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1160 PHINNEY'S LANE (7)
Z3 •o t�� c� Town of Barnstable ' x ` i ...�.;3 ,. - � -'; ,. .... .,.-. .�� . .,' ..-..fir . _. ... . . A. _ :, ..- . : andethisyCard;,Must.be`:Ke t.: - : :. ,:to U�s�ble. -: ng om the Street�A veddPlans Must be.Retained o Job -" . �P st,This Card SorThat i ,S ,� ",r ,.. PPr .b �• . •..IiAR*iSTABL�. ,,:n s �grE"s z ,� ,. i _ ,-. ✓ .... W?.x:{ is i< ,', ,F .� 1,Pi,alh.ns eetron�Has Un i n .yl '' a 3$ F: .: ,J erlt mod• Where a.4Cert�ficate of,Occu anc .as:Re wired.suchrBurldin sfiall NoL be,Occu fed unt><ha Fna,l lns ection h sheen Fad .,.. ' P any:: Q: :�.� ;-� ,.. ,g : p�,s,, p .��,..;� �, �. Permit No. B-17-1259 Applicant Name: BENJAMIN E THOMPSON _ Approvals Date Issued: 05/09/2017 Current Use: Structure :Permit Type: Building Siding/Windows/Roof/Doors Expiration Date: 11/09/2017 Foundation: Location: 1160 UNIT C PHINNEY'S LANE, HYANNIS Map/Lot 273 089 OOG Zoning District: SPLIT Sheathing: Owner on Record: STEINHILBER,CAROL A I on ct traor Name. BENJAMIN E THOMPSON Framing: 1 Address: 1055 KENSINGTON PK DR#311 Contractorl�cense CS-106046 2 ALTAMONTE SPRINGS, FL 32714 Esf, roJect Cost: $9,460.00 Chimney: Description: To replace 6 windows and one sliding glass door andgone storm door Perm t ee: $ 160.00 Insulation: and one skylight Fee Paid' $ 160.00 Project Review Re To replace 6 windows and one sliding lass doorand one stormy Final: J q: p g g % Date 5/9/2017 door and one skylight r, .. i r G . Plumbing/Gas a ....... Rough Plumbing Building Official Final Plumbing: Mk This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within 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. Rough Gas: All construction,alterations and changes of use of any building and str"uctures shall be in compliance with the local zoning by laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or r ad and shall be maintained open for pudic inspection for the entire duration of the work until the completion of the same. ` E Electrical LZ The Certificate of Occupancy will not be issued until all applicable signatures-by the Building and e 640a Is are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: ' 1.Foundation or Footing Rough: 2.Sheathing Inspection -._ ._a 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) ti 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" (asset fo"rth in MGL;c.142A).=° Fire artment r Building plans are to be available on site Final. All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION C 2� rack a PNsT�BL f1 I�5 C Map Parcel O 9 F Application # Health Division ? ? pi i P`i Date Issued Conservation Division Application Fee Planning Dept. �:., .r : ...� Permit Fee { O Date Definitive.Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address 11(00 PI,itg- a vs �n And' ZC Village _ r'7 Y iAr.1N I S Owner CAro t }eW W Lber Address BOSS KPNsiAot}'tY! Pk. hc. #3// Telephone O� - 3©1 ' 3 11 c0 Atmoryfe Spruwqs F1. 327/9 Permit Request "rt) Mp lace W I N dcu,&T- a,ad oNe slid; a IVP sio rrn c6o,- "a en/e Vi y 64 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation d Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name _ZT "Aft Gr n{w TIJC. Telephone Number _ S08-3 G2o - 3 y 7 Address �9 1 v JV aN nrava rJ License# k4y orm i S MA 02 C001 Home Improvement Contractor# Wce Email -t'�P �1_ J p �.Cow Worker's Compensation # S0050/1-73 9 2 0/7 A ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE DATE O 1 /17 FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED R MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: f FOUNDATION j FRAME i INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL., PLUMBING: ROUGH FINAL GAS: ROUGH FINAL j FINAL BUILDING I i DATE CLOSED OUT { ASSOCIATION PLAN NO. i Massachusetts Department of Public Safety - Board of Building Regulations and Standards License: CS406046 Construction Supervisor BENJAMIN E THOMPSON 9991YAN000H ROAD;;> "Q .t HYANNIS MA 02501 �! Expiration. Commissioher 02/09/2019 `1 Office of Consumer-Affairs and Business Regulation - .10.Park Plaza-Suite 5170 Boston;:,M SMChusetts 02116 Home Improvement Coactor Registration - - -_ - Registration:, 79345 Type- Corporation °i�'''' "`- Expiration: 7/23/2018 Tr `419291 BT CUSTOM CARPENTRY INC. M BENJAMIN THOMPSON -- 999 IYANNOUGH RD HYANNIS, MA 02601 Update Address and return card.Mark reason for change SCA 1 r, 20M-05/11 Address M Renewal n Employment Lost Can C'%/c tpnrii��ea✓�ulc��ll/a���ir�ac�ersetlb Office of Consumer AQairs&Business Regulation License or registration valid for individual use only MEN=WiHOME IMPROVEMENT CONTRACTORbefore the expiration date.If found return to: Registration:.�`1:79345 Type: Office of Consumer Affairs and Business Regulation Expiration:::.7123=18 Corporation 10 Park Plaza-Suite 5170 - Boston,MA 02116 BT CUSTOM CARPENTRY INC.. BENJAMIN THOMPSON G: 9991YANNOUGH R[) HYANNIS,MA 02601 Undersecretary of valid without sWture f BTCUSTO-01 MVAUGH N .4COR®� CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 2/2/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must 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 endorsements. PRODUCER NONTACT R R e 134 Gray Insurance Agency,Inc. PHONE x ) ) (A/C,No,Ext): C No 877 116-2156 South Dennis,MA 02660 I&'Akss:mail@rogersgray.com INSURER(S)AFFORDING COVERAGE NAIC H _ INSURER A:Main Street America Assurance Company 29939 INSURED INSURER B:Associated Employers;Insurance Company 11104 B T Custom Carpentry,Inc. INSURER C: 999 Route 132 INSURER D: Hyannis,MA 02601 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXPLTIR LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR MPT6472F 08/29/2016 08/29/2017 DAMAGE TO RENTED 500,000 PREMISES(Ea occurrence) $ MED EXP(Any oneperson) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 HPOLICY�J JECT u LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: AUTOMOBILE LIABILITY Ea COMBINED acciden SINGLE LIMIT $ ANY AUTO BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTNOOSWN BODILY INJURY Per accident $ AUTOS ONLY A�TOS O1N pPeOr..dentDAMAGE $ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE _ $ DED I I RETENTION$ $ B WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/NSTATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE WCC50050117392017A 02/0112017 02/01/2018 500,000 �FFICER/MEMBgER EXCLUDED2 ❑N N/A E.L.EACH ACCIDENT $ Allandstory In N(I E.L.DISEASE-EA EMPLOYEE $ 600,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS 1 VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Dennis THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN To To Main Street ACCORDANCE WITH THE POLICY PROVISIONS, South Dennis,MA 02660 AUTHORIZED REPRESENTATIVE ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD The Coinnionivealth of Massachusetts Deparhnesrt of Indrrso al Acciden& Ogre of Invest gallons _ 600 W'ashmgtou Street Boston,MA 02111 wmnmass.gov/din Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Businessiorganizaaon idnel)_ WT C VS+'+ v" e4rpe17!ne I ntC. Address: 9 99 T yA-ir&CV%h r d City/Statrjzip: Oynoorls. MA ®2!00/Phone#-- VO 6—36 O — eV 3 417' Are you an employer?Cfieck the appropriate box: Type of project(required): 1.r ,� I am a employer with 1- 4. ❑ I am a general contractor and I employees(full and/or part-time)-* have hued the sub-contractors, 6_ ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g- ❑Demolition working .for me in any capacity- employees and have workers' 9. ❑Building addition [No workers'comp.insurance Comp-msurance,i retprired] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their l 1.❑Plumbing repairs or additions myself [No workers'comp- right of exemption per MGL 12.❑Roof repairs insurance required.]`r c.152,§1(4} and we have no employees-[No works' 13.0 Other camp.insurance required-] ;Any applicant that checks boa#1 also fill our the section below showing their workers'compensation policy information- I HDineowners who submit this affidavit indicating they are doing all wail and then hire outride contractors umst submit anew affidavit indicating such Connectors that check this box must attached an additional sheet showing the name of the sub-canusctnis and state whew or not those entities have eupktyees. Mthe sub-contractors have employees,they must pnovzde their workers'camp.policy number. I am an employer that isprm!dWg worker's'conWmsadon insnranco for nzy employees. Below is thepolicy and job site information. Insurance Company Dame: �tcAefS Vfty Policy#or Self-ins.Lic.#: WeC Pt Expiration Date: OZ 101 '?a is Job Site Address: l 1 G O yh W NQy f �r City/Statelzip: Aidmo is AM #7 G o/ Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c: 152 can lead to the imposition of criminal penalties of a Fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification- I do Hereby certify zrnder tlzepains and nalties of perjury that the information protrided above is bw and correct Si tie: Date: 10 /7 Phone#: 5-010 - 360 -T3 4'7 Offi dal 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 I Building Department 3.CitylTown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: oF� snatvsrnst�, . Town of Barnstable " Regulatory Services Richard V.Scali,Director Building Division Paul Roma Building Commissioner 200 Main Street, Hyannis,MA 02601 www.townbarnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, C'Ak(� L . �1CL1 N 1�i kL-1L"z- —,as Owner of the subject property hereby authorize�C�� `���m to act on my behalf, in all matters relative to work authorized by this building permit application for: 11bo �\AIWNgC s U) N aC (Address of Job) M zA N 1\1 1 S VkA 1-1 Signature of Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C..\Users\decoWk\AppData\L.ocal\MicrosoR\Windows\INetCache\Content.Outlook\L7U69LF2\EXPRESS(2).doc 01/25/17 BARTLETT ASSOCIATES P.O. BOX 646 WEST YARMOUTH, MA 02673 5OB-790-1 B 1 2 April 25,2017 Benjamin Thompson The Board of Trustees at Arbor Terrace Condominiums 1160 Phinney's Lane,Hyannis, MA has given you the right to install windows of the same configuration at Unir 2C . Any questions should be directed to George Bartlett at 508-790-1812. Vbery truly yours The Trustee Signed by George Bartlett for the Trustees AGeorge Bartlett Property Manager Town of Barnstable Regllatoi Services o Richard V.Scali,Director 4 Building Division �sxsresi.E, « . 9 MASS. � Tom Perry,Building Commissioner �Fb N►a� 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: .3 t Permit#: c Z l iC j HOME OCCUPATION REGISTRATION Date: - Name: Phone#: Address: —Village: rlV Name of Business: C -L-A t'C� ���y 00 P e Business: M t C — c> Tyr •f= � T.' �/U IN'I7ENr: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor,no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment • There are no commercial vehicles related to the Customary Home Occupation,other than one van or one pickup truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation.. • No sign shall be displayed indicating the Customary Home Occupation. , • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit I,the undersigned,have read and a with the above restrictions for my home occupation I am registering. Applicant Date: �� LS YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) Business Certificates are available at the Town Cleric's Office, 1"FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) DATE: IS Fill in please: APPLICANT'S YOUR NAME/S:� L' 41`''' "` i t BUSINESS YOUR HOME ADDRESS: Gr;nr�� e;�42 ��E _I 1 G y S L, Xf' c C'✓i 1 ✓�, �e3� `al(;?s"p. .;fig it .i,-'" F af. 't:✓..: XJc�—36•7-7 1�,� TELEPHONE # Home Telephone Number 1�,';,r :�I�'.�,'—•:114�F;a�r'1:�;wrNR � ' C� /Vlt @ /t.�(l,L�. COM NAME OF CORPORATION: NAME OF NEW BUSINESS ellr_ %5 1pvoff f✓J TYPE OF BUSINESS IS THIS A HOME OCCUPATION? YES NO ADDRESS OF BUSINESS h �L—en ✓�.�G MAP/PARCEL NUMBER � Assessing] When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you-may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to malce sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COM SID ER'S OFFICE MUST COMPLY WITH HOME OCCUPATIONI This individu I 11 �e_nme of n permit requirements that pertain to this type of business. RULES AND REGULATIONS. FAILURE TO 'COMPLY MAY RISULT IN FIND: Au on Sig re O MENTS �— kA 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: c7)] TOWN'OFTARNSTABLE ` R I S E Division of Thielsch Engineering,Inc. 2013 MAY 10 MtM 11 2 1341 Elmwood Avenue ENGINEERING Cranston,Rhode Island02910 DIVIS-10IN 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 1160 Phinney's Lane, Parcel 4 2730890OG 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 0 401-784-3700 •800-422-5365 •Fax 401-784-3710 ARBOR TERRACE - 81-12-1636 01�_13,),TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION v Map 273 Parcel 089/OOG Application �i V Health Division Date Issued o� Conservation Division Application Fee Planning Dept. Permit Fee { _ __ ; �'• c�� Date Definitive Plan Approved by Planning Board Historic - OKH _Preservation/Hyannis " Project Street Address UNIT # 2C ; 1160 PHINNEY'S LANE; HYANNIS, MA 02601 (ARBOR TERRACE) Village HYANNIS Owner BRETT WHITEHURST Address 1160 PHINNEY'S LANE #2C; HYANNIS, MA Telephone 774-323-2100 Permit Request PERFORM AIR SEALING MEASURES; INSTALL ATTIC INSULATION. SEE ATTACHED COPY OF JOB DESCRIPTION FOR MORE DETAILS. OWNER AUTHORIZATION ATTACHED. Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation $1,212.50 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family, ❑ lwo 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 Numb of Bedrooms: existing —new Total Rom Count (not including baths): existing new First Floor-Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other $§ ,R�• Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: 2"Yes ❑ No a Detached garage: ❑ existing ❑ new size Pool: ❑ existing ❑ new size _ Barn: U existing,,❑ 66_w size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use RESIDENTIAL Proposed Use SAME APPLICANT INFORMATION (BUILDER OR HOMEOWNER) RISE ENGINEERING; A DIVISION OF Name THIELSCH ENGINEERING Telephone Number 401-784-3700 EXT. 6133 Address 1341 ELMWOOD AVE. ; CRANSTON, RI 02910 License# CSSL-100459 EXP. 3/28/14 Home Improvement Contractor# 120979 EXP. 3/25/14 Worker's Compensation # 3730961-01 EXP. 1/1/1_3 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO YARMOUTH T FE ST ION• 0 WORKSHOP RD • SOUTH Y02664 SIGNATURE _ ®ATEZ<X�� ERIK NERSTHEIMER FOR RISE ENGINEERINGARBOR TERRACE - 81-12-1636 i� FOR OFFICIAL USE ONLY 'L +j APPLICATION# if DATE ISSUED ; MAP/PARCEL NO. ADDRESS - VILLAGE OWNER x DATE OF INSPECTION: ' FOUNDATION., FRAME r INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL ,e r } PLUMBING: ROUGH FINAL :G r GAS: ROUGH FINAL ,,;FINAL BUILDING _ _ r DATE CLOSED,OUT.' ,F ASSOCIATION PLAN NO. : Print Form � � The Commonwealth of Massachusetts � Department of Industrial Accidents Office of Investigations _ I Congress Street, Suite 100 Boston,MA 02114-2017 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 THIELSCH ENGINEERING Address: 1341 ELMWOOD AVENUE City/State/Zip: CRANSTON, RI 02910 Phone#: 401-784-3700 EXT. 6133 Are you an employer?Check the appropriate box: Type of project(required): 1.0 I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees . These sub-contractors have g. ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.# required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. o workers' comp. right of exemption per MGL y [N p 12.❑ Roof repairs insurance required.]t c. 152'§1(4),and we have no employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: THE PRESTON AGENCY,INC. Policy#or Self-ins.Lic.#: 3730961-01 Expiration Date: 01/01/13 Job Site Address: 1160 Phinney's Lane, Unit#2C City/State/Zip: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$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 certi d e ins an enalties o er'u that the in ormation provided above is rue and correct. Si ature: - _.__ _ ._._____._.._._ __.._ � 1. __-_- .__..___ Date.._... Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: • ' 3 _ Town of Barnstable , �� �-APR 3 0 2012 Regulatory Services __ y Thomas F.Geiler,Director Building Division Thomas Perry,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, BRETT B. WHITEHURST ,as Owner of the subject property hereby authorize RISE.,`ENGINEERING; A DIV. OF THIELSCH to act on my behalf, in all matters relative to work authorized by this building permit application for: 1160 PHINNEY'S LANE, UNIT 2C; HYANNIS, MA 02601 (Address of job) . Signature of Owner Date BRETT B. WHITEHURST Print Name -If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. - C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary IntemetFiles\Content.Outlook\DDV87AAZ\EXPRESS.doe Revised 072110 Arbor Terrace Condominiums nationalgrid PROGRAM SIGN-UP SHEET INSTRUCTIONS: Please complete this form to authorize the installation iF'a measures in your unit. You can choose any combination of measures.I 1n =Q� installation. RISE Engineering will contact you to schedule appointments) plete a work. 5' Return the completed form within 7 days in the enclosed postage paid e . 0, 't to RI Engineering at i�®, 401-784-3710. If you do not want to participate,you do not need to retur f rms If you have any qquestions, please contact Meaghan Quinn at RISE Engi, at 1-800- -53ti5xt 31 qr E- Energywise mail: MQuinn @THIELSCH.COM. Oln/NEQl4IMF�R/MATIO/N�,'(Please print) l� Owner's Name:�l.7�'e-..� t L,�F kitz l�S }� �ti �cs/Lt PAI LW_ 1' Owner's Address/unit# 2.C Daytime phone 7 3 q —` 2-3--2.1 Even+ngph,on�e. eAir_S.ealin —Attic-Insulation-and-Hot Water-Conservationo 1 me u es a matena an costa anon : z YES ❑NO Total Cost: $1,212.50 National Grid Incentive: $972 50N Your Cost: Not to exceed 240.00 billable upon completion �s ® Air Sealing: Air seal attic chases, plumbing and electrical penetrations, . bypasses, access openings, transitions, ductwork and other leakage points to . reduce heat loss through air infiltration. High quality foams, caulks, baffles, } weather-stripping and other materials will be used to seal sources of air leakage. NOTE: a) Includes insulating and weather-stripping the attic access hatch, b) furnishing and installing weather-stripping and door sweeps on the front entry door, +i c) basement major penetrations through sill and floor. ® Attic Insulation: Furnish and install R-30, 9" of cellulose to approximately 5000 SF of open attic areas to achieve an approximate R-49 insulation value, including soffit baffles, as needed, for all flat ceiling areas. NOTE: Attic flooring and storage items may reduce the amount of area that can be insulated. ® Hot Water Conservation: Furnish and install hot water pipe insulation for the 1st 6' •"` from the water heater, water saving showerheads and faucet aerators as applicable. Attic roldin g.Stair Insulation and Air-Seal inc u es a ma ena an insta ation : y S ❑NO Total Cost: $166.5 NGrid Incentive: $83.25 Your Cost:,Not to exceed 83.25 billable upon completion Thermo-dome Cover: Furnish and install "thermo-dome"attic stair insulating ' cover. ES ONO for Digital/Procirammable Low Volta a thermostats(No Cost 1 ) ® Digital/programmable love voltage thermostats (Robertshaw RS6110 or exact equal) replace existing manual thermostats in dwelling units 4Quantity of digital thermostats needed? ------------------------------------------------------------------------------------------------------------------------------------------------=-- By signing below, /agree to hav you i lement t.e improvements I have selected and agree to the associated costs shown. ✓ Owner(please sign) G Date 'V ( / THIEL-1 OP ID:-27 CERTIFICATE OF LIABILITY INSURANCE D4T01tj DIYYYY) 01�13/12 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE'POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER _ 401-886-8000 CONTACT The Preston Agency,Inc. 1350 Division Rd Suite 303- 401-885-1700 PHONE Exl: A/C No PO BOX 810 E-M FAX AIL East Greenwich,RI 021318-.0810, ADDRESS: Judith A.Wright CPCU AAI ARM INSURER(S)AFFORDING COVERAGE NAIC M INSURER A:Zurich-American INSURED Thielsch Engineering,Inc. INSURERS:American Guarantee Liability Thielsch Group Inc. Hi Tech Realty Inc. INSURER c:Twin City Fire-Hartford Att195 FrancTrentes Avenue INSURERD:North American Capacity 195 Frances Avenue - _ Cranston,RI 02910 INSURER E: INSURER F: - COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF*INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL TYPE OF INSURANCE POLICY EFF POLICY EXP LTR POLICY NUMBER IMM1DDfYYYY1 IIMM/DDNYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY X 3730962-01 01/01/12 01/01/13 PREMISES Ea occurrence $ 300,00 CLAIMS-MADE a OCCUR MED EXP(Any one person) $ 5,00 PERSONAL BADVINJURY $ 1,000,00 GENERALAGGREGATE $ 2,000,00 tIPOLICY L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000,00 X PRO- LOC Emp Ben. $ 1,000,00 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 2,000,00 A X ANY AUTO 3730963-01 01/01/12 01/01/13 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OVvNED PROP AUTOS PR DAMAGE HIRED AUTOS er acc dent $ $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 B EXCESS LIAB CLAIMS-MADE AUC4857188-01 01/01/12 01/01/13 AGGREGATE $ 10,000,000 DED RETENTION$ $ WORKERS COMPENSATION VvC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N X T RY LIMIT ER A ANY PROPRIETOR/PARTNER/EXECUTIVE 3730961-01 01/01112. 01/01/13 E.L.EACH ACCIDENT $ 1,000,00 OFFICER/MEMBEREXCLUDED? r_1 NIA (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,00 If es,describe under DESCRIPTION OF OPERATIONS below E-L.DISEASE-POLICY LIMIT $ 1,000,00 C Property Section 02UUNHE6930 01/01/12 01/01/13 Property see belo D Professional Liab DVL000026802 01/01/12 01/01/13 Prof Liab 2,000,00 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Is required) When required by a written contract. CERTIFICATE HOLDER CANCELLATION TWNHARW SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Building Division ACCORDANCE WITH THE POLICY PROVISIONS. 200 Maul Street AUTHORIZED REPRESENTATIVE Hyannis,MA 02601 �1914 'V ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Details Fage 1 of 1 Licensee Details Demographic Information Full Name: ERIK S. NERSTHEIMER Gender: M Owner Name: License Address Information Address: 228 Gleaner Chapel Rd. Address 2: City: North Scituate State: RI ipcode: 02857 ,Country: United States License Information License No: CSSL-100459 License Type: CSSL-IC-Insulation Contractor Profession: Building Licenses Date of Last Renewal: 4/24/2012 Issue Date: 5/6/2009 Expiration Date: 3/28/2014 License Status: Active Today's Date: 4/25/2012 Secondary License: Doing Business As: Status Change: 18 Prerequisite Information Licensee: NERSTHEIMER, ERIK S. Relationship: Attribute Of License No: CSSL-100459 Discipline No Discipline Information Documentum http://elicense.chs.state.ma.usNerification/Details.aspx?agency_id=1 Mcense_id... 4/25/2012 Office of Consumer Affairs d Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration p JUN 20 2012i I 1 I Registration: 120979 6UJ Type: Supplement Card THIELSCH ENGINE RING Expiration: 3/25/2014 1341 ELMWOOD AVE. - CRANSTON, RI 02910 Update Address and return card.Mark reason for change. SCA 1 C: 20M-05/11 Address Renewal n Employment Lost Card ��e�aorvnzarrruerrlt�n/'C�/fla��ccc��rde� � . face of Consumer Affairs&Business Regulation License or registration valid for individul use only. ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation egistration s:120979- Type: 10 Park Plaza-Suite 5170 Expiration.*.:: 3/25/2014 _'•: Supplement Card Boston,MA 02116 THIELSCH ENGINEERING ERIK NERSTHEIMER 1341 ELMWOOD AVE CRANSTON,RI 02910 Undersecretary Not valid without signature I Control No: 34244 THE COMMONWEALTH OF MASSACHUSETTS DEPARTMENT OF LABOR e DIVISION OF OCCUPATIONAL SAFETY g 19 STAN-FORD STREET, BOSTON,MASSACHUSETTS 02114 LEAD-SAFE RENOVATION CONTRACTOR LICENSING WAIVER RISE Engineering A Division of Thielsch Engineering, Inc. 1341 Elmwood Avenue Cranston, RI 02910 WAIVER: LWO00672 EXPIRES: April 15,2015 IN ACCORDANCE WITH M.G.L. C. 111, § 197(B)(b)AND 454 CMR 22.03(3)(b), THIS LEAD-SAFE RENOVATION CONTRACTOR LICENSING WAIVER IS ISSUED BY THE DIV. OF OCCUPATIONAL SAFETY TO THE CONTRACTOR ABOVE FOR THE PURPOSE OF PERFORMING LEAD-SAFE RENOVATION WORK. THIS LEAD-SAFE RENOVATION CONTRACTOR LICENSING WAIVER MUST BE MAINTAINED BY THE CONTRACTOR IN ACCORDANCE WITH M.G.L. C. 111, § 197B(b)AND 454 CMR 22.04 WHEN PERFORMING LEAD-SAFE RENOVATION WORK. HE ATHER E. R OWE ACTING C OMMISSIONER Printed on Recycled paper I / 4 s "2 v Town of Barnstable *Permit Expires 6,mont ftom issue date w BARNSTAB y Regulatory Services Fee M Thomas F.Geiler,Director � 6 N ti 601 .� �J� Ns Building Division Cb � Tom Perry, Building Commissioner �� �F 200 Main Street, Hyannis,MA 0260S18d1SN8V9 qo NM Office: _"&4038 Ol Fax: 508-790-6230 909? 9 Z Nnr EXPRESS PERMIT APPLICATION - RES Not Valid)"Out Red X-Press Impri Ud Ic Map/parcel Number` G(jJ �'� 00 Property Address ( l u ® PhiNwe-mc �-}- ❑Residential Value of Work Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address (o y 2ontractor's Name '1� �7i� �C �m(,� Telephone Numberbb "l L 8— .Tome Improvement Contractor License#(if applicable) 1 �� LA V construction Supervisor's License#(if applicable) 252, ]Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner '-� I have Worker's Compensation Insurance nsurance Company Name Vorkman's Comp.Policy# �c\m0 2-'Ou� :opy of Insurance Compliance Certificate must be on file. 'ermit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side Replacement Windows. U-Value a O (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. Home Improvement Contractors License is required. tgnature Forms:expmtrg ,vise063004 1` ` RI SIT PA1'MENi R.ECETPI r,T EN T�rl�. F PARII^'�P,f3f_E _ HA s r 4, Ali fit C f + Late: 6/13/2Uub Time: 8:40 AM To: (9 9,1,b084281547 R&G 1nS. AgCY. page: UUl I t A Client#:47298 CAPIHOM ` acORV. CERTIFICATE OF LIABILITY INSURANCE 61131M/DDIYYYY) 06/13/06 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Rogers&Gray Ins.Agency,Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 434 Route 134 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR P.0.Box 1601 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. I{ South Dennis,MA 02660-1601 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: National Grange Mutual Ins.Co. Capizzi Home Improvement,Inc. INsuRERB: GUARD Insurance Group Capizzi Enterprises,Inc.1645 Newtown Road INSURER c: Cotuit, MA 02635 INSURER D: INSURER E: - COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INbK AD POLICY EFFECTIVE POLICY EXPIRATION LTR INS TYPE OF INSURANCE POLICY NUMBER DATE MM/DD DATE MMIDD LIMITS A GENERAL LIABILITY MP010707 06/08/06 06/08/07 EACH OCCURRENCE $ 1 OOO OOO X COM O R MERCIAL GENERAL LIABILITY DAMAGE TENTED $500 000 CLAIMS MADE a OCCUR MED EXP(Any one person) $10 000 PREMISE PERSONAL&ADV INJURY $1 000 000 GENERAL AGGREGATE s21000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $2 00O 000 POLICY F1 JPERD 171 LOC A AUTOMOBILE LIABILITY M1010707 06/08/06 06i08/07 COMBINED SINGLE LIMIT $5OO OOO ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ X SCHEDULED AUTOS - (Per person) X HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) X Drive Other Car PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $EAUTO ONLY: AGG $ A EXCESSIUMBRELLALIABILITY CU010707 06/08/06 06/08/07 EACH OCCURRENCE s5,000,000 X OCCUR CLAIMS MADE AGGREGATE s5,000,000 $ DEDUCTIBLE - - $ X RETENTION $10000 $ B WORKERS COMPENSATION AND CAWC702365 12/25/05 12/25/06 x WCSTATU- OTH- EMPLOYERS'LIABILITY - IR ANY PROPRIETORIPARTNERIEXECUTNE E.L.EACH ACCIDENT $500,000 i OFFICERIMEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $500,000 Syes,IAL PRO de PRO V I under SIONS below E.L.DISEASE-POLICY LIMIT $500,000 SPEC OTHER 1 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL I_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001108)1 of 2 #M22681 MEE 0 ACORD CORPORATION 1988 600 41sh PO&O12, JVA 02111 WHM:�M-418&001 M U NVw)�ex's", (;OWPOMAJOYI )x)Swrx)C,,C. Capin! I]orne Improvement In. own Rnnd ldn-,ss: cciultl MA 02635 Pja oD c A eyoxz 7n e7ozplopery Cbeck Type of project(required): 2M a e4loya w'ilb 4. F Iazfl a genezal coni7actorand 1 . 6.* El NeV const-0060M 1-MV10Yces(�-m& r paA-Jjme,). have b-b-c-d-bc sub-cauincloTs am* 7- -a Usb--d'on fie atacbfd sheet ship'aDd 17 2 7c hc)-employe.,s These sub-CODt-3d0n 8. Demolition WOT)'ZiDg &'Me iD any CapaGhy. V,7j()jf.=' comp.insx�rance. 9. B;iildiiag nddidwi' - trams_in e El WP-are a corporation aad its I-e--quired-j10.D T--I&llical 3-z-,paiz o3-ndditions offacl--rs have exercisr'd ibeiT homeowncl dDiCL,-all W01L, ri.OX of cxmppdo3a p ej:h4C3L 11-El Plumbiag repairs oi addhimas c.152:, §1(4),and we have,no 12-0 RoDf repairs msura3IC4- cr�P1031(=-- [NO -act comp-MSM-a *qUiell 140W ShD-xk'iRg CMM=Wh4D 14�ads aEds,,�mditME-!bey doiag SB vvoll,-eau f)ca dare birtsideconixar'I'D=M�dya submits new sffidavit idCE6affilg sucl- CID= atacb(--a;ez aacii-6onsi coma_policy±nfb=Biion.- aci-,CampanyNamt G-mLP or self-ju.s.tie. Expimtiou Date :,c,A4ddr�;ss- k:a c y of CAMP MS2�io)a qlicy d cjar.,2fj on page(sllo the policy namber a-ad expix-afvan aate)- c -erWider .win-<., . 1 0- o" age as req`ircd liva(--r&,'��On25Aof MGL c- 152 cailead iD flae-imposition of crhnhlad penalties.0iln o $1,500-100 and/or 6ne-year 3a33-Pl-.i2ojjMt3at BS IAI-itll as rilra P malties za&e form of a STOP-WORK ORDER and a fmc .D $250-00 a day agai-eSt jhe"'iolatDx- -6eaal" copy forwarded to t4t 0Mize of 70,aJ10S of fl e M�for .rerfficaticm, OfRetiwi,tjud a;z qvi&d obzw is P-ac=44 Coma Date: :r-w use exlly DO not lwi4e in this area,to or hag A xxt)[iority (cwde oard —- --- -------- -tact Persoll- _ = _ Board of Building Regulations and Standards One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement-.Contractor Registration Registration: 100740 Type: Private Corporation Expiration: 6/23/2008 CAPIZZI HOME IMPROVEMENT, INC Thomas Capizzi, jr. — 1645 Newton Rd. Cotuit, MA 02635 Update Address and return card.Mark reason for change. ores-CA1 Co 5OM-04i05-PC8698 Address ❑ Renewal ❑ Employment ❑ Lost Card 9Xe Vonz��zoo�cuea o ✓f�a�otxc�ivaeCta Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration:. 100740 Board of Building Regulations and Standards Expiration:' 6/23/2008 One Ashburton Place Rm 1,301 Type:._Private Corporation Boston,Ma.02108 CAPIZZI HOME IMPROVEMENT, INC. Thomas Capizzi jr.., 1645 Newton Rd Cotuit, MA 02635 Deputy Administrator Not valid without signature D � BOARD OF BUILDING REgytAU6NS - 1-icense. -CONSTRiDCTION S- Numbed 057032 `- Exp--iresJ�0�12fiI2bD7 ='`! l Res" triftea.j 7HM�wro AS X CAPI c:: 164O5l IV � w r; _ E. coTUIT, 635" - C , Comrnlss�orier � f f HIml;rome ent Inc. I, Thomas Capizzi Jr., owner of Capizzi Home Improvement, hereby authorize Lisa Haworth, to sign on my behalf for permit applications filed through the town. Signed: C)t-12 Thomas 6dplizzl,fK Date: aworth Date: 1645 Newtown Road Cotuit, MA 02635 (508) 428-9518 (800) 262-5060 FAX (508) 428-1547 Page 7 of 7 CAPIZZI HOME IMPROVEMENT INC. SPECIFICATIONS AND ESTIMATES STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT OWN THE PROPERTY LOCATED AT p inA-ey 2 jk, IN ( ��II�� MASSACHUSETTS. I HAVE AUTHORIZED CAPIZZI HOME IMPROVEMENT TO ACT AS MY AGENT TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. I GIVE MY PERMISSION TO LESSEE TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. -- SIGNATURE OF OWNER: OWNER'S ADDRESS: OWNER'S TELEPHONE: LESSEE'S SIGNATURE: LESSEE'S ADDRESS: LESSEE'S TELEPHONE: a APLLICANT'S SIGNATURE: APPLICANT'S ADDRESS: 1645 Newtown Rd. Cotuit MA 02635 APPLICANT'S TELEPHONE: 508-428-9518 RESPONSIBLE OFFICER: RESPONSIBLE OFFICER ADDRESS: RESPONSIBLE OFFICER TELEPHONE: 1 Engineering Dept. (3rd floor) Map 'oZ 7.3 Parcel a87 , 0067 Perm it# House# /l 6 Q `� r Date Issued Board of Health,(3rd floor)(8:15 -9:30/1:00-4:30)(,(w rf�f 3-V f 1 Fee C*2..5, a,:) Conservation Office(4th floor)(8:30- 9:30/1:00 4 2:00) A Planning Dept.(1st floor/School Admin.Bldg.) SEPTIC MUST BE Definitive Plan Approved by Planning Board 19 INSTAL PLIANCE S ENVIRO CODE AND TOWN OF BARNSTABLE TOWI/N LATIONS Building Permit Application Project Street Address 0 �Q1- i, p S ��►>�� j (�I Village - Owner c �,�hi G� �i-,��'�i� � Address 2 C, Telephone i ,.Permit Re uest G v . �d First Floor square feet Second Floor ` square feet Construction Type Estimated Project Cost $ 1 Qua Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No 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 No.of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name f L10 4�'L Z57 Telephone Number TC� �Z Address C/1ae/z License# 0 VO Home Improvement Contractor# S'- 6 ? _ Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE _ BUILDIN9 PERMIT DENIED FOR HE FOLLOWING REASON(S) 1 //`mow ::���s�Y s�'• ` ►• .,:� L"=6`+; ash, ;` FOR OFFICIAL USE ONLY PERMIT NO. k DATE ISSUED M - MAP/PARCEL NO: - - t ADDRESS VILLAGE , - OWNER a k DATE OF INSPECTION: FOUNDATION j FRAME - - INSULATION FIREPLACE p ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH fINXL �. _ to GAS: W S RO1 GH FINAL r cr FINAL BUILI (gt- � Mrp DATE CLOSE ASSOCIATION; M0 t .r •, ,•. � STANDARD 5 1EGEN D 7.0 -- Now not all s boU wKl appetai on o ma , i ../... 1'I `•i `: Q..-_-:� 60EF COURSE FAIRWAY I , , , j�..$0• #1161 i _ _ D aouousrRFEs 7 �` `'°--• EDGE OF BRUSH -�« F �:....� _ �.7_ ..: y _i''4 i^`; �..a• .._...�� `:i\....� .. \ 0. ORCHARD OR NURSERY �3" "- .. Ai - CONIFEROUS TREES \', r._._.... 1 _ _ .. - __ .. MARSH AREA 70.1 _ \ - EDGE OF WATER , ...•1 > -._.....__,'I DIRT ROAD ,9 DRIVEWAYS • - PARKING LOT 1 ! 1.20 AC\ • \/69.0 ' �� 1PAVEOROAD , DITCHES 5 _ }`,ar`��-``..,�,' �� ! '� _ — — •i, %/ I` PATH/TRAIL V PROPERTY LINES :., ;._. �.'.� �`, C :i•�--r ` \ ._......._. ...: .. ne° LOT ACREAGE , % , �• f j." ?' 21 PAR(Et NUMBER ,`• , / :•% ..;•..,r,_. �` �\/ - ir... �OUSENUMBER 6 7� , ,r.3 _ •, .: ..•� � � 2 FOOT CONTOUR LINE /\ , 10 Four coxtoue LINE \/ 6 x,• SPOT ELEVATION l \ 69 1 —' N WALL , ' 7 2 ,r.. � , . FENCE -c i . r RETAINING WALL RAH TRACKS ROAD 1 , , 74.5 .. "•�,. ''l 4. •�� _ , :` TELEPHONE POLE STONE JETTY 0.0 �P c " 0A .'. . . WINNING POOL .):_.... _ 6 I ,' •\ 0 3.-3 PORCH DECK L331#1160 / _ /\ S ., 4 BUILOIN65/ST RES \ / �f :c' �' '� .; �•s - .:i_::: DOCK/PIER/1ETIY , , ASSESSORS BOUNDARY Ij l i._ f� _.. • p ' MAP „ , , , ' SITE MAP 1 1..,......_, 3 A( , ,. ,g 2 • �� � ....._ .. - INFORMATION mrLMsulDr , i .� !11 f / a T.D.I.r.D.e.GEOIaTAPxH...._............ 0.32 C 0.30AC ` 8 6 - 10 ' 110- 4 �. SCALE:in feet ` �73�$3 #15 °1 #21�, ' o so ioo 0.41 N ' \/72.5 0.28 AC 0.29 A( :r .37 Al, +f /,� F WR:IN!/LLO[l Hnff ARE k"NOT Fat RIRF51NtMI0Nem , #33 110- 3 /•. i I rRDYEAneoueoARHs.rxnurRmmHlaAtmRs..eea.P, ( ; VIGIIAIION,TOPOGRAPHY AND nARIMUKIC DAIAIRIERPRI 110 i # :': ' z 36 A( , \ , FILM 1909 AERIAL OVERFLIGHTS.PHOTOGRAPHY AT I'-000' , ' vl :30 AC �...,' : T ^ \ IEEO FROM I-100 �� ! , / � � \ \ 1l SB 1 .......r....... _......... `�/_....�•.......... ��I ..'� ENGIR[LRIRG ASSESSORS MAK 1989 I'�! '� I /Y j('�� 0: 2 AC — I i x log t-� 1U � �.IgtilJ�Y► G� Z (��� 07��� 3 , h g� � l yt -. - b s i � ✓fie �arr✓rn;o�r�ulea�� a��,��a�c�ucaeC� HOME IMPROVEMENT CONTRACTORS REGISTRATION Board of Building Regulations and Standard One Ashburton Place - Room 1301 Boston , Massachusetts 02108 HOME IMPROVEMENT CONTRACTOR Registration 120055 Expiration 10/10/97 Type - DBA T .A . BISSELL & SON CONST TODD A . BISSELL 75 POINT OF ROCKS RD BREWSTER MA 02631 The Commonwealth Of Massach uscas •rii '` �__`�i; �- Department of Industrial Accidents ofice81109SM92Aons 600 11'asltington Street `L Boston,A1ass. 02111 Workers' Compensation Insurance Affidavit nhcant information• r- Please PRINT le;tb1 name• locition- city phone# 1 am a homeowner performing all work myself. 1 am a sole proprietor and have no one working to any capacity ...... ....--,r..,.,.j•N-r-,.,.a.•.,.,4� A�..grtr,!aewTX.•'�,vRae7f -.-w�,.�y�...! '+-.-w-t.T'..—.. I am an employer providing workers' compensation for my employees working on this job. coniyanv name• address: city phone#: insur ee o lic•# I am a sole proprietor, tracto or homeowner(circle one)and have hired the contractors listed below who have the following wor-ers' compensation polic coonliany name• •tddress• Sim phone N: insuran e co, lJolicy# �0 R L �aSa � ^y•_ -.. - _... tK.r7'r _ -.a�w¢,;-Nr,s'•.•'T•CY s^T;rr,. ..i;-cry-;zre• ;;•�i-s�;;�,r�+,,r..��••±sp>::.r�,.,r., �yp_r-'e?--:•,�e7.ttt}{, "„e-+-•-••--r company name: address: cites phone#: insurance co policy# -.Attach additi6oal sheet if niceessa M + -+�^ * % _;vie w_ r 'r ^•�-'* -- _ -�' �''� --•--..__. r�..::�. '�.ra.�+.:i. ".�— _ £:: , -- ymV�� "' :rw.,.`ici,w Failure to secure coverage as required under Section 25A of h1GL 152 can lead to the imposition of criminal penalties of a fine up to S1.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. 1 understand that a copy of this statement may be forwarded to the Office of Investigations of the D1A for coverage verification. 1 do herebl•certijp under llre pains and Wallies of perjun•that the information provided above is true and correct. Signature Date,� / 2, ,/ b Print name Phone# 7it)% or nly do not write in this area to be completed by city or town official permit license# riBuilding Department OLicensing BoardOcheck mmediate response is required �Sclectmen's Office �1lcalth Department contact person: phone#; nOther (revised 3.195 PJAI. OFtHE Tp� The Town of Barnstable BAMSTABIM 9e� ' Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner • For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. Type of Work: /0,77 fX/d _g.� , Est. Cost Address of Work: D 1a f Owner's Name Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under$1,000. Building not owner-occupied s Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the age f the owner: /2 bat4 Contractor Name Registration No. OR Date Owner's Name