application # c l 6 I T
Health Division Date Issued 3131 1
Conservation Division Application Fee 2�
Planning Dept. Permit Fee 1U -OL
Date Definitive Plan Approved by Planning Board
Historic - OKH _ Preservation / Hyannis
Project Street Address 9 6 ('le 1)P a.5 lE 1b(11'v
Village (_',.n+tC V(I P, .
Owner -V h 0 rn 0 s e n W Address ash�.
Telephone _ 508 g-I
II f
Permit Request (���1 R 3 ��be f ass and Cl 1 a (Os 0 I-kc' eff i'0
Al� R- 19 �`�bers �a�_`f� +�►e 0X s1,11.
r SP-kl '� �� w l�[ � � �E aid �aSerNroq�- (lJl JG/ c11�i�� 7=►qrr►.
Square feet: 1 st floor: existing proposed 2nd floor: existing prop-dosed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation 'A 01o� Construction Type
Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units)
Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No
Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other
Basement Finished Area .ft.
(sq ) 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
Y
Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: Li
�Yes ❑ No
Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn':C7aexisting -❑ nevv size_
(",:1s- to
Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Others=' .,a
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 MtCIv,56Va$ --In c. Telephone Number 5 D 8 952 n 3 9 g
Address Z- NAV(Ac4in Ahre License# !I: C L f7a 74-b
5a vA 1 tirm.oyA. M& 0 9A 4 Home Improvement Contractor#
Email Worker's Compensation # UJ W 30 L 3
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO_ K#t_ e�,4
SIGNATURE DATE �3
FOR OFFICIAL USE ONLY
G APPLICATION#
DATE ISSUED
MAP/PARCEL NO.
ADDRESS VILLAGE
OWNER
DATE OF INSPECTION:
FOUNDATION
FRAME
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
FINAL BUILDING
DATE CLOSED OUT
ASSOCIATION PLAN NO.
The Commonwealth.of Massachusetts
+ Pgpartiftloprof Wi4trial'Accidents.
Office'of Investigations
VI—tO-7 [,„ I Congress Street,Suite 100
Boston,MA 02114-201
www.mass.gov/dia
Workers' Compensation Insurancie Affidavit:Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legiblv
Name (Business/organization/Indiv dual)*,. Cape Save Inc.
Address: 70 Huntingtori Ave -
City/State/Zip;_ South Yarmouth. MA 02664 Phone#: 508-398 0398
Are you an employer?Check the appropriate box: Type:of project(required);:.
1. yl am a em to er with 4. ,[] 1 am a general contractor and 1
p Y 6. M New construction:
employees(full and/or part-time): have hired the sub-contractors
2. 1 am li;sole proprietor'or partner= listed on,the attached sheen: 7. []Remodeling
ship and have no employees These ub-contractoshave:. g: [_]Demolition
workin forme in an capacity. employees and have workers'
g Y P y. 9. [Q Building addition
[No workers' comp,'insurance, comp.insurance 4
5. We are a corporation and its 10.E] Electrical.repairs or:additioris
required.] .
3.(, 1 am a homeowner doing.aIt work. officers have:-exercised their 11. Plumbing repairs or additions.
myself. [No workers' comp;.: right of exemption per MG:L 12.[] Roof repairs
1
insurance required,],t C. 15?1 § (4) o
„and we have n
em ployees. [No workers' 13.C✓ .Other Insulation: _
comp. insurance required.]
*Any applicant that checks box#fl must also,.fill out the section below showing their.vorkers'compensation policy information:,
t Homeowners who submit this eiidavit indicating..th arc doing all Nark and then hire outside contractors mustsubmn•a new affidavit di i such
=Contrtictots that check this box tntist attached an additional sheet sho.vittg.the name ofthe ub contractors anti stateaHlietC;ertir'lot iho`se eiiiittes Have.
employees. lfthe sub-contractors have employees,they muscprovide their workets'.comp:policy number,
1 ant an employer that is providing<workers'colripensatinn insurance for my employees. Below is the policy and jab site
information.
insurance Company Name Wesco Insurance"Company
•
Policy#or Self4ns..'Ltc #; ..WWC3085633 Expiration;Date: 04/09/20:15
. 1
Job Site Address- e t f`_ City/State/Zip: _Cfv l (� e
Attach a copy of the workers'compensation policy declaration page(showing the policy numbe_ and capitation date).
Failure to secure coverage:as required ureter Section?5A:of MGL c. 152 can lead to the.imposition o'f criminal penalties of a
one up to $1,500.0U and/or`one-yeax imprisonment,as c�relt as civil penalties in the,form of 4 S.TO.P WORK ORDER and a=fine;
of up to$250.00 a day against the.violator; Beedvised that a.copy of this staiement maybe forwarded to the Office of
investigations of the DlA for insurance coverage verification:
I do hereby certify under the poirs and enalties o er" that the in`orinption provided above is true-and correct:,
mature: ` Date 3 �. �. ...
Phone
'.Official use only.. Do not write rn this area,to be cornpld by city or town official.
Gity or Town:.. PermitfLicense_#
Issuing Authority(circle one):
1.Board of Health 2. Building Department 3.0tyaown Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact-Persons Phone#:
l
,�CC�RI?® CERTIFICATE OF LIABILITY INSURANCEFi i/10Dl/10/201TFIMMl21)01Y}
4
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 pollcy(les)must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the
cert}ticate,hoider In Ile6 of such endorsements.
PRODUCER NAME!TACT Colleen Crowley
Risk Strategies COIDpIAIIy PHONE (781)986-4400 F Z. (TSl)963-4420
faig.No
15 PAcella Park -Drive ccrowley@risk-strateg es.com.
Suite 240 , INSURERS AFFORDING COvERAGE NAICg
Randolph_ bl& 02368 INSURERA:Selective ins..I or America ,
IWUREo _ .
INSURERS Allmrica LPinail-ial Alliance 10212
Cape Save, Inc INSURERC DPesCo Insurance any.
7 D Huntingto& %ve INSURERD:
INSURER E
South Yarmouth, MA Q2G6,4 INSURERS:
COVERAGES. _ CERTIFICATE NUMBER:CL14111085532 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 VIMICH 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.
IL TYPE OF INSURANCE POLICY EF 'POLICY EXP
T
POLICY NUMBER MI )DQ, LIMITS
GENERAL LIABILITY EACH OCCURRENCE : $ 1,000,000
DAMAGE TO RENTED—
X COMMERCIAL GENERAL LIABILITY PREMISS Me o rre $ 100,000
A CLAIMS-MADE OCCUR S1994480 0/16/2014 0/16/2015 MED EXP Any one person) $ 10,900
PERSONAL&ADV INJURY $ 11000,000
GENERAL AGGREGATE $ 2,000,000
GENI AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP Add $ 2,000,000
POLICY ,X PRO-ECT X: LOC $
COMBINED SINGLE LIM
AUTOMOBILE LIABILITY (Ee accident ' 1 000 000
ANY AUTO BODILY INJURY(Per person) $
ALL OWNED SCHEDULED 6796600 1/6/2014 1/6/2015
AUTOS X AUTOS BODILY INJURY(Per accident) $
NQN-OMX HIRED AUTOS X AUTOS ED N�ecPdent3AGE LJ
X' UMBRELLA LIAR X
OCCUR. EACH OCCURRENCE $'' 1,000,000
A EXCESS LABCLAIMSNIADE AGGREGATE $: 110001000
DED RETENTION tlil. 1994480 0/16/2014 0/16/2015 $
C WORKERS COMPENSATION Officers Included for X VICSTATTS OTH-
AND EMPLOYERS'LIABILITY
ANY PROPRIETORIPARTNERIEXECUTIVE v J N overage. E,L.EACH ACCIDENT $ 500,000
OFFICER/MEMBER EXCLUDED) NIA 3085b33 /9/2014 /9/2015
(Mandatory In NH} E.L.DISEASE;-EA EMPLOYE '$ i-500 000
If yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE`-POLICY LIMIT 1$. 560r,000
DESCRIPTION OF OPERATK)NS I LOCATIONS ivEHICLES(Attach ACORD 101,Additlonal Remarks Schedule,llmore space Is required)
Issued as evidence of insurance. Issued as evidence of insurance.
Th elseh r Engineering, Incc is listed as additional insured as respects General Liability as required by
written contract.
CER71FICATE HOLDER CANCELLA710N.
msong@capeliglitcoMact.org SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Cape Light cnpaCt ACCORDANCE WITH THE POLICY PROVISIONS.
Attn: Margaret Song
PO Box 427/SCH auTHORIztDREPRESENl1AT7VE
3195 'Haiti-Street
Barnstable, HA 02630
'chael Christian/CLC
ACORD 25.(2010/05) O 1988-2010 ACORD CORPORATION. All rights reserved.
INS025(201005):o1 The ACORD name and logo are registered marks of ACORD
I
. ......-- --..... _ ... .. .. .i its w
Housing
Assistance
Corporation
Cape cod
DOME OWNER/RESIDENT WF-ATHERIZA 14 WORK PERMIT&FUEL RELEASE:
PLEASE FILL OUT AND SIGN THIS FORM IF YOU ARE
THE APPLICANT HOME OWNER.
I hereby consent to and agree that weatherization work may be
done by the Weatherizatlon Program of Housing Assistance Corporation(herein after referred•as
°Agencyl on the property looted at:
The weatherization work done will be based on programmatic priorities and availability of funding and it
may include all or some of the following measures:
Weather-stripping &caulking of wrindows and doors, insulation of attics, sidewalls&basements, attic and
other ventilation measures and possibly replacement of badly deteriorated windows. in consideration of
the weatherization work to be'done at my home 1 agree to the following:
1. i give permission to the"Agency"Its agents and employees to travel onto or across said property
with such equipment and materials as may be necessary to perform weatherization work on said
property.
2. The Housing Assistance Corporation reserves the right to Inspect the fuel or utility bill for.the
weatherized unit on an ongoing basis for no more than five(5)years after the weatherization work
is completed.
I have read the provisions . th' , as a 'resly give my consent.
Home Owner: (Signature) �-Zf
Date: _ 3-1I 7L.
Agent: (signature)
Date- . "
HAC approved Weatherization Company: _ i✓ L
Adam T Incorporated All Cape Energy Alternative Weathedzation
Building Performance Contracdzg LLC Cape Cod Insulation a Save
Frontier&ergy Solutions Lohr Hame Improvement Resolution Bnergy
• .rw.1 e•at fir,• �. i.t.+iV 4�-tit<iJ• 7 V�;::i;t:i{r•� _�• a:fCr:':+.'::°•F. � ti•:ti .4' i-.�;i�.rr.'
'. �12'6 (po" y"n'O'nive(X lm �- � lr�fYrC 'LLli1E
Office of Consumer Affairs and Business Regulation
uive 10 Park Plaza - Suite 5170
Boston, Massachusetts 02116
V
Home Improvement Contractor Registration
Registration: 171380
Type: Corporation
Expiration: 3/14/2016 Tr# 249649
CAPE SAVE INC.
WILLIAM McCLUSKEYs ---�
7-D HUNTINGTON AVENUE
SOUTH YARMOUTH, MA 026644 ---- - — --
-, Update Address and return card.Mark reason for change.
SCA 1 0 20M-05/11 [3 Address E] Renewal 0 Employment Lost Card
lj�str�arirrriu iluegl��Of�l'(�kIJ!lPillCJ�(.3 --- .
Office of Consumer Affairs&Business Regulation License or registration valid for individul use only
4 fg;
OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
egistration: -4'11380 Type: Office of Consumer Affairs and Business Regulation
Expiration 3/14/2016. Corporation
10 Park Plaza-Suite 5170
Boston,MA 02116
CAPE SAVE INC. j 5
WILLIAM McCLUSKEY -1-
7-D HUNTINGTON AVENUE
SOUTH YARMOUTH,MA 02664 a
Undersecretary Not vali ithout signature
Massachusetts-Department of Public Safety
Board of Building Regulations and Standards
Construction Supervisor Specialty.
License: CSSL-102776 `
WILLIAM J MC C-LUS M
37 NAUSET ROADk
West Yarmouth MA 02673
�.•�,,, JJiSG '" Expiration
Commissioner 06/28/2015
p� Town of Barnstable *Permit#
Xvin a 6 Months froth Issue da e
:. , FeeRegulatory Services
_
v �Av9' g Thomas F.Geileri Director
Building Division
Tom Perry, Building Commissioner
200 Main Street,.Hyannis,MA 02601
Office: 508-862-4038 X-PRESS,
IT)
Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAJ 'r 2005.
Not Valid without Red X Press Imprint
TOWN OF BARNSTABLE
Mapiparcel Number
Property Address 96
❑Residential Value of Work 6&1:!20 Minimum fee of•$25.00 for work under$6000.00
Owner's Name&Address
+ Telephone Number
Contractor_s_Name 1� - _--------- _—_—•---
Home Improvement Contractor License#(if applicable) :26 36
Construction Supervisor's License#(if applicable)
JgWorkmaes Compensation Insurance
Check one:
❑ I atn a sole proprietor
❑ I am the Homeowner
❑ I have Worker's Compensation Insurance
Insurance Company Name V
Worl man's Crimp.Policy#
Copy of Insurance Compliance Certificate must be on file.
Permit Request(check box)
Re-roof(stripping old shingles) All construction debris will be taken to
❑Re-roof(not stripping. Going over existing layers of roof)
[] Re-side
[] Replacement Windows. U-Value (maximum.44)-
'where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e..Historic,Conservation,etc.'
***Note: P wn t ' Property O er Letter of Permission.
ome Improv to a is required.
Signature
Q:Fo, :expmtrg
Revise063004
I
~. Fraser Construction
R� Roofing & Siding Specialists
TOTAL INVESTMENT:
XT AR 30 - $6,09 .00 I� C7,1
LANDMARK AR 30 - 61195.00 �/
*Free 4 star warranty will be app ie (see broche
Payable immediately upon completion
NO MONEY DOWN-NO Payment at the start or part way thru ®&, M-f
Payments accepted are:
CASH-CHECK-MASTERCARD-VISA-AMERICAN EXPRESS
Possible Extra: After the shingles are removed from the roof, we will lift one
sheet of plywood to make sure that the insulation is not up against the plywood
sheathing, preventing ventilation from the eaves to the ridge. If it is, ventilation
panels will be installed by; removing the plywood sheathing, installing the
panels, turning the plywood over and then re-installing the plywood. If needed,
this would be charged for as an extra at the rate of$4.00 per panel including
Materials & Labor. There are 6 panels.per sheet of plywood.
Possible Extra-Any rotted or otherwise deteriorated trim boards, plywood
sheathing, lead flashing, or other carpentry needing replacement will be done
and charged for as an extra at the rate of$45.00 per hour, plus materials, plus
20%overhead mark-up on total extras.
FRASER CONSTRUCTION Warranties the labor for 10 years
FRASER CONSTRUCTION Warranties the shingles against Blow-Offs for 10 years.
CERTAINTEED Warranties the shingles and labor 100%for the first 5 years,
and then on a pro rated basis for 30 years total if the shingles become defective.
CERTAINTEED Warranties the shingles to be ALGAE resistant for a full 10
years.
Any deviation or alteration from above specification will be executed upon
written orders and will become an extra charge over and above the estimate. All
agreements contingent upon strikes, accidents or delays are beyond our
control. Owner should carry fire, tornado and other necessary insurance upon
the above work. We, if not accepted within thirty days may withdraw this
proposal.
FRASER CONSTRUCTION: Carries Workman's Compensation and Public
Liability Insurance on the abov w rk.
DATE OF ACCEPT
SUBMITTED BY:.
Homeowner struction
Board of Building Regulations.and Standards j
' )r
HOME IM {OVEMENT CONTRACTOR
Re istr8titire�12536
lug 2007 ]
• � r �p
FRASER CONS -
DEAN FRASER
71 TARRAGON CIR
COTUIT,MA 02635 Administrator
Sept. 9, 2000
Town of Barnstable
Building Dept.
Dear Sir: Y
Did the owner of 96 Gleneagle Drive in Centerville get a permit when h e built his-new
room?
_J
Concerned neighbor.
tve,��00�j
33USA ... j
MA
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l9 '1f11:11 still III IIIIIt1IIl Ill Mill I"life 111111i111111114i .14111
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TOWN OF BARNSTABLE BUILDING PERMIT:APPLICATION
Map j Parcel / Permit# Q/7 y
Health Division & <r 46 Ba�oc�f�� Date Issued rO/to'
/Wo
Conservation Division /o6 Acc, Fee '
Tax Collector ��/pg��1a � A� ¢� F'1 L
Treasurer 16 SIoa
Planning Dept.
Date Definitive Plan Approved by Planning Board
Historic-OKH Preservation/Hyannis
Project Street Address 7te &/FW,9 ef/A Afl-'
Village
Owner Address J��z"_ _ft&
Telephone 7 7 /-&1 7 s
Permit Request %�/G�D %-XI�►Ti}✓�' ��C TO �I�Sd�4-/ syy, ,0v.,
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Valuation ® Zoning District Flood Plain Groundwater Overlay
Construction Type
Lot Size 3a� Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family CJ/ .Two Family ❑ Multi-Family(#units)
Age of Existing Structure 30 ks Historic House: 0 Yes o On Old King's Highway: ❑Yes 2116
Basement Type: dFull ❑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 Y new
Total Room Count(not including baths):existing _ new / First Floor Room Count
Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other
Central Air: ❑Yes 21 No Fireplaces: Existing I New Existing wood/coal stove: ❑Yes Wlo
Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size
Attached garage: existing ❑new size Shed:0 existing ❑new size Other:
Zoning Board of Appeals Authorization 0 Appeal# Recorded❑
Commercial ❑Yes @ o If yes, site plan review#
Current Use ,�i/,&A1g4 Proposed Use SW&A/ ,6140-i
BUILDER INFORMATION
Name- Telephone Number
Address License#
Home Improvement Contractor#
Worker's Compensation#
ALL CONSWa
RUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
AOR J S
SIGNATURE DATE
FOR OFFICIAL USE-ONLY
A
PERMIT NO. ( ~
ISSUED ;
MAP/PARCEL°NO.
ADDRESS VILLAGE _
OWNER
DATE OF INSPECTION:
FOUNDATION
r t -
FRAME
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
'E GAS: ROUGH FINAL
FINAL BUILDING Lqo�
t
DATE CLOSED OUT
ASSOCIATION PLAN NO.
t
4
f
• OF THE 1p�
> AB The Town of Barnstable
ST
Regulatory Services
'°rEn►�+° Thomas F. Geiler, Director
Building Division
Ralph Crossen, Building Commissioner
367 Main Street,Hyannis MA 02601
Office: 508-862-4038 Fax 508-790-6230
Permit no.
Date
AFFIDAVIT
HOME IMPROVEMENT CONTRACTOR LAW
SUPPLEMENT TO PERMIT APPLICATION-Y''---M-=--irr='==` - Y
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 . .A
such residence or building be done by registered contractors,with certain exceptions,along with other
requirements. /00w®
Type of Work: ✓ sAr 4,4�gk, x Estimated Cost - - -
Address of Work: ,�,�-1✓-,�,�/..-�:i,'---.._/�-� ��/t�'aC����,d - --.__ - -.
Owner's Name: /- V i ®/A 4 d /y AF cS
Date of Application:
I hereby certify that:
Registration is not required for the following reason(s):
[]Work excluded by law
[]Job Under$.1,000
❑Building not owner-occupied
G210wner 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. .
OR
Date Owner's Name
q a N/uA S
q:forms:Affidav
730CL tA4pudki
• M
.. Pt'esesiptt►e Paeica�a for ana aad Twa-Fami1�Reafdeadat Baitdiap Seated w�tb Fas:d Farb
MAXIMUM Ml1�l 0� i
Qiaug g Wait t7oar .Wall t Slab ��
Amn'm U-vaitt� &vsbml Rry w Rrvataet S.� lGvahw
Pace 5701 to 6500 undm new"Bad Nosasal
Q iZY. 0.40 3E 13 19 10 6
mW
R 12% 0.n 30 19 19 10 6 NAFU I
S 12''A 0 SO 3E 13 19 to . 6 tS AFVE I
T 13% 036 3E u 2S' WA wA N0�
U iS'ii OA6 3E 19 19 10 6 Noeami
- 13 - WA
19WIA !s AFUE
19 10• 6 iS AFUE f
7c 1V/. 0.32 3E 13 25 WA WA Nmami
19 ZS WA wA
Nazi I
_ - -
jX
AA 1E•/. M - i9 19 10 6 90 AFTJE
-----.I. ADDRESS OF PROPERTY:
___2;_SQUARE FOOT-AGE-OF'AL-L_EXTERIOR W
3. SQUARE-FOOTAGE OF ALL GLAZING:
4: %GLAZING AREA(#3 DIVIDED BY#2): 1 A
—==- --5:•SELECT PACKAGE(Q—AA-see ch/abve
NOTE: OTHER MORE INVOLVED MEDETERMINING ENERGREQUIREMENTS
`-AREAVAILABLE. ASKUSFOORMATION.
BUILDING INSPECTOR APPROVAL:
YES: NO:
/ q-fforms-f980303a
780 CMR Appendix 1
Footnotes to Table J5.2.1b:
Glaring area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and
basement windows if located in walls that enclose conditioned space,but excluding opaque doors) to the gross wall
area,expressed as a percentage. Up to 1%of the total glazing area may be excluded from the U-value requirement.
For example,3 ft of decorative gins may be excluded from a building design with 300 fl of glazing area.
2 After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with
the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.53a. U-values are for
whole units:center-of-glass U-values cannot be used
' The ailing R-values do not assume a raised or oversized tress construction. If the insulation achieves the full
insulation thickness over the exterior walls without compression, R-30 insulation may be substituted for R-3 8
insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R-values represent the sum of cavity
insulation plus insulating sheathing (if used). For ventilated ceilings,-insulating sheathing must be placed between
the candiilonea spacc and the"irmull� pu uon GAO the AMC GE
'Wall R-values represent the sum of the wall cavity insulation plus insulating sheathing (if used). Do not include
exterior siding,structural sheathing,and interior drywall.For example,an R-19'requirement could be met EITHER
by R-19 cavity insulation OR R-I3 cavity insulation plus R-6 insulating sheathing Wall requirements aPply to
wood-flame or mass.(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction.
'The floor requirements apply to floors over unconditioned spaces(such as unconditioned ctawlspaces, basements,
or garages).Floors over outside air must meet the ceiling requirement4.-F._...
`The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must
meet the same R-value requirement as above-grade walls. Windows and_sliding glass doors of conditioned
basements must be included with the other.glazing. Basement doors must meet the door U-value requirement
described
cribed in Note b _.. _
< . t ' e R-value-requirements;are for unheated slabs Add an additional R-2 for heated slabs.
• If the building utilizes electric resistance heating-.use-compliance-approach 3,-4,-or:5. If you plan to install mot_
r.. than one piece of heating equipment or more than one piece of cooling equipmenta_the equipment with the lowest
efficiency must meet or exceed the efficiency requ#ed.bythe selected package. _
'For heating Degree Day requirements of the-closest city or town see.Table J5.2.1a
NOTES:
a)Glazing areas and U-values are maximum:acceptable levels. Insulation R values are minimum acceptable levels.
R-value requirements are for.insulation only and.do not include-structural components.
b)Opaque doors in the building envelope-must have.a U-value no gmater than 0.35. Door U-values must be tested
and documented by the manufacw=r in.accordance with the NFRC_iett procedure or taken from the door U-value
in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the
and use the opaque door U-value to determine compliance o
glass area of the door with your windowsf the door.
One door may be excluded from this requirement(Le.,may have-a-U-value greater than 0.35).
c)If a ceiling,wall,floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with
different insulation levels, the component complies if the area-weighted average R-value is greater than or equal to
the R-value requirement for that component. Glazing or door components comply if the area-weighted average U-
value of all windows or doors-is less than or equal to the U-value requirement(035 for doors).
43
ESTIMA TED PROJECT COST WORKSHEET
LIVING SPACE Value
(high end construction) square feet X$115/sq. foot=
(above average construction) square feet X$96/sq. foot=
(average construction) square feet X$57/sq. foot= `�U
GARAGE (UNFINISHED) square feet X.$25/sq. foot
PORCH square feet X$20/sq. foot=
DECK square feet X$15/sq. foot
OTHER square feet X$??/sq. foot=
Total Estimated Project Value
For Office Use Only
-:. _r 1:*!cIas onarV Affordsb/e Housing_, Fee
Residential Commercial"
Property Owner's Name -- - -
Project Location
Project Value Permit Number
"Existing Sq. Ft. "Proposed New Sq. Ft.
Fee $
IAHFORM 1/3/00
The Town of Barnstable
oF1He r -
°`'tio Department of Health Safety and Environmental Services
Building Di
vision
iARNSCABLE, ` 367 Main Street,Hyannis MA 02601
MASS.
1639.
AIFp�,lp
J
Office: 508-862-4038 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
HOMEOWNER LICENSE EXEMPTION
p Please Print
DATE: f
JOB LOCATION:
number,/ street l 'J village
"HOMEOWNER": v 9� yA4 4 S
name home phone# work phone#
CURRENT MAILING ADDRESS: �C� t//�/•� ���� �`�
EhA
city/town state zip code
The current exemption for"homeowners"was extended to include owner-occupied dwellings of
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,on which there is;or is-
intended to be,a one or two-family dwelling,attached or detached°strictures 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-
De edures and requirements and that he/she will comply with said -.
pro es quir ents. W
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 Controf.
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
j unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible.
I 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 he/she understands the responsibilities of a Supervisor. On the last page of this issue is a
form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community.
Q:FORMS:EXEMPTN
=�, � y �y.�. .,•;`7{��'✓"' fly ��i^ 3 .^''�eF"'�
�'�• r �A �_, �'r�.�"` , �- »�,,,.E '�
r•
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�`^+x'�� J ` S _.•yam -i � ~ 1 3,t r.R'r
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L
Y s ,
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iL
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Ir.
�. � ;.y� ''ems I •y' ;. .:. ��
I -
W ,
- /4� Z3 �
z4% Z07-- #�7
,s-385 4p.f-7:.:�-
v
//S:23
I certify that this property is
located in Flood Hazard Zone C (out-
side the 500 year flood) as identified
by the Department of Housing and Urban
Development (HUD) .
Date NoV, Zo 1!'9d CERT I FI ED PLOT PLAN
LOCATION Bi9���LSTfIBI.c:�CE�!r ✓.[GE�'
SCALE DATE Noy. Zo
VPLAN REFERENCE .4O.7!/C
Reg. ,Land Surveyor • •.
I certify to its title insurance company
that there are no visible encroachments I CERTIFY THAT THE �5 'v�. .D ` �^
or easements except as shown and that this SHOWN ON THIS PLAN IS LOCATED ON THE GROUND
plan was prepared under my immediate SETS CKNREOUIREMENTS HEREON AND HOF AT ITHE TOWN of THE
supervision. BANSTf�BGv� WHEN CONSTRUCTED.
DATE
REGISTERED LAND' SURVEY94
Assessor's m "p andrlat number .. J / v `�
t r 7 - �%f= /J�� ��� _ - �� - �i� sN011d1mu wAm �.O%THETp�1
" " / BNV 3000 w.�3r>�NOa
�;..Sew�ge Permit number ........................................................ t u,,�p
5 3"W1 KM Z BaaasTAILE, i
House number ...........`7. ........C. .................................... 3�(!�b'llelWOJ iV10311� VUL_
t639.
39 isnW W31SAS OUd3S
TOWN OF BARNSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO ..ie�' T......e.S� ..�����r'�11..4f/1.�� , .f�1.�.h/ ......................
TYPE OF CONSTRUCTION ......\-.,,A,PA..� ��........................................................................................
r Cfl�i✓ ......' ...............19.7
x'TO THE INSPECTOR OF BUILDINGS
The undersigned hereby applies fora permit according tp the following information:
Location .... .(i—-----------� .................................................
rProposed Use .... l�h .. / /.QIC�'..........................................................................................
ZoningDistrict ........................................................................Fire District ..............................................................................
Name of Owner 1e v�9✓ .. - T.�l7AAeW51........Address 40'. .s„
Name of BuilderT.........Address �9'IN�NP �'111� P /�2s
Name of ArchitectC ......Address l g /.atllw111 ..� .ri,r �r?!JS
Number of Rooms "� Nam'................�...........................................Foundation :.-�...s.�.°�..a�?...�. . .J'.....................
Exterior ... �/P. ... C?fib/ ..........,....Roofing ..../.� .'o tv-.. �f/.i►9,�-Cry.....................
Floors ............. .tl/f!Sl.... '/}.t��J :.. ol �lEt�J..lnterior .....e�`� �� ...........................................
Heating / Q�". � k.'®1.<.<...........Plumbing ......:........................... ................................. .......
Fireplace ..............e -,.v.4: e-V4...........................................Approximate Cost ........ :.:.......�..��.:.���................
Definitive Plan Approved by Planning Board ________________________________19________. Area . .......................
Diagram of Lot and Building with Dimensions Fee { `
SUBJECT TO APPROVAL OF BOARD OF HEALTH
gyp,
�All
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regardi-qg the above
construction.
Name .. ......
_ n
nIT
71456Tidewater Realty°Trust
6...... Permit for .Single•••f=ily••••••
.............dwelling.......:.........................Lot.A47...1v1mems1aa••Z,a,•••hsm#78••
.......................... r;
Owner .......:...TidewaterAW-alty..Truat...... -
r
` Type of Construction .....Wood-Frame...............
r-
Plot ............................ Lot ................................
•
Permit Granted ...............July.....U.......19, 79
Date of Inspection ....................................19
Date Completed
PERMIT REFUSED
............................... 19 r {
0%0.
.e ....................................................
...................................................... '
�wwtyy r
rF �hl� V
...jad
....� ..................................................
Approved
....... o .................................................................... f,'
. ........ .............................................................. {
Assessor's map and lot number ........1... � �...t... ..fr. '.
Sewage Permit number ........................................................
Z BASB9TABLL i
House number NM.......:........:.......................................:..... 9 0
+ �p 1639 00
YPy a\
TOWN OF BARNSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO .. ``t'.' .T . �.. i,r... L*•'- ,f c
..............................................................................:.....................:..
TYPEOF CONSTRUCTION ..... —.... C .Y.�--r......:.........................................................................................................
...... ........ ...............19......
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
,� ��.�4'�i►-ls h`�" ,fir-.��.1,�, -
Location .... ................ ...7 ,..... .. ._. . %.T.....tz-_!4:«....... ..:.'.::: ..:..: G.:..F...:...
ProposedUse ..... ... �.. .. ;r ?, ; ar^t':..........................................................................................
ZoningDistrict .........................................................................Fire District ..............................................................................
Name of Owner .!�!F...: ��.... • . 7-�...................• Address ..........................................
r it .. �
s.
Name of Builderf :.. .. ,. •, a''��ic'°w.......Address � .1..:.r .: �lr .l�. :..1 f
...... ..... .... . .. .
Name of Architect —44,- ,::x-rr /r, *,. .....:.'?.......Address '`. ')�1f /�'�is�i, a,�t r ...
Number of Rooms E . 't' '' •!-� l
..................................................................Foundation ..............................................
` .� ins E..n .. �G-*- �,,
Exterior ..... :....: ::....... :..................Roofing !a :..'.'
�� d�l.c! /�a.2.1 ..7... �/ ......er%t: .....•.r �f /•�/1.`-,.._.
Interior -Floors -.._......:..............:..:..... ......... ........,.:....:...........:........................................................
Heating :. .('':........ .....................a.'...............................Plumbing ..................................................................................
Fireplace ..............: '.fir.^ -.. '-R`...........................................Approximate Cost ....... ?.r., ..:3A`..... :: ................
Definitive Plan Approved by Planning Board ________________________________19________. Area ��: .'�...:�.f..................
Diagram of Lot and Building with Dimensions Fee
SUBJECT TO APPROVAL OF BOARD OF HEALTH
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction. / -^' (FY,{y
Name ..' i ?on., /........ ..........................it '....................�:....... . .
21456" Tidewater Realty Trust
No ......2,;1+56 Permit for ....Single...family...
....................rlweliiy . . . . ,'- ...I�V7
Locati n ...Lot..#4.7. 78
•'Vr7vY,
..............Cer-tervil-le.........................................
Owner .....Ti-dewater•••Real •yTrus•t......••••••
� �
Type of Construction .....Wbed F-rame............••
................................................................................
Plot Lot ....../.......................
Permit Granted ...........,Ju . .....12...........19 79
Date of Inspection ... 19
Date Completed ......................................19
PERMIT REFUSED
y .................................. ................... 19
... . . /
.................................... .�..................................
Approved ................................................ 19
...............................................................................
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: iDATE w.. ` REGISTERED: LAN:D., SURVEYOR. OR. BY r '; 'S '!4,Tr; OF
., V
' A=
IF
'Oel A/' Z
i
A. - HOME OFFICE
KEENE, NEW HAMPSHIRE
An Old New En land Com an=
LICENSE OR PERMIT BOND
KPdOW ALL MEN BY THESE PRESENTS, That we, Tidewater Realty Trust
Robert F. McLaughlin, Trustee , of
69 Winn Street, Burlington, MA as Principal,
and PEERLESS INSURANCE COMPANY, A New Hampshire Corporation, and having its principal of-
fice in the City of Keene, New Hampshire, as Surety, are held and firmly bound unto
Town of Barnctab e
hereinafter called the Obligee, in the penal sum of Nine hundred fifty six --------------
-------------------------------------------'DOLLARS ($ 956.00 )
lawful money of the United States of America to be paid to said Obligee, for which.payment
well and truly to be made, we. bind ourselves, our heirs, executors, administrators, suc-
cessors ,and assigns, jointly and severally, firmly by these presents.
Signed with our hands and sealed with our seals this, the 1st day of June
A.D. 19 79
WHEREAS, a LICENSE or PERMIT has been granted by the Obligee to the above bounden
Principal authorizing him to construct a dwelling at Lot #47 Glen Eagle Drive,
Centerville, MA
Now,, therefore, the Condition of this Obligation is such, that if the said Principal
shall faithfully observe the provisions of the Laws, Ordinances, and Resolutions, governing
the issuance of this License or Permit, then this Obligation shall be null and void) other-
wise to remain in full force and effect.
xxxxx� ����� �xx�x�t��txxxxxxx�xc
X=XXXX3C X3CbX�3
The Surety may cancel this bond at any by filing with the Obligee thirty (30)
days written notice of its desire .to be relieved of liability. The Surety shall not be
discharged from any liability already accrued under this bond, or which shall accrue
hereunder before the expiration of the thirty day period. _
rr
G
Principal
PEERLESS INSURANCE .COl,JPANY,.
y: -
- - Attorn -in4Fact
PSB-226 0��4�,5�• �..� .'�r
a
PEERLESS INSURANCE COMPANY .
KEENE, NEW HAMPSHIRE
POWER OF ATTORNEY
'Itrnow Flit Men by abese mresents: That the PEERLESS INSURANCE COMPANY,a New Hampshire Corporation,having its principal office
in the City of Keene,.County of Cheshire,State of New Hampshire,pursuant to the following By-Law,adopted by the Stockholders of the said Company
on May 2,1966,to wit:
"ARTICLE 4 OF SECTION 2 — The President shall be the chief executive officer of the Company and shall have the powers generally
possessed by such officer and any additional powers that may be conferred upon him by the Board of Directors or by the Executive Committee.
The President or a majority of the Executive Committee may appoint_ Attorneys-in-Fact, Resident Vice Presidents and Resident Assistant
Secretaries and assign to them such duties as may be advantageous to the Company including the execution and attestation of bonds,undertakings,
recognizances,contracts of indemnity,and all other writings obligatory in the nature thereof and other documents on behalf of the Company with
power to redelegate such authority. In case of the death,absence or inability to act of the President,the duties and powers of the President shall
devolve upon an acting President who shall be a Director and shall be designated by the Executive Committee and act until the next Directors'
meeting."
This 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 the Peerless Insurance Company at its meeting duly called and held on the 14th day of December,1972.
"RESOLVED,that,the signatures of the President,Secretary,Treasurer,Vice President,Assistant Vice President,and Assistant Secretary may
be affixed to any such Power of Attorney or any certified copy thereof or any certification relating thereto,by facsimile and any such Power of
Attorney or any certified copy hereof,or any certification relating thereto bearing such.facsimile signatures or facsimile seal shall be valid and
binding upon the Corporation in the future with respect to any bonds, undertakings, recognizances or contracts of indemnity to which it is
attached." Vivian A. Souza and/or Wpyne A. %hamah,
does hereby make,constitute and appoint
Hymmis Massachusetts
of in the State of
its true and lawful atorney(s)-in-fact,with full power and authority hereby conferred in its name, place and stead,to sign, execute,acknowledge and
deliver in its behalf.and as its?ct and deed,without lower,of redelegation,as follows:
bonds guaranteeing the fidelity of persons holding places of public or private trust, and executing or guaranteeing bonds and
undertakings required or permitted in all actions or proceedings or by law allowed,excluding contract bid and performance bonds;no
one bond to exceed TWO HUNDRED FIFTY THOUSAND DOLLARS ($250,000.00):
and to bind the PEERLESS INSURANCE COMPANY thereby as fully and to the same extent as if such bond or undertaking was signed by the duly
authorized officers of the PEERLESS INSURANCE COMPANY, and all the acts of said Attorney(s), pursuant to the authority herein given, are
hereby ratified and confirmed.
In Witness Wbereof, the PEERLESS Ili20,�kNCE COMPANY has caiFeb ,1yesents to be signed 79 its President,and its Corporate
Seal to be hereto affixed by its Secretary this day of 19
Attest: PEERLESS INSURANCE COMPANY P**sU�RA�j'�•.,
CIL—
Secretary President
State of New Hampshire
County of Cheshi�e0 th ss. Februa 9 ``4":p;tuns+ t````
On this 4 day of '19 before the subscriber;La Notary'Public of the State of
New Hampshire in and for the County of Cheshire ,duly commis ios ned and qualified,came
Robert G.Pyne,President and Hans Sprangers,Secr"eta%y\
of the PEERLESS INSURANCE COMPANY,to me personally known to be the individuals and officers described herein,and"who�executed the preceeding
instrument,and they acknowledged the execution of the same,and being by me duly sworn, deposed and said"tha they lie officers of said Company
aforesaid,and that the seal affixed to the preceeding instrument is the Corporate Seal of said Company,anU
e said Corporate Seal and their signatures
as officers were duly affixed and subscribed to the said instrument by the authority and-duection�of the saorpofration,and that Article 4 Section 2,
of the By I0, ($��,fy>}rlpany,referred to in the preceeding instrument is now;in forc"e.\
1iri Di'fWeOnlg- U 1"ftt, I have hereunto set my hand and affixed mrooff 1 Sea`l at Keene,New Hampshire
the dad alsfl-Fear above wn tsoi'.,, 7
My 40111i, Za O J
Jul '1 4,1981 V f✓1
y= fl �� a� 0 Notary Public
StatXrof•
y Sfi
County.i�'Cheshire ,:F �; ��
or ; �!}```. Hans Sprangers Secretary of the\\=P!\�ERLESS INSURANCE COMPANY,do hereby certify that
the above'A&4 4ore�oii} is i true and correct copy of a POWER OF ATTOR�N,FY%executed by said PEERLESS INSURANCE COMPANY,which is still
in force and ef`feci'- `J
In Witness'Q>1lbereot, I have hereunto set my hand and affixed the Seal of the Company,at Keene,New Hampshire ("I"N
�s1JRa,�,this /.z>1 day of197
1go1 E,p.�
Form PS-97C(Rev.12/78) Secretary