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TOWN OF BARNSTABLE Permit No. —20223_-----_
Building Inspector Cash
♦ � °Yl
OCCUPANCY PERMIT Bond _—X-
"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 Spiros Construction Co. Address 35 Carla Road, Hyannis
Int. dk9� 941 Cl�nnaol a nroi vc. RnnP nrrr9l o
Wiring Inspector .��/ � ` � - Inspection date s y �l�
�+ / /Y
Plumbing Inspector �� � AI. F Inspection date
Gas Inspector n Inspection date
✓Engineering Department /,��� Inspection date
THIS PERMIT WILL NOT BE VALID; AND THE BUILDING SHALL NOT BE'OCCUPIED UNTIL
SIGNED BY THE:BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS.
..................V.T.l�_6........._, 19.�� ..............................B .........:................._.:._....r ...........
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wilding Inspector
Assessor's map and lot ,numEyer .. .`"..�.7 .....�;`t ` SETIC SYST.EIt
MUST BE
INSTALLED Ph ,�
�;, IA CE
c' 7� �.. ...................... WITH TIC .O r
Sewage=yP,ermit.number ..:..... ...................... ,• S/�NlTA
R �Y d6f��AND. TOWN
.0 QyOF TH E pO�^ TOWN ®�' r1 T Sl{"h LJ ■ �
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9 b 9 =< ��' i; W IR"" INSPECTOR'
ARRLICATION+FOR APERMLT TO u 1 L Pt ST y /yo,f� r. .
i' ........................................................ .......
TYPE OF C014STRUCTION ....wa u.... FiP.!p.....F................. ................... .....................................
ICJ
�o J..l..............19.7 L
q- T_0 THE -INSPECTOR-OF BUILDINGS:
f r The undersigned hereby applies for a permit accordinng to the following information:
Location ...�:.° .#a✓. ......�.4.-4/V E16:G,6......Z-)0e°........C�.e /....�101GG�.................................................. '
ProposedUse ....................................................................................................................................................
C o
ZoningDistrict .................:......................................................Fire District ....... .....................................................................
Name of Owner ®5........../V.� ''��CT/d!�....co.:...Address .3-5......'IRe�. !..pl....... `/.�,I?ias!. .............
Nameof Builder ......................................Address ...............................................................:....................
Nameof Architect ............. .....................................Address .....................................................................................
Co•!LGl2f�
Numberof Rooms ................. ...............................................Foundation .................,..........^...............................................
L(/jC // S d,6'�4G%
Exterior .................. . .............................................................Roofing .............................. ....................................................
Floors R 0 Interior .... °G
.............. ............j ................................ ....................... ................I.................... .......
:
Heating �"r Gv Plumbing
......... ............ ................�._....................... ....... .................... _ _ ....
Fireplace ...........®.NF...........................................................Approximate Cost ..........✓....0.. .............................................4�.Definitive Plan Approved by Planning Board ________________________________19________. Area J.3 ...... ...� .. y
.. . ,.
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.
� P�
Name .........�................................. ..........••••••• .......
Spiros Construction Co.
No
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PERMIT REFUSED
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^Approved ---------------- lV
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Assessor's map and )o* number ' / /'�-- �'�.r -'/� �� �
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Sewage Permit number --.`.`....-':--=--------.
THE
. TOWN OF BARNSTABLE
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APplN�kTU�����FOR PERA80['TO .���.-..��--.—.�--..-!--.......�.,�--------------------.-
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TYPE OF .- Z/ � ..��/��*� �� . . . -. . .. .. .
CONSTRUCTION
� -- . ---. --''--.----.----. -- - . .. .. . -.. --------..-.
............................ .......l9.........
�-^` TO THE INSPECTOR OF BUILDINGS:
_
� The undersigned hooe6v applies for o permit according to the following information:
Location .../-.'.-' ;�--- -..�...v.�....'....- -- __../.. ...`_ . . _____________.___.. .
,
ProposedUse --------------------.-----_______________________.-________
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ZoningDistrict .........�n............................................................Fire District ......./.....................................................................
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� Nome of Owno/ -�` -��� -.�..��*x \� �.�/��� /~ �-A66ns» ............................. -,/Y.,^o...........................
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Nome of Builder -----'�-'����------------.A66ros -----------------------~--..'
Nome of Architect .............)��^�� .....................................Address -----------------------.----.
` ~~ /~��� c/W���~
Number of Rooms -----'�t----.----------'Foundation -.��-----------------------'
Ex/e�or ____/&v� ----------------RuofinQ ---�� �.�/�'^��.�- ---------------
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Floors -----.��/�.(.��-;~-----------------|n�rior -.�,./��'�/�---------------------
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Heating --.-.....--- ..........................................................Plumbing --.:...r----------_--------,---
Fin:p|000 ...........
�......................................................................Approximate Cost --..~� ....................................................
Definitive Plan 6v Planning Board lA---_' Area '��4,1j^) ��/ � "^
Approved ' ��������������� ' ....................................�
Diog,om of Loo on6 8ui\ding with Dimensions Fee ..... ��, �_______
SUBJECT TO APPROVAL OF BOARD OF HEALTH
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| hereby agree to conform to all the Rubs and Regulations of the Town of Barnstable regarding the above
construction.
Nome ......... ........................................................
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Spiros Construction Co. A=192-143
No .... 02�•3 permit for .,,,,one story .
i single family dwellin
......................... ....... ...........
Location ....241 GleneaRle,.Dri„ .............
j Centervil
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Y S os Con traction Co.
Owner ..........�............... ...................................
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` Type of Construction ..........rams
.............................
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#23
Plot ............................ Lot .... ......................
Permit Granted .......CM
19 78
Date of Inspection ... ...........19
Date Completed ..... ...........19
' PERMIT TUSED
......................................... ................. 19
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......................... ................. ........................... ^
........................... .......... . .J........................
2.4.74�.......... .. .. �... ..............
Approved ..................................... .......... 19
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CERTIFIED A PLOT PLAN
LOCATION C ?2 .ViGG „MASS,
SCALE . .l. .=XO . . .. DATE .!`? . *!J�'7$
WWARD E. KELLEY /
aMMAQUID, MASS. 02637 PLAN REFERENCE
Sl+WAcl .qg. G' vgASe---NE"
OF
E.
K
o I CERTIFY THAT THE
SHOWN ON THIS PLAN IS LOCATED ON THE GROUND
su AS SHOWN HEREON AND THAT IT CONFORMS TO THE
SETBACK REQUIREMENTS OF THE TOWN OF
. . . . . . . . WHEN CONSTRUCTED.
DATE 3.5' C.9,eLA ,20,�YD AY•> • ��'L'ir.,rr� f'.
PETITIONER'- /�/✓N /'�A.5S. o ze4/
0 REGISTERED LAND SURVPfOR °'
X n 11 1410:18a Tupper Co lb08116bulu P.
T IP E
CoriSTRUCTION CO..LLC
7§6 MID-TECH DRIVE,WEST YARMOUTH,MA 02673
PHONE: 508-778-0111 FAX: 508-778-5010
WVVW_TUPPERCO"COM
Date:
Town of Barnstable
Thomas Perry CBO
200 Main Street
Hyannis, Ma 02601
(508) 790-6230 fax
Re: Insulation Permits -
Dear Mr. Perry
4
This affidavit is to certify that all work completed for permit application
Issued on (p�5�i y has been inspected by a certified
Building Performance Institute (BPI) inspector. All work performed meets
or exceeds Federal and State requirements.
Sincerely; Permit #: a 0f�`/3 S- '
Address:
Richard Tupper
License # CS-69058
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
t � ANNlicaMaN Parcel tion
t
Health Division Date Issued
• f
Conservation Division Application Fee
Planning Dept. Permit Fee
Date Definitive Plan Approved by Planning Board
Historic - OKH _ Preservation/ Hyannis #
Project Street Address d �r
Village C e_41&_VJ Y t-
Owner ( Kl �l�d-E�2i �h Address
Telephone-6 Zp----
Permit Request f lQ J/` l /���'
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed-! Total newi-
'Zoning District Flood Plain Groundwater Overlay . %"" CD,
Project Valuation &�c Construction Type
x�
Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting docun tation.
Dwelling Type: Single Family W Two Family ❑ Multi-Family (# units)
v
Age of Existing Structure `. Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No
Basement Type: ❑ Full ❑ Crawl ` ❑Walkout ❑ Other
Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft)
Number of Baths: Full: existing 2 new Half: existing new
Number of Bedrooms: :Y existing —new
Total Room Count (not including baths): existing new First Floor Room Count
Heat Type and Fuel: ❑ Gas Z-61'1' ❑ Electric ❑ Other
Central Air: ❑Yes C=1-No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No
Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size — Barn: ❑ existing ❑ new size_
Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size — Other:
Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑
Commercial ❑Yes ❑ No If yes, site plan review#
Current Use Proposed Use
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER)
NameW_ �m4kz / UDC Tel
Number J � 7� f��/ /
Address M/4) License # (ff `0(Q.�iOS0
Home Improvement Contractor#
Worker's Compensation #&CCRKS-�201.2 07
—� r
ALLLONSTRUCTION DEBRIS RESUL ING FROM THIS PROJECT WILL BE TAKEN T0�/�Q I�ZJ
SIGNATURE _.z DATE
FOR OFFICIAL USE ONLY
APPLICATION#
_ DATEFISSUED
MAP/PARCEL.NO.
v
ADDRESS VILLAGE "
OWNER
lY
ly
DATE OF INSPECTION: G
�,�FO.UNDATIOIV���`-i��!;���t�-�'f�•ti�tJ,�t��t:x.
Ir a fr
FRAME -
I. JNSULATION__,
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH 'FINAL
FINAL BUILDING
s -DATE CLOSED OUT
ASSOCIATION PLAN NO.
iE -
:The Catnritoraweailth of Mmsikkiisefts .
3 Department of IndusirialAccidents
Office of Investigations. r
L Congress Street,Suite 100: .
Boston,AM 02114 201
www.mass gov/diar
Workers'Compensation Insurance Affidavit:Builders/Contractors/Elec#ricYaris/Pluinbers ,
Applicant Information
Please Print Legibly
Name(susiness/organizati n/Individual): Tupper Construction .
Address:79B Md Tech,Or .
City/State/Zip:West YannoUth, MA 02673 Phone#:508-778-0111
Are you an employer?Check the appropriate:box:
Type of project(required)-.
l..❑■ I am a emplover with 4. El:I am a general contractor and I
employees(full and/or part-time).- have hired the sub-contractors 6• ❑New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheet. T ❑Remodeling
ship and have no.employees These sub-contractors have g. []Demolition
working forme in any capacity. . employees-and have workers'
9. Bu ti
ildin addion ;
[No workers''comp._insurance comp. insurances g❑ . . .
required.] �: We are a corporation and its 10.[�.ElectriCal repairs oraddmons
3.01 am a homeowner doin all work officers have exercised their
g l 1..❑.Plumbing repairs or addition's
myself. [No workers' comp. right of exemption per MGL
.insurance required.]4. . . .0. 152,¢1(4),and rave have no 12.[J:Roof repairs
employees. [No workers' .13.(J Other eatheri zat ion%
comp.insurance required.]
nSu a ion -
"Any applicantthat cheeks box#1 must also}ill out the section below showing theirworkers'compensation policy information.
t Homeowners who submit this affidavit indicating they are dotug all work and then hire outside contractors must submit a new atlidavit indicating such.
zContractors that check this box must attached an additional sheet showing the name of the sub<eontractors and state whether or those entities have
employees. ifthe sub-contractors have employee! they must provide their workers'romp:policy number.
I ant an employer that is provkfi ig workers compensation insurance Jr r my employees Below Is.the policy:anc[J'o6 site: .
information.
Insurance Company Name:
AElG -
Policy#or SelPins.'Lic.4:WCC5005593012007. Expiration Date:10/3/14
JobSite_Address - 241 .Gleneagle Dr
City/State/Zip: Centerville MA 026.32
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration,date]:
Failure to secure coverage as squired tender Section 25A of MGL c. 152 can lead to the imposition of criminal penalties.of a. .
fine up to$1, 00,d0 and/or ear irriprisoliment,as well as civil penalties in the:farm ofa STOP WORK.ORDER and a fine
of up to$25U,U0 a day a rise th ,vlolator. -Be advised that a copy of this statement may be forwarded to the Office of .
Investigations of the DI for ins u ce coverage vet7tication.
1 tia hereby certify un r dt ' and penalties of perjury.that the"lil ormatlox provided above is due surf correct
Si e: te: 5/2/14
5087780.1
Official use only..Do not write in this area,to he completed by city or town uncial.
City.or Town: Permitfl icense.#
Issuing Authority(circle one)::.
1,Board of Health 2:Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing IilspeCtor
6.Other
Contact Person:
Phone#:
mCORLa CERTIFICATE OF LIABILITY INSURANCE 12/03/D2013)
12/03/2013. .
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW..THIS CERTIFICATE OF INSURANCE DOES NOT.CONSTITUTE A CONTRACT BETWEEN THE ISSUING iNSURER(S),AUTHORIZED
REPRESENTATIVE OR PRODUCER;AND THE CERTIFICATE HOLDER:.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed if SUBROGATION IS WAIVED,subject to
j the terns and conditions of the policy,ceftain policies may require an endorsement. A statement on this certificate does not confer rights to the -
j certificate holder In lieu of such endorsement(s).
PRODUCER C014 I ACT Lora Low@
NAME:
Southeastern Insurance Agency, IncsNo ; Z508)997•-6061 N,;(508)990-2731
439 State Rd.
Q°
:ADDRESS: .
P.O. Box 79398 cusTocEa D
N. Dartmouth, MA 02747 INSURER(S)AFFORDING COVERAGE NAIC p
INSURED INSURERA: Arbella Protection Insurance
Tupper Construction Co LLC INSURERS: AEIC
INSURERC: CNA Surety
27 Roberta Drive - _ INSURER0: -
West Yarmouth, MA 02673 INSURERE:
INSURER F
COVERAGES CERTIFICATE NUMBER: 2013/14/1 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 TYPE AMID
OLICYEFF. PO P
LTR INSR INVO POLICY NUMBER MMIDO MM/DD LIMITS
GENERALLIABILIIY - - 850000874 11/01/2013 1/101/2014 EACH OCCURRENCE $. 1,000-,00
X COMMERCIAL GENERAL LIABILITY E o S lOO,OO
CLAIMS-MADE OCCUR MED EXP(Any one person) $ 5,OOO
A PERSONAL&ADV INJURY S 1,000,00(
_ GENERAL AGGREGATE :$ 2,000,00(
GEN'L AGGREGATE LIMIT APPLIES PER- - PRODUCTS-COMPIOPAGG 5 2,000,00
POLICY PRO- LOC S
JECT Ll
AUTOMOBILE LIABILITY S6662400002 12101/2013 1 TJ0112014 COMBINED SINGLE LIMIT
ANY AUTO (Ea accident) 1,000,000
_ALL OWNED AUTOS BODILY INJURY(Per person) S
A X SCHEDULED AUTOS - - - _ BODILY INJURY(Per accident) S
PROPERTY DAMAGE
X HIREDAUTOS -- (Per,accident) - $ INC
X NON-OWNEDAUTO5 $
UMBRELLA LIAB X OCCUR -4600.05836 11/01/2013 11/01/2014 EACH OCCURRENCE $ : 1,000,000
EXCESS LIAB . . CLAIMS-MADE -A AGGREGATE. .5. . 1,000,000
DEDUCTIBLE
RETENTION $ $ . .
woRKElts COMPENSATION WCCS00559301200 10/03/2013 10/03/2014 X X10
AND EMPLOYERS'LIABILITY Y I p - - - ORY LIMITS -
ANY PROPRIETOR/PARTNER/EXECUTIVE RICHARD TUPPER IS E.L.EACH ACCIDENT $ 1,000,00(
B OFFICER/MEMBER EXCLUDED? .,� NIA - - -
(Mandatory lnNH) I LUDED FOR"WC COVERAGE E-LDISEASE-EA EMPLOYE $ 1,000,00
If yes,describe under . . - -
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000.00(
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional RemaAts Schedule,If more space is required)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS:
"For Information Purposes Only"
Tupper Construction Co LLC AUTNORREDREPRESENTATNE
27 Roberta Drive
W Yarmouth, MA 02673 Lora Lowe
01988-2009 ACORD CORPORATION. All.rights reserved.
ACORD 25(2009109). The ACORD name and logo are registered marks of ACORD
� 1
f
OWNER AUTHORIZATION FORM
PRe wvcJ,
(Owner's Name).
owner of the property located at
6QN 4tuu' (,e,—
(Property Address)
(Property Address)
herebyauthorize U
,
(Subcontract
an authorized subcontractor for RISE Engineering,to act on my behalf to obtain a building
permit and to perform work on my party.
Owner's Signature
yap .
Date
j
1_ _
0
i,E Baia�fefKi-tildll�Ald$ti�.19'i 3I I I U i x, t
ti Massachusetts-Department of Public Safety
: 187 Hmu Rostd.St3klE T1 t Board of Building RegulatiOns and Standards
MWAw7
1,9771 k74-12?4 t.:n%i rut:ri•in Nuiwr%iv,r
srw 3 .ra�asi Lfeense: CS-o68058
R)CHARD S TUPPER
79 B imw-TECH DR
WEST YARMOUTH I< 73
d
S a
:y.,7. *. ✓� ..ice
Expirmion
(SH_WEWSQ FOR DE,s^W trat,mq: �ot�revis5{� 12/31/2014
193% People Nei
ping People Build uilda$aferW6rl4-
ON ow=
MEMBER,
Richanl Twpper
Tupper.Construction
Building Safely Pmltessionat ,
Member#:"8158119. Exp:4M/2014
!'��e Ca��a��ecruucufl�-r.In;�t<c;,ctc�rue/C '
._ Office of Consumer Affairs&Business Regulation License or registration valid for individul use only
jlOME IMPROVEMENT CONTRACTOR before the expi date. If found return to:
-Registration 178434 Type: Office of C ffairs and Business Regulation
.-Expiration 4/16/2016; LLC 10 Par aza-Su' a 5170
Bo ,MA 021
TUPPER CONSTRUCTION`CO PLC:' —
RICHARD TUPPER
79 B MID-TECH DR
W.YARMOUTH,MA 02673` Undersecretary No vtthout signature
7