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HomeMy WebLinkAbout0012 OVERLOOK DRIVE - � ., �f � .. �� � o . . . - a � � . , p ., .; �. ..� 0 t o 0 �� o ; : ��� , . e P , , . a .. a _a o � „ �. � � � � � ,. : . ,. � , ., ., Town of Barnstable Building Post Th�s;CardSo That it is;Uis�ble;Fromthe Street Approved Plans Must,be Retained onJ,ob and;this,Card Must be Kept - °" ,�-` In fo`n Has Been Made , y t y' r 1f Posted Until`Final spec Y. , ° {Wherea;Certificate<ofxOccupancy,s Requred,such Bu�ldrng shall Not be Occupied;until a"F�nal Inspection hasbeen made rmit P e Permit No. B-18-3 Applicant Name: James Curley Approvals Date Issued: 01/05/2018 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 07/05/2018 Foundation: Location: 12 OVERLOOK DRIVE,CENTERVILLE Map/Lot: 188-079 _ Zoning District: RD-1 Sheathing: 77 Owner on Record: MORAN,SHARLENE T&JOHN M Contractor Name a JAMES P CURLEY Framing: 1 ' to Address: 12 OVERLOOK DR Coritract ii,[11 nse; CSSL-099138 2 CENTERVILLE, MA 02632 Est Protect Cost: $7,500.00 Chimney: V Description: Strip and re-roof approximately 12 square of as halt roof shin les. Permit Fee: P P PP Y q P g $38.25 Insulation: Project Review Req: Fee Paid- $38.25 < Date s 1/5/2018 Final: £ ' Plumbing/Gas Rough Plumbing: g: K Building Official final Plumbing: Y & This permit shall be deemed abandoned and invalid unless the work authorized bey this permit is commenced within siz months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved applicatio n and he approved construction documents for wh�cfi this permit has been granted. Final Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoriing by laws;-and codes. This permit shall be displayed in a location clearly visible from access street or daa and shall be maintained open for public mspectI the entire duration of the work until the completion of the same. AV pV� u Electrical . ' .. � x g; r, u Service: r � ''thecBuiltlm and�Fire'Officials are rovided,on,ihis permit. The Certificate of Occupancy will not be issued until all applicable signatu yes by g � � p � ..�. p Minimum of Five Call Inspections Required for All Construction Work g `§ ROu h: 1.Foundation or Footing 2.Sheathing Inspection final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. . Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Q Building,plans are to be available on site final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT 3 Town of Barnstable AREE�PT " 200 Main Street, Hyannis MA 02601 508-862-4038 a39 1� Application for Building Permit Application No: TB-18-3 Date Recieved: 1/2/2018 Job Location: 12 OVERLOOK DRIVE,CENTERVILLE Permit For: Building-Siding/Windows/Roof/Doors Contractor's Name: JAMES P CURLEY State Lic. No: CSSL-099138 Address: Centerville, MA 02632 Applicant Phone: (508) 790-4508 (Home)Owner's Name: MORAN,SHARLENE T&JOHN M Phone: (508)360-4931 (Home)Owner's Address: 12 OVERLOOK DR, CENTERVILLE,MA 02632 Work Description: Strip and re-roof approximately 12 square of asphalt roof shingles. Total Value Of Work To Be Performed: $7,500.00 1 Structure Size: 0.00 0.00 0.00� Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with theWorkers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and-that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject'of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true'and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: James Curley 1/2/2018 (508)790-4508 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $7,500.00 Date Paid Amount Paid ? Check#or CC# Pay Type Total Permit Fee: $38.25 1/2/2018 j $38.25 XXXX-XXXXXXXX-i Credit Card I 5483 Total Permit Fee Paid: $38.25 Town of Barnstable' r t"E Regulatory Services Thomas F..Geiler,Director 1 I '" MASS. " Building Division '°tFp ►�� Tom Perry,Building„Commissioner 200 Main Street, Hyannis,MA 02601 www.fown.barnstable.ma.us Y Office: `508-8624038 Fax: 508-790=6230. PERNHT# SHED REGISTRATION .,200 square feet or less Coo PRI C c . Location of shed(address) Village Property.owner's name Telephone number • - .N' Loy 1� . Size of Shed Map/Parcel# Date Hyannis Main Street Waterfront Historic District? V Old Kings Highway Historic District Commission jurisdiction? p, If over 120 square feet,'you must file with Old King's Highway Conservation Commission(signature is required) Sign off hours for Conservation 8 00-9:30 &3:30-4:30 6 PLEASE NOTE: 1F YOU ARE WITHIN THE JURISDICTION OF ANY OF-THE ABOVE COMNIISSIONS,THERE MAY BE Aw REVIEW PROCESS AND APPLICATION FEE.: .'' PLEASE SEE THE APPROPRIATE,COMMISSION FOR DETAILS. r TINS FORM MUSYBE ACCOMPANIED BY A. PLOT PLAN. -forms-sh Q edreg REV:05201 »: I Town of Barnstable Geographic Information System January 31,2(113 188043 #2 �.188089 " t 188088 #1171- 1w 41191 188045' #124$ y 188044 #1222 188090 188079 #1153 #12 v 2 188087 _ #27 188078 I #1241A 188080 �2 #32 .. 188086 #41 0 28 Feet DISCLAIMERS:This map is for planning purposes only. It is not ad uate for legal Map:188 Parcel:079 boundary determination orregulatory interpretation. Enlargements beyond a scale of Selected Parcel to 1"=100'may not meet established map accuracy standards. The parcel lines on this map Owner.MORAN,SHARLENE T&JOHN M Total Asses :$339800 are only graphic representations of Assessors tax parcels. They are not true property Co-Owner: Acreage: .48 acres Abutters - boundaries and do not represent accurate relationships to physical features on the map Location:12 OVERLOOK DRIVE .: such as building locations. �. � Buffer o -AppUmir'i o ra n loca :Orvaerty: Gn-teY'y c e J ® 14 6.8,3 3 - � VN - story � m � Ur `r���� � �o 1'65 08 ow ref=�500/265 Mood�a X.2500010016�D ood gone: 17A of C a PAUL G J,hmt9EE1� CQrtL�j that thus mortgage inspectionwa�.pcVPare ,For 0 GROT. VER y Wynn&Lid%nn/Tc & cow agg—c,3ank, S" � � 'V No 31 ate dwell& vm-hereon,does noes fr�U im a,special q'EMA fjoo& Elk ° h� stet with an.effective date of 7-2-92a" rthe locahbml op su"�+ the dweltind048 confarm rto the local Motu 6y-laws i tef eW 0F tm io with. respeettD horl�oi 6tyl dim?Yli5tOtla� Seale: 1" - seibcw 2 utre1i1�'t'<t5 or is exe t " _ 50// mapt'�rnt� VIO�Q Lott ¢ry�OC'CQYYl r . n I Date.,v om under Mass. General,Zawsp r4oA-_5ect'tort 7. File NO,.�.. PLEASE NOTE- Thee structures as shown on this plot plan are approximate only. An actual survey is necessary for a precise determination of the building location and encroachments, if any exist, either way across property lines. This plan must not be used for recording purposes or for use in preparing deed descriptions and •must not . be used for variance or building plan purposes. This plan must not be used to locate property lines. Verification of building locations, property line dimensions. fences or lot configuration can only he accomplished by an accurate instrument survey which may reflect.different information than what is shown hereon. Please note that this is "NOT A BOUNDARY SURVEY" and is "FOR MORTGAGE PURPOSES ONLY". a COLONIAL LAND SURVEYING COIViPANY INC. 4 269 Hanover Street Hanover, Mass. 02339 Phone: 781-826-7186 Fax: 781-826-4823 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Pas Parcel 675 Application #20'10 OS 0003 Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee, Date Definitive Plan Approved by Planning Board /D OD �ZS/lo Historic - OKH Preservation / Hyannis Project Street Address 12 Overlook Drive l it I L li'7 I I I �� I In Village Centerville Owner John Moran Address same Telephone 508-771-2352 By u Permit Request air sealing, insulate attic space, sloped ceilings, install 2 kneewall access hatches, insulate basement ceiling Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 3607 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) 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 RISE Engineering Telephone Number 401-784-3700 Address 1341 Elmwood Avenue, Cranston, RI License# 100459 Home Improvement Contractor# 120979 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE `�` DATE Erik Nerstheimer for RISE j - [s FOR OFFICIAL USE ONLY F APPLICATION# ; DATE ISSUED "71 MAP/PARCEL NO. s ADDRESS VILLAGE [ ilt OWNER f DATE OF INSPECTION: f �.:.FOUNDATION t FRAME INSULATION. : 1 /0111 FIREPLACE ELECTRICAL: ROUGH FINAL 4 PLUMBING: ROUGH FINAL tGAS _ ROUGH' °.fi FINAL 1 :R FINAL BUILDJN_G ,Y DATE CLOSED OUT r.s ASSOCIATION PLAN NO. . 7 Y• ti The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston;Mass. 02111 U. www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/OrganizationAndividual): RISE Engineering a division of Thiel ch EnginePrjng Address: 1341 Elmwood Avenue City/State/Zip: Cranston, RI 02910 Phone#: (401)784-3700 or 1-800-422-5365 Are you an employer?Check the appropriate box: Type of project(required): 1. N I am an employer with 14. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part time).* have hired the sub-contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. �• 0 Remodeling ship and 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: ❑Building addition required] 5.0 We are a corporation and its 10. ❑Electrical repairs or addition_s 3. ❑ I am a homeowner doing all work officers have exercised their myself [No workers' comp. right of exemption.perm MGL 11.;❑Plumbing repairs or additions insurance required] t c. 152,§ 1(4),and we have no 12. ❑ Roof repairs employees. [no workers' 13: Other Insulate comp.insurance required.] Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. tHomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contactors that check this box must attach sin additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. 'I am an employer that is providing workers'compensation insurance for my employees.Below is the policy and job site information. Insurance Company Name: The Preston Agency. Policy#or Self-ins.Lic.##: 3730961-00 Expiration Date: 1/1/11 Job Site Address: �/� • City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration (date). Failure to secure coverage as required under Section 25a of MGL 152 can lead to the imposition of criminal penalties of a fine up.to$1,500.00.and/or one year imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of 1250.11 a.day against violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certt and fhe ins endlties ofperjury that the information provided above is true andcorrect. Si nature: '` Date: / F Print Name: Erik Nerstheimer Phone#:(401)784-3700 or l 800 422 36 x 111 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 Heath 2. .Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact person: Phone#: ACORD, CERTIFICATE OF LI�4BILlTY INSURANCE OP ID 47 D�O4m/ MIDDlYY(y) THIEL-1 13/10 PaooucER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION The Preston Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1350 Division Rd Suite 303 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR PO Box 8'10 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, East Greenwich RI 02818-0810 Phone: 401-886-8000 Fax:401-885-1700 INSURERS AFFORDING COVER AGE NAIC INSURED INSURERA; Zurich-American'Ins Co. Thielsch Engineering, InC INSURERS: A■•r.ic.n w•rant.• Thielsch Group Inc. s Ll.bi.lty Hi Tech Realty Inc. NSURERC: North American Capacity Iranston RI: 02910 Frances Avenue Cra INSURER0: Hartford Insurance Company INSURER E' COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REOUIREMENT,TERM Oa CONDITION OF ANY CONTRACTOR OTHER OOCUMENT`NITH RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR WAY 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. ' LTR INSR TYPE OF INSURANCE POLICY NUMBER DATE(MM/DDM) DATE( ) - LIMITS GENERAL LIABILITY EACH OCCURRENCE ` $ 11000,000 A - X COMME-RCLk GENERAL LIABILITY 3730962-00,.. 04/01/10. 01/01/11 rTPWMPREMISEs(EaR oc wence) S 300.,000 CLAIMS MADE'a OCCUR' f MEO EXP.(Any.Ono person)' $ 10,0 0 0 PERSONAL&ADV IWURY $1,000,000 GENERAL AGGREGATE- $ 2,0 0 0,0 0 0 GEN1 AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG ;2,0 0 0,0 0 0 POLICY X PJEC : LOC Emp Ben.. 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ; 2,000,000i'. X ANY AUTO 37309,63-00 - - 04-/01/10 01/01/11 (Ea accident) ALL OWNED AUTOS `— S BODILY INJURY SCHEDULED AUTO _ - (Per person) HIRED AUTOS NON•DYRJEU AUTOS - ` BODILY INJURY - S �t (Per accident) - { I PROPERTY OANIAGE, _--- (Per accioenl) GARAGE LIABILITY e AUTO ONLY-EA ACCIDENT g ANY AUTO - OIHERTPWJ EA,ACC $ , AUTO.ONLY: AGG EXCESS/UMBRELLA LIABILITY " EACH OCCURRENCE ; 10,000,000 B X 6GUk F]CLAIMSMADE UNB 9263637-00 04'/01/10 OT/01/11 AGGREGATE ; 10,000,000 DEDUCTIBLE - • - --- • .. ,�- R RETENTION $10,000 WORKERS COMPENSATION AND X TORY 1.IfdITS EP - A EMPLOYERS'11ABILITY,V4YPROPRIETOR/PARTNER/EXECUTIVE 3130961--00 04/01/10 01./01/11. _E:L.EACH ACCIDE14T $ 1,000,000 OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,OeScribe Under - - , SPECIAL PROVISIONS below - - E.L.DISEASE-POLICY LIMIT 5 1,000,000 OTHER _ - C ! Professional Liab DVL000026800 64/01/10 04/01/11 Prof Liab 2,000,000 D � Leased/Rented' Egp 02UUNTD5678 , 04/01/10 04/01/11 Equipment 100,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS(VEHICLES!EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS - CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION • DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN a NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO 00 SO SHALL IMPOSE NO OBLIGATION OR LIABILITY_OF ANY KIND UPON THE INSURER,ITS AGENTS OR r REPRESENTATIVES. - AUTHOR¢ED REPRESE v ACORD 25(2001/08) LDACORD CORPORATION 1988 91te aio/a nusnes seu tion.Office O onsumer a 10 Park Plaza Suite 5170 Boston, ssachusetts 02116 Home Improve ontractor Registration Registration: 120979 m Type: Supplement Card x J r w Expiration: 3/25/2012 THIELSCH ENGINEERINGC. ERIK NERSTHEIMER . 1341 ELMWOOD AVE.' a CRANSTON, RI 02010 '� yr�y k Svc~ Update Address and return card.Mark reason for change. Address T Renewal Employment ❑ Lost Card DPS-CA1 it 50M-04/04-Q101216 �le �omzmoniueac ./�aaoac�ivaelya Office of Consumer Affairs&Bu mess Regulation License or.registration valid-for individul use only OME IMPROVEMENT CONTRACTOR before"the,expiration date. If found return to: Office of Consumer Affairs and Business Regulation Registration�g79 Type: _ .10 Park Plaza-Suite 5170 Expira ""'12 Supplement Card Boston,MA 02116 THIELSCH ENG J � ERIK NERSTH 1341 ELMWOOD Ar CRANSTON, R1 029'f 4: Undersecretary Not valid without signature -- -- -..--.............. ....... raele 1 OI 1 The Officia(VUebsite of the Executive Office of Public Safety andSecur.ity (EOPS) ' Mass,Gov Home Public Safety Department of Public Safety Licensee Complaints License Type Construction Supervisor License 4 100459 Restriction WS,IC ` Name Erik Nerstheimer City, State, Zip North Scituate, RI, 02857 Expiration Date 3/28/2012 Status Current No complaints found for this Licensee. Back To Search Board of]3iiil g Regulations and St dank „ b-Cense or registration varid-for individid HOME IMPROVE ENT CONT CTOR [ use only I •� I' before the expiration date. If found return to: Registratipn:. 1209 Board of lBuilding Regulations and Standards I EzpTatio:n`_3.25/20 0 One Ashburton Place Rm 7 301 1 TYPe �PPleme t Card T )stc�3i,]42. 021-08 ELSCH ENGINE_>E_R-,1—: K NERST -HEIMER�-'-' _= 1 ELMWOOD.AVE`+--:.F �NSTON, RI 02910 r i — Admtnrst�aco Not valid without sign2#r;re I ht-tp://db.state.ma.us/dps/licdetails.asp?t)ctSeai-chl•N=r.(�T inni,,�o r- A 'a 3 Y t NAT=2453,1 1 RISE ENGINEERING Federal ID#06-MS629 RI Contractor Registration No 8186 A division of Thielsch Engineering MiA Contractor Registration No 120979 CT Contractor Registration No 620120 1341 Elmwood Avenue,Cranston,RI 02910 (401)784-3700 FAX(401)784-3710 CONTRACT �p{ Page 2 L I S .. • THIS CONTRACT 18 ENTERED INTO BETWEEN RISE ENGINEERING MD THE CUSTOMER FOR WORK AS ENGINEERING DESCRIBED MOW CUSTOMER - ,. PHONE - _DATE Client It .. John M Moran (508)771-2352 . 08/06/2010 1,11555 SERVICE STREET - BILLING STREET _ 12 Overlook Drive 12 Overlook Dr SERVICE CITY,STATE,LP - - - BILLING CITY,STATE,LP .. Centerville,MA 02632 Centerville,MA 02632 JOB DESCRIPTION $297.00 RISE Engineering will provide labor and materials to install.123 square feet of R-19 faced fiberglass insulation to the perimeter of the basement ceiling at the house sill. $135.30 RISE Engineering will remove 200 square feet of batt style insulation from the basement ceiling area(not incentive-eligible.) $130.00 RISE Engineering will apply all applicable,eligible incentives to this contract. You will be billed only the Nei amount. Currently,for eligible measures,the Cape Light Compact offers 75%incentive,not to exceed$2,000 per calander year. " -$2,871.98 • r WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ' ***Seven Hundred Thirty-Five S 321100 Dollars $736.32 UPON FINAL INSPECTION AND APPROVAL BY RISE ENGINEERING.CUSTOMER AGREES TO REMIT AMOUNT DUE IN FULL INTEREST OF 1%WILL BE CHARGED MONTHLY ON ANY UNPAID IRALANCE AFTER 30 D SEE REVERSE FOR IMPORTANT INFORMATION ON GUARANTEES,RIGHTS OF RECISION,SCHEDULING,AND CONTRACTOR REGISTRATION. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES' 6 f AUTHO TU E•RISE ENGINEERING CUS OMER-44CEPTANCE NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE �4 : ? �' I W ACCEPTANCE OF CONTRACT-THE ABOVE PRICES,SPECIFICATIONS AND CONDITIONS ARE S018FACTORY TO US AND ARE HEREBY ACCEPTED.YOU ARE AUTHORQED TO DO THE WORK AS SPECIFIED.PAYMENT WILL BE MADE AS OUTLINED ABOVE I Town_-of Barnstable *Permit#au% -PRESS P Expires 6monihsfto issue date 1�' Regulatory Services Fee OCT 2 � - 2007 Thomas F.Geiler,Director . Tp WN OF BARNS Building Division �1 TABLE Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 W www.town.barnstable.maA is Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION' RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number /ei z 671 Property Address 12 (7lk� lei vlc �v- C-C ;,Jy l(� ''\ Rkesidential Value of Work` 3©D Minimum fee of$25.00 for work.under$6000.00 Owner's Name&Address �n�✓(c K e_ eNc�-�-. 1 1_ C���-✓ (.c�u 1/t ��. �.�-.,�w,lvl�; - Uti`-r�' C.��,L-3-Z. , Contractor's Name elephone Number U�j —7'7L Z0-70 Home Improvement Contractor License#(if applicable) /t>0 '71 2; Construction Supervisor's License#(if applicable) JY,0`� ❑Workman's Compensation Insurance ' Check one: ❑ I am a sole proprietor ❑ I am the Homeowner DKhave Worker's Compensation Insurance ' Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping, Going over existing layers of roof) [2 Re-side 0 .Replacement Windows/doors/sliders. U-Value ja (maximum.44) *Where required: issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License is required. G�c SIGNATURE; Q:Forms:expmtrg Revise061306 6 t s y ZE9Z0 dJ� , Nd �p�s9 aot r r r a�,r,ue6oW do nogl P {ICA l0 ; aic eaod�o�alE^ud oj!elidx4 k EZ 9 uoR s00Z1 :u -As! �oo vBa�I . 6g0ls0S 6660E1 '�l 83 ,R\ WON 3n�adW13 801Zo`Cl� sp�C n c1S `Vo1�!!nn gca! tnq auus l d anp i 1 N2rg�3Wa.2 I�$nlpl �to p1roil su ollCln uC wlaavanQ l �I, CpnClS p asotoil 5u!P1l �a suopcln dxao ralP asuaa!l nno} uol; als! "'u P :oluaF p a�eoi[<, 91«a asn 1nP!A!Ppi a ! s - The Commonweatth of Massachusetts t. Department of IndustrialAecidents ` Office of Investigations 600 Washington Street .` Boston,Mgt 02111 www.m ass.gov/dia Workers"Compensation lasuranceffi.Adavit: Builders/Contractors/Elecfricians/PIumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): fla �. Address o� �..,..� City/State/Zip: Ca,_ Phone.#: 'U -7 J Axe you an employer? Check the appropriate box: -Type of project(required):. 1.L"1 tarn a employer with -v 4. [] I am a general contractor and I employees (full and/or part.time).* have hired the stab-contractors employees ❑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• 0 Demolition worldng for me in any capacity. employees and have workers' [No workers'comp.insurance comp.insurance. t' • 9. []Building addition required.] 5• [] We area corporation and its 10.❑Electrical repairs or additions officers have exercised their 3.El am a homeowner-doing all work 11.❑Plumbing repairs or additions 3mysel£ [No workers' comp: right of exemption per MGL 12.❑Roofrepairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' .13.[] Other 5��,,,u v comp, insurance required.] , *Any applicant that checks box#1 must also fin out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. TContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors lave employees,they must pravidt their workers'comp.policy number. lam an employer that is providing workers'compensation insurance for my employees Below Whe policy and job site information Insurance Company Name: 7Zw.�-c c��-• Policy#or Self ins.Lic.#: C1 -1 1q `�1 v Expiration Date: v Job Site Address:_t 2 OUt✓ [vvk D1 City/State/Zip: V\-_,�- 0-;2 L 3--L- 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 iip to$1,500.00 and/or one-year imprisonment; as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the OfEce of Investigations of the DIA for insurance coverage verification Ido hereby certify and thepains•andpenalties ofperjury that the inform ation provided above is true and correct: Sienature; Date: /U Phone 4: p _ 7 71- g U-'D ' Official use only. Do not write in this area,`to be completed by city or town official A: City or Town: Permit/License# Issuing Authority(circle one): X.Board of Health 2.Building Department 3. City/Town CIerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: J oF1He I own of Barnstable. y Regulatory Services Mass $ Thomas F.Geiler,Director �Alf1 19. A- v Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 "v Vy'town.barnstable.ma.us Office: 508-862-4038 ' Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder ; L" VNAo ,as Owner of the subject property hereby authorize ��,�,,^ to act on my behalf, in all matters relative to work authorized by this building permit application for: , _ I� Du car l,�-y l��,,- -(�r -,.�•�-✓►�- (Address of Job) ignature of Owner Date S�6v-L-c Print Name QTORMS:OWNERPERMISSION OCT-23-2007 14:07 LOVELY AGENCY P.01i01 DATE(MMIDDhYVV) II rM CERTIFICATE OF LIABILITY INSURANCE 1o�23/zoo7 �� 508-543-3131 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION THE LOVELY INSURANCE AGENCY, LTD. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE „^ I . THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ;I 6 RAILROAD AVENUE THE COVERAGE AFFORDED W THE POLICIES BELO P 0 BOX 374 NAIC FOXBOROUGH S AFFORDING COVERAGE - -_• INSURED YMOGAN&CO., INC. AMERICAN-ZURICH 1 _ ;86 JOYCE ANN RD.CENTERVILLE,MA 02632 COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT,TERM E 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 I$SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. --•. •-•---•- "''"" '----' - POLICY EFFECTIVE IPpI.ICYEXPIRATION' ...—. .._ .. LIMITS INSR DD- POLICYNUMBER DATA IMMIDONY) EACH OCCURRENCE GENERAL LIABILITY DXFfAl3ETORl PoTED ,COMMERCIALGENERAL LIABILITY PREMISES(EfloC�y_rrence) s — � --- MEDEXP(Anyone�eraon) ,..--- 1 CLAIMSMADE L 1 OCCUR f I PEpSONAL d AOV INJURY GENERALAGGREGATE _�S _J_ I PRODUCTS,COMPJOP AGG S _. --- �..—. _ GEN'LAGOREGATE LIMIT APPLIES PER i ""-' --- -- POLICY r PRO+ LOC _ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S ANY AUTO ALLOWNEDAUTOS SODILYINJURY(Per pomm) .S - SCHEDULED AUTOS I MIRED AUTOS I BODILY INJURv S ` (Peraccldenl) NON.OWNED AUTOS PROPERYY DAMAGE i _—_ --, (Peteccldeni) AUTOONLY,EA ACCIDENT 5 —_ GARAGE LIABILITY I - AC —� C $E . OTHERTHAN EA 3 ___ •„ ANY AUTO AUTO ONLYi AGG S EACH OCCURRENCE 3 —_ HXCE$&/UMBRELLA LIABILITY - CLAIMS MADE AGGREGATE OCCUR f ::_) DEDUCTIBLE 8 RETENTION' E - WC STAT�1- OTW X TOR.Y..LIMITS.._— ER WORKERS C.OMPENSATIONAND 6ZZUB�9574AS1=8-07 I 05/14/2007 05114/2008 100,000' A EMPLOYERS'LIABILITY I E L.EACH ACCIDENT_ $'_ ___0 ._. ANV P IOPRIETOR/PARTNERlEXECUTIVE I - E L.DISEASE•_EA E_MPtOYEE $ SOO,000, OFPIC4RNEMBER EXCLUPFC? 1 OO 000 II yes.describe Under E.L.DISEASE POLICY LIMIT S PECIAL R VISIONS olow OTHER OESCRIPTION OF OPERATIONS J LOCATIONS I VEHICLES I EXCLUSIONS ADDED PY ENDORSEMENT l SPECIAL PROvIS10NS ON ALL OPERATIONS USUAL TO THE BUSINESS OF THE INSURED. ' 4 CANCELLATION CERTIFICATE HOLDER' _ { SHOULD ANY OF THE ABOVE DESCRIBED POLICIES B CANCELLED SEF00'TTHE EXPIRATION TOWN OF BARNSTABLE DATE THEREOF,THE 1$SUING'INSURER WILLWDEAVOR TO MAIN DAYS WRrTTEN 'LOG MAIN ST:_ NOTICE TO THE CERTIFICATE HOLDER NAMED TO 74E LEFT,BUT FAILURE TO DO SO SHALL HYANNIS, MA 02601 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR FAX; 508--790-6230 REPRESENTATN AUTHORIZED RE TIV 'ACOR CORPORATION 1980 ACORD 25(2001108) TOTAL P.01 Assessors map and lot number ..�................... ........... o�7NETo Sewage Permit, number :..� g SEPTIC SYSTEM MUST BE . House number ..... . r! jj INSTALLED lib COMPLIANCE/�// Z BARNSTa LE, i /fir[........ ............................... ,.,..... 9 ' ` a WITH TITLE 5 °° Mb ! T AND gar a TOWN OF BA � � r EN S f : BUILDING INSPECTOR r 1 . G t APPLICATION FOR PERMIT TO ... . -. ....1 ................................... . ............................................. W.(5TYPE OF CONSTRUCTION ,,........ .. ...... :.............................................................................. A4..✓.........�. ........... ,9.4`` TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following- inf Irma tion: Location ..... ... ....01 �!1!r.).✓.A . ..... . ..... . 1 ._ ................. ................................... ProposedUse ...........K1t ' .!^..'......................................1.................... ...............................................I......................... Zoning District ...............�.F. ..-/.....................................Fire District �� .............................................................................. Ivl�-} Vs MJ1 A.k,..................Address V� : rr�� a✓�Uo tr" '✓-� lt�keTc� ✓�( Name of Owner ..............................!�..... t ,/� V!1...................... 1........1�.. ............... Name of Builder�A;!Js .: �.± !3. '� ! . ,,..Address ..34.......& 6°V. . 6111:... `. .. Nameof Architect ..................................................................Address .................................................................................... Number of Rooms .....Foundation ......bl.Q Exlerior ...1.TAk ....... R!. . .�........................................Roofing .....(! �w9 r"..... 1�^(,,,-. Floors ........t.!.�a .! ""..........................................................Interior ......... te Heating ..................................................................................Plumbing .....Co- A--- nt ............ Fireplace — .........Approximate Cost Definitive Plan Approved by Planning Board ________________________________19________. Area ......../.. lO...................... Diagram of Lot and Building with Dimensions Fee .. /4�!:..® SUBJECT TO APPROVAL OF BOARD OF HEALTH �rO,�pS 9 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 , ... .P........ .................... Construction Supervisor's License ...e. .................... MORAN, JOHN 28719 Addition No ................. Permit fort Single Family Dwell-ing ...........:t...................................:............ ....... ......... Location 12 Overlook Drive............................................ Centerville ............................................................................... Owner ......J..o.....hn.,.....Mo.ran............. .. ................... Frame Type of Construction .......................................... ................................................................................ Plot ............................ Lot ................................ December 2� 85 Granted ...... .. Permit G .................. ..............19 bate of Inspection ....................................19 Date Completed A/....................... ...19 tr 1 0 M I ci , I