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0357 LAKESIDE DRIVE WEST
H e� P � .•.�.L ,L.- ... - v✓ � -.,:4 =�., ;,.,q `�,. ., a' •d t ky. ��{ ;�.'y � C,._ � `•c° ,N•. ct<:k 3.»':;"r+s��' ''�..�;,��gr�,.�, ,�,� �` 'q -,h.' -,s..• v' .- �� t..- hg.�,:,,:'�� �. -..'-".: 1-�` � w� f•�: ., �:, 9r - �,i" a., .^p i.� q.'' ,�,� :« �a•�^_ :du.- �'.�+..1t�#,�dh,o"`^`-G��-"fe°. �' v�';'.�'$..k.`�..` 'y d n , # r ° o o y 79 n e o • e of ° e 0 a • - t • Town of Barnstable *Permit# I(� Regulatory Ser >iCg , Efpefressmonth�sfmmissueda(e �• BARN i Richard V.Scab,Director /t erg° Building Div r FEE? 01 Zi; Paul Roma,Building Com gi � u 200 Main Street,Hyannis,MA 02601 wwww.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number �3'� G�` Property Address J.�-7 441,1e il l ilk' desidential"Value of Work$ (�6 U ` !J d Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address /f 0 1r.1��lyf�t -, Jref.� �� 3/,�4/Ke, flee ,0/// C�r/_41�yjIVll je 14 ,f 9v Contractor's dame 150 1 XVJ ./f rJ0 Telephone Number W/W �! ��• Home Improvement Contractor License#(if applicable) / O Email:6 A�� c Construction Supervisor's License#(if applicable) e S 0 ? y 4 Yo LUe"1 MW/orkman's Compensation insurance Check one: ❑ I am a sole proprietor WIam the Homeowner have Worker's Compensation Insurance Insurance Company Name p. y Workman's Comp.Policy#__*Z•U_C.Copy of of Insurance Compliance Certificate mast accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over __ existing layers of roof) :. WReplacement B-side Windows/doors/sliders.U-Value d1a (maximum.32)#of windows !® jkl y`<yG�t/ - Jo 141 *Where required: Issuance orthis perntit does not compliance with other town department regulations,i.e.Historic.Conservat ***Note: Property Owner must sign Property Owner Letter of Permission. a A copy of the Home Improvement Contractors License&Construction Supervisors License is e ' ed. SIGN ATUR : /'t 64 C A.Users,dewilik'.AppUad.LocaFiMicrosorV,Windows�INetCache%Content.Outlook?L7U69LFZtEXPRESS(2).doc Q1P?5/17 Page 7 of 7 Capizzi Home Improvement Inc. Specifications and Estimates STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT WE, JOSEPH &ANNA ROGERS, OWN THE PROPERTY LOCATED AT 357 LAKESIDE DRIVE WEST IN CENTERVILLE, MASSACHUSETTS. I HAVE AUTHORIZED CAPIZZI HOME IMPROVEMENT TO ACT AS MY AGENT TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. I GIVE MY PERMISSION TO LESSEE TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. SIGNATURE OF OWNER: FR - � OWNER'S ADDRESS: 357 LAKESIDE DRIVE WEST,CENTERVILLE,MA 02632 OWNER'S TELEPHONE: 508-744-7225 LESSEE'S SIGNATURE: LESSEE'S ADDRESS: LESSEE'S TELEPHONE: APLLICANT'S SIGNATURE: APPLICANT'S ADDRESS: 1645 Newtown Rd., Cotuit,MA 02635 APPLICANT'S TELEPHONE: 508-428-9518 RESPONSIBLE OFFICER: RESPONSIBLE OFFICER ADDRESS: RESPONSIBLE OFFICER TELEPHONE: Construction Supervisor Massachusetts Department of Public Safety Restricted to. u which contain Board of Building Regulations and Standards Unrestricted-Buildings of any use group g91 cubic meters of 4 less than 35,000 cubic feet( License- CS-074640 - enclosed space. Construction Supervisor _R GARY GUSTAFSON 8 SHORT)NAY ; SANDWICH MA 02563 Possess a current edition of the Massachu�� F�lure to po ' State Building Code is cause for revocation of this licen'�• _ Expiration: pps Licensing information V-d'�y�•�S•GOV/DPS y Co�J is er 111"12018 i i s :/!u• i•ruiurlrrrrrt///�ryr r''Ilai.;ar/itrrlfJ r tBce ofC....w AMU,4 Bnsslne�1 , iV1E IAIIPROVMENT CONTRA►MR . lid ffm iudWAd sae 0* iie gish-Mo : 100740 TlfP� S.iecesg°r va � a rn fu: iratio 6PAMI S pleaneM Card itw MF=�e�@ daft and Ru 8 R29"lAhm: r CAPITZi HOME IMPROVEMENT,INC- t8garkPi�- 5l190 l�s�sstnn,ffiA tiRftli GARy GUSTAFSON 1645 Newton Rd. moult,MA 02635 Az�-' Wat { s ACORO® CERTIFICATE OF LIABILITY INSURANCE FDATE(MM/DD/YYYY) `.� 12/27/2017 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: Rogers and Gray Processing ROGERS& GRAY INSURANCE AGENCY INC PHONE o Est (508)398-7980 FA No: E-MAIL ADDRESS: mail@rogersgray.com 434 ROUTE 134 INSURERS AFFORDING COVERAGE NAIC# SOUTH DENNIS MA 02660 INSURERA: AMGUARD INSURANCE CO 42390 INSURED INSURER B: CAP1771 HOME IMPROVEMENT INC INSURERC: INSURER D: 1645 NEWTOWN ROAD INSURER E: COTUIT MA 02635 INSURERF: COVERAGES CERTIFICATE NUMBER: 225463 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. NOTVVITHSTANDING 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 MM/DD/YYYY MM/DDMIYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMACLAIMS-MADE OCCUR PREMISES (Ea ccED PREMISES Ea occurrence) $ MED EXP(Any one person) $ NIA PERSONAL BADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY CEa OMBINEDSINGLELIMIT $ accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS NIA BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE N/A AGGREGA $ DED I I RETENTION$ $ WORKERS COMPENSATION X SPE T UTE OERH AND EMPLOYERS'LIABILITY YIN A OFF CEOR/MEMB REXCLUDED ECUTIVE N/A �A NIA R2WC863728 12/25/2017 12/25/2018 E.L. CH ACCIDENT $ 1,000,000 (Mandatory in NH) .DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 01 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 N/A DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/lwd/Workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Daniel Cr ey,CPCU,Vice President—Residual Market—WCRIBMA @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD CAPIHOM-01 CLEDDUKE CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDOIYYYY) 06r2812017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED,--BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. Astatement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. NTACT PRODUCER NAME, Rogers&Gray Insurance Agency,Inc. Ext): jtic,No:(877)816-2156 434 Rte 134 EMA South Dennis,MA 02660 A RRILESs,mail@rogersgray.com INSURERS AFFORDING COVERAGE NNC N INSURERA:Arbella Protection Insurance.CompanV,Inc, 41360 INSURED INSURERB: Cap'rzzi Home improvement,Inc. INSURERC: Capizzi Enterprises,Inc. 1645 Newtown Road INSURER o Cotult,MA 02635 INSURERE: INSURER F: COVERAGES GES CERTIFICATE NUMBER: REVISION NUMBER: O 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 UBR POLICYEFF POLICY EXP LIMITS LTIR TYPE OF INSURANCE IN SD WVD POLICY NUMBER p A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE �OCCUR 3600067380 06/08/2017 061DB/2018 pRAEAISES Fao rare ce $ 500'000 0D0 MED EXP An one person) $ 10, PERSONAL&ADV INJURY $ '11000,000 GEN'L AGGREGATE LIMIT APPLIES"PER: GENERAL AGGREGATE S 2,000,000 POLICY JEL'T F_x1 LOG PRODUCTS-COMPIOP AGG $ 2,000,000 OTHER: COMBINED SINGLE LIMIT 1,000,000 A AUTOMOBILE LIABILITY acci' S ANY ALYTO 1020D64960 06/08/2017 0610812018 BODILY INJURY Perperson) $ OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUUTOSWN x ALIT 0.S ONLY AUi05 ONLY PeOOEoRdB7r,1 GE $ A X UMBRELLA LIAB X OCCUR EACHOCCURRENCE $ 21000,000 EXCESS LIAB CLAIMS-MADE 4600067381 06/0812017 06/08/2018 AGGREGATE $ 2,000,000 DED X I RETENTION$ 10,000 $ WORKERS COMPENSATION PS ER ER OTH- AND EMPLOYERS'LIABILITY ANY FICERO/AMRI BORRIPPA EXCLUDED? Y NIA EL EACH ACCIDENT $ {Mandatary in F) E.L.DISEASE-FA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY UM Fr. $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) WORK'COMP CERTIFICATE TO BE ISSUED DIRECTLY BY THE CARRIER CERTIFICATE HOLDER CANCELLATION 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 ACORD 25(2016103) O 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD f 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): Capizzi Home Improvement;,Inc. Address: 1645 Newtown Road City/State/Zip: Cotuit; MA 02635 Phone#: 508-428-4613 Are you an employer?Check the appropriate box: Type of project(required): 1. ✓ I am a employer with 40 4. I am a general contractor and 1 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' comp.insurance.t 9. Building addition [No workers comp.insurance p required.] 5.. We are a corporation and its 10. Electrical repairs or additions 3. 1 am a homeowner doing all work officers have exercised their 11. Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12. Roof repairs insurance required.].t c. 152, §1(4),and we have no 13. ✓Other ile fox! �hh$ employees.'[No workers' a � 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 th en hire outside`contractors must submit a new a iidavitindicating 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 myemployees. Below is the policy and job site information. Insurance Company Name: AMGUARD INSURANCE COMPANY/NAIC#42390 Policy#or Self-ins.Lic.#: R2WC775326 Expiration Date: 12/25/2017 Job Site Address: 4 lee� �e ��l�Z' �'�J City/State/Zip: C�� 1�®ll� *D2 y 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,asmell as civil penalties in the form of a STOP WORK ORDER and a fine. d 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 A for insurance coverage verification. I do hereby certify de th pains'and penalties of perjury that the information provided above ' true and correct Sian Date: he Phone#: 508-428-9518 Official use only. Do not write in this area to be completed b city or town o �ciai ff y p Y, tY f.T � 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.4: TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 00 1 Parcel G Application# a Health Division Date Issued /O—7— Conservation Division Application F X_ Z u- Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address 3�7 Village o OwnerN/�� a�IDIQ� �o�el�� —Address �� ���f�J`y� �o• 1LSt'`�� �ue/C� Telephone firs `® Permit Request L ��o C lo�'�!� s"�'aa a A/?EA opt! AJ�/'�ENf B� 0��`, vee ®fie J 44,ft 440lull;!/'� �,4o/fS ` 4 1 /JOT Square feet: 1 st floor: existing 319 proposed d 2nd floor: existing 0 proposed ® Total new Zoning District Q� Flood Plain Groundwater Overlay Project Valuation U®d Construction Type 2�O�y 4Mofe Lot Size o• Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family L/ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) �I f J Basement Unfinished Area (sq.ft) /A41 Number of Baths: Full: existing -3 new Half: existing new Number of Bedrooms: l existing Q new _ Total Room Count (not including baths): existing new First Floor Room":Count Heat Type and Fuel: 2 Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑'Yes ❑ No Fireplaces: Existing New Existing wood/co'al"stove: ❑Yes I;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 ❑4o If yes, site plan review# Current Use tfes/(. -c1JP'At -S/iylz -� yf/y Proposed Use 1(o. fliVe APPLICANT INFORMATION (BUILDER OR HOMEOWNER) - -_. - -- 1411' Afe Name 4;�Y 'rPi Telep one Number Address 14�f 3'� �)JaAt ft License # C 5 YS Ye ce/V _/ PY4 Home Improvement Contractor# NOW �e i� e eA 1yfLl!/�01ne. (`0%- Emai Workers Compensation # TA C6�5 2r4 l /� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. Page 7 of 7 Capizzi Home Improvement Inc. Specifications and.Estimates STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT I/WE, Joseph& Anna Rogers , OWN THE PROPERTY LOCATED AT 357 Lakeside Drive West IN Centerville , MASSACHUSETTS. I HAVE AUTHORIZED CAPIZZI HOME IMPROVEMENT TO ACT AS MY AGENT TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. I GIVE MY PERMISSION TO LESSEE TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE - MASSACHUSETTS STATE BUILDING CODE. SIGNATURE OF OWNER: �a ram- OWNER'S ADDRESS: OWNER'S TELEPHONE: LESSEE'S SIGNATURE: LESSEE'S ADDRESS: LESSEE'S TELEPHONE: APLLICANT'S SIGNATURE: APPLICANT'S ADDRESS: 1645 Newtown Rd., Cotuit, MA 02635 .APPLICANT'S TELEPHONE: 508=428-9518 RESPONSIBLE OFFICER: RESPONSIBLE OFFICER ADDRESS: RESPONSIBLE OFFICER TELEPHONE: ACC)RO® CERTIFICATE OF LIABILITY INSURANCE DATE(MMI°D/YYYY) 12 29 2015 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: ROGERS &GRAY INSURANCE AGENCY, INC. PHONE FAX LAIC. /C No Ext: A/C, /C No): 434 Route 134 E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC# South Dennis MA 02660 INSURERA: AmGUARD Insurance Company 2390 INSURED INSURERS: CAPIZZI HOME IMPROVEMENT INC INSURERC: 1645 N EWTOW N ROAD INSURER D: INSURER E: COTUIT MA 02635 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 ADDL SUBR POLICY EFF POLICY EXP LTR IN D POLICY NUMBER MM/DDIYYYY) (MMIDDIYYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ CLAIMS-MADE 7 OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY 7 PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Peraccident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION WC STATU- A AND EMPLOYERS'LIABILITY. YIN R2WC655250 12/25/2015 12/25/2016 J OTH- ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? � N/A - - . (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 000 000 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 is required) CERTIFICATE HOLDER CANCELLATION Town Of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 200 Main Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Hyannis, MA 02601 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD r - - - srsa. VVrruiq/re FYGKi07t'Ld tI1NiAriK.Ii�yGtiJ' _ Department of1ndu9tr1n1Acddents 1 Congress Street,Sine 100 Boston,Mgt 02114 2017 wwwumas&gov/die Workers'Compensation Insurance Affidavit;Baders/Coutne ors/Etectrldans/Plnmbers. TO U FII,ED WHHTHEP KRMT1KGAUTH4$TI'g ADDIiCBIItIII1'OTntatidII. . Pease Print Lag& Name(Bvstness/OrgsaazatxomRndzvld�;CAPiZZi HOME IMPROVEMENT INC Address:1645 NEWTOWN ROAD City/Slate/Zip:COTUIT,MA 02635 Phone#:508,428-9518 Are you an employes?Che he Wropdute bo=: --- I.�I am a employer whh 40: employees{frill and/orpart time). Type of project(required): 2.0I am a sole pmpriebr or 7 ❑ construction Psrtnmship and employees working forme in ERY MPAY•1No worlm comp.insurance tequi�] 8. Remodeling 301 am a homeowner doing all work myself[No worths'comp.insurance require(]t 9. ❑Demolition 4.❑I am a homeowner and wJM be hiring coutractors to cemd=Q u air on my property. Iwilt 10 0 Building addition ensure do ell coatsactora either have warim.compensation insurance or are sole 11. Eleclxicai Priors wish no employ. ❑ repairs or additions sOI am a gmarw contractor and I have hired the sub•ca rs listed on the eUached sheet 12.QPlumlliag repaitg Or addit7o11& have employees and have wudrers•comp.tasmaaoe t 13.QRoofrepairs 6.❑We are a carporatsoa and its offiecershave eaendsed their rw t ofeuomptiou per MaL c. 14.[(Other 152,§i(41 and wehaveno employees.(Noworkers'cwmp.tnsurancereg hv&l tappIicani first cheers bour#1 must also till o�rttl i a i 11 ''1 m below showing their workers'wmpm po&, ftmin FAMM aerswho submit this affidwitMcaft they ere doing all wmkond then hire Od1aUW& tCw � t submit a aewaittdavit indicating such truftz tl Atchwk this bar must attached an additiond sheetshowbg employe. Ifthesub-contracinm hayeGuV9Ta gWnmstprovtdegw Vwr1usV0fth8 mandstatewholherornotihpseenweshave �P.policynnmh>en I mn an employes that isproY&W worke;!s'ro'Ve»s=atdon kwdJ ceforrtty empttoy , Belowte the th�foramwor� popsy andjob staff Insurance Company Name:AMGUARD INSURANCE COMPANY Policy#or Self-ins.Lic.#l:R2WC527200 won Data 42125/207 8 Job site Address: . el (ge Attach a copy of the workers'compensation policy declaration a /s ���6/l �� R+p Showing the policy number and expiration date). Failure to secure coverage 88 required under MOL a.152;§25A is a erlmhW violation punbhable by a.SIIe up to$1,50o.0o and/or one-pear hnid dement as well as civil �3' 8>e violator.A penalties m the issue ofa STOP T�VOlt1�OR.D�Rand afine of np to$250:t10 a copy oftius statement maybe forwarded to the Office of In _average veiific Lion. vestlgatioas ofthe DIA for insurance I do hereby stnderthepal m andpenWtdes olPe�ury thaEthe m Rurth'on pm� d abov Isfte i nd correct S 50&428-95 o U:. FOtfier on& Do not wrme In,ft.area to be eonplete� or loam by� offldid ns PerimltlUeense# hority`(circte one): Healfh 2.BaQdingDeparhnent 3.City/Town Clerk:4.ElectricalInspector S.Plumbinglnspector son: Phone#: ... :• :.. :.. :: . .:: .. 'lasaacrlasa s-Dapa Mani of Public SafeinI rt i gays Board of Building Regulations and Standards tTt1.4i%►'9)t:titk+��sIlice�Iri . x,?;u 1-16enze:C5.94540 @ 9HORT WAY SAMWCH r A M5ci w§ }f� atone M Q Gommissionar QN, a � . . �. •1� •a io °o � m E k � o Co z c, a o r�i lt!'�Y'trsW cted'� 4 of use 18�9 which w �'W m corm Jos 35,000 cubic feet(991>ra)ofo C C >. enclosed ° enclosedt z U Ca. 00 j a u, � W W 2 N O 1 D ;. >- z 4 � n. i a I I Failure topossess a current edition of the Massachusetts State Building ale i*cause for revocation of this license. . For DP5 igcermng information visit: u+wwAf s.Gov/DPS ' J d Town of Barnstable Regulatory Services :,7r Richard V. Scali,Interim Director 'Z-b B"MASS. ` Building Division AjFt MA'lA � Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 - www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 S 8�PERMIT# D� FEE: $ SHED REGISTRATION RESIDENTIAL ONLY 200 square feet or less baKmde- btive Ws+ Cen Location of shed(address) Village Ana TM(K q / 8 - 634138Z9 Property owner's name Telephone number )2 ' x ICE ' Size of Shed Map/Parcel# 0 1 Cn� Ly Sign ture r Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? If over 120 square feet,you must file with Old King's Highway Conservation Commission(signature is required) Sign off hours for Conservation 8:00-9:30&3:30-4:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. r THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:110413 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 3 L Parcel U 500 Application # �O/ y 606 3 Health Division Date Issued (aS /y' Conservation Division Application Fee 0 Planning Dept. Permit Fee �'� Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address 3 57 L AXes/oe- Dl'if0e y°e7 Village C eii eA ®1*ff e, Owner A tINq 15 g g ,ro fel# L • Re hers Address 3 �17 LQ Telephone CetfJ-eev111e1 Nj1 016 32 Permit Request RCNe1,4T101/ or 5rX1Jt1Ny ri v`'rJ-/e41 i41.e/d/_o1v1'- AA,O AAU X /Z 4 ol��1e /.lifer � CIA/et �lt e4t/P�om . ,ev/! R-47l-1 Wj,,11 .l6�ocv-ev• �l4 N7eXji)v OillN t Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District j Flood Plain Groundwater Overlay Project Valuation✓/ psi 1904 Construction Type wooD r/L4rne. Lot Size 0' Grandfathered: ❑Yes ❑ No If yes, attact pporting�iocLgentation. Dwelling Type: Single Family UV Two Family ❑ Multi-Family (# units) �a Age of Existing Structure Historic House: ❑Yes ❑ No On Old King s H 9! ighwg ❑ s ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area ( q.ft) �9 s w Number of Baths: Full: existing new D Half: existing wnew Number of Bedrooms: existing 0 new Total Room Count (not including baths): existing q new First Floor Room Count 9 Heat Type and Fuel: U(Gas ❑ Oil ❑ Electric ❑ Other Central Air: iYes ❑ No Fireplaces: Existing / New O Existing.wood/coal stove: ❑Yes Vlo 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 # AY Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use 5 IAJ CA0)*1V ifyli .PN7i9 L Proposed Use 11 V y&r i"g 1Nil y APPLICANT INFORMATION (BUILDER OR HOMEOWNER) _ G A 9-/ G0,1f,4 FfOP Name C /1�l/ 2 Z i �f0 M e =m1 e/aye t�LP,tf¢ Telephone Number Address NewTyajo fin License # 0 1 y 4 yo 0S ' f M Home Improvement Contractor# Worker's Compensation # UJC T()10 S-Y? 0 cdl ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 1-vLott cr 134 au r 6l2 kuKn�i// i f G U U% I a SIGNATURE DATE / FOR OFFICIAL USE ONLY APPLICATION# DATEISSUED S -MAP/PARCEL NO. s, e R r ADDRESS VILLAGE OWNER b DATE OF INSPECTION: FRAME _ R12abY FIREPLACE ELECTRICAL: ROUGH FINAL q' PLUMBING: ROUGH FINAL GAS: ROUGH FINAL a r FINAL BUILDING (06lS ^ DATE CLOSED OUT •L ASSOCIATION PLAN NO. r �1HE t Town of Barnstable Regulatory Services y�MASS. Thomas F.Geiler,Director '0rE1639. 6. Building Division Tom Perry;Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 February 7, 2014 Capizzi Home Improvement, Inc. Attn: Gary Gustafson 1645 Newtown Rd. Cotuit, MA. 02635 RE: 357 Lakeside Drive West, Centerville, Map: 232 Parcel: 050 Dear Mr. Gustafson: This letter is in response to application number 201400038 submitted to remodel the above referenced address. Unfortunately,the application can not be approved at this time because there are currently already two open permits to remodel the property. The prior permits must have successful completion of all required inspections before an additional permit is to be issued and further work is authorized. Please do not hesitate to call with any questions. Respectfully, r L. Lauzon Local Inspector (508) 862-4034 jeffrey.lauzon@town.barnstable.ma.us I I i I W"o_�_4:s: vT#s 5r FLOOR JOIST I CONTINUOUS NAILERS ATTACHED W/C2I1/E' DIA. 1/4' THRU-BOLTS a 24' O.C. I tt TAGTGEREDIjs eNac, II X NAILER lu D) I 21 NIN, WOOD 1 EDGE DISTANCE I /� 1 L• I CAP PLIA-Xg XD_� I I SIWSON JOIST HANGERS 1 I I i 1 OF N- I/2' • BOLT I CCC A ' STEEL COLIAtld 1>1 GAGE I I} CAP PLATE DETAIL 1 TO FOOTING, I OR CONTDfJOUS W FOOTING ryry /�H u BASE PL.1/2--X-- x4+ to I GENERAL NOTES AND MATERIAL SPECIFI AT ❑N& 1 1. Structural Steels ASTM A. , shop painted w/ rust Inhibitive paint 2. Anchor Bolts, ASTM A510(Galv,), �'_'_ dia. expansion - type x _L_' Min, embedment. 3. All workmanship to conform with American Institute of Steel Construction and Massachusetts State Building Code Latest Edition requirements. 4. All welds to be E70xx electrodes. Shop weld cap and base plates to columns. 5. Coordinate all dimensions with Architectural Drawings, and field verify oFnnq where required. �Nsgoy 02� MICHELE Gs� CUDILOi L -4 o S RUCTLA No 347 R o Q I STEEL BEAM CONNECTIONS MICHELE C. TUDOR, P.E. TO TIMBER FRAMING Consulting Structural - Engineer (FLUSH FRAMED) 123 Cottonwood Lane Centerville, MAssachusetts 02632 ;eLNOl El.t f�G y: 2 j Drawn B MCT Date: Figure g u r e 7� Ls Checked By: Scale: none _ S K— '�--`_—`-File Name .Project No.:z�� l ®ffiee oflnvesdgations - 1 Congress,Street,Suite 100 _ Boston,.MIA 02114 2017 www.mass.gavldia Workers' Compensation Insurance Affdavite Builders/ContractorslElec ricians/Plumbers Applicant Information PIease Print Leibly frovernen Name(Business/Organization/IxidividuaI):Capizzi Home(mp . Address:1645 Newiown Road City/State/Zip:Cotuit, MA-02648 Pone#:508-428=9518 Are you an employer?Check the appropriate box: ype of project(required): 1.®•I am a employer with 40+ ,4. El I am a general contractor and I T ❑New construction employees(full and/or part ia_me).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner: listed on the attached sheet. .7. [remodeling shipand have no employees These sub-contractors have . 8. ❑Demolition working for me in any capacity. employees and have workers' No workers' comp.insurance comp:insurance. 9 El Building addition required_] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3-.❑ Dint.a homeowner doingall`�dork officers have exercised their 11. � Plumbing repairs o❑ r additions right o g P bons myself.[No workers' comp. f exemption per MGL 12:❑Roofrepa rs. insurance required.]t a L52,=§.1(4);and eve have no. employees. [No workers Ij.❑Other comp.insurance required.] *Any app icant that cheb1 box#I must also fill out the section,,below shov:Yng their workers'compensation pol y informations" T Homeowners who submit this affidavit indicating they are(Zing all work.atjd then hire outside contractors must submit anew affidavit indicating such. TContia0rs that check this box must attached an additional sheet showinatae name of the sub-contractors and'- whether or not those entities have - employees. If the sub-contractors have employees,they mustpmvide their workers'comp:policy number I:am an employer that is provid izg workers'compensation insurance for my employees. Below is the policy and job site i rfarrzation. Insurance Company Name:Associated Employers insurance Company Policy.#or Self-ins.Lic.#:WCC5010 547012011 Expiration Date: 3s'7 t 4 ke/1 l)4 �l/1 tJe id. City/State/Zip: Job Site Address: rill,{loili%/f' &J Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). F41ure.to.secure coverage as required under Section,25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine tip to$1,500.00 and/or one-year imprisoninerit,as well as civil penalties in the form of a:STOP WORK ORDER and a fine o up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Off ce of Investigations of the DIA.for insurance coverage verification. I do hereby certify d e pains and penalties ofperjury that the information provided above.is true and correct .Si acute: Date: ©/ Phone#: 508-428-951 ff [13: l use only.. Do not write M this area,to be completed by city or town official a Town: Permit/License# Authority(circle one): d of Health 2.BuildingDepartmenf 3.Cify/Town CIerk 4.Electrical Inspector 5.Plumbing Inspectorrt Person: Phone#: Unrestricted -Buildings of any use group which contain less than 35,000 cubic feet(99IM )of enclosed space. 1t Massachusetts -Department of'Public Safety Board of Building Regulations and Standards Construction Supen-isor Failure to possess a current edition of the Massachusetts License: CS-074640� State Building Code is cause for revocation of this license. GARY GUSTAFS(�N For DP5 Licensing information visit: www.Mass.Gov/DP5 Y ; 8 SHORT WAY ` .. _ SANDWICH MA702563 JAM 6-1 �1 of . Expiration Commissioner 11/29/2014 ✓lae "t°iaminwr�usecclCt o����acla+,iael,�a - I Office of Consumer Affairs&Business Regulation l keasa or t .87�afion vaftd for T1Ft71'Idol use only OME IMPROVEMENT CONTRACTOR l sfora the e�2rkttan date. If found returno. 'Qffmee of Cbns=er.Aff&s and Bwlnas Re latfcn- Registration:':1'00740 i10 '�r ;Ia»5`txfaSl7Q' i Type.. _ -:::-. i Expiration 8123/2014 Supplement Stan K4 tS CAPIZZI HOME 1MPRO.VEMENT;INC. I - GARY GUSTAFSON _ 1645 Newton Rd. C Cotuit, MA 02635 ' Undersecretary +` ftta�sr'e . .. - �,h '.�.{sr.a,.an•t+rtsnazt 4c .. 3,0141(vine &I Carr i CAPIHOM-01 APELL AGOR,Q' DATE(MMDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE. 12/27/2013 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: Ann Pell - -- Rogers&Gray Insurance Agency,Inc. PHONE FAX 434 Rte 134 A/c No Exc: A/C No):(877)816-2156 South Dennis,MA 02660 A AAliess:apell@rogersgray.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Main Street America Assurance Co. INSURED - INSURER B:Associated Employers Insurance Co. Capizzi Home Improvement,Inc. INSURERC: Capizzi Enterprises,Inc. INSURERD: 1645 Newtown Road Cotult,MA 02635 INSURER E: , INSURER F: - COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADD VD POLICY NUMBER MMIDPOLIDY MM DDIYYYY - LIMITS GENERAL LIABILITY - EACH OCCURRENCE $ 1,000,000 A X--COMM ERCIALGENERAL LIABILITY MPB1075H. --_ ..._ ._.- .6/8/2013 6/8/20%.. PREMISES Eaoccurrence $ -500,000 CLAIMS-MADE I-XI 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 POLICY I X I JEC PRO- X LOG $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT SOO,000 Ea accident $ " A ANY AUTO M1 M28044 6/8/2013 6/8/2014 BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident X UMBRELLA LIAB IX OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESSL.IAB CLAIMS-MADE - CUB1076H - 6/8/2013 6/8/2014 AGGREGATE - - $ DED I X I RETENTION$ 10,000 $ WORKERS COMPENSATION X WC STATU- OTH- . AND EMPLOYERS'LIABILITY - TORY LIMITS ER B ANY PROPRIETOR/PARTNER/EXECUTIVE Y I N CC50050105472013A 12/25/2013 12/25/2014 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? - N/A - - (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,006,000 If yes,describe under - - DESCRIPTIONOFOPERATIONSbelow E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD101,Additional Remarks Schedule,if more space is required) - CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable THE EXPIRATION DATE THEREOF; NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. ' Hyannis,MA 02601-0000 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Page 7 of 7. Capizzi Home Improvement.Inc. Specifications and Estimates STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT WE, JOSEPH &ANNA ROGERS, OWN THE PROPERTY LOCATED.AT 357 LAKESIDE DRIVE WEST IN CENTERVILLE,MASSACHUSETTS: I HAVE AUTHORIZED CAPIZZI HOME IMPROVEMENT TO ACT AS MY AGENT TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. I GIVE MY PERMISSION TO LESSEE TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE; SIGNATURE OF OWNER: OWNER'S ADDRESS: 357 LAKESIDE DRIVE WEST;CENTERVILLE,MA 02632 OWNER'S TELEPHONE: 508-744-7225 LESSEE'S SIGNATURE: LESSEE'S ADDRESS: LESSEE'S TELEPHONE: APLLICANT'S SIGNATURE: APPLICANT'S ADDRESS: 1645 Newtown Rd., Cotuit,MA 02635 APPLICANT'S TELEPHONE: 508-428-9518 r RESPONSIBLE OFFICER: ' RESPONSIBLE OFFICER ADDRESS: RESPONSIBLE OFFICER TELEPHONE: Town of Barnstable �TMe rqy, Regulatory Services o Richard V.Scali,Director Building Division 9 MASS. $ Tom Perry,Building Commissioner i639' 10TFo�.i a 200 Main Street,Hyannis,MA 02601 www.town.barnstabIe.ma.us Office: 508-862-4038 Fax: 508-790-6230 Approved- Fee: Permit#: HOME OCCUPATION REGISTRATION Date: Name; YWI'lV Phone#: Address: 2-� uje--;� Village: lfH-�-rl/M-e- Name of Business: rC)F S� u 51 vie SS Type of Business:_ P M 1'n Mapa qc-�� V INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling. there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal.residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment.., • There are no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. I { • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned,have read and agree with the above restrictions for my home occupation I am registering. Applicant: Date:_ 'oZ—5-/�f Homeoc.doc Rev.103113 YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L. it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take.the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE: L . Fill in please: ' ;r APPLICANT'S YOUR NAME/S: Y�rv� Co�i �s {' Fk '`z'; BUSINESS YOUR HOME ADDRESS: Ewm _� s \\cam , YVVf-1 TELEPHONE # Home Telephone Number z:�77<- `-714 l- "�-7DQ5 NAME OF CORPORATION,., NAME OF NEW BUSINESS::�- e� TYPE OF.BUSINESS 66Ir{ VV '; Yv��S,' _ TION�:': lYES IS NO;THIS A'HOME OCCUPA A.,DDRESS OF„BUSINESS MAP/PAR.CEL NUMBER [Assessing] When starting a new business there are several things you must do in.order-to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to'assist you in obtaining the information you may need. You MUST GO TO 200 Main St. (corner of Yarmouth Rd.,& Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S PKNCE This individual has be ed of n permit requirements that pertain to this type of b�b&-p:OOMPLY WITH HOME �.rGGUPATION, RULES AND REGULATIONS. FAILURE TO - -� orized Si a- re** F~ - COMPLY MAY RESULT I COMMENTS: (� FPtVES, 2. BOARD OF.HEALTH This,individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature* COMMENTS: 3. CONSUMER AFFAIRS.(LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business, Authorized Signature** COMMENTS: i _ f ' -Commonwealth of Massachusetts & zh� 2 �2 -Sheet Metal Permit . Map Parcel rr _ Date: 7_l 7/ - Permit#Z 6 .� `-f 6 5 IC� ce 1 J 'Esftmated.Job.CC04 . o� Plans Submitted; YES NO t/ Pl ewed: YES NO `I-'--- Business License# / 0 � nt Lic=e A # I . q�,* 5 Business"Infonmtion: Propertymokta�acati'on.Information: Name: T. /r eG/f 'h S Name: Street. Street City/Town: (V4 ` Cify/Town: Telephone: T69 �S-6 7 COY Telephone: �08 — ! Z / 5-/U Photo ID.required I Copy of Photo.ID. attached: YES. V-' .hTO J-1 unrestricted license I J-2/M-2-restricted to dwellings 3-stories or less and commercial up to 101000 sq. I/2-stories or less / i Residential: 1-2.family ✓ Muni-family Condo/Townhouses Other Comrmercial: Office Retail Industrial Educational i Fire Dept Approval Institutional_ Other i A PP � Square Footage:. under 10,000 sq.fL V over.10,000`sq.1 Number of Stories: 2- Sheet metal work to be completed.- New Work: Renovation: HVAC Metal Watershed Roofing Kitchen Exhaust System Metal Chimney/Vents Air Balancing I Provide detailed description of work to be done: .INSURANCE C01/ER4GE: t Vhave a'current Wbility insurance policy or its equivalent which meets the 'requirements of M.G:L Ch.112 Yes o❑ ff you:Have checked];lig,:indicate the ty .vf coverage by.chicldpo ttfe appropriate.box below: i A liability'instirance.palicy ❑ . '^' ''`�' Othertype of indemnity El Bond ❑ OWNER'S_INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the Massachuseifs General Laws,and that my signature on t3iis permit application waives-this requirement Check One:Oniy Owner ❑T Agent ❑ t _ Signature.of Omer or-Ownees Agent j By checking thls bo ,.!.hereby cart*that all of the details and informallon I have submitted(or entered)regarding this applicatioq.ane true and accurate to.the best of my lmowledge and that all sheet metal worts and instailatiorm performed under the permit issued for this application will be in compliance with all pertinent provision of the Massachusetts Building Code and ChapW 112 of the General Duct inspection required.prior to.insulation installation:'YES. NO Progress I asReeflons Date Comments Final Inspection Date Comments Type.of License: BY le(master rile ❑Master-Restricted 7Aty/Town - ElJ.oumeyPerson Signature/o�jf Licensee �e[m ❑J.oumeyperson-Restricted (/ i ' erase Number. ! Check at www.mass.aov/dnl . • l nspector Signature:of Permit Approval i ., DRT Heating 508-564-9595 P.1 08/06/2014 12:10 5084281547 CAPIZZI _ _ PAGE 01/01 TOWR Hof Barnstable Watoty services • �. 1'itomea R Gceer,.Die�ect'or • Bmil`d'in��?iivn T m Am Bar Iang.Comnowamor 2""Main *Mdis.:IAM6itI "W-m•m.bar *Rb,c.ma.srs QMos: 508-852.40M Fm -: 508.7904230 ]PtOPert,y Gamer.Must CflDaplete andIgn 'his Setion Tszn A ,Buulriet ^ ` cofthe eubjeetpzop" do-stet on=7 b �all�4tieis rr��W'a�oekau&�oyize,d by this b t'�°g`.Pemut (Addess of jt b) knces and. at are'not .he s ate the r�spotxs WHty of the•appiiCpnj. •poeth fd�ed:before fence is insealled air 'aged iatU ' uaspections ace= ais are noi�to be P pd. ad aopepte& tarm�of:A, Lca�t JIr e��c Ps mt:1�iarae p flat to e, Pii&'mjie ire y, The Commonwealth of Miusachusetts Department oflndustHd Accidersb Office ofTnvm*adores 600 Washington Street Boston,MA 02111 www.massgovAdfa Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plu nbers Avylicant Information R / Please Print Lezllv Name(Rusin s or on/Fndivi&4: Afi�ress: M J- 2 o i9 City/State/Zip: Al Phone# Are.you an employer?Check the appropriate box. Type of project(regaii ed):: t 1.1 I.am a employer� �. 0 I am a general contracorr and I employ ( p Vie)•*. Have hued the sib-contractors 6. ❑New construction - ere frill and/or art 2:.❑ I Mn a'sole pirogrietor Or partner- listcdbn the-attached sheet:. 7. ❑Remodeling ship and have no employees Tie sub-contractors have & ❑Demolition working for me in"any capacity, employees and have workers' [No workers'comp.insurance comp,insurance.#. 9. ❑Building addition �) 5.❑ We are a corporation and its 10:❑-Electrical repairs or addtions •3.❑ I am a homeowner doing all work officers have exercised then 11.0 Plumbing repairs or additions myself [No workers'comp. right of exemption per'MGL 12 Roof airs •arr- irictnn required-]t C.152,§1(4),.and we have no - ❑ reF 13..❑Other employees.[No Warms' comp•insurance required-] 'Any applicant that ---box fl mast alpfiffouttheseLdanbelow showing titcawu-6as'ea tioa.poiicyinfaro=S= t Homeawneis who W—it affidevitindieatiog they are doing aliwork aid then hue outside c=uactu must submit a.new affidavit indicating such. �Caahactais.thatCheck this box mkt anacbj5d s¢sddi7foaal SbseC sbowiag the name of flee sub couRactoss aid state whc@ter eruct those entities Have employees. If fhe sub-cmizacias have employees,theymristprovidt(heir woda&-comp.-poHcynumber. lam an employer that is providing,workers'compensation insurance for ray employees Below is the policy and job site Insurance obey Name r TncnraTtcr /q /'► .r r� Policy#or Self-ins.11c.#-_ Z Expi ationDate: �3 / Job Site,Address: CPS��P ( ty/StatelZip: Attach a copy of the workers'compensation policy declaration page'(showing the policy number and expiration date). Failure,to scc ui coverage as requited under Section 25A of MGL c. 152 c�m lead to the imposition of criminal penalties of a fine up to.$1,500.00 anchor one-year imp=so=elt,as wen as civil penalties in the form of a.STOP WOR K.ORDER and a fine of up to$250.00 a day a the vioLdm Be advised that a.copy of this.stafemerit maybe for_warded to the Office of Invest, •omof f}ie fa..insurance coverage verification. I do hereby certify the.pains-and penalties ofperjury that the information provided above is trae and correct: Si Date: _ Phone Official use only. Do not write.in this area.to°Fie completed by city or town offWal City or Town: Permit/I,icense 1%miag Authority(circle one): : .'I..Board of Healtli. Z.Biuldiag pepartnient:3.C ityiTown Clerk 4-.Electrical Insppector,5..Plumbi49 Inspector b.Other Contact Person: Phone#: �Y pig / .G4 dy+ p p n x �5 SPIN fl zb a R ---- J �i.WAREHAM'MA y,� t ; _ate- A� CERTIFICATE OF LIABILITY INSURANCE DATE i2o�'"' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON' 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 INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER: IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)mast 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 NAr1E KFE C.L. HOLLIS INSURANCE PHONE (781)344-8578 (781)3d1-0126 140 N3MION RD E-MAIL HELANIE@insurehollis.aom INSURERMAFFORDMG COVERAGE NAIC 0 WARBAlIM MR 02571 ]INSURERA-Valley Foxge Insurance Co 20508 INSURED plsupERs-Twin City Fire Insurance Co 29459 JAMS DIEDZ DBA INSURERC: DRT HEATING & AIR CONDITIONING INSURER D: PO BOX 666 INSURERE: BUZZARDS BAY MA 02532 1,INSURERF: COVERAGES CERTIFICATE Nt1NISER.-,CL1391200767 REVISION NUNBER: 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. I S TYPE OF INSURANCE POUCYNUMBER POLICY YMMII CY Ei(P L Ulm , GENERAL LIABILITY EACHoccuRRBNCE $ 1,000,000 $ $ COMMERCIAL GENERAL LIABILITY p M a 300,000 1 A CLAIMS•MADE ®OCCUR 017719112 /12/2013 /12/2014 NEDEXP one person) S 0,000 I PERSONALA AIN INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENLAGGREGATEUMITAPPLIESPER PRODUCTS-COMPAPAGG E 2,000,000 7X POLICY PRO• LDC $ AUTOMOBILE LIABILITY COMBINED SINGLE UMI 11000,000 ANY AUTO BODILY INJURY(Per person) $ A ALL OWNED S SCHEDULED 016640007 /4/2013 /4/2014 BODILY INJURY(Peracddent) $ AUTOS AUTOS S ON-OMEDPROPERTY DAMAGE $ HIRED AUTOS g AUTOS S UMBRELLA LIAS OCCUR EACH OCCURRENCE S EXCESS LIM CLNM"ADE AGGREGATE $ D D I I RETENTK)N B WORKERS COMPENSATION $ TORY WCIIMIT OTH AND EMPLOYERS'LIABILITY YIN ANY PROPRIEfORIPARTNERMCECUTIVE row NIA E.L.EACH ACCIDENT $ 500,000 OFFICERAIEMBEREXCLUDED? I 1 SNg�657S /13/2013 /13/2014 .ELDISEAS'E-EA EMPLOYEE $ 500,000 (Mandatory in NH) VK dascribounder E.L DISEASE-POUCYLIMIT $ 500,000 DESCRIPTION OF OPERATIONS below t DESCRIPTION OF OPERATIONS I LOCATIONS VEHICLES(Attach ACORD 101.Ad dRiorwl Remarks Sdadule Bmoro apace Is rsqukad) L CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANC[I LED BEFORE THE EXp MTM DATE THEREOF, NOTICE WILL BE. DOWERED IN ACCORDANCE WTrH THE POLICY PROVISIONS. TO= 03F BARNs+AWA BARNSTABLBt MR AUTIM=DREPRESENTA3wE lanie Keefe/ILK ACORD 25(2010106) 01988-2010 ACORD CORPORATION. All rights reserved. INS026(min6rit Dt Tht+ArJWn narna and Innn arm rntrrct"Od rrmrrre:of AMAn t , r f k 4 I t TOWN OF B RNST TLE Lq 1 1 V �_ iN S G-T o/Z '�L,-�v.1 o F .4 TT A/'cti se Ti' ii to c v ry e 2 +v l� V�i,e--r 'S i Coot,/7CA . _L�...1� ,6 te.r� - �N � y�,�-J�1T w r45 yV oT C v v e2 4--o S 1-�C'.-------- (�10 u L-,o c L V S -'t�V i �hi°��-► Hl f-1 70 o e.S kV a7-Li I; 37 I. i ... . Z-. OM :KPELECTR I C FAX"NO.-:1748495500 y Feb. 10 2014 03: 14PM P1 }" Feb. ilk. 201 2: 1FM DI ,i Town. of BarnnstabreMN.� ®_ Regulatory ServicesNI TELP3 MUNM i Richard v.ftalt,Interim Director Building MvWon Tom Ferry,Building CoYutnlxsionor 200 Maki Str"k fiy=iis.MA l7260i 0$ics: 508-862-4038 Fax: 508-7904230 REQUEST FOR, ELECTRICAL INSPECTION EI.TCT�iFG:�►Y.'1'E�a611'NJMRFR .__,_..�._ Nunit req-,xired in ardw to prcv�;aa inapection) Toda�s DoU - G/ &qunetsd Data of Inapeetion :/�.� I,q,-)1_._P iT A—& S v✓(-.hereby requeat:an';.nspoetion under Mmsachusetts Q6rieYA1 ' Law eh nter 143:section 3Y.and 297 OMR 4.02(3.). The inetailation v2I be ready for inapection atI L ?L '/C e 5/C)C- 2 f S C:A'aerty Laoce.taoa� Type of inspection mquuested: ❑ Temporary Service El Ser-ice Rein Poetic= ` ovation (� Rough Re-inspection �] �xvica Ttas„wrtinn ❑ Fiuhl$e-inspectio�a [,] Rough hiapection for- ($100.00 Re-inspection Fee) (� Fi::a1�nEPsatir,,:fir. 'TG ff�.�✓ ' Owner or-Iez=tAtY__ x IdCanase's roams, aadrrft,aL::ip'laone R L_If_ P. T/ SS 7 �,L .'-I D42g: 'Y 3 d76 Ro- mA•�d�77d L.icetwe mumb�ar �l jig 7.icemme'a sipatura.� Ma section to he cutpplatetl by bearmatsble:nspect�ir of Wired LaspUct vo datFEB 12 1014 ElAppiow3. ❑Not Approved Thie work vvu not approvo-d for violation of the tollow' g t doo 115ectione of Elect riag Cade (1p�llao:ib�rasaka�agpta� . aM..yinm� A =y Town of Barnstable , . Regulatory Services • Thomas F. Geiler,Director ir- [ ncr 90 7: 'i aARNerAau Building Division s6 9. 16 o� Tom Perry,l3ailding Commissioner , 200 Main Street,Hyannis,MA 02601 Fax: 508-790-6230 Office: 508-862-403 8 RE VEST FOR ELECTRICAL INSPECTION ELECTRICAL PERMIT NUMBER process ins ection) (Permit required in order to pro P Today's Date Requested Date of Inspection_l '. --a 0 IJ---- I,�n r hereby request an inspection under Massachusetts General (Electrician) Law chapter 143, section 3L and 237 CMR 4.02(3). r The installation will be ready for inspection at 3 S 7 S T- (Property Location) Type of inspection requested:, ❑ Temporary Service ❑ Service Re-inspection ❑ (] Rough Re-inspection Excavation ❑ Service Inspection ❑ Final Re inspection (T Rough Inspection£or SyN Rae ($100,00 Re-inepectiozi Fee) I{ lT��cN 4- Ci�TN2� p, ❑ Final Inspection for i t<C y w 02 K 'S` S L 10 e 2 0 Av VJ e c�� ❑ Other nJ e �o Y Owner or tenant-17 O D/L G r,4 M i L V L Ro Ge-2 PodTR �S T2 sC'S'W 1"s- Y3-7 Licensee's name, address,and phone Pro .80 K G 7(o 0C0d s 7-C 2 License number/ `� Licensee's Signature This section to be co I Barnstable Inspector of Wires Inspection date®EC 21 2611 ❑A p oved ❑Not Approved i This work was not approved for violation of the following Articles and Sections of the MA Electrical Code= I Q;WPFilcs:furms;cic=equest Rev;4/8/08 ' f COmmonwea&o f Madeac4udeth Official(\Usp Only c� Permit No.cD , 1A Apartment of Jim.ervinm Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] l(leave blank) Q APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: City or Town of: To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. 1 Location(Street&Number). 3 S 7 L o}"K C S!Q f— 0 R ► y e w S �- Owner or Tenant T O 8 /C e, FQ A, t L Y L /� Telephone No. Owner's Address 3 S 7 L A}/l e S la e- 4 a t U C S r Is this pe�mit in conjunction with a building permit? Yes ❑"--No ❑ (Check Appropriate Box) Purpose bf Building ' e 51 S.DA,t/ G. -e Utility Authorization No. Existing service _�pd Amps /off l a t/ Volts Overhead Undgrd❑ No.of Meters f vo "New Service ' Amps / Volts Overhead❑ Undgrd ❑ No.of Meters i=-Number of Feeders and Ampacity g -d 0 ,9t,7/: oL i r2, U r- -) /'% 'S -- 6 Location and Nature of Proposed Electrical Work: IQ z2 e Ae / rr- -I c t/ —3 H't N4 S�cJ of/1 oa r, ► w " " Completion ofthefollowing table may be waived by the Inspector of Wires. No.of Total _ No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans 1144- ,_ Transformers KVA No.of Luminaire'Outlets No.of Hot Tubs Generators KVA Above In- o.o mergency ig ng No.of Luminaires Swimming Pool rnd. ❑ nd. ❑ Batte Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners o.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices Z W a Municipal No.of Dishwashers Space/Area Heating KW Local❑ Connection ❑ Other o L9 No.of Dryers Heating Appliances .KW Security Systems:* No.of Devices or Equivalent W a :No.of ater K`,1, No.of No.of Data Wiring: �Z Z s Heaters Signs Ballasts No.of Devices or Equivalent Z = e Telecommunications Wiring: Q o Z t No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent o � a a €;OTHER: O w"w < Attach additional detail if desired,or as required by the Inspector of Wires. IL 5L,T 8� FEstimated Value of Electrical Work: (When required by municipal policy.) F O u 4 _� 5 w Work to Start: d2 -/ // Inspections to be requested in accordance with MEC Rule 10,and upon completion. a o m `,INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless Ir Y Lcu' the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The o E ndersigned certifies that such cover is in force,and has exhibited proof of same to the permit issuing office. Q o a aCHECK ONE: INSURANCE [�BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury,that the information o'n this application is true and complete. FIRM NAME: , , L C_G %� / C- Q O rVG LIC.NO.: Licensee: �CzCe� ,i7Y{,;L S J -1 Signature 9 .:1 N0 LIC. 3 / 5 / (If applicable,enter "exempt"in the license number line.) Bus.Tel..NO.:/ 8-7��-o [�3� Address: �,6o x / 7� /;ac hte s7 sL o"��. Q�7 7a Alt.Tel.No.: 5�8'-7�8-5 4 3 *Per M.G.L.c. 147,s. 57-61,security work requires Department of Public Safety"S"License: Lic.No. 141319,99 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ TOWN OF BARNSTABLE Bufluing 201207799 • EARNSTABLE, Issue Date: 12/20/12 Permit 9 MASS. 1639. A�� Applicant: CARE FREE HOMES INC. Permit Number: B 20123090 Proposed Use: SINGLE FAMILY HOME Expiration Date: 06/19/13 Location 357 LAKESIDE DRIVE WEST `Zoning"District RD-I Perrut Type: RESIDENTIAL ADDITION/ALTERATIO .fi Map Parcel 232050 Permit Fee$ . 260.10 Contractor CARE FREE HOMES INC. Village CENTERVILLE App Fee$ IW;, '+ 50.60 License Num 100503 Est Construction Cost$ 51,000 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND REMODEL BATHROOMS THIS CARD MUST BE KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: IODICE FAMILY LP BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 64 NEWPORT DR INSPECTION HAS BEEN MADE. WESTFORD,MA 01886 Application Entered by: JL Building Permit Issued By: yy' THIS PERMIT CONVEYS NO RIGHT TO OCCUPY'ANY STREB7,ALLEX OR,SIDEWALK OR ANY PART THEREOF;,EITHER T ORARII Y O 13 LY.'ENCROACIITNTS ON PUBLIC PROPERTY NO. SPEC IFICALLY:PERMITTED UNDER THE BUILDING CODE,MUST BEAPPROVED BY THE JURISDICTION STREET OR ALLEY GRADES ASWELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAYBE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORK:THE ISSUANCE OF THIS PERMIT:DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF�ANY APPLICABLE SUBDIVISION RESTRICTIONS. ° :3 � MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). 5.INSULATION. 6.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). .;ua � „ u u• . 7- R R ems: �4 BUILDING.INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 3 2 2,. ti 2 , . 3 1 Heating Inspectipn Approvals Engineering Dept j f f , t Fire Dept 2 Board of Health TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION _9 OF Map.. Parcel V ApplicatochT# �4 Tnq 01? Health Division Date Issued Conservation Division Application Planning Dept. ® ' Permit Fee Date Definitive Plan Approved by Planning Board Z Lo /L Historic - OKH _ Preservation / Hyannis Project Street Address S��, we Village U Owner -Address ��: Telephone - �O .Permit Request 4- r + � Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuatio Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family a,/ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing 2-. new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including bathe): 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) �S Name ( Telephone Number Address License # 1CA j r LAd, AGI- Home Improvement Contractor# �d3 Worker's Compensation # 64-jl S t( ? ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO (oZJ 3� SIGNATURE DATE l Z / Z FOR OFFICIAL USE ONLY R APPLICATION# ` DATE ISSUED f, If MAP/PARCEL NO. 4} ADDRESS VILLAGE r OWNER p. 1 ' DATE OF INSPECTION: -J 1 k . FOUNDATION: . . FRAME j INSULATION a 1 3 FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING IT Z DATE CLOSED OUT i ASSOCIATION PLAN NO. t r IIPe c®nzmonwealth of Massachusetts Department of Industrial Accidents ` Office of Investigations i; 1 Congress Street, Suite 100 Boston, 17�1,4 0211 -2017' , www.mass.gov/dia Workers' Com ensationInsiarance Affidavit': Builders/Contractors/Electa-icia as/Pluanbe s Applicant Information Please Print Legibly. Tame (Business/organization/Individual): CARE-Rk HOMES INC. 39 Address: FAIRHAVEN, MA 02719 City/State/Zip: Phone#: Are yop an employer?Check tU appropriate box: Type of project(required): 1.r`�-,Y,i(am a employer with 4• ❑ I am a general contractor and I 6 ❑ Ne onstruction employees(full and/or part-time).* have hired the sub-contractors 00, 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. emodeling ' shipand have no employees These sub-contractors have ,8. ❑Demolition ., • working for me in any capacity. employees and have workers' 9 Building addition [No workers'comp, insurance comp.insurance.$ g required.] 5. 0 We are a corporation and its S10.❑Electrical repairs or additions . 3.❑.I am a homeowner doing all work " officers have exercised their l 1.❑Plumbing repairs or additions myself. [No workers' comp, right of exemption per MGL 12.F1Roof repairs insurance required.]t c. 152, §1(4), and we have no . . employees. [No workers' ` f 43.❑ 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. lContractors 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 isprovitl'zg workers'compensation insurance for my employees. Below is thepolicy and job site infor ratio rl Insurance Company Name: , Policy#or Self-ins.Lic.#: _35 H-7� Expiration,Date:_ , Job Site Address: } t4A /I V A City/State/Zip: Attach a copy of the workers' compensation`policy declaration,page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL.c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisomnent,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a gainst the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations the A for insurance coverage tion.' ''' _ - I rlo hereby cer. . r the and er It' erju that the inforrnatiorz provided above is true and correct. Si nature: -Phone 3 z Official use only. Do not write in this area,to be completed by city or town.offrcial 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#: Client#:33723 CAREF ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MWDD/Y M 9/21/2012 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:N the certificate older Is an ADDITIONAL IN ,the poi Iss)must be endorsed.If 3USARMA-TION iS WANED,su eat W the terms and conditions of the policy,certain polichm may require an endorsement A statement on this certificate does not confer rights to the Certificate holder in Asu of such endorse s).. PRODUCER Herlihy insurance Group Inc. mE: 51 Pullman Street •508 756-5159 lee: 508.751.5747 Worcester,MA 01006 r 9 AD Soo 766-5159 dueTOMER o r. BNSU a AFFORDBIB COVERAGE MAX e SNSMED Care Free Homes Inc INSUIMA:Peerless Ins.Comp. � 239 Huttleston Avenue x INSURERS:Interguard Insurance Company Fairhaven,MA 02719 wmamc:safety Indemnity Insurance Comp 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. TYPE OF INSURANCE POLICY NUMBER M b LIMITS q GENERAL UABILmr CBP8929704 9/01/2012 09101/2013 EACH occuRRENcE_ $1 000 000 X COMMERCIAL CLAIMS-MADE GENERAL AL LIABILITY OWAGE TO G occu nce s100 D00 CLAIM MADE I ^I OCCUR MED EXP(Any one per"n) $15,000 X BUPD Ded:250 PERSONAL s AOV I WRY S11,000,000 .,:•. GENERAL AGGREGATE s2,000 000 ' GE N1 AGGREGATE LIMB APPLIES PER: PRODUCTS.COMP/OP AGG s2,000,000 POLICY PRO LOC ' s C AUTOMOBILE LIABILITY 6213850 7/01/2012 07/011201 COMBINED SINGLE LIMIT ANY AUTO (E$wzwwt) $1000 000 5, BODILY INJURY(Per person) $ ALL OWNED AUTOS ' X SCHEDULED AUTOS . i t' BODILY INJURY(Per accident) S X HIRED AUTOS PROPERTY DAMAGE rF j (Pereoddenq S X NON-OVVNED AUTOS , E UMBRELLA•LIA OCCUR r EACH OCCURRENCE $ EXCESS LIAB HCLAIMS41AADE AGGREGATE : DEDUCTIBLE $ B WORKSCOMPENBATIoN CAWC359478, 9/01/2012 09/01/201 X sTATLI AND EMPLOYERS`LIABILITY YIN � '�PROPRIETOR/PARTNERIE7� E.L.EACH ACCIDENT s1 000 000 OFFICER/MEMBER EXCLUDED9 CUT111E�N NIA ' R 4 f (Mandatory In NIQ E.L.OBEASE-EA EMPLOYEE $1 000 000` CRIdepatrlbe under gr r .' ELD�EASE-POICY LM1rr s1000000 3 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Aft ch ACOR0161,Additlenal Remarke Schedule,N mac epeae In required) * - CERTIFICATE HOLDER CANCELLATION 30 Days for N -P ent SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town of Barnstable ? ACCORDANCE VWTH THE POLICY PROVISIONS. Building Department 367 Main Street AUTHOMMI)REPRESENTATWE { Barnstable,MA 02601 F ®OF884069 4ZORD CORPORATION.All rights reserved. ACORD 25(2009/09) 1 Of 1 The ACORD name and logo are registered marks of ACORD #S57018/M56619 P02 by r ,t / 1c1� � License or regtstrat'ion valid for mdiytdul use-only �e anvinoa�us J . i Bus, , ; ' return ti):. ffice of Consumer Affairs& before the expiration date:'If found ME IMPROVEMENT CONTRACTOR Office of Consumer.Affairs.and Business ltegulation l` egistration 100503_ TYP ; 10 Park Plaza Suitr 5170 SUPlement :aM Roston,MA 02116 i Expiration 6/1912014 jP CARE FREE HOMES tjJC F. - >� DANA PICKUP JR 239-Huttleston ave `= r g Not valid.without signa e Fairhaven,MA 02719 "Undersecretary71 J -•- - _ Massachusetts -Department of PublWsafety Board of Build:ing;Regulatioas and Stat Bards Construction SuPen isor x License CS-095228 J DANA J PICI ��S� \ 19 HANMTST. �^ Fairhaven M 02719 Expiration. , Commissioner 3r2ti2otd 4 CARE Fome sFiE � i n c. 239 Huttleston,vent Fairhaven,Mass 02719 Telephonre St"471111 FAX SM-M-1297. 'wVVebsfte:�rw,e�refi eefiomescumpaey.00at To the Town of: garn.5 164L L Job Address: 5 (-c�. G S tG t'• Gee S City,State,Zip: 1' n RI)q c rS avrner of the home at the above Cutskmw nwne local,ion,auftrize Care Free Home,IM as MY agent to obtain all n i �its and to . perforra all home impravernents to my home as stated,in the accompanyiqg camract and � application. .! Mainers natnLvl Date ,i Z—, ZO/ZO 3Jdd TT0tZ698L6 TE W ZTOZ/EO/ZT � - --- ����-� s,. v� �--- - � � s, e� } TOWN OF BARN, TABLEBultuing - m ■ 2 0 1 la 0 4 90'6 9 BARNSTABLE, Issue Date: 10/17/11 Permit MASS. i639• A licant:a pp Permit Number: B 20112251 Proposed Use: SINGLE FAMILY HOME Expiration Date: 04/15/12 Location 357 LAKESIDE DRIVE WEST Zoning District RD-1 Permit Type: RESIDENTIAL ADDITION/ALTERATIO ,-Map Parcel 232050 Permit Fee$ 484.12 Contractor CARE FREE HOMES INC. Village CENTERVILLE App Fee$. 50.00 License Num 100503 I�. Est Construction Cost$ 94,925 Remarks +APPROVED PLANS MUST BE RETAINED ON JOB AND REM SUNRM ROOF&REBUILD CATH ROOF OVER SUNR.00M&KI ,RI4IS CARD MUST BE KEPT POSTED UNTIL FINAL 1 INT NON-BEAR LOAD WALL&BLD NEW,REMODEL MST BATH,N W MaECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: IODICE FAMILY LP BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 64 NEWPORT DR INSPECTION HAS BEEN MADE. WESTFORD,MA 01886 Application Entered by: JI_ Buildin,Permit Issued By: Lq �4" U��, THIS PERMITCONVEYS NOQRIGHT-TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PARI'THEREOF,EITHER T V ORARILY:6 P R TL . ENCROACHMENTS ON'PUBLIGPROPERTY,N0- SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS:WELL AS DEPTH,AND LOCATION OF PUBLIC SEWERS-MAY.BE'. OBT'AINEDFROM THE DEPARTMENT OF PUBLIC.WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION", a ` RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: 1,FOUNDATION OR FOOTINGS. I 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). 5.INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY. A. 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 MGI c.142A). BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 4w, 2 2_. ✓ 2 3 1 Heating Inspection Approvals Engineering Dept F>reDE t 2 Board of Health p { TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map_ �3 Parcel Application # Health Division - Date Issued 4r0 1 Conservation Division No 4w� C' c - Application Fee Planning Dept. Permit Fee 4 4< <Z Date Definitive Plan Approved by Planning Board a K ►6)r7117 Historic - OKH Preservation /Hyannis Project Street Address � l�1��1 �1 (��� WL Village W Owner T� :�,CIA vw,. P l -C e • NAddress AlfiWood 11112. C r Telephone 7� g� 38` 7°► Permit Request (-4 �v. t j 64,�,O )U' J !'61Qf,' 6W"-r ai&W ¢ V-41 : `•0 ` 1 0 Lvi ( 11-1 in-.A l D c 1 "`^ , yyp Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District / Flood Plain Groundwater Overlay Project Valuation Z y Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family I/ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes US No On Old King's Highway: ❑Yes &lo Basement Type: UlFull ❑ Crawl ❑ Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: ex isfng new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ 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 Bt A- LGx-, Lflt s Telephone Number �'� �'� 167 Address es le,.(7�14 ,/ _ License # u'I v e v. Home Improvement Contractor# Worker's Compensation # Cl�G 2 Ll4 0 t( ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE_ DATE I. ' FOR OFFICIAL USE ONLY E _ APPLICATION# DATE ISSUED ' MAP/PARCEL NO. r ADDRESS - VILLAGE OWNER i • DATE OF INSPECTION: FOUNDATION FRAME INSULATION c�® `ko��n�►3. ��1. 'FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH i FINAL GAS:''` '' ROUGH' FINAL 'FINALBIJL-'DINGI R DATE.CLOSED OUT f ASSOCIATION PLAN NO. ' y 1 r The Commonwealth of Massachusetts Department of Industrial Accidents E�i4 r Office.of Itivestiations y, a 600 Washington Street Boston, HA 02111 www.niass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electriciahi /Plumbers Applicant Information Please Print Le ibl Name (Business/Organization/Individual): Care, �e_,e_ �,ov Address: uuffl-,63 �,K \f City/State/Zip: r Phone Are you an employer? Check the appropriate box: . I am a general contractor and I Type of project(required): 1.� 4 ❑ g am a employer with Z. employees (full and/or part-time).* have.hired the sub-contractors 6. ❑ New construction 1❑ I am a sole proprietor or partner- listed on the attached sheet. 7. D l eemodeling . These sub-contractors have ship and have no employees 8. ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers'.comp. insurance comp. insurance. required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions . officers have exercised their. . 3.❑ I am a homeowner doing all work : l L❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required] t c. 152, §1(4), and we,have no employee`s. [No workers' 0.[1 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. xContractors 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 ani an employer that isproviding workers'compensation insurance for zny employees. Below is thepolicy and job site information. . Insurance Company Name: Policy#or Self ins.Lic.#: C Expiration Date:_ Job Site Address: .57 City/State/Zi P i 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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification, 'I do Izereb under the pain penalties of-perjury that the information provided above is ue and correct. Signature: �.. Date: Phone9 —( /l 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. 1. Building-Department 3. City/Town Clerk 4..Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#,: Client#: 33723 CAREF ACORD- CERTIFICATE OF LIABILITY INSURANCE DATE TE(M DDf'' 11 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,sub)ect 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 Herlihy Insurance Agency,Inc. NAME: PHONE 508 756-5159 51 Pullman Street ac No,Ext: ac,No: 508 751.5747 Worcester, MA 01606 AODRt-MAIess: 508 756-5159 CUSTOMER to#: INSURED INSURER(S)AFFORDING COVERAGE NAIC# Car@ Free Homes Inc wsuRERA:Interguard Insurance Company 239 Huttleston Avenue INSURER B:Safety Indemnity Insurance Comp Fairhaven,MA 02719 INSURERC: 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. INSR TYPE OF INSURANCE L BR POLICY EFF POLICY 7EACH DPOLICY NUMBER MM/DD MM/DD LIMITS GENERAL LIABILITY OCCURRENCE $ COMMERCIAL GENERAL LIABILITY AEMISES Ea occurrence $ NItU CLAIMS-MADE OCCUR D EXP(Anyone person) $ PERSONAL&ADV INJURY $ GENERALAGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRO- PRODUCTS-COMP/OP AGG $ POLICY LOC $ B AUTOMOBILE LIABILITY 6213850 07/01/2011 07/01/201 COMBINED SINGLE LIMIT ANY AUTO (Ee accldent) $1,000,000 ALL OWNED AUTOS BODILY INJURY(Per person) $ X SCHEDULED AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS PROPERTY DAMAGE $ (Per accldent) X NON-OWNED AUTOS $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE DEDUCTIBLE AGGREGATE V RETENTION $ A WORKERS AND EMPLOY RSELIABILIITY NSATION Y/N O CAWC244043 09/01/2011 09/011201 X WC STATU- OTH- $ OF ICER/MEMBER EXCLUDED ECUTIVE� NIA E.L.EACH ACCIDENT $1,000,000 (Mandatory In NH) "yes,describe under E.L.DISEASE-EA EMPLOYEE $1,000,000 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 Is required) CERTIFICATE HOLDER CANCELLATION 10 Days for Non-Payment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town Of ACUShnet THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Building Department ACCORDANCE WITH THE POLICY PROVISIONS. 122 Main Street AUTHORIZED REPRESENTATIVE Acushnet,MA 02743 019 - 909 A66Rb CORPORATION.All rights reserved. ACORD 25(2009/09) 1 of 1 The ACORD name and logo are registered mat of ACORD #S48857/M48747 PB2 CARE FREE omes 239 Huttleston Avenue Fairhaven,Mass 02719 Telephone 508-997-1111 Fax 508-997-1297 Website: www.carefreehomescompany.com To the Town of: R Job Address: O owner of the home Customer Name at the above location, authorize Care Free Homes,Inc. as my agent to obtain all necessary permits and to perform all home improvements to my home as stated in the accompanying contract and application. g Customer Signa a V Date f The Commonwealth of Massachusetts William Francis Galvin- Public Browse and Search Page 1 of 2 The Commonwealth of Massachusetts psi William Francis Galvin sl Secretary of the Commonwealth, Corporations Division One Ashburton Place, I7th floor Boston,MA 02108-1512 k � Telephone: (617)727-9640 IODICE FAMILY LIMITED PARTNERSHIP Summary Screen Help with this form • ,��Re,questa�Gertificate„ uw The exact name of the Foreign Limited Partnership(LP):JODICE FAMILY LIMITED PARTNERSHIP Entity Type: Foreign Limited Partnership(LP) Identification Number: 000851618 . Date of Registration in Massachusetts: 10/07/2003 The is organized under the laws of: State: DE Country: USA on: 09/25/2003 The location of its principal office: No. and Street: 64 NEWPORT DRIVE City or Town: WESTFORD State:MA Zip: 01886 Country:USA The location of its Massachusetts office, if any: No.and Street: 64 NEWPORT DRIVE' City or Town: WESTFORD State: MA Zip: 01886 Country: USA The name and address of the Resident Agent: Name: ANNA E. ROGERS No. and Street: 64 NEWPORT DRIVE City or Town: WESTFORD State: MA Zip: 01886 Country: USA The name, business and residence addresses of each General Partner: Title Individual Name Address (no PO Box) First,Middle,Last,Suffix Address,City or Town,State,Zip Code GENERAL PARTNER IODICE FAMILY LIMITED LIABILITY COMPANY 64 NEWPORT DRIVE WESTFORD,MA 01886 Consent _ Manufacturer _ Confidential Data Does Not Require Annual Report Partnership _ Resident Agent _ For Profit Merger Allowed Select a type of filing from below to view this business,entity filings: htt ://co .sec.state.ma.us/co /co search/Co SearchSumma .as ?ReadFromDB=True... 9/14/2011 � P IP � IP � �' P f The Commonwealth of Massachusetts William Francis Galvin- Public Browse and Search Page 2 of 2 ALL FILINGS Annual Report ? Articles of Amendment l Certificate of Cancellation i Certificate of Withdrawal ~ Vie Filmgs � :New Search ) Comments ©2001-2011 Commonwealth of Massachusetts L:7 All Rights Reserved Help http://corp.sec.state.ma.i s/corp/corpsearch/CorpSearchSummary.asp?ReadFromDB_=True... 9/14/2011 r . +ri n1:tCntrllrt5- UeWil'tinent of Public S:Ifl`tI , Bo Ird of'Building Regulations and St:ulZ'-as C6:hstruCtii'om-Supervisor.License Licensed CS 95228 �9 Restricted to: 00. i # .i DANA PICKUP I 19 HA e v' MLET STREET w. MA 112719, �.,, .. Expiration: 3/22/2012 (:irnuuissioncr,• '. Tr#: 18680 �. �fze �o7rz�no�uuecz/ o�/f/fczaaac�iticae ,19 Officc of ConsumcrAffaii s S Bu3iness Regular ui, p License or.registration vand.for indiv:ad I use on. HP,M.,E IMPROVEMENT CONTRACTOR ;: before the expiration date.Jf.found fetus."to': Office-of Consumer Affairs and Business Regulatiort-. Registration +100503 TYP- 1.0 Park Plaza=Suite 5170. ------------ w4 Expiration �6/19/2012 Supplemeri, 2,rdr Boston,MA 02116 a CARE-FREE HOMES DANA PICKUP 239 Huttleston ave � �— Fairhaven, MA 02719 — ---f'= Undersecretary Not:valid wit out,signa - -- �-� Tt� rz - -..- - 1 _....-........... _ F? . t , _ .._...._._.__..._....... .. _.._._._. .. ..._ ....... .._ .... ......... _._ ......----_:......_.:.....__:. .__.._.__._.. .._ .. ._ ... -:. ._. . .__. -._.._...__....__._ ..i ....... ._.-.. ._...._ ... 4 r-, gem 3��'y°�pss,261 d / Gary D Braekins a knoeiateg Professional Building Designers s Rosidonfial.Cpoeialisfs 313 Main Street - Fairhaven, Massachusetts 02719 Office: 508.758.6708 - Facsimile: 774.206.6942 GBrackins@GDBAssociates.com October 7, 2011 Nate Pickup Carefree Homes, Inc. 239 Huttleston Avenue Fairhaven, Massachusetts 02719 Dear Nate: Enclosed are the insulation and glazing requirements for the Rogers' Project at 357 Lakeside Drive West in Barnstable, Massachusetts. These requirements are found in the 2009 International Energy Conservation Code by the International Code Council. SECTION 401 GENERAL 401.1 Scope. This chapter applies to residential buildings. 401.2 Compliance. Projects shall comply with Sections 401, 402.4, 402.5, and 403.1, 403.2.2, 403.2.3, and 403.3 through .403.9 (referred to as the mandatory provisions) and either: 1. Sections 402.1 through 402.3, 403.2.1 and 404.1 (pre- scriptive); or 2. Section 405 (performance). These requirements as shown below are based upon the Prescriptive Compliance Method as shown in Section 401 —General and not the Performance Compliance Method (Section 405 - RESCheck). As a designer I am allowed to use either the Prescriptive or Performance methods to demonstrate compliance. Per Table 402.1.1 the following are the required insulation and fenestration y requirements, see next page. OFM "f — wroc,sne w ji Where Tatont. Toehnology and Exporioneo Croate Uniquo Custom Romos N} A 1111 Lp,p AFIIII Acc AVA BID® ,w COUNCIL NAb[3 py,p. N7�fiAtl3�:4 COUNCIL I The prescriptive requirements below are based upon Table 402.1.1 of the 2009 Internation Energy Conservation Code (IECC09) by the International Code Council. Per Compliance Option of Section 401.2 of IECC09 this project shall comply with the Prescriptive requirements of Section 402.1 through 402.3 and Section 404.1 instead of the Performance Based Criteria of Section 405, which includes a ResCheck Report. REQUIRED PROVIDED FENESTRATION U-FACTOR 0.35 0.35 SKYLIGHT U-FACTOR 0.60 N/A CEILING R-VALUE R-38 N/A Full Height at outside wall R-30 R-30 WALL R-VALUE R-20 R-13 FLOOR R-VALUE R-30 R-30 Full cavity insulation R-19 R-19 CONDITIONED BASEMENT WALL R-VALUE R-10/13 N/A CONDITIONED SLAB PERIMETER R-VALUE & DEPTH R-10. 2 FEET N/A UNVENTED CRAWL SPACE WALL R-VALUE R-10/13 N/A PRESCRIPTIVE ENERGY GOMPLIANGE 1 SCALE: N.T.S. Gary D Bracking & Associates Professional Building Designers s Residontial Rpeeialists Per Section 101.4.3 where we are using the existing exterior walls and we are not required to install R-20 minimum cavity insulation. See Exception 3 below. I have specified R-13 which will fill the cavity of a 2x4 wall. 101.4.3 Additions, alterations, renovations or repairs. Additions,alterations,renovations or repairs to an existing building, building system or portion thereof shall conform to the provisions of this code as they relate to new construc- tion without requiring the unaltered portion(s),of the exist- ing building or building system to comply with this code. Additions,alterations,renovations or repairs shall not cre- ate an unsafe or hazardous condition or overload existing building systems. An addition shall be deemed to comply ,with this code if the addition alone complies air if the exist- ing building and addition comply with this rode as a single building. Exception:The following need not comply provided the energy use of the building is not increased: 1. Storm windows installed over existing fenestra- tion. Z. Class only replacements in an existing sash and frame. 3. Existing ceiling, Nvall or floor cavities exposed during construction provided that these cavities are filled with insulation. The existing floor assembly shall receive R-30 full cavity insulation which was not shown in the original drawings. This is due to the change in the energy conservation code from the time they drawings were prepared. Again, see Exception 3 above. R-30C cavity insulation is specified for the cathedral ceiling. R-30C is high density insulation intended for cathedral ceiling installation. This will provide the air space for ventilation. 313 Main Street - Fairhaven, Massachusetts 02719 Office: 508.758.6708 - Facsimile: 774.206.6942 GBrackins@GDBAssociates.com Gary D Braekins & associates Professional Building Dssignors s Residential Rpeelalists I hope this answers your question in regards to the insulation and fenestration for the Rogers'Project. If you have any questions please do not hesitate in contacting me at your earliest convenience. Sincerely: Gary D Wackins Professional Building Designer—AIBD.ORG 313 Main Street-Fairhaven, Massachusetts 02719 Office:508.758.6708-Facsimile:774.206.6942 GBrackins@GDBAssociates.com Double 1-314" x 11-114".VERSA=LAM@ 2.0 3100 SP Roof BeamAR1301 BC CALCO 3.0 Design Report-Us 1 Span No c-arrtiteveis 1 0/12 slope Tuesday, Cctober 11,2011 Build 517 File Name: BC CALC Project Job Name: Roger's Description: roof edge beam Address: 357 lakeside Dr West Specifier. City, State,Zip:Barnstable, MA Designer. Customer, Company: Code reports: ESR-1040 Misc: 12 , a - a 1 i y 17..n-..q.vrr ,i ... .. "4- ' 71-70-00 - so,3-1/z, DL 421 Ibs SL 710 Ibs DL 421 Ibs SL 710 Ibs Total Horizontal Product Length=11-10-W- UVe Daaird Snow Wind Roof U e " Trib. Load Summary T Descripyon toad Tye Ref. Start End 100% 90% 116% 133% 12S% 1 Standard Load Unf. Area(psf) L ,0040-00 117-10-00 15. 30 04-00-00 Controls SUMMaQ value %allowable Duration - Case Span Disclosure Pos, Moment 3,091 ft-lbs 14.0% 115% 3 1 -Internal ComploWness and ecru CY of Input must End Shear 896 lbs 10.4% 115% 3 1 Left- be verlied by anyone would rely on Total Load Defl. L/1,575(0,087") 11.4% 3 1 output as evidence of su blllty for particular Lave Load Uefl- U2,508(0.054") 9.6% g 1 application-Output here on building Max Defl- O,Ot37" 8-7% 3 1 ` code-aompteddesign rtiesand Span/Depth 121 n/a 1 analysis methods.Install of BOtsL engineered wood produ must be In a=rdanCe with caunent I istallabon Guide Allow Bearing Supports Dim L x Value SUPPRI Member - Material Installabon Guide or ask c juestions,please SO Post 3-1/2"x 3-1/2" 1,131 Ibs n/a 12.3% Unspecified caU(800)232-0788 befo installation. 61 Post 3-10 x 3-'f/2" 1,131 Ibs n/a ' 123% Unspecified 8C C►LC®,BC FRAMs 0,p18' , ALUOISTO,8C RIM ARD- BCI®, Cautions BOISE GLULAM-,SIMI LE FRAMINr. For roof members with slope(1/4)/12 or less final design must ensure that ponding SYSTEM®,VERSA4A 0,VERSAAM Instability will not occur PLUSO,VERSA-RIMO, For roof members with slope(1/2)112 or Im final design must account for Rain-on-Snow vERsa$TRANDO,VE SA-STUB are surcharge load. trademaft of Boise Cau aft Wood Products L.L.C. Notes Design meets Code minimum(U180)Total load deflection criteria. Design meets Code minimum(L/240)Live load deflection criteria.: . Design meets arbitrary(1")Maximum load deflection criteria, i Page 1 of 2 6orae cuuaaao - z Double 114'" x 11-1I4" VERSA-LAAA@ 2.0 3104 SP Roof EleaMXRB02 BC CALCO 3.0 Design Report-US 1 span I No cantilevers 1 0/12 slope Tuesday, 0 ober 11, 2011 Build 517 File Name: ,BC.CALC Project Job Name: Rogers Description: roof edge beam Address: 357 lakeside Dr West Specifier: City, State,Zip:Samstable, MA Designer, Customer. Company: Code reports: ESR-1040 Misc: 12 411 ' - 17-03.0$ DL 615 Ibs DL 615 Ibs SL 1,038lbs SL 1,038 Ibs Total HorLzrital Product Length 17.03-OB Live Dead Snow Wind > Roof Lh 0Tdb. Load Summary , Tag Description Load Type Ref. Start 9nd ' 100% 90% 116% 133% 126% 1 Standard Load Unf,Area(psf) L_ 00-00-00 17-03-08 15 30 0400-00 Controls Summary vatue %Allowable puration case span Disclosure Pos. Moment 6,768 ft-lbs 30.6% 115% 3 . 1-Internal Completeness and accu y or input must End Shear 1,417 Ibs 16.5% 115% 3 ` 1 -Left be verified by anyone who would rely on Total Load Defl. U486(0.416") 37.096 3 1 output as evidence or suit bility for particular ,- Live Load Defl. U774(0.2611-) 31.0% 3 1 application,Output here b tod on building I' Max Defl_ 0,416' 41.6% 3 1 code-acc['Pted design pr sties and Span I Depth 18_0 Na 1 analysis methods.Irmtall of BOISE engineered wood produ must be In accordance with current t (laWn Gulde %Allow %Allow and applicable building To obtainBearin S ofts Dirn Lx lue Va Member Material lr*talladonGuideOrask ,please BO Post 3-1/2"x 3-1rZ' 1,652 lbs n/a 18.0% Unspecified call(✓w)232-0788 before installation_ l31 Post 3-1/2"x 3-10 1,652 Ibs n/a 1$_0% Unspecified BC cALCO,BG FRAMERO,AJS"", ALWOISTS,BC RIM B D- SCID, Cautions BOISE GLULAM%w,SIMF LE FRAMING For roof members with slope(1/4j/12 or less final design must ensure that ponding r SYSTEMS,VERSA-LA. ,VERSA-Rim, instability will not occur. PLUSH,VERSA-RIM®, For roof members with slope(1/2)/12 or less final design must account for Rain-on-Snow VERSA-STRANDO.VER A-STUDS are surcharge load. badernwks of Boise Cue We Wood Products L.L.C. Design meets Code minimum(U180)Total load deflection criteria- Design meets Code minimum(U240)Live load deflection criteria. Design meets arbitrary(1")Maximum load deflection criteria- .Page 1 of.2 r Double 1-3/4" X 14" VERSA-LAMOD 2.0 3100 SP Roof BaamIR1303 BC CALCOD 3.0 Design Report-US 1 span(No cantilevers 1 0/12 slope Tuesday, O ober 11,2011 Build 517 ) File Name, BC CALL Project ' Job Name: Roger's Description: ridge beam Address: 357 lakeside Dr West Specifier City, State,Zip:Barnstable, MA Designer: Customer Company: Code reports: ESR-1040 Misc, 12 7 y, ,, y:.. .�}.;4h.i{rSzY.' a�,�.•,�.:.. .;r,. ,r.:r _ .n. 4i i ig � i'e. 'y .I•,{ i:; n...a........... .,..,, ,.t:. y......tiJ...... ,m ..,.".:'.>rr''-.1> .,. ':F'j• y,� ✓i:'":*...''••.;G.,.•,-r..7. i4`' 22-0 80,3-1/2 131,3 fl2" DL 1,433lbs DL 1,453 Ib6 SL 2,598 Ibs SL 2,5N Ibs Z Total Horizontal Product Length=22-03.08 1 Uve Dead Snow'. Wind Roof Ui e 7YIt1. 4 Load Summary Tmg Description Load lye ReL Start, End 100% 90% 115% 133% 126% 1 roof Unf. Area(psf) L 00-00-00 22-03-08 15 30 07-09-04 Controls Summary value--- %Allowable Duration Case_ Span 'Disclosure Dos. Moment 21,659 ft-lbs• 64,9% 115% 3 1 -Internal Completeness and scou y of input must End Shear 3,521 Ibs 32.9% '115% 3 1 -Left, be verified by anyone would rely on Total Load Defl. L/226(1,161-) 79.8% 3 1 output as evidence of sul bilfty for particular Lave Load Defl, L/352(0.745') 68.2% 3 1 application.outpLA here on building Span/Depth 1$.7 n/a 1 c design rties and analysis methods.Install -on of BOISE engineered wood produ must be In %ANW 'A AUow accordance with current i Wtallation Guide Beariing Supports Dim(L x W) value _ Support member Material and applicable brulding cx des.To obtain 80 Post 3-1/2"x 3-1/2' 4,051 IbS nla 44.1% Unspecified Installation Guide or ask uestions,please B1 Post 3-1/2'x 3-117 4,051 Ibs n/a 44.1% Unspecified Cal1(sw)232-0788 befor lnst$tlation- BC CALCO,BC FRAME d),AJS-, Cautions _ _ ALUOISTS,BC RIM 8 ARDTM,BCIO, For roof members with slope(1/4u12 or less final design must ensure that ponding BOISE GLULAMT",SIM ILE FRAMING $ instability will not occur. SYSTEM®,VERSA ,VERSA-RIM For roof members with scope(1/2)/12 or less final design must Account for Rain-on-Snow PLUSO,VERSA-RIM0, VERSA-STRANDO,VE ;SA-STUI)v are surcharge load. trademarks of Boise Cm ade Wood i Frodurts L,L.C. Notes Design meets Code minimum(U180)Total toad deflection criteria, Design meets Code minimum(LJ240)Live load deflection criteria. Connection Diagram lC e1 e M a minimum Y 2" c=10" b minimum 3"- d=24,, Calculated Side Load= 174,8 Of Connectors are: 1,6d Box Nails - Page 1 of 1 y k ANfl°w°C Double 1-3/47 x 11-1/4'` VERSA-LAM@ 2.0 3100 SP Roof e=1111304 BC CAW*3.0 Design Report-US 1 span No cantilevers J 0/12 slope, Build 517 Tuesday, Cctober 11,2011 File Name: BC CALL Project .lob Name: Roger's Description:door header supporting ridge , Address: 357 lakeside Dr West Specifier: City, State,Zip:Barnstable, MA Designer:,! Customer. Company: Code reports: ESR-1040 Misc: 12 1 r. r j 15�08 DL 1,034 The DL,3- /2 SL 1,5$31b5 lbs SL 1,637lbs - Total Horizontal Product Length 15t06 OB - Live Dead Snow Wind Roof Lie Trio. Load Summary Tag Desci lion Load Type ReL Start End 108% 90% 115% 133%' 125% 1 Standard Load Unf:Area(prf) L 00-00-00 15-06-08 i5 30 01-00-00 0-0 2 gable Trapezoidal(plf) L 00-00 0 0 n/a 07-09-04 40 0 n/a 3 gable Trapezoidal(plf) L : ,0�-09-04 D, 40 n/a 15-06-08 0 0 u n/a 4 ridge Cone.Pt. (Ibs) L 07-09-04 07-09-04 1,463 2,598 n/a j Controls Summaq Value %Allowable Duration Case ti n Disclosure Pos. Moment 17,632 ft lbs 79.8% 115% 3 1 -internal Compidenew and accu of input must End Shear 2,544 The 29.6% 116%, 3 1 -Left be verified by anyone who would rely on Total Load Defl. U252(0.718") 71.4% 3 output as evidence of May for particular Live Load Defl. U405(0.447") -59.2% $ 1 a eppikation.Oulput here on building, Max Defl. 0,718" 71.8% •3 1 code-accepted n r iesand Span J Depth 16.1 n/a 1 analysis ntethoda.InaW of WISE engineered wood produ muat be in accordance with ounwit Ir stallaWn Guide Bearin Su ortS %Allow` x,Allow and applicable building as,To obtain Dkm(L x ffl Value Support Member IWaterial InstEMon Guide or ask s,plam B0 Post _ 3-10 x 3-1J2' 7 2,617 Ibs n/a 28.5% Unspecified cW(WOW2-07M befofe instaliation. B1 Post 3-1t7 x 3-1/2' 2,617 Ibs, n/a 28.5% , Unspecified 8C CALC D,BC FRAME ,AJSTm, Cautions AWOISTO,SC RIM 80 kRD-,SCIO, BOISE GLULAM- $IMP JE FRAMING For roof members with slope(1/4)l12 or less final design must ensure that ponding SYSTEMS.VERSA-LAM 0,VERSA-RIM instability will not occur PLUS®,VERSA-Rime, For roof members with slope(1/2)!12 or less final design must account for Rain-on-Snow VERSA-STRANDS,VER -STUD®are surcharge load, badernaft of Boise cam 4o Wood Products L.L.C. 4 Notes r Design meets Cade minimum(Ul80)Total load deflection Criteria Design meets Code minimum(LJ240)Live load deflection criteria,: Design meats arbitrary(T)Maximum load deflection criteria. •4 Page 1 of 2 Town of Barnstable Regulatory Services DIME Thomas F.Geiler,Director Building Division BMWSTnBUF4 Tom Perry,Building Commissioner � 1' `0$ 200 Main Street,Hyannis,MA 02601�r A Office: 508-862-4038 Fax: 508-790-6230 January 14, 2014 Carefree Homes, Inc. Attn: Dana Pickup 239 Huttleston Ave. Fairhaven, MA. 02719 RE: 357 Lakeside Drive West, Centerville, Map: 232 Parcel: 050 Dear Mr. Pickup: This letter is to inquire on the status of two separate building permits at the above referenced address (application numbers 201104969, 201207799). To date, this office does not have a record of a final building inspection for either of the projects. Additionally, there is no record of successful completion of final plumbing and electric inspections. Please contact this office with an explanation and arrange for the required inspections. Thank you for your immediate attention in this matter. Respectfully, r L Lauzon ocal Inspector (508) 862-4034 jeffrey.lauzon@town.bamstable.ma.us i PROJECT NAME: ADDREss: PERMIT# �Q 0 PERMIT DATE: (ID IC1 l M/P: LARGE ROLLED PLANS ARE`IN: B9X q SLOT_ C Data entered in MAPS program on: t t B Y: eN� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 23 2 Parcel d5^0 'Application # �� Health Division Date Issued Ii_7n Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board (� C 1713A/ Historic - OKH _ Preservation/Hyannis ll� f / Project Street Address 35-7 �-Kc S d c t�r• (fie ST Village Ce V e y► I jip Owner i c �e rvi L-� .j �a*-tn s ddress 3 92 �.�k� 51 JC �Jrr. f�1 csT Telephone °I 6q gal1 Permit Request �vc[J f 3 deck i Pc S r tStt� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay roject Valuation 000 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family . ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) vNumber of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count;, --� Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other p �_ a Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing J. new'.,,' size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: u 0 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 Ft Telephone Number Address Z'M 4YHIe, 4rV, License# Y3 16 6 �At f—�A1/e� Ad4_ Z7113 Home Improvement Contractor# Worker's Compensation # e AWC- IV? ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE_Z 11WAg DATE FOR OFFICIAL USE ONLY APPLICATION# [SATE ISSUED ..MAP/PARCEL NO. ADDRESS VILLAGE OWNER- DATE OF INSPECTION: }x L FOUNDATION 50*0 hFRAME 'fs INSULATION- ,; . c. FIREPLACE `z ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL P 1 r , GAS.:` 7•:. <= ROUGH :_ FINAL aF=INAL BUILDING:: Z t4dil •- I -- --— — , _ DATE CLOSED OUT ASSOCIATION PLAN NO. �t y �of�NF> � Town of Barnstable y�P Regulatory Services BARNSTAHLE t Tbomw F. Geller, Director y MASS. g $A i6J9.D Building Division QE AlA'�d � Thomas Perry, CBO, Building Commissioner 200 Main Street, Hyanais,MA 02601 www.town.barnstable.ma.us Office: 508-862 *4038 Fax: 508-790-6230' PLAN REVIEW Owner: Ann a for ef'S Map/Parce1: .13 0- O� r Project Address 3V 1-a1<144c' D, Builder: (.�- � G� 4aymS (A� 7yta.� �'Lk `'`/0) I G►9ca-4- The following items were noted on reviewing: 41. Reviewed by: . .a _ — . . � � ��►��� .Q:Forms:Plnrvw The Commonwealth of Massachusetts ( I Department of Industrial Accidents Off ce of Investigations tl tom,N l 600 Washington Street ii!!lu Boston, MA 02111 "f www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information PIease Print Legibly Nane (Business/Organization/individual): A fr C (sVIG� Address: Z3 14iy� Cit7/State/Zip:_ rAirl La Veo MA MI Thone #: q/?7t/./ / A��a n employer?Check the appropriate box: Type or project(required): 1. employer with 4. ❑ I am a general contractor and 1 6. ❑New construction employees (full and/or part-time).* have hired the sub-contractors 2.❑ '1 am a sole proprietor or partner- listed on the attached sheet. 1 7• ❑ Remodeling ship and have no employees These sub-contractors have S. Demolition vorking for me in any capacity. workers' comp, insurance. 9. ❑ Building addition [No workers' comp. insurance 5. '❑ We are a corporation and its nquired.] officers have exercised their 10:0 Electrical repairs-or additions 3.❑ Iam a homeowner doing all work right of exemption per MGL 1 1.0 Plumbing repairs or additions myself. [No workers' comp. c. 152, §](4), and we have no. 12.0 Roof repairs insurance required.] t employees. [No workers' 13.0 Other comp. insurance required.] 'Any applicant that checks box#1 must also fill outthe section below showing their workers'compensation policy information. t Homeowters who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. lContractoa that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information, 1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: vt fir AP' Policy #or Self-ins. Lic. M_ Ltl� �C7 Expiration Dater Job Site Address: Ss-1 CCikes1 Jc bf 1A e,& City/State/Zip; 6eviilerV i d c 4. 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 copyof this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification, 1 do hereb er ify and the pai nd p lti perjury that the information provided above 's.lrue and correct. Si nature: Date: 11 �2 1 ,0 Phone#: FFhe e only. Do not write in this area, to be completed by city or town official n: Perm it/License# thority(circle one): Health I Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector son: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. lursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, X txpress 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 nceiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having*nott rAre 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 of on the grounds or building appurtenant thereto shall,not becraus,-V-SUc�h'employroent be deemed to be an employer." NGL�chap1erAl52.k§25C(6)also states that "eve.ry state orilocal 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' 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 �Z:11 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 6 contact you regarding the applicant. TPlease be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that m st ssubmtmultiple permit/license applications,in any giv n year, nee 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 burn 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 anyhquestions, please do not hesitate td;give u a call. r\ A � k A �\ The Department's address telephone and fax number: `—' t`*- '�, )i The Commonwealth of Massachusetts 1 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 5 2'6=05 www.mass.gov/dia -' Client#:33723 CAREF .. , DATE(MM/DD/YYYY) ACORD. CERTIFICATE OF LIABILITY INSURANCE 0910 10 PRODUCER - - THIS:CERTIFICATE IS ISSUED AS-A MATTER OF INFORMATION' Herlihy Insurance Agency,Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 51 Pullman Street HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Worcester,MA 01606 508 756-5159 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Interguard Insurance Company. Care Free Homes Inc INSURERB: General Casualty Insurance Companies 239 Huttleston Avenue INSURER C: Fairhaven,MA 02719 INsuRERb: INSURER-E; - - - COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCE0.BY PAID CLAIMS: LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE: POLICY EXPIRATION - - DATE MM/DD DATE(MM1DDfYY1 LIMITS. GENERAL LIABILITYEACH OCCURRENCE - COMMERCIAL GENERAL LIABILITY " DAMAGE TO RENTEDPREMISES(Ea occurrence) $ CLAIMS MADE DOCCUR ME EXP(Any one person) $ PERSONAL BADV'INJURY $ GENERALAGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER:POLICY PRO- PRODUCTS-COMP/OP AGG $ _ ,JECT - LOC B - AUTOMOBILE LIABILITY - - CBA0816810 07/01/10- 07/01/11 COMBINED SINGLE LIMIT ANY AUTO s (Ea accident) $1,000,000 ALL OWNED AUTOS BODILY INJURY X SCHEDULED AUTOS . (Per person) $ € . X HIRED AUTOS F BODILY INJURY $ X NON-OWNED AUTOS (Per accident)- PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY - - - AUTO ONLY-EA ACCIDENT $ - ANY AUTO " ._, .. ' OTHER THAN EA ACC $ AUTO ONLY: AGG $. EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE' $ OCCUR CLAIMS MADE AGGREGATE $- DEDUCTIBLE ` $ RETENTION' $ $ A WORKERS COMPENSATION AND - - CAWC134097 - - O9/O1/1 O O9/O1/11 X WC STATU- OTH- - EMPLOYERS'LIABILITY E.L.EACH ACCIDENT, - $1,000,000 ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $1,000,000 If SPECIAL describe under 4 E.L.DISEASE-POLICY LIMIT $1,000,000 SPECIAL PROVISIONS below OTHER - DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES IEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION . Town of Barnstable,Bldg Dept DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3n ' DAYS WRITTEN 367.Main Street, - NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,.BUT FAILURE TO DO SO SHALL Barnstable,-MA ;O2601 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR, REPRESENTATIVES. AUTHORIZED REPRESENTATIVE - - - ACORD 25(2001/08)1 PB2 of 2 #M42357 0 ACORD CORPORATION 1988 t I 4 c } V s 1 � 5 s Massachusetts Delmitin I of puhhcnS:itct�> * r Board of Building Regulations and Stand Construction Supervisor Licerise 4.. 8316(i License: CS, f Restricted to 00 % 1 NATHAN J PICKUP € 239 HUTTLESTON AVE FAIRHAVEN, MA 02719 Expiration: 1/18/201.2 ('finuuisaiunc► Tr#: 13584 v, ,.' .I:r-----.-�. _ .i:....�a.._.__:...._.-..... '.. .y,"•nYan.'_pIIAO.�"-•L•w ma.rato-.,_..n+.�:+—... �_._ _ _ _ �_ ,. _._._..- ° �1ze �o�nmeoouuea/,t/ a�✓�aaaac/zuaelta ' ' ,_ .._ .._ .� ,.,` . { Office of Consumer Affairs&Business Regulation License or registration valid for individul use only i 'f before the expiration date. If found return to: f HOME IMPROVEMENT CONTRACTOR r . . Office of Consumer Affairs and Business Regulation z` Registration a'100503 Type: 10 Park Plaza-Suite 5170 r' Expiration v6/19(2812 Supplement Card Boston;MA 02116. } t )E_ CARE FREE HOMES INC A' , but JJ NATHAN PICKUP,,)CF�-+ K f i 239 Huttleston avr Fairhaven,MA02 Undersecretary 1 Not valid without signatu e fi 5Y .. - h y r is' k h n S. f. 13-7 ref {} Y�pl "1 +1 ♦ ,j' 4 A «6 r +r F � .s t5{��{,x s rt r:~ .x,�t' f i.• i �i. p� � a,(r�" t j gL� 9'$pi F�'��,y,� � -.�2' r '�r�� 1 - •.: .x { .i ,k, t + i .x s ! j.. xe•7���"'4ryr�r�m� �-cC Y !p 5� f7`rr � c � L" < � x rp�.. ,+ �r R=400.00: L=136. � oO 4i . f r LC s s t"t �zqM� � £nrt.Y• :r w �yk�'vj .,p,, �Y '� r y, -y�'`Fr7'"ixP .3v`wn,. w AREA=1542S F A M 232 0 LOT .rot *•r _ t';� : J :.5 " r r ' ri r' r, r i—r "- y4 � -r4+. r .45 i !�,r r..!r ii•_r r r r i.. r.. Q �'irS 4 � � 23;ucv A M. tit ak DECK t 1 l g .Scj r J ^ y l}. ltl• I t I Of 4 DC,�C' O r> P OF9�'A7'ER _ r UAQ UET Jy LAKE:: r - :'r z t g.Fi �. } i i �i c; grz•t r t, r`;�5 S{ �r r � -•��s,et r r � ys`fii �','. t eY��`i.,�t �� `� '��- �-t ,� "'$b R. > t �Y ws ....�, .,r. f y � W i� �': r ��v•i �,, i.�.b � �2 h sF`''� i� � �r �- >w ,�e� F � �. ty,.;j:i��� `r �t w�*;�,��k ^@' r,. ... z,��. '"x.r'�1 !t,. '"t���'N3�yYL'pt ,���',-.i 1 F"s����,,�F���� y..;�tu-lr �, 5 � d`.� -•±tiR''°•�� �+' � 3j �' AN-13-2011 08 : 16 AM P. 01 jjWCARE � FtEE 11eS Inc. 239 Huttleston Avenue Fairhaven, Mass 02719 Telephone 508-997-1111 Fax 508-997-1297 SEND TO Company ft fI / Fmm ��� Pc�v Affendort / Date ORloe locedon Ofte locadon Fax number Phone number g9? f 4 Urwant ❑ Reply ASAP D Please comment CI Please review C�Fw your lhftw ftn Total a es, includin ; .� P8 8 cover COMMENTS gke.......... ...... ........... ............................ ... ...........................................................................: ....... ......,....................... In Or -T��C. F�M r .�Us ................................................................ ., .............. ................................................. ............................................ . ......... ............. .......... .............................................. .....11.................................................... ......... ................................................... ......... ....... . ......... ...................................... ....... JAN-13-2011 08 : 16 AM P. 02 CERTI ICATE OF LIUffE13 PARTNERSHIP OF IODICE FAMILY LN UED PARTNERSHIP This CoMfloate of LknRsd Partnership of the IODICE FAMILY LIMITED PARTNERSHIP (the "Partnership') dated 20D3„ Is being duly executed and Sod by the IODICE FAMILY LIMITED LIABILITY COMPANY to form a limited parbmwaiMp under the Delaware Revised Uniform Lied Partr w" Act(6 Deal C. § 17 101. of aegq). 1. Nam®. The name of the Urntted pefMeraNp formed hereby Is the 'IODICE FAMILY LIMITED PARTNERSHIP'. 2. Reglaterad Agent The name of the registered agent for service of process on the Partnership In the State of Delaware Is Corporation Service Company. 3. Reglatensd Office. The address of the mgtstermd *Rive of the Partnership in ft State of Delaware Is 2711 Centerville Road, Suite 4D0, Wirnington. New Castle County, Delaware. 19W8. 4. Genera/oar&w. The norm and business address of the We General Partner are IODICE FAMILY LIMITED LIABILITY COMPANY.of 64 Newwport.Drive, WesbWd, Massachusetts, 01886. IN WITNESS WHEREOF, the undersigned has exemAed this Certificate of Urntlted Partnership as of the date first above wditn. DICE FAMILY LIMITED LIABILITY OOMPANY: Oy: G/6AQ Arm E. PAm;drre, &maser General Partner &*mQ. of 00 M"I I.A%led I. lkaUy I.wtN rsr cn.NlIJP\oaaatantJ\LYrllq rr.e.,ul Pon.aurr.sem - �rsGitii��+ fJi 6'L"1l+11 . .�7�.it�tst4R o�.ce�peatOdOrts . iVered 31 too �r 09/ri/JPOQd �SxaD 1 A.00 Jar 001241"" ffi2V OJ061tt2d •• 9�OTR��� ' L'd L LOt^Z69'8L6 sreboj{#euuy em;L L 1 Co.per JAN-13-2011 08 : 17 AM P. 03 �..rrr...n...www w o�10auYMwu n4ur11 NW1 a VM�IY�l pl�l8f1(.(� FUUMStupILP)Pl7bw PSe t of 2 The Commonwealth of Maw achus®ft Few Ors M Willlarn Francis Galvin Soo VWY Of ft ConuuonwaRW Carporadtoos Division One Ashburton Pled, 17th floor Boston,MA 02109-1512 Telephone:(617)727-9640 PtG,Qrt 2010 (Oonerel LS.wj.Chapter 109,Section OM Anntod Report RIMnp Year, 1.and l odthe 0UXAM bited OeMtneislYp: 2-If dWOFOM the n®ma urdK which It prepoNe to do brace In the Conunoweestfh; &The jradeftftn wodbr the WOO of whtoh the pub mdrlp Is organized: Steto:2B Country:O® S ,L The demo or organtmf ".. The f �oha�dctor dl buemnaee bf the Connmm-ww j; &The bushan addneee of Ito pdndpei oAlea: No.and i3b%st My or Town: WRSTFORD. State: 2�p: 01 gg6 Caant7 A 7.TM,e boat and deracs of Ite MggKW f Addmw(no Po beep C*r or TaWA&a*Vp cods KKOM FMINLY UMMEb weem COMPAW ea NRV* oRr Dam wEi1'POpD,w�o+eee 8-The bumirnm addown of IA prindpid oMtce In the Commonweaf ft V my. No.and Street City or Town: Slaft:BLA Ap: ALM CaumY-l" 9.The Mane and addroae Of Poe r"Idont agent In the Camnionwaatlh; Nww! AWALAQ= No.and Streit c—q or Town: ] TFORIa State: Zip: Cowrtry:MA 1t Tito addnm of the o"Im st wWb a loseps tr Ilat of the names and addressee of the llmited oapffal corrtrlbuftbns.The Nollad peetrarehip agrees to kW those mcards until ifd ��°�and flhelr 1 Is cancelled: No,and Street: City or Town: State,Jim Country:SZSA Fllor"s Contact kffi wafts (Ewt6ir a onn(ecf rlamik maft and emaitwx&brPlK+re n"Vber,) Corthct f�larne: AM E.Room t�pa%Naap.reasmo.�a� - arp?stegoyComlrm 91MIO { g•d hl-Em' fi 9L6 eUe8oj#aUUV sZ9:L l b l CO uer Commercial Programs k t per, 9 uT�HE 1 1 H RTFORD CIL - a� •n e �y} as ,K--'- i 1 a• t• e +is LILEJ CARE FREE Ol�les Inc: ;Y 239 Huttleston Avenue Fairhaven,Mass 02719 Telephone 508-997-1111 Fax 508-997-1297 Website:www.carefriehomescoinpany.com . , To the Town of: SAMS• Job Address: 35.7 CAk S 1 .A City, State; Zip C 4 N?4 .v 11 L !� I, A&tv4 , owner of the home at the above Custother-Name 166ti4n4 authorize Care Free Homes,Inc: as I my agent to obtain all necessary permits and to perform all home improvements to my home as stated in the accompanying contract and application Customers Name Date } 5 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel ® ''Application # / 0��� �U � U > Health Division Date Issued Z Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board 12 f 2�l o Historic - OKH _ Preservation / Hyannis Project Street Address SS-7 to ke S;Je ��• fiJeST Village Cer4erv, d! . Owner ru + l +�r C d ddress W r s tp i�t'• weS. Telephone q7f 4/ Permit Request acts n� 4_1 461 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District od Plain Groundwater Overlay Project Valuation Construction Type 301 too Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family, 2( Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes C No On Old Kings'Highways, ❑Yes &No Basement Type: -Full ❑ Crawl ❑Walkout ❑Other _ Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ` ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ 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 . _. ao, Z.-.c.Pt G - Telephone Number --�;'07- J Address 2 9,V_&1e !t41/L3I Ave- License # B?66 MGM 027 l 1 Home Improvement Contractor# �00 f-0 � Worker's Compensation # (Akk f N 04 7 ALL CONSTRUCTION D BRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO f hL f SIGNATURE DATE 1( ! �® r ` t 1 ! 7 FOI OFFICIAL USE ONLY z , � APPLICATION# - v ti = DATE ISSU.Ep A MAP/PARCEL NO. it --- ADDRESS VILLAGE OWNER, ` f DATE OF INSPECTION: � � -fFFOUNDATION: FRAME '• ` INSULATION', {'s FIREPLACE ' ELECTRICAL: ROUGH FINAL ' PLUMBING: ROUGH FINAL GAS: ROUGH FINAL 4,FINAL BUILDING"'' . All, DATE CLOSED OUT r ASSOCIATION PLAN NO. y � The Corrsn-tonwearlrt of hlrxssdchuset�s -Deparfinertl`of In dustria1,4ccidertls Office of rn�estigalians 600 Yfrdsh.j-neon Sfr,-ee Bos[oti, A- lf-4 02111 ` w t"vK.to ass•go v1dt a Workers' CompensationTngarance Affidavit: Builders/Contractorg/EIectrice nrz�nt�e� Pleas P I kTp' Licant Znforraatiori NaTne (BusinosslOrgani�tion/Individue.i): (�G "Address: Z3 U eSTD�t AV6 n`� so 9��7/lii Cil Y P"/Statc/Zi f —air-A,A /�'` 4 Phone.#: Arc ors an cmployer7 Check the appropriate bar: Type oEproject (required): 4• jam a gcncral contractor and j 6 cw construction 1. vi am a cmploycr with haVc hired the strb-contractors . cmployccs (frill andl�r part-Lime).* 7. Remodeling list.cd on the attached shcct ❑. 2.❑ T am a•golc propriCtor or pa#cr-, t ,, These sub-contactors bavc 4 t g. E] hcmolitian ship and have no cmployccs " adtion � working for me in any capacity, , cmployccs and have cvorkc"rs' 9. �Built�ng� •di camp. insurance. [No workcrs'.comp.imsvrancc 10.[] Electrical repairs oz add r�quircd ] 5. [].Vrc area corporation and its oflccrs hay cxcrcised their jI__❑Plumbing repairs or attd 3, j am a homeowner doing all worl right of exemption par MGr 12 jZoofrcpa%rs myg elf. [No workers' comp. 1(4), and we have no ujs, ra Dc.v griircd]� 13.0 Lber . e�loyccs. [l�o workers' comp. insurance required_] �J r,y applicant fhzt chccl�box U]must also fill out the rcr_6Dn below rhowing the r tvork�rs''compG ion policy information. t HomtowncrC who rvbrtit(his a�idavit indir�ng tficp art doing all work Ord than hire outsidt contra.cior5 inusl submit a new aot rhos Indic cs h cvcF tConlraelnrs fiat check Lhix box rnrstatiaLhcd m additional rhect rho Ang the name of the sub-canh kd�r;and si�Ic ahctlicr of not those cn6dcs have ernployus. if fhe rub-con h�ctnrr have rn"rploycci,they mar{prm�id6 their workers'corrrp. poGc7'�wnba'. .. . I arn, ors employer zlid!s providvtg workers' cPmpertsali-oH insurance for my empCoyees. Belo�N is the policy artdjob sit Itcf o rm o:fIort jnsuran c c company Name: er- V A r 9 Expira6=bate' Policy# or Sclf-uis, Lic. #: 64�/1f � lr�` 11� . w�. bt; WeS F city/StatdziP; c � Job Site kddress: f> Attach a copy of the workers' compensation policy de�larz�on.Me{showing tbep.oficy number and expiration da Failure to secure.covcrago as rcquircd•undcr`Smtim 25A of MGL c. 152 tan Icad to'tbo imposition of urmi ai pmaltics c fino dp to 31,500,DO and/or ono-ycar iMaprisonrncnt, as Wc1I as .civilpcnalti'cs in thctform bo forward d STOP oe fh� cc of Of up to S250;00 a day against the viclatMr c advised that a copy of this statLmcn may jnvcsti atiow o c ID for insurance vc c VCH cation I do hereby urrd the pains• t err s o erjury elccyThe irrformadoH provided above is true artd coj7ee� Date; !/LI s ! Si aturc: Phone Official use only. Do no!Write in tJtu area to be comblefed by city or Cown official City or Town; Permit/License #--------------------------- _ Issuing Authority (circle one): 1, Board of Health 2• Building Department 3, City(Town Clerk 4. Electric, S, Plumbing Inspec{or 6. O fh e r tions Info j a fcr 152 r uires all•employers to provide workcrs' comperuatioa foco�a toiplboyrccs: cral Laws ch cq tier and y Massachusetts Gcn p crson m the scrncc of ono ,pursuant to this statute an employee is defined as "...every p express or implied, oral or written-" co- oration or other legal entity, or any two or more Am ertptnyer is dtfnod as "a.o individual, partnership, association rp P. a cd in a joint cntLtprisc and including the Icgaj rcprescntativcs of a deceased employer or the of the foregoing trig g c 10 ccs, However to receiver or trusteo.of an individual, partncrshrp, association or other legal entity, employing p y owucr of a dwelling)douse having not more than three`apartments and who resides therein, or the occupant of to dwelling house of another who cploys pets ns to do rnaintcnancc,of s h emo]oyrnentabe dcemod to bcdan c plDYCf or on the g DuOds or bv:dding,app�ur�tenant c c o sha ins •-cause P L cha to 152, §25C(6) also states dial "e-very state or-1�}1 licensing agcnoYn hoe corornon ealthsf ru�Y r rerlepYa =o,-a,License or permit to operate a business or to,constTiic.t birildi ' ' S1 appLicantwho has.notproduccd•acccptrble cvidencc0.�thc coni>nonR th nor.anyofi�political subdiYision9 sba11 Additionally, MGL ohapter l52 §25C(7)states 'Nc�th r - , I jienec v2th the in✓uranec enter•into any contract for.nc�performance of public work acccptablc evidence of cop rcccn Pr quircmnts of this.c}iaptcr have besented to the con[racting authoi fy. ' APPLi can ts. . e out tho workcrs' compensation affidavit completely, by chcck ag the boxes that apply to your situation and, . Pleas fLU ( ) address(cs) and pbont)numbcr(s) along with thdr ccrdBGAtc(s) Of ncccssazy, supply sub-contractors)names , insurance, X imitcd Liability CapaRjcs'(LLC) or Limitod Liability Partnerships (LLP)with po cployccs other than ambers or armors, arc not Tr," cd to carry workcrs' compensation insurancc•t If anp ut oa]nnduussvtrro'a_l m P employees, a policy is required B 9 adyiscd that this affidavit may be submrttc P c�davi.t should Accidents for confirmation of insurance covcraga. A1So be sure to sign and data tho affidavt bo returned to the city or town that the application for.the permit or Jiccnse is.being rcqucs to obtainlacwrnt of Industrial Acci.dcnts. Should you have any questions regarding the law or if you arc regtur rd co cnsafion policy,pXcaso fall the pePa eat at the nur4ber listed below. ScLf insured coropanics sho!�ld enter tl�cir If jmsuranro license number on tho a ropnato line. C1ty oz TovYA Officials Ncasc be sure that the affidaYit is'eomplctc and printed legibly. The Dcpbas toncoataGt oo dregard-i-ng the apphc t t of'tho affidavit for yoU to fill out in the went the Office o'�lnvcsusod ons has to y tense number which will be used as a reference number. In addition, an applicant Please bo sure to fl.l in the permit/li A - ..,� ' t current ]c crIIlit/11ecIIse appli�adons in any given year,Dr cd.�only suba onG a$idavi t indicating l of n u`t submit multip p policy information(if Peccssary) and under"Job Silc"Address"itho applicant sho}u�ld write"all loco r towm mayb ns> dcd C or "v ` 'Y' Otown)_;yA rbpy Of the efJ davit that has bccn officiall If.y tam o kccnsc s iA ncwoaffidavi mustbo �out cacti apP c- nt as proof that a yalid affidavit is on file for'f- p year.'Whcro a home owner or citizen is obtaining a liccn_s c or permit'not rclatcd to•any business or comrncreial vcnhuc i_e. a dog Jcense ox Permit to bum leaves etc.) said persou is NOT required to comPloic this affidavit~ ( you in advance for your cooperation and should you baYc anY questions, Tho Office oflnvcstiga-tions would h1c to tbauk y .please do not hesitafo to give us a cal The Department's address telephone and fax tk .Tbn Comm(MWC-4t of MassaC,> rrtts y D �pO1c•IL1L1I_ .AG��G�CIIItS �parzn t Office of kzvestipa ioaas 600 j7,la_ h gton Street �� ♦' `!;J Boon, MA 02111 TGI; # 617-72.7-4,W.0 'rxt 406 pr 1-V7-MASSAFE Fax# 617-727-7749 Rcyi-scd 11-22-06 v.masS..gov/dia 4 Client#:33723 CAREF A MMIDD/YYYY) A CORDTMCERTIFICATE OFLIABILITY. INSURANCETDTF 09 (/08/1l1 t LL: PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF.INFORMATION Herlihy Insurance Agency,Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 51 Pullman Street HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR , ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.. r Worcester,MA 01606 508 756-5159 INSURERS AFFORDING COVERAGE NAIL# INSURED' ' INSURER A: Interguard Insurance Company * Care Free Homes Inc &SURERB: General Casualty Insurance Companies ',. 239 Huttleston Avenue ' . Fairhaven,MA 02719 INSURER Ci- INSURER D: INSURER E:, COVERAGES y THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING t 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 =a=' POLICIES.AGGREGATE LIMITS_SHOWN MAY HAVE BEEN REDUCED BY PAID CLkIMS. " .POLICY EFFECTIVE POLICY EXPIRATIONNSR . LTR IN SRN TYPE OF INSURANCE POLICY NUMBER DATE MM/DD DATE MM/DD LIMITS i GENERAL LIABILITY i EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ CLAIMS MADE OCCUR MED EXP(Any one person) $ a., PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY JE O- LOC B AUTOMOBILE LIABILITY CBA0816810 07/0111 O 07/01/11 COMBINED SINGLE LIMIT 1 ANY AUTO (Ea accident) $ OOO,000 ALL OWNED AUTOS . BODILY INJURY $ t X SCHEDULED AUTOS (Per person) - X HIRED AUTOS BODILY INJURY a - ` Per accident ' $ X NON-OWNED AUTOS ( ) PROPERTY DAMAGE $ (Peraccident) G - - - ARAGE LIABILITY AUTO ONLY-EAACCID AC CIDENT T $ t ANY AUTO rr' OTHER THAN EA ACC $ i AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ n, OCCUR CLAIMS MADE - AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ TY A WORKERS COMPENSATION AND CAWC134097 ;; 09/01/10 " O9/O1/11 X WCMITS ER STATU- OTH- t ' EMPLOYERS`LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT . $1 000,000 OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $1 OOO OOO If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $1 000,000 . OTHER DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES!EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS - CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION ' Town of Barnstable,Bldg Dept - DATE THEREOF,THE ISSUING INSURER WILL.ENDEAVOR TO MAIL Rn.. DAYS WRITTEN - 367 Main Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Barnstable,MA 02601 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS IAGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001/08)1 of 2 #M42357 PB2 0 ACORD CORPORATION 1988 jtWii C ^ RE FREE mes zIM4C. 239 Huttleslon Avenue Fairhaven,Mass 02719 Telephone 508-997-1111 Fax 508-997-1297 Website:"www.carefreehomescompany.com x; 1 J L To the Town of Job Address: 3 S 7 LA k.'rL Sri O"4 O 2• lN4.S i City, State, Zip: C4.NT5 2 u Ll� y fM,/� I, /V Iv A �Og—�� , owner of the home at the above Customer name location, authorize Care Free Homes,Inc. as my agent to obtain all necessary permits and to perform all home improvements to my home as stated in the accompanying contract and application. �G y Customers name Date r, Yrr �< f Massachusetts Del *tment of PuhlieSafih� « Board of Building �J Regulations :in(I Standards" tls+ Construction.Supervisor License' License: CS 83166 j'. Restricted to: 00 }. :f I NATHAN J PICKUP 1 239 HUTTLESTON AVE 4 FAIRHAVEN; MA 02719` Expiration:»1/18/2012 1 t bnnnisci+mce. Tr#: 13584 X. '` s .� ,1 ._:�. ✓�ze TDor��mwozurea� a�./�.aaaac�tuJel7d. f. y..,c=..M., ., ,... .� a �i Office of Consumer Affairs&Business Regulation License or registration`valid for individul use only a 3 HOME IMPROVEMENT CONTRACTOR before the expiration date.If found return to: Office of Consumer Affairs and Business Regulation Registration' 00503 TYpe:j. 10 Park Plaza-Suite 5170 Expiralk 6119/28i2. Supplement Card Boston,MA 02116 CAREFREE HOMES,INCF 4 {.., Si h ;� - NATHAN PICKUP j 239 Huttleston av4 Fairhaven,MA 02719`;r Undersecretary �r4 .... Not valid without signatu a <I....;,..._�.__�_ __'• - .^.._.-. .............:. �'.,s-r•�n rraTi•'"' :. r.rq�T N'f :FY'•£.Y a. „ ^ , Y. r *rfa - fr 3 _ v r, r GARY D BRACKINS & ASSOCIATES k , p• . �- 313 Main 'Street, Fairhaven, Massachusetts 02719 Office: 508.758.6708 GBrackins@GDBAssociates.com l Client: Carefree Homes; Inc: File#: 10.59 Address: 357 Lakeside Drive West Contact: D.Pickup Town: Centerville, MA. Date: 10.19.10 �2 I 6'-0Y4' _ 1 7+ 91 - PD6066 PD6065 t EXI51TING j i in _ 5UN � OOM, in 4 Description: F L O O R P L A N I Scale: 1/4" = 1'-0" . 1 • .. a �� ./ 'v/• + � e 1 , 7 �P 1 Ll - yS y � — GARY D BRACKINS & A'SSOCIAT`ES i�m= - >..•u 313 Main Street, 'Fa irhaven, Massachusetts 02719 Office: 508.758.6708 GBrackins@GDBAssociates.com Client: Carefree Homes, Inc.* File#: 10.59 __ Address: 357 Lakeside Drive West Contact: D.Picku P � _+ Town: Centerville, MA. Date: 10.19.10 a Description: REAR ELEVATION Scale: 1/4" = 1'-011 2 A r GARY D BRACKINS & ASSOCIATES 313 Main Street, Fairhaven, Massachusetts 02719 ,.•_•-Y Office: 508.758.6708 GBrackins@GDBAssociates.com +T 7 Client: Carefree Homes, Inc. File#:` 10.59 Address: 357 Lakeside Drive West Contact: D.Pickup Town: Centerville, MA. Date: .10.19.10 r F Description: LEFT ELEVATION Scale: 1/4" = 1'-0" 3 A r GARY D BRACKINS & ASSOCIATES 313 Main Street, Fairhaven, Massachusetts 02719 -� - Office: 508.758.6708 GBrackins@GDBAssociates.com r - Client: Carefree Homes, Inc. File#: 10.59 - Address: 357 Lakeside Drive West Contact: D.Pickup Town: Centerville, MA. Date: 10.19.10 i Description: RIGHT ELEVATION 4' Scale: 1/4" = 1'-0" A IL r GARY D BRACKINS & ASSOCIATES 31 3 Main Street, Failrhaven, Massachusetts 02719 Office:508.758.6708 GBrackins@GDBAssociates.com Client: Carefree Homes, Inc. File#: 10.59 i Address: 357 Lakeside Drive West Contact: DPickup Town: Centerville, MA. Date: 10.19.10 1-3/4x11-/4 LVL RIDGE BEAM d1�12 2x 10 RAFTER5 AT 16" O.G. (2)2x12 I. I — ---- A/FLY I I I I I I I I 1 I Description: REAR ELEVATION 5 Scale: 1/4" _ 1,_b". A A' GARY D BRACKINS & ASSOCIATES - -.." 313 Main Street, Fairhaven, Uassachusett's 02719 T•T- Office: 508.758.6708 GBrackins@GDBAssociates.com x Client: Carefree Homes, Inc. File #: 10.59 1 01-j Address: 357 Lakeside Drive West Contact: D.Pickup Town: Centerville, MA. Date: 10.19.10 I 0 6 EX15I1ITIN6 N �` 5UNgOOM ' III _ ul in J yI � ttl P05T BEAM N I IN WALL - a I C-� m w r � cV \ I J Lu = O i • r- i r- � N t' r•— I I I � L_ 1 r x m i N P05T ENDS OF L\/L BEAM DOWN IN WALL TO LALLY COLUMN BELOW IF LALLY COLUMN NOT WITHIN 10 INSTALL 3 y2"(P 5TEEL LALLY COLUMN WITH 24"x24"x10" CONC, FOOTING Description: B E A M P L A N 6 Scale: 1/4" = 1'-011 A .oFtHE. Town'of Barnstable *Permit# - P� ��d .% Expires 6 mon la r ne iss late ER% Regulatory Se`rvices.. Fee * BARNS SS' 2010 Thomas F.Geiler,Director ARN87,4 Building Division Tom Perry,CBO,'Building Commissioner. 200 Main Street,.Hyannis, MA 02601 �. wwwaown.barnstable,ma.us ` Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY Not Valid without Red X_Press Imprint Map/parcel Number Z 3 Property Address E4'Residential Value of Wo Minimum fee of$35.00 for work under$6000.00 Owner's Name& Address T Contractor's Name �, 3(A�t _ A. � Telephone Number 7 7 7-1 J/� / Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) 9/ 5 -Z 2, S ❑Workman's Compensation Insurance Check one: - ❑ I am a sole proprietor �11 am the HomeownerL F-I have Worker's Compensation Insurance E Insurance Company Name Workman's Comp:Policy Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(stripping old shingles) A11 construction debris will be taken to Ei e-roof(not stripping. Going over .,existing layers of roof) Re-side n of doors Replacement Windows/doors/sliders. U-Value .(maximum .44)#of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,,i.e.Historic;Conservation;etc...;. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home ro ment Contractors License & Construction Supervisors License is require SIGNATURE: Q:\WPFILES\FOR S\building permit forms\EXPRESS.doc Revised 070110 JUL-12-2010 02 :49 PM P. 01. wrcuTM CERTIFICATE OF LIABILITY INSURANCE 9jo2j"°°°"""' o9ro21o9 PRODUCER. THIS CERTIFICATE Is ISSUED AS A MATTER OF INFORMATION Herlihy Insurance Group Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 81 Pullman Street HOLDER:THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, Worcester,MA 01808 608 788-5109 INSURERS AFFORDING COVERAGE NAIC S MOURED INSURER A; Acadia Insurance Company Cars Free Homes Inc. _ INsuRERe: Inter nerd Insurance Company Fairhaven, Hut Ave INSURER C: Travelers Insurance Company el M n MA 02719 INSURER 0, a INSURER B: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, ZEE TYPE OF INSURANCE POLICY NUMBER imam! LIMITS A GENERAL LIABILITY CPA026507411 09/01/09 09/01/10 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMPREA @ TO RIF,ENT O E O oO CLAIMS MADE a OCCUR MED EXP Wy one on 15,000 PERSONAL 0 ADV INJURY OOO GENERAL AGGREGATE s2.00OMO GEN'L AGGREGATE LIMIT APPLIED PER: PRODUCTS-COMPIOP A00 92 O00 000 POLICY PRO-JECT LOC C AUTOMOBILE LIABlUrf BA7011 Nd4709BEL 07101/09 07/01/1 O coMelNEo SINGLE LIMIT ANY AUTO Me awkfsrd) 91,000,000 ALL OWNED AUTOD BODILY INJURY X 8CHEDULED AUT08 (Pw porn) 9 X HIRED AUTOS BODILY INJURY x NON-OWNED,AUTOD - (Per aoddent) PROPERTY DAMAGE 6 '(Par acadant) GARAGE LIABILITY AUTO ONLY•EA ACCIDENT 6 ANY AUTO OTHER THAN EA ACC AUTO ONLY: AGO 9XCESSAIMBNELLAUAOILITY r EACHOCCURRENCE 6 OCCUR CLAIMS MADE - AGGREGATE 6 DEDUCTIBLE 8 RETENTION $ B WORKERS COMPENSATION AND 6AWC917420 09/01/09. 09/01/10 X we sTAru• o EMPLOYERS'LIAEILITY E.L.EACH ACCIDENT. 61,000,000 ANY PROPRIETORMARTNERIEXECUTIVE OFFICPR/MI!MBER EXCLUDEW 2 E.L.DISEASE.EA EMPLOYEE 61 000'000 HYN,chaarlde under E.L.DISEASE-POLICY LIMIT 61,000,000 P P OTHER , DBWMPTION OP OPERATIONS I LOCATIONS I V041OLNG I EXCLUYIONY ADDED By ENDORSEMENT I SPECIAL PROVISIONS PICATE HRLRER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of Barnstable'' x DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MIA4- An DAYS WRITTEN Building Department NOT10E TO THE CERTIFICATE MOLDER NAMED TO THE LEPT,BUT FAILURE TO 00 So SHALL 387 Mein Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Barnstable,MA 02801 ASPREUNTATIVIIIIII. AUTHORIM IMPRISEN'TATIVE ACORD 20(200VOS)1 of 2 #M98934 g2 ® ACORD CORPORATION 1986 d FICE: (508) 997-1111 'i ®® MA. Builders Lic. #021330 p ,I FLAX: (508) 997-1297 CARE FREE Home Improvement TOLL FREE: 1-800-407-1111 ®� �� InC Contractor's License WEBSITE: #100503 MA. www.carefreehomescompany.com 239 HUTTLESTON AVE. (RT 6)• FAIRHAVEN, MA 02719 #15179 R.I. NAME S `7 DATE ADDRESS .�1�� L.�`L�S'il�v ��P/1/� �l 46,41T2kV� -SIP ADDRESS OF JOB TEGL JOB DESCRIPTION �� ���s�(/� D l.L�'L- YjC4� . �'iiti�'�•-�L ���2� c�i'�l��/C-ft�i Gee e /f� »�S� ,�/1c ti y G //� /ts°r- -szx/e rig. -;Ue z� 2 J> cSo G G Scheduled Start Z /2 Gt�fJI/G'!/J'T� -�'-�'� Scheduled Completion 'A. Replacement of missing or rotted Iumberis not included'.unless specified. B.All start&completion dates are approximate and could change due to weather conditions.- C..Stripping of roof includes removal of up to two(2)11ayers'of shingles each additional layer to be charged @ ft2. D. Replacement of rotted roof,boards/plywood to be charged Q /`�at ftz. . E. Exisiting chimnet flashings will be reused; replacement, if necessary, is not included':F. Care Free Homes, Inc. is not responsible for,mold/mildew conditions that are pre existing or result from leaks not brought to the attention of C.F.H., Inc.promptly. The Company hereby proposes to furnish labor and material to complete-the above work for the amount herein. Fulfillment of this order is`contingent, however;upon the want of strikes,fires, and any natural disasters;.the abilittairry�ate i aor ny other conditions beyond the control of then om any, 0A1 ajt��, Cost of Project$ PAYMENT TERMS ~� U OF 1. You,the Owner may cancel transaction at any time prior to midnight of the third business day after the date of this transaction, 2. You,the Owners agree to pay any and all expenses incurred by Care Free Homes, Inc:in collecting money due under this contract and enforcing the,terms of this.contract, including but not limited to reasonable attorney's fees, interest and court costs. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK'SPACES , CARE FR E HOMES INC. P ACCE T D: y• [ .' receipt cknowledges Owner:B Buyer acknowledges - ffullycompleted, . _ cope of this Areement Owner:' All contractors and subcontractors shall be registered by the:director and any inquiries about.a contractor,or subcontractor relating to a registration should be directed`to: Director,'Home Improvement Contractor Registration One Ashburton Place, Room 1301 Boston, MA 02108 Tel.(617)727-8598 r i NI nsachusetts- D Board of'B PlIrtment of Public ,- uildinf; Re�,'ulationfi and, ` Saf'et} Construction S St In�lards License: Cg u 7ervisor License Resfricte 95228 IANA PICKUP I` ,1 s HAMLET'S7 REET;$ r ; IFAIRHAVEN,IVIq � ¢ , a, 02719 7 f umiii�ss�one,•; ;Expiration: s 3/22/2012. r , ✓Lee �arnnzooicueal a�� aaac�ivaelia Office of Consumer Affairs&Business Regulation License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation Registration` 100503 Type:' 10 Park Plaza-Suite 5170 Expiration rggzg-- Supplement Card Boston,MA 02116 CARE FREE HOMESTIN'C� DANA PICKUP Jl� 239 Huttleston ave g ��_ Fairhaven, MA 02719 Undersecretary. Not valid wit out signa f The Corrrrrrorrivealth of Massachusetts Deparinterrt of lndrtstrial Accidents = Office of Investigations A. 600 Wash igion Street Boston, 3Ia 02111 s -jvnhu.rnass.gos,1d v = 'Workers' Compensat an Insurance Affidavit: Builders/Conti-:rctat•s/El,&cti- citns/Fl.umbers Applicant Information. 00 Please Print Le-gib Name(Baisnes&'Orgamzatiawln&vidml): Address: -7,3 „0 City/state/zip- 61kLA A &14 NA Phone A_ Are yo n employer?Cheiktke appropriate box: Type of project(required)- : am s enml contractor and I 1_ I am a employer unth 4 ❑ I g 6_ ❑I�veu*constnnctiosr employees(fu11 and/or part-time).* have `d the subs-contractors ?.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. errodeling slip and have no employees These sub-c6ntractors hs =e 9- ❑ Detnoliriort working, forme in an capacity- employees and have workers'• Y ty-. 1 9. ❑�Buildi°sag addition [No workers' comp-insurance comp.insurance- - ed.. 5. ❑ We area corporation and its ME]Electrical repairs or additions eriuir ] . 3.❑ I am.a homeowner doing all work officers have exercised their' 1.1.❑Plumbing repairs or additions ry ntyself. [No workers'camp. right of exemption per MGM 12.❑Roofregiairs insurance required.]Y , 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 infoctnation_ 11~omeeowners who submit ibis affidmi.inxhsating they are doing all wcA and then hire outside contractors must sub um a new affidavit indicating such ICantractors that check this box west attached an additiooA.sheet showing tlae aarne of the sub-conttazinrs and state whether or not those eatittes have employees. If the siib`conusaoEs have employEes,they must provide&eir Workers'comp.policy number. I ain first employer that is prof idng workers''compenswdon insl4ratrce for ntq, erirp*ees. .Below is the palter and job site informatra►r Insurance Company Dame Policy A or Self--nos:Lie.#: G � �] 7,�1 Expiration Dater C� T Job Site Address: C l YO" �bt� City/StatelZip:_ 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.2.5A 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 W OR ORDER and a fine of up to$250.00 a day against the violator. Be advised.that a copy of this sta.temeaat may be forwarded to the Office of Investigations of the.DIA for insurance coverage�erification'_ I do hereby cer under thg 'ns 9FPe11a16OSqfPedMrs,that the informadon provided a ne is tme and correct_ Si lure:: bate: f 14(o Phone#: / Offrrtnl um.only. Do not write in this area,to be completed bti'city or town vac at City or Town: Permit/License# Issuing Authority(circir one): 1.Board of Health 2.Building Department 3.City/Fon°rr Clerk: 4.Electrical Inspector 5.Plumbing Inspector f.Other Contact Person: Phone#: 6 ..n��- -F ,.. -.-^ - .+. •.t.. ,.r..K-x.�.,..::++., ...r. ;.rr'�.r+.:,�.»..r••,..,.,neyY..�l,..r;;�.�rY"+.:-.i:7.;'�°t,4.,,r 7; :,� tw �''.Ms'�m t}'Mi-.{r�,.:J^wJ.4/+Y'' ..,;. f -,.mar^ � - _...JS-r r Y.r17"F�n'f'1� 1�". .,p'��T'r"•v+iaxY'.tr,11};n+•�H.r".tx, -/3.::w3+ht4."S'hr.f-, Ass a(1st Floor): i. Assessd�oT� map and lot number — J' `�1 �wc T �o o` Board of Health(3rd floor): A I Sewage,Permit number Engineering Department(3rd floor): V/ MU o ' House number ��o 143o•-`c; ', J Definitive Plan Approved by,Plannirig Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.-and 1:00-2:00 P.M.only i TOWN OF BAµRNSTABLECr ' BUILDING INSPECTOR =Y APPLICATION FOR PERMIT TOe/71�{ TYPE OF CONSTRUCTION ( 19 '. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according Ito the following information: Location 2)iP .yee,r Proposed Use �)E'Ck i Zoning District' Fire District 4� Name of Owner. e,0A49,ey ,'�UC'�%�!il,N Address&,:5''l .�t,�cs/De /�,e /.�.?�T /Z)614 Name of Builder Address /g�� �LP9�1 Gi�Q��.V si Jh►�. Name of Architect Address, Number of Rooms Foundation Exterior "Roofing Floors Interior Heating Plumbing Fireplace Approximate Cost ao O Area `a s Diagram of Lot and Building with Dimensions Fee r— t' F 5 'f# 1 yA _ OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. � Construction Supervisor's License ds �� SILVERMAN, LEONARD A=232-050 T ss - 61so p 34491 Permit For REMOVE & REPLACE DECK Single Family dwelling Location 357 Lakeside Drive we�t- Centerville Owner Leonard Silverman Type of Construction Frame Plot Lot Permit Granted July 29 , 19 91 Date of Inspection 19 Date Completed 19 PERMIT COMPLETIEP /61 .a . Assessors offic `(1si4Floor): Assessor's map and lot number v SEe�ra4A$Y �� o� 4 r�(iv ` Board of Health(3rd floor):, , '� 1 0 ♦w Sewage Permit number - M j Engineering Department(3rd floor) House number =-6d'�!�/= E o Aso. Definitive Plan"Approved by Planning Board _ 19 �• _ 0 MAY ® d APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only,' TOWN OF BARNSTABLE BUILDING INSPECTOR ! APPLICATION FOR PERMIT TO �e✓r✓0�1e ,4 r .0 ✓,> e4ee /s AIC J TYPE OF CONSTRUCTION w 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: / '/ Location�? 04tee.<14,'_ Ae VeS T 6'1y C_eyr Cle Proposed Use Zoning District Fire District / �y Name of Owner •&Dmwz) .,'4Ueie77/f 4/ Address c3S~l ��eS/O G ✓�,2 � �. ti v Name of Builder I/Gf1A 2 1 75 Address_ .2L Name of Architect Address Number of Rooms Foundation Exterior Roofing Floors Interior Heating Plumbing Fireplace Approximate Cost 000 Area � � f° Diagram of Lot and Building with Dimensions Fee �D o� OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Nam \ Construction Supervisor's License 06-->4 c(-/ l SILVERMAN, LEONARD TNO 3 4 4 91 Permit For REMOVE & REP ACE DECK Single Family dwelling -ocation 357 Lakeside Drive Wesf- Centerville Owner Leonard Silverman Type of Construction Frame Plot Lot Permit Granted July 29 , 19 91 Date of Inspection 19 Date Completed 19 n;w Sri14 w 4 � Rf Z N 12 ft; , v r } Custom Homes Additions * Repairs Robert E. Harvey License No. 016919 385-4252 BUILDER AND GENERAL CONTRACTOR 185-28?? Res. 930 Old Bass River Rd. P.O. Box 371 Dennis, MA East Dennis, MA 02641 Tr. Leonard Silverman 3pneral Specifications for prnpos-& nddjtion Location: 157 Vleside Dr. West 1 . Strip shingles and trim in area of addition 2 . Excavate for footing, pour concrete footing and cemqnt floor at basement level. Set I" PVC pipe under floor for air conditioner drain. 3 . Lower level walls to be constructed with 2"A" KD spruce 16H on center. Glass slider to be installed (taken from existing living room wall) , jH CDX sheathing with extra clear grade white cedar shingles to be used on remainder of wall area. 4. Upper level - floor joists , 2 H,10H KD spruce spaced 16 H on center. (Existing joists , and 5/4 H flooring to remain, for added su port ) /8H H P Sub flooring to consist of 3 CDX over existing 5/4 stock. 5. exterior walls , 2 H Q H KD spruce with IH CDX covered with white cedar shingles (extra clear grade ) . Two Anderson glass sliders lc.. o bp placeR in outer. waii . Roof- to be constructed of 2"Y" T&G planking over wood bQams set to match existing living room . Roof shingles to match existing roof 6. Tnsulation- All exposed walls to have I"" batts , floor- 9" battc. roof- I" insulation board between planking & roof shingles 7. Remove door from kitchen , and form archway. Remaining slider from existing living room to replace existing one at rear of house. 8. All electrical work to be done as node requires 9. Extend heating Act work into new addition. 10. Interior wails to be constructei of JH,3" matching V grove planki,' (same as existing livinE room) 1101001- tO be covered with white oak flucring over Posen pape.r. 12.All Qcor & winJow openings to have matching trim to existing house 13.Aluminum gutter & down spout to be placed along facia of addition. 14.Extend gas lino for outside grill ,,-, 15.All exterior & interior painting to conform to existing colors unless specified . Mr. Leonard Silverman s' L357 Lakeside Dr. C s�t - ` 'Centerville , 1�ass. Map. 232-050. I I iOf ! I mill I i I Llli III I I II � ' � I i I If ! I ! � I � I ! Ilill ! i ! li l ! ? Il it Clill � ll it llii ' I � ! li , 111i ! Ili . i l � � iiil ( jl i I ! ; I ! Irli . t 1 - ; l i • ! I I ! ! I ` I ! I � i i i i l i ' I I l l i l l l i 1 � l i i ^j _ 1 1 i i I i t I Assess&soffice"(1st Floor): �3� _ O� SEpnC S MUST BE- c c AUMMOOM Assess&'s map and lot number Q� TNc r �♦ Board of Health (3rd floor): !�`�T Sewage Permit number 49. �iT a ssA , EtMRCOZ BAHd9?ADLL Engineering Department(3rd floor): ,j�3 s1 ris t O MMOSAMM �o rasa House number I ° 'b -4 Definitive Plan Approved by Planning Board 19 �Fo ray d• APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only A P PRp v ETOWN OF. BARNSTABLE °° °°�s$g'�U I L D I N G INSPECTOR ,; F o xtend existing living room I'f f Si o t ,yn TYPE OF CONSTRUCTION wood frame Oct . 1 , '1989 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: 357 Lakeside Dr. West j �� Z", (ter R, Location o Proposed Use enlarge living room Zoning District ! Fire District Name of Owner Leonard Silverman Address 210 Nahanton St . Newton, Cnt . Ma Name of Builder Robert E. Harvey Address 942 Old Bass River Rd• E. Dennis Name of Architect Address xfooting w wall and. Number of Rooms enlarge room by (13 t x15' ) Foundation 3" slab (front wall) & floor Exterior cedar shingles over 2" CDX Roofing Ashpalt shingles over 2"x6" T&G Floors Oak over 2" CDX over existing Interior Rt 1"x8" T&G planking Pi. ec ing Heating extend hot air duct work Plumbing none none $12000900 Fireplace Approximate Cost Area Diagram of Lot and Building with Dimensions Fee OCCUPANCY PERMITS REOUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable reg di he above constructi n. Name obert E. Harvey o16919 Construction Supervisor's License �, SILVERMAN, LEONARD � 33335- Buil•,��trAddition I}o Permit For � _ , �n Single Famix 25wel ncr Location Lot #9 ,3A L eside Dkive West ' Centervrll y ro Owner Leonard Silverman U Type of Construction Frame w t VI: Plot Lot Permit Granted November 5, 19 .89 Ji Date of Inspection 19 i Pate Com0plleted �! 19 i.. 4-4 iY y AssesscWe..;dfftce(1 st Floor): Assessor,sc map and lot number �✓ rj= of THE To Board of Health(3rd floor): J/ mow" d�Qy�� ♦� Sewage.Permit number �� /�7/ 4, �-- V' v / Z BAB35TADLL i Engineering Department(3rd floor): / rsea House number 0 3.5?`05, ' _ °o 1639. Definitive Plan Approved by Planning Board 190 A, APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OF BARNSTABLE BUILDING INSPECTOR j APPLICATION FOR PERMIT TO Extend existing living room t TYPE OF CONSTRUCTION wood frame - Oct. 1 , 1989 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 357 Lakeside Dr, West Proposed Use - enlarge living room Zoning District Fire District NameofOwner Leonard Silverman Address 210 Nahanton St. Newton, Cnt . Ma Name of Builder Robert E. Harvey Address 942 Old Bass River Rd. E. Dennis Name of Architect Address l ., V footing w/ b" Nall and Number of Rooms enlarge room by (13 t x15' ) Foundation~ 3 slab (front wall) & floor Exterior cedar shingles over 2" CDX Roofing Ashpalt shingles over 2"x6" T&G Floors Oak over 2" CDX over existing Interior Ritz 1"x8" m&G planking w t'i UeUA-iiiC Heating extend hot air duct work Plumbing none none $12000.00 Fireplace Approximate Cost Area Diagram of Lot and Building with Dimensions Fee s OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS F I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name obert E. Har ey 016919 Construction Supervisor's License SILVERMAN, LEONARD A=232-050 j5c� - tea _ o'33335 Permit For BUILD ADDIT"I'ON� ti Single Family Dwelling ti Location Lot #9, 357 Lakeside Drive Centerville Owner Leonard Silverman Type of Construction Frame Plot Lot Permit Granted November 5 , 19 CS 9 _ Date of Inspection 19 II Date Completed 19 l PERMIT COMPLETED 1/1/ S� ell �f Assessor's ri p and lot number a 3a.-. aJ:��1 � � /'. `a... .............. ..� 0*THE Tod - yw �� 1]�Sewage Permit number ............................ f.. ...........::.... p Z B9BHST/1DLE, i House number ......................................................................... '°o r639 �fi _ �e 0 OR A'. f TOWN OF BAR J�f NTABLE S BUILDING INSPECTOR APPLICATIONFOR PERMIT TO ..........'........�.................................................................................................... 11 TYPE OF CONSTRUCTION ......(�t10G;. rd.,r?���.......:.......................................................................................... ........ ................................. .��...........19. TO THE INSPECTOR OF BUILDINGS: ` The undersigned thereby applies for a permit according to -the following information: Location .J 7.... ��c'SEde.... r. W �f A)�.-erv, e * �� Proposed Use � ... �....a... t+l...�.. ................................................................................ ............................... ....... e Zoning District ...... .................................................Fire District .....6..L.Q.......................................................... � � + f Name of Owner ..��'r�/l 4.r.d....... ).!.d.11�vX.C►".aYV...............Address 5 7 ' r rS' � I s Vie........ !- :.... ........... ` v� Name of Builder .w ......r... .n!% .........................Address �� /7eIY��oCf. ... �? tJ �.. /J,IY! SZ�►r ............ ................... ...... J +, Nameof Architect ......................?............................. ~"':.................Address .................................................................................... � 3 E, t� Number of Rooms ...........................Foundation ................. ...:........ 1 ..................................................................:........... Exterior !':�.'.�<.. `...�.'? LXj..�: ?:.`'�1 e.S. J� k ..... Roofing i;. .....� oL� ...rya i.!11�.................................... �.. v s Floors ..... � �.' SSuh ..... .k '�� �.��...................Interior �� r1 .......................:....... ......f ....................., Heating g � ., Fireplace ..................................................................................Approximate Cost ......(q.— ::?rx-)............................................. Definitive Plan Approved by Planning Board ________________________________19________. Area ........l..............�.!...�4.�... Diagram of Lot and Building with Dimensions Fee f Q' 00 ......... .... .............................. SUBJECT TO APPROVAL OF BOARD OF HEALTH Y - - :, 6v; OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .. .' :....... .............................................. k1. �} Construction Supervisor's License ..1,.`�-:.. U............. t `,_ ,l SILVERMAN, LEONARD A=232-050 No ... Permit for ...ADDITION Deck ............................................................................... Location 357 Lakeside Drive ............................................................ W. Centerville ..........................................................:..................... Owner .......Leonard Silverman ................................................... Type of Construction .....Frame i ................................................................................ Plot ............................ Lot ................................ Permit Granted .......November 5, 19 85 Date of Inspection ....................................19 Date Completed 19 F 4 t 1 I � r I Assessors,milli-and lot number ... ....................I.....:....... . /:U �oF THE rot C SYSTEM MUST BE �Q Sewage Permit number ...............Q14.(.1... ................. INSTALLED IN COMPLIANCE WITH TITLE 5 = 89HBSTADLE, Housenumber ..........................:.......................{....................... 9�p 1639• . ENVIRONMENTAL CODE AND M�a TOWN REGULATI S �o gar a © tastable onservati a ssYVtal N � ®F BARNSTABL YJ/ igned Date I L D I H G INSPECTOR APPLICATION FOR PERMIT TO ........... ....f,............:....................................................................................... TYPEOF CONSTRUCTION ...... ..... .1.4m.0....... ..................................................................................... ......................... ......19. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ......... .(....... .die........r....i..!...?....f............C�! rY-".1�. ,4,. .�'Ln. ............ ................................... Proposed Use 15Ive"se.4 dC _e... .................................................................................................. Rp '�. ..........................Fire District .....��'Zoning District .....I..— ...�..............C.............. I �.,.......................}.�...................................... Name of Owner ../�,ANd�.......1.Id&X-ry):hV...............Address .3,�7.....'Y h:;Is e......!?r ........ Name of Builder �:44t....� .S.w,,'�.�# Address �� /7�CQC��; �vL�w ,Cd ..6 "r ... ............'........ Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ...............i.................................................Foundation .............................................................................. r Exterior W.. .SXA:S tC.NJ).Roofing cq f :'.H?q. Floors a ��...................Interior y:. rh�U w� ......�?�cs .! .t....{.re ..... T G....... ..............!!'I.... .,....................................... Heating ........................... ................................................Plumbing .................. ....................................................... Fireplace ..........................:.......................................................Approximate Cost ......bc?0Q... .-.................................... Definitive Plan Approved by Planning Board ---------------____-----------19________ . Area ......../.. ..S,��...� ./,... Diagram of Lot and Building with Dimensions Fee .........�D, D!� .... . ............................ SUBJECT TO APPROVAL OF BOARD OF HEALTH 13A 20 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .. ../?.... ............................. Construction Supervisor's License ... ....`3 d.�.......... SILVERMAN, LEJNARD YL—� R No .2. �?56..... Per for : `;A..I?X.K................ r � i.n9....................... Location •,;357 LaAsid Drive f P' W. Fe tervi ................................................... ............... .-1 . Leotard SiAerman - w a - - Owner Type of Construction u........ .r4ame ............................. a Plot .. .................... Lot ................................ Permit Granted .......November..5...........19 85 Date of Inspection 19 Date Completed ., .............................. ..19 S _ v . Y � V CST SI"d., R�mP PROPOSED • � � , IJ�C k II� y ►�-F I< _ REs 5CN or Yt X 1 S-�-t,N G y=4 0 u 5 Caj v�l.t.&- fL SC-PLr- .� — 8 . Assessor's Smap and lot number ..�.�.................................... :-' �/�_ •��`_ ./� r� - �� - �s't�/�� s/.sly=�> Sew a Permit number /Ulti ,�_........ . y V yo`T"ET°�. TOWN OF BARNSTABLE i 13ARISTABLE BUILDI-NG . INSPECTOR * .ty f.. 1 • L � .F .. �N C�H.....e .........�.1/..,`A....���r�r` l`�S7f�L:�....pt 4: lZ,.:... . APPLICATION FOR PERMIT TO .... .. .. .................. /... N 7 4; TYPE OF CONSTRUCTION .......... 1.'. ......'....L.......:......G!Jv¢�.... ..................................................... �< .......: ..............19.�.� TO THE INSPECTOR OF BUILDINGS: The 'undersigned hereby applies for a permit according to the f lowing information: Location ........... 5 .... f�/.� �Q ...../ ..Cf? ? .41/..lv�sr�. ............�� t�T ��lt' ....... ProposedUse ........................................................:.........................................................:.......................................................... ZoningDistrict ..:.....................................................................Fire District .............................................................................. Name of Owner .4901.'/1. 10....... �l.�u•�2�,�N....:.......... Address �5 �.R�G/'.5��� �+`�. G`.�"f���.u'4.......... Name of Builder ��.�.C�t�;rf .....�j....l.lv.C�..................Address 12 . . 4...................: _ Nameof Architect. ..................................................................Address ..................................................................................... . _Number of Rooms ...:......:Foundation ... ....................................................... /............ ............................ Exierior ....................................................................................Roofing .................................................................................... Floors ......................................................................................Interior .................................................................................... Heating ..........................................................................:.......Plumbing ................................cc.................................................. Fireplace ....................Approximate Cost Definitive Plan Approved by Planning Board -------------------_------------19________. Area /...l� ..o-S'.....'....... Diagram of Lot and Building with Dimensions Fee ....... ... ....T +.... .................... . . SUBJECT TO APPROVAL OF BOARD OF HEALTH U W'TAOLE CONSER'JAEONT C'�;. r"':', �1a Town Hall, 397 Main St. l� *annls, Mass. 02601 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ' Name .... ...... ...... ......... Silverman,, Leonard \ 1�8726 deck No r..—»—.. P'e,mk for. . /' . . ............—_____..__.. _ ' . ' -----------'' J9 *t »* ' &54 Lakeside Drive ' Location ....... ........................... m» . . Centerville �-------------------------.. � ` . ' � �0 ' ' Leonard Silverman . � ' . ' r F �� Owner ---------------------- . . ' ' ^ . . �rame ' Type of_ Construction -------------- . ' ...----'--"^^---------'r------' Plot ............................ Lot ----------- ' ` . Permit Granted -- ..&3.---]A �� ' ^ ` . ^ ~ ' Date of |n .....................................lq ' ' -'-r��' `Dote Completed —2*--� �-----lp . � ^ � . . ' PERMIT REFUSED --.—.'_..!.--. ....................... 19 . . ' . -----------.~----...'-----~.^—. ` . .—_---.-----.--~—.-----.----. . .----~--..—.----'...~.—,---.---.. . � --------.—....---.----.. - ^ . . `'�---^' ^ ' ^ . / Approved ................................................ lg --------- ... -----..----.—.---. ' ~ . . . . ' ----'�-----.--------_--.....—. . . � ' . ' ^ __ .....-.�..,,�.,� ., �... r.•:,�..�.-..-.r'...xrr..-•^...-.Fi• ,..-...._,. .;,a..�yy, -. ...,..w.. r,. .wr-..,,`.Pt..'7,....�..Y ...+Lwi�•ia,t'F;:.S.�' .'�..•r :,�,:_..-"_...:+. -p'n. , .�_ �3 Assessor's mapand lot number ... ............. . a................ Sewage-'Pemit number THE TOWN OF BARNSTABLE �� r�� "6 9 - BUILDING INSPECTOR 'E�ypY tr• 4 • n APPLICATION FOR PERMIT TO .... .���1,....d.!r.....14.............................................� !��G TYPE OF CONSTRUCTION f !'t ilk. ,v„ q L .Jo 0,�., ,..ad;car .. ........................................... ...........fJ........:. ..............;9 . TO THE INSPECTOR OF BUILDINGS: I The undersigned hereby applies for a permit according to the following information: Location ...........�5` .... r// �r..... L, /; ').......... c1;1 .............................................. ProposedUse ............................................................................................................................................................................. ZoningDistrict ..... ..................................................................Fire District .............................................................................. Name of Owner /� laiv :p....... ! a.cf�w�.!r.................Address �5�/ / �=�.�� .. ....... Name of Builder Address ✓l `���'.........1��„!,.tC� .................... r-- Nameof Architect ..................................................................Address ................................................:................................... Number of Rooms .....Foundation ... ��1�a4 � .Ig ............................................................. ... ......................................................... Exlerior ....................................................................................Roofing .................................................................................... Floors ..........................................................Interior ............... ............................ ..................................................................... Heating ..................................................................................Plumbing .................................................................................. Fireplace ..................................................................................Approximate Cost ..... Z .*�..h� !.' ...:........................... Definitive Plan Approved by Planning Board _______________________________19________ . Area ..; .. J Diagram of Lot and Building with Dimensions Fee .............. . .......................... SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. —�` Name ................./ �...... .;�-�f............................ Silverman, Leonard A=232-50 ' • 18726 add deck Ito No .............:....Permit for ......................1.. ....... r, dwelling .................................................... Location ...............Lakesi'de Drive Centerville ............................................................................... Owner Leonard Silverman ................................................................. Type of Construction . ..............frame .. .................... .................................... 1!........................................ . Plot .................. Lot ................................ �er 12 76 Permit Granted .............. .......................19 Date of Inspection .........................19 Date Completed ...... ...........................19 PERMIT REFUSED ................................ ........................... 19 ............... . ..... ........................... ............... ..... ...... .. . ......... ~ -i. .......... .................................... . ....... ........................ Approved .................:.............................. 19 ............................................................................... ...........................................................:................... - •,,.,,..,,.p.,,.. -m.t._ rN.e�1;,r,.,.,.. .. .. ....- ., .- r,• .-_ : ., .. ....,..,^•aJ.s.aw„�;..,...o-.,. - Fiyo,.q, _: .L _ .�'w:.;-.;d. �'. *°;e+*;<Iwa.:�.=�-. 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Q U' EXISTING'WALLTO I I ,}LALLY I BOX-IN EXISTING THROUGHOUT BE REMOVED FIN.LIVING 5PAGE W ADD ENGINEERED BEAM ALLY TO REMAIN v GGE55 NEW 3 CABINET FROM — — — — = — — — — — — = W N N THI5 51DE I' to rem 9 E N , FLR TO GLG 25'-1,5/8" 28,b„ I I 0) W N LEAVE APPROX SPAN-OF NEW BEAM J m N � SPACE EX LALLYS lB SHELVING 6U5TOMER 5UPPLIE N Z 0 -- --- -- TO REMAIN 2166 _ OYgNER soss . a 3' NEW aoee 11 soo I° ° ` " e EXTEND G UNTE W I 5UPPLIED 51NK ,m �� - ,, FOR REF NDER I I N AND BASE BASE GABS:/ POTTING 1'b" „_ AREA —-- iv UTILITY SINK -. - OFFIGE� UTILITY 2 �N NEW (UNFINI5HED) ROOMS c-AREAS q 24'b„ existing I LUm STORAGE — VINYL FL (UNFINI5HED) szss 4' to remain 48' soss NEW 4 „ I WASH R LOUVERED BF existing .J 5HOWE t exi i - STOP A E , o . N EN 2- ------------------ - ---`-----------=----------- ------ - _ m� BOX IN , ase DUCTS TO REMAIN PIP 5 b'-2" sting e m _ STAIR L EX. L----------- — — — NEW SINK, STEAM w v ---- _. ----r------- �' sass 3 existing r . 4 �. � SINK BA5E, UNIT in FREE 5TANDING J — — AND I I L N g r S ROOM r — — — — — — — I I GOUNTERTO N `n DIVIDER :.; ;:,.: r m UP O - Ln 'tI . � ; — — — `� NOTE:DUGT WILL PROTRUDE ry ca IF 77 1 = IN TO TOP OF DOOR OPNG; :, Q N — = — — — — — R 5UPPLIED DOOR; V BOTTOM OF DUCT AT b 4 1/2 AFF — � Z r I I �m� 17-2 112" 21'-9 1/2" T b" 26' I N existing I I Date: to remain I I 11-1 q-13 FINI5HED LIVING AREA PLAN su le: 3/16=1-0 I ` I I I Revisions: I 11-22-13 i I - - L- - - - - - - - - - I 12213 - - - - - - - - - - - - 12-19-13 �' BUILDER TO CONFIRM ALL 1-3-14 CONDITIONS Final Plans: AND DIMENSIONS ON 51TE Accepted b : Date: p y Note: These plans are for the sole purpose and S�4j 7. use of Gapizzi Home Improvement and are not to be distributed or used for construction other • Accepted by: Date: than by Gapizzi Home Improvement. I . >r ' N � �. > 0 V Q E E AD V N O Z U) la i = in v. 39'-2" 5HTRK'ABOKE 48 I - _. EXISTINGLU - - _ .. .. • - GL05 REMOYE,GLO° T X e•„NEW GAS FP LOG TION Q W 0 (RAISE LU • � I ;,' :_.; PT X ..�., FLOOR)'�'. �.;.I - GR.A. ,. 500 NO • .. ... - .. ti AREA fAMI ROOM - .4 z:.. .. VINYL FLRG :. PEPPHAGE DE 28 NOTE FINISHED AREA BY CHI:-WA 5F w LY R N - EMOVE EXISTING ...:EXISTING WALL_TO _ .. BE REMOVED B . .. .���� ''� �LALLY' ��'` X-IN'EXISTING p E- Q ��� �� � ADD ENGINEERED BEAM�� LYTO REMAIN -�: I Z V ACCE55.NEW :., . ., EXISTIN6FINI5HEDAREAi193.35F ju N n ti CA$INET.FROM - - , I .. .28'f 5l8 '.:S ..., .. FCRTO G¢G iEAVE _ iD •�- .SHELVING Ex LA4LYS EXISTING UNFINISHED:694.E SF R ry SPAQE r I - '.� CUSTOMER SUPPLIE :_' � TO REMAIN � •� • .. OWNER .:. ... _ 5UPPLIED SINKku AND BAS - . EXTEND G UNT FOR REF NDER.� ..-AREA ._...:- -::OFFICE I t�•'.2'. _ I :.. .. .._. _. ._ STORAGE; - . NEW NNFINfSHED}• AREA y - --.-: VINYL.FLRCi; : .11 b i -�--�•4Mir - . WASHER I NEW 2 . DUCTS TO REMAIN 3 b 2'—>• _ I - L STEAM - _ ....i E 51NK BASE; .. UNIT AND - r GOUNTERTO - L 5 i NOTE:DUCT WILL PROTRUDE • IN TO TOP OF DOOR OPN6; ` N OWNER SUPPLIED DOAFF OR; BOTTOM OF DUCT AT 6-4112 N - _ 12'-2 112" ' ,21'9 112"- � Vz PLAN SHOY'IING_FINISHED/UNFINISHED S Ln V • , I I Date: i Revisions: 11-22-13 BASEMENT PLANT scale: 1/6=1-0 12-2-15 12-1q-13 BUILDER TO CONFIRM ALL 1-3-14 CONDITIONS Final Plans: AND DIMEN51ON5 ON 51TE Accepted by: Date: t - Note: These plans are for the sole purpose and use of Gapizzi Home Improvement and are not to be distributed or used for construction other 20 Accepted by: Date: than by Gapizzi Home Improvement. VLL/'11VVV I ULI/'11L z z 0 WEQUAQUET LAKE TB6 EDGE OF WATER(PER PLAN . EDGE OF WATER E�=34.2 9 /30/14 Tg� z can TB2 _-- _ cn r j o LOT 9 LAND COURT PLAN No. 20239C - AREA=15,423t S.F. z, m Sp BCirrF� I p ( 1 j i4i,04 X/STING' t/ FULrLI*�WALKOUT� - c II�IIlI illll lll� i; lil o li. ! 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I 11-19-13 FINISHED LIVING AREA PLAN scale: 3/16=1-0 I I I '•' I Revisions: 11-22-13 — — — — — — — — — J I 12-1-13 12-2-13 L— — — — — — — — — — — — — — — — — — — — — t-= 12-19-13 LI W'j BUILDER TO CONFIRM ALL Final Plans: CONDITIONS AND DIMENSIONS ON SITE Accepted by: Date: h1 r Note: These plans are for the sole purpose and ® �'-t) 910 use of Gapizzi Home Improvement and are not to be distributed or used for construction other • Accepted by: Date: than by Gapizzi Home Improvement. - - - - - -- - - - - - - - - -- - - - - -- - - - - - - - EXISTING 6068 ... 73 \ EXISTING 6068 I . I I I •: I a i E E� : _ I I #2 PINE T&G (RAISE '__ I I I -- -- 0 z FLOOR) DOUBLE TRAGK \ I I FAMILY ROOM I INCREASE EXISTING 3'-Ot'"� TO BE OPENING, M o 28' / I �' existing I v TRAGK STORAGE • / / EXISTING TRIPLE WALL TO � \ � I u I � I Ilu II w IL N 25'-7 501 i _ __# I I s w ca APPROX SPAN OF NEW BEAM. + : „_ v .. �. EX LALLY5 cv 12-6 5/5 I w N Q) 2.6s — —' — —`-- ----------- .. u� -_ —=-- --- L --_ 6066 - - 13DB18 ll SE30 LZ i — i 11 ° D lL LU UTILITY OFFICE I ,. STORAGE 24'-6" ROOM :fl _ I existing existing — 11'-6" STORAGE ~ ^ 4' to remain 6066 I I L m DUCTS TO REMAIN 06'-2" " sting I I n exi — — — - -, STAIR------------- - - ---------------------------------------------- �- — — — S633 N - - - - - - - - NG UP I I t m U r— - - - - -`_ — - - - - - - _ I I " o 0 - I I Date: I . I I Revisions: 11-22-13 12-1-13 21'-9 1/2" 7'-61, 26' 12- �. I 12-lq-1 9-13 1-3-14 NO SIAlG Cabinet f fan BUILDER TO CONFIRM ALL I ;. I .( i REV. 4 existing REY. #2 GONDITION5tl REYI5ED PLAN scale: 1/4=1-0 a-2b-16 10-5-16 AND DIMENSIONS ON SITE IAl K)c Note: These plans are for the sole purpose and use of Gapizzi Home Improvement and are not to be distributed or used for construction other — — — — — 0 — yidt K!N 1'd 'J ! M tl 1 than by Gapizzi Home Improvement. i j y 5 Opt i� } �.._./'�✓S..V I,SM . r f IL JAI 4 -7 i I 1 . i • 3 t3S'l �n is : e- Jam ' <:2 r. T ;+ SCAtt APPROVED BY, DATE l� _ r / .�i'/�+�2' •7r DRAWING NUMBER