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HomeMy WebLinkAbout0143 INWOOD LANE �'�.� ��Gt1oC�'.��I- �' .;� Np 0 0 I (r 4iI o I � o NO. 152 9/3 B GR ESSELTE 10°io 0 0 0 .: Town of Barnstable Building Post ThimsCard o-Thai i#is UisibleFrom:the Street`=A rovedPlans Must•,be,Retained on JobFand this Gard Must-;be Kepis ',�`, M" Posted Until Final Inspectio.nHas,Been Made ter, ,,s y`.M_ ,. a pis i,: s fit i z, �. R <. " f Permit Where a:.Certificateof Occu anc ,pis Re ulred,such Bufldmgrshali Not be Occupied until a Final In'sgect�on"hasEbeen made �,§., Permit NO., B-18-1061 Applicant Name: Tim Sanborn Approvals Date Issued: 04/25/2018 Current Use: Structure Permit Type: Building-Solar Panel-Residential Expiration Date: 10/25/2018 Foundation: Location: 143 INWOOD LANE,CENTERVILLE Map/Lot 225-027 001' Zoning District: RD-1 Sheathing: Owner on Record: INKER, LESLEY A k Contractor Name R U S S E L L CAZEAULT' Framing: 1 tp tractor re License C5 108157 Address: 776 BOYLSTON ST UNIT 1C 2 M BOSTON, MA 02199 _. Est. ProjeFct Cost: $53,260.00 Chimney: Description: Install 12.8 KW Solar System with 40 LG 320 Watt Panels on Roof. Permit Fee: $321.63 Insulation: Project Review Req: } ; Fee Paid $321.63 Date 4/25/2018 Final: ( . � Plumbing/Gas r� Rough Plumbing Building Official mal mbi BuiF' Plumbing: A : �Y _; . This permit shall be deemed abandoned and invalid unless the work a br—and by t hi permit is commenced within six mo th fter ssuance. Rough Gas: All work authorized by this permit shall conform to the approved application dithe approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zomng�by lawsarid codes. Final Gas: This permit shall be displayed in a location clearly visible from access str oa eet or d and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are promded on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work Rough: 1.Foundation or Footing a.. .�., g 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department 7- Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT \� i Solar&Home v t Home.Performance Solutions Since 1927 June 12, 2018 �. t - f� -n Robert McKechnie — W Local Inspector v� Building Department Town of Barnstable cn 200 Main Street CO cv Hyannis, MA 02601 rn 508-862-4033 RE: Solar Final 143 Inwood Lane, Centerville Permit#TB-18-1061 Mr. McKechnie, In reply to your email on 6/7/18, our solar install at 143 Inwood Lane, Centerville:originally called for 40 panels which we. pulled Building Permit#TB-18-1061 for. As installation approached, the customer decided to eliminate the panels on their poolhouse, reducing the system to 9.92 KW with 31 panels. You were able to view 18 panels during your final inspection and there are an.additional'13 panels on he west facing roof. Thank you for your cooperation and we apologize for any confusion this has caused. Since y, fimothy.J. Sanborn - Cazeault Solar& Home 103 Maplewood Avenue' Gloucester, MA,01930 978-281-4625 HIC#187000 ' n AV, Mckechnie, Robert From. Mckechnie, Robert Sent: Thursday,June 07, 2018 12:54 PM To: 'kathy@cazeaultsolarhome.com' Subject: solar final at 143 Inwood Lane, Centerville Good Afternoon, I will need a letter from your company stating how many panels were installed on the property. I could only count 18, but there may have been more on the west facing roof which I could not see. Thank you, Bob Robert McKechnie Local Inspector Building Department Town of Barnstable 200 Main Street Hyannis, MA 02601 508-862-4033 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION OCq/ Map �arcelZ^ 6:99=23 Application # Health Division � �'13 Date Issued 4 l 2z Conservation Division a � P� PIP Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board �� /Z ,3 Historic - OKH _ Preservation/ Hyannis • Project Street Address `�.� a N wove L A Village W 44ti A�•'i s;�N^-Ir Owner ,%TgCiJ' .4 cJ R "-. LZ Y T^J ss Telephone Permit Request /,T—k X4 ___Z_- rJ C-- 3i�� � j E©K 9?t TPA YI (A10AJ c L.4.4ytt 1 i T Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation v a Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach s ~"iltrting id;oCum e4ation. C.n CD Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Yes, ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other ° Basement Finished Area(sq.ft.) Basement Unfinished Area (sq. tni e r J Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including bath.,,): 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 ❑ 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) Name � � ��� 'j '.0 Telephone Number 7 �7f" Address fA License# 0`�C$l 4k 2 6Sv I +� ee-;N, dvSL/ Home Improvement Contractor# Z a man Z lt��d,/4::�hc�,Cf' vorker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO - c, SIGNATURE ZZe e � DATE !©� ��� i }LL, FOR OFFICIAL USE ONLY APPLICATION# r DRTE ISSUED MP,P/PARCEL NO. T A ADDRESS _ VILLAGE f , OWNER DATE OF"INSPECTION: FOUNDATION FRAME INSULATION } FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH 'FINAL GAS: ROUGH FINAL FINAL BUILDING E DATE CLOSED OUT ASSOCIATION PLAN.NO. 1 The Commonwealth of Massachusetts r Department of IndustirialAccidents Office of Investigations ' 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit;Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): ��f Ta-It QuAiq _ �[�3 LJ' ��'►�C„ Address: ` G�/� -•, Phone#: Are you an employer?Check the appropriate bog: Type of project(required): 1.�am a employer with 4. 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. 7. ❑Remodeling ship and have no employees These sub-contractors have g• Demolition working for me in any capacity. employees and have workers' insurance 9. ❑Building addition [No workers'comp. insurance com P• required.] 5. We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself ' right of exemption per MGL Y �o workers comp. 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no 1 employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. (Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: � �ahD l (��'a•-s� i>1�' Policy#or Self-ins.Lic.#: L,.)L.6,j!S j -7 R Expiration Date: 2— Job Site Address: f .? ��w� � � City/State/Zip: f?o ff /111;1 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$1,50.0.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of p Fury that the information provided above is true and correct. Signature: Date: Z0 Z cf- l Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: t Information and Instructions % s Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the - dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §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." Additionally,MGL chapter 152;'§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance.. requirements of this chapter have been presented to the contracting authority." Applicants Please fill 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' I 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 permit/license 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. a The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Xnvestigations 600 Washington Street Boston,MA 02.111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 4-24-07 w .mass.govfdia m:nry5zima t7ui-ray ra,xiL: Llal(.G: J/ JLJ/GV1J VO;-10 ftVl ra ,c: G. V.L e. �•� OP ID: KM =CERTIFICATE 4F LIABILITY INSURANCE DATE 03113DIYYYY) 3/13f13 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 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 781-642-9000 CONTACT Eastern States Insurance 781-647-3670 P"oNE FAX Agency, Inc. 0 No E : A/C No 50 Prospect Street ADDRESS: Waltham,MA 02453 PRODUCER CUSTOMER ID 1:CUSTO-1 INSURERS AFFORDING COVERAGE NAIC 8 INSURED Custom Quality Pools,Inc. INSURERA:Acadia Insurance Company 31.325 P.O. BOX 1031 INSURER B:National Union Fire Insurance Billerica, MA 01821 INSURER C: - INSURER D: 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. INSEXP LTR TYPE OF INSURANCE POLICY NUMBER MMIDDIYYYY MMICY EFF POLDDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMtdERCIAL GENERAL LIABILITY CPA 0328206-13 02I01/13 02/01/14 PREMISES Ee occurrence $ 500,00 CLAIMS-MADE �OCCUR MED EXP(Any one person) $ 10,000 *. PERSONAL&ADV INJURY `c 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: o, - PRODUCTS-COMP/OP AGG $ 2,000,00 - �' POLICY X PROT El LOC - $ AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT $ 1,000,00 (Ea accident) ANY AUTO F MAA 0328208-13 02/01/13 02/01/14 _ BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ A X SCHEDULED AUTOS PROPERTY DAMAGE $ A X HIRED AUTOS 1 (Per accident) A X NON-OWNED AUTOS $ $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,00 • EXCESSLIAS CLAIMS-MADE AGGREGATE $ 2,000,00 A CUA0328210-12 02/01/13 02/01/14 DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS'LIABILITY TIC LIMITS ER B ANY PROPRIETOR/PARTNERlEXECUTIVE Y f N NIA C005871898 02/01/13 02/01/14 E:L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? ❑N (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,00 Iles,describe under DCRIPTfON OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 A Property Section CPA 0328206-12 02/01/13 02/01/14 Contents 9,01 A Equipment Policy CPA0328206-12 OV01/13 02/01/14 Deduct 1,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Is required) CERTIFICATE HOLDER CANCELLATION EVIDEN- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED. IN EVIDENCE OF INSURANCE ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE a O 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD r = Office of Consumer Affairs and Vusiness Regulation 10 Park Plaza Suite 5170 Boston,Massachusetts 02116 Home Improvement Contractor Registration Registration: 105084 Type: Private corporation Expiration: 7/16/2014 Tr# 227813 CUSTOM QUALITY POOLS INC Robert Bent PO BOX 1031 Billerica, MA 01821 Update Address and return card.Mark reason for change. Address ❑ Renewal Employment Lost Card DPS-CAI A 50444/04-Ca101216 ��-co nmr e &(e-fi c� License or registration valid for individul use only Office o nsnmer airs mess egn a on before the expiration date. If found return to: _-- HOME IMPROVEMENT CONTRACTOR T Office of Consumer Affairs and Business Regulation. istration: .:1 084 YPe� Reg - �' 10 Park Plaza-Suite 5170 • Expiration: ?/164014 Private Corporation --. Boston,MA 02116 - C OM QUALRY.POQLS ING:: Robert Bent - ZNot 16 Wyman RoadBillerica,MA01821 undersecretary valid�whoutit signature r VMassachusetts Department of Public Safety Board of Building Regulations and Standards Construction Supers Nor License: CS-040192 ROBERT A BE1VT ' PO BOX 1031 BILLERICA MA'01821 _ 01f1d/2015 . Commissioner 1 Town Of aa t" ry ThQ,nM.0 Di redor BUWWg ftrnns<�'errlr,.�BO , Via" �oicsoner 200 Main.'Street; Hymmis,MA O,2601' www—town.banistabWaams Offiice 5108-862-908 r Fax. 50&790-6230 t*oe ax $* TMs &-tet2Ot2 if Using-A Ruder: _ .. Owner cif the subject,property hereby a e e } ' '' teat at to art oft Y behalf,. in all:matters relative to work:authmized by this budding:pout application for: . , LA €Ad&ess®(j*. hd S:�gnatt>reof >: .ncr Date �8A Pnat N Lf Property+k)wwv r is:appbft for pormiit:please:goimtete the Homeowcters Ueonse:Exemption form,,r the reverse side. C:lUsersVtwA'Iik\AppDatalLocallMi=wftxwir4owstTem'pttimy ImIrm FdeslCOAWIt.Uudook18P-76BDVA\EXPRU-SS.dme Revised 0,611.13 .s ra "T g a Ir �• tot ., v w�!"Pt0e / Six _ � a .z d Th e 'Standard in Automatic Poo[ Covers AONJA MAINS (OVER SYSTEMS Hydramatic is a product of A uamatic Cover S stems Wh Y ChCCSC a HYDRAMATI autoCCVCr? matec oo On the surface, most pool covers look similar, but the most important and costly part of any pooh cover is the mechanism. The patented mechanism of the HYDRAMATIC represents the best value for your durable investment. Designed to last the lifetime of your pool, the HYDRAMATIC is maintenance free, and the most reliable cover x system manufactured with the most extensive warranty in the industry today. ryp,'°ia'FyRx77 • Unique all fluid dual motor drive is waterproof • No electrics near the pool, the pozoerpack (pump) can be placed up to 150 feet away • Quick and easy to open - travels about one foot per second on average • Patented trouble free Leading Edge slider system and cable compensating device • Rainwater Removal feature built-in on most covers • Installation on most pool types and shapes • Leaves and debris are collected when the cover is opened to remove rainwater • Saves money on chemicals, energy and water loss from evaporation • Pressure relief valves gently stop the cover at end of travel • 20 year limited warranty on the mechanism • 7 year limited warranty on the cover fabric CP cum t , o TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map z Parcel O 7 lica ion Health Division Date Issued a�2 . Conservation Division �` Application Fee Planning Dept. Permit Fee �� dv Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address 1 (43 1_;y (A_J 6 a Village ce-0- Al Owner 1_ YAK 11e r— A2 Address 7 6�+ �� v l 5 -0 duTelephone c v O q.y )30-C,A-C , 4 O z i cj 5 Permit Request ooL 1AQN25tQ .Square feet: 1 st floor: existing 0 proposed ll1qQ 2nd floor: existing !Zn proposed Total newel o Zoning District Flood Plain nJ` Groundwater Overlay T 3SQ 000 Construction (�oc�cb t-�e- Project Valuation F ype Lot Size 3 Ac Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(# units) _ Age of Existing Structure Historic House: ❑Yes A No On Old King's Highway: ❑Yes ❑ No Basement Type: A Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new ( Half: existing 0 new 6 Number of Bedrooms: n existing _new Total Room Count (not including baths): existing new 3 First Floor Room Count Z Heat Type and Fuel: YGas ❑ Oil ❑ Electric ❑ Other Central Air: YYes ❑ No Fireplaces: Existing New AJO Existing wood/coal stove: ❑Yes S No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Po® l ®y Se o ; 0 Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# ..a ' -n coo Current Use Proposed Use { APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name �� Y `''` G- Telephone Number >8 ?3 Address �Z 7 0 J11 Fes► License # 6 4 d- �f) S�� Home Improvement Contractor# 7 Worker's Compensation # IOC A- d 1 77 Iq ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE -3 /z I / 3 rya i3 A FOR OFFICIAL USE ONLY APPLICATION# t; DATE ISSUED !f MAP/PARCEL NO. ADDRESS VILLAGE OWNER s DATE OF INSPECTION: -FOUNDATION: k- 9 Z..6.11 A FRAME Iq 1 i INSULATION 1-7 I " FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL r FINAL BUILDING b lol la 4 ; ` DATE CLOSED OUT r ASSOCIATION PLAN NO. fo REScheck Software Version 4.4.4. 00 Compliance Certificate, a r Project Title: Inker Residence Pool House Energy Code: 2009 IECC Location: Hyannis,Massachusetts Construction Type: Single Family " Project Type: New Construction Conditioned Floor Area: 0 ft2 Glazing Area Percentage: 31 Heating Degree Days: 6137 Climate Zone: 5 Permit Date: Construction Site: Owner/Agent: Designer/Contractor: 143 Inwood Lane Peter Breese West Hyanisport,MA 02672 Breese Architects 11 Beach Street Vineyard Haven,MA 02568, Compliance: 3.3%Better Than Code Maximum UA: 211 Your UA:204 The%Better or Worse Than Code Index reflects how close to compliance the house is based on code trade-off rules. It DOES NOT provide an estimate of energy use or cost relative to a minimum-code home. Envelope Assemblies ' Wall 1:Wood Frame,16"D.C. 1,155 21.0 0.0 45 Window 1:Wood Frame:Double Pane with Low-E 318 m 0.350 111 SHGC:0.00 Door 1:Glass 40 0.350 14 SHGC:0.00 Ceiling 1:Cathedral Ceiling 754 38.0 0.0 20 Floor 1:All-Wood Joist/Truss:Over Unconditioned Space 550 38.0 0.0 14 Compliance Statement. The proposed building design described here is consistent with the building plans,specifications,and other calculations submitted with the permit application.The proposed building has been designed to meet the 2009 IECC requirements in REScheck Version 4.4.4 and to comply with the mandatory requirements listed in the REScheck Ins Checklist. 6r,11 3 z3 t3 Name-Title What6re Date Project Title: Inker Residence Pool House Report date: 03/22/13 Data filename: S:\PROJECTS\Inker\Drawings\Area Calculation-Energy\Energy Calculation Guesthouse.rck 'Page 1 of 1 ' r. , 2009 IECC Energy Efficiency Certificatemew s Wall 21.00 Floor 38.00 Ceiling/Roof 38.00 + ' '/ 64>e^t— Ductwork(unconditioned spaces): Window 0.35 'Door 0.35 Heating System: L at A,r 0/0 . Cooling System: Cc, .(( 9 f S Water Heater: Name: Date Comments: a - F n. 4 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION t Map Parcel -a a?- 3 Application # C;�16 Health Division 1 Date Issued Ln Conservation Division _/'� Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis QV Project Street Address y A _-27y woos 14&6! Village2u� Owner f kesLeV __T;�ke,P Address l q A Telephone So�S - 95 Permit Request Square feet: 1 st floor: existing proposed 0 2nd floor: existing proposed &25(n-Total new Zoning District - Flood Plain Groundwater Overlay _ 9P Project Valuation I�TbV, Construction Type Woo Lot Size 73 �1, F Grandfathered: ❑Yes Jk(-No If yes, attach pportingoc uqentation. Dwelling Type: Single Family ,� Two Family ❑ Multi-Family (# units) ` Age of Existing Structure NAW Historic House: ❑Yes jd No On Old Kit s Highway: ❑- s O No Basement Type:. d Full ❑ Crawl ❑ Walkout ❑ Other P Basement Finished Area (sq.ft.) O Basement Unfinished Area rft) ' Number of Baths: Full: existing new j Half: existing new Number of Bedrooms: existing 1 new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: A Gas ❑ Oil ❑ Electric ❑ Other Central Air: (Yes ❑ No Fireplaces: Existing New IY Existing wood/coal stove: ❑Yes;40 Detached garage:Oexisti ng ❑ new size_Pool:,S(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) Name � A —Og2 Gpesba"C&, Telephone Number ��� ' 6119- 7377 Address ���7 l�-liKo ► K� License # C— 5 6 3 -6a j 05�e_&U f!P, Home Improvement Contractor# Email i ,s o G a oeg jQ Se�qt)&e. C®✓q Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO FF- � c SIGNATURE DATE FOR OFFICIAL USE ONLY 1 APPLICATION# � DATE ISSUED MAP/PARCEL N0. ADDRESS VILLAGE OWNER DATE OF INSPECTION: "- — FOUNDATION FRAME r INSULATION FIREPLACE Y ELECTRICAL: . ROUGH FINAL PLUMBING: ROUGH FINAL y ' r GAS: ROUGH ' ' FINAL FINAL BUILDINGlo DA-T&CLOSED OUT ASSO�kATION PLAN NO. — — a f. T[m Ga7unt'onfE h q—Mas'sachusrfts Deparhnent ofladmshial Accidents - t��ace o��`xttres�g�rtiatrs . 600 Wayldngfoa Street fasfon,.MN 02111E wi iv.7nassgatvfdira Workers' Compensation Insurance affidavit$tuTdeis(Cen"ctorsMectricianMumbers A, IAkant Information Please Print Legibly J Name ousjueWoyg�m&66dual): Address:— q1, CitYlstateMp Pho <9/7- Ya-�3 pE _... _._Are you an.employer?Check the appropriate box; o'ect r 1-El I am a employer with 4. ] I atn s peal con5�actor and I employees(Eiji an:dlorpart-time)-* have hired the sub:�oniraetors 6_ �Nees won _ 2_❑ I am a sore prapiietor or partner- listed on the attached sheet 7- ❑Remode-ling s1ir and have no employees These sub-oontractors have g_ ❑Demolition wcAing for me in any capacity employees and have warkers' g- ❑Ruil ding addition [N workers'comp-insurance comp-menrarxg d-] 5-❑,Are are a corporation and its If?_❑Electrical repairs or additions negapre s'_❑ I am a lramecwner doing all work officzrs have exercised their 11-❑Plumbing repairs or additions Myself[No workers'ccnT right of exemption per MGL 11❑$roof repairs inzirranm required]1 c 152, §1{#},and we haze n ' employees_[No workers' 13-❑other comp-insurance required.] Anyagpticaatthatcbe[ksbcm-91tons#also fill out the sectiflnhelosyshoWingiheuwa�ses'rnaapensatiaupplit infutm na T Homeowners Who submit this affidavit in&cmt g they ate doing m9 xvwk and rhea hire autsi contractors must submit anew afdnAt mdirating such_ tCuntcacrors thst check this bear,must sttsrhed as addiIIonsl sheet showing the mine of the and statE Whether ornot$xise MAWIeShWe employees_ If the sub-cont mctos bare eacpIogees,the}must provide their—1--s' P.policy number I am atz employer fhatis-prrr►Uiag morkers'conWensalion iresztrazzw for rely enWEo ees, Edotr is thepalicy aa.d,job site inf brmaluon- Insurance CompauyName: Policy 4 or Self ins- Expiralio.n Date: Job Site Address: , CiWstawzip: Attach a ropy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as repaired under Section:25A of MGL c, 152 can lead to the imposition ofcriminal penalties of a fine up to$1,500.0(}andlor one-year imlttiso t,as well as chat penalties in.the form of a STOP WORK ORDER and a fine ofup to S250_00 a day against the violator_ Be advised that a copy of this statement may be fnrwanded to the Office of Im-eeigations of the DIA for insurance coverage:verification: I do hereby ce& u. tlts 'trs all enalfies a thatthe irzformation pratrzded above is 6ua and correct VC;) SiPJraatt7r€: bate: Phone 9: cb. Official use only. Da not trrife in this area,to ba completed by cif} or fawn officiaL City or Town•. PermiVLicense# Issuing Authority{circle one}: 1.Board of Health' 2.Building Department 3.CitvrEOwn Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone 9- 6 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this sfatate,an m ployee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written_" An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer;or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the - dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §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.- Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their cer tincaic-(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 m' su anCe coverage. Also be sure to sign and date the affidavit The affiidavit 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 permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permitfhcense applications in any given year,need only submif 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 affida-�-it The Office of Investigations would ae 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 CommonWea&of Massachusetts Depaitneat of Indnsizial AccidaDfs affii�e of kvestigatjans 6GG Washingtaa Strut Boston,NIA 02111 Tei,9 6I7-727-49QO W 446 or 1-.3 I ASWE Revised.4-24-07 Fax#617 727-7749 _raas&gav/dia • � e arre+ino�casealG�c�C�/��.�ac�iciae�. :. .. ffice of CooBtimer Affairs&Business Regulation E ME IMPROVEMENT CONT License or registration valid for individul use only RACTOR a l before the expiration date. If found return to: Registration 117898 Office of Consumer Affairs and Business Regulation j ti Expiration Y Type'' 2-15/2015 $r 10 Park Plaza Suite 5170 d SEA-DAR ENTERPRISE$_INC._;;i Supplement ,3rd Boston,MA 02116 JOHN SOGARD i 46 WALTHAM ST #2A L J BOSTON,MA 02118 j Undersecretary, 1 __. ._ ___ Not valid without s' nature } Massachusetts -Department of Public Safety, Board of Building Regulations and Standards Construction Supen isor License: CS-043031 JOHN L SOGARD- 456 Taunton Streef t Wrentham MA 02093 Expiration Commissioner 02/18/2015 AC�® DATE(MM/DD/YYYY) � CERTIFICATE OF LIABILITY INSURANCE 12/5/2013 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(ies)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Sall Costello NAME: y The Getchell Companies PHONE (g]B)697-7773 aC No:(978)897-1553 183 Great Road, Unit 15 AIL ADDRESS:sally@ getchellcompanies.com PO BOX 844 INSURERS AFFORDING COVERAGE NAIC# Stow MA 01775 INSURERA:Union Insurance Company INSURED INSURER B-Acadia Insurance 31325 INSURER C FRANCISCO TAVARES, INC. INSURERD: PO BOX 398 INSURER E: EAST FALMOUTH MA 02536 INSURERF: COVERAGES CERTIFICATE NUMBER 2013-2014 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 OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MMIDD/YYYY MM/DD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 250,000 PREMISES Ea occurrence $ r A CLAIMS-MADE OCCUR X PA0273113-16 12/2/2013 12/2/2014 MED EXP(Any one person) $ 5,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 ANY AUTO BODILY INJURY(Per person) $ B ALL OWNED SCHEDULED 0344385-14 12/2/2013 12/2/2014 AUTOS X AUTOS X BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS Per accident $ included $ X UMBRELLA LIAB rd OCCUR EACH OCCURRENCE $ 5,000,000 B EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED RETENTION UA0273117-16 12/2/2013 12/2/2014 $ B WORKERS COMPENSATION X WC STATU- I OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 11000,000 OFFICER/MEMBEREXCLUDED? N/A CA0310189-15 12/2/2013 12/2/2014 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1 000 000 If yes,describe under DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Ben & Lesley Ink and Sea-Dar Construction are listed as additional insureds on a primary and non contributory basis on all coverages other than workers compensation as required by contract. Waiver of subrogation shall apply to general liability, auto, umbrella and workers comp. policies CERTIFICATE HOLDER CANCELLATION mmakkas@seadar.com SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Sea-Dar Construction ACCORDANCE WITH THE POLICY PROVISIONS. 46 Waltham Street Floor 2-A AUTHORIZED REPRESENTATIVE Boston, MA 02118 Christina Dennehy/CRD C Pi 4 1✓,r—_ "4 ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 ontnost nt The ArnRn name and Innn are reniefererl marlrc of arnpn f CERTIFICATE CA,TE OF LIABILITY INSURANCE DATE MMIDD"� THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.iTHIS 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 eFTWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT; If the certificate holder Is an ADDITIONAL.INSURED,the pollcy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditlons of the policy,certain policlee may require an endorsement. A statement on this certificate does not confer rights to the certlflcato holder In lieu of such endorsemen s, PRO DUC;i co Mark Sylvia Insurance Agency,LLC NANTA T 404 Main Street PHONe 508 957-2125 MAIL F Xe No 508 957-27a1 Cenlervilts,MA 02632 8D.BSINUnArtc marks Iviainsurance.cem INSURERS AFFORDING COVERA08 NAIC S qusVREO INSURER t FarmFamll Casualt Insurance —D=B�-T=''Construction-'Ii►C" _.-...Y.:.,:--_ __ ._:.. _.._ ._...._..„._,-,,.:._....':::'-1N9URBR'n'S "- ......---•-.... _. .--•-..._ - —-- - PO Box 168 INSURER C; I Centerville,MA 02632.0168 INM3UR6R D: � INSURfi E: � COVERAGES rN SRF: I CERTIFICATE NUMBER; REVLSlON NUMI3Efi: )THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE fNSUREQ 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 SUE)ECT TO ALL THE TERMS, I EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR R TYPE OF IMSURANCB P VCY E F POL Y EXP t A GENERAL LIABILITY POLICY NUMBER M LIMITS X 20OIX0486 72112 14 7 21/2015 X COMMERCIAL GENEML LIABILITY EACH OCCURRENCE a 000 000 CLAIMS-MADE a]OCCUR REMISES fEe occunegW S 100,000 IVIED EXP Any one arson $ 61000 g PERSONAL R ADV INJURY $ 1;000 000 B GENCRAL AGGREGATE S 21000,000 ; GI;N'L AGGREGATE LIMIT APPLIES PER: I X I POI ICY PRO- PRODUCTS-COMPIOP AGG $ 2,000 DQD LOC AUTQMQBILE 4ABILITY $ ANYAUTO CCU ALL OWNI FD BODILY INJURY(Per per�an) $ ^ED SCHEDULED AUTOS BODILY INJURY(paracrident) L HIP,- TOS NON-OWNED AUTOS AOP RTY DAMA'E Pa Ap)dentj $ UMBRELLA L10.8 r 3 OCCUR g EXCESS 4Aa CLAIMS-MAnF EACH OCCURRENCE y I AGGREGATE S D O RETEMrrI N$ I A AND KZRS eMPL0Yk R LI ATION 2001V 601 7/25i2014 7/26/2015 AND EMPL6YER3'LIA9MLnY OFFICEANY R ME OEREXCLUD4�ECLITIVE Y(—�t, NIA (Mend LT J C L,EACH ACGIppNT S 1,000 000 t(Mandatory In MH) E.L.OISEASE•EA EMPLOYE $ 1,000,000 f It ye^daealbe under DESCRIPTION OF OPERAT ONS DcIaN E.L.DISEASE.POLICY LIMIT $ 1,00D,000 S i v DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES lAttech ACORD 101,Addillonel Rlimatks Sehedefe,It Mora mce Is taNuirod) Carpentry The workers compensation does not provide coverage for Troy A Thomas and Shawn M Doyle. Job Loc: Inker residence,143 Inwood Lane, West Hyannisport, MA 02672, Job DeScrp: Roofing&.Siding,Sae-Dar Construction named as additional Insured on the general liability policy, Including with on a primary and non-contributory basis on ell coverage other than WOrkare Compensation as required by contract. , Waiver of Subrogation applies to General Liability, e CERTIFICATE HOLDER CANCELLATION y (617)423-0872 SHOULD ANY Oy THE ABOVE DESCRIBED POWCIE$BE CANCELLED BEFOt t Sea-Dar Construction THE EXPIRATION DATE THEREOF, NOTICE WILL BE 134LIVERED IN 46 Waltham Street ACCORDANCE WITH THE POLICY PROVISIONS, Floor 2& ®oston,MA 02118 AUTHORIZED REPRE3ENTATIVE i ©lae8.2010 ACORD CORPORATION, All rights reserved, ACORD 26(2010/05) The ACORD name and fog*are registered marks of ACORD OATE(MMJDONYYY) t.�46 R,b CERTIFICATE OF LIABILITY INSURANCE 4129/2014 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 certfcate holder Is an ADDITIONAL INSURED,the pollcy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terns and conditions of the policy, certain pollcles may require an endorsement, A statement on this certificate does not conrer rights to the certificate holder in lieu of such endorsement(s . PRODUCER coNrncr Berkle Ass! ned Risk Services i MGShea Insurance FAA A No . 800 634-4589 (AIc,No.} 866 215-8118 1 1550 Falmouth Rd RT28 Ste 2 Iz AwAILss: Po IlrySeNees@barkleyrisk.com Centerville,MA 02632 INSURERS)AFFORONB v a E IN3URER A: 9 INSURED INSURER e: Tyler and Traywick Building Company LLC INSURER C. PO Box 216 INSURER Dt s West Hyannisport,MA 02672 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: TI4IS 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 Tills CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY TI-IE POLICIES DESCRIBED HEMIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPEOf•INSURANCE SUOR IN&R WVO POLICY NUMBER POLpq pplyyy MYEF M1001YYYICY Y LIMITS OENERAL LIABILITY AUTOMOBILE LIABILITY $ WORKERSCOMPRNSATION WCSTATU• OTH- AND EMPLOYERS'LIABILITY YIN TORY LIMITS ER _ ANY PROP RIETORIPARTNERIEXECUTIVE (� E.L EACH ACCIDENT $500,000 A OPPICEIMEMBEREXGL.UDED? NIA WC-20-20-00531MO 04I19(2014 04/1912015 If yes,EeSCdbO H) -EA EMPLOYEE $ 5D0,000 DESCRIPTIONOP OPERATIONSbelow EL.RISE E. OLICYLI IT 600,000 _ DCSCRIPTIDN OF OPERATIONS I LOCATICHS I VEHI=$(Altaoh ACORD IOIt Addlbonal Remarks Schedule,a more spaoa isrequ'od) Coverage Elecbon Category Elect.Status Name State(s) Ali ErlUties LocBUorls Officer Include Sam Traywick MA Tyler and Traywick Building Company LLC 0f7icer Include Tyler Sanford 648 Cralgvllie Beach Rd West Hyannisport,MA 02672 7 i i CERTIFICATE HOLDER EANCELLATION i SHOULD ANYOF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE:THEREOF,NOTICE WILL BE DELIVERED IN Sea Aar Construction ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZE AUTHORIZE15 REPRF.EE ATI 46 Waltham street Floor 2 A ..�'}. Boston,MA 02118 Signature: . , ^2— ACORD 25(2010/05) BRAC 3139 '4CjOR" CERTIFICATE OF LIABILITY INSURANCEF9/12/D12//DDIY20144 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Andrew Roth NAME: Murray & MacDonald Insurance Services, Inc. PHONE (508)540-2400 FAX A/C. IC No: (508)269-4111 550 MacArthur Blvd. E-MAIL A D DRESS:aroth@mmisi.com INSURERS AFFORDING COVERAGE NAIC# Bourne MA 02532 INSURERA:Travelers Indemnity Company 5658 INSURED INSURER B:PrO ressive Insurance Co. M.S. Sethares Corporation INSURERC:WeSCO Insurance CO P.O. BOX 2210 INSURER D: INSURER E: East Falmouth MA 02536 1 INSURER F: COVERAGES CERTIFICATE NUMBER:14-15 Master GL 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 OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MMIDDIYYYY MM/DDIYYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ 300,000 A CLAIMS-MADE 7 OCCUR 680-5304A944-14-42 6/16/2014 6/16/2015 MED FRCP(Any one person) $ 5,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,0 00,000 X I POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) $ 250,000 B ALL OWNED SCHEDULED 07834318-3 /20/2014 /20/2015 AUTOS X AUTOS BODILY INJURY(Per accident) $ 500,000 NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident) ccident $ Medical payments $ 5,000 UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ C WORKERS COMPENSATION X WC SLATU- DER - AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? N I A (Mandatory in NH) C3091209 6/16/2014 6/16/2015 E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under - DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION.OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Inker Residence 143 Inwood Lane West Hyannisport MA 02672. Ben & Lesley Inker and Sea-Dar Construction are listed as additional insureds including with respect to Completed Operations. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Sea-Dar Construction ACCORDANCE WITH THE POLICY PROVISIONS. 46 Waltham Street Floor 2A Boston, MA 02118 AUTHORIZED REPRESENTATIVE Courtney Finigan/CLF - ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025(201005).o1 The ACORD name and logo are registered marks of ACORD ©©go�p[3 G�q©4�DQ4�Dq Building trust one project at a time Trademark Builders M.S.Sethares Corporation Tyler&Traywick Building Company, LLC. D&T Construction, Inc. Francisco Tavares, Inc. 2957 Falmouth Road Osterville, MA 02655 508.419.7372 F 508.420.7280 www.seadar.com 776 Boylston St PH1C Boston MA 02199 May 27,2014 To Whom It May Concern Re 143 Inwood Lane,request for permit change ,- Please note that we plan to use the structure under discussion primarily as a pool house with occasional use as a place for guests to sleep.We will not rent it out on a stand-alone basis. Sincerely, 4 Lesley and Ben Ink r ' i Town - ow of Barnstab e 1 Regulatory Services z�isr.►ace, aMnas Thomas F.Geiler,Director . Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 i - Property Owner Must Complete and Sign This Section If Using A Builder I, , as Owner of the subject property hereby authorize ?4i4+j jr4,. r-e)re3 lge-4-04- Ce-es ct on my behalf, in all matters relative to work authorized by this building permit (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signa e of Ownel Signature of Applicant eo6 Print Name Print Name Date f� WORM&OWNERPERM(SSIONPOOLS 6/2012 i E ' wz 71 {�,o, 781-85i-1000 �v.tta&Jl®]�9.Y� �o r.. . Fax781-857-1054 wwmandersonmsul.com 706 Brockt hO-Box 2003A tgton, MA 02351 - Insu/anon Cent Misate WORK AREA ITEM STALLED- y. �.. •9 IN< .. � Underside of Roof R'23.6 Icynene Closed Cell Spray Foam Insulation MDC-3.5in' Garage Walls. R-21 51/2 X 15 Kraft Faced FG Batts Hi pens, Customer: Sea. Dar Construction , Y „1 Job Number: 195969 ]ob Address.;" Inker 143 Inwood Lane Hyannisport Detached Garage zDabe Completed: i '4/ G ' In,talier ign re tie r ,. �ii t `oFtHE r Town of Barnstable * ' Regulatory Services BARNSTABLE. MASS. 1639. N0 Building Division - pfED MA'S A 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice .,. ...... Type of Inspec<. tion =._JiltJ�~�- Location M 3 TW W o m Permit Number Owner Builder One notice to remain on job site, one notice on file in Building Department. The following items need correcting: F_AJ N-E D tic' 5rk- 4U /J 6 i HAV C Pe®PEA SG FFa f S Pj�ti;' k--01Av^ 71:o)5u L ST!b PFKr^T-I- N E-F b�EJ) FOR— G b kry\ Please call: 508-862-4038 for re-inspection. Inspected by Date 5�1 r Amderson 7131-85 i-loco Fax 781-857-10% a Rnsulaflon, Inc. � _ www andersoninsul.com 706 Brockton Ave PO Box 2003 Abington, MA 02351 Insuite on ceitiricata f WORK AREA ITEM INSTALLED Underside of Roof R-38.5 I neneClosed Cell:S ra Foam Insulation MDC 5 7 n cy p° y Floor R-30A Icynene Closed Cell Spray Foam Insulation MDC-4.5in � —4 EXT.Wails 2x6 1140,3 Icynene Open.Cell Spray Foam;Insulation LDC'-5.5in. Interior Partitions R-13 3 1/2 (15 Unfaced Fiberglass Batts , Windows and Doors Foamed Great;Stuff-Minimal Expansion Foam Floor DC 315 Sprayetl on Thermal.Barrier for Foam C:) Customer; Sea Dar Construction ,. lob Number: 195969 r Sob Address Inker 143 Inwood.Lane Hyannisport Guest House Insulation Pate Completed WRO C I q er ignatu , Ott ; RN_TAp- „ �p SEP $0 25June2014 . � ;1 . 06. Mc xENZ`IE ENGINEERING Mr Thomas Perry CONSULTANTS Building Commissioner DIV, smctma,-civil-emimnmmte1 Town of Barnstable: . 20.0 Main Street Hyannis,:MA 0260 l RE:Framing Inspection;,Inker Garage and Pool House,!143, Inwood I ane;Hyannisport, MA Dear Mr-Perry, McKenzie Engineering Consultants,Inc.was retained by-Breese Architects to complete structural and wind'design plans for the Inker Project at 143 Inwood Lane;in 4 Hyannlsport During,the:course 4 framing we completed site visits to inspect progress and to review the major framing,elements.as well as. nstallation of the wind resistive construction elements%for the garage and pool house. On June 16,2014,we completed a site visit to. 4 do the final:inspection of the framing;elements And the wind resistive-hardware. Based on these inspections, we find that the rough frame and wind resistive.construction ., -- elements were constructed in siibstaritial comphanee with the stamped design plans for the garage and pool house. If there are:Any questions=on this matter,.feel:free t ct me at:any time. y r; Sincerely, a WKI<€ F' G6 r 1VI A.IvlcKe s a g Pres.;:McKenzie.Eng_ ring Consultants;Inc: h- cc. Sea-Dar Construction,Breese Architects: :-1 1279 Millstone Road 6rewster,.MA 02631 " t 774.353.2144 f 774.3512142 ' w",mckengineers.com `oF,HE Tow Town of Barnstable � RARNSTARLE.p Regulatory Services Y MASS. 0 - ,639. Building Division prEO MAC s 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 w a,•y Fax: 508-790-6230 E Inspection Correction Notice Type of Inspection Location W S ;3 W y 0 0 Permit Number Owner Builder One notice to remain on job site, one notice on file in Building Department. The following items need correcting: 3 A n)0 g" -TZ) 63f— �T,—O57A-L•LF-D 0!AT. Df 13A-:�&'-- ter- T S "5 F,,6EP-G4 CERTT-F7-C&Tf -M 13 JE PC)5FE-S�) Et) Please call: 508-862-4038`for re-inspection. Inspected by Date v ) / Town of Barnstable Building Department - 200 Main Street y'a * B"NST"LE. # Hyannis, MA 02601 �1639. ' (508) 862-4038 Certificate of Occupancy Application Number: 201406038 CO Number: 20140134 Parcel ID: 225027001 CO Issue Date: 10/14114 Location: 143 INWOOD LANE Zoning Classification: RESIDENCE D-1 DISTRICT Proposed Use: SINGLE FAMILY HOME Village: - CENTERVILLE • Gen Contractor: SEA DAR CONSTRUCTION Permit Type: RC00 CERTIFICATE OF OCCUPANCY RES Comments: i Poo L f4 o r✓c S.te . F Bui mg epartment Signature Date Signed w TOWN OF.BARNSTABLE B011 di"ng tNE 201406038 Permit = 6 BARNSTABLE, Issue Date: 10/07/14 y MASS. i639• Applicant: SEA DAR CONSTRUCTION Permit Number: B 20142717 ATFp�A Proposed Use: SINGLE FAMILY HOME Expiration Date: 04/06/15 Location 143 INWOOD LANE Zoning District RD-1 Permit Type: RESIDENTIAL ADDITION/ALTERATIO Map Parcel 225027001 Permit Fee$ 35.00 Contractor SEA DAR CONSTRUCTION Village CENTERVILLE App Fee$ 50.00 License Num 85071 1 Est Construction Cost$ 800 Remarks. APPROVED PLANS MUST BE RETAINED ON JOB AND CHANGE EXISTING POOL HOUSE TO GUEST HOUSE BY CHANGING THIS CARD MUST BE KEPT POSTED UNTIL FINAL SITTING RM TO BEDROOM INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: INKER,BENJAMIN L&LESLEY A BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL s Address: 776 BOYLSTON ST.,PH1C INSPECTION HAS BEEN MADE. BOSTON,MA 02199 Application Entered by: JL Building Permit Issued By: THIS PERMIT CONVEYS'NO RIGHT TO OCCUPY ANY STREET ALLEYiOR SIDEWALK'OR ANY PART,THEREOF,EITHER It ORARn,Y` R ENCROACHMENTS, 4 PUBLIC PROPERTY,NOS' SPECIFICALLY.PERMITTED"UNDER THE BUI DDING CODE;MUST BE APPROVED, THE JURISDICTION. STREET MALL GRADES A L-AS DEPTH AND LOCATION OF PUBLIC SEWERS)W BE OBTAINED FROM THE z DEPARTMENT OF PUBLIC WORKS THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM',THE CONDITIONS OF ANY APPLICABLE SiJBDIVISION P RESTRICTIONS �`r r MINIMUM OF FIVE CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.SHEATHING INSPECTION 3.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 4.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 5.PRIOR TO COVERING STRUCTURAL MEMBERS(FRAME INSPECTION). 6.INSULATION, 7.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 2 2 2 3 1 Heating Inspection Approvals Engineering Dept Fire Dep 2 Board of Health i &P.5s,�taq -C-E)mot TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map T Z Parcel 7 ©b 1 Application # Health Division ` Date Issued Conservation Division Application Fee Planning Dept. Permit Fee to( 2 � d� Date Definitive Plan Approved by Planning Board V12.L113 Historic - OKH Preservation / Hyannis Project Street Address 3 o d Village C Owner Address 77,6 1?0 Ai Is40 k� S� Telephone 1 7 �} 7, O V6 420540 4 19 d7 Permit Request D y VL!C 'Z Lt -Y C-LA d Ll X ZZ Square feet: 1 st floor: existing proposed 2nd floor: existing 0 proposed Total new �o Zoning District �� l Flood Plain Groundwater Overlay Project Valuation 00b Construction Type ao d Lot Size -3 Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure Pe'6i Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other q �C+—V) Basement Finished Area(sq.ft.) 0 Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing C3 new Number of Bedrooms: (3 existing 0 new Total Room Count (not including baths): existing -� new 2 First Floor Room Count z - Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other /J D c w � Central Air: ❑Yes L1Xo Fireplaces: Existing New A3 Existing wood/¢ stove: UYes7l' o Detached garage: ❑ existing whew size Pool: ❑ existing ❑ new size _ Barn: ❑ extsl ng ❑ MV Attached garage: ❑ existing . ❑ new size _Shed: ❑ existing ❑ new size _ Other: z w A Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ V c Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) p �o 9`23'7- 12-SN Name �Ac�r_ .M �- Telephone Number Address Zq �7 }'a-�B''�o v�� lit License # ��0 Ac O Z.,c cam_ Home Improvement Contractor# A 1-7 S'"/ k' Worker's Compensation # LA-24 7 l L� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY --. APPLICATION# � a DATE ISSUED MAP PARCEL NO. �t ADDRESS VILLAGE OWNER .f t DATE OF INSPECTION: 3 FOUNDATION:C@R -7 q 113. _. ,t FRAME G hq 4 INSULATION - 3 FIREPLACE 'FS ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL x GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT tau .�.► ...� .r f� ASSOCIATION PLAN NO. s p �G`l✓\ H�JS2_ PROJEC NAME: "LA ADDRESS: Zp i3al ��g P ERMIT# ��\3 O 115 S" PERMIT DATE: M/P: 6:1 O� l LARGE ROLLED PLANS ARE IN: BOX SLOT Data entered in MAPS program on: BY: 'L, q/wpfiles/forms/archive PROJECT I NAME: ADDRESS: ©D I <anC-(CF 0✓ e� PERMIT# /^ PERMIT DATE: LARGE ROLLED PLANS ARE IN: BOX � 1 SLOT Data entered in MAPS program on: 45; ,r)---7 BY: q/wpfiles/forms/archive Com nionwealth,,of Massachusetts `o k ¢0/23113 Date: Estimated rob,Cost: QCT 18 F2013 Permit Fee: ,QU O Plans Submitted: YES No ltw6d YES ' NOWN OF fN' A ff� Business License# f U/d Applicant License n" ` Business Information Property Owner/Job Locatlon Information: I\7ame: - Vern Gt�]' : .��I ����(�, , Dame:ix,� ) �(2 Street: a v) J-tea-�. �J��'�.)�G Street:• ' 7.J. ��w( J� ' l�._ F CityfTowri: 0 :City mn �J(Y//✓(`''Jr A i V' '" • Y Telephone: rY 9y5 100 Telep3i orie: _ Photo I D rzuired /`Copy.of Photo I.D attached YES`_/ _]gip -t t,k sraff Initial xi /M-1-unrestricted license J-2 /M=2-restr1cted to dwellings stories oz;less arid'•cgnirriercial up to 10,000 sq.,ft-/2-stories or i.ess- Residential: 172 family V: Multi-family Condo f TouTnhouses ,: C?ther . Commercial: Odice Retail . Iridustial Educational ' - Institutional Other Square ff• ' F'oota e: und er r 10 a OOO s rl .ft. ve � ' / o r 10.000 - 1 �'W s ff 'umber of Stories: Sheefmetal work to be completed: New Fork: Renovation:` HVAC _Metal 1� atershed Roofin6 K itchen Exhaust System; Metal Chimney/Vents Air Balancin¢ Provide detailed description of tivorl.torbe done. 3 UoDAr Con and . i,: _4 w s r i a n i x INSURANCE COVERAGE 4 a " t have a current liability insurance policy or its equivalent which.rneets',ihe r gu;"rements of G.L.M: Ch.112 ,Yes No❑ d r If you have checked Yes,indicate the type of coverage by checking the[['approl3 ylate box.below: A liability insurance policy Other type of indemn►ty� ❑, � Bond ❑ OWNER'S INSURANCE WAIVER: 1.am aware that the licenseedoes no have the ins1. 0 ance coverage required by Chapter 112 of the Massachusetts General Laws,and that my signature on this per mit appfitatron waives this requirement. {. Check One Only " ,Owner ❑ Agent ❑ Signature of Owner or.Ownel's Agent By checking this boxEl,I hereby certify that all of the details and mfonnation l.have Submitted(or entered)regarding this application are true and accurate to the best of my.knowledge and that all sheetinetal work and instal]tions performed under the permit issued for this application will be in compliance with all pertinent provision of tWlVlassachusetts Building Code and Chapter,112 of the General Laws. Duct inspection required prior to insulation installation: YES NO Pro!ress Inspections Date ,. Comments a A �, rh Final Inspection y - Date Type.of License: 6Y Master Title Master-P.estricted ❑ L _ I City/Town ❑Journeyperson Signature of Licensee Permit# ❑Journe erson-Restricted YP _ f "License Number: Fee$ _ Check atv"Ni.rrlass.aovldpI Inspector Signature of Permit Approval Town-of Barn Regulatory-So as rnnxs.MAS& Tait e'er ty. ,R utlding°'"o31)?OC's5"Z4,�ea. 200 z�°�91I}�}CC'' C e:,5,desA C f ce; 508-86�4038 fax: -7 1-62w0 Property F Corr plete and. .�� ,bjs, �Cct,4,)-n" ui If Using A. 3 � s...... t ..r_.. hercby;aa thc�ri e F n a _ .�.e��._� _to zCt 0n IV'iie6ff in aU.matters relative to wodk iuthonized by this L-A,:=x; (Addr ss of Jol> ) Pool fences.and alarms are the r s onsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final specdona9 are petfortned Arid ae epted. io"t 1 W att z e of Oar .ex ,t t; 4a c oz-r,� y1«;.:. 6 G k)NPrintName . i Date E,c'^t.�'; ftt:Ft)n4S:O'W E,'R FR3t,4[SSI€}'vt't3OLS 6 012 r `:COMMONWEALTH OF MASSACHUSETT.S" is➢ ➢ a o -� i � a e ➢ - SHfET METALWORKERS ' AS A BUSINESS ISSUES THE ABOVE LICENSE TO: ER;IC T WH'ITELEY W VERNDN WHITELEY :PLBG AND 28 :1/ILL.`AGE . LANDING • I PO ...BOX '1266 CHAT AM MA 02G69=000 ; 1'60 12/22/14 292629` --- ---------------- ------ — GOt�,Mo{VWEALTH OF MASSACHUSETTS . -..-.. 91( 8 6 ➢ a 7l 0' 0 ➢ 8^ .. SHEET METAL WORKERS AS A MASTER-UNRESTRICTED ISSUES THE ABOVE LICENSE TO: .ERIC T WHITELEYs - m .PO BOX 248 .; WEST CHATHAM MA 02669-02"48 2967' 02/28/14 119423 : .. _ �l , fie -=3�A'1'fi F.eh ➢ s�� i o '=�.. .. Fold,Th=_n Detach Along All Pe6orations 15�y'y Y Mi oi , s e IT-Ell X1. lint E _� i • �. .ERiC Ty�i�a� I �� <i an�'s �n I, 1.8��MAINIST�(3��Fy � �,i'��'�.3R'�• �"� 1 M1 I i 4� F 1.W ifr19FA y Ftri .3~ff '`"� Nip ai`� a .� The Commonwealth of Massachusetts Department of Industrial Accidents - Offce of Investigations- _, -600 Washington`Street - Boston, MA 02.111, www.mass.gov/dia Workers Compensation Insurance Affidavit: Builders/Contractors/Eleefricians/Plumbers Applicant Information Please Print Legibly, Name (Business/Organization/Individual): \11 VP o + in 1 n L 01-7 Address: :V U,i I A h A n ti. o City/State/Zip: ��s C, 4 A a 1 m Phone -09 7 y - 11 o o Are you an employer? Check the appropriate.box: Type of project(required): 1.� 4. I am a general contractor.and I I am a employer with 4 9 ❑ 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 working for me in any capacity. employees and have workers' . 9- ❑ Building addition [No workers' comp-insurance comp.insurance_< ` required.] 5. ❑ We area corporation and its 10:❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11-❑ Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL. c�152..§1 4 we'have Roof repairs insurance required-]�` � O,and we have no. employees. [No workers' 130 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. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees- if the sub-contractors have employees,they must provide their workers'comp.policy number. 'I am an employer that is providing workers'compensation insurance for my employees.'Below is the policy and job site . information. Insurance Company Name: LA n t-w ai n tee_ Policy#or Self-ins.Lic.#: L)U C_C_— Z i 1 - a o o 3 0 ) Expiration Date: l cl i a o/3 Job Site Address: V o us City/State/Zip: ►M A Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date): Failure to secure coverage as required under.Section 25A of MGL C. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and%or one-year imprisonment,as well as civil penalties in the form'of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of thisstatement may forwarded to the Office of Investigations of the DIA for insuranoAl'overage verification. I do hereby certify under p ale perjury that the information provided above is true and correct. Si ature Phone#: ` b g> 9 — l 1 0 0 t — 1 Official use only. Do not write in this area,to be', inpleted by city or town official. City or Town: ermit/License# Issuing Authority(circle one): t 1. Board of Health 2.Building Department 3. City/Town Clerk^.4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: t 10/17/2013 07:27 5089455549 WHITELEY PLMB PAGE 03/03 N1-.t 10/4/2o13 7 :19:41 AM PAGE 51/055 Fax Serer 6• AC=R� CERTIFICATE OF LIABILITY INSUIRANCE 1004-2013 HE THIS CERTIFICATE IS.ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE AFFORDEDTER THE COVEPAGE HBY THE POLICIES BELOW.OTH THISFIRMATIVELY OF CERTIFICATE OF INSURANCE DOES NOT CON, NEGATIVELY AMEND STITUTE AD OR LCONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. PORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(tes)must be endorsed. If SUBROGATION 1fi WANED, IM 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 tha certificate holder in lieu of such endorsement(s)- CONTArT PRODUCER NAME; FAX ROGyERS&GRAY INS AGCY PHONE N �. Fxl: 434 ROUTE 134 F nIAIL SOUTH DENNIS.MA 02660 I SURERIS)AFFORDING COVERAGE NAIC 9 IMIauRER h;AC AMERICAN INSURANCE COMPANY INSURED INSURER B t W VERNON WHITELEY PLUMBING& IPISURERC: HEATING CO INC&CHATHAM SHEET rNsuReRo; METAL INC PO BOX 1266 INsuRERe WEST CHATHAM,MA 0266E INRUREA F; COVERAGES CE TIFICATE NUMBER: REVISION UN M8ER' THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED G ANY HAVE BC-EN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDIPIG 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. ADD Sue POLICY F,FP POLICY EXP LIMITS INSR TYPEOPINSURANCD INSR WVD POLICY NUMBER MMro01Y1' MNBDDIY LTR EACH oCCURRENCE R GENERAL LIABILITY ME' ID aSNTED g. comMeRCIALOENERALLWNLITY E' = CabcI nca CLnI S.MADE OCCUR MEO EXP AnY nn�Pr•=on) SI PERSONAL&ADV INJURY S' GENERAL AGGREGATE A PRODUCTS-COMP:OF AGG GENIL nOGREGATE LIMIT APPLI0 PER; POLICY CHE C CNISINEDSWIaLELIMIT g ALIJOMOBIL.E LIABI a ice. , BODILY INJURY(NrPnr..ea) S ANY AUTO A ALL Q�M•IFp BODILY INJURY(Per Ac-ye�r'q AUTOS OPEPTY AI.I/,eE S D HIRED AUTOS S C,ACH OCCURRENCE S _ UMBRELLA LIA ACGREGATE CXCESSLIARAOEOro RE 'X we srnTLl- oTH- WOPNKERSCOMPENSATION TORYLIMITS ER AND EMPLOYERS'LIA5ILnY ANV PRO?RIETOWPARTNEP.:XECUTIN Y'�mI E.L.EACH ACCIDENT �500,000 OPMERIMEMBEREXCLU0E0? NI NIA 6562UB 10.01-20,13 10-01-201A CL DISEASE•EAEMPLOYEE $500,000 IMmndAlnrylnNH) g9721_664 E.L.DISEAaF,-POLICY LIMIT $500,000 It yex,em;rdhn undor 5C,REMN-OF DpF,t MM"'9 on•, - DESCRIPTION OF OPERATIONS I LOCATIONS I VDHICLES(ACaeh ACORD 101,Addtttonnl Remarks Schadula,tt more zpoee is required) CERTIFICATE- L CELLATION - -- TOWN OF BARNSTABLE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE 200 MAIN STREET CANCELLED WILLBBEODELIV RED E THE INIRATION DAT5 THEREOF, ACCORDANCE WITH THE HYANNIS,MA 02601 POLICY PROVISIONS. AUTHOROD R13PRE3ENTATIVE 0)1980.2010 ACORD CORPORATION.An rights reserved. ACORD 25(2D10105) The ACORD name and logo are registered marks of ACORD TOWN OF BARNSTABLE BUILDING PERMIT AP ILP CATION��� Map 7 Z Parcel 0 Z 7 - .ApplicatronT#` Health Division Date Issued p Conservation Division Application Fee �iZS ,13 Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board y)Z(,II 3 Historic - OKH _ Preservation/Hyannis Project Street Address ( H Loon Village L'o,AN V, I L&- Owner_ , ti P.J�L e� Address �7L Ro vc -1 5400 9 !`fie L Telephone ? �0�1 7 — O� 6 U N i+ 0 I C &54,, Q 2 i q Permit Request 1>2 16A 0�� �� �� a � ��� �.•mac ��uS e o tr- l� 14 'D Square feet: 1st floor: existing :Y0 0 proposed � 2nd floor: existing proposed Total new 5' Zoning District " 1 Flood llod Plain Groundwater Overlay Project Valuation Construction Type Wo 0 d Ft-~-c Lot Size 1 -36 4-C Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family a/ Two Family ❑ Multi-Family (# units) Age of Existing Str7Full e la ( (� Historic House: ❑Yes XNo On Old King's Highway: ❑Yes ❑ No O Basement Type: ❑ Crawl ❑Walkout ❑ Other — Basement Finished Area(sq.ft.) `[6 Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: C7 existing 9 new Total Room Count (notinccll ing baths): existing i i new i $ First Floor Room Count Heat Type and Fuel: L�'Gas ❑ Oil ❑ Electric ❑ Other yp ec c O e Central Air: 9 Yes ❑ No Firepl L 'ng New ✓ Existing wood/coal stove: ❑Yes No Detached garage: ❑ existing 12 new ol: ❑ existing ❑ new size _ Barn: &existing ❑ new size Attached garage: ['existing w s d: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ # Recorded ❑ yL Commercial ❑Yes CYNo If yes, site plan review# Current Use S c� M t� C_ Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name (.C,a i( Telephone Number oT 7 f Address Fa m o v4 k License # 0N0 m A O z6 505 Home Improvement Contractor# 5 w � ; ao Worker's Compensation # W7 f C' ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 4-A x LO SO 1;� fit. be NdV, 5 ry SIGNATURE DATE b Z f ,r FOR OFFICIAL USE ONLY "APPLICATION# :v ' r,DATE ISSUED t MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION aK P2osr• Wu h3 FRAME a �� i INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL j FINAL BUILDING R- 5� is DATE CLOSED OUT low""o QLBa ASSOCIATION PLAN NO. S ML __ _ _ --The-Commonwealth-of-Massachusetts-_. - --- - Department of Industrial Accidents Office of Investigations ' 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Co"S�l'yj r 0'0 Address: Ll (i.'r-1 �' t1 Pam. S City/State/Zip: )�C) 04 1q 6Z 1-12�Phone#: f ,7 - y 7,3 ® 9 70 Are you an employer?Check the.appropriate bo Type of ct(required): 1.❑ I am a employer with 4. lam a general contractor and I employees(full and/or part-time). * have hired the sub-contractors 6. ew construction 2.❑ I am a sole proprietor or partner listed on the attached sheet. 7: ❑ Remodeling ship and have no employees ` These sub-contractors have g• Ft<emolition working for me in any capacity. employees and have workers' insurance. 9. ❑Building addition comp.•[No workers' comp. insurance P• required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ J am a homeowner doing all work officers have exercised their " 11.0 Plumbing repairs or additions myself ' right of exemption per MGL Y �o workers comp, 12.❑ Roof repairs - insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information f J Insurance Company Name: �-G. r 1•' TA-) C1 e KA vl i T � Policy#or Self-ins.Lic.#: ��) Q (.'7� �71 �( Expiration Date: 0 130 l Job Site Address:_1 .SAC,( —)04 C! 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 c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do.hereby c under the pains and penalties of perjury that the information provided above is true and correct Si afore: Date: Phone Official use only. Do not write in this area,to-be completed by city or town official City or Town: PermiVLicense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector ` 6. Other Contact Person: Phone#: } Information an-d-Instructions 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, express or implied,oral or written. An employer is defined.as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §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." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill 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' t I compensation policy,please call the Department at the number listed below. Self-insured companies should enter their i 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 permit/license 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.goy/dia Boston I Cape Cod 0131z.a2o ov©©Qlaooeoocq Building trust one project at a time Building Site-143 Inwood Rd,Centerville Mass TRADE NAME ADDRESS WORKMANS COMP# EXP. DATE Sitework/Demo Francisco Tavares Inc. P.O Box 398,E. Falmouth Mass 02536 WCA0310189-14 12.2.13 Foundations M.S.Sethares Corp. P.O. Box 2210, E. Falmouth Mass 02536 TWC3320152 6.16.13 Framing Covell and Sons 34 White Horse Rd, P;lymouth Mass 02630 WCC5011423012012 10.9.13 Plumbing/Heat/Electrical Harwich Port Heating&cooling Inc 461 Lower county Rd, Harwich Port Mass 02646 WC7938097 9.1.13 Insulation Greenstamp Corp. 184 Riverview Ave,Waltham Mass 02543 WC531S387575012 9.20.13 Board and Plaster K D Plastering Inc. 29 Langdon Rd, Norwood Mass 02062 IWCJ4152C 7.24.13 Painting RJ Painting 176 Sudbury Lane, Hyannis Mass 02601 WCT5943B 7.26.13 `ACC)R EP® CERTIFICATE OF LIABILITY INSURANCE D /DDIYYYY) 1/9/29/2013 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(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT -NAME, Costello The Getchell Companies PHONE (978)897_7773 IF No:(978)897-1553 183 Great Road Unit 15 -MAIL -ADDRESS:sally@ getchellcompanies.com PO BOX 844 INSURERS AFFORDING COVERAGE NAIC# Stow MA 01775 INSURERAAcadia Insurance 31325 INSURED INSURER B: Francisco Tavares, Inc. INSURER C: P.O. BOX 398 INSURER D: 69 Old Meetinghouse Rd INSURER E: East Falmouth MA 02536 1 INSURERF: COVERAGES CERTIFICATE NUMBER:2012-2013 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. ILTR TYPE OF INSURANCE ADD BR POLICY NUMBER MMIDDY EFF MM%DDYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTEIT_— PREMISES Ea occurrence $ 250,000 A CLAIMS-MADE F OCCUR PA0273113-15 12/2/2012 2/2/2013 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 }� POLICY JECPRO LOC $ 7 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident) $ 1 00.0 000 A ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED 0344385-13 2/2/2012 2/2/2013 AUTOS AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS Per accident $ included $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 A 4EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED I I RETENTION$ LA 520273117-15 12/2/2012 2/2/2013 $ A WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS'LIABILITY Y I NTORY LIM ITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED9 N N/A (Mandatory in NH) CA0310189-14 2/2/2012 2/2/2013 E.L.DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) * 10 days notice for non payment of premium, Project: Dowling Residence - Address: 106 Ransom Road, Falmouth, MA 02540. John and Judith Dowling and Sea-Dar Construction are listed as additional insureds on a primary and non contributory basis on all coverages other than workers compensation as 'required by contract. Waiver of subrogation shall apply to general liability, auto, umbrella and workers comp. policies CERTIFICATE HOLDER CANCELLATION mmakkas@seadar.com SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Sea-Dar Construction ACCORDANCE WITH THE POLICY PROVISIONS. 46 Waltham Street Floor 2-A AUTHORIZED REPRESENTATIVE Boston, MA 02118 Christina Dennehy/CRD ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 ontnns)nt Tho Ar:r)Rr1 name anti Innn arc rcnictororl mnrlrc of Ar:r1Rr1 Fo o --A 4toA 5 DATE(MMIDDIYYYY) A�" CERTIFICATE OF LIABILITY INSURANCE 12/4/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Andrew Roth NAME: Murray & MacDonald Insurance Services, Inc. PHONE (5O6)$40-2400 A/C No:(508)289-4111 550 MacArthur Blvd. E-MAIL ADDRE ,aroth@mmisi.com INSURERS AFFORDING COVERAGE NAIC# Bourne MA 02532 INSURERA:Travelers Indemnity Company 5658 INSURED INSURER B:PrO ressive Insurance Co. M.S. SETHARES CORPORATION INSURER C:Technology Ins Cc P.O. BOX 2210 INSURER D: INSURER E: EAST FAIMOUTH MA 02536 wsuRERF: COVERAGES CERTIFICATE NUMBER:12-13 Master GL 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 LTR TYPE OF INSURANCE I DL UB POLICY NUMBER MMIDDY/YYYY MMIDDIYYYY LIMITS_ GENERAL LIABILITY x EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTMT- X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 300,000 A CLAIMS-MADE Fx_1 OCCUR I6805304A944 6/16/2012 6/16/2013 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY(Per person) $ 250,000 B ALL OWNED X SCHEDULED 07834318-1 /20/2012 /20/2013 BODILY INJURY(Per accident) $ 500,000 AUTOSAUTOS X OWN HIRED AUTOS ED AUTOS XNON ED PROPERTY err a.dentDAMAGE $ AUTOS Medical payments $ $ 000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ C WORKERS COMPENSATION NI STALIMTU- OTH- AND EMPLOYERS'LIABILITY YIN CRY ANY PROPRIETOR/PARTNER/EXECUTIVE❑ N/A E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? C3320152 6/16/2012 6/16/2013 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space is required) Mooney Residence- Woods Hole- 96 Penzance Rd, Falmouth, MA 02543 . James and Lisa Mooney and Sea-Dar Construction are listed as additional insured including with respect to Completed Operations on a primary and non Contributory basis on all coverage other than Worker's Compensation as required by contract. Waiver of Subrogation applies to General Liability, Auto, Umbrella, and WC policies. CERTIFICATE HOLDER CANCELLATION kpearcel@seadar.com SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Sea-Dar Construction 46 Waltham St Floor 2A Boston, MA 02118 AUTHORIZED REPRESENTATIVE C Finigan, CIC, CRM/C ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 on1nn51 nt The A(:nPn namc and Inn^arc ranicfororl mnrlrc^f ARr)Pn Fr t­� ® DATE(MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 1YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME:CONTACT BRIAN J NOLOAN Nolan Schelle Insurance Agency PHONE FAX 508 746-6099 /a N,; (508) 746-6521 79 South, Street ADDRESS: BRIANNOLAN@NOLAN-INSURANCE.COM Plymouth, MA 02360 INSURE S AFFORDING COVERAGE NAICN INSURER A:ASSOCIATED EMPLOYERS INSURANCE INSURED INSURER B:Nautilus Insurance Cc Adam Covell INSURERC: Dba Covell & Sons INSURER D: 34 White Horse Rd INSURER E: Plymouth, MA 02360 INSURERF: 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MMIDDIY MMIDD/YYYY LIMITS g I GENERAL LIABILITY NN299413 12/21/12 12/21/13 EACH OCCURRENCE $ 1,000,000 X t COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTEDEa occurrence) $ 50,000 CLAIMS-MADE F_x1 OCCUR MED EXP(Arty one person) $ 5,000 PERSONAL&ADV I NJURY $ 1 00,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-CO MP/OP AGG $ 1,000,000 X1 POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED S INGLE LIMIT a accident $ _ ANYAUTO BODILY INJURY(Per person) $ ALLOWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIREDAUTOS _AUTOS Peraccident $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION WCC5011423012012 10/9/12 10/9/13 WC STATU- X OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN N/A E.L.EACH ACCIDENT $ 1,000,000 7 OFFICERIMEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,O00 000 If es,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1 000 000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Isrequired) CARPENTRY Zimmerman residence- 1 Way 26 Wellfleet, MA 02667 Nancy Zimmerman and Sea Dar Construction are listed as additional insured when required by contract CERTIFICATE HOLDER CANCELLATION SHOULDANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN SEA-DAR CONSTRUCTION ACCORDANCE WITH THE POLICY PROVISIONS. 2957 FALMOUTH RD OSTERVILLE, MA 02655 AUTHORIZED REPRESENTATIVE BRIAN J NOLAN ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Phone: Fax: (508) 437-0743 E-Mail: mmakkas@seadar.com fDate: 2/j/2013 Time: 8:57 AM To: Sea Dar Construction ® 1617- 23.0872 Rogers & Gray Ins. Page: 002 Client#.47452 � I �� � pi=�� HARWHEA ACORD. CERTIFICATE OF LIA ILITY IN URANCE DATO/YYYY) 2101 1120/2013 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(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: Margaret Young.-- Rogers&Gray Ins.-So.Dennis PHONE A 877-816-2156 (AIC,No,Ext): AIC No 434 Route 134 E-MAIL ADDRESS: South Dennis, MA 02660-1601 508 398-7980 INSURER(S)AFFORDING COVERAGE NAIL r i INSURER A:Selective Insurance Co.of S.C. INSURED INSURER B:Selective Ins.Co.of the South Harwich Port Heating&Cooling,Inc. INsuRERc:Safety Insurance Company 461 Lower County Road Harwich Port,MA 02646 INSURERD: INSURER E: INS URER 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 CONTRACTOR 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 OF INSURANCE DDL SUER POLICY EFF POLICY EXP LIMITS E LTR INSR WVD 'POLICY NUMBER MMtDDIYYYY MMIDDIYY A GENERAL LIABILITY S1899080 0910112012 0910112013 EACH OCCURRENCE $1 000,000 X COMMERCIAL GENERAL LIABILITY REM E TO RENTED PREMISES Ea occurrence) $100 OOO CLAIMS-MADE Fx�OCCUR MED EXP IAny one person) $10 000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $3,000 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $3,000,000 POLICY PRO- $ JET LOC C AUTOMOBILE LIABILITY 2436113 0910112012 09/01/2012 COMBINEDSINGLELIMIT 1,000,000 Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED M SCHEDULED AUTOS N AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOSNON-OWNED PROPERTY DAMAGE $ AUTOS Per accident A X UMBRELLA UAB OCCUR S1899080 9/0112012 09/01/2013 EACH OCCURRENCE $5 000 000 EXCESS LIAR CLAIMS-MADE AGGREGATE $5 00O 000 DED I X RETENTION$O 1 $ B WORKERS COMPENSATION WC7938097 9/01/2012 09/0112013 X WO VTITWs ORH- AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN N E.L.EACH ACCIDENT $500 OOO OFFICERIMEMBER EXCLUDED? � N I A (Mandatory in NFL E.L.DISEASE-EA EMPLOYEE $500,000 It yes•describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT s500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space is required) **Workers Comp Information** Included Officers or Proprietors Mooney Residence-Woods Hole-96 Penzance Road,Falmouth, MA 02643 James and Lisa Mooney and Sea-Dar Construction are listed as additional insured including with respect to Completed Operations on a primary and noncontributory basis on all coverage other than Workers' Compensation as required by contract. Waiver of Subrogation applies to General Liability. CERTIFICATE HOLDER CANCELLATION Sea Dar Construction SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 46 Waltham Street ACCORDANCE WITH THE POLICY PROVISIONS. Floor 2-A Roxbury,MA 02118 AUTHORIZED REPRESENTATIVE ©198 -2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD #S94523/M945220 TLH '`` CERTIFICATE OF. LIABILITY INSURANCE DIDD/YYYY) 2/4/24/2013 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(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: BOynton Insurance Boynton Insurance Agency PHONE (761)449-6766 AAIC No:(781)449-4269 72 River Park Street -MAIL ADDRESS: PRODUCERCUSTOMER,pff 00007330 Needham MA 02494 INSURERS AFFORDING COVERAGE NAIC# INSURED -INSURER ANautilus Insurance Company INSURER B Norfolk & Dedham Mutual Fire 23965 INSURER CLiberty Mutual Ins Company GREENSTAMP CORPORATION INSURERD: 184 Riverview Ave INSURER E: ' Waltham MA 02453 INSURERF: COVERAGES CERTIFICATE NUMBER:CL3012600226 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 I ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE IN SR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS GENERAL LIABILITY X EACH OCCURRENCE $ 4,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 A CLAIMS-MADE OCCUR CP01524204-12 11/17/2012 11/17/2013 MED EXP(Any one person) $ 5,000 X Pollution Liability PERSONAL&ADVINJURY $ 4,000,000 GENERAL AGGREGATE $ 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 4,000,000 X POLICY PRO- E T LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ 1,000,000 91032062A 8/31/2012 8/31/2013 BODILY INJURY(Per person) $ B ALL OWNED AUTOS BODILY INJURY(Per accident) $ X SCHEDULED AUTOS PROPERTY DAMAGE X HIRED AUTOS (Per accident) $ X NON-OWNED AUTOS Medical payments $ Underinsured motorist BI split $ A X UMBRELLALIAB X OCCUR FX153222212 EXCESS LIAB CLAI EACH OCCURRENCE $ 1,000,000 MS-MADE 1/17/2012 1/17/2013 AGGREGATE $ 1,000,000 DEDUCTIBLE $ RETENTION $ $ C WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N co ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1 OOO OOO OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) C531S387575012 9/20/2012 9/20/2013 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under E.L.DISEASE-POLICY LIMIT $ 1 000 000 DESCRIPTION OF OPERATIONS below �fficers Covered DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Project: Mooney Residence - Wood Hole - 96 Penzance Rd. Falmouth MA 02543 Sea-Dar Construction and James & Lisa Mooney are listed as additional insured's including with respect to Completed Operations on a primary and non contributory basis on all coverage's other than WC as required by contract. Waiver of Subrogation applies to General Liability, Auto Umbrella and Workers Compensation policies. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Sea- Dar Construction ACCORDANCE WITH THE POLICY PROVISIONS. 46 Waltham Street Floor 2A AUTHORIZED REPRESENTATIVE Boston, MA 02118 William Rohr/WRR .' '� = _"!�"r wit• ..��. ACORD 25(2009109) ©1988-2009 ACORD CORPORATION. All rights reserved. INS025(200909) The ACORD name and logo are registered marks of ACORD ,a6o 6 CERTIFICATE OF LIABILITY INSURANCE (MMIDDIYYYY) �� FO8DAT� 22/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER r CONTACT NAME: Dianne PHONE Dupont Insurance Agency Inc. (A/C,,, No, Ext): (617) 376-0795 jalc, No):(617) 479-9121 410 Willard Street ADDRESS: dupontq@quixnet.net PRODUCER -CUSTOMER ID p.R Plastering,r D Plterin Inc. Quincy MA 02169- INSURER(S)AFFORDING COVERAGE NAIC p INSURED INSURER A :Main St America K D Plastering, Inc. INSURER B NGM INSURANCE COMPANY 29 Langdon Rd INSURER C INSURER D INSURER E Norwood MA 02062- 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 TYPE OF INSURANCE S POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER (MMIDD/YYYY) (MMIDDIYYYY) A GENERAL LIABILITY IIPJ4152C. 7/24/2012 7/24/2013 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED / / / / PREMISES Ea occurrence $ 500,000 CLAIMS-MADE Fx_1 OCCUR / / / / MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: / / / / PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY PRO- LOC / / / / $ AUTOMOBILE LIABILITY / / / / COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS / / / / (Per accident) NON-OWNED AUTOS / / / / $ $ UMBRELLA LIAB OCCUR / / / / EACH OCCURRENCE $ EXCESS LIA9 HCLAIMS-MADE / / / / AGGREGATE $ DEDUCTIBLE / / / / $ RETENTION $ / / / / $ WORKERS COMPENSATION KCJ4152C 7/24/2012 07/24/2013 WC STATU- OTH- B AND EMPLOYERS' LIABILITY YIN X TORY LIMITS X ER ANY PROPRIETORMARTNERIEXECUTIVE / / / / - E.L.EACH ACCIDENT $ 500,000 7N(A OFFICERIMEMBER EXCLUDED? (Mandatory In NH) / / / / E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below / / / / E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I-LOCATIONS I VEHICLES (Attach ACORD 101, Addilioeal Remarks Schedule, if more space is required) James and Lisa Mooney, The James F. Mooney III Residence Trust, and Sea-Dar Construction are additional insureds on a primary and non contributory basis on the General Liability policy when required by written contract by means of BPM 3105 (12/07) . t CERTIFICATE HOLDER CANCELLATION mmakkas@seadar.com SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Sea-Dar Construction 46 Waltham Street AUTHORIZED REPRESENTATIVE Floor 2A 4 ` Boston MA 02118- ufr 1 ACORD 25(2009/09) ©1988-2009 ACORD CORPORATION. All rights reserved. INS025(200909) The ACORD name and logo are registered marks of ACORD Ie .�z ,�,.►,'.;,. 1ri- :.; .- ' ,fi _ k 3?',: w z:' ' ..; z ;..,,,a a,.:,:r �.:,.� 'k`...,''.^�,."F' `:: + OATEIMM/DD/Y1'.YVI ". CERTIFICATE OF LIAtB'ILITY INSURANCE 1 09/�2012 THIS CERTIFICATE IS ISSUED AS,A MATTER,' OF INFORMATION ONLY ,AND CONFERS^ NO RIGHTS-UPON THE.GERTIFICATE HOLDER THIS CERTIFICATE' DOES NOT AFFIRMATIVELY'ORi=NEGATIVELY °•AMEND EXTEND° OR ALTER, THE COVERAGE AFFORDED y BY THE" POLICIES ' ' BELOW... ,THIS. CERTIFICATE OF ,INSURANCE,, DOES ,NOT"CONSTITUTE A ♦CONTRACT`'BETWEEN THE 'ISSUING, INS,URER(S) •'AUTHORIZED „ REPRESENTATIVE OR PRODUCER,.AND THE CERTIFICATE HOLDER L F A IMPORTANT: If'-the certificate«holder Is..:an ADDITIONAL INSURED; +the policy(le$) 'must be endorsed If SUBROGATION 'IS', WAIVED subject^to . i the terms and'coriditions:: ot'the>'policy certain"policies may ,require`san en`dorsement.`A statement on:,thls certificate,does not,.confer`rights to the ' certificate holder in lieu of such,endorseljient(s): PRODUCER h:. z, Schlegel 6 Schlegel` Insurance Brokers Inc ' y FAX ' 1 - 1 c No508) nT71 0+.663(508) 77(A7C,No,Ex1). 34 MAIN STREET 1 'ADDRESS s .PRODUCER CUSTOMER ID#`. n �- .. ,'.• =1."Te3t`�YarIIlOIIth, MA, 02673 J' ;.� 1 ,f� - 9N8URER(S�AFFORDING COVERAGE _ a NAIL#, :INSURED a' _ INSURANCE; 1 %ManoeY;Ozanot:Neto Dba R Painting , "•� wsuRERANGM � F � p (, z ,, w>;uRER BNGM INSURANCE`4 •� ! � r.� # t= 1_1 176.Sudbury_.Lane. , INSURERC: ti 7 :Hyannis, MA ,0 ,, 260.1... ,.- + - -� a .IN§uRER,E: :. _ •r.- ,; SURER* a... 3 COVERA.GES CERTIFICATE NUMBER', ° r '' t P ,F �� . I REVISION NUMBER ' THIS AS' 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;j TERM OR -CONDITION OF:"`ANY,4•CONTRACT ;OR OTHER DOCUMENT NTH, RESPECT TO UVHICH'THIS CERTIFICATE,MAYtBE ISSUED ,OR'•. MAY PERTAIN, 'THE ,INSURANCE, 'AFFORDEDCSBY THE",POLICIES,DESCRIBED 'HEREIN IS• SUBJECTe TO ALL `THE ,TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES'e11MITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS " as n INSR .a. 4 I .) TYP.E OF INSURANCE _z WSR WVD, # LTR n' _ ,f ROLICY NUMBEJL R p .' (MMC�OfYYYY ' r 'LIMITSf= T = GENERAL LIABILITY _ MPT5948B 07/26/2012 07/2, 13 EACH gccuRRENCE §2,00`0,000 1 * '" - 5-, x p DAML4GET0 RENTED -- _ i g.i t6MMERCIAL GENERAL LIABILITY. •, Y•# i. { ' + ` PREMISES(Ea occurrence),, §50 0,OO 0 ==V r CLAIMS-MADE x-Y OCCUR, } < " - - MED•EXP(Any o64,person)=, $ -0,,600 PERSONAL&AOV INJURY �' §2,O,OO i . ' xr ;.! ,GENERAL AGGREGATE §4,000,000,,,•' GEN'L AGGREGATE'L`l APPLIES PER Ii, + �' ,� �a PRO- .,- .S PR §4,OQ'0,000.._ i - , ODUCTS COMP%OP AGG .POLICY..:: JECT•- LOC ' AUTOMOBILE LIABILITY ,q'• - ) z sl COMBINED SINGLELIMIT Y '°T 1 - (Ea accident) ,, S ° -�:ANYAUTO 'r• a Y _I BODILYINJURV(Per person) § OWNEDAUTO6 <• BODILY INJURY(Peraccident) SCHEDULES)AUTOS' I 1•' r ` :` 1 PROPERTY-DAMAGE - HIRED AUTOS r ) T '` ,> ° '�` (Per aSatlenQ i". "'- § r zf IJON-OWNEOAUTOS ;- ` �-UMBRELLA LIAB' 'OC CUR, , ; I EACH-OCCURRENCE § '" _ EXCESS LIAB' CLAIMS•MADE• } a: AGGREGATE § .. , DEDUCTIBLE x [RETENTION_,:, •§ - `` x' 'fr ,t� 1 B WORKERS COMPENSATION AND�EMPLOYERS LIABILITY "' ",. Y/N .., WCT5943B 1 O7/2�6/2012 07/26/20,13 R ORY IM TS' ER- " r ANY PROPRIETOR/PARTNER/EXECUTIVE- ' k ` OFFICERIMEMBFA'EXCLUDED7`' NFA r �f t - p z EL EACH ACCIDENT _ 5 lOO�,OOO e (Mandatory In NH)':� DISEASE EA EMPLOYEE $ 1OOy tf,yes;descnbe under - '! ' t . 4 s - DESCRIPTION OF OPERATIONS beI f EL.DISEASE POLICY LIMIT q DESCRIPTION-0F OPERATIONS 1 LOCATIONS!VEHICLES(Attach ACORD 101,,Addrtr66a4Remarks Schetlule if morespace Is regwretl) etx * .�$" z�, w '• J•t 1 MANOEL HAS ED ELECT ,'TO -BE'COVERED ON HIStT+TORKERS COMPENSATION ,POLICY­l • -LISTED- AS ADDITIONAL INSURED BY:CONTRACTiONLY MILLER*STARBUCK CONSTRUCTION INC ; CERTIFICATE HOLDER!,",' t es d CANCELLATION• , SEA DAR CONSTRUCTION tiv­ 29,57 FALMOOTH ROAD i,, ,z "SHOULD uANY OF,4HE ABOVEDESCRIBED POLICIES BE'=CANCELLED BEFORE' xt • .ate t THE .EXPIRATION, ; DATE THEREOF NOTICE' WILL ~TBE DELIVERED ':1N OSTERVILLE./ -MA 02655 . ? .i + A ACCORDANCE WITH THE POLICY-PROVISIONS = r 'AUTHORIZED REPRESENTATIVE i j`•. t - _ € ©I988 199 5,, C0 D CORPORATION All.rights reserved ACORD 25,(2009/09) The ACORD ri'ame and logo...... glster`e arks of ACORO, ' p r.w..a�..-• r.,,�•`. r",.'` Y REScheck Software Version 4.4.4 Compliance Certificate Project Title: Inker Residence Energy Code: 2009 IECC s Location: Hyannis,Massachusetts Construction Type: Single Family Project Type: New Construction ` Conditioned Floor Area: 0 ft2 Glazing Area Percentage: 36% Heating Degree Days: 6137 Climate Zone: 5 Permit Date: Construction Site: Owner/Agent: Designer/Contractor: 143 Inwood Lane Peter Breese ` West Hyanis Port,MA 02672 r Breese Architects 11 Beach Street Vineyard Haven,MA 02568 Compliance: 2.9%Better Than Code Maximum UA: 1203 Your UA:1168 The%Better or Worse Than Code Index reflects how dose to compliance the house is based on code tradeoff rules. I It DOES NOT provide an estimate of energy use or cost relative to a minimum-code home. Envelope Assemblies Waft MUSIXG �'...• 1 Floor 1:All-Wood Joist/Truss:Over Unconditioned Space 3,550 30.0 0.0 117 Wall 1:Wood Frame, 16"o.c. "_ 5,140 21.0 0.0 187 Window 1:Wood Frame:Double Pane With Low-E 1,235 0.350 432 SHGC:0.00 Door 1:Glass 630 0.350 221 SHGC:0.00 Ceiling 1:Cathedral Ceiling P 3,970 38.0 '0.0 107 Ceiling 2:Flat Ceiling or Scissor Truss _ 975 38.0 0.0 ; •29 Basement Wall 1:Solid Concrete or Masonry f 1,660 21.0 0.0 75 Wall height:9.0' Depth below grade:8.0' Insulation depth:8.0' Compliance Statement: The proposed building design described here is consistent with the building plans,specifications,and other calculations submitted with the permit application.The proposed building has been designed to meet the 2009 IECC requirements in REScheck Version 4.4.4 and to comply With the mandatory requirements listed in the REScheck Inspection Checklist. 3 f 2 31 t-> Name-Title 7 Signature Date Project Title: Inker Residence Report date: 03/22/13 " Data filename: S:\PROJECTS\lnker\Drawings\Area Calculation-Energy\Energy Calculation Mainhouse.rck Pagel of 1 2009 IECC Energy Efficiency Certificate Wall 21.00 Floor 30.00 " Ceiling!Roof 38.00 Ductwork(unconditioned spaces): + Window - 0.35 Door 0.35 Heating System: r— q ' Cooling System: G k L Water Heater: a 5 r6 r Name: Date Comments: F ^:_,>' 'x Cr3 '• 'k,.[ R 'pY_ y:-.. ...._. , .>. ,.r x•, >'- S. &:r. ,.,,.H�k ,'. � �sf:, A,Y.. .r x._ u...'�z �it� .. 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C77, s,, f r* I ` } 3 � 7-7 IPAa ray a a, y i � ' $�� ,'� f �'' ><°��. ��it '� .'- fir. � � X ti�& ��,� S ..,R s ��',.n •�,� ::c �'.� _ r � t e' ,. "�' 4 . +.'�{''( wj "Eft IM £ ! •'t x AUa At yY ♦1�� � :,��v MAW �q � ,� 'x , �'lg +' ,is, h 'ty :�1, u F a• ' r w h _ {=n' a'�'R $,a" 'rx �,*' PF t r , t- �C s� c. lid �'� ' k �✓f��' � �� r � salt' �w "✓'j u+ no3 f1 J N (1 O N 3 nala o a5l N O N 6 7 N all Q i N o �O �7 March 28, 2013 MA NZIE ENGINEERING Mr. Thomas Perry CONSULTANTS Building Commissioner structural•civil•environmental Town..of Barnstable - 200 Main Street Hyannis,MA 02604 H, p >`� RE: Structural Design for Inker Project, 143 Inwood Ln, Hyannisport M Dear Mr. Perry, x McKenzie Engineering Consultants; Inc. (MEC Inc)has been retained by Breese Architects to complete structural design for the proposed new house, garage, and pool house for the Inker Project located at 143 Inwood.Lane in Hyannisport4,4 y5 To date we have completed the wind.and framing design for'the main house and have r %; started review and design for the wind and framing for both the garage and pool house. J The plans for the main-house have been stamped and submitted for permitting. k1 � Per discussions with the architects and the contractor;MEC Inc will complete all design for,the framing systems,the wind resistive construction requirements for 110 mph in Exposure C, for the pool house and garage and will.submit stamped drawings for permitting as,soon-as possible; At this point we do not see.any issues with the overall plans and elevations that will prohibit•An adequate design for framing.and wind resistive construction requirements. rt The contractor would like to have the permit review process be completed qn the main house while awaiting the final permit set plans for the garage and pool house in order to begin construction on the main house.as;soon as possible. No work will:be started on the pool house or garage until plans are.complete and approved by your office for :1:.. permit: If you have any questions,,feel free to give me a c �:;. ; S Sincerel MAR�t A McKENZE A Pres.,McKen i ring Conw.l ants, Ing ' cc. Breese Architects LA 4 CO CO 1279 Millstone Road Brewster,MA 02631 cx� t 774.353.2144 f 774.353.2142 www.mckengineers.com � g � ' '0' off° ar . e ' Iaolr 5 -me es. ` y. zr.�trtsrAaa:�, asses Thomas F.Geiler,Director. Building Division Tom Perry,Buildmi k Commissioner 200 Main Stiee,Flyannis,MA'0260I" WW ;to rri.bariastable aiza us„ Off ice: 508-862-4038 Fax: 508-790-6230 Prop ner.. us Complete and Sig-n Tl s Section If Using A.Buiider ,as Owner of the subject property hereby authorize .: V-L �,6 J 'to act on ray behalf, in all.matters relative to,Work author zed:by this buildingpermit : (Address of job).. - 'Pool fences and alarms are the restionsibility cif the applicant. pools are not to be filled or utilized before fence is ingtalled..and all final inspections are performed and accepted. �igl?atz e of Owner: . Signature o£App;lca tTAkf Print Name Print Name " 311 Z Late Q:FORtvIS:OWNM�ER-WSSIONPOOLS 6P-012--- -- - r. OF THE A Town of Barnstable Barnstable Historical Commission 200 Main Street,Hyannis,Massachusetts 02601 M $TABIZ (508) 862-4787 Fax (508) 862-4784 i639, www.town.bamstable.ma.us ArFD MA'S A Arlene M. Wilson, PWS A.M. Wilson Associates, Inc. 20 Rascally Rabbit Road Unit 3 ;. Marstons Mills, MA 02648 Linda Hutchenrider, Town Clerk 367 Main Street, Hyannis, MA 02601 JThomas Perry, Building Commissioner 200 Main Street, Hyannis MA 02601 Re: DECISION of the Barnstable Historical Commission, pursuant to the Code of the Town of Barnstable ss 112-1 through ss 112-22; an application for DEMOLTION as follows: 143 Inwood Lane, Centerville,MA MAP PARCEL: 225/927-001 The Barnstable Historical Commission considered the above referenced application for demolition of the house at the e above referenced location at a duly noticed Public Hearing held November 14,2012. The applicant's representative reported that in addition to posting the Intent to Demolish notice on the dwelling,the owners sent notification to the neighborhood association who forwarded it to the members. Architect Peter Breese discussed the architectural features of the dwelling and noted that less than half the footprint is the old gambrel house which has been added onto at least twice. He also reviewed a rendering of the proposed structure. Members reviewed photographs of the house,'discussed its architectural significance and asked the applicant to consider incorporating a gambrel fagade into the design of the new structure. George Jessop appreciated the design of the new dwelling and that it is stepped into the landscape. It is a predominant style and well used on the Cape, however,the scale of the new dwelling would allow the incorporation of a gambrel,element. No one from the public was present. Present and voting for the motion that the Historical Commission finds that the structure located at 143 Inwood Lane,Centerville is not a preferably preserved significant building and that the demolition of this structure would not be detrimental to the historical, cultural or architectural heritage of the Town. Jessica Rapp Grassetti,Marilyn Fifield, George Jessop,Len Gobeil,Laurie Young, Ted Wurzburg Voting against the above motion: Nancy Shoemaker S' cerely, Jessica Rapp Grassetti, Chairman' November 20;2012 J t Town of Barnstable tie Barnstable HistoricgtjC h isn o�n 200 Main Street, Hyannis, Massachusetts 02601 9BMMSTABLE,9* (508) 862-4787 Fax (508) 862-4784 039. Vr www.town.bamstable.ma.us Arlene M. Wilson, PWS A.M. Wilson Associates, Inc. 20 Rascally Rabbit Road Unit 3 Marstons Mills, MA 02648 0NJ = '' Linda Hutchenrider, Town Clerk m`` 367 Main Street, Hyannis, MA 02601 , Thomas Perry, Building Commissioner 200 Main Street, Hyannis MA 02601 Re: INITIAL DECISION of the Barnstable Historical Commission, pursuant to the Code of the Town of Barnstable ss 112-1 through ss 112-22; an application for DEMOLTION as follows: 143 Inwood Lane, Centerville, MA . MAP PARCEL: 225/927-001 The Barnstable Historical Commission considered the above referenced application for demolition of the house at the above referenced location at their meeting of October 25, .2012. The Commission.reviewed photographs of the building and.heard from the applicant's representative, Arlene Wilson, regarding the condition of the property and the historic analysis conducted by Breese Architects. The=Commfission=members-bel evedxthere=was=architecturalmsigni-f cance-not=only=for the house butalsoh owit - tesato-heneig-hohod= n . fer-red heppiotoaPublice ii Hearing.Th s_Hearing will beTheldiat 4-00pim: -November 1=4;:201-2;in=thezS-electmen's Conference,;Town-Hall;367 Main-Street-,Hyannis;MA. Sincerely, . Jessica Rapp Grassetti Jessica Rapp Grassetti, Chairman October 29, 2012 F Town .of Barnstable Growth Management Department Barnstable Historical Commission ' www.town.barr stable.ma.usmistoncalcommission NOTICE OF INTENT TO DEMOLISH OR MOVE A HISTORIC BUILDING Date of Application 10/17/12 Building Address: 143 Inwood Lane Number Street West Hyannisport 02672 Assessor's Map#225 Assessor's Parcel#27-1 Village ZIP Property Owner R.Walker T.Walker& Blue Herron Trust Name Phone# Property Owner Mailing Address (if different than building address) 3754 Lamb Hill Road, Wells, VT 05774 Applicant: Lesley & Benjamin Inker PFGpeFty QwF;e Applicant e-mail address: Ben Inker ben.inker( gmo.com Lesley Inker Inker(alTuftsmedicalcenter.org Contractor/Agent: Breese Architects A. M. Wilson Associates, Inc. Contractor/Agent Mailing Address:. P 0 Box 1110 20 Rascally Rabbit Road, Unit 3 Vineyard Haven, MA 02568 Marstons Mills, MA 02648 Contractor/Agent Contact Name and Phone#: Peter Breese 508-693-8272 Arlene M.Wilson 508-420-9792 Name Phone# Contractor/Agent Contact e-mail address:.peter aQbreesearchitects.com amwilsonassoc(a)amwilsonassociates.com Existing Building Material: Wood Type of New Construction Proposed: Single Family Residence Provide information below to assist the Commission in making the required determination regarding the status of the Building in accordance with Article 1, § 112 Year built: 1910 Additions Year Built: Various Is the.Building listed on the National Register of Historic Places or is the building.located in a National Register District? No ® Yes ❑ Is the Building associated with one or more historic.persons or events, or with the broad architectural, cultural, political, economic or social history of the Town or the Commonwealth? No Is the Building historically or architecturally.important in terms of period,.style, method of building construction, or association with a famous architect or builder.either by itself or in the context of a group of buildings? No (See Attached) December 2011 r An-derson nsu ion Voice: 781-857-1000 s Fax: 781=857-1054 RT TO: L L)2 OUCl FROM: JW Ext. a6 � DATE: RE: Dumber of pages including cover: . Message L et 'v �o Anderson 781-857-1000 Fax 181-857-1054 Insulaflon, Inc. www.andersonlnsul.com 706 Brockton Ave PO Box 2003 Abington, MA 02351 lnsu/amon Cerfifimfe WORK AREA ITEM INSTALLED Overhang R-38 Icynene Open Cell Spray Foam Insulation 10.31n e? EXT.Walls 26 R-20.3 Icynene Open Cell Spray Foam Insulation LDC-5.51n Blockers/Rim Joist R 20.3 Icynene Open Cell Spray Foam Insulation LDC-5.5in "' Furred Walls R-13.5 Icynene Closed Cell SprayfFoam Insulation MDC-2in ^ - Windows and Doors Foamed Great Stuff-Minimal Expansion,Foam Under Flat Roof Deck R-38.5 Icynenegosed Cell Spray Foam Insulatlon MDC-5.7in -' Furred Walls DC 315 Spayed on Ignition Barrier for Foam Customer: Sea Dar Construction ` Job Number: 195969 Sob Address Inker 143 Inwood Lane Hyannisport Date Completed In er one na I t\�EtRoo 7 �a international Fireproof Technology Inc. 0 r 17528 Von Karnlan Ave. Irvine, CA 92614 .'� September 21,2010 To whom It may concern, This letter is to verify that Anderson Insulation is a qualified and certified applicator of our product DC 315 over polyurethane spray foam.Anderson has received the appropriate training necessary to apply and coat both thermal and Ignition barrier according to the specs of the paint.if you have any questions please feel free to contact me. Thank you, Richard Guarnieri Vice President of technology and Operations Phone:949-975-8588 Dl recta 949-306-4253 . Fax: 949-724-8898 Web Site www.pailittoprotect.com . Email Richardepalnttoprotect.com_ oor International Fireproof Technology Inc. faint To Protect Tm ` Leading Edge Technology for Unsurpassed Fire Protection 949.975.8588 DC315: Certified Thermal Barrier over(SPF) Polyurethane Foam. DC316 is approved at the highest spread rate on the market. DC315 is Warnock Hersey Listed. DC315 is a Green Product, VOC is Less then 50 a/I. What is truly amazing about DC316, It applies as easy as regular latex paint and being a water base it cleans up a snap. Easily satisfying IBC code compliance for "Thermal Barrier" and "Ignition Barrier". DC315 was tested and meets and qualify as a low emitting material In the Collaborative for High Performance Schools rating system Using DC315 will satisfy IBC code compliance for"1S Minute Thermal Barriers" and "lgnition Barriers" on your next foam Job means: • Large single coat spread rate UL-1715 Thermal Barrier o (88.88 sq. ft./gal @ 18 mils wet and 12 mils dry)coverage rate of 1.136 gallons(.4.3 Q per 100 square feet(9.3 m2) 'NFPA 286 (AC377)Attic Crawl Space Ignition Barrier o (130 sq.ftJgal'@ 12 mils wet 8 mils dry)coverage rate of.77 gallons(2.9 L)per 100 square feet(9.3 m2) • Reduced labor cost,reduced material cost and higher profits Fast turnaround time • No formaldehyde • Easily applied with a sprayer,brush or roller No complicated mixing-Just stir the paint before application - - • No waste • Fast and easy cleanup of ourwater base latex paint,tools.&equipment • WIII not gum up or block spray equipment • Passed strict EPA-VOC and AMQD tests • Non Toxic,Low Vapors,Low VOC lase the 50 making DC316 a Green Product: • Two year shelf life • Certified Code Compliant Coating Recommended Uses:This product is designed for use on Interior polyurethane foam surfaces PRECAUTIONS:Adequate ventilation must be provided during and after application until the coating has dried.Avoid breathing vapors or spray mist.Close container after use. Read�MSDS before opening containers. SURFACE PREPARATION: Can be applied directly to fully cured polyurethane foam surfaces.All surface preparation ` should be carried out In accordance with good painting practices.'Remove all loose,peeling or powdery existing paint from the surface.All dirt,grease,oil,wax,and other foreign matter MUST be removed with a detergent, rinse surface thoroughly with clear water,and allow drying. i Application Equipment:DC315 can be applied by brush,roller or airless sprayer. Brushing:Use top quality polyester/nylon blend brushes such as those supplied by Purdy,Wooster,or equivalent. Rolling:3/8"polyester blend nap roller covers generally work well. Spraying:Pump:(Greco)for best results use Graco 795 airless sprayer,with a minimum 2000 PSI •Tip:526—529 or equivalent. • Filter:60 mesh • Hose:Use minimum size of 3/8"airless spray line for the first Sol from pump. Airless Spray: •Fluid Pressure: .........................2000 PSI or higher • Strainer:,..„.............................60 Mesh • Fluid Hose:..............................3/8 diameter with a X"whip . •Tip:...................... ..................021-.029 Conventional Spray •Air Supply.................... ......12 CFM;50 psi at nozzle, • Fluid............„.............. .. 15-20 psi • Gun.............................. .....Graco 217-800 to 217-816 •Type....... .. ... ...... .....External Mix •Reduction .................................Up to 756 .APPLICATION:Stir thoroughly and apply WFT per test. .Do not apply in temperatures below 502F(10RC). CHARACTERISTICS: , Finish ..:„.„.........................,...................Flat Color.................. .................... .........Off-White Spreading Rate...............„.:.....,...........For 15 minute Thermal Barrier coverage rate of 1.136 gallons per 100 square feet. Spreading Rate...........................„,.,,...For AC377 Attic Crawl Space coverage rate of.77 gallons per 100 square feet. (47 g/I) Volume Solids.. „..............................65% Drying Time @ 770F&50%RH:.......To touch 1-2 hours to recoat 2 to 4 hours Type of Cure....................... ..............Coalescence Flash Point... .............................None Reducer/Cleaner.„......„....„..............Water Shelf We.........................................:..2 years(unopened) Packaging......... „....... ....1&5 gal.Containers Shipping weight................. ;.......1 gal-13 Ibs 5 gals-58 Ibs Application „.............. ...........Brush,roller,conventional and airless spray I Anderson781-8574000 Fax 781-857-1054 nsulation, Inc. www andersoninsuiXorn 706 Brockton.Ave PO$ok 2003 Abington, MA 02351 nsu/ation Certificate WORK AREA ITEM INISTALLED Underside of Roof R-38.5 IcyneneClosed Cell Spray Foam Insulation MOC-5.71n Overhang R-38'Icynene Open Cell Spray Foam.Insulation 10.3in. EXT.Walls 2x6 R-20.3 Icynene Open CeILSpray Foam Insulation LDC-5.5in Blockers/Rim Joist R-20.3 Icynene Open'Cell Spray Foam Insulation LDC-5.5n Furred Walls R-13.5 Icynene Closed Cell Spray Foam Insulation.MDC-2in' Windows and Doors Foamed Great Stuff-Minimal Expansion Foam Under Flat Roof Deck R-38 5 Icynen-Closed Cell Spray Foam Insulation MDC-5:7in Customer: Sea Dar Construction Job Number: 195969 Job Address Inker 143 Inwood Lane Hyannisport Datecompleted.: 3/ jqll � nstfiller a 25:1ebruary 2014 M C K<E Nil I E Mr.Thomas Perry . ENGINEERING Building Commissioner CONSULTANTS Town of Barnstable xruccuml•d%il emimn-Mml 200 Main Street Hyannis,MA.02601 RE: Framing Inspection;;Inker:"ecti; 143 Inwood Lane:Hyannispork.M;A:. Dear'Mr..Perry.; McKenzie E Consultants;`Inc was retained by Breese Architects to complete structural and wind design plans for the I.nker:Protect at 143 Inwood Lane in H_ aunts ort. During the course.of framing we completed site visits to nspeet;progress and foxeview f3Sn'W.E:W .. f the,major framing elements as.w-11 as installation of the wind resistive construction elements. On February.211'of,2014, we.complet -d:a site�Visit to>do the:final inspection of the framing elements;and the wind',resistw hardware. ' Based on these inspections, we find that the rough frame and wind resistive construction elements were constructed in substantial,compliance wath;<the stamped'design plans:.. oIP there are an uestions on this matter feel:free to contact me at an time:: y:9 y ' t Sincerely, M kA•; enzie tug Consultants; Inc_.- i 'nuat ce. Sea-Dai Construction, Breese Architect 1279.Milktone Road Btewster, MA 02631 774:353.2144 z. F.774.353.2142 www.mckengi n eers.com DON S,GREER Craigville Beach Road West Hyanniaport Maasachuaotta 02672 MailAddreaa RO.Box 327 October 3,1974 Mrs.Grosvenor C.Barry c/o Dr.Robert T.Barry Box 308 W.Hyannisport.Ma.02672 Dear Mrs.Barry: The Harvard Trust Company and I are trustees of a trust which owns a parcel of land with the buildings thereon,lying south of yours and sometimes known as the Still son property,between Greely Avenue and Harborvlew Street In that part of Barnstable,Massachusetts,known as Craigville.I bought the land from Mrs.Still son and conveyed It to the Harvard Trust Company and myself as trustees. This deed Is recorded In Barnstable County Registry of Deeds In Book 1497, page 461.Included with the deeds,both from Mrs.Still son to myself,and my self to the trustees,was a right of way.In conmon with others,to use Harbor- view Street and to use a parcel of land approximately thirteen (13)feet wide at the southern end of Harborvlew Street,being a part of beach lot 19,for access over the beach to the water. The beach shelter In this strip of land which prevents this access to the water and cuts off the right-of-way I understand was erected by you and Is your property. While the existence of the beach shelter might be considered a technical matter. It effectively and legally prevents access to the beach over the right-of-way except by going around the shelter onto other peoples property.Therefore,If the beach shelter was moved from this right-of-way or torn down there would be no problem. Under the circumstances,and having a desire to protect my property rights,I write you to Inquire If the facts as I have them are correct and If so what action win be taken to correct the situation. Yours very truly. Don S.Greer DSG/jgm May 14,1976 Dr.Robert T.Barry Box 308 West Hyatmlsport,Ma. Ret Don Greer property Dear Dr.Barry: We have searched our files and find no record of a Building Permit for the work completed on the property of Mr. Greer. In 1956 that locus was in an RA-1 zone requiring a 71/2*side and rear line setback.In 1957 the zoning was changed to RB-1 requiring a 10'setback. As was mentioned upon our recent inspection,the Town has no jurisdiction in this matter and any litigation would be your responsibility. JDD/gr cc:Board of Selectmen Town Counsel Peace, Joseph D.DaLuz Building Inspector to time date Vip phone message message from firm name phone number •telephoned •please call back •called to see you • will call again •left the following message AMSTSAOAH PRINTINO AND LITHO CORP.AMSTEROAM.N.T.ITEM NO.30600 y'fre^/l^ 77r-?700 December 29#1975 Dr.Robert T.Barry- Box 308 West Hyannlsport,I'ia. He;Don S.Greer Dear Dr.Barry: I have viewed the property of Mr. Don S.Greer in reference to your inquiry.I find that the foundation has been there for many years and that the foundation does not meet todays zoning setback requirement.Howeveri I would belie-ve that the foundation has a non-conforming status. I understand that at one time the garage in question had a flat roof.There is now an "A"type frame.My records do not show any permit for the new type roof or breezeway addition. In order to establish the status of the aforementioned property I request from you the date the v;ork was done. I am sorry I did not contact you sooner but 1 have concentrated on pressing matters. Peace, JDD/gr Joseph D.DaLuz Building Inspector June lit 1976 Dr.Robert I#Bara:y Box 508 West Hyannlsportt Massachusetts Bear Bohi On May 14th oxir Btiildlng Inspector wrote you pro viding the infonaation on setbaclcs which were required and which are presently required.He also indicated that the town has no jurisdiction in the matter and it must be settled between the two parties. I have enclosed a copy of Joe's letter,which I believed had concluded our involvement,and can only add that the matter has been checked carefully and there is no further action possible on the part of the town. Kind regards* William H.Eshbaugh,Chairman Board of Selectmen WHEtcm Enclostire DON S,GREER Craigvlllo Beach Road West Hyannisport Massachusetts 02672 Mail Address RO.Box 327 October 3,1974 Dr.Robert T.Barry P.0.Box 308 West Hyannisport,Ma.02672 Dear Bob: You will recall that about a year ago there was a discussion here in the neighbor hood about beach lots,boundary lines,etc.including the small triangular spot adjacent to your driveway where my evergreen hedge is growing.Peoples'emotions became involved and I think we all quite rightly dropped the issue and so far as I know it has been dormant ever since. At that time I discussed the question with my attorney in Boston and inquired of him as to what would be the best way to resolve the problems I felt this left with me. His answer was that I give you a license to use that small triangular parcel of land and that this license should be put in formal form and recorded with the Registry of Deeds so there would be no question about it.To accomplish this,he sent to me the enclosed form of agreement which I have approved and signed and which I submit for your consideration and if you find it in accord with your understanding,that you likewise sign it and we will have it officially registered. Three copies are enclosed and when signed by both of us they will be forwarded to my trustee.The Harvard Trust Company, who will sign them and then my attorney will see that they are recorded in the Barnstable Registry of Deeds.You will want to keep one for your records.Since the date on the first page is now in accurate,I have crossed this out and initialed it and suggest that in signing it you can put that date on the paper and also initial in the margin. I hope that you will agree with this procedure so that we both can have the question out of our minds. On another matter,you will have noticed that I have cleaned out the lot around my tennis court and adjacent to Irving Street,which is the acdess to your pro perty.I would have liked to clean out the rest of it adjacent to your driveway and where you have the catamaran parked,but have deferred doing this until the catamaran is removed.The reason being is that as I come down my driveway the catamaran,particularly in the wintertime when the leaves are off the trees,is rather unsightly and I therefore prefer to have it obscured.It is my desire to Dr.Robert T.Barry 2.October 3,1974 clean out the rest of the property upto your and my property line and I would therefore appreciate very much if you would either have the catamaran removed or else pulled back off of my property so that I can continue my landscaping. From our previous conversations on this point,I know of your intention to have the boat removed and I would now ask that you please do so as your earliest convenience.I would like to finish the project this fall,if possible. I Finally,there is the matter of the beach shelter which has been erected on the 13 foot right-of-way which is supposed to be accessible to the property I call the Green House and which was originally owned by the Still son Family.If possible,I would also like to find some resolution of this problem at an early date. Accordingly,I have drafted a letter which is addressed to your mother and which is enclosed.I am not sure whether she still owns the property or in whose name it may now be,but presumably you do know the answer to this question and would therefore be able to direct the letter to whomever it should reach.I would therefore greatly appreciate your doing so. As Mrs.Greer and I are going out of the country shortly after I dictate this letter,and before it can be typed I am not able to sign either of the letters, but have asked my secretary to do so and to forward them to you.We will be back here on the Cape the week end of October 13 and then will be away until about the 28th of October.If you have any questions,you could therefore reach me at the times indicated and if you wish to have your lawyer look these papers over and he would like to contact my attorney,it is Mr.Geoffrey A.Sawyer, Sullivan &Worcester,225 Franklin St.,Boston,Ma.02110.Telephone:423-7474. I am sure that we would all like to have these neighborhood questions resolved and if you have any questions or would like to discuss it with me,please don't hesitate to contact me. With kind regards. Sincerely yours. DSG/jgm Enclosures Don S.Greer DON S,GREER Cralgville Beach Road West Hyannisport Massachusetts 02672 Mail Address P.O.Box 327 Qct 2>0, )^a.UL .ajpict a^uJi Aa£^cut s4> ^>1u AM.'i'U IpSuty2^dti "1-Ct-^^tCK,/Kijj^U>-'iXsL4.^ (Xd OUj'^Mud-C^ (j 0.^y ^^-^^^^-kjv dy,%M.-^riC^Audc. l\)(nJUi ^-KJ iAa-^,o^d'OxiJ.'^^ ^^O dt^fx 'TJ^^-tdL t-Ax. 0 ^ui^xAa ^ AGREEMENT made this day of au!ba*ltfUBag-Ly'3,by and between HARVARD TRUST COMPANY and DON S.GREER,as they are Trustees under Indenture of Trust dated December 1,1970/recorded in Barnstable Deeds,Book 1495,Page 954,hereinafter called the Licensor,and ROBERT T,BARRY,of Barnstable,Massachusetts,hereinafter called the Licensee, WITNESSETH WHEREAS,the Licensor is the owner of Lots 330 and 331,among others,shown on a plan entitled "Section No. 1 Plan of Sea Shore Lots Belonging to the Hyannis Beach Association on Vineyard Sound,Barnstable, Mass."recorded in Barnstable Deeds in Plan Book 34,Page 91,by virtue of a deed to them dated January 13,1971,recorded in said Deeds,Book 1497,Page 458; WHEREAS,the Licensee is the owner of Lots 310,311 and 312 shown on the above-mentioned plan;and WHEREAS,the Licensee desires to use a triangular part of Lots 330 and 331 owned by Licensor as part of Licensee's driveway; NOW,THEREFORE,in consideration of One Dollar paid by Licensee to Licensor,the receipt of which is hereby acknowledged,it is agreed as follows: 1.Licensor hereby licenses Licensee to use that small triangular part of Lot 330 and that part of Lot 331,if any,adjoining the easterly side of Licensee's land and lying west of the cedar trees planted by Licensor,as part of the Licensee's driveway. 2.Licensee agrees for himself,his heirs,executors,adminis trators and assigns,that no rights shall accrue to him or them on account of his or their use of said Licensor's land by right of adverse possession or otherwise,and that neither he nor they shall claim any rights to use said land of Licensor except such as may be given by this license. 3.This license may be revoked by Licensor at any time by giving thirty (30)days notice in writing to Licensee,his heirs, executors,administrators or assigns. IN WITNESS WHEREOF,the parties hereto have caused their hands and seals to be affixed hereto the day and year first above written. HARVARD TRUST COMPANY By Don S.Greer TRUSTEES AND LICENSOR Robert T.Barry LICENSEE THE COMMONWEALTH OF MASSACHUSETTS Barnstable,ss.December ,1973 Then personally appeared the above-named Don S.Greer and acknowledged the foregoing instrument to be his free act and deed, before me. Notary Public Geoffrey A.Sawyer My commission expires 4/1/77 0 o • IZP , r h \° = � y 00 46000 , D, r h /(• 4 0 S>? S osm _ ti r , Sr r �(, 'T •WJ ( I , _ A , ti / r IV a, 6I00 Zr CID 4, I o f - � fs iC A - ()(1 .: ,L s ��✓� � tip''� �h J PLAN OF LAND IN - �rxrY�f v�u�v ' 7a Tr WEST 14YANNI9P0RT. MASS. BELONW In (A To POMAN S � U RSU LA RONN SON 5 C .o.L E + I I N. - 40R . � • ��� NeL30N b6AQ3E, QiC H.o cz c> l_ nw_$vRVEYo�tS CENT MR V I L L.E, M L"S�3• See Deeele 6k. lj er n�fable Qey;etry fp 42 ';►D +. ,.. I