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HomeMy WebLinkAbout0068 MCGEE DRIVE � ��� �`uc � �r � -- � � NOTE: VARIANCE GRANTED: #2018-034 HYANNIS RECORDED IN DEED BOOK 31435 PAGE 68 DEC 24 Rtl AS! [a 43 f 1) TO CONSTRUCT AN ADDITION 21.7' FROM THE STREETLINE OF STRAIGHTWAY NORTH, AN 8.3' VARIANCE $)0, PARCEL ID: 272/201 �Z � w = t_OCU8 .53 SION Z LOT 14 USE Za o AREA=15,000 S.F.SION o R' RO I I O 0 I LOCUS MAP 1 PLAN REF: 417/5 SEPTIC 57.9, TITLE REF: 2 41 89/21 9 PARCEL ID: MAP 271 PAR. 006/ I I AREA ZONING 'FZC-1"SETBACKS: 30.F-15'S-15'R SEE'NOTE c� DOS EO NOT!N 1 MILE WIND DISTRCT I �p FLOOD ZONE: "X" _ .cl; cl� COMMUNITY PANEL: 25001CO562J DATED:07/16/14 0 DECK FOUNDATION LOT 15 ' ~ Z ON CERTIFICATION I 12.0 (ADDITION AS—BUILT) z 24.1' LOCATED AT: ' O #68 i o 0 68 McGEE DRIVE I HYANNIS, MA. 28.1 a-'o N o PREPARED FOR SCOTT B. GILMORE Ai 21.9:__s„_ H - o i— LEIGH A. SOARES NOVEMBER 24, 2019 3Q, / N ARP ` No 2 .r MacDougall Surveying & Associates P.O. Box 2428 S86'32'36E 58.73 / � ,! '° 20 M'ashpee, Ma. 02649 16MMIPMU91 PH. .508 419-1086' GRAPHIC SCALE fax R08�419-1087 1=20' email: C.BAS. ---" i MCG�E RIVE mocdougallsurveyC�Dcomcost.net ! J#1999FND. _. I - Town of Barnstable Building t •, Posi'This Card So-That�t is=VisibleFrom;the Street. A • ,roved Plans;Must be Retained on Job and this CardFMust be Kept,,.. * en Yc Pos ed Until'F�nal Ins action HasBeen Made PP .',�� � a Wherea Certificate of Oc pancy Required,such Bu Id rig shall Not be Occupied until a Final Inspe039. ct�onEh�as been made Permit Permit No. B-18-2348 Applicant Name: Thbmas Cox Approvals Date Issued: 08/20/2018 Current Use: Structure Permit Type: Building-Addition/Alteration-Commercial Expiration Date: 02/20/2019 Foundation:(e) Location: 68 MCGEE DRIVE, HYANNIS Map/Lot 271-006 005 Zoning District: RC-1 Sheathing: Owner on Record: SOARES, LEIGH A&GILMORE,SCOTT B Contractor Name:`:oLAGADIN05 BUILDING&DESIGN Framing: 1 " ANC Address: 68 MCGEE DRIVE I , 2 HYANNIS, MA 02601 Contractor'License- 104804 Chimney: Description: CONSTRUCT A GARAGE ON THE RIGHT SIDE OF THE HOUSE WITH ,Est Project Cost: $125,000.00 DORMERED ROOM ABOVE. R Permit Fe'e: $772.50 Insulation: Fee Paid $772.50 Final: Contractor removed himself from permit 9/20/2018z' LP Date 1 8/20/2018 Plumbing/Gas Change of contractor to Nicholas Lagadinos o641/5J18 ' EfC Rough Plumbing: Project Review Req: AS BUILT REQUIREDy ; Building Official Final Plumbing: Rough Gas: , Final Gas: . ... � ��. �, �. ., Electrical This permit shall be deemed abandoned and invalid unless the work authorized by this;permd is commenced w th*'six months after issuance. All work authorized by this permit shall conform to the approved application and-the approved;"construction documents for which this permit has been granted. Service: All construction,alterations and changes of use of any building and structures shall be in compliance"with theAlocal zoning by=laws and codes. r r ,. Rough: This permit shall be displayed in a location clearly visible from access street_or rbad and shall 6,e rnaintained`o.pen forpu6lic inspection for the entire duration of the work until the completion of the same. Final: The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Low Voltage Rough: Minimum of Five Call Inspections Required for All Construction Work:' 1.Foundation or Footing Low Voltage Final: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Health 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Final; 6.Insulation 7.Final Inspection before Occupancy Fire Department Final: 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. U, " ��epoayr�y�rzcueal�o� aacccLuJeGt� Office of Consumer Affairs&Business Regulation License or registration valid for individual use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration:; �104804 Type: Office of Consumer Affairs and Business Regulation Expiration 7/151201,8 Private-Corporation 10 Park Plaza-Suite 5170 n f , Boston,MA 0211 LAGADINOS BUILDING&,DESIGN,!lNC Nicholas Lagadinos y , � �' l,.1 13 Thankful Lane1 Cotuit, MA 02635 " Undersecretary Not a i w Fout signature ?`lice CommompeaM of aassachusettr Deptrlrrtart qfrndastrid,4ccideftts - -- fre afIM.Wtigatiarrts. y 600 IEashingtort,S'treet y Baston,IA 02.III twFPi.v rnas&,gorv1dia '"Tar.leers' Compensalien Iusmrance Affidavit;Bm'lder-JCunfractGrsJEIecfricians/Phmnhers Applicant Infarma6Gu Please.Print le�"hly T 'Oiganiia4ioa *itt��7 �/�i19/71.clU.S V) l�I✓�Cr F SSG�l -,1✓/� �aII3$ Address: city/st:ateJzip -( 1-r Phano ` ztVol Are you an employer?Checkthe apprapdate box: Type of project(required)- 1.[A I am a employer uiffi Id 4 ❑I am a general contractor and I • employees(Tull atxdloryart-time)_ * have lured.the sub-contractors 6. ❑N. consfiuction 2.❑ I am a sole propnetos or partner- listed on.the attached sheet 7. RRemo&Hng slop and have no employees. these sub-confrac#Ors have g- ❑Demolition w addng for me in any capacity employees and hatre wodcers' �. El Building addition [No corkers'camp.insumace comp.insurauml - required.] 5. ❑ We are a-corporation and ifs 16❑Electrical repairs cr addrt%om 3.❑ I am,a hameoumer doing all work of<ice3s have exercised their 11.❑Plumbingrepairs or additions set€ o-workers' t of exemption per MGL 'n3' � - 17.❑Rnafrepairs insurancereciuised Y c.132,§1(4kaadwehaveno employees-[No worlcers' 13.E-10ther comp.insurance required.1 'AecyWNczatfstchecksboxRmastalsafilloutthesettionbelowshmdng&ei wu&es'compenudonpolicyinfumadon. #I3ameoaraers uha submit rlus sf5davu indixaiing they are tiain�zlf wofic aad theahiiz autsida continctors nmst saTrmit a new affidavit indics#iq;=cT3 fContractorrVnt dhec:1 ibis box must zttarhed sa addid nat sheet showing dienzug of the sub-ccotrw bars.snd state whether or not thnse eaMeeshave employees.If the sub-contactomkive employees,&eynntstpruvide their wurkes'mmp.policy number. lam all.euiplo}Yrr fl�atis prm2riing workers'caniperesatzutt uesurance f or�vcy*elrrplpj�¢s ,Below is fltepoFicy arrd jah site ir�ormafiarL '� Insurance Company Name: 6 t —M L l nA f Pohcyorelf-ins_Lio_# - Oho qd(D ' piaationDate: l Z Job Site Address 6 9_2 1' • City/Stafel2sp: �1/� 6C)l a Attach copy of the workers'compensationpolicy declaration page-(showing the policy numbdrand expiration date). Failure,to secure coverage as required.uuder Section 25A of MGL c 1521 can lead to the imposition of criminal penalties of a fine up to$15OD 00 anjitor one yearimprisoument,as well as civil penalties.in the form of a STOP WORK ORDERand a Eke of up to SM0-00 a day against the violator_ Be adidsed that a copy of thus statement maybe Bx vmded to the Office of Investigations of the DIA for insurance coverage,-verificaiion- I da hereb .T rt Rr•tF is axed pertaIfres aflrer try'fJtattlte irifarautfiQrtprmztfed abai�i�bare ar d correct Sieaahxe: Date: 3 Phone It !?,�iaL tx�e rtrtly. iJa✓tat o-Frtte>rt fFt�<rrea,f�be crrrnptetesd b}�r-ify rrrtatt�n affic�t City or Town.: PermitlLicense;g Issuimg Authority(ci r.Ie one): L Board of Health 2.13u ing Department 3.Cityl Town Clerk 4.Electrical hmpeetior 5.Phr¢abmg Inspector b.Other Comfact Person: Phone#: f A�®® DATE(MM/DDIY`Y V CERTIFICATE OF LIABILITY INSURANCE 02/20/2018 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. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER - CONTACT Larissa Camba NAME: Leonard Insurance Agency,Inc PHONE (508)428-6921 FAX (508)420-5406 (PA No Et: (A 683 Main Street E-MAIL larissa@leonardagency.com ADDRESS: Suite B INSURER(S)AFFORDING COVERAGE NAIC# Osterville MA 02655 INSURERA: NGM Insurance Company 14788 INSURED _ INSURER B: Applied UWCaptive Risks AUC001 Lagadinos Building&Design,Inc. INSURERC: INSURER D: 13 Thankful Lane INSURER E: Cotult MA 02635 INSURERF: COVERAGES CERTIFICATE NUMBER: Master 18-19 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AIJUL POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICYNUMBER MM/DD/YYYY MM/DDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACHOCCURRENCE $ 1,000,000 DAMAGE TO CLAIMS-MADE ®OCCUR PREMISES Ea occurrence)nce $ 500,000 MED EXP(Any one person) $ 10,000 - A MSB87460 01/01/2018 01/01/2019 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERALAGGREGATE $ 2,000,000 X POLICY PRO ❑LOC PRODUCTS-COMP/OPAGG $ 2,000,000 JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANYAUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OT YIN AND EMPLOYERS'LIABILITY STATUTE ER ANYPROPRIErOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 B OFFICERIMEMBEREXCLUDED? NIA 46-880906-01-05 01/02/2018 01/02/2019 (Mandatory in NH) - E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Builder in Massachusetts CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main St. AUTHORIZED REPRESENTATIVE c�Hyannis MA 02601 J t J- - ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD l f Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Constructiorn Supervisor CS-012653 Expires: 07/16/2019 NICHOLAS A:LAGA®INOS � 13 THANKFULLANE _, ¥ COTUIT MA 02635 ' £ Commissioner "- Town of Barnstable Building Department Services s „� z Brian Florence,CBO MASS. . Building Commissioner " 200 Main Street,Hyannis,MA 02601 www.town.barnstaliknia.us Office: 508-8624038 Fax: 508-?96-6230 NOTICE TO THE BUILDING DIVISION OF CHANGE OF LICENSED CONSTRUCTION SUPERVISOR owner of property located.at 'Y1 to, ,hereby certify that 'rOYV\ C6jL� bX CaYI%+rir J;M is no longer Construction Supervisor listed on the application for the project under construction as authorized by building permit#Q�-)�-Z�7 ,issued on $ 2.0 20113 I understand that the project under construction must cease until a successor Licensed Construction Supervisor,is submitted on the records of the Building Division. PROPERTY O DATE � I Q:WP;FORMSPROPERTYOWNERREMOVINGCONTRACTOR.DOG Town of Barnstable Building Department Services RIASSL Brian Florence,CBO Building Commissioner 200 Main Street,Hyannis,;MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, nN-G7jj6joYf_,I W15,1A OCAAA,& ,.as Owner of the subject property hereby authorize /E/1('�( /o,,,w,S 'to act on my behalf, in all matters relative to work authorized by this building permit application for: d� dress of Job) **Pool'fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and ac pied. Si ature of er Signature o p ' ant 11 �IL6104%v ` I& LhV#DHe)S Prir4 Name Print Name i Date QFORMS:OWNERPERMISSIONPOOLS Rev:09/16/17 Town of Barnstable Building Department Services „ARNSTAI= : Brian Florence,CBO MASS eso ��� Building Commissioner - 200 Main Street,Hyannis,MA 02601 www.town.barnstable.raa.us Office: 508-8624038 Fax: 508-790-6236 NOTICE TO THE BUILDING DIVISION OF LICENSED CONSTRUCTION SUPERVISOR ASSUMPTION OF RESPONSIBILITY h lCw rn Ldml: iZ ws ,Construction Supervisor License #C5^ 01 Z6.53 ,hereby certify that I have assumed responsibility for the project under construction,as authorized by building permit# 1 Q Z3 y g ,issued to (property address) GS fN1C �eA t911VltS on — a 0 ,201!�. The following documents are attached: copy of my Massachusetts State Construction Supervisor's license or Homeowner's License Exemption form(if applicable) copy of my Home Improvement Contractor registration(if applicable) Commonwealth of Massachusetts Workers'Compensation Insurance Affidavit. Road Bond(if applicable) L10ENSE#0EDLFR DATE t ' 1 q/fonns/newcontrb rev:08/23/17 1 pFTHE rqk, Town of Barnstable o„ Building Department Services • B Rr,srnsrE, • Brian Florence,CBO y rrasa g, s63y. �0 Building Commissioner SAT f �a 200 Main Street,Hyannis,MA 02601 www.town.barnstAk1ia:us Office: 508-862-4038 SEP 20 2018 Fax: 508-790-6230 tOWN 0i-BA'RNt-,TA 3LE NOTICE TO THE BUILDING DIVISION OF WITHDRAWAL OF LICENSED CONSTRUCTION SUPERVISOR FROM PROJECT Construction Supervisor License # (j'-��} � , hereby certify that I am no longer the Construction Supervisor listed on the application for the project under construction as authorized by building permit # -.23 Q q, issued to (property address) LA K)� Gta-' Pr 14 Q on 0 , 201�S. I also certify that on ' — , 2019 ,I notified the property owner,that the project under construction must cease until a successor licensed Construction Supervisor, is submitted on the records of the Building.Division. LIC 59L lf6LDER DATE q/forms/newcontr reference R-5 780 CMR rev:08/23/17 Town of Barnstable RE,CE�PT 200 Main Street, Hyannis MA 02601 508-862-4038 4603 Application for Building Permit Application No: B-18-2348 Date Recieved: 7/20/2018 Job Location: 68 MCGEE DRIVE,HYANNIS Permit For: Building-Addition/Alteration-Commercial Contractor's Name: State Lic. No: Address: Applicant Phone: (508) 888-3838 (Home)Owner's Name: SOARES,LEIGH A& GILMORE,SCOTT Phone: (508)827-7073 B (Home)Owner's Address: 68 MCGEE DRIVE, HYANNIS,MA 02601 Work Description: CONSTRUCT A GARAGE ON THE RIGHT SIDE OF THE HOUSE WITH DORMERED ROOM ABOVE. Contractor removed himself from permit 9/20/2018 LP Total Value Of Work To Be Performed: $125 000.00 Structure Size: 0.00 0.00 9000.00 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 the Workers' 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: Thomas Cox 7/20/2018 (508)888-3838 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $125,000.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $737.50 7/27/2018 $637.50 1 Paypal Paypal Total Permit Fee Paid: $737.50 7/27�Zo18. $100.0o Paypal Paypal r VIE Town of Barnstable Building z a Pos ':This,Card So That�t is 1/is�ble:From.the Street ;A roved Plans Must be:=Retaned,on.Job and•#his Card Must:be Kea t ,*. '` '. .�. `.�, :,:•,:"a<� 9 �, pp� �� ,y� , i P M Po1039. Permit sted.`<Until"Final Inspection Has�Been Made ; s • Where aCectificate�of Occw anc, wis Re ulred,such Buildm shall Not,be Occupiedu°ntil a Final Inspection has been made•, Permit NO. B-18-2348 Applicant Name: Thomas Cox Approvals Date Issued: 08/20/2018 Current Use: Structure Permit Type: Building-Addition/Alteration-Commercial Expiration Date: 02/20/2019 Foundation: Location: 68 MCGEE DRIVE, HYANNIS Map/Lot 271-006 005 Zoning District: RC-1 Sheathing: Owner on Record: SOARES, LEIGH A&GILMORE,SCOTT B � �Contrgctpr Name ; . Framing: 1 "RN �' Address: 68 MCGEE DRIVE u� Contractor;License 2 'm Est Pro ect Cost: $ 125,000.00 HYANNIS, MA 02601 Chimney: i' £ Permit Fee: $737.50 Description:_ CONSTRUCT A GARAGE ON THE RIGHT SIDE QF THEHOUSE WITH t DORMERED ROOM ABOVE. Insulation: f _ Fee Pald $737.50 Project Review Req: AS BUILT REQUIRED Date 8/20/2018 Final: F Plumbing/Gas Rough Plumbing: t r� Building Official �� _ �� Final Plumbing: Rough Gas: This permit shall be deemed abandoned and invalid unless the work authorized by tth s permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved applicatn an the approved construction documentsfwhich th dis permit has been granted. Final Gas: All construction,alterations and changes of use of any building and structures�s�hall be in compliance with the local zon g bylaws-,and codes. This permit shall be displayed in a location clearly visible from access st rir reet ooadand shall be maintained openforpubl�4c inspection for the entire duration of the work until the completion of the same. " Electrical y Service: The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. E• < � Minimum of Five Call Inspections Required for All Construction Rough: 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. Final: Work shall not proceed until the Inspector has approved the various stages of construction. "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Final: Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT s. Town of Barnstable RECEIPT ` MASS 200 Main Street, Hyannis MA 02601 508-862-4038 Application for Building Permit Application No: T9-18-2348 Date Recieved: 7/20/2018 Job Location: 68 MCGEE DRIVE,HYANNIS Permit For: Building-Addition/Alteration-Commercial Contractor's Name: State Lic. No: Address: Applicant Phone: (508) 888-3838 (Home)Owner's Name: SOARES,LEIGH A& GILMORE,SCOTT Phone: (508)827-7073 B (Home)Owner's Address: 68 MCGEE DRIVE, HYANNIS,MA 02601 Work Description: CONSTRUCT A GARAGE ON THE RIGHT SIDE OF THE HOUSE WITH DORMERED ROOM ABOVE. Total Value Of Work To Be Performed: $125,000.00 Structure Size: 0.00 0.00 4500.00 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 the Workers' Compensation Act(Chapter 568). I understand that pursuant to 3.1-275 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: Thomas Cox 7/20/2018 (508)888-3838 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $125,000.00 Date Paid Amount Paid Check#or CC# i Pay Type Total Permit Fee: $737.50 7/27/2018 $637.50 Paypal Paypal i- ...._.,-.. ..._ ......_ Total Permit Fee Paid: $737.50 1 7/27/2018 $100.00 Paypal Paypal I f Generated by REScheck-Web Software Compliance Certificate Project GILMORE RESIDENCE Energy Code: 2015 IECC Location: Hyannis, Massachusetts Construction Type: Single-famiLy Project Type: Addition Climate Zone: 5 (6137 HDD) Permit Date: Permit Number: Construction Site: Owner/Agent: Designer/Contractor: 68 MCGEE DRIVE HYANNIS, MA 02601 • G33 'm •'' Compliance: 41.9%Better Than Code Maximum ILIA: 43 Your UA: 25 The%Better or Worse Than Code Index reflects how close to compliance the house is based on code trade-off rules. It DOES NOT provide an estimate of energy use or cost relative to a minimum-code home. Envelope Assemblies .0eiRf*g:-flat.'Ce'itir4`o*SCis50r•'I.ra ss• 28& 3&-0. 3&-0. 4 Wall:Wood Frame, 16"o.c. 384 21.0 21.0 0.025 8 Window:Vinyl Frame 50 0.250 13 Compliance Statement: The proposed building design described here is consistent with the building plans,specifications,and other calculations submitted with the permit application.The proposed building has been designed to meet the 2015 IECC requirements in •RES.heckVersion.;.,K$c-heck IAI�k�:�1►tl.to.4 rrrpj..yAoith:thg-mj3netAk4lY RESIzhec-k-FnspectioP:-be-klj x.. Name-Title Signature Date Project Title: GILMORE RESIDENCE Report date: 08/17/18 Data filename: Pagel of 1 --------------- --------------------------------------------------------- - D o D e D 'D D ww A .a Y � . 1 C m Q. X D D W Cp m ��y D V °° A O DD r •v o v' - a a a •------- a --'---•-------------�-----_--• ' WO O_____________________ _ S2 z s m xj z s -I m D D t c m C) �o= eA.rn m m 0 —4 -(Am u> 'u —1 p it. ? m = z �n O ; z —1 z C -- O O D ZXim j -1 m m 0 o ------------------ t v 23'-2° m m .� z m 0 Sa PL*N GILMORE RESIDENCE 68 MCGEE DRIVE ARCHITECTURAL DESIGN SOFTWARE PROPOSED WYANNIS, MA. 02601 COX CONSTRUCTION COMPANY FOUNDATION ro WINNIES WAY PLAN DRAWN BY:TpC PAGE: EAST SANDWICH, MA.V 02531 / 508-888-3838 SCALE: DATE: 01/14/2015 II 11 II II Z Z II !li nt II � 11 � II it 3 A� X\ O O Z\ Z O O\ n N m\ m �\ 10 II 1� .I N � o rD 3 r ----------------- u o � z - - - -----------: m - R.O.7-C."x 4'01,n D 24'-0" D F w �JVI 1 ■ ILI� CsILMORE RESIDENCE ARCHITECTURAL DESIGN SOFTNARE PROPOSED 68 MCGEE DRIVE FIRST WYANNIS, MA. 02601 COX CONSTRUCTION COMPANY FLOOR ro WINNIES WAY DRAWN BY:TPC PAGE: EAST SANDWICW,MA.V 02531 PLAN / SCALE: 508-888-3838 DATE: 0l/14/2018 R.O.5'-614"x 4'-516" \ W .. 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GLMORE RESIDENCE MCGEE DRIVE eASJURA E_w«FMmE CROSS . ANN Is MA. o roa COX CONSTRUCTION COMPANY SECTION (o WINNIES WAY DRAWN BY:Tpc PAGE: EAST SANDWICH, MA.v 02531 SCALE: , oT: oZ4� <o» The Law Office of DAVID V. LAWLER, PC 540 Main Street, Suite 8 Hyannis, MA 02601 Telephone: (508) 778-0303 Facsimile: (508) 778-4600 962 Main Street Email Address: Osterville, MA 02655 david@dlawlerlaw.com Tel:(508)428- 0542 August 1, 2018 Building Department 200 Main Street, Hyannis, MA 02601 Re: Variance No, 2018-034- Soares/Gilmore Dear Sir/Madam: Enclosed please find a recorded copy of the Variance for the property at 68 McGee Drive, Hyannis, MA. �o Thank you. Very truly yours, Ct'f f W w3 Cat Sue King, Paralegal SDK/s enc. Bk 3143:5 P bB 437008 • 07-30-2015 a 03 = 18P Town of Barnstable Zoning Board of Appeals Decision and Notice r i Variance No. 2018-034—Soares/Gllmore Section 240-14(E)—RC-1 District Bulk& Dimensional Regulations To allow the construction of an addition within a required front yard setback on a corner lot Summary: Granted with Conditions Petitioners: Leigh Scares and Scott Gilmore Property Address: 68 McGee Drive, Hyannis, MA _, - Assessor's Map/Parcel: 271/006-005 Zoning District: Residence C-1 Zoning District Hearing Date: June 13,2018 Recording Information: Deed: Book 24189 Page:219 Background Leigh Scares and Scott Gilmore petitioned for a Variance pursuant to Section 240-14.E. - RC-1 and RI= Residential Districts Bulk Regulations. The Petitioners propose to construct a 12 x 24.3 foot addition that would encroach into the required thirty (30) foot front yard setback by 8 feet 3 inches. The subject property is located at 68 McGee Drive, Hyannis, MA as shown on Assessors Map 271 Parcel 006-005. It is located in the Residence C-1 (RC-1)Zoning District. The subject property is a .34 acre, rectangular shaped, comer lot with frontage on Straightway North and McGee Drive. It is located in the single-family residential area north of Falmouth Road (Route 28). The property is improved with a 2,444 gross square foot (1,267 square foot living area), three-bedroom, single-family dwelling, constructed in 1989. It is a one- and a half story Cape Cod Style dwelling with a full dormer on the rear and a rear deck. It is accessed from McGee Drive. Straightway North is unimproved at this location. Proposal & Hearing Summary Variance No. 2018-034 to allow the construction of an addition at 68 McGee Drive, Hyannis, MA, was filed at the Town Clerks office and the office of the Zoning Board of Appeals on May 18, 2018. A Public Hearing before the Zoning Board of Appeals was duly advertised and notice sent to all abutters and interested parties in accordance with M.G.L. Chapter 40A. The hearing was opened on June 13, 2018 at which time the Board found to grant the variance subject to conditions. Board members deciding this appeal were: Alex Rodolakis, Paul Pinard, Herbert Bodensiek, Jacob Dewey, and Kyle Evancoe. The hearing was opened on June 13, 2018 with Attorney David Lawler representing the Petitioners. Also present were the Petitioners Leigh Soares and Scott Gilmore. Attorney Lawler stated that the Petitioners own a comer lot with two front yard setback requirements and one of the roads, Straightway North, is an unimproved road and essentially ends at their property. He noted the dwelling is connected to sewer and the addition is modest but needed for their growing family. He argued that it would be an economic hardship if the Board should deny this petition and cause the Petitioners to seek a larger home in the area. Attorney Lawler also argued this lot is unique in its location with two front yard setbacks. Attorney Lawler submitted a letter of support from James Walker who resides at 96 Straightway North. The Board Chair requested public comment and David and Tiana Wiseman of 29 McGee Drive spoke in support of the Petition. I Bk 31435 Pg69 #37008 Town o£Bamstable Planning and Development Department Decision Appeal 2018:034—Soares/Gilmore I Findings of Fact At the hearing on June 13, 2018, the Board voted and made the following findings of fact in Variance No. 2018-034, a request for the construction of an addition located within the front yard setback at 68 McGee Dive, Hyannis where a 30 foot front yard setback is required: 1. Owing to circumstances related to soil conditions, shape, or topography of such land or structures and especially affecting such land or structures but not affecting generally the zoning district in which it is located. The Board found that the corner lot presents a unique hardship when trying to construct an addition; 2. A literal enforcement of the provisions of the zoning ordinance would involve substantial hardship, financial or otherwise to the petitioner. The Board found there would be a financial hardship seeking a larger home in the area. s. Desirable relief may be granted without substantial detriment to the public good and without nullifying or substantially derogating from the intent or purpose of the zoning ordinance. The Board found there would be no substantial detriment to the public good or to the neighborhood with the grant of this Variance. The vote to accept the findings was: AYE: Alex Rodolakis, Paul Pinard, Herbert Bodensiek,Jacob Dewey, and Kyle Evancoe NAY-. None Decision 1. Variance No. 2018-034 is granted to Leigh Soares and Scott Gilmore to allow the construction of an addition to the single-family dwelling at 68 McGee Drive, Hyannis MA. 2. The addition on the east side of the dwelling shall not exceed a footprint of 12 feet by 24 feet 3 inches, shall be two-story, and shall not be located closer than 23 feet 9 inches to Straightway North. 3. The site development shall be constructed in substantial conformance with the plan entitled "Site Plan (for Addition) located at 68 McGee Drive, Hyannis MA" prepared for Scott B. Gilmore & Leigh A. Soares dated April 25, 2018 drawn and stamped by MacDougall Surveying & Associates. 4. The above-described addition shall represent full build-out of the lot. No further additions shall be permitted without approval from the Board. 5. This decision shall be recorded at the Barnstable County Registry of Deeds and copies of the recorded decision shall be submitted to the Zoning Board of Appeals Office and the.Building Division prior to issuance of a building permit. The rights authorized by this variance must be exercised within one year, unless extended. AYE:Alex Rodolakis, Paul Pinard, Herbert Bodensiek,Jacob Dewey, and Kyle Evancoe NAY: None Ordered Variance No. 2018-034 to construct a 12 x 24.3 foot addition that would encroach into the required thirty (30) foot front yard setback at 68 McGee Drive, Hyannis, MA has been granted with conditions. This decision must be recorded at the Barnstable Registry of Deeds for it to be in effect and notice of that recording submitted to the Zoning Board of Appeals Office. The relief authorized by this decision must be exercised within one year unless extended. Appeals of this decision, if any, shall be made pursuant to MGL Chapter 40A, Section 17, within twenty days after the date of the filing of this decision, a copy of which must be filed in the office of the Barnstable Town Clerk. 2 Bk 31435 Pg70 #37008 Town of Barnstable Planning and Development Department Decision Appeal 2018-034—Soares/Gilmore AI Rodolakis—lie Chair Date Signed I, Ann Quirk, Clerk of the Town of Barnstable, Barnstable County, Massachusetts, hereby certify that twenty (20) days have elapsed since the Zoning Board of Appeals filed this decision and that no appeal of the decision has been filed in the office of the Town Clerk. Signed and sealed this 13 day of -'U -( Z 01 8 under the pains and penalties of perjury. Age Ann Quirk, Town Clerk �4 '"t 3 Bk. 31435 Pg71 #37008 Town of Barnstable` 8 Assessing Division 1� 367 Main Street,Hyannis MA 02601 www.townoibarnstable.us Once: 508-8624022 Edward F O'Neil,MAA FAX: 508-8624722 Director of Assessing ABUTTERS LIST CERTIFICATION DATE: May 25, 2018 RE: Adjacent Abutters List For Parcel(s) : 271-006-005 68 McGee Drive Hyannis, Ma 02601 , As requested, I hereby certify the names and addresses as submitted on the attached sheet(s) as required under Chapter 40A, Section 11 of the Massachusetts General Laws for the above referenced parcels as they appear on the most recent tax list with mailing addresses supplied. ,L✓�-ate. .i. /�a�� Board of Assessors 2 Town of Barnstable 15. 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J r !sr � a••<r ,F r Ir.r rr.0- ri 271024 V 1 3 Y� 1 ! r. r.,tr•..> 1.rrr f '271.• •1' r + r i'r r •%� n%` 271012 r 'V r "f' .•r.•#7 •r, r f r r.• Aw 0399 fir•fr f'r r l• •-r r t 1f% a r- i 271004004 7 2 1011 i2 N 271004 t 8 •• 0080 27 1 8 '`: 71#2 �. 2 #387 0040 6 .�`- 023•:•r-271 271 DISCLAIMERS:Thts map is for planning purposes only. it is not adequate for legal Map:271 .Parcel:006005 Zoning Board of Appeals(ZBA) Selected Parcel a boundary determination or regulatory Interpretation. Enlargements beyond a scale of Abutter List Type-Parties of interest are those directly opposite subject lot on w� >r 1'=1oD'may not meet established map acGaacy standards.The parcel lines on this map an public or vote street or way and abutters to abutters. Notiflcatlon of all Abutters :•:j'� ..F OD are only graphic representetlons of Assessor's tax parcels.They are not true property Y P Pn S@ boundaries and do not represent accurate relationships to physical features on the map properties within 300 feet ring of the subject lot. Buffer such as building locatbns. - _ r 5/2412 0 1 8 AbutterReport gk. 31435 Pg73 #37008 Zoning Board of Appeals (ZBA) Abutter List for `h,ap & Parcel(s): '271006005' Parties of interest are those directly opposite subject lot on any public or private street or way and abutters to abutters.Notification of all properties within 300 feet ring of the subject lot. Total Count: 2.4 A Close mailing Map&Parcel Ownerl Or city vner2 Addressl Address 2 o Country Deed ityStsteZip 271001 VENTAS WHITEHALL C/O ALTUS GROUP US 21001 N TATUM BLVD STE 1630-630 PHOENIX,AZ 19738/220 ESTATES LLC INC#2806 85050 271004005 AKKAWI,SALEH 8 PLUM HOLLOW EAST FALMOUTH, 27135/158 ROAD MA 02536 POLLOCK,JESSICA M, HYANNIS,MA 271004006 GALLAGHER,MIRIAM GALLAGHER,JOHN A 4 GUY LANE 02601 28367/238 J& 271006001 TEODORO,VILSON A 51 STRAIGHTWAY N HYANNIS,MA 24566/106 02601 271006002 ERVING,JEFFREY& 65 MCGEE DRIVE HYANNIS,MA 10276/337 CAROLINE 02601 271006003 BALDNER,RICHARD F S5 MCGEE DRIVE HYANNIS,MA 23381/307 02601 271006004 MONAHAN,GREGORY ELIZABETH B 41 MCGEE DRIVE HYANNIS,MA 28933/171 8&ILLONA D&1MRE, 02601 271006005 SOARES,LEIGH A& 68 MCGEE DRIVE HYANNIS,MA 24189/219 GILMORE,SCOTT B 02601 271006006 CHADWICK,BRANDON 58 MCGEE DRIVE HYANNIS,MA 28073/340 P 02601 LIVINGSTON,GARY M 44 MCGEE DRIVE HYANNIS,MA 25115/39 271006007 &BARBARA C 02601 273007 MORIN,PHILIAS T 80 STRAIGHTWAY HYANNIS,MA 14721/230 NORTH 02601 271008002 WALKER,JAMES A& 40 STRAIGHTWAY 725 FALMOUTH ROAD HYANNIS,MA 29347/3 LYNNETTE L TRS NORTH TRUST 02601 LONGO,WILLIAM& 391 OAKLAND ROAD HYANNIS,MA 22673/139 271013 DEANNA 02601 271014 MCMAHON,ELAINE F ELAINE J MCMAHON 423 OAKLAND ROAD HYANNIS,MA 29180/252 TR FAMILY TRUST 02601 271169 WALKER,LYNNETTE STRAIGHTWAY NORTH 60 STRAIGHTWAY HYANNIS,MA 23014/77 LOUISETR REV TRUST (NORTH) 02601 271232 WISEMAN,DAVID J& 29 MCGEE DRIVE HYANNIS,MA 30454/242 TIANA L MACKENZIE, %FERNANDEZ,CARLOS HYANNIS,MA 272005001 JENNIFER M&PLEAU, H&ALVARADO, 33 ALICIA ROAD 02601 25945/144 JASON MARIANA LRAY 272005002 ASHMAN,KENNETH G 2250 SW 35TH AVE FL 3344 BEACH, 14753/34 FL 3445-6663 272005003 SALIT,PAUL W 40 KILKORE DRIVE HYANNIS,MA 9291/28 02601 272005004 WESSON,WALTON A 1214 FIFTH AVE APT NEW YORK,NY 12378/294 &ROSEMARY HENRY 49B 10029 272010001 WALKER,JAMES A TR JAMES A WALKER 2009 726 FALMOUTH ROAD HYANNIS,MA 24459/101 TRUST 02601 272011 MCMURRAY,JARED& 6 WINGS LANE COTUIT,MA 02635 26513/151 HALEY 272099 ALEXANDER,GLORIA 449 OAKLAND RD HYANNIS,MA 2327/299 02601 272201 L08UE,CHARLES V ET COBBLESTONE LANDING 50 CENTERBOARD HYANNIS,MA 29962/15 ALTRS IITRUST LANE 02601 This list by itself does NOT constitute a certified fist of abutters and Is provided only as an aid to the determination of abutters.If a certified list of abutters is required,contact the Assessing Division to have this list certified.The owner and address data on this list is from the Town of Barnstable Assessors database as of 512412018. htip://maps.townofbamstable.us/arcims/appgeoapp/AbutterReport.aspx?type=ZBA 1l2 CD JR :;,`• s>.;.:.��� �� Vie;. �+ "�.� �..:.i$3.u' p��••:gam �m �.o;C � .N�`: • i� :P���go'i 'rd .�p. i!.i:"�'�v� '',"'_.f�� a'.Lf :v`w'' �� w Ul • w r � OD I Bk 31435 Pg75 #37008 I Proof of Publication Publication Date Townureams k • 2oNng Board a[+Dpeals. :, :-� • �• Notxe of PutiTrc lieartnos un0er 0 Zordng 911rce r • To aU:persbiis.imerested Hior e11Bc180 Dy:thB;'acdonsafthe ZoNag ' Board.of:App€als:'you`are herepy"aoti(fed;pdrsiwri[:to.Secaon l]pf ChaDtef 4 ',p1;tAe.6enerol:laYrS'of.the"CnmliioriweaBk.oi Massri:. chusells and a8.eir etidmeola;Zl;that's'ab hearing on the tolbcMngg appeals:wiq aeid.on`WeAnesday;.JuYje 13,:2018:at'the r fimeindirated:. >:; :. ;,.; 7M.PNI $tepfreri.Cote as Appellant,. eppeataig,ttie issuance of a Building Parmit foj 1he,reconslrucbun Dl..an a�eessnry'sVucture not in cam pl6iriee whli Me'parent lrgt Ordeferrce-Chapter 240 g94 A'. CAaoraldo,rrtihq:UseMarirs siD Md51 a74 PBaarcey SlNhoone. .tt is lonited;ir Me Aesldegge B{RB)Zordnp District:;..= .•. 7:01 PBp�`Appeal,No.201S-034•; ':C` '�.SoareslGilm�e. . + Leigh Scares.and Scori Gilmore Mara petdioned.(oCaVarierrce par- suard.to Sectloo 240.14.E:-Rlrl,and.AF Aeside&,DLwicts Bulk Regulallans. The➢eotionersareproposlnoln,oei)strdcta.12z.24.3 foot addtion that woulA eiicroaeA;in(o.the re4ulied'MIr1y(30)tool Iron8:McI selbaek by 11 feet 3:ioches Tbe•sLbject property k located , at 68'Mc6ee Orve;.Hyannis,A1Aas•atiown:oo Assessors Map 271 Parcd:006-005; flis.focaledlrilhe:ReaiOenee.C=1(RC-1)'2aning OIsMd' These puDBc hearings wig beheld at the Babble Town Hall 367 Main Street Hyanrris M0.Hear ng Room k>rai�.on the 2nd r . 5 Wednesday,June 13,2018 Plans and'appGcations may bereviewed at Me Zamn0 Board of Appeals Office,Plann'mg and Development Department,Town Offkes,ft Main Street,Hyanna,MA. ` BannaL a Patriot Ales Rodolalti.Chair May 25,2018 and June 1,2018 Zoning Beard of Aooeals BARNSTABLE REGISTRY OF DEDS John F. Meade, Register 'THE TOWN OF BARNSTABLE Permit No.32f�4....... g i< BUILDING DEPARTMENT { ""'� I TOWN OFFICE BUILDING Cash 7 .Yl /J 6im ''tour HYANNIS,MASS.02601 Bond ...�. CERTIFICATE OF USE AND OCCUPANCY Issued to Greenbrier Corp. Address Lot #14, 68 McGee Drive Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND.IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. .......May....'..........., 19.........8 9.:.. .. . ...... `0✓.. '�� Buil�ing I Spector 1 i 4 TOWN OF BARNSTABLE BUILDING DEPARTMENT _ Isar°T TOWN OFFICE BUILDING � rua i6J9. � HYANNIS, MASS. 02601 �OIUY M. MEMO TO: Town Clerk FROM: Building Department DATE: An Oc upancy Permit' hasp been 'issued,, for the building authorized by BuildingPermit .'3p...2..... ....................................................................................._.......... ...... ............................_..... issued to P ',vJ -ii'.... . " .....r- ' ./ ..... ....��'.!...:.. .. '.....<.::..„/ Please release the performance bond. it TCPWN OF BARNSTABLE, MASSACHUSETTS � BUILDING:':' P R.Ml ,; < A-171-006-005 .r ,!! DATE r'ebruary U , 19 89 ��� .PERMIT NO. r APPLICANT Grc:er,bricr forP AD ' Centerville #0013. DRESS �. U. HU.{ rJ 1 O IN0.1 (STREET) (CONTR'S LICENSE) PERMIT TO _ b 17 l!.i (,.)fin]'=� I l Yl(� ( ) STORY SZ.I�,C��^_ �' T`14J1 J ( NUMBER OF y�.,__.. .v 0WF1,LING 61NIT5(irr[ or Irwrn uvtn•t N.II Nu, r (PROPOSED USE) --- �_ AT (LOCATION) LUG i=14 F8 11`1C"Gee Drive . I'Ta'i.i 1.n is ZONING IN0.) (STREET) DISTRICT BETWEEN AND (CROSS STREET) (CROSS STREET) t SUBDIVISION LOT LOT BLOCK SIZE BUILDING IS TO BE FT, WIDE BY FT. LONG BY FT, IN HEIGHT AND SHALL CONFORM IN CONSTRUCTI TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION �. 4; REMARKS: Sewage 943085 (TYPE) I I:. AREA OR - - Bond VOLUME _. 76il rat "i��' ESTIMATED COST $ 45, 000 0 ) FEEMIT _ 61. CO (CUBIC/SQUARE FEET) J OWNER Greenbrier Corp. � (-� 7 DEPT.'ADDRESS Y. U. i'�O`i 510 , CL;it,c� 'l,L�.ic; BUILDING . BY `WR•t�i0E-Y'>i'E"tt'�"T�7xTYYi01 t'-i U B D I '1I SN RESTRICTIONS. wU`frR s. '"t'ssY7'1�'G`r`�-"OF""7Ff1-s''7�Eu1:xYT`rPC7E'sir'G`'r'R'�"�"E7c5"t""`"rTT�-J'SC`F'� tC'A N'Y•-1="Tr(`tlTJI"rt�"E'T'rO KrtSi'r`rfi� OF ANY APPLICABLE SUBDIVISION MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ELECTRICAL, PLUh1BING AND 1. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MEMBERS(READY TO LATH). 3. FINAL INSPECTION BEFORE FINAL INSPECTION HAS BEEN MADE. OCCUPANCY. POST THIS BARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS I 1 2 -----— ----- 2 - 'hi ct 3 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT OTHER - BOARD OF HEALTH WORK SHALL NOT PROCEED UNTII. IHE INSPEC PERMIT 'v!LL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN TOR HAS APPROVED THE VARIODUS STAGES OF + WORK 15 NOT STARTED WITHIN SIX MONTHS OF DATE THE CONSTRUCTION. lJ PERMIT iS ISSUED AS NOTED ABOVE, ARRANGED FOR BY TELEPHONE OR WRITT 'NOTIFICATION. N rot s3 �► E LOT 14 15,000 S.F.f 15 EL.=62.5 O 28.2' 32'3 33.T Q LJ W LO 58.72' MCGEE DRIVE (50' WIDE) 1 1 27 INITIAL ISSUE CF NO. DATE DESCRIPTION BY AS—BUILT FOUNDATION PLAN—LOT 14 WHITEHALL ESTATES PHASE 2 BARNSTABLE MASSACHUSETTS /p`�1A OF^'gs GREENBRIER CORPORATION 1" = ' I CERTIFY THAT THE FOUNDATION r� PAUL a. yN SCALE 40 ,IOB NO_ 1398 SHOWN ON THIS PLAN IS LOCATED LEVY ! 0 4-0 80 ON THE GROU - INDICA D " No. 1G517 y Ii V^ Z' IM, KDROn k TAGM ASSQ TES INC. OE R E G I T R E D LAND SURVEYOR —� 869 ,IZsr rtuar sTttgs t cIrrrtav>1aa >Iu 02632 Assessors office ' THE Ust floor): fifi �7 // Awssor�s,map and lot number Board -of Health (3rd floor): o Sewage Permit number g .............................................. Z B6HII9TGDLE, Engineering Department (3rd floor): ` k- moo 2639- \0�� House number ........:...:.........:. .(J. . . .......................... a Mai a' Definitive Plan Approved by Planning Board __________L ----------19 APPLICATIONS PROCESSED 8:30-9:30 N.M. and 1:00-2:00.P.M.'only I N .. _ TOWN -OF - BtARNSTABLE r BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...eUN;SrkUCT.......... �� ................................................................... TYPE OF CONSTRUCTION �1 (.�JOd� lZ' �n/G-C t� f(lM3c cf.......... �. ...... .. ...................... ........... / .' w r� a� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit accordi to the following i formation: A Location .a f �/ ...� ............................... / ' c..G. .. ............. /!. ............................... Proposed Use „.„ Zoning District ............................................................'..............Fire District. •.......................... • �� E_E v(3ZJ � . /dName of Owner ... c..... ........ .....6!V!......,...... .... .....�:Q Q. J erc Fir v ..................ll�.. ......... Name of Builder p S✓�`4 :'...Address ............ -� Name'of Archifect ........ ..............::..........Address ........ ..............:............: Number of Rooms .:....Foundationk !r.SLY.......... :�.!�C -....:................ CCAS 5 119N(1 e �A� ior Exle ..........................................Roofng ../. ............ ... . ... .............................................................: ` e 4C Floors D .Interior ...... hr • � GAs - Heating ........�W.A.........1 . ......................................'......Plumbing ................g/.. � .J ................................................ . Fireplace ............,.N....................................................:.... :...Approximate Cost .................E."° .......... Area 7�.. .. ... Dia ram of Lot and Buildiri with Dimensions 0e g 9 Fee ........(.0/1 r � �.....ti............V, 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 A00.5. 7...................... ` GREENBRIER CORP. ry 4 No 3262.4Permit_for ......1.2....Story......... m I Single Family Dwelling ... .� ..................... ...................... ...... ... j Location • Lot #14 , 68 McGee "Drive . annis . ................. ' Owner Greenbrier Corp. �,. ..Greenbrier{... ......... -.......... Frame _ r-• �y .!'' _ ' Type of Construction .......................................... f, r Plot................... . . _ Lot . ........ ........ _ r February 6; 89 a Permit Granted ... .......19 Date of Inspection ..... .. ................ .... .19� • �. ` Date C mp eted ... �1,1.i�''�. .. .".......:19� • : .. ,� , \ + p` a" .a �� -. i..n`SS-aa'7 �V.`1✓---. : ��1}'�A:R'i*-Yie� 'y � � +Kfi� - kY�S'ViWiT+y����i� l.iL�'�K�.}�e�F��i`✓.},`�}T� .r. /y.-« �'V•'�Z �.��r-t•1F.%'r. "� W"x '^K.� S+;iy-."" -.y:.` Vl/\ it/(^.1/Y1.M.i /n`N/� � �I 1/V//_✓�,✓/_��p ?. Assessor's office-.(1st floor): a Asyessor's„map and lot number ... .�7-. .���.......va FTHE Board of Health (3rd floor): -57 .. Sewage Permit number :.......: Engineering Department (3rd floor)._P:��� L-- °o "6 9- House number 3 `e........................................... craya Definitive Plan Approved by Planning Board _____________________________19_______ . 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 ....��.T...N..f�'U C If.......................... .. ............. . TYPE OF CONSTRUCTION ..... . ............ . ...............................i .......... ........................................... ................ ...............19. F TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit accordin' to the following information: Location �f l.X/ c G tF L r'.�........................................................................................ .................................................. .................................. I x,f Proposed Use .......... ..................... . ............. /............ ........................................................................................................... ZoningDistrict .........................................................................Fire District .............................................................................. ,!Z EE�v(jiL3ch.......1..02� a. ��o- 5 Q ( �r(�Cr Name of Owner .................Address ................... O..........�...�......�..................................... Name of Builder .......�,.' ............................................Address ............S-�..fl: ......................................................... Nameof Architect ......... ......................................................Address .......................................................... Number of Rooms ..................................................................Foundation ?byKf .........C.b kC re--t PL Exlei for ......e.� AP51 ..5.N-T v6 C C' C F 0Al� " � 14.. ...................................................Roofing ................................................................................ 1-1 Floors .......................................Interior .......................................................... r Heating .......A.........��.......... .5..........................Plumbing .................�.�...1.........r ..................I.................... Fireplace ..............N4............................................................Approximate Cost .... .4..S. -U ............................................... Area .......................................... Diagram of Lot and Building with Dimensions Fee A (y C)N /\j C- 0 P6-rA 1 K OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS. _ t I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .....I............ Construction Supervisor's License .bG�.j4.7 GREENBRIER CORP. A=271-006-005 No .�2.62.4... Permit for .l2...Story.............. Single Family Dwelling ........................................................... Location Lot #14, 68 McGee Drive . ................................................................ Hyannis ............................................................................... Owner Gr.eenbrier. . . . . ...Corp. . ............................ .... .. .... .. . .. .. .. .... Type of Construction .......Frame ........................... .................................................................I............. Plot ............................ Lot ................................ Permit Granted .,, February 6, 89 E .........................19 Date of Inspection ....................................19 Date Completed ...................:..................19 r tt1E Tp Town �of Barnstableuildin .: :: 4- r v d P.l a Retained.,dn:7obsnd s ,Y rsnkusraeiE ;, •. .Post_T,his:Card So.Tlaat it.is,Visible FromAhe Street Ap.p o e ,. ans Must b p w' MAC. Posted Until Final'lnsP ection:HasiBeen Made.. .. �$� 1N.here;a Certificate of-Occupancy:is;:Req:uired�such B.ulldrng shalh:Not be Occupied`unt�l a=Final InspectCon;ha5 been made. - ,.. Permit NO. B-17-3476 Applicant Name Elwell Perry Approvals" _... .. Date Issued: 10/17/2017 Current Use: Structure Permit Type: Building'—Insulation-Residential Expiration Date: 04/17/2018. Foundation::- Location: 68 MCGEE DRIVE,.HYANNIS Map/Lot: 271-006-005 Zoning District: RC-1 Sheathing: Owner on Record: SOARES, LEIGH A&GILMORE,SCOTT B Contractor Name: Elwell H Perry,Jr. Framing: 1 Address: 68 MCGEE DRIVE Contractor License: CS-104088 2 HYANNIS, MA 02601 Est. Project Cost: $2,847.00 Chimney: Description: 9 hrs Air Sealing. Install 10" Cellulose to 512'open attic. Reposition Permit Fee: $85.00 400'of existing insulation. Insulate back of attic hatch w/2" poly ins Insulation: Fee Paid: $85.00 board. Install 2" poly ins board to 128'kneewall. Install 9" of R-30 Final: fiberglass to 128' kneewall floor. Insulate back of attic hatch w/2" Date: 10/17/201.7 poly ins board. Install exhaust hose w/roof mounted flapper. Install 72 prop-r-vents. ,, ;, Plumbing/Gas Rough Plumbing: Project Review Req: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents for which 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 zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: Rough: 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. Final Work shall not proceed until the Inspector"has approved the various stages of construction --" : Fire De'art'ment' Perso•ns,contractmgwith;unreglste.red..contr.actors,do.not have access to the guaranty fund (as set forth_In MGL c:142A). P ::. Building'plans are to be avail /t able on site _.. On .. irl� Final: - All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT" Town of Barnstable *Permit# ' oO CD Expires 6 months , is to X-PRESS PERMIT Regulatory Services Fee al-1; Thomas F.Geiler,Director AUG 2.2 2006 Building Division Tom Perry,CBO, Building Commissioner A TOWN OF BARNSTASLE 200 Main Street,Hyannis,MA 02601 JVC') D www.town.barnstable.ma.us I Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint lap/parcel Numbei '271M0.A)f,24r roperty Address �sidential Value of Work ' Minimum fee 25.00 for work under$6000.00 lwner's Name&Address rollf9St7 lo`b 1�cA�e_� L-�.wnn ig i�lof71 .ontractor's Name �1 WHE!SKI) Telephone Number come Improvement Contractor License#(if applicable) L3 orkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I the Homeowner [geflhave Worker's Compensation Insurance nsurance Company Name 1,6Z Lou Yorkman's Comp.Policy# �opy of Insurance Compliance Certificate must be on file. 'ermit Request(check box) t Re-roof(stripping old shingles) All construction debris will be taken to �Iry ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A opy, f the Home Improvement Contractors License is required. SIGNATURE: —i Q:Forms:expmtrg Revise061306 CERTIFICATE 11UNISER PRCCUC2R THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NIARSH USA,INC. NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THA•v THOSE PROVIDED IN THE ATTIV: BRENDA BOOKER (404)995-2594 POLICY.THIS CERTIFICATE DOES NOT AMEND, EXTEND CR ALTER THE COVERAG'< MAYA NICCLURE(404)995-3206 OR AFFORDED SY THE POLICIES DESCRIBED HEREIN- — TAIMI ROUSE(404)995.3430 FAX(404)750-5Gc3 I COMPANIES AFFORCING 1_-0'/E,9.�,GE 3d75 PIEDMONT ROAD, SUITE 12CO -- ! ATIANTA `�5 I CC:.IPA;IY -` 1 a s 1 C ;aC� GA 361 .... T-10; L I^,kIr ]��I�•^ II\ice '.j ..„t•.r- 1-i- - F7] I C:,,.I:..N-• `'= 1r;t,lV = It. -, ,. AI'�Ai`I I_A.GA , I ...L.._..:. p .__glyi(?.;Cl i•I i-Ir,f,:i''::\SS6'R.1NCt C1)P:'I''Ai`IY---------"- i c;v DES This cerli5.:ate sup-rsedes and replace:.any pre'A.USIy issued .:::Itiricate,c: the p,aicy period rn. ":r1 below. ." 3 .5 TO CERTIFY THAT 'CLICIES OF •NS URANCE DESi:RiSEO HEREIN.HAVE BEEN ISS:,EO TO THE INS a 0 NAME- HEREIN FOR THE KI.. •r PERICO INGICA:E: NC:',v.THSTANOING ANY AE..UIREMENT•TE.:M OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENTWITH RESPECT TC WHICH THE CERTIFICA-z-NIAY BE ISSUED OR MAY PEA'AIN•THE INSURANCE.AFFORDED BY THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALL THE TERMS.CCNOITIONS AND EXCLUSIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY EFFECTIVE POLICY EXPIRATION LIMITS CO co TYPE OF INSURANCE POLICY NUMBER DATE(MMIDD/YY) DATE(MM/DDIYY) LTR A GENERAL LIABILITY IPR 3757 608-01 03/01/06 03/01/07 GENERALAGGREGATE $ 4.000,000 i X COMMERCIAL GENERAL LIABILITY 'LIMITS OF POLICY ARE EXCESS' PRODUCTS-COMP/OP AGG $ 4,000,000 CLAIMS MADE F OCCUR 'OF SIR:$1,000,000 PER OCC' PERSONAL&ADV INJURY $ 4,000,000 RENCE $ 4,000,000 OWNER'S 6 CONTRACTOR'S PROT EACH OCCUR FIRE DAMAGE(Any aria fire) $ 1,000,000 MEO EXP(Any one person) $ EXCLUDED © AUTOMOBILE LIABILITY BAP 2938863-03 AOS 03/01/06 03/01/07 COMBINED SINGLE LIMIT $ 1,000,000 X ANY AUTO ALL OWNED AUTOS BODILY INJURY $ (Par person) SCHEDULED AUTOS . HIRED AUTOS BODILY INJURY $ (Per accident) NON-OWNED AUTOS XqELF-INSURED AUTO PROPERTY DAMAGE $ HYSICAL DAMAGE GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLAFORM AGGREGATE $ OTHER THAN UMBRELLA FORM $ OTK G WORKERS COMPENSATION AND 6610998(AZ,ID',MD,VA) 03/01/06 031OV07 X TogY LIMITS ER SIATU. ` � '' C EMPLOYERS'LIABILITY 6610995(AOS) 03/01/06 03/01/07 EL EACH ACCIDENT $ 1.000,000 -- G THE PROPRIETOR/ -X INCL 6;-11326(OR)^ 03/01/06 03/01/07 EL DISEASE-POLICY LIMIT_ $ 1.000.000 PARTNERS/EXFCUT1VE 6610999 NY,WI 03/01106 03/01/07 EL DISEASE-EACH EMPLUYEE $ 1,000,000 E OFFICERS ARE: EXCL ( ) --- — o HER WORKERS E COMPENSATION CONTINUED 6610997(FL) 03/01/06 0310V07 p 6610996(CA) 03/01/06 03/01/07 DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESISPECIALIIEMS - - CERTIFICATE HQCDER ` 'CANCELLATION 1 • r?•s... ,��- A.,'t a '_'.. SHOuLO ANY OF THE POLICIES OESCRIBEO HEREIN BE C.ANCCLLED BEFORE THE EXPIRATION DATE THEREOF, THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL_In DAYS WRITTEN NOTICE TO THE FOR INSURANCE PURPOSES ONLY CERTIFICATE HOLDER NAMED HEREIN,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY VJND UPON THE INSURER AFFORDING COVERAGE,ITS AGENTS OR REPRESENTATIVES,OR THE ISSUER OF THIS CERTIFICATE. MARSH USA INC. aY: WalterGitstrap U 1(3►p=) VALID Ag OF 0212 106 r i eF/ - ��ie o��� t�6ns an�tandar s Board of Butt t� g One Ashbuncin Place m Room I301 . Boston. Massachusetts 02108 Home Improvement Contractor Registration Registratiow.. 126893 Type: Private Corporation Expiration: 81312008 THE Home Depot At-Horne Services BOYD LIPHAM 3200 COBS GALLERIA PKWY #200 AtIANTA, GA 30339 Update Address and return card.!Sark reason for change. Address Renewal Employment lost Card OPS Grr r, 504 paor PCe490 - "z ;2N_ Board nl Building Regotaliaos aad Staodards Lirense or registration valid for iodividul use only KOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Board of Building Regulations and Standards u,p Registration: 126893 OneAshburloo Place Ran 1301 Expiration: 8131200E Boston.Ala.O2108 Type: Private Corporation THE Home®epot Ai-Home Services 3200 COBB GALLERIA PKWY 020 ty AliANTA.GA 30339 Deputy Adminklraior Not valid wtlhou tor¢ I F' I i Aug 22 06 08: 23a Michael Bedard 1 -401 -246-2868 p. 1 HOME tMpROVEMENT CONTRACT 9 Sold.Furaished end 1n31411c4 bY! Name31.5 0,0 Braoeh ✓ Date.. TIeD A Services.lee. d'bN Tier Home Depot en Aj lu-liame Srrriete One t atHp=J.)�_3768-_ aviile,NY 08691 Brandt Ntunber: k Job d: 3 rJ NJ L!c oToutaal Rc 1F 7)rFIJB 401Lici 19971123 09 /'', j „ E;a mra II)1115-1696e60 Installation Address: ` ' MC C�. D2,_,,i� 'a DS D-A.aO/ Cityr Stoto Zip rurmva s•r Latrd0 ism ao 0.Ire*° ad - Melrr. Wo esS�4 Z A� 9 ( ) �jt � ) Home Address: / '43 (if d)Kereae from tnzrallsoen S) City Stu zip E-mail Addroo(to rtceivc updales and promotions Qon,The Honio Depot): Prn et ac - VWarYbs r•'Pstrehaso"),the Owners of the prop"localtd ar the above itimilation adaress.Offer to contract Nn erne pepot U S.A..Inn. o 15nr6115h.deliver and arrange for the Iretallation of all matedats as described on etc yttacbed Spec She r 7 incorporated heroin try mftrmee and Made a part heteot Homo Depot reserves the right to cancel this contract If,upon relonpeetoo of tik:job,Home Depot dekrntlnet ebot It eannot perform Its ebiitiv&as due to a structural problem with the home,pridag errors or boeaute work regoired to complete the job was not laetudod In the Spte Shtcs or Contract. DEPOSIT PAYMENT OPTIONS ) (SwNea w Ron leffla fan antlerro.Croats eppaf.) ,l70- A d[J I. Chuck.CwhKn Check topUS Poets!Servlre Memy Order J, CONTRACT AMOUNT S •49 py (MadopayAleto Rio Rd-vBepat). •LE99DEPOSIT S p Y r Crealr Cdrd'.ndfa other P.rrem npuorr.[vela 0a.8eta. V:ha MaurCttd ta.cevcr wrneneanE+aratr BALANCE DVE �y� -t16 T},oRom,OOKNataelmpm-AmbnlLeen ThoAnavNp.1C*ditCwd ON COMPLETION S_ 0 Nra natant D e,aotlhta.►eenaa (NIL b HPCC QNt.Y1 •rdwaam2:9%o(ConeractAmount do*oven MaQtbleCradtel tri7L elocution o(thla contract. + ta35-�o0�G28 � � nata:-- _Eno Oats:-- were�itrppeuvtataod:.�JiLAlafleLl tndkete Payment Maebad For *By my/our siputtere below.IIWo agree a allow)tome Depm to BALANCE DIIE ON COMPLETION: emerge The above refuenced credii card tar the deposit indicated. bo3�-�'ZAo 3L - c& h.ta h Pearim Die, '�- I ®�,�j• NIL or KDCC Authorization Codes lJt.osll _Fhtal P� a�,mMt � Purchmor agroes tint iminedliudy upon completion of the worts,Puruhasei w(li owcute a Cerripledoh Certificate and pay any balandt due. Purehascralso ogrcct to be jointly ant:severally obtij ated ad liable hereunder. IEndro Aereatnent:This agtenenerit and Its stueturents,inr Willett any ftnareing agreement,conh'len tbo complete agretrnent beiwaso the patties and ow not be amended or modirled unless in writing in a separate dgreeraent signed L'y both patties. NOTICE TO PURCHASILR Do not alien this contract before you read It. You are entitled m a cotnpletly lilted-(n copy er Lhe cuntract at the date you sign. Keep It to prow s ymur rlrbts. Do not alg a a Completion CartIlIcAle before tblo prcjcct It complete. Law prohlbiis home rtpa:r contractors from e'teutatnt or SOMP0119 a ComPletloa CrA fieate signed by the owner prior to the actual completion of fbe work to he parforehad ander the contract. You may eeaeel eblt Mcitattiea at any runt prior to midnight of rbe third autlnete day antler the date of this contract, See Notate or Cancellation for on astplanatlot of this right. Tt:ere wql be a serrdto cheree equal to 23%of the contract amount U the job Is cancotlod by Purehattr AFTER the third buv1gpSa day, BY MY/OUR SIGNATURE BELOW, VWE AGREE TO BE,BOUND BY THE TEWS OF THIS CONTRACT. VINE ACKNOWLEDGE RECEIPT OF A COPY OF THIS CONTRACT AND TWO COMPLETsD COPIES Of 714E NOTICE OF CANCELLATION. BY MY/OUR SIGNATURE BELOW,IAVE UNDERSTANO THAT THE AGREEMENT 13 SUBJECT TO REVIEW OF MY0L1R CREDIT HtSTOKV AND I/WE AUTHORIZE HOME DEPOT TO VERIFY AND REVrBW MWOCR CRIiO.'T RECORD WITH AN iNDEPENDENI`CREDLT REPORTING AOENCY AND NFL-EASE TKSM FILOM ALL LIABILITY INCURRED FROM N VERTEN`OMISSIONS 09 ERRORS, e SIJBMITTED BY; 11 ,1ti•ll _ � a Daft: ` elhg d Is com h hCCEPTED BY: _ed Dace: �G NO a9vncr �— NOTICE!ADDITIONAL TERMS AND CONDITIONS ARIL STATED ON THE REYEASL SIDE AND ARE PART OF TH19 CONTRACT 7-+8•05 GBC wnea.6rnna Fite Yetar-(•jjatamor Pink-Sapp Conswunt Z81-�. 100/100 d IEO-i 80069i1605+ SDIAUS 30 V 0111-NU OWN 900NZ-7fp r The Commonwealth ofMassaehusetts Department of Industrial Accidents Office of Investigations J 600 Washington Street Boston, MM 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Pluffibers r Applicant Information Please Print Legibly Name (Business/organization/Individual): Address: 26yes City/State/Zip: Phone #: c7sM ta5!7 S1 Are you an employer?Check the appropriate box: Type of project(required): 1. with 4. ❑ I am a general contractor and I [�I�am a employer �,Q� 6. New construction employees(fall and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet:'$ 7� ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. g, ❑ Building addition [No workers' comp. insurance 5. ❑ We area corporation and its ME] Electrical repairs or additions required.] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12 oof repairs insurance required.] t employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.' t Homeowners who submit this affidavit indicating they an doing all work and then hire outside contractors must submit a new affidavit indicating such iContractors that check this box must attached an additional sheet showing the name of the subcontractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: 63 Policy#or Self-ins.Lic. #: Expiration Date: Job Site Address: City/State/Zip: S (SO/ Attach a copy of the workers' compens ' policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500,.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250-00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office Of Investigations of the DIA for insurance coverage verification. I do hereby certify un r the s an penalties of perjury that the information provided above is true and correct Si ature: Date: 4;zi9,7//V_ Phone I ��. Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# � Issuing Authority (circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other 'I Contact Person: Phone#: Town of Barnstable ti Regulatory Services BARNSTABLE. r Mnss, g, Thomas F.Geiler,Director 1639. �ATEDMAI�`e Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder L Gil QWC6 6 , as Owner of the subject property hereby authorize 1 Ck F acn� to act on my behalf, in all matters relative to work authorized by this building permit application for: (Addre s If Jo Signature of Owner Date t Print Name Q TORMS:O WNERPERMIS SION