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0338 MEGAN ROAD
dal. I 6/23/2021 Citizen Web Request Citizen Request Management Request ID: 81661 Created: 6/23/2021 1:04:46 PM Status: Closed Assigned To: Crocker, Sharon Health Department Anonymous: No Category: General E.C. Date: 7/8/2021 ' f Created By: Crocker, Sharon Citations: Health Department Time Worked: 0.25 Response Time: 0.25 Request Location: 338 MEGAN ROAD Hyannis, Ma 02601 Parcel Number: Map: 291 Block: 295 Lot: 000 I Request: There is a camouflage but with concrete floor and person is working on cars there and I has a lift > Zoning Request Work History: Entered on 6/23/2021 1:05:38 PM i Forwarded onto Zoning(RA) ! I https:/litsgldb.town.Barnstable.ma.us/CitizenRequest/WRequestPrintPub.aspx.ID=81661 1!1 6/23/2021 Citizen Web Request e _T ..,¢, ., 'e• .` a' -rw,r..° .r,._'ia? =,;tea; •";^ . o- f` (s.: ' Citizen Request Management ;Request ID: 81658 Created: 6/23/2021 12:28:45 PM Status: Assigned To Staff Assigned To: Crocker, Sharon Health Department Anonymous: No Category: General i E.C. Date: 7/8/2021 Created By: Crocker, Sharon Citations: Health Department Time Worked: 0.00 Response Time: 0.00 Request Location: 196 MEGAN ROAD I Hyannis, Ma 02601 Parcel Number: Map_:_ 291 Block: 264 Lot: 000� Request: I i Caller said repairing cars (business) on property. Directed to Zoning (RA) I i l Request Work History: i d i I I a i l I I https://itsgldb.town.barnstable.ma.us/CitizenRequest/WRequestPrintPub.aspx?ID=81658 1/1 ce - same &nqL f -- i` -� 2 44 Town of Barnstable Ai IeA SHE ' Regulatory Services i�Ui�QIf�G ���� Richard V.Scali,Director MAM g Building Division JUN 12 2011 AiE1 5 ��� Paul Roma,Building Commissioner 200 Main Street, Hyannis,MA'02601 TOWN OF SAPINSTABLt www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 PERMIT# / FEE: $35.00 SHED REGISTRATION RESIDENTIAL ONLY 200 square feet or less 33R P)C A&.) Location of shed(address) Village Property owner's name Telephone number 1a MAP QC PPrGe L 1 Size of Shed Map/parcel# AIV Signature Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? You must file with Old King's Highway Conservation Commission(signature is required) Sign off hours for Conservation 8:00-9:30&3:30-4:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-sbedreg REV:06/20/16 ` FEMA Zone: REFERENCES: a X Assessors Map: 291 Legend: Based on Map # Parcel: 295 ® Drain Manhole 25001 CO568J LCP 27099E ® Catch Basin July 16, 2014 El CB - Concrete Bound ZONE"RB o- utility Pole Setbacks: ® Woter Gate (round) Front: 20'min —OHW— Overhead Wires Side: 10'min S— Underground Utility Line Rear: 10'min Lot 100 ' Proposed Shed Lot 98 85.00 (20kt0) Lot 99 85.00' - Lot 96 160.10 � S, 75.10' N82'S5'40"E ...... CB Fnd .B Lot 95 ;. o ` AM=Sept �:\ o.•'' m w ttai 11,536tSF nswmt cmd 7 300 20'min ' !`o sue. i Lot 94 T \\ 9 ♦19. to.?' P\A o �O?S Ste• �.`` , by�j f O � _ ftel 1 certify that the structures shown hereon conform to the setback requirements of the Zoning Bylaws of the town of Barnstable. PLOT PLAN Of 336 Megan Road BARNSTABLE Hyannis NOTES: MASS. DATE:091JUN117 SCALE: 1"=30' 1.) The structures shown were located on the ground 0 15 30 45 60 FEET by conventional survey methods on 11/APR/17. 2.) The property line information shown hereon was PREPARED FOR: O'Connor Neal compiled from available record information. 3 N 38 an Road 3.) This plan is not for recording and is not to be Hyannis MA 02601/� used for construction layout or deed description PREPARED BY: C apeSury purposes. 23 West Bay Rd, Suite G Osterville MA 02655 DWG #: C378_2g1 cppl FIELD BY. WHK/ASK (508) 420-3994 / 420-3995fox CapeSury 23 West Bay Rd, Suite G Osterville MA 02655 DN (508)420-3994 (508)420-3995 fox copesurvftopacod.net Sketch 1 "=20' C378_2g 1 10/JUN/17 85• 0 5 10 15 20 30 40 FEET 85.00' 160.10 SQ 75.10 N82e55'40"E IO'min 10 ord— Sidey .......................................... 20min' 00/1-1 's 0 / i Town of BarnstableBuilding p ... s•a ."`'e xi, i'� a 3 z, `r" '.:'', �..� `" S $.; `.: "'' p ,:,. ..,. �, nr�kz. rY. ':• ' y s `Thi i?d.SoThat`it;isrUisif%Ie Fromthe Street A rovedPlans°IVlust bezRetamed o�n lob and#his Card Must:beKe t Post- p f .r BA WA'CA61.6, ,,, Permit a' Posted UntilFinal Inspection Has Been Mader � � ° Where a'Cert�ficate.of Occu anc' 'is'R";, u�red such Sw,ld�n sli'all NotbeOccu ied.until,a Final Inspect>on as;beenmade p, <y..Y�.. �,; ,.. �g� .«4p. :.�.v.�,� «., s�� :��".�;.:.; _ �'fg ,"f'.ti..'�•�:.. �,,.,.. . Permit No. B-16-3539 Applicant Name: Peter Barbosa , Approvals Date Issued: 01/10/2017 Current Use: Structure Permit Type: Building-Solar Panel-Residential Expiration Date: 07/10/2017 Foundation: Location: 338 MEGAN ROAD, HYANNIS Map/Lot 291 295 Zoning District: Sheathing: Owner on Record: O'CONNOR,WILLIAM NEAL Contractor Name PETER BARBOSA Framing: 1 Address: 338 MEGAN ROAD Contractor License GCS-077725 2 4� HYANNIS,MA 02601 Eskt Project Cost: $36,827.00 Chimney: Description: 26 panel roof mounted solar array with disconnects,soladeck, Per, Jt Fee: $237:82 inverter and tie into existing service w Insulation: Fee Paid,. $237.82 7.28 kw system Final: s Date 1/10/2017 Project Review Req: 26 panel roof mounted solar array with d sconnec%`J5-oladeck, Plumbing/Gas Gas inverter and tie into existing service g/ 7.28 kw system i u Y X 4 Rough Plumbing: „ _'Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work a6thor1zed bythis permit is commenced within six months after-issuance. V 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. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning!by lawsand codes. Final Gas: This permit shall be displayed in a location clearly visible from access steet or road and shall be maintained open for publicnspe lion for the entire duration of the work until the completion of the same. �d x Electrical. The Certificate of Occupancy will not be issued until all applicable signa by,the Building and Hire Offkcials are provided tures "Ahis'permit. Service: Minimum of Five Call Inspections Required for All Construction Work 1.Foundation or Footing h � Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health 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 IVIGL c.142A).:. t Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT, a orr�•ZN F� �i�L. 5�f Customer Signature Page Authorization by Customer to allow Amergy or its sub-contractors, Devlin Contracting Maintenance to act as Customer's Agent and Act on Customer's behalf and to sign and submit all necessary applications. C,,,Vw.r , residing at 3,U Vk receive electrical service via Utility Account# iiy 38A 9J9" Oa6) , I authorize Amergy Solar to be my agent and act on my behalf for the installation of my Distributed Generator Project until issuance of a Letter of Acceptance. Amergy Solar or its sub-contractors will also complete, sign and submit all necessary utility, and Massachusetts Department of Building (DOB) permit applications on Customer's behalf. Please sign in blue permanent ink within4he,box below. Signature must be entirely within the box and cannot touch edges. Your signature will be scanned and used on the permits and forms to be submitted to the required authorities. Signature: 's r®�� 13Z��6 o�eq,�a/�sr� Print Name: � �\ � �� Date: 2 I3 Phone: - 1� ) Email: pO cop QEM Q`t@ft01-CO-4 P10 Town of Barnstable *Permit ��s7�g Expires 6 monS e Regulatory ServicesWLAAq Fee f • snxxsrasie, • 619. 16gq. Richard V. Scali,Director �� ��ED MA'1► ==Buitding=Division—= Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERNIIT APPLICATION - RESIDENTIAL ONLY 4q5i Not Valid without Red X-Press Imprint Map/parcel Number -�Ja I , Property Address A%3 1dResidential Value of Work$ S1 ppp Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address O`1 CC2,aj C 92 Contractor's Name Telephone Number 50� 3 3 Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check e: °e►Qd1 �� ❑ am a sole proprietor I am t e Homeowner �E ❑ I have Worker's Compensation Insurance TO C 072015 INNOFOA%S Insurance Company Name rjgB�c Workman's Comp. Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to e-roof(hurricane nailed)(not stripping. Going over existing layers of roof) e-side Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows -Tz,M , #of doors: ❑, Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ;j( ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is equired. SIGNATURE: Q:\WPFILES\FORMS\building permit forms\E)PRESS.doc Revised 040215 r ?lie Commonwealth of-Vassadiusetts D'•eprvtnre�it o,f lndu,sh ia[Accidents - Office of.investigations $a. 600 Washington Street 02111---- __ - _ it-mmt,na=grrvfidia 'Workers' Compensation Insurance Affidavit: Bu ildersiContractorslEIectricians/Plumbers Applicant Information Please Print Le�ibIy Name(Buskess anindonfFn&ami): (�� II rwr. Address: pp,,S f� cityista& �txv one �®Z 3 9 �a Are you an employer?Checkthe appropriate box: I Type of project(required): I_❑ I am a employer vrith. 4. ❑I am a general contractor and I 6. ❑New construction employees(fish andfor part-time)-* have lured.the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sob-contractars have g_ ❑Demolition wad-in; Rwme in any capacity. employees and hate wo&ms' INo utorkm' comp.insurance comp_irm=nce-# 9. ❑Building addition 10_ Electrical r ed_ � S. ❑ We are a corporation and its ❑ epaira or additions 3. I am.a homeoumer doing all work of have exercised their 11-❑Plumbing repairs or additions myself o workers' fight of exemption per MGL �` � cam- 12.❑Roofrepairs insurance required..]7 c.152,§1(4h and we have no , employees-[No workers' 13.❑Other comp_insurance required.) *Any W caut&atcheclrsbox#1nm4talsoMootthesectionbeTaw--hawingthenworkers'campensa>ionporkyininrmatraa 1 Homeowners who sabmit dais IMM2191 iadi+catmg they are doing all wol and then raee outride contractors mmst submit a new affidavit iadicatiag such_ =Cantzsctors ff=check this boa roust attached an additional sheet shouffig the name of the sub-cant wAm and state whether air not those entities have employees.If the subtontmctorshwe employees,they rauscpmuide their workers'camp.policy number. I a rt art elrepkywr tdtat ispreniding it orkers'comperlsaiioti inmiraum for trzy enrplal,ee-s $etoW is the panty avid jab site inforlrraliom Insunanct:Company Name: Policy or Self-ins.Lic_ k Expiration Date: Job Site Addresw. Citylstate/ztp: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section.25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,50a-Oa an1for one-year imprisons as wen as chit penalties in the fo=of a STOP WORK ORDER and a EM of up to$.25O_DO a day against the violator. Be adidsed that a copy of this statement maybe forwarded to the Office of Investigations of the DIA.for insurance coverage uurerfication- I do hereby certrjy,under thepauls and penattres ofpedury that the information prmided abmw is trove andd ccarrect Signature: Date: / a2 J Phone ik Q 3 �o / Official use only. Do not wMe in tars area,to be completed by city ortotwn official i City or Town: PermitUcense 5 Issuing Authority(circle one): 1.Board of Iffealth 2.Budding Department 3.CRyffo,vn Clerk 4.Electrical Inspector 5.Plumbing Enspector 6.Other Contact Person: phone#: Information and Instructions ` Massachusetts General Laws chapter 152 requires all employers to provide wormers'compensation for their employees. P to this s�¢e,an empl°J'e is defined as."-.every person in the service of another under any contract of hire, =press or idled,oral or writt cnII" +l An errpIoyer is defined as"an individual,partnership,association,corporation or other Legal entity,or any two or more a joint and inc the legal representatives of a deceased employer,or the of the forcgomg s J �c� �� receiver or tmA=of an individual,partnership,association or other 1% entity,employing employees- However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the - ' dwPiIing horse of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or budding appurtenzat thcmto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or Iocal ficeusing agency shall withhold the issuance or renewal of a license or permit to dpemte:a business or to construct biarZdmgs in the commonwealth for any applica.ntwho has not produced acceptable evidence of compliance with the insurance.coverage required." Additionally,MGL chapter 152, §25CM states-Neither the commonwealth nor Eiiy ofits political subdivisions shall entz roto any contract for the perfounanee.ofpubho work until acceptable evidence of compliance with the insm-ance.. rtq item ents of this chapter have been presented to the contracting arthor*" { Applicants Please fill ort the workers'compensation affidavit completely,by checking the boxes that apply to your sifnation and,if c s necessary,supply sub-contractors)name(s), address(es)and phone numbers) along vrrththeir cert� fie()of m umn ce. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is requited. Be advised that this affidavit maybe submitted to the Department of Industrial Accidents for confmnation of insm-ance coverage. Also be sure to sign and date the affidavit The affidavit should be returned to the city or town that the application for the permit or license is being requested,not file Department of urn T„rh,sfr;a1 A ccidents. Should you have any questions regarding the raw or ifyou are required to obtain a workers' compensation policy,please call the Department at the nrunbcr listed below. Self-insured companies should enter their s 6if-filsizrancz license member on the appropriate im.e. City or Town Officials icials . f . Please be sure that the affidavit is complete and printed legibly_ The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to coact you regarding the applicant- Please be sure to fill in the peffiit/Iicense nwnber which will be used as a reference number. In addition,an applicant that must submit multiple permit/hcense applications in any given year,need only submit one affidavit i adicatrag current policy it l rnation(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)_"A copy of the-affidavit that has been officially stamped or marked by the city or town may be provided to the " applicant as proof that a valid affidavit is on file for future permits or licenses_ A new affidavit must be filled oust each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial ventta'e (i_e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations wound like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call_ The Department's adriress,telephone and fax ntnnber: e anWmjtbE of Massachusetts ' Degar�m�nfi of�'nd�s�fzzal Aocid�nts ' �t�e of�,ve�fig�tio�� 6G�4�a�hingtan Stt°� ' Bostou.,MA G� I I I Tf,-L 4 61 t 727-4900 Qxt 4-06 or 1-97TMASSAM Fax#617-727 7749 Revised 424-07 as",gQ�ft�ia Town of Barnstable Regulatory Services �oFil+�rgtyr Richard V.Scali,Director Building Division * MaS&saBrr ' Tom Perry,Building Commissioner ss �,, 1639• �0 200 Main Street, Hyannis,MA 02601 ATEo www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION /2, 1 3 Please Print DATE: (� � ` JOB LOCATION: 3.3 y f 1 r 5 A-" R,` > number pl �� �/ street village ••HOMEOWN tW 11� ER": A(� y' 1 �T I �.UM Vba Soy 3 3 2_ o I name home phoon/ep# work phone# . CURRENT MAILING ADDRESS: 3 COCA city/town' state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) w The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. SignaffreofHomeowner t Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules &Regulations for Licensing Construction Supervisors,Section 2.15) .This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In' case,'our Board�canriot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EJPRESS.doe Revised 040215 r y 7` 1 O„ b * 3ARNbTABLE. • - 9�, 16,1 ,m�' Town of Barnstable - ArFp�a Richard V.Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Y Office: 508-8624038 i Fax: 508-790-6230 f Property Owner Must Complete and Sign This Section g If Using A Builder as Owner f the subject property hereby authorize to act on my behal in all matters relative to work aut\' edby this:b, * g permit application for: � � (Address ob) Signature of Owner Date bj"k 1 \ C Print Name If Property Owner is pplymg for permit,please complete th Homeowners License Exemption Form on the reverse side. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 040215 TOWN OF BARNSTABLE 21350 b`� a Permit No. _-_----__—__ - Building Inspector ` Cash NAM ' 79• i -_--- ' �0 39� .� OCCUPANCY PERMIT Bond X_ g / "No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Gray Oaks Development Address Box 957, Eyannis_ lot #95 .338 McFmn Road, Hvannis t Wiring Inspector 1�•p �i �'/��.. _ Inspection date Plumbing Inspecto�� � A� f. Inspection date Gras Inspector f Inspection date Engineering Department ,. , ��r , Inspection date r C U 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. 19 �o _ f.f. ...._......... , _. ..............................B.....Building Inspector / /07 AssesNsa s map and lot number ............................................ %THE 2V Sewage/Permit number ../.....)-S"%o ................................................. Housenumber ........................................................................ WITH 009 ONME C Mnsa 16 9. TOWN OF BARNSTARrEEGULATI©N BUILDING ANSPECTOR APPLICATION FOR PERMIT TO ...... a(q. ........................................................................................ TYPE OF CONSTRUCTION .............WARP ............................................................................... ...... .............. A.7.1..71........19........ TO THE I'NSPECTOR OF BUILDINGS:-- The undersigned hereby applies for a permit according to the following information: Location 04 RfAN R A ... .. .............................................. ........................................................................... ProposedUse ...... �1...................................................................................................................................... ZoningDistrict ........................................................................Fire District .............................................................................. Name of Owner ...6.9A V....®&<A.......0_17_4n.................Address ...6.P.e*..... ............................ Nameof Builder ....................................................................Address .................................................................................... Name of Architect ....IR.!..F!fA ...........................Address . ...... ..................................... Number of Rooms ...........4.....................................................Foundation ........./A......................................... Exierior .......011 ...................................Roofing ....."115 ......Ase- 11-1-1.............................. Floors .... ......... ...........................................Interior ......bAy... .............................................. Heating ....F,...d. .....................................Plumbing ......... /.t........................................................... A z Fireplace ....7v/../7.e............................................Approximate Cost ....W-A--0-P-,P............................. .1 ...... Definitive Plan Approved by Planning Board --------------------------------19--------- Area ...... ........0;dS' Diagram of Lot and Building with Dimensions Fee ............................................095— . SUBJECT TO APPROVAL OF BOARD OF HEALTH 0 AAQ I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .... .................................................. 00 Gray Oaks Dev, A291-295 , y , No .. 13�Q.. Permit for ... story ........ .... ?ell. g. ....................... ..... ........._.. Location ...IOt---05.33a- ega. .. d................. ................ yarmi.s............................. ............... owner ..Gray.Oaks...Dev................................... I Type of Construction Wood..Fr&une............... ` 4 ............................................................................. y 1 irk Plot ......................... . Lot ................................ Permit Granted 19 79 June....6............. Date of Inspection .......19 ` Date Completed .. !/�.".........'........19 PERMIT REFUSED ................................................................ 19 - . . ................................................ .`.... ....n. ............................................... r ................................................:. ' ' g ............................................... 800 � .App .....0.. ................................... 19 -- M a � ' N f . 3 , r?5*jTUPPER- CONSTRU +s,1 lk ''i1' ? 79B MID-TECH DRIVE,WEST YARMOUTH;MA"02fi73'` a PHONE: 508-778-0111 FAX. 508-778-5010 WWW. PPERCQ.COMtt o I nep ' : � t s Date: Town of Barnstable Thomas Perry CBO 200 Main Street Hyannis, Ma 02601 (508) 790-6230 fax Re: Insulation Permits Dear.Mr. Perry This affidavit is to certify that all work completed for permit application # Issued on 2.9 A has been inspected by a certified Building Performance Institute (BPI) inspector. All work performed meets or exceeds Federal and State requirements. Sin y, Ric rd Tupper Lic nse # CS-69058 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION i M . 'after Map Parcel IL Ptr. �; t Application # 6.�i., {� t�3F E —an e,�Ocf'7 j.f S f.« .. Health Division Date Issued � �-� 3 Conservation Division "_ Application Fe Planning Dept. s Permit Fee Date Definitive Plan Approved by Planning Board - Z�' 3 Historic - OKH Preservation/ Hyannis Project Street Address ?�7J8 EiE — N:& . Village HVAIIQ1,W5 ENALrf Owner LE ddress 25613 HE.G-A&RP Telephone Z' 0 Permit Request L Square feet: 1 st floor: existing proposed 2nd floor: existing .proposed Total new Zoning District Flood Plain Groundwater Overlay Project ValuatiJ 1-7 b.04 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 bathe): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ i 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 1 1".L40&,JO uppfw— Telephone Number 508 - -7-7$ d Address R EGb� T�Z License# J - f'foq 058 IN Ag-ROUT 1 "A 02.((e O Home Improvement Contractor# Worker's Compensation # W(!5b0r593o 12o 12 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO t�PpE( � to SrP.�.LfiarJ 10 i 1 3 rl-2) SIGNATURE DATE h, z r FOR OFFICIAL USE ONLY APPLICATION# { DATE ISSUED t MAP/PARCEL NO, •1 ' ADDRESS VILLAGE T t ' • L OWNER ts, ,x DATE OF INSPECTION: f .•FOUNDATION ' FRAME INSULATION FIREPLACE t ELECTRICAL: ROUGH FINAL r PLUMBING: ROUGH FINAL x. GAS: ROUGH FINAL FINAL BUILDING E DATE CLOSED OUT r ASSOCIATION PLAN NO. � T The Commonwealth of Massachusetts Lh Department of Industrial Accidents Office of Investigations 197 600 Washinglon Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Tupper Construction Co. , LLC Address: 79B Mid Tech Drive City/State/Zip: West Yarmouth, MA 02673 Phone#: 508-778-0111 Are you an employer?Check the appropriate box: Type of project(required): 1.❑X 1 am a employer with 4. ❑ I am a general contractor and 1 Ei ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet.+ 7' ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity, workers' comp. insurance. g, ❑Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ t am a homeowner doing all work right of exemption per MGL I LM Plumbing repairs or additions myself. [No workers'comp. c. 152,§1(4),and we have no 12.❑Roof repairs insurance required.]t employees.[No workers' 13 ❑Other cornp, insurance required. *Any applicant that checks box#I trust also till 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 anew affidavit indicating such. �Contraetors that check this box must attached an additional sheet showing the,name of the sub-contractors and their workers'comp.police information. lam an employer that is providing workers'compensation insurance for my employees. Below is the policy and jab site information. Insurance Company Name: AEIC Policy#or Self-ins.Lie.#:�WCC 5005593012012 Expiration Date: 10/0 3/2 013 Job Site Address: 3 3 8 Megan Road City/StateiZip: Hyannis, MA 02601 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to S 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 a Ire sins and penalties of perjury that the information provided above is true and correct. Si nature: Date: 7 8 2 013 Phone#: 508-778-0111 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): I.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 2412 4:37PM No. £524 P; '/2 AGuxu� CERTIFICATE OF LIABILITY INSURANCE DAD/112 • 12/19//19/zolz THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not corder rights to the certificate holder in ileu of such endorsement(s). PRODUCER CONTACT NAME: Lora Lowe Southeastern Insurance Agency, Inc. t""- Ext: (508)997-6061 ac No: (508)990-2731 439 State Rd. EMAIL ADDRESS: P.O. Box 79398 PRODUCER CUSTOMER ID k;N. Dartmouth, MA 02747 INSURER(S)AFFORDING COVERAGE NAIC9 INSURED INSURER A: Arbella Protection Insurance Tupper Construction Co LLC INSURERS: AEIC _ INSURERC: CNA Surety ..:....._.........................................:.....................__.._.._....:_._.._................_......_.___._._._--_— ___...._._._._ 27 Roberta Drive INSURER0: West Yarmouth, PIA 02673 INSURER€: INSURER F: COVERAGES CERTIFICATE NUMBER: 12/13-2 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 MAYBE 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. _ LTR TYPEOFINSURANCE _ INSRSWUVD POLICY NUMBER D (WIDOW"I ^ LIMITS GENERALUABILMY 8Sd0008743,1110112012 11/01120f3 =Aerc c�'Rl.e�tcE s 1,000,00 I XVAC._TO R;: X i COMMERC',AL GENER-L LIA81i 11Y ARE hiScS_{Ea,¢currar:t:I...._......$....._.._.._.._.._ 100,00 _........;....._.... ,...._......_.._.._ .......................................... i CLAIMS400E �OCCUR { MEG EtP(Any one person) 5 5,000 A i PERSONO a ADV NJU r $ 1,000,000 __._._.. ._._....___ GENE?AL AGGREGATE $ 2,000,000 K1 AGGPEGATE LIM r aFPL1ES PER: PRODI l'a-C.ON•PiOP AGG $ 2,000,000 PRO PCLICY JECT LJC AUTOMOBILE LIABILITY 5666240000 12/0112012 1?J01/20131 d6INE.:SINGLE L€MIT- $ (Eaacoft') 1,000 000 i ANY AUTO ._._.._ ..$.__..___....._..__.....__.._.!_._......... 1 I BODILY iNJLRY(Per pers:in7 I ALL OWNED AUTOS .___. j :BODILY NJIW7f(Per acciaenti 1$ A X I SC;EDULED A)171.)S i pn... DID tAGE '__...._.... ff' P._ E $ aden'sc Per X €HREJAtJ`fOS i ( ) i-- INC X NON OWNED AI"GS � $ UMBRELLA LEAS OCCUR EACtr OCCLIPRENi E $ EXCESS LIAS ,CLAiRAS-IvtkDE A_G_GRE_G_,_CT_E__ i $ DEDUCTIBLE RE?'ENfiGN $ $ WORKERS COMPENSATION. WCC500559301200 10l0312012 1010312013 X �"`r`T'A ' X OT"I AND EMPLOYERS'LIABILITY YIN TORY l M TS' ER ANY aFJPRIETOR�auT1�ERr E I'r•C �1 RICHARD TUPPER I r..L.FA,CHACCI EN'r � 500,000 B OFFICERIME IB`PEXCLUI)ED) 1 NIA: — (Mandatory In NH) INCLUDED FOR WC COVERAGE E L.I)SEASE_EA EMPLOYEE$ 500,00 Mdev'rit;'o undo; tR PT ION OF OPERA.T.,ONS bcJcw E .DISEASE-PO KY L.hdlT $ 500,000 ---B-ond for theft of money ar 11 710698130212812012 02128/2013 Limit of $10,000 C property. I DESCRIPTIO DF OPERATIONS I LOCATIONS I VEHICLES(AftchACORD 101,Addrdonal Remarks Schedule,I/more spade Is required) ill.ju io@csgrp.com CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE IAALL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Conservation Services Group Attn: Bill 3ulio AUTHORi2E0REPRESENTATIVE 50 Washington Street We tborough, MA OIS81 Lora Lowe C31988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009106) The ACORD name and logo are registered marks of ACORD { h OWNER AUTHORIZATION FORM �wneF'Name) owner of the property located at 3 3' - Mein, (Property Address) (Property Address) y hereby authorize N—Jvo�—� d (Subcontrac r an.authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform work on my property. r Owrers Signature Date dURA M ftKPVKMAN(;t MWITUTt,ING Pftsaachusetts M Departnient of Public safety tea. . 107 Heffm Rwd, 0 Board of Building Regulations and standards 12m License: CS469056 www.bpi.cm WC€iARD S TUPPER ,g WEST VARM011TH 4 RkhWdT 1"o BPI 1006040040 ERR- FJ ED PRAI ' � IONAL ., cam' Expiration -„� Cost smoner 1213112014 r r � a i F offlee et oswt tr Aft€r d aina t Ri�t€4 ► He P�� opke` u d 4 fer�o l � ME€MPROWAIEWt'Ctt�itliA��i)it z� �f E� tt€�r ..:1 ratlow td Ind's5tk€uaCOX 6 Yt �x1EM N f w r 21 #2C►Tt3PpER s z > iCHBCdU 1" W d , 20 Robeda Drive x €d€�t saf Pr sg�na€ .YARMOUi"hi.MA 0 613 t» aeer+�taryW ^ r �� rrir t r' � j4q TOWN OF BARNSTABLE RISE Division of Thielsch Engineering,Inc. 2013, MAY 10 t4�,- 11= 19 1341 Elmwood Avenue ENGINEERING Cranston,Rhode Island 02910 ®��1s C'};{ May 1, 2013 Thomas Perry, CBO Town of Barnstable Building Division 200 Main Street Hyannis, MA 02601 Re: Insulation permits Dear Mr. Perry, This affidavit is to certify that all insulation work completed for 338 Megan Road has been inspected by a Building Performance Institute (BPI) certified Professional. All work performed meets or exceeds Federal and State requirement. Sincerely, Erik Nerstheimer Supervisor of Installations, BPI certified Building Analyst Professional and Envelope Professional, RISE Engineering, a division of Thielsch Engineering, Inc. 1341 Elmwood Avenue Cranston, RI 02910 401-784-3700 •800-422-5365 •Fax 401-784-3710 111396 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel �, Application # Zo S�s t c7 Health Division Date Issued xx Conservation Division Application Fee V Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis Project Street Address 338 Megan Rd Village Hyannis Owner Bathsheba Miller Address same Telephone 617-938-0790 Permit Request air sealing, insulate attic (R_38), lngfnll 1 thermadame, 9 soffit vents Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 2821 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 v 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 ❑ -o Commercial ❑Yes ❑ No If yes, site plan review# co 12 Current Use Proposed Use o. a 0� APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name RISE Engineering Telephone Number 401-784-3700 Address 1341 Elmwood Ave, CRanston, RI 02910 License# 100459 Home Improvement Contractor# 120979 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE �� �� 10 Erik Nerstheimer for RISE i t `{ FOR OFFICIAL USE ONLY i APPLICATION# DATE'ISSUED _: _ • "` Mf i _MAP/PARCEL NO,. '4. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATIONS = t FRAME INSULATION jz i FIREPLACE , t ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL t r GAS: (-P--*. ROUGH Ridsf FINAL V,FINAL BUILDING = x=t w DATE CLOSED OUT- ASSOCIATION PLAN NO. r n 1 ` t, RISE ENGINEERING Federal ID#06-0405629 RI Contractor Registration No 8186 A division of Thielsch Engineering MA Contractor Registration No 120979 CT Contractor Registration No 620120 fv { 1341 Elmwood Avenue,Cranston,RI02910 CONTRACT (401)784-3700 FAX(401)743710 Page 1 THIS CONTRACT IS ENTERED INTO BETWEEN RISE ENGINEERING AND THE CUSTOMER FOR WORK AS E NG IN EE R)NG DESCRIBED BELOW CUSTOMER PHONE- DATE Client# Bathsheba Miller (617)938-0790 08/05/2010 111396 SERVICE STREET BILLING STREET - 338 Megan Road 338 Megan Road SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Hyannis,MA 02631 Hyannis,MA 02 JOB DESCRIPTION RISE Engineering will provide labor and materials to seal areas of your home against I waste ,excess air leakage. This wont will be performed in concert with the use of special tools and diagnostic tests to assure that you of air exchange and indoor air quality.Materials to be used to seal your home can include caulks,foams,weatherstripping and other products. Primary areas for sealing include air leakage to attics,basements and other unheated areas(windows are not generally addressed.) This work will be performed at the rate of$66 per man per hour,which includes materials and testing. 18 man hours. $1,188.00 RISE Engineering will provide labor and materials to install a 11"layer of R-38 Class 1 Cellulose added to 1100 square feet of open attic space. $1,320.00 RISE Engineering will provide labor and materials to install an easily moved,insulating cover for the attic access folding stair. The cover has integral weatherstripp ing to restrict air leakage. $160.00 RISE Engineering will provide labor and materials to install(9 4" X 16"rectangular aluminum soffit vents to increase ventilation in attic areas. $153.00 RISE Engineering will apply all applicable,eligible incentives to this Contract. You will be billed only the Net amount. Currently, for eligible measures,the Cape Light Compact offers 75%incentive,not to exceed$2,000 per calander year. renter Owner Richard Morse do Fred Bleu $2,821.00 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***00/Dollars $0.00 UPON FINAL INSPECTION AND APPROVAL BY RISE ENGINEERING.CUSTOMER AGREES To REMIT AMOUNT DUE W FULL INTEREST OF 1%WILL BE CHARGED MONTHLY ON ANY UNPAID BALANCE AFTER AYS.SEE SE FOR IMPORTANT INFORMATION ON GUARANTEES,RIGHTS OF RECISION,SCHEDULING,AND CONTRACTOR REGISTRATION. - t DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES AU SI TURE-RISE ENGINEERING TONER ACCEPTANCE TE: ONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE ACCEPTANCE OF CONTRACT.THE ABOVE PRICES,SPECIFICATIONS AND CONDITIONS ARE SATISFACTORY TO US AND ARE HEREBY ACCEPTED.YOU ARE AUTHORIZED TO DO THE WORK DAYS. AS SPECIFIED.PAYMENT WALL BE MADE AS OUTLINED ABOVE c The Commonwealth of Massachusetts Department of Industrial Accidents IV Office of Investigations 600.Washington Street Boston,Mass. 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): RISE Engineering a division of Thiel ch EngineP,rjng 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 4. 0 I am a general contractor and I 6. ❑New construction employees(full and/or part time).* have hired the sub-contractors 7. ❑Remodeling 2. 0 I am a sole proprietor or partner- listed on the attached sheet. 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 additions 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. 0 Roof repairs employees. [no workers' 13. TS 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 an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees.Below is the policy and job site information. Insurance Company Name: The Preston Agency Policy#or Self-ins.Lic.#: 3730961-00 Expiration Date: 1/1/11 Job Site Address: �� (� rn Q�,�/') V A City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the po lcy 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 $250.00 a.day against violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certi and the ins enalties of perjury that the information provided above is true and.correct. Signature.- Date: 101 2n I L D Print Name: Erik Nerstheimer Phone#:(401)784-3700 or 1-800-422-5365 extM Of use only Do not write in this area to be completed by city or town official City or Town: Permit/license#: Issuing Authority(circle one): LBoard of Heath 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact person: Phone#: A ACORD, CERTIFICATE OF LIABILITY INSURANCE OPtD 47 DATE(MM/DO/YYYY) THIEL-1 04/13/10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION The Preston Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1350 Division Rd" Suite 303 HOLDER-.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR PO Box 810 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, East Greenwich RI 02818-0810 Phone: 401-886-8000 Fax:401-885-1700 INSURERS AFFORDING COVERAGE NAIL$ INSURED INSURERA: Zurich—American Ins Co. �— Thielsch Engineering, Inc INSURER B:. Aw.4— Wsx.nt.. A Ll.bl.City Thielsch Gioup Inc. INSURER North American Capacity Ni Tech Realty Inc. _ Cra19Snston Frances Avenue INSURER 0: Hartford Insurance Company Cranston RI 0291.0 p y INSURER E' COVERAGES IME POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY RECUIRE RENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCLIMEPTT WITH RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED.HEREIN IS SUBJECT"TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IfTSR"fI17D . LTR INS R TYPE OF INSURANCE POLICY NUMBER DATE(MWDDlYY) DATE( p yy) LIMITS GENERAL LIABILITY EACH OCCURRENCE 1 1,0 0 0,0 0 0 A X COMMERCIAL GENERAL LIABILITY 3730962-00 04/01/10 0 1/01/11 FREIdISEs(Es 4TE T300,000 CLAIMS MADE a OCCUR MED EXP(Any.one Gerson) T 10,000 PERSONAL&ADV IN.:URY S 1,000,000 GENERAL AGGREGATE s 2,0 0 0,0 0 0 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,0 0 0,0 0 0 POLICY X IEa LOC Emp B"en. 1,000,000 AUTOMOBILE LIABILITY i1 X ANY AUTO 37309*63-00 04/01/10 O1/01/11 COMBINED SINGLE LIMIT(Ea a T2,000,000 ccident) ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per per son) S HIRED AUTOS NON-OWNED AUTOS BODILY INJURY - (Per acciderd) PROPERTY DAI IAGE T (Per accidenl) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT I ANY AUTO OTHER THAN EA ACC $ AUTO-ONLY: AGG $ EXCESSIUMBRELLA L IABILITY EACH OCCURRENCE T,010001000 ,B X OCCUR �CLAIMS MADE U1,M 9263637-00 04/01/10 01/01/11 •A.GGREGATE $ 10,000,000 T _ DEDUCTIBLE 3 X RETENTION 410,000 $ WORRERS COMPENSATION AND l - EMPLOYERS'11ABILITY X TORY 1_ItnITS ER A ;M)PROPRIETORIPARTNER/EXECUTIVE 3730961-00 04/01/10 01./01/11. E.L.EACH ACCIDENT S 1,000,000 OFFICERIMEMBER EXCLUDED'] E.L.DISEASE-EA EMPLOYEE 8 1,000,000 If yes,describe under - SPECIAL PROVISIONS below E.L.DISEP.SE-POLICY LIMIT T 1,000,000 OTHER C Professional Liab DVL000026800 04/01/10 04/01/11 Prof Liab 2,000,000 DlLeased/Rented Eqp 021JUNTD5678 04/01/10 04/01/11 Equipment 100,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES J EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVSIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER"VILL ENDEAVOR TO MAIL 10 DAPS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO 00 SO SHALL - IMPOSE NO OBLIGATION OR LIABILITY OF ANY HIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESE ' V ACORD 25(2001I08) v @ACORD CORPORATION 1998 '-i1� a; i a z�}.,:,�. tt�s�g ��trt�"'.;�:��' �'�:r�:��1 i}„ !�:��s t zll �7 IktS�J�lh 9f 4tM1- !s�t..'s + S r t t (>• ?. -.:._ .�..u.:�..w i.:a...neRl:.;w.G.Ui,t... ..c_..-_� ... .... J i t e„ e I �t ia!i.� .•;N.€11%. s1... _�1t..,try .......�..�15M9E- t . :.._..,..,. A1So for RISE Engineering, a division of Thielech Engineering, Inc. Gaskell Associates; a division of Thielech Engineering;. Inc. - BAL Laboratory; .a division of Thielech Engineering, Inc. ESS Laboratory, a division of Thielech Engineering, Inc. ALCO Engineering, a division of Thiel.sch Engineering, Inc. Water Management Services, a division of Thielech Engineering, Inc. 1 91te n ume�'�Q falaan uslnes�G�sOn O ice o s o g 10 Park Plaza - Suite 5170 Boston ssachusetts 02116 Home Improve ontractor Registration _ Registration: 120979 m Type: Supplement Card z J i w Expiration: 3/25/2012 THIELSCH ENGINEERING M ERIK NERSTHEIMER 1341 ELMWOOD AVE. CRANSTON, RI 02910 '� 'ray Sv Update Address and return card.Mark reason for change. Address ❑ Renewal Employment Lost Card DPS•CA1 0 5OM-04/04-G101216 ✓�ie -L�anvrrcavu�irewl..l( 0�..2 ,«iu�►,lta Office of Consumer Affairs&Business 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 Registrati6nz�979 Type: 10 Park Plaza-Suite 5170 Expira `"'12 Supplement Card Boston,MA 02116 THIELSCH ENGR - i 1 i., 'may ERIK NERSTH 1341 ELMWOOD CRANSTON; R1 029 =`~� Undersecretary Not valid without signature r agt 1 0I 1 Tlie Official UVebsite of the Executive Office of Public Safety and Security (EOPS) Mass,Gov Home Public Safety Department of Public Safety Licensee Complaints License Type Construction Supervisor License tt 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 ,ze.'tjaar�y;cYruuecuc� o�✓o�iGe .G Board of)3uildino Regulations and standnii'>3 Lkense or registration valid for individid use only HOME IMPROVEMENT CONTRACTOR I` i before the expiration date. If found return to: Registration:: 12097-9 Board of Building Regulations and Standards P _.3J25/2010 1. One Ashburton Place Rm]301 Type--`SG'p'plement Card i T^PSt0l),�4a. 02108 E L S C H ENGINE>E1 ING-f= = K NERSTHEIMER 1 ELMWOOO,A�E.` >` �NSTON, RI 02910-"'-='- Aclrnkisti::itor - ---- __T _ Not valid without signitr�re a- hrtp://db.state.ma.us/dps/llcdetalls.asp?tXtScarchLN=(-'4T.10na.S4 x yt �F FF s NAT-24531 - 1 SOIL LOG V 2.".PEA9T ONE ..-LOAM B FILL-- 12"MAX w "0G 4"C. I.,' DIST. e' .1000 'BOX I, ° ;o 1° ° E o 2 4" to MIN. GAL. _ ,41�1 PRECAST OR • $ SEPTIC I� BLOCK • ° e� MIN TANK .. d SEEPAGE 20' MIN. I`. �'' , , . i E?L. 4 _ G. e FOUNDATION I I &bvD t r2! it;:yZ r 1 /2 WASHED STONE I -7 f ELEVATION SKETCH I i0, -----� PERC. 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