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0110 WEST MAIN STREET
� _ _ -. �:; �, 1 V ' ti i } t '� s t ._ � C2gd 73 b UJ- A A-[=K3 :::�-r aid L4 k t r Town of Barnstable Buildin `.' - `,'�'. ', '�`#. °`� ? 'fig ✓. ° " � k+ d 9 P,ost;This Card so That it is y�s�ble From the Street Approuetl Plans Mustbe Retained on Job and this CafdMustbe Kept ; M^ Posted Until Final InspectionHas Been�Ma�de ,,, k's 'ti r x _. x� ° Wh'ere�aertificate of Occupancy�s Required,-such Bu�ldmg shall Not be Occupied untt aFtnal Inspection has been made Permit Permit No. B-19-1782 Applicant Name: BRAULIO BRITO Approvals Date Issued: 06/04/2019 Current Use: Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 12/04/2019 Foundation: Residential Map/Lot: 290-173-OOM Zoning District: SPLIT Sheathing: Location: 110 UNIT 13 WEST MAIN STREET,HYANNIS Contractor"Nam f!, BRAULIO BRITO Framing: 1 Owner on Record: MARTIN, BARRY E ESTATE OF Contractor'. iceris CS-110548 2 Address: 707 MAIN STREET Est Project Cost: $ 1,000.00 Chimney: HYANNIS, MA 02601 Pe%mit4Fee: $85.00 Description: garage was made into finished room years ago Selling cohdo and Insulation: wants to legalize the room g' Fee Paid ' $85.00 Date 6/4/2019 Final: Project Review Req: '. Plumbing/Gas F Rough Plumbing: Building Official Final Plumbing: #` a� 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 structures'shall be in compliance with the local zomn b laws and codes. This permit shall be displayed in a location clearly visible from access street or"road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. ' Electrical The Certificate of Occupancy will not be issued until all applicable signatures byk,"the Building and Fire Officials are provided on this:permit. a IService: Minimum of Five Call Inspections Required for All Construction Work.'' 1.Foundation or Footing b ' 2.Sheathing Inspection Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 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: "Person ratting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: .r R p Application Number.............. ..R ...t.. d;. ........ • BARNBrABLF, . Permit Fee......T.... `... ....................Other Fee........................ 1639. FD Mfg a TotalFee Paid............................................................... ...... TOWN OF BARNSTABLE Permit Approval by.... ...........................on.....� �.1. . BUILDING PERMIT D......................Parcel... ...1.. .. OD.:.:..!.... MV... - - APPLICATION Section 1 — Owner's Information and Project Location Project Address k y Wes+ W t✓i S --*lb WEAr-,o/t lr Village c_r Owners Name A0 ( / 0✓G 1 ,� Owners Legal Address d ✓1 - City, State Zip 02-6® I V Owners Cell# J O7-- E-mail Section 2 —Use of Structure : o © . Use Group ❑ Commercial Structure over 35,0 cubic feet ❑ Commercial Structure under 35, 0 cubio&et ❑ Single/Two Family Dwelling Section 3 — Type of Permit ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment ® Sprinkler System ❑ Addition ❑ Retaining wall ❑ Solar ❑ Renovation ) ❑ Pool ElInsulation Other—Specify, -!V4 15nco /0 d tn 00f, b zr-J 4pe� Section 4 Work Description F � Application Number..................................................... Section 5—Detail Cost of Proposed Construction " b o o Square Footage of Project Age of Structure Dig Safe Number #Of Bedrooms Existing Total# Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics ❑ Wiring ` ` ❑ Oil Tank Storage ❑ Smoke Detectors ❑ Plumbing ❑ Gas ❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney ❑ Add/relocate bedroom Water Supply E Public ❑ Private Sewage Disposal BMunicipal ❑ On Site c Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: I am using a crane ❑ Yes 1No L Section 7—Flood Zone Flood Zone.Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No ❑ Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq. Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units(on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed Side Yard Required Proposed 1 Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No T act„nrio+PA• >>n anm Q The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA. 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit:Bulders/Contractors/Electricians/Plumbers Applicant Information Please Print Leeiibly Name(Business/Organiztiontindividual)• Address: ur�t City/State/Zip: 'C (J rJ2l� Phone#: 6 07-' Gi 3 Q — (o?V 5 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with- 4. I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for mein any capacity. employees and have workers' [No workers'comp.incnran� .insurance.: 9. El Building addition r ed] 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[No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance repired.]t c. 152,§1(4),and we have no 13 2Other rS� employees.[No workers' comp.insurance required.] *Any applicant that checks box#I 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 most submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their worker;'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees Below is thepolicy andjob site information. Insurance Company Name: Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL 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 fo ce c .erage verification. I do hereby cer ' under the p ' and penalties ofperjury that the information provided above is true and correct Si Date: �� Phone#: 0 (v 7 4a Official use only. Do not write in this area,to be completed by city or town official I City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions .. Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an wWloyee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a join enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal 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 dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised bunt this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials 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 contact you regarding the applicant. Please be sure to fill in the penvitllicense number which will be used as a reference number. In addition,an applicant drat must submit multiple permittlicense applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to drank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Me of Investigations 600 WashhVon Street Boston,MA 02111 Tel.#617-727-4900 ext 446 or 1-877-MMSAFB Revised 4-24-07 Fax#617-727-7749 www:maw.gov/dia'. �I i ►� RAM We IT } .- ON WOO f '260 N Y'£ t' • M1. y, 3 - ppass�P.o���aira�a.�• Y -'"� �'R.e«w•e - < � ,.y..r. 44 .. Y i•` drp``R-�# �plpl+ i w ones Q6t W 2Y20 .4- � boo tvj 1 w tin,allCO Barnstable Bldg. Dept. Approved by: ��rG Permit #: 13 78 Z Application Number........................................... Section 9- Construction Supervisor Name�jf L o %I t-v Telephone Number \ 3 u'47..1 Address City jo be rn✓i t 5 State I Zip License Number 1 5 License Type C Expiration Date 05 Contractors Email_ O[ y /P,--t-iw @ Oo Hc, , ( 'Veil # 60 I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentatio uired by 780 CUR and the Town of Barnstable.Attach a copy of your license. Signature Date ©S -Z y— 14 Section 10—Home Improvement Contractor Name Telephone Number Address City State Zip Registration Number Expiration Date I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your H.I.C... Signature Date Section 11 -Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT SIGNATURE Signature Date 5- S- I S Print Name �v�L4 Telephone Number S E-mail permit to: (-Wi C- n r Section 12—Department Sign-Offs Health Department ❑ Zoning Board(if required) ❑ Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation ❑ t For commercial work,please take your plans directly to the fire department for approval Section 13— Owner's Authorization i as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of job) Signature of Owner date Print Name l - 1%1 ssor s map and lot numb r .......... . .::.....................e � � . Q�OF tH E :wage Permit number ��} Z 33 STABLE, i House number ...................:..................................................... so Mass- O,o t639. 00 t� ? 'FO MAI a� TOWN OF BARNSTABLE 1*71 BUILDING INSPECTOR APPLICATION FOR PERMIT TO .......qe.-t'-2 ........ ...........................2w.(.J ... .y.. ......... TYPE OF CONSTRUCTION ........... �J�..... .................... ................. l� ...................19 �. ...•TO THE—INSPECTOR°OF BUILDINGS: The undersigned herebyyaa applies for a permit according to,the following information: Location ......./. ......... ..:�"/.....:��Cie�...`.s ......................................................... ProposedUse ........ .............� '� � ........................................................................................................................... Zoning District ........��..................................................Fire District ............ �'r',✓t! Name of OwnerL .... '. ... .... ...... ...... ...... /�ri4ddress ..... ................... Name of Builder ..� `F...... ... .�% G:�� J .....Address ... 6 .t-L.!�if�../ � Y...................`'� �/ Name of Architect ..� . ...+. ��.�G:... dress ...... ✓.. 5......� .................... �� ) Numberof Rooms ..... .. . .................�G� ..�...... ou datrs�..... ....................................................................... Exierior 4%�. i ... �"�� �1.............Roofing :..... ...`'4:f� 1.:.�lrt �. .�......................... ........./ Cam.. G� .� � C�2v Floors ......... .. ./F'.G.�...�:......;� .....................................Interior ...........Y........r:............................ ............................. Heating ... �..................................................Plumbing .. . J�� . '' `��.........��" U................ . Fireplace ............. 'L./..........................................Approximate Cost ...... ...c�/.............................. . . .......... ///Definitive Plan Approved by Planning Board --------------------------------19---------- Area C-�0v S � 4. 4� eo Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH Construction plans for entire project filed under Permit #22841 dated 2/5/81 Site plan for buildings 2, 3, 5 under this permit # . hereby agree to conform to all the Rules and Regulations of the Tow of Barnstab regarding the above construction. Name ...... ........................................................................ _J E COD MELODY VILLAGE, INC #01AI 6S -'VOZ�J 4 ...........2...... Permit for ...Build................................. Condominium (3Bldgs . 6 UnitEl.'_ea7. Location 1,10 West Main Street ................................................................ YE Hyannis . ..............................................................I................. Cape ,Cod Melody Village, Inc. Owner-e... .............. ................................................ Type of Construction ....Frame....................................... x r 11 ...................................................... ........... �0� 4) < P,ot ..... ...................... Lot .................................. .100 v May 19, 81 rP P krmit-Granted .........................................19 Date ofInspection ....................................19.Date#Completed ......................................19 PERMIT REFUSED ............................................... .... ............ 19 ....... ...... .. .... ..... .. ............... ... ........ . ..... .. ........... ........................... 4!t) I'l ...........................................................0................... '0 Approved .................................... .............. 19 .......................................................... ........ ............................................................... VIP ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 2G10 Parcel 173 IV& Application #C�® Health Division Date Issued L"i< Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/Hyannis Project Street Address iye—oD!f V I I HAiAl S7r,LjyA\ AJ I$ A- Village_ ��i/ 7 S 1 Z- 71-7 C006- S c.26) Owner MUcx0, rVmIW,17a�/c�/a�✓,L�.✓n��, rAddress LIO-rs I'z--4/7 "" /� G t LL Telephone 5U�eg�q `7© (�,v_s7 1'k&Pe_-4LzY"A9Y (•f4i-177ey-- Permit Request 12,&-1?z0 r= gL1 1 LC-2 10GOC rT Square feet: 1 st floor: existing lG r p sed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation (9 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) U01-7) Age of Existing Structure 30 Historic House: ❑Yes krNo On Old King's Highway: ❑Yes J No Basement Type: AFull ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sn( n Number of Baths: Full: existing new Half: existing ,-F ew Number of Bedrooms: ° sting _new cc/�p,It Total Room Count (not including baths): existing � %ew First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil *lectric ❑ Other Central Air: ❑Yes '42,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 ❑ y Commercial Yes ❑ No If yes site plan review# ��0n�11�1L(M-5 Q Current Use N (n) p iG4•L Proposed Use t --- (J") APPLICANT INFORMATION 0 (BUILDER OR HOMEOWNER) Name Telephone Number Address I` ,o (5VK_ License# �27 �✓ A- UtiPv 3 Home Improvement Contractor# L4:!-�3 S� Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN SIGNATURE DATE 3)W/0 FOR OFFICIAL USE ONLY ` APPLICATION# DATE ISSUED MAP/PARCEL NO. I ADDRESS VILLAGE OWNER DATE OF INSPECTION: r: FOUNDATION FRAME K INSULATION FIREPLACE r^ ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. I r�.0 • , . The COMAIOAWeW1th Of MosJOChi/Jetts Deparme4rof Adustrid Accidents r 0fflce of Investigations 600 Wosbington Street Boston,AKA 02111 www.MaJLgov/dlo Workers' Compensadon Insurance AMdavlt: Builders/Contractors/Electriclans/Pinmbers '%R09caat Information r /— Please Print I.Mbh► Name(BusinesvOWniratiotvindividual): C 6t'-�.t/I!, /Z t°a�S�S 1 LCG Address _ t� 7 64 Cityl tate/Zip: 60 " e 0 U-6 0 �ti Phone 0:Sl) 4UZ� ,+ln ou u etopioytir?Cheek t�ptoprlato bo:: Type of projest(requiredk . I am a contractor and I employer with�_ ❑ tI 4 enpbyees("and/or pact-time).• have hired the sub-contrictore 6. ❑Now construction 2.❑ 1 am a sole proprietor or partner• listed on the attached sbeeL 7. 0 Rawdeling These subcontractors have ship and have no empbyea a. ❑Demotitlon working for rile io any capai;ity, empbyees and love workers'[No workers'comp. insurance comp. iosurs 9. ❑Btu nce.t ldinf addition MVdMd1. S. 0 We are a corporation and its 10.❑Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised thek 11.0 Plumbing repair or additions myself(No workers'comp. right of exemption per MOL 12. Root rcpsirs insurance required:)f c. 152,41(4),and we have no employees.[No workers' 13. Other comp. 6urance 'My applieant.dtsR ehsKb,boat of muse also,fil sat do saedoa below +f tttdr wotkM'covw=1 an potter ittth mdam Hanoi sn whe wbnit dtir fllQavil iatdicaWy tent me dotty all work sst0 than hilt,aibide eontntston mart submit a new alRdavit indieatlng suer tContntcaw dot etndt diV boas ataaet atoditld m dditiatoi dwM showing the tome atdw subKoatrreton ad sots whethw arrm thou mddes,kne enpkrjm. Itdo sub cons store have ea gk3ma.day mace pavrib duct wake'cony Io Fj naratbr► l•aw ens MAW time Is prrvrdtwt wor M'ceawPentetlats 1"WINseo jer ANY emph7m ddtew 6 de pe&7 ead job sib lwjenstetleai. Insurance Company.Name: f'T ( �14 Policy N or Self-irn: Lic.M: S l Expiration Date: a ►�y 1, � �/lA a� f � /� lob Sito Address: - CityiStste/Zip: H'70��/w/S 42�oy/ Attach a copy of the workers'cons pensadon policy declaration pogo(showing the policy number and expiration dabN Failure to secure coverage as:required under Section 23A of MOL c. 152 can lead to the imposition of criminal penalties of a tine 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 tine of up to f230.00 a day agaiost the violator. Be advised theta copy of this statement may be forwarded to the Office of Investieadoru of the DU for insurance coverage verification ids bnrdr enrlJj►oolrr rA pelwr and pswe/Ma of pse/prp tNe/b1 lejOntta/e�t prarr/dtd`mow It tree end eoi►eat sigan c: Dee: iihOst Useaffly. Do not write/n IM arm to be cow efty or town oQfclal City or Town: Permit/ldcense,0 Issuing Authority(circle one): 1. Board of Health 1. Building Department J.City/Town Clerk 4. Electrical Inspector _5. Plumbing Inspector 6.Other Contact Peron: Phone 0: DATE(MMIDD/YYYY) ORD M CERTIFICATE OF LIABILITY INSURANCE 04/1512009 PRODUCER, (800)782-0251 FAX (781)261-2099 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ;astern Insurance Group LLC - Commercial ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 77 Accord Park Drive HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Unit Bl Norwell, MA 02061 INSURERS AFFORDING COVERAGE NAIC# INSURED Capewide Enterprises LLC INSURER A: Hanover Insurance Co. 22292 PO BOX 763 INSURER B: ACE USA Centervi 11 e, MA 02632 INSURER C: 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. INSR ADDT TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE IMM102MU— LIMITS GENERAL LIABILITY LBN5336555 0413012009 0413012010 EACH OCCURRENCE $ 1,000,00( X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 300,00( CLAIMS MADE FI—Av-11 OCCUR MED EXP(Any one person) $ 10,00( A PERSONAL&ADV INJURY $ 1,000,OO GENERAL AGGREGATE $ 2,000,00( GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 21000,006 POLICY PRO LOC JECT AUTOMOBILE LIABILITY TBD AUTO 0412012009 0412012010 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ 11000,006 ALL OWNED AUTOS BODILY INJURY ly SCHEDULED AUTOS (Per person) $ A HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY UHN5336545 0412012009 0412012010 EACH OCCURRENCE $ 2,000,006 OCCUR CLAIMS MADE AGGREGATE - $ A 2,000,000 s 2,000,00 DEDUCTIBLE $ X RETENTION $ 10,00 $ WORKERS COMPENSATION AND C45761472 0411412009 0411412010 wC STATUDRY LIM -S7 I oTH- EMPLOYERS'LIABILITY E.L.EACH ACCIDENT 500,00( i B ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 500,00( If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT 500,00 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Evidence of Insurance. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL Town of Barnstable 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Bu i 1 d ing Division BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 200 Main St. OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE Rona 1 d C1 eaves/KCl ACORD 25(2001/08) ©ACORD CORPORATION 1988 :Massachusetts- Uepai-tment cal' Public SafctN Board of Buildin Re-ulations and Standards Construction.Supervisor License .License: CS 89273 Restricted Lo ;00 RICHARD M;CAPI'N' 122 WHITMAk RD; C`OTUIT MA:0263'S ry Expiration: 1 1/271201 1 c'nm miss k)f10 Tr#.: 9638 i s I� i y 1 . i Z. et. o0 p,, 44 ---- - i. J 'FROM 1ST PROP. MGMT. PHONE NO. Mar. 10 2010 11:27At-i P1 CAPE COD MELODY VILLAOECONDOMINIUMS IW,,Main SL Upt,#11 Telepliom, 308-420.0299 flw# .Al.,ARA MFGC �a..t FOR 420 0'799 Maroh 10, 2010 To Who it May Concern Capewide Enterprises LLC. has been retained to perform certain construction work for th*Cap*Cod Melody Village Condoininiusix Tx'uuL. xnuludirxF,roof rupl usumont. S ncerely, Ali cw Witt L,ptvv�a ty millusgri a 0 0 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION e - Map 21 V Parcel` 13 Application # Health.Division Date Issued '1 L -0 Conservation Division Applic In�Fee. n•�. l�P�.. ... Planning Dept. Permit L�l +�Date Definitive Plan Approved by Planning Board $EP'2 j REC'D Historic - OKH Preservation/Hyannis B y Project Street Address 69 D k4C�L0.b`( �i�( A��� 1 )0 Ly9U/(1o,) S--r S Village : 4yAra/a✓1 S Owner (�A-P�-' M(<—( J C& i UAic�,r- Address 1 10 U,)14, -70 SZ 415�0's Telephone Permit Request 11A)S�ZA-c.L Z2(lr C2 a•/ (jkj1-js Square feet: 1 st floor: existing �2� rdpo ed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type i104::� Lot Size ���"° Grandfathered: ❑Yes ❑ No If es, attach sup porting pporting documentation. Dwelling Type: Single Family. ❑ Two Family ❑ Multi-Family (# units) 4 Age of Existing Structure Historic House: ❑Yes A 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: Wexisting ❑ 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 t APPLICANT INFORMATION (BUILDER OR HOMEOWNER) n1 Name COW) 06— �M,179450-f c-1-•(5_ Telephone Number Address License 01-( --y Home Improvement Contractor# Worker's Compensation # ��o� 4--77,4 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TOiG //�-- SIGNATURE DATE !U FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. 4 — ADDRESS VILLAGE OWNER } DATE OF INSPECTION: FOUNDATION I FRAME INSULATION r FIREPLACE c ELECTRICAL: ROUGH FINAL t PLUMBING: ROUGH FINAL GAS: ROUGH FINAL i ,. FINAL BUILDING DATE CLOSED OUT . ASSOCIATION PLAN NO. The ComwonweeM of Matrsocliasdts Departr vet t'of lndNot d Accldenb Offlee of Invadgadons 600 Wa hington Street Restong AKA 02111 www.wats.Pov/dla Workein' Compensadoo insurance AM ON: Builders/Contractors/Electrielaos/Plumben ��Dnikast Iaifocdtadoo Please Prl>,t Leaibh► Name(Busines 0WwiatioNlndlvAW): c m6wl c— Address: 7(03 CitylStatelZip: Phone 0: �Vg f ze 4OZ8, .fro roe u implorer?Chuck tl o appropriate box: Type of project(rr9uire01+ 1.. 1 am a errpbyer with�_ 4. [3 1 am a general contractorand 1 employees(Ihl11 and/or part-time).• have hired the sub-contrecton 6. ❑Now construction 2.❑ 1 am a sole proprietor or partner, listed on the attached sheet 7. Remodsliag and have no to Terse sub�eoatraCtora'hav0 8. Demolition ship, n,,. cap yeea or me to any capacity, employees and have worker' (No workers'comp. insurance coup. insurance.t 9. ❑Bluldio addfitbn , rcquhV&( S. [] ,We arse a corporation and its 10.0 Electrical repair or addidom 3.❑ I am a homeowner doing aU work ofDcent have exorcised their 11.0 Phmd*repair or addition myself.(No workers'comp. right otexernption per MGL 12.1g Roof repairs insurance requir+et) t c. 152, 41(4),and we have no employe".(No workers' 13.0 Other comp.insurance •llnr awitant:dnt ehaaob boa NI.rraMt elan AM our die saetioa babw'howMy drir wo�kan'eo'rynados prfiap inthnrodoa. t Hognowawrf whe subpail d a atlldVit infra ft tiny ats doing A wort aN its"pile MM&coeaacrora naratsubndt a now antdavit Mcnfta.� te-M& etors'da f eAadt tlitr boar erwr anaaW w addidNW d"abowhy dr m of dw wbeon efts and seats whsdw :orim Nola anddu hm mwN yon.`ttdr v*voMft%n haw engioyew,Nay n"ponds dwtr waatiwa'comp potiry wm*w /aw ew serpfi�►er tAer Ls pnsddlnt woite►s'ciapinserloN 1niNrwra fir w.y�� difiw l:tlYi pitlry utI/e1,tMr rNfinssetlia Insurance Company.Name: Polley N or 5eU ire: Cie.M: C44, 2,V4-?7 A— Expiration Date: Idb Site'Addren: f Lr.t S /3-4 110 /AI d4 A-1 kJ -J City/State/Zip: 1 A:t/ItJ:5 OS Co) Attach a cop.of the wgfkera'comp osadon policy doelirotloo pop(showing the poBcy number and expiration date). Failure-Jo secure coverage as required under Section 23A of MOL c. 152 can lead to the imposition of crimirW penalties of a fine up to.S1,300.00 and/or one-Year imprisonment.as well as civil penalties in the form of a STOP WORK ORDER.and a fine of up to$230.00 a day against the violator. Be advised.that a copy of this statement may be forwarded to:he Office of Investio'atioaaof lie DIA for irourance_coveraae veriikation. di ho,*cerdo.glader the pains and penifts if pal ory thor the fefinrredm p►ovWd&SVW is aw end cinerct Date: I tj 0 Pl1ntte I let use 1t01 i not write/N this oral,to be cow cW or tower offk/el City or Town: Permit/License 0 Issuing,Authority(circle one): 1.Board of Health 2. Building Department 3.CltyrTown Clerk 4. Electrical Inspector S. Plumbing Inspector 6.Other Contact Peron: Phone*: EIG Fax Server 5/10/2010 3 : 08: 38 PM PAGE 2/003 Fax Server �O p DATE(MWDDIYYYY) /1, /'1 RD. CERTIFICATE OF LIABILITY INSURANCE o5/10/2010 PRODUCER (800)666-0200 FAX (78 15 26 1-1111 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION tern Insurance Group LLC - Main ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE NAccord Park Drive HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Unit Bl" ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Norwell., MA OZO61 INSURERS AFFORDING,COVERAGE NAIC# INSURED CAPEWIDE ENTERPRISES LLC AND INSURER A Selective Insurance Co of SC 19259 JP MACOMBER & SON INSURER B: ACE USA PO BOX 763 INSURER C: CENTERVILLE, MA 02632-0763 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. INSR DD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLIDATE(MMIDD/YYI TY EXPIRATION E(MMIDONYI LIMBS GENERAL.LIABILITY S 1929637 04/30/Z010 04/30/Z011 EACH OCCURRENCE $ 11000100 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100,O CLAIMSMADE F_Xj OCCUR MED EXP(Any one person) $ 5,00 A X - PERSONAL$AOV INJURY $ 11000,00 GENERAL AGGREGATE $ 2,000,00 GENL AGGREGATE LIMIT APPLIES PER; PRODUCTS-COMP/OPAGG $ 2,000,00 POLICY X jET LOC AUTOMOBILE LIABILITY A 9092960 04/20/Z010 04/ZO/Z011 COMBINED SINGL E LIMIT $ ANY AUTO (Ee accident) 11000,000 ALL OWNED AUTOS BODILY INJURY X SCHEDULED AUTOS (Per person) $ A X HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident PROPERTY DAMAGE $ (Per accident) - GARAGE LIABIUTY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY S 1929637 04/30/ZO10 04/30/2011 EACH OCCURRENCE $ 5,000,000 X OCCUR CLAIMS MADE AGGREGATE $ 5,000,000 A $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND C46Z8477A 04/14/ZO10 04/14/Z011 X ITORY C STAT' OT LIMER EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $ 500,000 B ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 500,000 It yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Evidence of Insurance CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL , Q_DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. 9 / / o AUTHORIZED REPRESENTATIVE C /f Ronald Cleaves/SEWZ ACORD 25(2001108) ©ACORD CORPORATION 1988 ,l1assachusetts- Department of Public Sitfeh Board of Building Regulations and Standards Construction Supervisor License License: CS 89273 ,,.�,, Restricted to: 00 �, ' RICHARD M <CAFjL L 1,22 W,HITMAR R`D, GOTU'IT, MA 0263.5 Expiration: 11/27/2011 ('ommiti�iancr �r#,: 9638 Tow fBayrm'table teguatory Services Thomas F. Geilar,Dickor Bail ding .. , - Tonq.'Perr}%,.Bufld#rig Commisstab�r 200lUaln Strom Hyaanlo,MA 02601 vevvw.town,b.arnsta=bl&ma as Office:: .508-86�-403.8 Fax: 508-790-623 0 Property O ur Must: Cox-npzc.tc and Sx T-his Sectxoxx if Using A. BtWdeir as Bet. ofthe'subject pxoperty to act on my diva • in ali�aaattesa xelativc to 0*tuthot ized by W bul&a :pezno r:appliestioa for CAddress of lob) ft cl'/l-7' i S Flture of: . . ate X'zat Nine if Property Owaex xs;agpl g foz.pe=.,t plcasc compIcte the omeowxicts X. ceaasc xemptioa Pom= o �Vt ds ucvossc xde: L•' First Property Management 1046 Main Street,#11 Telephone: 508-420-0299 Osterville,MA 02655 Fax: 508-420-0789 September 16, 2010 Town of Barnstable Hyannis, MA 02601 To Whom It May Concern: Capewide Enterprises is authorized to obtain a building permit for roofing work to be don n Units#13-18, Cape Cod Melody Village, 110 West Main Street, Hyannis, MA. Andrew J. Witter, Property Manager As Agent for the Board of Trustees M1 Town of Barnstable Building Department Brian Florence, CBO Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Pre-application for Business Certificate Date Map Parcel Applicant Information, Applicants Name Dr?,�'� �Nw- Applicants Address I Q vJ Tnc;•y\-S�k Ao ((e Email Address 10.�� k,�e7GP�,Q Cove Telephone Number -7�7(4� q Q 3 3— Listed ❑ Unlisted ❑ Business Information New Business? ____ No i Business is a registered'corporation? _______________________. Yes If yes Name of Corporation Does business operate under the registered corporate name? Yes No Is the business a sole proprietorship or home occupation? -__--____ Yes VC, If yes.then a Home Occupation Registration is required-See Building Division Staff -- --- --Name of Business - - - - - Business Address 1��J S7L�Yy�S�cvD\Q .�� yG� S MA o260\ Type of Business Building Commissioner Office Use Only Conditions 0 ��q,,z•.. U Building Commissioner Date ?j f (T_ Clerk Office Use Only i INE Application number /.-/Jr ® (� �j— —Date Issued... .1.J..................1......�.....�.. ... sARA1STABY.E, .. MASS a6 9. `0o SEP 0 6 2018 Building Inspectors Map/Parcel...���� Initials... ...... `�g�ns&•:�� -r01���� �,��' ����/-����' ��.�7.1... �./.................. . .. ...�... L.)............... EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY MORMATION Address of Project: //n NUMBER STREET VILLAGE Owner's Name: 67,1 r3 yr v�-, Phone Number 7 0Lf- 77,f- 4 g p Email Address: /]G nn y a(��o S@CoMcc s ne Cell Phone Number _So L 36a- y 9 � o Project cost$ L4 3 R ( — Check one Residential V11 Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: S e �-E(a��Q C���cc,c-� Date: TYPE OF WORK Siding U Windows (no header change)#_ ? Insulation/Weatherization lei Doors (no header change)# Commercial Doors require an inspector's review El Roof(not applying more than 1 layer of shingles) Construction Debris will be going to G4I a s4e' CONHR ACTOWS E4IC®l[61V11ATION Contractor's name �J(1all�R/44SO✓, - '`'ern C, 'F C`t-V4 1 nG�Q�i�S Home Improvement Contractors Registration(if applicable)# 17 3 2- 5 (attach copy) Construction Supervisor's License# yJ E 7 07 (attach copy) Email of ContractoraS c°4 q C R 9MQIL i c-oA. Phone number L101' z 2 9 -9 go() _ ALL PROPERTIES THAT HAVE mucT�ovER 75 YEARS oc®OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU UST OBTAIN HISTORICAPPR®vat BEFORE PERlvrar CAN BE ISSUED. APPLICATION NUMBER............................................................ *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X , X Additional tent dimensions can be attached on a separate piece of paper. Check one:this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached.Provide a site plan with the location(s) of each tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3.30 pm-4.30pm. Commercial events may require Fire Department approval. YW OOD/COA LI/!L E LLET STOVES x Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side H01MEO R'S LICENSE EX1EMTTION Homeowner's Name: Telephone Number Cell or Work number I understand any responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CAM and the Town of Barnstable. Signature Date 1C L1LCAN 1l 9 S SIGNATURE Signature b� v - . Date 9- All permit applications are subject to a building official's approval prior to issuance. r - Renewal Agreement Document and Payment Terms Andersen. dba:Renewal B Andersen of Southern New England Y _ g Barbara Matta&Richard Byrum Legal Name:Southern New England Windows,LLC 110 West Main St:UNIT 3 RI #36079, MA#173245,CT#0634555,Lead Firm#1237 Hyannis,MA 02601 wixoow xE ....... 10 Reservoir Rd I Smithfield,RI 02917 - - - H:(508)778-4960 Phone:866-563-2235I Fax:401-633-6602 1 sales@renewalsne.com C:(508)360-9673 Buyer(s)Name: Barbara Matta &Richard Byrum Contract Date: 08/24/18 Buyer(s)Street Address: 110.West Main St. UNIT.3, Hyannis, MA 02601 Primary Telephone Number:.(508)778-4960. Secondary Telephone Number: (508)360-9673 Primary Email: nannybear2005CPcomeast.net Secondary Email Buyer(s).bereby jointly and severally agrees to purchase the products and/or services of Southern New England Windows,LLC d/b/a Renewal By Andersen of Southern New England("Contractor),in accordance with the terms and conditions described in this Agreement Document and Payinent.Terms,any documents listed in the Table of Contents,and any other document attached to this Agreement Document,the terms.of which are all agreed to by.the parties and incorporated herein by reference(collectively, this"Agreement"). Buyer(s) hereby agrees to sign a completion certificate after'Contractor has completed all work under this Agreement. Total Job Amount-. $4,391 By signing this Agreement;you acknowledge that the Balance Due;and the Amount Financed must be made by personal check,bank check,credit card,or cash. Deposit Received: $2,195 Balance Due: $2,196 Estimated Start: Estimated Completion: Amount Financed: 6-10 WEEKS $4,391 6-10 WEEKS Method of Payment: Financing We schedule installations based on the date of the signed contract and secondarily on the date in which we complete the technical.measurements.The installation date that we are providing at this time is only an estimate.We will communicate an official date. and time at a later date. Rain and extreme weather are the most common causes for delay. Notes: 50%deposit-GREEN SKY, 50% balance due upon completion-GREEN SKY; Buyer(s)agrees and understands that this Agreement constitutes the entire understandings between the parties and that there are no verbal understandings changing or modifying any of the terms of this Agreement.No alterations to or deviations from this Agreement will be valid without the signed,:written consent of both the Buyers) and Contractor. Buyer(s)hereby acknowledges that Buyer(s) 1) has.read this Agreement, understands the terms of this Agreement,and has received a completed,signed,and dated copy of this Agreement,including the.two attached Notices of Cancellation,.on the date first written above and:2)was orally informed of Buyer's right to cancel this Agreement: . NOTICE TO BUYER: Do not sign this contract if blank.You are entitled to a copy of the contract at the time you sign. YOU,THE BUYER,.MAY CANCEL THIS TRANSACTION AT ANY TIME NOT LATER THAN MIDNIGHT OF 08/28/201.8 OR THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION, WHICHEVER DATE IS LATER.SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT Legal Name:Southem New England Windows,LLC. dbai Renewal By Andersen of Southern New England Buye(s) Signature of Sales Person: Signature Signature Chris'Huison Barbara Matta Richard Byrum Print Name of Sales Person Print Name Print Name UPDATED: 08/24/18 Page 2 / 12 Commonwealth of Massachusetts ^' Division of Professional Licensure ss Board of Building Regulations and Standards Con struCt$r 1Sdpprvisor CS-095707 , ires 09/08/2020 p � BRIAN D DENNISON 8 BLACKWEL'k;PRIVE CHARLTON MAi01507 r � h CZ Commissioner \ J i Office of CO'nsumer Affairs and Business Rep,Tiation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 173245 Type: Supplement Card SOUTHERN NEW ENGLAND WINDOWS LL Expiration: 9l19/2018 BRIAN DENNISON 26 ALBION RD _.. . L+N'COLN. RI 02865 Update Address and return card.Mark reason for change. Address Renewal Employment Lost Card office of Consumer Affairs&)sasiness Regulation Registration valid for individual use only before the - HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: Office of Consumer Affairs and Business Regulation Registration: 1;3245 Type: 10 park Plaza-Suite 5170 Expiration: 0/1912018 Supplement Card Boston.MA 0=I16 )UTHERN NEW ENGiAND WINDOWS LLC. :NEWAL BY ANDERSON IIAN DENNISON ALBION RC _.. r JCOLN, RI 02865 �-Uudersecreiary Not valid without signature 4 ;Rec;i:;a- :-ns and Siars.' cCa..ivJ BRIAN D DENNISON 7 LI BOND CIRCLE �ARLTON A 0150.7 r o �I .n m `; .. ;y Jq� The Commonwealth of Massachusetts ' Department of Industrial,_Accidents 1 Conb ess street,suite 100 Boston,MA 02114-2017 www.mass-govldia Workers, Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE F XD WITH THE PERMITTING AUTHORITY. A an lict Information Please Print Legibly NTaMr- (Business/Organizarion/lndividual): Address:__ City/State/Zip: p Phone#: Are you an emplover?Check the appropriate bom Type of project I required): l-XI am a employer with Z0 femployeesOW]and/or part-time).* F7.,D New construction 2.�I am a sole proprietor or partnership and have no employees working forme in any capacity.[No workers'comp..insurance required.] ` 8• D Remodeling 3.Q I am a homeowner doing all work myself[No wprkers'comp.insurance required-!t 9• ❑Demolition 4.❑I am a homeowner and wri]l be hiring contractors to conduct all work on my property. I ' I 0 D Building addition I ensure that all contractors " P P� wily l - ctots either have workers compensation insurance or-are sole 11_❑Electrical repairs or additions Proprietors with no employees- 50 1 am=general contractor and I have hired the sub-contractors listed on the attached sheet 1'..[]Plumbing repairs or additions These sub-contractors have employees and have worker.'comp.insurance= 13-7Roof repairs 6.D We are a corporation and its officers have exercised their right of exemption,per MGL c. -'4.[E Other_ W t A f4..%� 152§1(4),and we have no emplovees.f Tlo workers'.comp.insurance required.] lle p l c r-evne r--z ;Any applicant that checks box gl must also fill out the section below showing their workers'compensation policy information Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new aff-idavit 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'coma.policy number. 1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy 6d job site information. _ Insurance Company Name--t irf OW/)S �D M Policy tr or Self-ins.Lic.t: �,(�c��1��7 Z q — Z t� Expiratior.Date: Job Site Address: //O City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and ea iration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. 1 do hereby certify under ih alas and penalties ofperjury,that the information provided above is true and correct Signature- e D2te: �— 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): 1.Board of Health 2.Building Department 3.City/Town Clerk d.Electrical Inspector. 5.Plumbing inspector 6.Other Contact Person: Phone W- CERTIFICATE OF LIABILITY INSURANCE DATE(MMMDfYYYY) THIS CERTIFICATE IS ISSUED AS A M 12/29/2017 ATTER 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 IN5URED,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). 'RODUCER CONTACT CoBiz Insurance, Inc.-CO NAME: 1401 Lawrence St, Ste. 1200 PHONE .303-988-0446 F Denver CO 80202 EMAIL (A/C Not:303-988-0804 oD COMaiI cobizinsurance.com INSU S AFFORDING COVERAGE NAIL a NSURED ESLERCO-01 INSURER A:Acadia Insurance'Com an 31325 Southern New England Windows, LLC. INSURER B:Firemens Insurance Company of WA.D.C. 21784 9ba Renewal by Andersen of Southern New England INSURER c:Homeland Insurance Companv of New York 34454 10 Reservior Rd INSURER D Smithfield RI 02917 INSURER E: INSURER F :OVERAGES CERTIFICATE NUMBER:1252851165 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. ISR ADDL SUB, T R TYPE OF INSURANCE POLICY NUMBER APA;Lpp EFF POUE EXP A X COMMERCUIL GENERAL LIABILITY .CPA3158728 1/12018 1(MMMDNY YYI LIMITS EACH OCCURRENCE $1.000,000 CLAIMS MADE OCCUR -PREMISES Me o=uffence) $300.00E MED EXP(Any one person) S 1C.D00 PERSONAL8ADVINJURY 51,W0,0D0 GEN'L AGGREGATE LIMB APPLIES PER X R CTT POLICY GENERAL AGGREGATE S 2.000,00E 7 E LOC _ PRODUCTS-COMP/OP AGG S 2.000.00D OTHER: $ A AUTOMOBILE LIABILITY N CPA3158726 I 1/12016 1/12cis COMBINED SINGLE LIMB Ea accident S 1 D0D DDD X ANY AUTO I ALL OWNED SCHEDULED BODILY INJURY(Per person) $ ' . AUTOS AUTOS BODILY INJUR NON-OWNED Y(Per accident) $ X HIRED AUTOS X AUTOS i PROPERTY DAMAGE Per accident $ 1 $ A X UMBRELLA LIAB X OCCUR CPA315872E 1/1/2016 1112019 j EACH OCCURRENCE g 10.OD0,000 EXCESS LIAR CLAIMS-MADE AGGREGATE $10.OD0,000 DED X RETEAmON$ $ B WORKERS COMPENSATION WCA3158729-20 1/1201E 1/12019 X PER - OTH- AND EMPLOYERS*LIABILITY YIN. STATUrE ER I ANY PROPRIETORMARTNEWEX=CUTIVE OFFICERIMEMBER EXCLUDED? N 1 A EL EACH ACCIDENT $1,000,000 (Mandatory in NH) M yes describe under E.L.DISEASE-EA EMPLOY $1,ODO,DDO DESCRIPTION OF OPERATIONS below EJ_DISEASE-POLICY LIMB 51.000.000 C Pollution Liabft 79300733400DO 1/12016 1/12MS Each Occurrence $1,OOD;ODD Claims-Made Policy A9Bmgate S1,DOO.D00 Retroactive Date 062D2013 peductble S1E,00E iESCRIPTION OF OPERATIONS/LOCATIONS 1 VEHICLES (ACORD 101,Additional-Remarks Schedule,maybe attached if more space Is required) :ERTIFICATE HOLDER 'CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE .EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. For Informational Purposes AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. kCORD 25.(2014/01) The ACORD name and logo are registered marks of ACORD Re newal byAndersen. WINDOW REPLACEMENT an'Andersen Company To whom it may concern: The Association,or its'Management Company,grants permission to Renewal by Andersen to install custom-made replacement windows in the following facility: I Name of Development Cape Cod Melody Village Customer Name_ Barbara Matta&Richard Byrum Address 1.10 West Main St., Hyannis Unit# 3 State. MA *'converting rear double casement window to double Glider window to meet safety code; same exterior Number of windows [11 doors [M appearance" Style(i.e.double hung/casement,etc.) (8)double-hung, (1)2-panel gliding Exterior window color White Exterior window,trim finish Yes '® No 0 Color White Grids Yes® No 0 - Grids between the panes Yes [j_7] No .0 Color White Grid pattern matches existing Yes. No 0 TO BE COMPLETED BY HOA MEMBER: Signing below indicates approval of window color, grid pattern and color as well as trim dolor/finish on exterior for the above unit and homeowner. P¢r�� a)dt ' Andy/Devin Witter Signature Print name Title Property Manager Phone# Date " 10/26/17 Product Specialist Chris Hutson Offices: Rhode Island/Cape Cod/CT 16 Reservoir Rd Smithfield,RI 02917 Fax 401-633-6602 T - �o. Application number..,,,,,,,,,,,,,,,,Q,215 ®� .......... p Date Issued............��/. //. sna.'�srnBL , ®� +�039. oin Inspectors Initials........ g Ins p ......... JUL 8 20�8 Map/Parcel........i C�. .......17 3 OA C ..................................... '0 WIN N� S TO OF A I C� E-XPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: c Ps !'7a,� St. �2 A �� S NUMBER STREET VILLAGE Owner's Name: e l�P �f o/1P Phone Number 5 ok-9 r.(p_ 7 2- Email Address: eV,LeStone 6k&lo4,d � Cell Phone Number Project cost$ /,� (o fj — Check one Residential J Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: S-e \a �� �-�- Date: TYPE OF WORK Siding Windows (no header change)#__�_0 Insulation/Weatherization Doors (no header change)#__I _ Commercial Doors require an inspector's review Roof(not applying more than I layer of shingles) Construction Debris will be going to Lrl a s4e-/rwa I eej-� - 2,Y,C CONTRACTOR'S INFORMATION Contractor's name i�t�an `7�n.�,'so� - SoAf cn &/ ,. &, 1 tv4 tJ'i'n Jouw S Home Improvement Contractors Registration(if applicable)# 17 3 Z.cL,�- (attach copy) Construction Supervisor's License# 70y (attach copy) Email of Contractor Phone number0 ALL PROPERTIES THAT HAVE STRICTURES COVER 75 YEARS OLD OR IF TIME SUBJECT PROPERTY IS IjV A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEF®RE A PERMIT CAN RE ISSUED. APPLICATION NUMBER............................................................ *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Check one:this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent If food food is being served at your event please obtain a Health Department approval betaweeu tke hours of 8.00am-9.30 am or 3.30 prn-4:30pm. Commercial events may require Fire Department approva *WOOD/C®A>L/)PELILET STOVES x Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOME® R'S LICENSE LXE TTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State]wilding Code. I understand the construction inspection procedures`,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date F LIICANT9S SIGNATURE Signature Date 7— All permit applications are subject to a building official's approval prior to issuance. Renewal. RI License n9sors {,�,/�,� RENEWAL, BY A1�TDERSEN AU License#173245 7/`V lde�.en. CT License W634555 WINDOW aarubvaest -Aar—Compmr -10 Reservoir Road • Smithfield,RI 02971 - Lead Firm#1237 Phone 866.563.2235•Fax 401.633.6602. rederal Tax ro 446-0566630 Southern New England Windows,LLC d/b/a Renewal by Andersen of Southern New England ;.J / CUSTOM WINDOW AND DOOR REMODELING AGREEMENT Buyers)Name. i �-�'`Lf+-:1 Ti `5 rd ly re, /Darre.ofA;regiment Buyer(s)Street Address.City Smze,and Zip Code I P.O_Bost / _W• / l RI 7 y h -7 2- - r/'2 Na RIrJylS �-�,�(� E•Mail Address:M iy/71r•(�l.� IO�YIYT �t <11L-Coy ty HomeTelephone Number4SV D"YU��r/rJ'4 Work Telephone Number: Buyer(s)hereby jointly and severally agrees to purchase the products and/or services of Southern New England IVindom,LLC d/b/a Renewal by Andersen of Southern New England("Contractor");in accordance with the terms and conditions described on the front and the reverse of this agreement and on the attached sppeccification sheets)(collectively;this`Agreement"). ❑Historic Condo ❑HOA? Total JobAmountLFlJo - Es/u�mateed Starting Date: Method of Payment O Check ❑Cash Financed Deposit Received(33%). ` Credit Cards are accepted for deposit only-maximum I13 of the Balance at Start of Job(33%): Estimated Completion Date: project cost(Please see Gedit Card Payment Farm.)By signing this r Agreement,you acknowledge that the Balance at Start of Job and the Balance on Substantial . W� Balance on Substantial Completion of Job cannot be made by credit Completion of job(33%):t)J rO3 card and must be made by personal check bank check,or cash. Buyer(s)agrees and understands that this Agreement constitutes the entire understanding between the parties,and•that ' there are no verbal understandings changing any of the terms of this Agreement.Buyer(s) acknowledges that Buyer(s) (1)has read this Agreement,understands the terms of this Agreement,and has received a completed,signed,and dated copy of this Agreement,including the two attached Notices of Cancellation,an the date first written above and(2)was orally informed of Buyer's right to cancel this Agreetnent.DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. (Rhode Island Sales.Only)Notice to Buyer:(1)Do not sign this Agreement if any of the spaces intended for the agreed terms to the extent of then available information are left blank.(2)You are entitled to a copy of this Agreement at the time you sign it.(3)You may at any tithe pay off the full unpaid balance due under this Agreement,and in so doing you may be entitled to receive a partial rebate of the finance and insurance charges.(4)The seller has no right to unlawfully enter your premises or commit any breach of the peace to repossess goods purchased under this Agreement.(5)You may cancel this Agreement if it"has not been signed at the main office or a branch office of the seller,provided you notify the seller at his or her main . office or branch office shown in the Agreement by registered or certified mail,which shall be posted not later than midnight of the third calendar day after the day on which the buyer signs the Agreement,excluding Sunday and any holiday on which regular mail deliverie's are not made.See the accompanying notice of cancellation form for an explanation of buyer's rights. Buyer(s)received the consumer education materials provided by.the Rhode Island Contractors Registration Board: (Bryu's Initials) Renewal dersen o Southern New England Buyer(s) Buyer(s) By: rgnature of Product,Manager Signature Signature Print Name of Product Manager Print Name Print Name YOU, THE BUYER(S), MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION.SEE THE ATTACHED NOTICE OF CANCELLATION FORMS FOR AN EXPLANATION OF THIS RIGHT. NOTICE OF CANCELLATION X NOTICE OF CANCELLATION Date of Transaction u )-K —it You may cancel I Date of Transaction You may cancel this transaction,without any penalty or obligation,within this transaction,without any penalty or obligation,within three business days from the above date.If you cancel,any,l three business days from the above date.If you cancel,any property traded in,any payments made by you under the I property traded in,any payments made by you under the Contract or Sale,and any negotiable instrument executed I Contract or Sale,and any negotiable instrument executed by you will be returned within ten business days following'1 by you will be returned within ten business days following receipt by the Seller of your cancellation.notice,and any 1 receipt by the Seller of your cancellation notice,and any security Interest arising out of the transaction will be security interest arising out of the transaction will be canceled.If you cancel,you must make available to the Seller I canceled.if you cancel,you must make available to the Seller at your residence,in substantially as'good condition as when I 'at your residence,in substantially as good condition as when' received,any goods delivered to you under this Contract or I received,any goods delivered to you under this.Contract or Sale;or you may,if you wish,comply with the instructions of I Sale;or you may,if you wish,comply with the instructions of the Seller�regarding the return shipment of the goods at the the Seller regarding the return shipment of the goods at the . Seller's expense and risk.If you do make the goods'available Se1lePs expense and risk.If you do make the goods available to the Seller and the Seller does not pick them up within to the Seller and the Seller does not pick them up within twenty days of the date of cancel llation,you may retain or 1 twenty days of the date of cancellation,you may retain or dispose of the goods without any further obligation:If,youti'I dispose off the goods without any further obligation.If you fail to make the goods available to the Seller,or if you agree •I fail to make the goods available to the Seller,or if you agree to return'. goods to the Seller and fail,to do so,then I to return the goods to the Seller and fail.to do,so,then you remain liable for performance of all,obligations under I you remain liable for performance of all obligations,under the Contract:To cancel this transaction, mail or'deliver the Contract.To cancel this transaction, mail or deliver a signed and dated copy of this cancellation notice or any I a signed and dated copy of this cancellation notice or any. other written notice, or send a.telegram to Renewal by I other written notice,or send a telegram to Renewal byy Andersen of Southern New England at 10 Reservoir Road, I Andersen of Southern New'England at 10 Reservoir Road, Smithfield RI-02917,NOT.LATER THAN MIDNIGHT OF I Smithfield,RI 02917,NOT LATER THAN MIDNIGHT OF Lf-3-c—W- ((Date)) I .(Date) " 1 HEREBY CANCELTHISTRANSACTION: -. I HEREBY CANCEL THIS TRANSACTION. Buyer%Signature Hint Name - 'Data Buyer's Signature .• Print Name Date RbA Copy.White Buyer Copy:Yellow Buyer Copy:Pink I:iassachusetts Department or Public Sata i Board of Building Regulations and Stan.Cara _icense: CS-095707 BRIAN D DENNISON 7 LAMBS POND CIRCLE n CHARLTON MA 01507 ` �ummlSSlOnef U9i0$i2018 ---, JT_ _oPSui?Z. =1;s and_guSi iZSS _I 70 Plaza - S'uirn 5'... Home —1roproT-ement Contractor Relxistradcn. -. - Registmdon: 173245 Type: Supplement Card E::piradOn: 9l19/2D1S SOUT.-IERN NEW ENGUkND UViNDOWS LL BRIAN DENNISON3 _-----...- 25 ALBION RD -- ---------- LINC`?LN, RI 92855 ------------------.. Gudute_ddr^ss:md rc!n:n mrcL Mark zson 'or.:iunLe. --.Andress — 3eae..v:ll _Emploment _ �csi Card --t1Rec of Cnmumer.\trair�S.lasiu��s�+mL�linn Regisumriun•valid for ind idnai 3se:mi-ulury die , -Nuiradmi date ei.'ound return to: -" =iHOME IMPROVEMENT CONTRA.CTCP. tGc ai aawmer.-.:Tai:.and 3�iness.^•_rm Line ,'.9egistratlon:,1?3245 Type: I0 i'ar.:?Lrc•Suite 51,70 _ c:piration"9i.19/201a Supplement Card Sustun.NLA92L15 30U'HEr.DI NEIN SNGLAND WINDOWS I LC. 9Ei IE NAB Sy.ANDERSON 3RIAN DENNISON UNCOLN-RI 02965 —Uaderseomun Nat i a - amm _ The Commonwealth of Massachusetts U � Department of Industrial Accidenis o I Cona ess Street,Suite 100 l Boston,YLA 02114-2017 www.mass-goy/dia 11 orkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMI ENIG AUTHORITY. Applicant Information Please Print Le 'bh Name (Bus iness/Organization./Individual)_ ' e �w Q Address: (DLtl v City/State/Zip: P Phone ,D _ 2�� Q you an employer?CbecL•the appropriate box: Type of project(required):[Are am a employer with Zo femplovees(full and/or paz,_time).x 7. ❑brew construction,.❑I am a sole proprietor or partnership and nave no employees working for me in any capacity.[No workers'camp.insurance reouired.l 8• �Remodeling 1 i 3.[]l am a homeowner doing a!work myself(ldo worker'comp.irwu2nce reouised.l 9. ❑Demolkioq j 4.�I am a homeowner and will be hiring contractor to conduct all work on my pro 1,v;ilt l 0 Building addition i Pe' ensure that all,contractor ether have workers'compensation insurance or are sole I-L Electrical repairs or additiogs j proprietors with no employees. I 1=.[]Plumbing repairs or additions `.1 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. These sub-contactors have employees and have worker'cDmp.inswrance.c 1.F❑Roof repairs ? 6.�We are a corporation,and its officers have exercised their right of-exemption per MGL c. 14 Other j7,/S�aC�p C 52,§1(4) and we have po employees.[l io worker'comn.insurance required.; reel— 'Any applicant that checks box f1 must also fill out the section below showing the workers'compensationpolicy information_ 'Homeowner who submit this aitdavit indicating they are doing all work and then hire outside contractors must submit a new a$tdavit indicating such. 'Contractors that check this box_must attached an additional shmi showing the name of the sub-contactor and state whether or not those entities;-lave employees. 13the sub-contractors have employees,they must provide their, worker'comp.policy number. _ I am an employer that is providing workers'compensation insurance for my employees. Below is the policy annd job site information. I nsurance Company Name: `Irif Piet) S Policy or Sell ins.Lic.4:_w LA-31-S�1 z " _ Z Expiration Date: d 1 1 Job Site Address:_ f lO G+ �Je;ll Attach a copy of the workers'compensation policy declaration page(showing the policy nu bJ piratiou te_). Failure to secure coverage as required under_MGL c. 152,§25A is a criminal violation punishable by a fine up to S1,500.00 andlor one-year imprisonment as well as civil penalties in the form of a STOP urORk ORDER and a fine of up to S250.00 z day against the violator_A copy ofthis statement may be forwarded to the Office flflnvestigations ofthe DLA for insurance coverage verification. 1 do hereby certify under the sins and penalties of perjury that the information provided above is true and correct Sienature: Date: Phone : 40 irk Official use only. Do not write in this area;to be completed by city or town off cial City or Town: Permit/License Issuing authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector i b.Other Contact Person: Phone r: mac® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD)YYYY) 12292017 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 INSURE,R(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the*certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms.and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: CoBiz Insurance, Inc.-CO PHONE FAX 1401 Lawrence St, Ste. 1200 N ,303-988-0446 Alc No,303-988 0804 Denver CO 80202 ADDRESS: COMaiI cobizinsurance.com INSURE S AFFORDING COVERAGE I NAIC Y INSURER A:Acadia Insurance Company 31325 INSURED ESLERCO-ol INSURER B:Firemens Insurance Company of WA.D-C. 21784 Southern New England Windows, LLC. dba Renewal by Andersen of Southern New England INSURER c:Homeland Insurance Company of New York 34452 10 Reservior Rd INSURER D: Smithfield RI 02917 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER:1252851165 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. I SUER R' TYPE OF INSURANCE IN LTR POLICY NUMBER ! MM/DDIIYYYY I M M/DDryrYY I LIMITS LT A X I COMMERCIAL GENERAL LIABILITY CPA3158726 i 1112016 1/12019 I EACH SEC OCCURkENCE rDAMAGE TO �nce S30D.D00 CLAIMS-MADE I OCCUR i MED EXP(Any one person) I S 10.0DO 1 I I PERSONAL 8 ADV INJURY S 1.ODD,000 GEN'L AGGREGATE LIMIT APPLIES PER: I I GENERAL AGGREGATE 15 2.000.000 RI- X POLICY JECT LOC I I i I PRODUCTS:COMP/OP AGG i S 2.o0D.000 !OTHER: S A AUTOMOBILE LIABILITY i I N CPA3158728 1/12016 1112019 COMBINED SINGLE LIMIT 5 Ea accident 1 000 000 X ANY AUTO I�I BODILY INJURY(Per personl S I ALL OS OWNED �SCHEDULED 1 I BODILY INJURY(Per accident)1 S HIRED AUTOS H gpSWNED PROPERTY DAMAGE S X X Per acc dent IS A X UMBRELLA LIAR X I OCCUR CPA31513728 1112018 1112019 EACH OCCURRENCE S 10.000.000 L—I EXCESS LIAB CLAIMS-MADE I ( AGGREGATE S 10.000.000 DED X I RETENTIONS I I Is B WORKERS COMPENSATION I WCA3158729-20 1/12016 • 1/12019 X 1 START UrE I ER AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETORIPARTNER/EXECUTIVE ❑ EL EACH ACCIDENT 5 i.000,000 OFFICER/MEMBER EY.CLUDED? N I A (Mandatory in NH) E.L DISEASE-EA EMPLOYEd S 1 000.000 B yes.describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LJMrr S 1.00D,000 C Pollution liability- I 7930073340000 V7201S V72019 Each Occurrence S7.000.000 `Claims Matle Policy Aggregate S1 000.000 Retroactive Date 06202013 I I Deducl,ble S10,000 DESCRIPTION OF OPERATIONS I 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 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. For Informational Purposes AUTHORIZED REPRESENTATIVE zz _ ........ f I ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Jim Passonisi Senior Project Consultant Renewal by Andersen of Southern New England 10 Reservoir Rd. Smithfield, RI 02917 Cell: (508)930-0811 Jpassanisi@renewaisne.com Renewal by Andersen sells,installs and services energy-efficient replacement windows and patio doors resulting in beautiful homes and delighted homeowners. On Apr 28,2018,at 12:28 PM,Andrew Witter<andy@fpmcapecod:corri>wrote: yes Andrew Witter,AMS,ARM,CNICA President,first Property Management 508.420.0299 ' _ i From:Jim Passanisi<JPassanisi@renewalsne.com>. Sent:Saturday,.April 28,201812:27 PM To:Andrew Witter<andv@fpmcapecod.com> Subject: Re:Architectural Review.Committee.Request' Hi Andy, Does this mean we are good to go. ' Y Jim Passdnisi t Senior Project Consultant Renewal by Andersen of Southern New England 10 Reservoir Rd.. l Smithfieid, RI 02917 Cell:(508)930-0811 Jpastanisi@renewalsne.com- Renewal by Andersen sells, installs andservices energy-efficient replacement.windows and patio doors resulting in beautiful homes and delighted homeowners. On Apr 28;2018,at•1206 PM,"andv@fpmcapecod.com" <andv@fpmcapecod.com>wrote, The report Architectural Review Committee Request is attached'to this email. AndrewJ. Witter ANTS,ARM,.CMCA President,First.Property Management, Inc. 508-420-0299 i 2 s Danielie Erickson From: Jim Passanisi Sent: Sunday;April 29,2018 11:29 PM To: Danielle Erickson Subject: Condo approval for Michell,e:Stone; 110 W Main st unit 29.Hyannis MA Condo.approval,#17_18_1609.7 Jim Possanisi Senior Project Consultant Renewal by Andersen of Southern New England 10 Reservoir Rd. Smithfield;:R102917 Cell: (508)930-0811 Jpassanisi@renewalsnexom Renewal by Andersen sells, installs and services energy=efficient replacement windows and patio doors resulting in beautiful homes and.delighted homeowners. Begin forwarded message: From:Jim Passanisi<JPassanisi@renewalsne.com> Date:April 29;2018 at 9:3720 AM EDT To condo<does@ReneWalSNE.onriiicrosoft.c6m> Subject: Fwd:Architectural Review Committee Request l Jim Passanisi` f Senior Project Consultant Renewal by Andersen of Southern.New England 10 Reservoir Rd. Smithfield,.Rl 02917 ; Cell:(508)930-0811 Jpassanisi@renewalsne.com Renewal by Andersen sells,;installs and services energy=efficient replacement windows.and patio doors resulting in beautiful homes and delighted homeowners. Begin forwarded message:. From:Jim Passanisi<JPassanisi@renewalsne.com> Datd:,April 29,2018'at 9:10 3S AM EDT To:Andrew Witter<andv@fpmcapecod.com> Subject:Re:Architectural Review Committee Request Thank you 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION - - Map Parcel . 66A 8040ING Application #� Health Division JAB✓ 03 Date Issued //Z0//7 ✓L e. Conservation Division T41�I���®� ��I Applicatio�i Planning Dept. �� A �F Permit Fee Date Definitive Plan Approved by Planning Board S' Historic - OKH _ Preservation/ Hyannis r,Piz L_ S Project Street Address 410 /VC.9-r /VI%rIM S l` V 7 Village �/ 64 14., S �> Owner -7u e- A n at-i Address Gr/esr &kidk Telephone Permit Request 174,A AJt),4, rc,4,_a SP . 07e-y 7`v 4 , ✓'� �, �`v , 7d-t,l � �✓ ��`-�7`" TD©�` ,/� t�lJ�` (J'lQ✓1�®G •'1�� Square feet: 1 st floor: existing - proposed 2nd floor: existing_proposed Total new er Zoning District Flood Plain Groundwater Overlay Project Valuation �� 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 MNo On Old King's Highway: ❑YesNo Basement Type: ❑ Full ❑ Crawl f7 Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing -2' new O Half: existing -new Number of Bedrooms: 1, existing ®new Total Room Count (not including baths): existing S, new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑Oil Electric ❑ Other Central Air: ❑Yes No Fireplaces: Existing 0 New 0 Existing wood/coal stove: ❑Yes )'No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage:,Aexisting ❑ new size _Shed: ❑ existing ❑ new size _ Other: Q4Ac4e at Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes No / If yes, site plan review# Current Use 4 S ���7� .( Proposed Use as e We,-t. APPLICANT INFORMATION - (BUILDER OR HOMEOWNER) 4�. Name 9,',4 C', L IL L Telephone Number Address 4-f du e License#__ � �� 0 N, 4 w►O Home Improvement Contractor# ��6 ® Email r e Q . V C.r t -E, Worker's Compensation # �f"GZ � ALL CONSTR CTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATUR ' DATE A— G i FOR OFFICIAL USE ONLY r APPLICATION # DATE ISSUED MAP/PARCEL NO. . R . ADDRESS VILLAGE OWNER • � y DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. v t4 ' The Com •aamealth of MaS;SIfC hmetts Department efludkoiatACCidti Office vfImvs*a�i`G=e► Boston,MA 02111 i-Prov.mamgoplik WnrIce& CompenixtianInsm-ance Affidzvit RnfldeldCantrAdursMecEtz " � hers AmAic2idIufnrmain PleaseFrint IwTame �--� • L� Addre=� /7 cL-lt G rtyf ilr v d" v- phone LOY- W d Are YOU an employer?Qreclsthe ropriate bow Type of project(required): I. I am a 1 �. 4 ❑I am a gea�al camf ❑ on sctor and I 6. New osfG Ef n employees(an&br�* bave 7siredgm subcosiftneftnN 2.❑ I am a wle gropdetc r orpartaer- fined caLthe atbwhed sheet. 7.PRfznodermg ship and have no 1 These sub-comdractois have emp�� a to�e�SS aIId•�13Ve LFO�S' �. �DPr]81LfI9zF w 'gcgr Bu me•in any capacity- `"t`� cri` WO ■comp. COMP.iMSUM ECI g- ❑R�'�' addition req3ife&] 5. ❑ We are a corposatim and its lb-❑ 1 repairs ar ad&idous 3.❑ I am homeounw doing aif work officers have ewrcised dmw 1L❑Plumhingrepairs of adcritiems myself ❑Roof� o worloecs comp a of es ou pW M(M L- � ix li�rrequired-]a c.1.52,§1(4),aadwe•haveno employees.[NOwolixrs' 13_❑#?Sher rasp.,iu�mqdue&] '.dap apg&a OL,4 rbedsbos ff1 most alsa fMootthe swftnbelawshavdag&e rvm&ee co®pemationparuginUnnu m- 1�®eoaraerstrho submitdtisaftdae9ioXcaf8 Seep=edc&galfWC&sod&MbiMaatM&Con=Clam asIsubmitanewaMds¢tmdirztm sack fCaah�ctos&�stcbec3�ilSs600c attached=sddit shed staf whedmcrnotfmse IMM e playees.Ifthesub-c�m3rg�+�+�Uve emgtofw—.dLgy==pm7v && admm C—P-PolicF munhM lam rat erripr that is praucdirrg�vorkets'faanrpertstrf'rrrt ucsziraa jcr emg �e�. Seloev is riTeeprrFicy mrd jQIa site ixjorm+zticn. • IasmanEeComgafiyl atae: /�� IK op -Ii wt S 'P4RLy nor i .� AR P�©f6 7 Fsgirafiiaizl3ate: 3 02 Bch a copy of the workers°cbmpensationpolfcg deci+w76on page(shawbg the policy mzm6er and Mpfi-A684 date}. Failure to serum coverage as.requirednnder Swim 25A o€MGL c.157 can Imd to the imposition of ctirnimal peuaYlses of a fine up to$1,SaD-OD an&or one-year.in43 ism=eut,as w&as avd peualg iu the farm of a STOP WDRI£ORDERand a rime of up to$250-Da a dap apart#be vioWor. Se advised fiat a copy of this sbhmenit taayba fmvuded to the Office oKf Imtestig hans ofthe DIA for mvecage won. XrFa hereby c$t fY•u tltspaw_ plea3 Ma afpedkuy th&the info aban is liars a rrecit Date. /a 16 `� PhMe� CS-0 r. L/00 dc'G q O2Tdd uw anf,�c Do nat write in Bib area,to be cmnpWed by city arfoirn Officfat Cry or Town: PermetlLirense# Issuing 4uflarity(ci rIe one): L Saari of Health I Buffirmg Department 3.Cityfrown Clerk 4 Electrical Iusp wlmF S.Pla mbing hgmctar �.O&W contact Person: phow 0: 6 ��: •.: -n■/,a9L ■�. 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I 1■ •- •.111 nfi/ 1• ■/ �•.1 ■■■N■1 ■ ■11• t•. ■- ••t/■�• U •- I • n••t U J ■■ .b■•■r.t Ut •1 i1 •=UI • _ u ■■ M.�• R yt•• ■ •) 1: _n ■•:.■m -•:[ nu_ n" • a •• a - �•■n =t u •■cfn •••/��+ • r.1 n' �._I m:11 n" nnn-MMEMM I to 01 / r919999-■• ■•■ • a u 1 " •■ •) .l• •11 - tl■1■1•=i •1■ ■t .[.rl■'rl/.It" tt" `►- V■:l In i1■1 t. ■ •• ■>• • J ■■- .•■[•I■■ • n" _■n•. 1 • •1 n 7I ■n n n -•1 a Oil. • I•_.[_.n ur f: .• r•nlr •• _.■ • n: u er• r.■ r - • 1 to i■.■ U ■ `•••Il 1■ I/Ir •�-■II 11 ifI :t■• ra■•[/ 11 _[I• •J •�t •is 1= .1• Ytt■1.it •/ /■.Ir.k■ •• [■ •tl •I ■•••1 1• .- ■ •• •=t 1• U" �l ■■l • 1 1.1 .- �1�• • I J :n• M:n. •1 •• ■■•) • ■■• •1 •■ ..- I• Itnt1 ■N•tt I. •1 ri!1 ^ • - :■_• a J■ ••Vn w • r•nn■■r ■•I. •�+•■/l - moo d-15 ■- . ■■ • ■ • •':1■•t •••■ • .• Be tt_■■ •■t It • .It r" •) ••It r••■=s J••1■ .t1■ r•• • ••t 1 • _ll •■_�••]f w - •• ■• ■GYMS. t• J• rw : r: 1 r■- 1•a n■11 : •u :.a r r•••n" .n 1 r► ■Ilm• r 1 i ��.).ale n• 1•r `r �� Ito - = • � 'l l as ' 9• ■- � ti► �. .., Town of Barnstable Regulatory Services Richard V.Sca%Director Building Division Paul Roma,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, \) (�"►2 i n CU -a , as Owner of the subject property hereby authorize 6 yew Z6 U, 6. 11)"a (!'re ec/to act on my behalf, in all matters relative to work authorized by this building permit application for: ` NO � � &L"I (n�'�- � (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized before fence is installed and all final . inspections are performed and accepted. e of Owner Signature of Applicant Print Name Print Name 6 D e Q:FORMS:OWNERPERMISSIONPOOLS Town of Barnstable ' Regulatory Services dF Richard V.Scali, Director Building Division • Paul Roma,Building Commissioner MASS. 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 509-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EIG;IVII''I'ION Please Print DATE: lAkkl JOB L.00ATIO mo AleS f- /V ed'a (t nummber 'i street village "HOMEOWNER": ��F l7" R1 nal`i name home phone# work phone# CURRENT MAILINGADDRESS:_ 1,42 `fie s-(- "L,,L < f Uni'-t-- A/yc,vt r AMA I city/town e- state yip 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 workperformed under the buildingpermit. (Section 109.1.1) 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: Signature of Homeowner 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 this case,our Board cannot 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 to amend and adopt such a form/certification for use in your community. , DATE(MMIDD/YYYY) A� CERTIFICATE OF LIABILITY INSURANCE 712/9/16 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 thi s certificate does not confer rights to the certificate holder in lieu of such endorsemen s. PRODUCER CONTACT NAME: Gammons Adams Insurance PHONEWEN. (508) 587-5640 i Fax N (soe) 587-5362 385 West Center Street E-MAIL s: cadams@gammonsinsura,nce.com West Bridgewater, MA 02379 INSURERS)AFFOROOIG COVERAGE NAIL# INSURERA:State Auto Insurance Co INSURED INSURER B: Grew Building Company, LLC INSURER C:Arcadia Insurance' Company I 20 Atlantic Ave INSURERD: 4 Yarmouthport, MA 02675-2525 INSURERE: INSURER F: 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 CONTRACTOR OTHER DOCUMENT YL+)TH F�aFECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN tS SUB.JEGT TO ALL`THE'TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPEOFINSURANCE ADOLSUBR POLICY NUMBER POLICY POLICY LIWTS. A GENERALLIABILRY BOP2687872 8/13/16 8/13/17 EACHOCCURTRENCE S. 1 000. 000 COMMERCIAL GENERALLIABIUTY DAM4GETOr2ENT=�3 S 300,000 CLAIMS-MADE OCCUR ME EXP(AMorie psrsm) .. S 5,000 PERSONAL&ADVINJURY S 1,000,000 GENERAL AGGREGATE s 2,000,000 GEN'LAGGREGATELIMITAPPUESPER PRODUCTS-co>o?.AC-G i S 2,000,000 POLICY PRO- LOC IS AUTOMOBILE LIABILITY COMBINED SINGLE LIMTT a acciderd j S ANYAUTO BODILY INJURY(Per Persdn) !S ALLOWNED SCHEDULED BODILY INJURY(Per accident)]S AUTOS AUTOS NON-OWNED PROPERTY DAMAGE i S HIRED AUTOS _AUTOS eracoldent �S UMBRELLA LIAB OCCUR EACHOCCURRENCE {S EXCESS LIAB CLAIMS-MADE AGGREGATE #S DED RETENTION S Is `+ WORKERS COMPENSATION MA ARP3O1677 3/22/16 3/22/17 wCSTATU- IOTH-{ ' AND EMPLOYERS'LIABILITY W' ' ANY PROPRIETOR/PARTNER/EXECUTIVE Y� NIA E.L.EACH ACCIDENT 15 160,000 OFFICERIMEMBER EXCLUDED? € (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE'&S 1.00 If yes,describe under {{ DESCRIPTION OF OPERATIONS below EL.DISEASE-POLICY LIMB I S 500. 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Addrdonal Renerks Schedule,if more space is requl red) CERTIFICATE HOLDER CANCELLATION — V r,^� ��/q SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE !� be THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Zvi Ins ACCORDANCE WITH THE POLICY PROVISIONS. q AUTHORIZED REPRESENTATIVE I 00116vtiP1 'etre') c Ji Q4601 Melissa S. Pruett, CISR ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD Phone: Fax: E-Mail: vest Jdt%1 a?e r 1-2 - /6 A6, w 0 ,�, Massacnusetts Uepartment of F'uUl1c �atety j J Board of Building Regulations and Standards i License: CS-076458. Construction Supervisor DAVID A GREW i 438 WEIR ROAD, 6%w YARMOUTHPOR;T M� IO2 ,5 � nnt.,,� l� Expiration: Commissioner 06/01/2017 i V�G' (Q0497gT7"OOLGUBC/.LC1z-PlVlrlQ1dCLCleccdG'CC'1 j � .. . Office of Consumer Affairs&Business Regulatior HOME_IMPROVEMENT CONTRACTOR.. Registration valid for individual use only e: Individual before the expiration date. if found return to: .-type: Office of Consumer Affairs and Business Regulation eraistratlon Expiration •r 10 Park Plaza-Suite 5170 - 1- 40 09 03/2018 36.8. / � Boston,MA 02116 David Grew _ , David Grew :- 438 Weir Rd Yarmouth MA 02675 4 !'UndersecreteO Not valid without Signature ri t I f First k7k, Proper ty M A N A G E M 'E N T 1046 Main Street Suite 11 Telephone 508.420.0299 Osterville, Ma. 02655 Facsimile 508.420.0789 www.fpmcapecod.com December 30,2016 To Whom It May Concern, This letter is to notify you that 1,Devin Witter, acting as Property Manager and Agent to the Board of Trustees of Cape Cod Melody Village located at 110 West Main Street,Hyannis MA hereby authorize Grew Building to complete any and all work to the interior and exterior of unit 1 common areas necessary to properly vent the bathroom renovation taking place in said unit. If you have any further questions feel free to contact me at your convenience. Sincerely, Devin Witter CMCA,AMS Property Manager First Property Management Print this-page • Owner Information - Map/Block/Lot: 290/ 173/OOA - Use Code: 1020 Owner Map/Block/Lot GIS MAPS 290/ 173/ OOA BINARI,JUNE A Property Address Owner Name as of 111115 110 WEST MAIN ST UNIT 1 110 WEST MAIN STREET HYANNIS,MA. 02601 Co-Owner Name Village: Hyannis Town Sewer At Address: Yes GIS Zoning Value: SPLIT RB;HB • Assessed Values 2016 - Map/Block/Lot: 290/ 173/OOA - Use Code: 1020 2016 Appraised Value 2016 Assessed Value Past Comparisons Building Value: $ 75,100 $ 75,100 Year Total Assessed Value Extra Features: $ 17,700 $ 17,700 2015 - $ 89,600 Outbuildings: $ 0 $ 0 2014 - $ 89,600 Land Value: $ 0 $ 0 2013 - $ 102,400 2012 - $ 100,700 $ 92,800 2011 - $ 101,100 2010 - $ 108,700 2016 Totals $ 92,800 2009 - $ 144,200 2008 - $ 165,500 2007 - $ 165,500 Residential Exemption Received= $83,520 • Tax Information 2016 - Map/Block/Lot: 290/ 173/OOA - Use Code: 1020 Taxes Hyannis FD Tax (Residential) 224.5 8 Community Preservation Act $ 2 59 Tax Town Tax (Residential) $ 86.40 Fiscal Year 2016 TAX RATES HERE 31357 • Sales History - Map/Block/Lot: 290/ 173/OOA - Use Code: 1020 History: Owner: Sale Date Book/Page: Sale Price: BINARI,JUNE A 2005-09-12 20250/110 $178000 GOODFELLOW, SUSAN T 2002-06-24 15293/309 $119900 SIAFAKAS,JOHN A JR & MARYALICE 1987-06-15 5796/338 $77500 DEWIRE,THOMAS A 3RD TR 1982-04-15 3461/136 $40000 DEWIRE,THOMAS A 3RD 5844/168 $0 • Photos 290/ 173/OOA - Use Code: 1020 • Sketches - Map/Block/Lot: 290/ 173/OOA - Use Code: 1020 BAS BMT i I 19 e AsBuilt Card N/A • Constructions Details - Map/Block/Lot: 290/ 173/OOA - Use Code: 1020 Building Details Land Building value $ 75,100 Bedrooms 1 Bedroom USE CODE 1020 Replacement Cost $90,457 Bathrooms 1 Full-0 Half Lot Size (Acres) 0 Model Res Condo Total Rooms 3 Rooms Appraised Value $ 0 Style Condominium Heat Fuel Electric Assessed Value $ 0 Grade Average Heat Type Elec Baseboard Year Built 1980 AC Type None Effective depreciation 17 Interior Floors Carpet Stories 1 Story Interior Walls Drywall Living Area sq/ft 551 Exterior Walls Wood Shingle Gross Area sq/ft 1,102 Roof Structure Gable/Hip Roof Cover Asph/F GIs/Cmp • Outbuildings & Extra Features - Map/Block/Lot: 290/ 173/OOA - Use Code: 1020 Code Description Units/SQ ft Appraised Value Assessed Value Basement-Unfinished Unfinished 3440 $ 0 $ 0 Basement-Unfinished Unfinished 3440 $ 0 $ 0 BMT, Basement- 3440 $ 0 $ 0 Unfinished BMT Basement-Unfinished 3440 $ 0 $ 0 BMT Basement- 551 $ 15,800 $ 15,800 Unfinished BNff Basement- 3440 $ 0 $ 0 Unfinished BGAR Bsmt Garage 1 $ 1,900 $ 1,900 • Sketch Legend Property Sketch Legend B2N Barn-any 2nd story area FPC Open Porch Concrete Floor REF Reference Only BAS First Floor, Living Area FTS Third Story Living Area(Finished) SOL Solarium BMT Basement Area(Unfinished) FUS Second Story Living Area(Finished)SPE Pool Enclosure BRN Barn GAR Garage TQS Three Quarters Story(Finished) CAN Canopy GAZ Gazebo UAT Attic Area(Unfinished) CLP Loading Platform GRN Greenhouse UHS Half Story(Unfinished) FAT Attic Area (Finished) GXT Garage Extension Front UST Utility Area(Unfinished) i F'CP 'Carport KEN Kennel UTQ Three Quarters Story r� (Unfinished) FEP Enclosed Porch MZ1 Mezzanine, Unfinished UUA Unfinished Utility Attic FHS Half Story(Finished) PIRG Pergola UUS Full Upper 2nd Story (Unfinished) FOP Open or Screened in Porch PRT Portico WDK Wood Deck PTO Patio Microsoft VBScript runtime error'800a01a8' Object required: " /Assessing/print16.asp, line 151 Cape Save Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fag: 508-398-0399 11/1/16 k, _ r3 -7-1 Town of Barnstable i Thomas Perry CBO i Building Commissioner 200 Main St. Hyannis,MA 02601 RE: Building Permit TO: Building Inspector(s), This affidavit is to certify that all work completed for 110 West Main St APT 30,Hyannis has been inspected by a third party Certified Building Performance Institute(BPI)Inspector. All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCluskey -- TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Q_ V11 Ai �. Map- Parcel 1 Application # Health Division � �r+.DING DEPT Date Issued Conservation Division SAP 2 201� Application Fee Planning Dept. Permit Fee ►UVV0 OF BARNSTABLE Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address 0 Wee M ki n; S t a+ 3 b Village V4 n n i S Owner w1A4, e L, Address S otm P, Telephone So �b 9-1q I h Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation $ ® 0 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 XNo If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) I NameMCCIOS14 n GTelephone Number SO a 398 03 Address J: 4 H1q.&Tet, License # V �a.ra►o 7 I, (�m 6� "[ Home Improvement Contractor# Email Worker's Compensation # w ( R ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �a.► -,dJ1,� h SIGNATURE DATE &A FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED f MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. r HOME OWNER WEATHERIZATION WORK PERMIT: j PLEASE COMPLETE AND SIGN THIS FORM AS THE APPLICANT HOMEOWNER, I I _ I�t�1GyJ•C � -�1 hereby consent to and agree that weatherization work may be done by the Weatherization Program of Housing Assistance Corporation on the property located at: I i I The weatherization work done will be based on programmatic priorities and availability of j funding and it may include ail or some of the following measures: Weather stripping;air sealing; attic&basement insulation; exterior wall insulation;ventilation 1 measures In consideration of the weatherization work to be done at my home I agree to the following: 1. 1 give permission to Housing Assistance Corporation the property with such equipment and materials as may be necessary to perform weatherization. 2. The Housing Assistance Corporation reserves the right to inspect the fuel or utility bill for the weatherized unit on an ongoing basis for no more than five(5)years after the weatherization work is completed. I have read the provisions of this agreement and give my consent. Home Owner(signatun �l i alw Home Owner email �,Cagate: CV9 t Agent:(Signature) ry Date: Weatherization Contractors: Adam T Inc Cape Save All Cape Energy Frontier Energy Solutions Alternative Weatherization Lohr Home Improvement Building Science Construction Tupper Construction Cape Cod Insulation r DATE(MMMDtYYYY) aCoRE0 CERTIFICATE. OF LIABILITY INSURANCE 4/1a/2ois 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(iss)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 endorsements. PRODUCER CONTACT NAME: Risk Strategies Company Risk Strategies Company HOC E : (781)986-4400 FAX No:(791)969-4420 15 Pacella Park Drive ADDRESScrandolphcld@risk-strategies.com Suite 240 INSURER(S)AFFORDING COVERAGE NAICt. Randolph MA 02368 INSURERA:Selective Ins. of America INSURED INsuRERBAllmerica Financial Alliance Ins Co 10212 Cape Save, Inc INSURERC:Star Insurance Cc 7 D Huntington Ave INSURERD: INSUI ERE: South Yarmouth MA 02664 1 INSURERF: MIRAGES CERTIFICATE NUMBER:CL1641211375 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. NOTwrrHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO MICH 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. !NT DOLISLIBR POLICY TYPE OF.INSURANCE .POLICY NUMBER MMIDD EFF MOMI ICY EX LTR LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE F OCCUR PREMISES Ee onCe $ 100,000 X 81994460 10/16/2015 10/16/2016 MED EXP oneperson) $ 10,000 PERSONAL&ADVINJURY $ 1,000.,.000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ i 2 0.00 000 POLICY[�]PRO JECT 1-1.LOC PRODUCTS-COMP(OP AGG $ 2,0:00,00:0 OTHER':. COMBINED $ AUTOMOBILE,LIABILrTY Eeaccident SINGLE LI F $ 1,000,000 B ANY AUTO BODILY INJURY(Per person) $ ALL S AUTOMED M AAUUTOOSDULEDAWRA46796600 11/6/2015 11/6/2016 BODILY INJURY(Perraccident) $NON=OWNEO PROPERTY DAMAGE X HIREDAUTOS AUTOS Perecddent $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1.000 000 A EXCESS LIAR CLAIMS-MADE ) t? . :,, AGGREGATE $ 1,000,000 DED I X I RETENTIONS$. NIL �819941480 10/.16/2015 10/16./2016 $ WORKERS COMPENSATION _ officers Included for - ! ; ° X STATUTE ERH AND EMPLOYERS'LIABILITY - ANY PROPRIETORIPARTNER/EXE— I E YIN N IR couerage E.L.EACH ACCIDENT $ 500 000 OFFICERIMC (Mandatory In ER`EXCLUDED7 ® NCOBS540700 ,4/9/2015 4/•9/201.7 (Mandatory In NH)Under 4,, t E L.DISEASE-EA EMPLOYE ,$ 500 0.00 If yes,describe-.under DESCRIPTION.OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION-OF OPERATONS I LoCAT1oNs I VEHICLES(ACORD 101',:Additional Rema*s Schedule,may be attache d If more space Is required) National Grid Corporate Services LLC d/b/a National Grid,, Action Inc, Colonial Gas Company and NStar Electric are all included as Additional Insureds with respects to the General Liability coverage of named insured as required by written contract. -CERTIFICATE HOLDER. CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Housing Assistance corporation THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Cape: Light Compact ACCORDANCE WITH THE POLICY PROVISIONS. Barnstable County 460 West M`din Street AUTHORIZED.REPRESEWATIVE Hyannis, Ida 026:01 Michael Christian/(CL.C ' ' ©1990-2014ACORD CORPORATION. All rights rsserved. ACORD 25(20.14101) The ACORD name and logo are registered marks of ACORD INS025 gQ14Qi.) The Commonwealth of Massachusetts Department.of Industrial Accidents 3 I Congress Street,Suite 100 Boston,MA 02114-2017 s� www.mass.gov/dia «`orkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE.PERMITTING.AUTHORITY. Applicant Information Please Print Legibly Name (Bus ness/Organization/Individual):Cape Save Inc Address:7-D Huntington Avenue City/State/Zip:South Yarmouth, MA 02664 Phone#:508-398-0398 Are you an employer?Check:the-appropriate box: Type of project(required): 1.2 I am a employer with 15 employees(full and/or par-time).° 7. ❑New construction 2. I am a sole proprietor or partnership and have no employees working for me in ❑ 8: ❑Remodeling: any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.aI am a homeowner doing all work myself..[No workers'comp.,rnsurance.requ�red.]t 10 Q Building addition 4.❑I am.a homeowner and will be hiring contractors to conduct all work on my property. l will ensure:that all contractors either have workers'compensation insurance.or are sole I LR Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.❑1 am a general contractor and I have hired the sub-contractors listed on the attached sheet: 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance. 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c,. 14.[Other Insulation. 152,§1(4),and we have no employees.[No workers.'comp.insurance required] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensatiowpolicy 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: Star Insurance Co. Policy#Or Self-ins.Lic.#: WC085540700 Expiration Date: 4/9/2017 Job Site Address: 110 West Main Street APT 30 City/State/Zip;Hyannis Attach a:copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is:a.criminal violation punishable by 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.A.copy of this statement may be forwarded to the Office of Investigations of the WA for insurance coverage verification. I do hereby certify under the pains and Penalties of perjury that the information provided above is true and correct Si ature: Date: 22/ 6 Phone#:508:-398-0398 Official use:only. Do'not write in this area,to be completed by city or town official City or Town; Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electncal.Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: f uite bA��-Oazdw- offl.':n ce of Consumer:Affairs and.Bus>rless Regulatlor T: 1.0 Park Plaa- S5170 Boston,.Massachusetts 02116,,; Horne Improvement Contractor Reg> trat>ori - w Registrafion. 171380 Type. Corporation Expiration: 3/14/2018 Trl� 419291 CAPE SAVE INC. � = - t WILLIAM McCLUSKEY -14 , t 7-D HUNTINGTON AVENUE r r �. k SOUTH'YARMOUTH; MA 02664 'A Update Address and'return card.Mark reason for change. - .P D Address of Renewal: Employment Lost Card SCA 1 0 20M=05111. - Office of C ns mer.Affairs&Busiiiess k�egulation License or registration valid for individul use only JAM�HOME IMPROVEMENT CONTRACTOR before the expiration date. If found>return for Fha Registration 171380 Type: Office of Consumer Affairs and Business•Regulation Expiration 3/14/2018 Corporation. 10 Park Plaza-Suite 5170: r Boston,MA 02116 CAPE SAVE INC. i 3" •y..Jct,.�Y 1 f_ i WILLIAM McCLUSKEY a ( 7-D HUNTINGTON AVENUES SOUTH YARMOUTH,MA 61664 Undersecretary Not v 4101vihAsignature Massachusetts Department of Public Safety Board ofBuilding Regulations and Standards �v r. r_ 1.I1111tt Id(a11111 License: CSSL 102176 1 7040 �"i WILLIAM J MC 4ptU '�;. 37 NAUSET ROAD F West Yarmouth 1%A ✓.•�w•.�1 '.>r,4i;�� Expiration Commissioner 06/2812017 Cape Save Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fag: 508-398-0399 3/3/16 Town of Barnstable Thomas Perry CBO 4 Building Commissioner 200 Main St. Hyannis,MA 02601 v RE: Building Permit#B-16-361 , TO: Building Inspector(s), This affidavit is to certify that all work completed for 110 West Main St APT 19,Hyannis has been inspected by a third party Certified Building Performance Institute(BPI)Inspector. All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCluskey TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ,k. Map Parcel 3 Application # Health Division Date Issued. Conservation Division Application Feel Planning Dept. Permit Fee 13 Date Definitive Plan Approved by Planning Board d � Historic - OKH _ Preservation/ Hyannis Project Street Address `k o W CS+- M Village ki 10kanI`r Owner r 0 Address Telephone 5© 3 6 S a 5 Q Permit Request _R1111 a4LIC Pr R- 19 0 ` S cm f W C.iY Qnd i A t6 �i�l. Square feet: 1 st floor: existing proposed 2nd floor: existing proposed. Total new- Zoning District Flood Plain Groundwater OverlayJJ = -� Project Valuation 430 0 0 Construction Type g 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 R ighway:'-0 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 k-No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name WIWIAM N.a.4-ICA-be ' INC, Telephone Number Sd 8 39 V a 3 98 Address T -) ��" M� ��e License # 4—L to Home Improvement Contractor# 3�� Email Worker's Compensation # 3 13 b ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE L I ; 1k FOR OFFICIAL USE ONLY 1 ti f t APPLICATION # ii DATE ISSUED I ' i' MAP/ PARCEL NO. i , I ADDRESS VILLAGE i OWNER DATE OF INSPECTION: FOUNDATION i FRAME ` INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL 'r PLUMBING: ROUGH FINAL (SAS: ROUGH FINAL !,INAL BUILDING l DATE CLOSED OUT , ASSOCIATION PLAN NO. i i. l The Commonwealth of Massachusetts - } Department of Industrial Accidents 1 Congress Street,'Suite 100 - Boston,MA 02114-2017 ` www.mass gov/dia «'orkers'Compensation Insurance.Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name(Business/Organization/Individual):Cape Save Inc Address:'7-D Huntington Avenue City/State/Zip South Yarmouth, MA 02664 Phone#:508-398 0398 Are you.an employer?Check the appropriate box: _ Type of project(required): 1.M✓ I am a employer with 20 •'• ' employees(full and/or part-time).• 7. New construction 2. I solei am a proprietor or partnership and.have no employees working for me in • ❑ ._ 8: �Remodeling any capacity.[No workers'comp.insurance required.] ' 3:a I am a homeowner doing all work myself.[No workers'comp.insurance required.]! 9. Demolition- 10 Q Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property_I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions ' proprietors with no employees. 12.❑Plumbing repairs or additions 5.❑I am a general contractor and I.have hired the sub-contractors listed on the attached sheet. 13. ROoft repairs These sub-contractors have employees and have workers'comp.insurance. 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.E✓ Other.Insulation 152,§1(4),and we have no employees.[No workers'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.entiries have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. 7 ant an employer that is providing workers'compensation insurance for my employees. Below is the policy and job.site information:. 6 Insurance Company Name:Wesco Insurance Company Policy#or Self-ins.Lic.:#:WWC3136274 Expiration Date:,04/0.9/2016 Job Site Address: 110 West Main Street APT 19 City/State/Zip:--byannis Attach a co of the workers'compensation policy declaration page(showing the policy number and expiration date).' ,- copy p. p y . P g ( g 11 y p• ) - Failure to secure coverage as required under.MGL c. 152,§25A is a criminal violation punishable by 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;A copy of this statement maybe forwarded to the Office of Investigations of the DIA-for insurance coverage verification: 1 I do hereby certify under th pains and'Penalties of perjury that the information provided above is true and correct Signature: Date: /18/16 f Phone#:508:-398-0398 Ofcial use only. Do not write bi this-ar"ea,to'be coinpleted by cioy or town official r City or.Town, -� � Permit/License# rt' Issuing.Authority(eircle one) r{> L Board of Health 2.Building Department.3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector c 6.Other Contact Person:. Phone#: ...._. Aco" CERTIFICATE OF LIABILITY INSURANCE °A' '"W'°°` '' 10/14/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER cow NAME:CT Colleen Crowley Risk Strategies Company PH0�N a (781)986-4400 (FAX,No: (781)963-4420 15 Pacella Park Drive - _ ADD�sS:ccrowley@risk-strategies.com Suite 240 INSURERS)AFFORDING COVERAGE NAICf Randolph _ MA 02368 INSURERA:Selective Ins. of America INSURED iNsuRERB Allmerica Financial Alliance Ins Co 10212 Cape Save, Inc INsuRER c:Wesco Insurance Company 7 D Huntington Ave INSURER D: INSURER E Sough Yarmouth MA 02664 INSURERF: COVERAGES CERTIFICATE NUMBER:CL15101402127 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 D POLICY NUMBER MPMOI DILICY EFF POI IDCY EXP LIMITS LTR X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE X�OCCUR t PREM SES Ee occurrence $ 100,000 S1994480 10/16/2015 10/16/2016 MED EXP(Any one person) $ 10,000 PERSONAL&ADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE Ea accident) IMI $ 1,000,000 ANY AUTO BODILY INJURY(Per person) $ 13 ALL OWNED SCHEDULED AUTOS X AUTOS A(ieA96796600 11/6/2015 11/6/2016 130DILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident $ , X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAS CLAIMS-MADE AGGREGATE $ 1,000,000 DED RETENTION Nil 01994480 10/16/2015 10/16/2016 $ WORKERS COMPENSATION officers Included for X I SPER OTH- AND EMPLOYERS'LIABILITY YIN TATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE Coverage E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? FNI NIA C (Mandatory in NH) ;i VWC3136274 4/9/2015' >4/9/2016 E.L.DISEASE-EA EMPLOYE $ 500,000 If yes,describe under - ' DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 r DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) National Grid Corporate Services LLC d/b/a National Grid, Action Inc, Colonial Gas Company and NStar Electric are all included as Additional Insureds with respects to the General Liability coverage of Named Insured as required by written contract. r _ CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Housing Assistance Corporation 7HE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 460 West Main Street ACCORDANCE WITH THE POLICY PROVISIONS, Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE Michael Christian/CLC < �t'�� O 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INS025(201401) i c Office of.Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Ma 11 ssachusetts 02116 Home Improvement Contractor Registration Registration: 171380 s Type: Corporation i ? Expiration: 3/14/2018 Tr# 419291 CAPE SAVE INC. WILLIAM McCLUSKEY kh + 7-D HUNTINGTON AVENUE f �' SOUTH-YARMOUTH, MA 02662 r r � ii•, �ti r � a-n Update Address and return card.Mark reason for;change. MM Lj Address ❑ Renewal fj Employment ❑ Lost Card. sCA 1 % 20M-05/11 r/! �F'a>ncutm�tcuercfl/a�P�Cic:Unc�u:�e� - Office ofConsumer Affairs;&.Business Regulation License or registration valid for individul use only ^ G HOME IMPROVEMENT CONTRACTOR before the expiration date. If found,re.turn to: t Office of Consumer Affairs and Business Re ulation Registration -171380! Type: g r Expiration 3l14l2018 Corporation 1'0 Park Plaza-Suite 5110 Boston,NSA 02116 CAPE SAVE INC. WILLIAM McCLUSKEY 7-D HUNTINGTQNrAVENUE; SOUTH YARMOUTH,MA 02664 Undersecretary Not validlvhAsignature Massachusetts —Department of Public Safety Board of Building Regulations and Standards L.i1111Lt 1Il LI I'i1i.Jtijlt:/Yt1111'':711C1'IAtL\" �:�'-+� gi:�< . License: CSSL 102776 +x wlilmi M J MC f' ,U 37`NAUSET ROAD I IF West Yarmouth MA Expiration Commissioner 06i2812017 t 4 HOME OWNER WEATHERIZATION WORK PERMIT: PLEASE COMPLETE AND SIGN THIS FORM AS THE APPLICANT HOMEOWNER. hereby consent to and agree that weatherization work maybe done by the Weatherization Program of Housing Assistance Corporation on the property located at: The weatherization work done will be based on programmatic priorities and availability of funding and it may include all or some of the following measures: Weather stripping; air sealing; attic &basement insulation; exterior wall insulation; ventilation measures In consideration of the weatherization work to be done at my home ( agree to the following: 1. I give permission to Housing Assistance Corporation the property with such equipment and.materials as may be necessary to perform weatherization. 2. The Housing Assistance Corporation reserves the right to inspect the fuel or utility bill for the weatherized unit on an ongoing basis for no more than five (5) years after the weatherization work is completed. I have read the provisions of this agreement and give my consent. Home Owner(signature) y 3 r Home Owner email: j;51'./ `. date: i Agent:(Signature) Date: Weatherization Contractors:. Adam T Inc Cape Save All Cape Energy Frontier Energy Solutions Alternative Weatherization Lohr Home Improvement Building Science Construction Tupper Construction Cape Cod Insulation TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 0 3 ()o i? OF ARNSTABLE Map Parcel Application # Health Division " `F' ('`'? ' }Date Issued 7— Conservation Division Application Fee �• Planning Dept. r Permit Fee 6�0 •00 DINT Date Definitive Plan Approved by Planning Board SD O Historic - OKH _ Preservation / Hyannis Project Street Address b We-St NMI Y) S�-� ,g � � eT 18 Village 7(atndrS Owner G6r;S+6 er „n Address MC Telephone 3 U Permit Request R- 30 ce I I t&IaX 4 nJ 14 e a- o C. (�� � � �� r►s;� �nSr�,� ��ron fi 1'�e bdsPn,en+• sen I "'-ki, a tG (� I0.n , w1�h l�J,lnc Tea/Ir1I Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 00 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 ,KNo If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) , U / Name-" M MCd9ke-' 1CCAe- ��Zn�. Telephone Number GJ 0 3 8 03 90 Address +)n'14an (�-rc License # �.G ( 0&'4 S- Y( rrnaz' h A 0 C-6 6 -I Home Improvement Contractor# t V30 0 Email Worker's Compensation # WWC 3 13 6 a�9 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE V DATE G 46 41 S FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ` ADDRESS VILLAGE 4 '* OWNER .� DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL r PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING s DATE CLOSED OUT ASSOCIATION PLAN NO. HOME OWNER WEATHERIZATION WORK PERMIT: PLEASE COMPLETE AND SIGN THIS FORM AS THE APPLICANT HOMEOWNER. 1 t� 1`� lC� hereby consent to and agree that weatherization work may be done by the Weatherization Program of Housing Assistance Corporation on the property located at: ll0 - NIA Liz The weatherization work done will be based on programmatic priorities and availability of funding and it may include all or some of the following measures Weather stripping; air sealing; attic&basement insulation; exterior wall insulation; ventilation measures In consideration of the weatherization work to be done at my home I agree to the following: ' 1. 1 give permission to Housing Assistance Corporation the property with such equipment and materials as may be necessary to perform weatherization. 2. The Housing Assistance Corporation reserves the right to inspect the fuel or utility bill for the weatherized unit-on an ongoing basis for no more than five (5) years after the weatherization work is completed. I have-read the provisions of this agreement and give my consent. Home Owner(signature) . Home Owner email• Date: LA_ Agent:(signature) Date: Weatherization Contractors: Adam T Inc Cape Save All Cape Energy Frontier Energy Solutions Alternative Weatherization Lohr Home Improvement Building Science Construction Resolution Energy Cape Cod Insulation Tupper Construction Office of Consumer Affairs and Business Regulation 10 Park Plaza Suite 5170 - Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 171380 Type: Corporation r Expiration: 3/14/2016 Tr# 249649 CAPE SAVE INC. W WILLIAM McCLUSKEY 7-D HUNTINGTON AVENUE SOUTH YARMOUTH, MA 02664 ---- --- - --- t r V161(7 Update Address and return card.Mark reason for change. sca C. zoM-osrii Address � Renewal Employment Q Lost Card �%la (f'orirrictrrueult�n��llci:��rcc�rc,e/(-;' Office ofxpiration -,�3119/201 Consumer Affairs&Business Regulation License or registration valid for individul use only ( TOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration171380 Type: Office of Consumer Affairs and Business Regulation 2 10 Park Plaza-Suite 5170 'E ,6: Corporation Boston,MA 02116 CAPE SAVE INC. ' § j WILLIAM McCLUSKEY"��4 7-D HUNTINGTON AVENUE: ��� SOUTH YARMOUTH,MA 02664 Undersecretar Y Not vali tthout signature �r Massachusetts -Department of Public Safety . Board of Building Regulations and Standards. Licenses CSSL-102776 `. WILLIAMJMC 1ptU. 37 NAUSET ROAb % r= West Yarmouth I%A V17 y S 1 Expiration Commissioner 06/28/2017 ACC r DATE(MM DPffM CERTIFIC�iTE ®F LIABILITY INSURANC � z4�z19s5 THIS CERTIFICATE iS ISSUED AS A MATTER dF INFORMATION ONLY AND.CONFERS NO RIGHTS UPON THE CERTIFICATE'MOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES I BELOW. THIS CERTIFICATE OF INSURANCE DOES'NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),)AUTHORIZED' REPRESENTATIVE OR PRODUCER,<AND THE CERTIFICATE HOLDER.' IMPORTMT: If the:certif[Cate holder IS an ADQlT.IONAL INSURED,the policy must,be endorsed. !#sUBfROoATION i$WAIt#ff1; su6)ect to the terns and conditions of the policy;certainpolicies may require an endorsement. A statement on this.certificate does not confer rights to the certificate holder in ileU of..such endorsemen i PRODUCER NAM Colleen Crowley Risk Strategies Camp3ny _ PHONE. (7131)986:=4400 FA fC (181)963-4420 1 o; 5 Pacella Park Drive .ccrowley@tisk-strategies.com Suite 24Q_ INS 3 AFFORDING cDVERAGE NAIC I. i3ado �s M D23S8 tNSUtrERA;Se9 motive ins of America . . INSURED _ INSURERs�j.=Z_jCa Finaaaial''AliianC@ 0212 Cape Save, lac INSURERC wesc0 InsuranceCcmalXVL 7 D Huntington_Ave INSURERD.: INSURERE: SIDUM UM6,11th lei 02664 INSUR�IxF: . COVERAGES CERTIFICATE NUMBER:C"532491501 REVISION NUMBER: [INSM'R 4IS IS TO C€�RTIFY TWAT THE POLICIES WSURANCE LISTED BELOW HAVE BEEN'($SUED TO THE1NSURED'NAMED ABOVE'FO'R`TH'E POLICY"PERiOB `- DiCATED. NOTIIIIITfiSTANDifyG ANY REQUIREMENT,TEEi2A9 OR COND1TIOfV QF ANY CONTRACT OR OTHER DOCUPoIENT.4fUR}I RESPEGfi 1O WHICH THIS ERTIFICATE MAY BE ISSUED OR MAY;PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN:IS SUBJECT TO ALL THE TERMS, IS XCLUSIONS,AND CONDITIONS OF SUCH`POLICIES.LIMITS:SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS TYPE OF INSURANCE POLICY NUMBER ICY,EFF POL ICY EXP LIMITS GENERAL LIAMLITY EACH OCCURRENCE' X COMMERCIAL GENERAL LIABILITY AG��TED PREMISES Ee ocaurertce $ 100,000" CLAIMS-MADE a OCCUR 1994480 6/16/2014 0/16/2015 -- MED EXP(Any one:pemon) $ . 10,000 PERSONAL&ADM•INJLJ?Y f S 1rD:00,QQQ GENERAL AGGREGATE $ " 2,()DO,DOD GEN'L AGGREGATE UMff APPLIES PER: PRO PRODUCTS-COMPIOBAGG $ 2,000,000 POLICY X X: LOC. $ ALr"OBILE uA81L1FY Ea ccideru.I 1,000.,000 B ANY AUTO BODILY INJURY(Par person) $ ALL OWNED SCHEDULED 46796600 I/6/2014 1/6/2015 AUTOS AUTOS BODILY INJURY(Per accident) $ HIR197AlJTOS AUTOS PRDYr?A�IA(SE..: $ X UNBRELt A LlAt3 }� $ OCCUR EACH OCCURRENCE $ 1,.000,,000 A ErrrrrrrrrrrXCES9LIAB CLAIMS4WADE AGGREGATE $ 1/000/000 0ED RETENTION 6r 199441Q 0/16/2914 0.116/2"5 wORJSkRBCQM?9NSA110N _ $ ffi� Ys InCivded fo'r VAC STATU- TH- 771 ANDEMPLOYERS'UAPfLiTY X OFFICEa1MEMBEER�NERCUTIVEI:i NIA oveT3ge EL.EACHACCIDENT - $ 500 000 (Manda(oryin'NH} 136274 /9/201'5 /9/2016 If yyees,describe under E.L.DISEASE-EA EMF(.DY $. 5Q(j OOFt DESCRlPTX)MOF OPERATIONSbefdvr E:LDISEASE.-POLICY LIMIT $ 500 000 DESCRIPTIONOFOPERATIONS/tOCATIONSI VEHICLES(AltacfiACORD101,AddItIonelRemarksiSchedule, rmareapacetsrequired) Issued as evidence of insurance. Thielsch Engineering, Ina. is listed as additional iri�r•„-ed .as respects General,7,a.abil;L szri�t tract`.. Ir equir..ed.b)r CERTIFICATE HOLDER CANCELLATION mt IIg@Cape.lig]�tCQ t"org "OuLID ANY b'E'TNE ABOVE'DESCRIHED`POLIC08 LSE CANCELLED B1 FORE ACCORDANCE DATE THEREOF, NOTICE WILL 13E DELIVERED IN THE EXPIRAT9 Cape bight Compact MTN THE POLICY PROWSIONS.. Attn: Margaret song: . 0 SOX 427/5.G8. AUTHORIZED REPRESENTATIVE 32.5 Main street Barnstable;- i+� 'cheek Chrstian/CLC •cS' l" � At:t?RDr?E{ Oi4/05j IN . , hIsrreerr�ed. The AGORD Warne And logo]are regsteredmarks of ACORD - -- n The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite 1.00 a Boston,MA 0211.4-2017 ww» massgov/dia NVorkers'Compensation.Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY.. Applicant Information Please Print Legibiv Name(Business/Organization/Individual):Cape Save Inc Address:7-0 Huntington Avenue City/State/Zip:South Yarmouth, MA 02664 Phone#:508-398-0398 Are you an employer?Check the appropriate box: Type Of project required): i:❑✓':I am a employer with 20 employees(full and/or part-time);* 7. ❑New construction lr7 I am a sole proprietor or partnership and:have no employees working forme in any capacity.[No workers'co insurance. 8•. �Remodeling comp. required.] 9. ❑Demolition 3.Q I am a homeowner doing all.work.myself.[No workers'comp.insurance required.].t ; 4.[] g Y property. twill 10 E Building addition T am.a homeowner and he hum contractors to conduct all work on m ensure that all contractors either have workers'compensation insurance or are sole M❑Electrical repairs or additions proprietors with no employees. 12.n Plumbing repairs or additions , 5:❑I am a general contractor and I'have hired the sub-contractors listed ort the attached sheet. .r These sub-contractors have employees and have workers'comp.insurance. 13.❑Roof repairs b:❑We are a corporation and its officers have exercised their right of exemption per MGL c, 14.[]✓ Other Insulation 152, 1(4),and we have no employees.[No workers'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.policyn umber. 1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:Wesco Insurance Company Policy#or Self-ins.Lie.#:WWC3136274 04/09/2016 Expiration Date: Job Site Address: 110 West Main Street APT 18 City/State/Zip- Hyannis Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure.coverage as required under MGL c.152,§25A is a criminal violation punishable by a fine upto$1.,500.00 and/or one-;-year iinprisonment;: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.A.copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under th pains and penalties of perjury that the information provided above is true and correct. Signature: \\ Date: 6/26/2015 Phone#:508-398-0398 Official use only. Do-not write in this area,to be completed by city or town official, City or Town; Perditicense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical;Inspector 5.Plumbing:Inspector 6.Other Contact Person: Phone#.:. Cape Save Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fag: 508-398-0399 8/8/15 Town of Barnstable Thomas Perry CBO Building Commissioner 200 Main St. Hyannis,MA 02601 RE: Building Permit#201504062 TO: Building Inspector(s), m / / O � This affidavit is to certify that all work completed for 4A West Main Street 18,Hyannis-n has been inspected by a third party Certified Building Performance Institute(BP' Inspector. All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCluskey Cape Save Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 3-7-15 Town of Barnstable Thomas Perry CBO Building Commissioner Un 200 Main St.Hyannis,MA 02601 ri 6 RE: Building Permit ff2#&5dtM Zo 1 5'p09r 7 3 � TO: Building Inspector(s), This affidavit is to certify that all work completed for 110 West Main Street APT 20,Hyannis has been inspected by a third party Certified Building Performance Institute(BPI)Inspector. All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCluskey TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 9 Parcel 1 .3 Application #,PO 1 06 OL Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address OIje G 1 S'��84 Un'[ - M Village YaaLs ' Te+e f�zme Owner`v i ti Address Telephone 5 o 8 �- , -5 w d Permit Request Ig d R " 3 6 ceh.k t OS e 4t i e q4 ICI all R 9 1Ass Int —e 65CA Air sed Z-0(; o' ne TAJ �aje&:A� Wl�k CXpafiJf�% 44#7. Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation ,AI 0 o 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)�, i - 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 w I _± Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other 5! Central Air: ❑Yes ❑ No Fireplaces: Existing . New Existing wood/coal stove:l.,>]Yet'❑ 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 f(No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) � I,r � NameW ks— Xfzot � 10c. Telephone Number Address T- D H-kfAln',.1ho Aric License # 1)0,4+ arI.a VA f' - OA b "I Home Improvement Contractor# Email Worker's Compensation # W Air ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO 6COA4� SIGNATURE DATE L� �5 f S FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. y The Coinnionwealth ofMossachusetts Departrr:ent of Industrial Accidents Office of Investigations 4 , 1 Congress Street, Suite 100 r B6ston,.MA 02114-2017 www.mass gov/d a Workers' Compensation insurance Affidavit: Builders/Contractors/Electricians/Plumbers, Applicant Information Please Print Legibh; Name (Business/Oruanization/Individual) Cape Save Inc. Address.. 7D Huntington Ave City/State/Zip: South Yarmouth, MA 02664 Phone#: 508-398-0398 Are you an employer?Check the appropriate box: Type;of project(required):. 1. 1.®V1 am a;employer with `(\0 4. ( 1 am a general contractor and I 6. []New construction. employees(full and/or part-time). have hired the sub-contractors 2.[❑ 1 am,a sole proprietor or partner listed on.the attached sheet. 7. ❑Remodeling shill and have no employees These sub-contractors have. g, E] Dein ition workingfor me in an capacity,. employees and have workers' y9. [] Building addition [No workers' comp.insurance comp: insurance.• 5. We area corporation and its 10.0 Electrical repairs or additions regwrcd.] 0. officers have exercised their 11. Plumbing repairs.or additions 3.❑ I am a homeowner doing all work ❑ b P myself. [No v�torke"rs'comp:, right,of exemption per MC:L 12.❑ Roof repairs insurance required.] c. 152, §1(4)i and we have no employees. [No workers' 13.0 Other Insulation: comp: insurance required.). Any applicant that checks box#I:must also.fill out the section below showing their workers'coinpensation policy information, t Homeowners who submit this affidavit indicating they are.doing All work and then hire outside contractors mustsubmit a new atfidavitindicating such. Contractors that check this box must attached an additional sheet show ng the naive oN a sub-contractors and state whether or'aot those'eM! les l 9ve employees. Ifthe sub-cons actors have employees,they must provide their,workers'comp,policy number: I an an employer that is orouidiq workers'compensation insitrancc for eny employees. Below is the policy and jub site information. Insurance Company°Name Wesco Insurance Company Policy#or Self-ins.Lic.#: WWC3085633_ _ Expiration'Date: 04/09/2015 11 m Job Site Address: City/State/Zip; R Al ri i`S Attach a copy of the workers'compensation policy declaration page(showing the policy numbe and expiration date) Failure to securel coverage as required under.Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of'a tine: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$250.00 a day against theviolator Be advised that a copy of this statement may be:forwarded to the>Office of Investigations of the DIA for insurance coverage verification: !do,hereby i?erti lender the ppinsia.pdpenalfies Qfper` 'that the information provided above is true and correc>: Sig nature: _ Date a a0 BIRO#: 50$-399.-8398 Official use only. Do not writein this`area,:to be completed by city or town official. City or TowD: Permit/License-# Issuuig Authority(circle one); I.Board,of.Health 2.Building Department 3.CitylTown Clerk; 4.Electrical;Inspector 5.Plumbing Inspector 6.Other, Contact Person: Phone#; ACQR o CERTIFICATE 4F LIABILITY INSURANCE DATE(MMIDD 4) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERT1IFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BEI*. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADD171ONAL INSURED, the poilcy(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 confer rights to the Certificate holder in lieu of Such endorsements). `PRODUCER NAMEr Colleen Crowley Risk Strategies Company PHONE . (781)986-4400 1 MAX.No:(781)96.3-4420 15 Pacella ParklDriVe .ccrowley@risk-strateg es.com_ Suite 240 . INSURERS AFFORDING COVERAGE_ NAIC Randolph MA, 02368 '1NSURERd:Seleetide ins. , oEP:.'America IksURED iNsuRERta Allmerica Financial Alliaare 10212 Cape Save, Inc INsuRERc Wesco insuranceCompany 7 D Huntingtop�,Ave INsuRERD: INSURERS: South ,Yarmouth --b9i 02664 1 INSURERF: COVERAGES _ CERTIFICATE NUMBER:CL14111085532 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 POLICY EF.F POLICX E8P' LTR TYPE OF INSURANCE „ POLICY NUMBER MMI ,. LIMITS, GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES We occurrence) $ 1-001 000 A CLAIMS-MADE OCCUR 91994480 0/16/2014 0/16/2015 MED EX (Any one person) $ 10,000 PERSONAL&ADv i AIRY $ 1,000,000 GENERAL AG GREGATE` $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS`-COMP/OP AG $ 2,000,000 POLICY .X PRO-XCI X` LOG $ AUTOMOBILE LIABILITY Y COMBINED (EaaBcide L 1,000,000 ._� __ ANY AUTO BODILY INJURY(Per person) $ B ALL OWNED SCHEDULED ` 6796600 1/6/2014 1/6/2015 AUTOS X` AUTOS BODILY INJURY(Per accident) II - _ NON-OWNED ROPERTY DAMAGE }{ HIRED AUTOS X AUTOS Per ac'dent $ PUMBFMLLA LIAB XOCCUR EACH OCCURRENCE $ 1,OOO,DoAEXCESS CIAB q. CLAIMS-MADE AGGREGATE $ _. 1,000,000 RETENTION Hil , 1994480 0/16/2014 0/16/2015 $ C WORKERS`COMPENSATION Officers Included for STATU OH- LBI ANDEMPLOYERS _ YIN ANY PROPRIETORIPARTNEREXECUTIVE NIA Overage. EL.EACH ACCIDENT $ 5OO OOO OFFICER/MEMBERIn NH)EXCLUDED? 3085633 /9/2014 /9/2015 (Mandatory In NH) E.L.DISEASE.-EA EMPLOYE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.G-Di SE7 POLICY LIMIT $ 5O0 000 DESCRIPTION OF OPERATIONS I LOCATIONS?VEHICLES(Attach ACORD 101,Additional Remaft Schedule,if more space Is required) Issued as evidence of insurance. Issued as evidence of insurance. Thieisch Engineering., Inc: is listed as additional insured as-respects General Liability as required by written contract. CERTIFICATE HOLDER CANCELLATION. msong@capelighteg act.org SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRA71ON DATE THEREOF, NOTICE WILL BE DELIVERED IN Cape eight fact ACCORDANCE WITH THE,PO.LICY PROVISIONS. Attn --Margaret song PO 'Box 427/3CH- _ AUTHORIZED REPRESENTATIVE 3195,Main-Street - Barnstable, MA 02630 �,� chael Christian/CLC ACORD 26(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025(2olm).ol The ACORD name and logo are registered marks.of ACORD i Ho%ing Assis ni�e Corporation Cape Cod HOMEOWNER I RESIDENT WEMERIZATION WORK PERMIT&FUEL RELEASE: PLEASE FILL OUT AND SIGN THIS FORM 1F YOU ARE THE APPLICANT HOME OWNER. hereby consent to and agree that woatherization work may be done by the Weatherizatlon Program of Housing Assistance Corporation(herein after referred'as "Agencyl on the properly located at: - r The weatherizatlon work done will be based on programmatic priorities and availability of funding and ft may include all or some of the following measures: Weather-stripping&caulldng of windows and doors, insulation of attics, sidewalls&basements, attic and other ventilation measures and possibly replacement of badly deteriorated windows. In consideration of the weatherization work to be-done at my home 1 agree to the following: i. 1 give permission to the"Agency"its agents and employees to travel onto or across said property with such equipment and materials as may be necessary to perform weatherization work on said property. 2. The Housing Assistance Corporation reserves the right to inspect the fuel or utility bill for the weatherized unit on an ongoing basis for no more than five(5)years after the weatherization work is completed. I have read the provisions of greernent as listed and freely give my consent. Home Owner. {Signature) Date: / Agent: (signature) Date: HAC approved Weatherization Company J a Adam T Incorpomted All Cape Energy Alternative Weaftdzation Building Performance Contracting LLC Cape Cad Insulation ape Save Frontier Energy Solutions Lohr Home Improvement Resolution Energy s'u.: ,»�-+i;�la;i;%�all t:letL>•• ..;;.1't;i s'e: ::n.' :•F�.�,•,ti':t i•.'t f-Y:�ii'.G,r R d?P 160) jw�101>?(Ivealmlyl ovz � 1 G?'C�Ylill/SPi � Office of Consumer Affairs and Business Regulation r 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration { � Registration: 171380 Type: Corporation ` w J-1 Expiration: 3/14/2016 Tr# 249649 CAPE SAVE INC. m , WILLIAM McCLUSKEY ---�- 7-D HUNTINGTON AVENUE __— SOUTH YARMOUTH, MA 02664 _ ---- - ---- - Update Address and return card.Mark reason for change. sCA 1 0 20M-05/11 Address Renewal Employment D Lost Card �/!P`((rrilillNtuvelrlAA1 rt�����l�:idrrrllrcreC�' . Office of Consumer Affairs&Business Regulation License or registration valid for individul use only J,F'Expi OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: 079380 Type: Office of Consumer Affairs and Business Regulation ration 3/_14 201.6 Corporation 10 Park Plaza-Suite 5170 _ Boston,MA 02116 jn CAPE SAVE INC. WILLIAM McCLUSKEYYt�` . 7-D HUNTINGTON AVENUE° SOUTH YARMOUTH, MA 02664 Undersecretary Not val4Tt signature Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supen'isor Specialty License: CSSL_102776r WILLIAM J MC C-LUS ' 37 NAUSET ROAD West Yarmouth NIA 026 E " ' Expiration Commissioner 06/28/2015 TOWN OF BARNSTABLE R I S E Division of 7hielsch Engineering,Inc. 2013 MAY 10 AM 11: 21 1341 Elmwood Avenue ENGINEERING Cranston,Rhode Island02910 DIVISIOpq 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 110 West Main Street 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 J 401-784-3700 •800-422-5365 •Fax 401-784-3710 Ilk ('�D,�a � l Town of Barnstable *Permip F4ires 6 no ;— te Regulatory Services Fee BARIMANX Thomas F.Geiler,Director . Building 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 PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Lnprint Map/parcel Number oQ9C) Property Address I(� c�J�J�- .�it� - A�}• �yC 1 A c S [Residential Value of Work Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address er IjCA H: do W-4 fy)g::Li n Contractor's Name Sprinkle Home Improvement Telephone Number 508 775-1778 Ext. 10 Home Improvement Contractor License#(if applicable) 103757 .PRE Construction Supervisor's License#(if applicable) CS 6643 jX Workman's Compensation Insurance Check one: ❑ I am a sole proprietor TOWN OF BARNST ElI am the Homeowner ABLE ® I have Worker's Compensation Insurance Insurance Company Name Associated Industries of MA / A.I.M Mutual Insurance Co. Workman's Comp.Policy'# AWC 7004943012012 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 ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑.Re-side #of doors replacement Windows/doors/sliders.U-Value (maximum.35)#of windows _ *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property.Owner Letter of Permission. A copy of the vement Contractors License&Construction Supervisors License is requ' SIGNATURE: `\ C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Int et Files\ContenLOudook\DDV87AAZ\EXPRESS.doc Revised 072110 The Commonwealth of Massachusetts Print Form Department of Industrial Accidents Office of Investigations 1 Congress Street, Suite 100 w, J` Boston, MA 02114-2017 ov/dia www.mass. _�f g Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Aimlicant Information Please Print Legibly Name(Business/organization/individual): Sprinkle Home Improvement Address: 199 Barnstable Road City/State/Zip: Hyannis, MA 02601 Phone #: 508 775-1778 Ext. 10 Are you an employer?Check the appropriate box: Type of project(required): 1.2 1 am a employer with 10-12 4. ❑ 1 am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑ New construction 2.El 1 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. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance. required.] �. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their I I.[:] Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152, §1(4), and we have no employees. [No workers' 1 Other�Jz&& 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: Associated Industries of MA./A.I.M Mutual Insurance Co. Policy#or Self-ins. Lic. #: 7004943012012- Expiration Date: 01/01/2013 Job Site Address: 1 L 0 Cam' (Yh`n 5�_f lelj App - City/State/Zip: gwmAz'r MA 49661 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 hereb certify u e he d penalties ofperjury that the information provided above is true and correct; Signature: Date Phone#: 508 775-1778 Ext. 10 Official use only. Do not write in this area,to be completed by cih,or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: f Town of Barnstable Regulatory Services Thomas F.Geller,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 ae,r as Owner of the subject property hereby authorize Sprinkle Home Improvement to act on my behalf, in all matters relative to work authorized by this building permit application for. 1 o west Mc in S�'r (Address of Job) Si natur f Owner Date Print Name If Property owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. a C:\Users\decollikWppData\LoW\MicrosoR\Windows\Temporary Internet Files\ContenLOutlook\DDV87AAZ\E.NPRESS.doc Revised 072110 I � 1L/ lU/1U11 y : 35 : 33 AM 8740 ® 02 /09 CERTIFICATE OF LIABILITY INSURANCE D"'Ei`vzoi20Di1 THIN CEATIrIch" IN WANED As A YATTRR Or INrong"ION ONLY Am CONFRRS so SIGN" grow TQ CRRTIrIC1VN: NOLDRR. TEIN CBMIrICRTR Dona NOT ArrIRNATIVSLY OR ■Z"TIVZLT MEND, N�Q'RND OR ALTO TAR COVRRAM ArrORDm NY TNR IVOLICIRB mmow. TRIG CN'1TIrIC3LTR Or INBIIRANCR DONE NOT CONNTITVW R CONTRACT MVMXffN TNR IBNOINe INBOMM(B), AOTNOlutso MPRRB=TATIVR OR FROMM, AND YEN I IWORTANT: If the Oertificata bolder is an ADDITIONAL INsV=W, the policy(les) must be andorsed. If sos=oaDTION Is n►IVRD, sub)•ec 1 w to the taraim and conditions of the policy, cartain policies soy require an andoraasent. A statnt on this certificate does not confer rights to the certificate holder in iisu of sucb an(torseaens(s). I sat► Btyden 4 Sullivan Ins Agency Use Inc u/c. s.. m). ta/c. a.): j N-Bo.a 88 ftlmouth Road • "memo Hyannis, ML 02601 m*�■ I»• IsoBW >sltto(s) arpm►Ot{csUNLa►s auC• Sprinkle Home zrravement Inc Dawn• A.I.X. Mutual Insurance Co 33758 199 Barnstable Road IB►wo C. — Hyannis, DID► 02601 i . nano .: I COVERAGES CiRTIPICAT9 NUMBER: REVISION NUMBER: TES IN 10 YOr 7si POQ=X= ar 20rommacm umm./QAr mom MIN fimm SO!m nsoRm NAB ANO'M FOR TO POLECr 1NirOD ZXDMC m. j NOIRlIiTAlomm ANY RNCrarr, 1=0 OR como1TNON or ANY 00010h T OR oSm DOCOMMIRr tie mamrmcr so 20Z0 Sir? so>:Nil rER NO Issm as BONY ; '�Z♦, !4 �ANNIMM EY ME roLiras DEeCLam E� Is SMJWV SO ALL SY TEm, =CLV,IOrs Am OOEDITMM or moo roO=xn. LENS sear, UGLY ws one NmOCm RY rasa cum_ roLICY Nrr POLICY m tA' TYFN 01 aFOii1C: POLICY NOISQ ur/tanaTT ,tnwB/nTr, LIMITS . OOQAL LZaRII.iTY teat Ocaaaaes { C1094149MCK ,wnaAL LIABILITY - 004"IM wt►t «con y rs�IO�(e...�owa.no.) • '�.._._. O m (sawCl .r ps..w/ • a .saasta&L• Nov t.om . "NIL AG"I"7N LIMIT APPLINs IS: •�••t •►�s•TN • �,MICT �r{ancT ❑Loy I .owns- COw/or at► • AOrOYORIii LIASII.iTr - tarns►sumo LnIT 0— Awro BUILT TWWZ (pT No-) { . I ALL OtetD AOTDO _.� ❑BCNNBm.tD.OlOB I BUILT LEFUM(p..aoartl • 081980 AVID• =031TT NAM" � 1B•.•mt{w�tl { 1 0..... ..TD. C:lO OaRndA LW «con - - teat "C%t as • i I 0uc923 LIAR ❑ CLADO was B►ta,aAIn • I { THE PROPRIC(OR/VARTWE" 11 C.L. Naar WCDiaw* { 500,000 A DCLcvrrn orrICER7 mm ® 1nc1 ❑ excl " N,L. BINiai -►LICT LMZT 500,000 01/01/20 /2013 N.L. BISNAU --a 500,000 emons Nssmzn{s or mmamn m Loculm, ji WORICERB' COMPENSATION COVERAGE APPLIES TO MASSACHOSETPS EMPLOYEES CERTIFICATE HOLDER CANCELLATION DROOP 0P INSURANCE ssoum ANY or m AWTS ommcssNao ro== Ns CAXMLm UMM TES' . MZRATDON am 71maRDf, a"=WILL NO OULZMW IN 1000sn"m wm MIN tOLICY PRO►INIONs. ., atTwolm atsaNwT►TIwN�- • �� _ 5289 r Iir .li,j •,f I i;!,I :i L, Illtirr a (',Inca mer.�ffalrs.l ltdsiness 1(cgulattUtl HOME IMPROVEMENT CONTRACTOR Registration: 103757 Type: 6643 Expiration: 7/9l2012 Private Corpuratl( SPRINKt.i:. BUMF IMPROVEMENT INC BRAD K SPRINKLE 190 LOTHROPS LANE ,la, 5pI r,K c W BARNSTABLE. MA 02668 19:)Barrutat)Ie Rc 1 Ildl'1'\el'1'C 1:1 I"\ IQI� L . I ,rrn�l In Ie'-lslration %alid for indi�idul use uuh Failure to possess:1 current edition of the hctluc :Ile c�pir:u ion date. If found return 111: �lassachuletts State BuilJin Code 1 Iiticc III Consumer Affairs and Business Regulali'm is cause for resonation of this lireme. 111 I'arl. Plata—smite S 1711 1121I6 Refer to: w'WW.Mass.(;o%/lWS Not �alid withnul sign turc 119995 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map_ ��� Parcel Application # ( � Health Division Date Issued 17/ Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/Hyannis Project Street Address 110 west Main Street 26 Village Hyannis Owner Linda LegPyt Address same Telephone 508-827-4537 Permit Request Air sealing, r-19 insulation to atic, attic hatch Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 925.00 Construction Type , Zl 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: Q.Yes 0 No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Yp 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 U new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name RISE Engineering Telephone Number 401-784-3700 EXT 161 Address 1341 Elmwood Ave, Cranston RI 02910 License # 100459 Home Improvement Contractor# 120979 Worker's Compensation # 3730961-01 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO RI Resource R ove y SIGNATURE DATE l l Erik Nerstheimer for RISE Engineering i f y FOR OFFICIAL USE ONLY APPLICATION# c r DATE ISSUED Y MAP/PARCEL NO.. ._, ` ADDRESS VILLAGE } OWNER t _ , DATE OF INSPECTION: ;__FQUNDATIOW- . FRAME INSULATION x FIREPLACE -t 6 ' F ELECTRICAL: ROUGH FINAL i PLUMBING: ROUGH FINAL S GAS: I-Eillol. ROUGH% tu: _ }tiara FINAL -t`F.INAL BU ILDINGIC. DATE CLOSED OU.T 1 ASSOCIATION PLAN NO. a r I w The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600,Washington Street Boston,Mass. 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Build ers/Contractoars/Elect icians/plumberrs Applicant Information Please Priest Legibly Name(Business/Organization/Individual): RISE Engineering a division of Thiel ch Engineering 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. 0 I am an employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees (full and/or part time).* have hired the sub-contractors 7. ❑Remodeling 2. ❑ 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' 9. ❑Building addition [No workers' comp.insurance comp.insurance.$ 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 11. ❑Plumbing repairs or additions myself [No workers' comp. right of exemption perm MGL insurance required] t c. 152, § 1(4), and we have no 12. ❑Roof repairs employees. [no workers' 13. l& 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.#: 3730961-0 1 Expiration Date: 1/1/12, Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration (date). Failure to secure coverage as required under Section 25a of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one year imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of $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 ofperjury that the information provided above is true and.correct. Signature: ' Date: Print Name: Erik Nerstheimer Phone #:(401)784-3700 or 1-800-422— 365 x 1 j3 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): LBoard of Heath 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact person: Phone#: OP ID: 31 oM CERTIFICATE OF LIABILITY INSURANCE DAT 12/3 D/YVYY) 12/30/10 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 endorsements. PRODUCER 401-886-8000 CONTACT The Preston Agency,Inc. 401-886-1700 PHONE I FAX 1350 Division Rd Suite 303 a/c o xt: AC No EMAIL PO Box 810 ADDRESS: PRODUCER THIEL-1 East Greenwich,RI 02818-0810 CUSTOMER ID#: INSURERS AFFORDING COVERAGE NAIC q INSURED Thielsch Engineering,Inc INSURERA:Zurich-American Ins Co. Thielsch Group Inc. INSURER B:American Guarantee&Liability Hi Tech Realty Inc. 195 Frances Avenue INSURER C:North American Capacity Cranston,RI 02910 INSURER D:Hartford Insurance Company 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 DDLSUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MM/DDIYYYY MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY 3730962-01 01/01/11 01/01/12 PREMISES Eaocorrrence $ 300,00 CLAIMS-MADE Fx�OCCUR MED EXP(Any one person) $ 10,00 PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00 POLICY X PRO- LOC Emp Ben. $ 1,000,00 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2,000,00 A X ANY AUTO 3730963-01 01/01/11 01/01/12 (Ea accident) BODILY INJURY(Per person) $ ALL OWNED AUTOS - BODILYINJURY(Peraccident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (Per accident) NON-OWNED AUTOS $ $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,00 EXCESS LIAB CLAIMS-MADE [AGGREGATE $ 10,000,00 B.., AUC-4857188-00 01I01/11 01/01/12 DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION X T Y I WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN R -A ANY PROPRIETOR/PARTNER/EXECUTIVE 3730961-01 01/01/11 01/01/12 E.L.EACH ACCIDENT $ 1,000,00 ' OFFICER/MEMBER EXCLUDED? N I A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,00 It yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,00 C Professional Liab DVLOOD026800 04/01/10 04/01/11 Prof Llab 2,000,00 D Leased/Rented Eqp 02UUNTD5678 01/01/11 01/01/12 Equipment 100,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION • TOWN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©vv1988-2009 ACORD CORPORATION. All rights reserved. r ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD at NOTEPAD THIEL.-1 PAGE 2 INSURED'S NAME Thielsch Engineering,Inc OP ID:31 DATE 12/30/10 RI�� r nggineerin ,a division of Thielsch En meerin Inc Ijiter kell Associates a divisio f Thiels h tin ineenn ,Inc. a orato ,alvjs;on o lelsch In tn4erin ,Inc. orator ,a Iv'p qn.o TTiglsch n meenn Inc. n meerrin Ilwsion ofTh,I@Isch nq mee I ,Inc. anagemei�� ervices,a dlvlslon of hlelsch Engineering, Inc. O ice o nsumer fang an usmess e u ation o g 10 Park Plaza - Suite 5170 Boston, ssachusetts 02116 Home Improve ontractor Registration _ Registration: 120979 m Type: Supplement Card THIELSCH ENGINEERING W Expiration: 3/25/2012 ERIK NERSTHEIMER 1341 ELMWOOD AVE. CRANSTON, RI 02910 e r' x 6y Sv Update Address and return card.Mark reason for change. Address Renewal Employment Lost Card DPS•CA1 it 5OM-04104-GGIO12160p ✓fze TDomvrrzooubeai. + Office of Consumer Affairs&Bu iness 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 Registrationq79 Type: 10 Park Plaza-Suite 5170 Expira '12 Supplement Card Boston,MA 02116 THIELSCH EN& ERIK NERSTHE� - � 1341 ELMWOOD ct�;_ `f � CRANSTON; RI 029 + ' Undersecretary Not valid without signature f Control No: 34244 THE COMMONWEALTH OF MASSACHUSETTS DEPARTMENT OF LABOR e DIVISION OF OCCUPATIONAL SAFETY 19 STAMFORD 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: LW000672 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. , HEATHER E. RowE,ACTING COMMISSIONER L� Printed on Recycled Paper 1 Licensee Details , Page 1 of 1 The Official Website 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# 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 http://db.sfate.ma.us/dps/licdetails.asp?txtSearchLN=CSLI00459 1/7/2011 4 I v� wr w NIAT-24531 - 1 �a i RISE ENGMERING Federal ID#05-0405629 RI Contractor Registration No 8186 A division of'1'hielsch Engineering MA Contractor Registration No 120979 CT Contractor Registration No 620120 1341 Elmwood Avenue,Cranston,R102910 (401)784-3700 FAX(401)784-3710 CONTRACT Page 1 ' PROGRAM THIS CONTRACT IS ENTERED INTO BETWEEN RISE CLC-RCS ENGINEERING AND THE CUSTOMER FOR WORK AS ENGINEERING DESCRIBED BELOW CUSTOMER PHONE ----- DATE Client 9 Linda Legeyt (508)8274537 10/13/2011 119995 SERVICE STREET BILLING STREET 110 West Main Street 26 9243 Se 72nd Ave SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Hyannis,MA 02601 Ocala,1134472 JOB DESCRIPTION RISE Engineering will provide labor and materials to seal areas of your home against wasteful,excess air leakage. This work will be performed in concert with the use of special tools and diagnostic tests to assure that your home will be left with a healthful level 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. 6 man hours. $396.00 RISE Engineering will provide labor and materials to install a 6"layer of R-19 Class 1 Cellulose added to 560 square feet of open attic space. $504.00 RISE Engineering will provide labor and materials to install insulation and weatherstripping to 1 attic access hatch(es). $25.00 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. $396.00 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 exceed$2,000 per calander year. $396.75 Df OCT 1 9 2011 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUN OF ***One Hundred Thirty-Two&25/100-Dollars $132.25 UPON FINAL INSPECTION AND APPROVAL BY RISE ENGINEERING.CUSTOMER AGREES TO REMIT AMOUNT DUE IN FULL INTEREST OF 1%WILL BE CHARGED MONTHLY ANY UNPAID BALANCE AFTER SO DAYS.SEE REVERSE FOR IMPORTANT INFORMATION ON GUARANTEES,RIGHTS OF RECISION,SCHEDULING,AND CONTRACTOR REGIS TION. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK S C I AUTHORIZED SIGNATURE•RISE ENGINEE CUSTfiMER CCEPTANbE NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE _ 3 ACCEPTANCE OF CONTRACT-THE ABOVE PRICES,SPECIFICATIONS AND CONDITIONS ARE SATISFACTORY TO US AND ARE HEREBY ACCEPTED.YOU ARE AUTHORIZED TO 00 THE WORK DAYS. AS SPECIFIED.PAYMENT WILL BE MADE AS OUTLINED ABOVE �1 . 7 t OWNER AUTHORIZATION FORM I, (Owner`'s Name) ' owner of the property located at (Property Address) (Property Address) ' hereby authorize (Subcontractor) an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform work on my property. Owner's Si ture Date i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Cf Map Parcel Application # Health Division Date Issued 9 Conservation Division Application Fe 4> 0�, Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis V Project Street Address e2L KW a V VJu*_-C i <( 0 W d MAO S r. (4-YI*NX-S- Village Owner MAW aAVGC- TAqu Address Telephone ��) Permit Request C-O� 3 ( DOW— V PfAS SCO ,� ChWI) 0P1V4,1zNG WON - '90 , Q��,TJPJ Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation f�rZ�S� 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 i APPLICANT INFORMATION (BUILDER OR HOMEOWNER) r M" Name Telephone Number �'�� 7 3 Address IG07` 840 W5TrPT V1,11 -r License # �' 5`?5- Home Improvement Contractor# 75 Worker's Compensation # Imo-5U&e K6UI W i0 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �UrAPSYKR SIGNATURE DATE q ((5- �� l r- r, s FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL N0. h� ADDRESS VILLAGE OWNER t DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE { ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL c GAS: ROUGH FINAL y FINAL BUILDING i 1 DATE CLOSED'OUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.go v1dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LeFibly Name (Business/Organization/individual): TLSi 4 SATbw UST41M UV.p:rn1: Address: 13o7t i9 A0tV1U9,Js AuLf City/State/Zip: MA &Z4 Phone #: UYC� .Y29' -7/17 Are ou an employer? Check the appropriate box: Type of project(required): I.X am a employer with � 4. I am a general contractor and I 6. ❑ New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑' I am a sole proprietor or partner- listed on the attached sheet: 7. ❑Remodeling ship and have no employees AQ Thesesub-contractors have g. emolition working for me in any capacity. employees and have workers' [No workers'comp. insurance comp. insurance. 9. Building addition required.] 5. EJ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all officers have exercised their work 11.❑ Plumbing repairs or additions myself. o workers' com right of exemption per MGL Y � P• 12.❑ Roof repairs insurance required.] t . c. 152, §1(4), and we have no employees. [No workers' 13.❑ Other 1 comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homcowncrs 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. 1 am an employer that isproviding workers'compensation insurance for my employees. Below is the policy andjob site information. Insurance Company Name: CV AV&r,- �Jr * Q Policy# or Self=ins. Lic. #: � ��$���®I Z� i® Expiration Date: o Job Site Address: (� S� [�' i► �'zs City/State/Zip: OZ-Go 1 Attach a copy of the workers' compensatiefl 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 coveragetye�Tification. 4 I do hereby certify under tthhee�pains and penalties of perjury that the information provided above is true and correct. Signature: / /"\ Date: Phone#: Y Z 0- /y-7 Official use only. Do not write in this area, to be completed by•city or town official City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspect&r S. Plumbing Inspector 6. Other Contact Person: Phone#: Information and Instructions. Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership,association or other legal 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 dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that"every,state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence.of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out.the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub-contractors)name(s),addresses) and phone number(s) along with their certificates) of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships (LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the'pemtit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit 's 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 contact you regarding the applicant. Please be sure to 611 in'the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year;need only submit one affidavit indicating current o_ft ation(if-ibcessary) and under'Job Site Address"the applicant should write"all locations in (city or policy inf tow "A copy of the.affidavit that has been officially stamped or marked by the city ay be provide n). d to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each ye4r. Where a_home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Departmen t's'address, telephone and fax number: t The Commonwealth of Massachusetts Department of IndustriallAccidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel-0.617.727-4900 ext406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 4-24-07 www.mass.gov/dia s� Massachusetts- Department of Public SafctN hnill Board of Building Regulations and Standards Construction Suoervisor License License: CS 88595 Restricted to: 00 ALEXANDER M RANNEY 140 SEAVIEW AVE BASS RIVER, MA-02664 ' Expiration: 4l16/2012 C'ummisioniy Tr:: 26903 .=.. ✓fe i�arno�zoozcaeal!� a�,/jfaaaac�auoeC/4 Office of Consumer Affairs&Bddsmess Regulation = ..HOME IMPROVEMENT CONTRACTOR Registration 144752 Type: lei° _ Expiration: 11/2/2012 DBA RANNEY&RIMINGTQN CUSTOM;GARPENTRY r._ ALEXANDER RANNEY 140 SEAVIEW AVE. g r � BASS RIVER,MA 0266,4 �— Undersecretary License or registration valid for individryul use only before the expiration date. If found return to: C Office of.Consumer Affairs and Business Regulation 10 Park Plaza_Suite 5170 Boston,MA 02116 if i , j ! f /Not valid without signature Date: 8/18/2010 Time: 8:36 AN TO: PAN BIION f8 CiierAk 4W03 RIMiPAT7 ATE ACORM CERTIFICATE OF LIABILITY INSURANCE Dollf18110 YYY, " Im CM 171RGATE{S ISS4W AS A MATT OF InVOMMMON ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOY AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BYTHE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(Sh AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CITE HOLDER. fipO :It We ct Vftaft bower is an ADDITIONALUMnED,the po ws)must be endorsed.if SUBROGATION IS WAIVED,subject to theta.. and conditions Lions of the policy,certain policies may require an endorsemmaL A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). I PRODUCER M1110 Vaughan Rogess&Gray Ins.So.Dennis awPHONEEX*508 3�-T980 WA c.No 434 Route 134 P.O.Box 1601 CUSTOMER o s: South Dennis,MA 02660-1601 INSUREM AFFORDING COVERAGE NAIL s ,,&VRED A.Nat9 Grange Mutual Insurance C Patrick Rimington&Alex Ranney USURER 9:Associated Employers Insurance dim Ranney&Rimington Custom Carpentry USURER C: P.O.BOX SIG INSURERD: Marston Mills,MA 02648 r USURER E.- USURER P COVERAGES, CERT►RGATE.WMEtt REVISION NUMBER: THIS IS TO CERTIFY THAT THE POUCMS OF OMMANCE LMED 88AW HAVE BEEN ISWW TOTHE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWQHSTANDM ANY REQUIR139N(T.TERM OR CONDiT1ON OF ANY CONTRACTOR OTHER DOCUMENT WiTH RESPECT TO WHICH THIS CEIrTWCATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BYTHE POLICES DESCRIED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOVM MAY HAVE BEEN REIXICED BY PAO CLAUN& 07 POLICY EtP LIMITS OF INSURANCE POLICYNI� A GENERAL LIABILITY MPOI6069 IMO 08I21=1 EACHoccuRRENcE $1 000 000 X 00MIAM1AL GENERAL LIABILITY PREMISES(Ea Occurrence) $500,000 CLNMS4%DE 0OCCUR MED EIP OnY ona pe.sm) $10,000 PERSONAL 6 AIN INJURY $1,000,000 GENEnALAGGREGATE $2,000,000 GIDM AGGREGATE LIMIT APPLIES PER:, - • ,3 PRODUCTS-COMPI�AGG $2,000,000 POLICY PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea acddeM ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEMILEDAUTOS PROPERTY DAMAGE $ HUM AUTOS (Per accident) $ NOI-0WHEOAUTOS. $ UMBRELLA LAB OCCUR EACH OCCUMM14CE $ EXCESSLIA8 -AGGREGATE $ DEDUCTIBLE $ B WORKERSCONPENSATION WCCS00848=2010 nwim 0 08/06/201 i X WCSTATLF OTH-- AND EMPLOYERS'LIABILITY YIN ANY PROPRIETORIPARi WE�r� E.L EACH ACCIDENT $100,000 EXCLU ,DED? - • E.L.DISEASE-EA EMPLOYEE $100,000 (Mandatory in NHi Dyes,die under E.L.DISEASE-POLICY LIMIT $500,000 DESCRI:iNON OF OPERA71ONS below OF QWnON OF OPERATIONSI LWA71ONS IVOUCLES XAIdd/ACQRD 101.Addlatat Rw;uaft Sdudu4 it mote space Is required) "Workers Comp Information-PropristDislParbar fElrscudwOWmem Members Excluded:Patrick Rimington& Alex Rannay'* CERTIFICATE HOLDER EU •N 10 Da or Non-Payment `i i SEiX3ULD ANY OF THE ABOVE DESCRIBED POUCIES SE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ' AUTHORS REPRESENTATIVE 6190 2009 ACORD CORPORATION.All rights reserved. ACORD 25(2009109) 1 pf 1 The ACORD name and logo are regisliared marks of ACORD M5668IM55165 MLV 1 } , � ` � � �_ i 1 iz }-+., -1{ S Ill.! .. • V - � f .. -. ._..t. ' ;,� 4.. ,. tr-..a�:., - ��».- .f 'k.+ ,. _x a r r��..•,.. t .r. ,,.,.,-�..� f ,`- r..+.. _ `-_ _ _ i v The Cape Cod Carpenters i .Ranney & .Rimrngton Custom Builders April 13, 2011 ESTIMATE - revised www.ThieCapeCodCarp4nters.com Site: 26 Melody Village, 110 W.Main St, Hyannis; Anne Barrett&Bruce Taquette;941-91�-6423; contact: Adrienne Siegel open up doorway in existing basement to be at least 5' wide Work io include- ' 1 • Obtain demo permit i • Open up wall by deconstructing paneling and framing as needed • Dispose of construction waste material • Frame out opening as necessary for safety � • Please note: This demolition work is to create a minimum of 5' opening and is to rou4h frame only; it does not include any design or finish work; future use of the basement partitions to be determined I TOTAL-LABOR& MATERIALS � 1,7.75.00 Due upon completion Ploase note-our sandaid contract: • Coomu nor Is not mptmuiblc for any damage to lavra or plaotinga wtomd dcmolidon area, • Contractor is m responsible for any damage to interior fateishstga the may need to be moved to complete work. • Qi mnstruedm waste arid.repimcd ihrms dioeludiag windows,*tams&wl(attmeil will be considaed dlsposabk unless other iodk4w4 by proven owner. I • Property owner is respwmable,for all costs a,soeiatad with M ZU4oua naatrxials,lead.mava y sWito water pollution dischdW or macs associated with America Alsabilltim Act t+ptdrdlt %if nocasmy I • Any rep*moving or inewlladop of alarm system is dw responsibility of the prgpaty owner. • Customer is to supply A pair if any is being used(uakn odttxwise qxx iW' ' Prop trV Owner agrees that xa my&Rhro ft=Custom"may dkP)xy.*Akan slgo on the propmty daring the duisdoo of the work and ooa month after tvmpktiom. • Property Owafr is respposibk for any and albwl:kkeerlulg coin and site plan cods oeeesbory in aseociation with obwining any necessary permits uokes 0* wise noted. � • A11 boe iroprovemcm compactor, ad aabeacase ors*hall be tegist.wd by me Mramr and a+y inorki iea about a eoaRacter or submaheom fasdoA to a registration should be ii—W to:Director. Roma lmpreo mem Coatrocmr Registration,Ode Aebbwma Plwce Rto 1301,Boston,MA 02108 1 • The tae'I'c b'oww bee t ow4lay raooellation 68W of tbia contract under M.G.L,o.43,48;M.G.L a 1401),10 or KO.L•c,2551),14 as applicable,After 3 drys all deposit and 40"1 Order payments sm ao-ref utdable. • AN ww=tk4 and property owner's tigb s at under the proviSivnB of 780 CMR I I D.6&W M.G.L,c,142A • Any vlteMoh or deviation from abovo sr IfIcadoos%vat ieg extra coats will become an extra tbargo ova aml above(be nuhnate A$75.00 pa boar pew materiels. If ooa of t>♦saaials and labor changes,this estimate may inane w mm dean 15% • It Is me obligation of dx htmc ingwovemeat contractor to obtain any and all necessary wows tion-raland permits;in the event that tltf propeay owns semen their owls eovhroUOn-related permits or d als O t anyegistemd eamhaetm*try will be excluded from t1k Ilk uvoy fund provisions of M.O.L,a 142A. Work will begin no later thoo six momha from the isawace of luny necemary permits and will be raraph;etd no later than two rims from the issuance of nweWry permits. ' • property Owncr'a fbihn ro make payments for wait duly performed may result in a lift ttt=stoet the bomeowner's pr PWY,Owner is responsible lot nary lehel Res and court coati Ram"& Rintiugton may imur to co)Wt da AaoDlea due on this eadmew,lbe contractor and the property owner hereby mutually ago*in advance that is the even the coueraetpr has a dis$ute concerning this a_pimate,the contra"may submit such dispute to a private UbIntian service which has bow aWove4 by the secretary of dw uffi-of cenavmer affelro and busincaa r•gv4otivna and nie oonsumer shall be rcquirw to wbmtt to etch arbitration n pwide4 io M.G.L.e.142A. DO NOT SIGN THIS CONTRACT IF YOU HAVE NOT READ IT OR IF T HERE ARE ANY BLANK PACES 4/13/11 ZZWW �T for Ranney&Rimington Custom Builders Date Authorized signer for property Date Proud Member National Association of Home Builders Home Builders Association of Massachusetts Nome sunders&Remodelers ASSOCfat/an of Cape Cod 1 !$ACC "01isooOD'a+nivr aop10 I. saraw.aw Q.e.wo i 3O. BOX 816 CONSTRUCTION SUPERV150R LICENSE #CS-088595 MAR5TONS Mll-ids, MA 02648 HOME' IMPROVEMENT REGISTRATION 0 144752 PHONE: 08-428-7147 LIABILITY INSURANCE #MP076069 FAX' 08-428-7167 WORKMEN'S COMPENSATION # WCC50084520 1 20 1 O F-MAIL FEDERAL- TAX ID # 20.1633909 IN FOOTI-IECAPECODCARPENTER5.COM h r bod VTR mill 7AdfienneG.,,Iiegel' www.strawberFyhlllre.com ` P�ygERRl, E-mail:Info®strawberryhillre.com l REAL ESTATEAdrienne G. Siegel President;, 340 West Main Street,Hyannis,MA 02601 (508) 775-8000 x2 MLS cep rax:(sob)ns-s8o+ ® 1-800-882-8586 A0 i April 15,2011 Thomas Perry Building Commissioner Town of Barnstable 200 Main St. HYannis,MA 02601 Dear Mr pay. 1 am Purchasing Unit 26 at Melody'Village, 110 crest Main St-,H There is a basement room in this unit that T plan to use strietl for MA 02601,from Anne Barrett at this address. Y storage. I will be the only occupant Sincerely, r L" r�yt 61 Aurom Lane So.Yarmout,MA 02601 S08-394-2126 -a cn Apr 17 11 01:04p Bruce W.Paquette 941-346-2312 p.1 Tow/v t4yA-1vx1i s yy/ M ear o4AIVo u✓y► ��7,5 OU,2 U►'1i D BLS ��t/��I�t1G OF Tke- oAJ<--- ,.� i`v`1 e t�.gse e.�i AT //6; )W/W 57; 0 mot r V- j7— /74 5 No 7` 0 S r U tv R-00/VA f A) 2 Avyve- APR-9-2011 12:16 FROM:FIRST PROPERTY MANAG 5084200789 TO:5oe7758804 P.1 CAPE COD MELODY VILLAGE CONDOMINIUM TRUST 110 West Main Street Telephone:508-420-0299 Hyannis,MA 02655 Fax: 508-420.0789 April 12,2011 Town of Barnstable Health and Building Departments Main Street Hyannis,MA 02601 To Whom It May Concern; The Board of Tnistees of the Cape Cod Melody Village Condominium Trust approves of and grants permission to the owner of Unit#26 at Cape Cod Melody Village, 110 Wcst Main Strcet, Hyannis,MA to remydeLind remove the door entrance to the room in the basement of said unit. We understand the casement needs to be 5 feet. This work will he performed by Ra.nney and Rimington, custom builders. S' or ly, Robert Stansifer Trustee RSlaons iA0lSTlilt� , z ., , k` Home:Departments:Assessors Division:Property Assessment Search Results New Search New Interactive Maps» Owner: 2011 Assessed Values: BARRETT,ANNE TR A B BEACH REALTY TRUST 110 WEST MAIN STREET 201.1 Appraised Value 2011 Assessed.Value Past.Comparisons Map/Parcel/Parcel Extension Building Value: $152,800 $152,800 Year Total Assessed Value 290 /173/OOZ Extra Features: $0 $0 2010-$164,600 Outbuildings: $0 $0 2009-$180,900 Mailing Address Land Value: $0 $0 2008-$208,300 BARRETT,ANNE TR 2007-$208,300 A B BEACH REALTY TRUST 2011 Totals $152,800 $152,800 2006-$200,600 6130 CLARK CENTER AVE #107 Questions about your Assessed Value SARASOTA,FL.34238 2011 REAL ESTATE Tax Information: Tax Rates:(per$1,000 of valuation) Community Preservation Act Tax $36.90 Fire District Rates. Town Residential Barnstable FD-All Classes $2.31 $8.05 C.O.M.M.-All Classes $1.33 Town.Commercial . Hyannis FD Tax(Residential) $311.71 Cotuit FD-All Classes n/a $7.28 Hyannis-Residential $2.04 Town Tax(Residential) $1,230.04 Hyannis-Commercial $3.24 W Barnstable-Residential $2.65 W Barnstable-Commercial $2.34 Community Preservation Act 3%of Town Tax Total: $1,578.65 Construction Details Building Property Sketch & ASBUILT Cards Property Sketch Legend Building value $152,800 Interior Floors Carpet Style Condominium Interior Walls Drywall Model Res Condo Heat Fuel Electric ± 3 AS1452j'. Grade Average Heat Type Elec Baseboard . MT•[490] Stories 2 Stories AC Type None I=;•..f Exterior Walls Wood Shingle Bedrooms 2 Bedrooms - - Roof Structure Gable/Hip Bathrooms 1 Full+.1H Roof Cover Wood Shingle Living Area sq/ft 932 Replacement Cost. $173,605 . Year Built 1980 Depreciation 12 Total Rooms 4 Rooms Land Gross Area sq/ft 1,422 CODE 1020 AsBuilt Card N/A Lot Size(Acres) 0 i Appraised Value $0 1 � View Interactive Maps >> Assessed Value $0 tW Sales History: Owner: Sale Date Book/Page: Sale Price: BARRETT,ANNE TR Nov 1.5 1994 12:OOAM 9443/63 $1 PAQUETTE,BRUCE W& Mar 15 1982 12:OOAM 3456/89 $43,900 Extra Building Features Code Description Units/SQ ft Appraised Value Assessed Value Property Sketch Legend BAS First Floor,Living Area FST Utility Area(Finished Interior) UAT Attic Area(Unfinished) BMT Basement Area(Unfinished) FTS Third Story Living Area(Finished) UHS Half Story(Unfinished) CAN Canopy FUS Second Story Living Area(Finished) UST Utility Area(Unfinished) FAT Attic Area(Finished) GAR Garage UTQ Three Quarters Story(Unfinished) FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story(Unfinished) FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TQS Three Quarters.Story(Finished) 110258 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel << V� Application # -? Health Division Date Issued 2)1 l� Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address 110 West Min Street #i 0 Village Hyannis' Owner Barry Martin Address 8 Simone St. Worcester, MA 01604 Telephone 508-756-8419 Permit Request air sealing,' insulate attic Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 905 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 N:) Heat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑ Other _4 Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove.: Yes! ❑ No � >M Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑existing LJ.new k dize_ Attached garage: 0 existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name RISE Engineering- Telephone Number 401-784-3700 Address 1341 Elmwood 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 Erik Nerstheimer for RISE Eng. r y FOR OFFICIAL USE ONLY P i APPLICATION# DATE ISSUED MAP/PARCELNO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION F FIREPLACE K ELECTRICAL: ROUGH FINAL { Y PLUMBING: ROUGH FINAL GAS: ROUGH FINAL y FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. RASE EN��NEER�Q~i Federal ID#0"406629 RI Contractor Registration No 8186 A division of'Thielsch Engineering AAA Contractor Registration No 120979 CT Contractor Registration No 620120 1341 Elmwood Avenue,Cranston,RI 02910 r CONTRACT (401) 784-3700 FAX(401)784-3710 Page 1 iS 11 UL THIS CONTRACT IS ENTERED INTO BETWEEN RISE ENGINEERING AND THE CUSTOMER FOR WORK AS ENGINEERING DESCRIBED BELOW CUSTOMER PHONE DATE Client# Barry Martin (508)756-8419 06/06/2010 110258 SERVICE STREET _ BILLING STREET 110 West-main Street#13 8 Simone St SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP 1 _ Hyannis,MA 02601 Worcester,MA 01604 u 1 4 2010 JOB DESCRIPTION RISE Engineering will provide labor and materials to seal areas of your home against wasteful,excess air le performed in concert with the use of special tools and diagnostic tests to assure that your home will be left with a healthful level 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. 5 man hours. $330.00 RISE Engineering will provide labor and materials to install a 8"layer of R-30 Class 1 Cellulose added to 500 square feet of open attic space. $550.00 RISE Engineering will provide labor and materials to install insulation and weatherstripping to 1 attic access hatch(es). $25.00 RISE Engineering will apply all applicable,eligible incentives to this contract. You will be billed only the Net amount. Currently,for air sealing measures,the Cape Light Compact offers a 100%incentive. -$330.00 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. -$431.25 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF * *One Hundred Forty-Three&75/100 Dollars $143.75 UPON FINAL INSPECTION AND APPROVAL BY RISE ENGINEERING.CUSTOMER AGREES TO REMIT AMOUNT DUE IN FULL.INTEREST OF 1%WILL BE CHARGED MONTHLY ON ANY UNPAID BALANCE AFTER 90 DAYS.SEE REVERSE FOR IMPORTANT INFORMATION ON GUARANTEES,RIGHTS OF RECISION,SCHEDULING,AND CONTRACTOR REGISTRATION. DO NOT S N THIS CONTRACT IF THERE ARE ANY BLANK SPACES 1 AU ORIZED SIGNATURE-PIA NEERING CUSTOMER ACCEPTANCE. .L r NOTE:THIS CONTRACT MAYBE WITHDRAWN BY US,IF NOT EXECUTED WITHIN DAl'E OF ACCEPTANCt'• v- ACCEPTANCE OF CONI PACT-THE.ABOVE PRICES,SPECIFICATIONS AND CONDITIONS ARE SATISFACTORY TO US AND ARE HEREBY ACCEPTED.YOU ARE AUTHORIZED To Do THE WORK --- DAYe. AS SPECIFIED.PAYMENT WILL BE MADE AS OUTLINED ABOVE tea:... y' The Commonwealth of Massachusetts Department of Industrial Aceidents 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 Thielsch Engi neeri rig 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. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part time).* have hired the sub-contractors 7. ❑Remodeling 2. ❑ 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' 9. ❑Building addition [No workers' comp.insurance comp. insurance. I 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 [No workers' comp. right of exemption perm MGL insurance required] t c. 152, § 1(4),and we have no 12. ❑Roof repairs employees. [no workers' 13. l& 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 isproviding workers'compensation insurance for my employees.Below is thepolicy and job site information. Insurance Company Name: The Preston Agency Policy#or Self-ins.Lic.#: 3730961-00 Expiration Date: 1/1/11 Job Site Address: City/State/Zip: _ Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration (date). Failure to secure coverage as required under Section 25a of MGLµ152 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. Sign ture: Date: Print Name: Erik Nerstheimer Phone#:(401)7843700 or -1-800-422-5365 ext133 Official use only Ito not write in this area to be completed by city or town official City or Town: _ ]Permit/license#: Issuing-Autbority(circle one): 1.I?0are"of Heath 2. Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector . 6.Other Contact person: Phone#,!: AC®RD CERTIFICATE OF LIABILITY INSURANCE 47 DATE(MMIDDlYYYY) ' � THIEL-1 09/13/10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORh1ATI0N 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:401-88571700 INSURERS AFFORDING COVERAGE NAIC INSURED - INSURERA: Zurich—American Ins Co. Thielsch Engineering, Inc NSUREf28: A..r.1c<n 0�a .t.a 6 Llebll'Lty Thielsch Group Inc. INSURER North American Capacity Hi Tech Realty Inc. _ Frances Avenue Cranston RI 02910 INSURERD: Hartford Insurance Company -Cranston INSURER E' COVERAGES 111E POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTwI1TIS WIDING ANY RECUIREMIENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER OOCUMErTT`NITH.RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR WtY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT"TO ALL THE TERMS,EXCLUGI.ONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REOUCED BY PAID CLAIMS. IF75R'"fIODl . LTR 1NSR TYPE OF INSURANCE POLICY NUMBER DATE(MM/DOfYY) DATE I � LIMITS GENERAL LIABILITY EACH OCCURRENCE 111 0 0 0,0 0 0 A I X COMMERCIAL GENERAL LIABILITY 3 7 3 0 9 6 2—0 0 - 04/01/10 O 1 11 0l ''� D-- _ / I PREMISES(Ea occwenca) T300,000 CLAIMS MADE D OCCUR'- MED EXP(Any.one person) K 10,0 0 0 PERSONAL.&ADV INAjRY 3 1,0 0 0,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG 5 2,000,0 0 0 POLICY X PRO- LOC — --' Emp Ben. 1,000,000 AUTOMOBILE LIABILTTY A X ANY AUTO 37309 (Ea accid63-00 04/01/10 O1/O1/11 Ca a ccidD'SINGLELIMITent) s2 000,000 ALL OWNED AUTOS - BODILY INJURY S. SCHEDULED AUTOS (Per person) HIRED AUTOS '-- BODILY INJURY WGNOYJNED AUTOS. (Per acc,de,nq PROPERTY DAMAGE ; ?Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER 11-.44 EA ACC $ AUTO.ONLY: AGG 5 EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE . S 10,0 0 0,0 0 0 B X occuR —1 CLAIMS MADE LIMB 9263637-00 04/01/10 01:/01/11 AGGREGATE $ 10,000,000 DEDUCTIBLE f q X RETENTION 110,000 WORKERS COMPENSATION AND It TS ER TOW EIAP(DYERS'11AB ILIIY X TORY L AI P. :VJ}'RROPRIETGR/PARTNEP./EYECUTIVE 3730961-00 04/01/10 01"/01/11. El,EACH ACCIDEI,Fr _ $ 1,000,000 _ _ OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE I 1,0 0 0,000 If yes,describe under - _--- ----- SPECIAL PROVISIONS below F.L.DISEASE-PC+LICY LIIAIT 3 1,0 0 0,0 0 0 OTHER C Professioaal Liab DVL000026800 04/01/10 '04/01/11 Prof I,iab 2,000,000 D � Leased/Rented "Eqp 02UUNTD5678 09/O1/10 04/01/11 E.qu.iprnent 100,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES!EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOUI-D ANY OF THE ABOVE DESCPIBEO POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER"VILL ENDEAVOR TO MAIL 10 DA}-S WRITTEN NOTICE TO THE.CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO 00$O SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY WIND UPON THE INSURER,ITS AGENTS OR ` c RFPRESENTATNES. AUTHORaED REPRESE IV ACORD 25(2001/08) ��'- t�ACOR`D CORPORATION 1988 C� }�� �, .7�';' t' .I F.�x {�11' � �� +�£s� t'{ 6 c ,Ci�',�.l�i 'il•,if{.,y.ii+l�f'{��{�:tCi��s� �I},(�.cyll5iy��.f��'t! r ��r�,)S i.THIEL 1 { , I,�r PAGE 2 ° {�t!s`'"�fA�`u r ED}S{NAME a Tl£"i'e1'Sc l,•L�n�,�nee��}agS'wy n f n'flt'>'i��° � OP ID 2 r,9 I I!. DAT;E 04 12 10 °. A180 for RISE Engineering, a division of Thielsch Engineering, Inc. Gaskell Associates.; a division of Thielsch Engineering, Inc. BAL Laboratory, .a division of Thielsch Engineering, Inc. ESS Laboratory, a division of. Thielsch Engineering, Inc. ALCO Engineering, a division of Thielsch Engineering, Inc. Water Management Services, a division of Thielsch Engineering, Inc. { i 91te �Ofice _ 4 o nsumer fai�r�,; andiness e u at�on o g 10 Park Plaza- Suite 5170 _ y Boston, ssachusetts 02116 Home Improve ontractor Registration ~ Registration: 120979 Type: Supplement Card Z. THIELSCH ENGINEERING z Expiration: 3/25/2012 ` U. RI t' u1 ERIK NERSTHEIMER al 1341 ELMWOOD AVE. ° — CRANSTON, RI 02910 Update Address and return card.Mark reason for change. Address Renewal 0 Employment ❑ Lost Card DPS-CA1 0 50M-04/04-G101216 ✓�te (oanvazovtluea��t �//i(aadac�tcc6et6 Office of Consumer Affairs&Bu iness Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation Registration 79 Type: 10 Park Plaza-Suite 5170 U19Expira {12 Supplement Card Boston,MA 02116 THIELSCH ENG�t:. '�' 1:; i UNEE T� ERIK NERSTHE 91 1341 ELMWOOD `` CRANSTON; RI 029t9 Undersecretary Not valid without signature . . ........ - -- - r-dgt 1 0I 1 t Thpe Official Website 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# 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-�i o�ruinoozcuecz�z - _ .. - - .. Board of 73iiildino Regulations and Standan s Li.Cense or registration valid for individ>il use onl31 HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registr3tioh,_. 120979 Board of Building Regulations and Standards �i Ezp`rati'o:n_3).25�2010 One Ashburton Place Rm 1301 uRpiemeniCard Pit?stt�1? )'La. 021-0.8 ELSCH ENGINEER=INC,,_r =~ J K NERSTHEIMM. —^`'- --` 1 ELMWOOD.AVE",*-.__,. I aNSTON, R.I 02910_.: A, .:k` .,, —_ _ _ d mnUSfY.:ltOr '.' 'Not 0without - ----valid signzt��re hitp://d:b.state.ma..Lis/dps/.licdetails.asp?txtSearCE-N=C'SI.,I t j n 4 NAT-24531 - 1 TOWN OF BARNSTABLE.BUILDING PERMIT,APPLICATION,,. Ma q.D Parcel �� Application # Health Division Date Issued Conservation Division Application Fee Planning. Dept. Permit Fee' Date Definitive Plan Approved by Planning Board Historic - OKH - Preservation/Hyannis Project Street Address ) I 0 wpot Village Owner Address wyor w1 a-�--r•S� Telephone 509 ^ , 7q Permit Request r 3 a U-1� v LIT " D Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation ' Construction Type -�1.A- � -�p Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family >0 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 C),24lJVL F/t dA./-� Telephone Number 5 6 z-Z,1 Z Address P 0 6 o x I g6 5 License # C,-_-� & (2e)t U Atv ' P�- OP-6 3 Home Improvement Contractor# Worker's Compensation # 0 3yl M 5.56 —0 ALL CONSTRUCTIO DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE < `�' FOR OFFICIAL USE ONLY - APPLICATION# DATE ISSUED MAP/PARCEL NO. F ADDRESS VILLAGE � n OWNER DATE OF INSPECTION: FOUNDATION FRAME t INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL 4 ti GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT' . ASSOCIATION PLAN.NO. 4 4 The Commonwealth of Massachusetts - -- - Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): FA o-�� L LG Address: �j City/State/Zip: rn� oa63� Phone #: �Q Are you an employer?Check the appropriate box: Type of project(required): 12, 1 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 8. ❑ Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance.$ 9• ❑ Building addition required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.[-1 I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they 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: l� Policy#or Self-ins. Lic. #: U. 0 3 �J �Y} 5,5 6 Expiration Date: Job Site Address: 1 I C.e Jam,] l���p��..S� C City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy nu ber 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 he nd pe lties of perjury that the information provided above is true and correct. Signature: Date: Phone#: (56 toe Official use only. Do not write in this area,to be completed by city or town official Ity i or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: RightFax N3-2 10/1/2008 1 :56: 31 PM PAGE 2/002 Fax Server ::.:;•- ISSUE DATE ::•::. ::::.::::::::::::•:::::::•:::• 10/01/08 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY PRODUCER AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT ANIEND.EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. WISE&QUINN INSURANCE AGENCY COMPANIES AFFORDING COVERAGE 449 PLEASANT ST BROCKTON MA 02301 COMPANY A HARTFORD UNDERWRITERS INSURANCE CO LETTER INSURED COMPANY B FRASER CONSTRUCTION LLC LETTER PO BOX 1845 COMPaxv C LETTER COTUIT MA 02635 CoaIPANY D LETTER COMPANY MEXCLUSIONS -- E FY THAT THE POLICIES OF INSURANCE LISPED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD WITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS Y BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, D CONDITIONS OF SUCH POLICIES.LIhIITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS CO TYPE OF INSURANCE POLICY NUMBER POLICY POLICY LBIIIT S LTR EFFECTIVE DATE EXPIRATION DATE 1NI/DD/YY MM/DD/YY GENERAL LIABIIITY GENERAL AGGREGATE $ ❑COMMERCIAL GENERAL LIABILITY PRODUCTS-CONINOP AGG. $ ❑ CIAI14S MADE ❑ OCCUR. , PERSONAL&ADV.INJURY $ ❑OWNER'S&CONTRACTOR'S PROT. EACH OCCURRENCE $ ❑ FIRE DAMAGE(Any One FIm) $ MED.EXPENSE(Anvone person $ AUTOMOBILE LIABILITY COMBINED SINGLE I.IDIIT $ ❑ ANY AUTO ❑ ALL OWNED AUTOS BODILY INJURY $ {PvPerson) ❑ SCHEDULED AUTOS ❑ IfIREDAUTOS BODILY INJURY $ (Pet Accldent) ❑ NON-OWNED AUTOS ❑ GARAGELJABRIfY PROPERTYDAMAGE $ EXCESS LIABILITY ❑ UMBRELLA FORM EACHOCCURRENCE $ ❑ OTIM THAN UMBRELLA FORM AGGREGATE $ STATUTORY LIMITS X A WORKER'S COMPENSATION EACH ACCIDENT $500,000 AND UB- 09/26/08 09/26/09 DISEASE-FOUCY LVMT $500,000 0341M556-08 EMPLOYER'S LIABILITY DISEASE-BACHEMPL.OYEE $500,000 OTHER THE PROPRIETOR/PARTNERS/EXECUTI VE OFFICERS ARE INCLUDED. DESCRIPTION OF OPERATTOHLS/LOCATIOPiS/VEHICId.+S/SPECIAL ITFd►IS TIM INSURED'S NIA WORKERS CONIPEV.SATION POLICY AHED ITS II lrrM OTTIER STATES INSURANCE ENDORSEMENT AUTHORIZHS THE PAMENT OF BENEFITS FOR CL MIS A DE BY THE INSURED'S NU EAM OYEES IN STATES OTHER THAN WL1.NO AUTHORIZATION IS GIVEN TO PAY CLAIMS FOR BENEFITS IN ANY SPATE OTHER THAN NlA IF TBE INSURED IMES.OR HAS ERRED.HNIPLOYEES OUTSIDE OF NU.TMS POLICY DOES NOT PROVIDE COVERAGE FOR ANY SPATE OTHER MAN NIA. THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING w'ORKERS COI•jp COVERAGE . ..�7'k1'1�LP�til:�•!:[(Ji9•:{:;{:;:;{::{:;::{{:::.'..��}::�i}ii::;:•iii:•}:�:�:i:::::::•?:•}:•}}}:{:�::•?:{•}: TOWN OF BARNSTABLE SHOULD ANY OF 7M ABOVE DFSCRMED POLICIES BE CANCELLED BEFORE THE PO BOX 40 EXPIRATION DATE TfMREOF.THE ISSUING COMPANY WI(I,ENDEAVOR TO MAD, HYANNIS DIA 02601 10 DAYS WRITTEN NOTICE TO Tm CERTIFICATE HOLDER NAAIED TO TILE LEFT. BVI'FAUXEETOBTAII,SUCHNOTTCESBALL 1AWOSENOOBLIGATIONOR LIANUMT OF ANY KIND UPON THE COLIIPANY.ITS AGENTS OR REPRISFNTATIVES —I HOIU7JID RBPRB5BM AT R'R AWAIEL4 CJ4S7Z'EZ-OfflER ................................................................................................... ......:................................................................. ................................ ....... .... .. ..... ... ..................... i A {$oard.o 1 IdIggRegut ipns-eud Standunds b C6r�A-Pt rc$on Si pesvisg I:i-erase 6 • 'L �;� 9�668 - • . I ,�� , c itia 7oir 6l1%©11 TV 9.76ras DEAN FRASr=R __r- 104 TWINNAAME SY EAST Fi4LIllID1J TFi,IYdA 02936 Com�assioaer 6r 9 �®ard ofujuamg o Re � ®ne � ns n,?laces® and Standards Boston. Alas ROOM 13()l Istratiou A CA1 ��6 --- - ❑ ❑ ems& .cm�, � Ur Lon lip""m or re card 4ta�: ' ,, 2raa Mud for judl.1d, as 0: Did T�# 927g2D Q MUM b. . carver,A4A oat �Dt �t i. ' i R.igh°tFax C2-2 10/1/2008 1 :00:56 PM PAGE 2/002 Fax Server ]SSUE DATE __ 0/01/08 1 .............................::......:.... :. .... ....... THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY PRODUCER AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. WISE&QUINN INSURANCE AGENCY COMPANIES AFFORDING COVERAGE 449 PLEASANT ST BROCKTON MA 02301 CET A HARTFORD UNDERWRITERS INSURANCE CO LETTER INSURED �� B FRASER CONSTRUCTION LLC PO BOX 1845 COMPANY C IbITER COTUIT MA 02635 COMPANY D LETTER :}._:-•-,:�::Y•.:}• COMPANY 7EN [FTY THAT THE POLICffi OP INSURANCE LISTED BELOW NAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD TWITHSTAND]NO ANY REQUDtEM1ENT,TEILM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT W ITH RESPECT TO WHICH THIS CERAY BB ISSUED OR MAY PERTA]N,THE INSURANCE AFJ ORD®BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, D COI EDITIONS OF SUCH POL[CIF'S.LIMfCS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS CO TYPE OF INSURANCE POLICY NUMBER POLICY POLICY LIMITS LTR EFFECTIVE DATE EXPIRATION DATE MMIDDI MMMDNY) GENERAL AGGREGATE $ GF.NRRALLIABILITY PRODUCI3-COMP/OPAOO. $ ❑COMMERCIAL GENERAL LIABII.TIY PERSONAL&ADV.INJURY $ ❑ CLAIMS MADE ❑ OCCUR. EACH OCCURRENCE $ ❑OWNERS&CONTRACTOR'S PROT. PIRG DAMAGE(Any One Fire) $ ❑ MED.EXPENSE(Any ono person $ COMBINED SINGLE OMIT $ AUTOMOBILE LIABILITY ❑ ANY AUTO BODILY INJURY $ ❑ ALL OWNED AUTOS (Pa PusoW ❑ SCHEDULED AUTOS BODILY INJURY $ ❑ HIRED AUTOS (Pcr Accldcot) ❑ NON-OWNED AUTOS PROPERTY DAMAGE $ ❑ GARAGE LIABILITY 11 EXCESS LIABILITY EACH OCCURRENCE $ ❑ UMBRELLA FORM AGGREGATE $ ❑ OTHER THAN UMBRELLA FORM STATUTORY LIMITS X A WORKER'S COMPENSATION EACH ACCIDENT $500,000 AND UB- 09/26/08 09/26/09 DISEASE-POLICY UMTT $500,000 EMPLOYER'S LIABILITY 0341M556-08 DISEASE EACH McLOYEE $500,000 7PROPFUSTORIPARTNERS/EXECUTIVE =- P; DESCRIPTION OF OPERATIONS/LOCAMONSNBFBCLIZ/SPECIAL PIEMB THE 1NSURED'8 MA WORKERS CDMPENSATION POLICY AND ITS LMffrM OTHER SPATES DMURANCE RNDORSENNIENT AUTHORIZES THE PAYMENT OF BENEFITS FOR CLAIMS MADE BY BD TfI E9,OR�EHA,9 HIR®,EMPLOYEES IN STATESOUTSID OFIMA.THAN THIS POLICY DOES NOT PROVIDE COVERAGE FORIZATION IS GIVEN To PAYR ANY STATE OTHER THAN MA- LAWS FOR BEMFITS IN ANY INSURED OTHER THAN MA 1F THE THIS REPLACES ANY PRIOR CERTIFICATE IBSOED TO TIES CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE •lh':::�:•::1:fJ::•:.•• .. .... .. ... .....y.1.��•..�'tt:l.'hlf:f.:}.•:1lll.•l::l::{�. J�i:•::X:::. {•}•:}: •.•f:.'�{tiJ�lh :1L•::•.•.....•::.L:•11VJ:LV:. 7r5���� EXPIRATION ANY OF THE ABOVE THEJg DESCRIBED POLICIES 8E ILL ENLED BEFORE THE DEAVOR �RIATION DATE THEREOF,THE L�UIIYG COMPANY WILL ENDRAYO67'O MAR. ID DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMDIDTO THE LEFT, BUT FAILURE TO MAHLSUCH NOTICE SHALL EUIPOSE NO OBLIGATION OR LIABILPIYOFANYKDVDUPONTHECOMPANY nTSAGOYI'SORREPB�PPAT"V AWDORNMIUMMUSMNIAllym T>7/"1L4T1 CJ/M.-M-ER • . �.�:V.Y{{•:•: •:•:•:•.:::5:'.:':ti::•:K.':':::::•::hy}:.•`::~.•:��1-..•}..�ti.Y�.11ti.;�.V.V 1•:�1}�'.'•}::•::h:}�:L:V.:.:}}�}�:1: ..V:•..•ti:}k1.- 23:45 From:DR. D. O'MALLEY 508 540 0201 To:15084280123 P.2/3 Fraser Construction., LLC CONSTRUCTION N.O. Box .].845, Cotuit MA. 02635 MEN ' Email: fraser constructi.onnverizon.net www.fr.aserroofmg.com 40 508-428-2292 FAX 1-508-428-0123 ,0%.�r& October 31, 2008 PHONE: $08-790-5797 , :3'^WE: Michelle Dennehy CELL: 508-695-3763 AIL ADDRESS: same ®B ADDRESS! 110 West Main St Apt 5 Hyannis, MA 02601 SAIL.. ,curlyeatl2@yahoo.com �-1ZASER CONSTRUCTION hereby proposes to perform the following services in neat ar,Cj professional like manner and in accordance with the manufacturer's specifications and ioc;al building codes. Harvey Replacement Windows -file Harvey Classic vinyl double hung replacement window offers homeowners the widest variety.of style, performance, color and options available in the marketplace today. The Classic ..indow Is custom made to fit your opening with very little carpentry needed, reducing ingtallation time and mess. Our sleek fully-welded sash and frame design provides a one piece Sloped sill and better performance than ordinary vinyl windows, with an air-tight seal that keeps ..rid and water where they belong outside. o ENERGY STAR qualified with optional Low-E glazing (add Argon gas for additional energy,efficiency) o Factory calibrated block & tackle sash balances never need adjustment or lubrication r, Ventilation limit latches that keep top or bottom sash partially open c, Locking fiberglass half screen 0 Color matched hardware with brasstone and brushed nickel optional n 6 over 6 grilles �t�•�; ��;�;.r.' a»,Ref... .r� w iell 01-11 )10) Windows @ 29 % X45 t1) Window 4 27 % z 36 3/8 Total of)1.1) Window Price $350 each for a total of$3,850 Initial It should take about two to three weeks to get the windows after ordering Payment Schedule: 1/2 to order windows balance payable immediately upon a completion POSSIBLE EXTRA CARPENTRY: Any Other Carpentry Needing Replacement will be done and charged for As an Extra at the Rate of$55.00 per Hour Plus Materials Plus 15% Overhead Mark-up on The Total Extras. Any alteration or deviation from above specifieiitions will be executed only upon written orders and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays are beyond our control. Owner should carry fire, tornado,and other necessary insurance upon the above work.FRASER CONSTRUCTION,LIC carries Workmen's Compensation and Public Liability insurance(in the above work, certificate available upon request. This proposal may be withdrawn by us if not accepted within thirty days. DATE OF ACCEPTANCE: � Li'141fl --Al ( ( C1 w HOMEOWNEIR FRASER C0NSTR l GN, 1 1,C e 12/2'd 22T082b8OST:Ol T020 0bS 80S A3-nUW.O 'a '6G:wo.Jd Sb:22 8002-20-00N Dec. 30. 2008 11 : 52AM No, 1011 P. 1 ULM _ Page 1 eef.1 Fraser Construction From: "Andy Witter' <fpm@intercape.com> To:" "Fraser Construction"' <fraser_construction@verizon.net> Sent: Tuesday, December 23, 2008 3:27 PM Sugject: RE Dennehy Project This is approved provided the size, color and design are identical to the existing. Please note existing have sills. Andrew Witter N From: Fraser Construction [mailto:fraser_construction@verizon.net] OF= :a; -, Sent: Friday, December 19, 2008 9:41 AM J c-) p To: fpm@intercape.com W - (Subject taennehy Project _ oCZ Good Morning Mr. Witter, Thank you for your help in this matter. The replacement windows are 6 over 6 to match existin C� co Regards, co rM Patty "GO T a �o Fraser Construction LLC P.O. Box 1845, Cotult MA. 02635 Email: fraser_c-onstruction„n.vcrizon.net wwwv,fraserroo fang.com 508-428-22,9 FAX 1 -508-42,8-0123 DATE; October 31, 2008 PHONE: 508-790-5797 NAME: Michelle Dennehy CELL: 508-685-3763 MAIL ADDME$S: same JOB ADDRESS: 110 West Main St, Apt 5 Hyannis, MA 02601 EMAIL: cur-lycat12@yaho cone . R CONSTRUCTION hereby proposes to perform the following services in neat and.professional like marlt&—and in accordance with the manufacturer's specifications and local building codes: Garvey Replacement Windows The Harvey.< c vin_yf double hung replacement window offers homeowners the widest variety of style, performance, color and options available in the marketplace today. The Classic window is custom.made'to fit your opening with very little carpentry needed, reducing installation time and mess. Our sleek f0ty-welded sash and frame design provides a one piece sloped sill and better performance than ordinary vinyl windows, with an air-tight seal that keeps wind and water where they belong.outside. Dec. 30, 2008 11 ; 52AM No, 1011 P, 2 Page 2-6f 2 o Ehl:�Y STAR jualified with optional Low-E glazing (add Argon gas for additional energy efficiency.) o ractory calibrated block& tackle sash balances never need adjustment or o Ventilation limit latches that keep top or bottom sash partially open o -Locking fiberglass half screen 0. Color matched hardware with brasstone and brushed nickel optional n 6 over 6 grilles s 4. i v (10) windows @ 27 % x45 (1) Window @ 27 % x 36 3/8 Dec. 30. 2008 11 : 53AM No, 1011 P. 3 - Contact • page 1....of 1 - 5 I r PROPERFY MANAGEMENT i _ Lonq EstablrA d Residential & Commercial Condominium Mana ement S ecialist Home r Contact About i Services ; I First Property Management 1046 Main Street, Sulte 11 Maintenai'rce Ostervllle MA 026SS Fr,>rryis &Links (508) 420-0299 office ti (So8) 420-0789 fax FAQ Contact LPresid-eniLt, Andrew Witter I Administrative Assistant: Anne Schulte (508) 42070299 Accounting: Frank Inzirillo E-.; r Cape cod MA .. ..... qx � .^�.•,7P-r-;,;f-r'eS:!%1�'"�r7lln�i v-�r,;'..�, � - i I Horne' l�t7c;ui N w;, l n�ilce FU �. l�._.........-........�. ................... ... . ..0 is � Mrll ..C.r. . � tl:i.5.. ...L..I.II.kS'. I FAQ i CS11ltac'C ` TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # Health:Division Date Issued Z Conservation Division Application Fee r Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic:- OKH _ Preservation / Hyannis Project Street/Address IAA. 10 IN 'S7_q f Village Owner CAP6 60DO /#,,�7LOO Y 2 Address' IIC2 W . /Yw//V , �y��y�� 00/l Telephone r� �- —b IL �OY 0`�( � 3 � Permit Request /v r �J s Square feet: 1 st floor: existing. proposed 2nd floor::existing proposed Total new Zoning District Flood Plain Groundwater Overlay 7Projecal do Construction Type 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 0 new size _Shed: ❑ existing ❑ new size _ Other: s Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ sZZ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT,INFORMATION sue, - e (BUILDER OR HOMEOWNER) Name E 064 Q G?_C ✓0&6 Y1 111 Telephone Number -of Address b N U T I CA2 w A y . License # / 3 2.0 02 0� Home Improvement Contractor# �� 32 05 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO P/" -VW i( dT/ 0/", SIGNATURE DATE Y FOR OFFICIAL USE ONLY £` '• APPLICATION# DATE ISSUED ' MAP/PARCEL NO. ADDRESS VILLAGE OWNER w DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL x GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN'NO. I The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.govldia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organizationaclividual): H A V; 'S C 0a 17.&UC O N Address: 6 N4V rl CAL WAY _ City/State/Zip: IIZ *41 l ,4 1 �i 0/ Phone.#: So� �i�S 02 Are you an employer? Check the appropriate box: Type of project(required): 1.El am a employer with 4. I am a general contractor and I 6. ❑New construction . employees(full and/or part-time).* have hired the stab-contractors 2.LVJ 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 mein any capacity. employees and have workers' 9 ❑Building addition [No workers' eomp.-insuiance comp.insurance.t 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 I LE]Plumbing repairs or additions myselL[No workers' comp. right of exemption per MGL 12.[]Roof repairs insurance required-]t c. 152, §1(4),and we have no employees. [No workers' 13.FKOther IVIY comp.insurance required] 'Any applicant that checks box#1 must also fiD out the section below showing their workers'comparsation 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. tcontractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must providt:their work='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: Policy#or Self-ins.Lie.#: Expiration Date: job Site Address: 1 W t'Ai N 'S 1. City/State/Zip: YYAN/U/IS lVlq_d�t�®.� 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 tip to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains•and penalties of perjury that the information provided above is true and correct Signature: 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): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: •Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees: Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal 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 dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required." Additionally,MGL,ehapter 152, §25C(7)states`Neither the commonwealth nor any of its political subdivisions shall enter into any contract for,the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies'(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees, a policy is required Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured.companies should enter their Self-insurance license number on the appropriate line. City or Town Officlals 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 Investi ations has to contact you regarding the applicant. Y g Y g g PP Please be sure to fill in the permit(license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit onp affidavit indicating current policy information(if necessary)and under"Job Site Address" the applicarit 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 fixture permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (Le.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone-and fax number. The Commonwealth of Massachusetts Degartm t en of ladustrial Accidents Qffice of Investigations 600 Washington Sheet Boston,MA 02111 TO. #617-727-4900 ext 4-06 or 1-977-MASSAFE Fax#617-727-7749 Revised 11-22-06 www.mass.gov/dia FROM 1ST PROP. MGMT. PHONE NO. Apr. 28 2008 02:31PM P1 04/28/08 12:14 FAX 5087789429 KINRU s Ur' til.A.NAls 77 D � y� HAKI'S CONSTRACTION 76 NAUTICAL WAY PHONE# 508 685 7142 FAX# 508 771 5504 REGISTRATION#153203 NAME: Gape Cod Melody village JOB ADRESS: SAME ADRESS: 110 W. Main street TOWN: SAME CITY: Hyannis JOB PHONE: 508 775 3327 STATE: MA OTHER PHONE: 508 280 0736 ZIP: 02601 We hereby submit specifications and estimates to furnish and install new roofing as follows. 1. The existing siding shingles will be striped from the roof line up, the plywood. will be inspected for rot and the owner will be advised of any replacement needs. 2. During the striping of the existing siding the building will be covered with blue tarps to prevent any damages to the rest of the building. 3. A layer of ice & water will.be installed over the existing step flashing. 4. Paper will be stapled to the entire wall. 5. R&R extra siding shingles will be installed. 6. A dumpster will be taken to the job and all the debris will be taken away, 7. After the installation a detailed clean up will be-dote, the yard will be inSpeCLed for any nails wick a heavy magnet. 8. This price is only for the south side of building# 1 (approximately 6 sq)_ 9. 15 year labor warranty will 1 e provided in Writing by `FfAKFS CONSTRUCTION. 10. Workmen's compensation and public liability insurance on above work will be taken out by HA. I'S CONSTRUCTION The following is esti ted for 460.00 $ Proposal accepted.by ------------- ------------------ -� r. i Message Page 1 of 1 Giangregorio, Robin From: Wadlington, Ellen Sent: Tuesday, April 01, 2008 9:21 AM To: Giangregorio, Robin Cc: Shea, Sally Sent notice to the Dept. of Cosmotology re. operation of illegal beauty salon at 120 West Main Street, Apt. 2!�/ Hyannis, MA. _. E17411 Welyfon 4/1/2008 YOU WISH TO OPEN A BUSINESS? For Your Information: Business Certificates cost $30.00 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 Clerk's Office, 1 st FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) and 200 Main Street Offices at the Licensing counter. DATE: o ;. '`y Fill in please: p' APPLICANT'S YOUR.NAME: i' Ids w I Gc e r 4 y BUSINESS YOUR HOME ADDRESS: ( �� yJ�Sfi w�ti+'� s2� f �1h�V�nrS .M � rJZGo i TELEPHONE # Home Telephone Number: 5-n B 9�t, �Z NAME OF NEW BUSINESS i w i k 5 TYPE.OF BUSINESS L H S I+i 1 IS THIS A HOME OCCUPATION? YES NO Have you been given approval from the building division? YES NO ADDRESS OF BUSINESS l I v fa n`; n C-F ` MAP/PARCEL NUMBER �90 73 64 y When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. — (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1 . BUILDING CO SS NER'S OFF I This individ gal as eerfiin me any permit requirements that pertain to this type of bu4Ati8T.0 0MPLY WITH HOME OCCUPATIO �J RULES AND REGULATIONS. FAILURE TO Aut; orize Si ure** COMPLY MAY RESULT IN FINES. COMMENTS(��21 ill" 2. BOARD OF HEALTH This individual sbeen infor d the p rmit re 'rements that pertain to this type of business. Authorized Si ature* COMMENTS: 3. CONSUMER AFFAIRS (LICENSING ALIT RI This individual a, been ' med of e c n n requirements that pertain to this type of business. Authorized Signature* COMMENTS: Town of Barnstable oF'I"E Regulatory Services �� qo Thomas F.Geiler,Director Building Division MAss. Tom Perry,Building Commissioner 039. 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Approved: DO Fee: S— Permit#: HOME OCCUPATION REGISTRATION Date: Name: Q 6(J t r Phone#: 5019 , << CF � Address: I to Z S� G,n a t Y1 L�illage: hH t C Name of Business: Type of Business: tI?�- r5i ` �' Map/Lot: INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation ,,vithin 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 wlucln 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'Azth the Building Inspector,a customary home occupation shall be permitted as of right subject to the follohtizng conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located Aithinn 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 un 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,m 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 withui the required front yard. • There is no exterior storage or display of materials or equipment. • There are no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet ui length and not to exceed 4 tires,puked 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 ul the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned,have read and agree with the above stric o s for my home occupation I am registering. Applicant: Date: 0 3- Zl. oB Homeoc.doc Rev.01/3/08 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION _7S Map l� _Parcel Application# Health Division Conservation Division Permit# Tax Collector M,J)141 Ae �A� �P_D l'MA—S Date Issued / Treasurer Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board I , G l I Historic-OKH Preservation/Hyannis Project Street Address V Az,i vi Village L S Owner fy\ `2(..o `��-, f 1���, Address Telephone q Zo ' � 2-�g � �5 i �1 �� Mc, `i' Permit Request ` moo C�6--' �ZLtV T �`r� ����_ VPrn,r�b Te in) Pam_? mcx fit1-�✓ �Lrrl`�tiir yr S��►ngI� Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay Valuation I f*Project0 0 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. a -� Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure ; Historic House: ❑Yes Blo On Old King's Highway: ❑Yes t'No, Basement Type:"0 Full jO Crawl A&Valkout ❑Other Q- Basement yFinished Area(sq4c+,.ft) Basement Unfinished Area(sq.ft) Number of Bath`s:; Full!existing new Half:existing new 1 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 BUILDER INFORMATION Name- I�w� ZoO��� Telephone Number 50 Address Y- S`f 3 License# C wt-A'-w e k WIZ lc> 2-5 Home Improvement Contractor# 11 S`7 Worker's Compensation# �-� I© n:P'® �JJ ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO C4c SIGNATURE DATE i FOR OFFICIAL USE ONLY PERMIT NO. DAVE ISSUED f MAP/.PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. r - ROOFING Hamel Roofing R.J. Harrel PO Box 543 Cataumet, MA 02534 (508) 563-6092 HIC-115971 508-420-0299First Property Management 9/28/04 1046 Main Street Cape Cod Melody Village Condominiums Suite 11 110 West Main Street, Building39�3� Osterviile, MA 02655 Hyannis, MA We hereby submit specifications and estimates for: Z- Strip approximately 4,500 square feet of roof shingles and install vented drip edge along eaves. Apply ice &water barrier under all step flashing. Remove metal vents from roofs and cover openings-with sheet steel. Apply Tri-Flex roofing underlayment to bare roof. Roof, using IKO Cambridge 50 year algae resistant "Dual Grey' roof shingles. Install approximately 124 feet of ridge vent. Remove all debris from job site. yo �'r U✓Prl� 2� AF/ 'k 7 Z!��`_ A ti We PropOSe hereby to furnish material and labor—complete in accordance with above specifications,for the sum of: Fourteen Thousand Four Hundred Eighty Dollars ($14,480) Payment to be made as follows: $ _, in advance, and$7,240 upon completion All material Is guaranteed tc be as specified.All work t0 be completed in a workmanlike Authorized -- manner acmrdlno to standard practices.Any alteration or deviation from above specifications Signature Involving evira costs will be executed only upon written orders,and wit become an extra charge over and ebnre the ealimate.Alt agreements contingent upon strikes,accidents or delays beyond our control.Owner to carry necessary Insurance.Our workers am fully Note:This proposal may be withdrawn by us if not accepted within covered by Workman's Compensation Insurance. AAcceptance .F 6 — days. cceptalnce o Proposal—The above prices,specifications and conditions are satisfactory and are hereby accepted.You am authorized to do the Signature work as specified.Payment will be made as ouained above. Date of Acceptance: Signature dL R, :. ::.. r .: v r: :.: _p . . _ ;. .. ` . .'s_ r .�+,�'a•••art*.�;; .-ti�.,:. �.dr.,�? Assessor's map and lot number .. �r!...`.�../. ...:;.K� o�THEr Sewage Permit number �...:...........:.4`f�!� .. oU..T d`` °� Z BA"STADLE, i House number 90o NA 0� ........................ ......................... A MAY I,. TOWN' OF BARNSTABLE �E BUILDING INSPECTOR APPLICATION FOR PERMIT TO tip :z- .. .�.... 1.Q... TYPE OF CONSTRUCTION ........................... ............. C'' : ............................ .y.. / ..... . .... .... ...... ....................... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....... ..... `��� '`r..."-".... .......................................................... ............................ ProposedUse ...... .. !e ' �t. !�' .................................................. ............................................................. Zoning District ....... ........................... ....................Fire District ....�Y,, f ., '�' a"............................................ Name of Owner`' :..?.....''.� ` ...�r'�.. r�J"- ; . .....Address ..... ' .w..��J��s�*i�- Name of Builder f(.. ...L � '' !.......'."''.:'.`'!.....Address ... �..!�..... ....................�� Name of Architect . A' dress ........ ......... �..�f!r%5.... �.� .................... di'2 .� Number of Rooms / .(!/�?LGO...... 7 oundat 0 ... (.. ..... .... . ............................................................. Exterior /" ,!,,,�r ..�........:-!..`�'�..e`l i!�1 G;,r! ...�*?,,. .: ..... lF�' a....f..,r ".............Roofing ...... /J o6v' (/ Floors .a ..........................Interior ......./' ..... J .�..�...c...G..i..2.......c..-.....�............................. Heating Plumbing Fireplace ........... ...................... Approximate Cost .......f„ Q................................a a '�...,....... .... .. .. . Definitive Plan Approved by Planning Board ________________________________19________ . Area .............................. 6 th �666, ao Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH Construction plants for entire project filed under Permit #22841 dated 2/5/81 Site plan for buildings 2, 3, 5 under this permit # . I hereby agree to conform to all the Rules and Regulations of the Town4olf Barnstable regarding the above construction. ...................................:..................................Name ...... O � _ CAPE COD :MELODY VILLAGE, INC. A-290-173 & Pt. of 29 No ,23124 Permit for Build................... Condominium (3 Bldgs. 6 Units ova) . ............................................................................... Location 110 West Main Street Hyannis ............................................................................... Owner Cape Cod Melody Village, Inc. ............................................... /Frame Type of Construction .......................................... .. ................................................................................ Plot ............................ Lot ................................ Permit Granted .......:.May...19................19 81 Date of Inspection ....................................19 Date Completed ......................................19 PERMIT REFUSED ................................................................ 19 r. ................................................................................ ............................................................................... . ............................................................................... r Approved ................................................ 19 ...........:................................................................... s .�yr�rr....+'.^s.^,-.,...,.,--4..--.. .. •.. ,,..y.._,,,,_.� ..,,c..�. .-.r.,r•��.�rT'�a"**"^*••�'sy,n^s-« ,-....�.,.n.^«...+s.-ss4., �,..r,..._, r �:..�...:. ..-r Assessor's map and lot number nA..*....... .:.`................... f T C• f f ' r' G " Sewage Permit number TOWN OF BARNSTABLE Z BARISTADLE• i ° 16 9. BUILDING INSPECTOR o Mpr APPLICATION FOR.PERMIT TO ..'.r...`...'::.`.:{....`................`....`.....1:'..:` ........`.:`s..'.:.......?..........�1:.....r�`...`... TYPE OF CONSTRUCTION 6t- '................................................................................................ �................................... ........`! .......' .19... 4 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location `.... .�* - .......:.:......................... ............................. Proposed Use r4 .rr ........................t.......'�..�................................Fire District ..........�..�.i!feft• tr....S..........................................Zoning District "C ................................ "........................ Name of Owner ...................!`.... 1... ........:'f...l:!........rAddress .......:....Z......`.......................... `...... ......f............ ` Name of Builder•. ..+ ......f : ... ✓. Address .r' , c ...................................................(- Name of Architect ..`.........:........`................`..%t.,...:.�:"....�.,�.....Address ................... ........................................ ....................... Number of Rooms ' . / `"'v' �� •f s'x'f�{ "" ....................................................................Foundation .............................................................................. Exterior �. :..' f............................................ fir . t - .........Roofing ......!f '..'. t'"...................................................... Floors ! � . Y .............Interior .........',................................................................ ..:......................................:......................................... Heating r. •z . .r, g '. ................ • Plumbing Fireplace pp ................ fri� .................................................Approximate. Cost •.. Definitive Plan Approved by Planning Board -------------------------- ry ' 19 -. Area ......................................... Diagram of Lot and Building with Dimensions Fee L �• - ' ` SUBJECT TO APPROVAL OF BOARD OF HEALTH )f , G� I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction: f . lo Name ................................................: ................ MelodyVillage, I � ' ' oc. 73 & 29' � No ......22dA1Permit for —.. -- .............2.. ' ' .....6. ..eacb.bld�. Location ..............����.�p�n. ............... ^ ----.----..�^�°°°°~s--.--------.. - . Owner --.[ape..{Qd. . ' .][oc. Type of Construction ............frame................... � --------------------------' Plot ............................ Lot ___________ - February � 5 81 Permit Granted ........................................lg Dote of | ....................................lg � Dote Completed ------------..lg PERMIT REFUSED . . lV ' v- -'----'' ..-1� -------------� ---.----- � ------------- '^'—^--'—^--^^'' /r ~ Approved ................................................ lg � ' ----------------.-----.---~. . ` -----------'-------`------^— � | / - - Town of Barnstable Regulatory Services o��r Thomas F.Geiler,Director Building Division BARDWASM MASS Tom Perry,Building Commissioner �Eay Aim 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: . ?,s- Permit#:/ g q C7 HOME OCCUPATION REGISTRATION Date: /0/ �� Lo2tv� —� ' c7 Q Name: �A V 7�tVl E FQ Phone#: F0�o2¢o2 3�� Address: W,597- Ts *2 Village: &D h Name of Business: TA- RA 80(L-Y4A; CO Type of Business: W/'1 6 111?R-o11&H6ti 7- Map/Lot: 10 Pt 7 G D T .NT: 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 is 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 ,ee with above restrictions for my home occupation I am registering. Applicant: Date: Homeoc.doc Rev.5130103 YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates(cost$30.00 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 Clerk's Office, 1st FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) DATE: to S 20o M Fill in please: // ' APPLICANT'S YOUR NAME: KKVI . r BUSINESS YOUR HOME ADDRESS: 7 �l f TELEPHONE # Home Telephone Numbe MA NAME OF NEW BUSINESS 1 7` TYPE OF BUSINESS t !� IS THIS ~A.H.OME OCCUPATION? YES NO Have you been given approval from t e building divisi, n? YES NO ADDRESS OF BUSINESS l 4 k ^- MAP/PARCEL NUMBER When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St.-(corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S OFFIC This individual has informed permit requirements that pertain to this type of business. Authorized Sig ture" COMMENTS: 0 a/r P P:D, 2. BOAR D OF HEALTH This individual has e i forme of t er he mit re ire ents that pertain to this type of business. (3 Lo Authorized Signa4z,-, COMMENTS: N1 �r?r�cz� t � u S taeol .,,`r �u� cc �17�u S< 4 ' `5- �o� k 3. CONSUMER AFFAIRS (LICE SING AUTHORITY) This individual has been of d of the ' ensi a uir �tsthat�perta�into this,type.of business. Authorize Si nature" COMMENTS: r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel J " Permit# 777 l Health Division Date Issued 171146 D Conservation Division ` Fee Tax Collector ..0�� � Treasure Planning Dept. r Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address :U AR I', 1 O U). rh)q_t J S'TX4!56i Village h_� { /3 Andes Owner U2 c8d �loc�u �l�e I � Address 3 110 Telephone tl (o `2 sel, y ta-e- ' Permit Requestlk6w),b w Square feet:1st floor:existing proposed 2nd floor: existing _ proposed Total new Estimated Project Cost#'3,(,o'0 Zoning District Flood Plain R Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes Q�o If yes, attach supporting documentation. r Dwelling Type: Single Family ❑ Two Family ❑ Multi-Famil #units) Age of Existing Structure Historic House: ❑Yes L reo On Old,King's Highway: ❑Yes CW 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 r 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 W40 If yes, site plan review# Current Use Proposed Use nn II BUILDER INFORMATION Name le Z � ►'1 Plr i Telephone Number Address NP,a)h),�w License# 69.7 7 q l 7_10 —, MLg v J Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE _ eT AFGi9�°iTZi' - r' FOR OFFICIAL USE ONLY ILM a PERMIT NO. r _ DATE ISSUED '�"• ,t� - " � ° ><- •�' � _ � .S -�` r ,.. ,,�. MAP/PARCEL NO. rr ADDRESS ry _, £• VILLAGE f OWNER �`� - _ l DATE OF INSPECTION: - s FOUNDATION FRAME a � F - � _ • � INSULATION FIREPLACE ELECTRICAL: ROUGH ."FINAL , .. PLUMBING: ROUGH FINAL r .. F c•` k GAS: a:ROUGH FINAL # x. ='4 s •. t , FINAL BUILDING. , DATE CLOSED OUT 1 I , w ASSOCIATION PLAN NO. 74 1 `. HONE s1NraPRtO10VNE,1N..T�, 4 �' {ry i Num�ber CS 05�' 2E�aGaUaaLcA/uT�IaOt ehNa License: CQNST SBOARD OFBUILDINGR00140 SUPERVISORypeA RUCTION AT /aRA—a 032ETPion 70 6�23 j CATM' Nip ` s:� .�' � f G� — -MEINpROVE as Ca MENT,1 INC ;`• Expirgs ;qg/�6/ Q09 Tr:;po: 57a2 rAOM�----�, Pizz1, �Sr )' INISTRA70R' 1 45.:'Newto ,I- n;Rd 3 ` Rstricte ,To:.00 I Cotult NA 02635 i THOMAS X.CAPIZ,ZI _ G 74 j =� 280 P.ERCIVAL DR R.i W BARNSTABLE, MA 02668 Admen; cator'.: 4 j #a 04 ;? ✓lac 'V�omv�na�uuea a�!� dacfzuJe�fJ f DEPRRTNENT OF'PUBIIC SRFETY ` r DEPARTMENT OF PUBLIC..SAFETY SUPERVISOR,aICENSE;' I. i CONSTRUCTION SUPERVISOR LICENSE Number EW r:es, l � Ij i. Rest>� :tg� io:r ; 00 Reskrtcaed To 00 '77 i � FREDER ,I�V:RRSCHsLI, 164 'NEWYOWN RD BOURNE,RD COTUIT, NR 02635 r i PLYNOUTH. NR k" WA - THE The Town of Barnstable » anxtvsrABM 9�A Department of Health Safety and Environmental Services TEa + Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner 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. ) 7 J Type of Work: Sigoo gta&,r(cS 4/ Estimated Cost ) ✓� Address of Work: �� / dfiv& '" Owner's Name: �/ Sr Date of 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 []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME I,MPROVEMENT.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 agent of the owner: 0 0 Date Contractor Name jp/L. Lrf?Piz-z;.j*Mg riuRegistration No. OR Date Owner's Name q:fonns:Affidav --_ _ --- The Commonwealth of Massachusetts Department of Industrial Accidents Office offolvestinaflas 600 Washington Street Boston,Mass. 02111 Workers' CoTsensation Insurance Affidavit canE:rrttortzu3c. �/%///� name: location: city ho # ❑ I am a hom m er perforin all work myself. ❑ I am a sole oronrietor and have no one working in any ca acity �Q I am an emplover providing workers* compensation for my employees working on this job. compnnv name: /u_/ MN =KiIP l2(1✓�11U�Al T address: /&#S- ll1e&J713/.dAl ��. ... .... city: �d l d 3 hone#: ^l lal insurance co. / /'TG /l�R� policy# ❑ I am a sole proprietor, general contractor, or homeowner(circle one) and have hired the contractors Iisted below who have the folloning workers' compensation polices: comvanv name: address: city phone#� insurance co. obey# comvanv name- address. citti: phone M ::......::.:... ...::.: insurance co. Rolfcv#��%%% ;.;•.;;:;:.::>; :;:.;.;>::::::«: .:....:.;.:,..::...:.. %%//%/ �% Failure to secure coverage a+required under Section 15A of' Failure ii can lead to the imposition of criminal penalties of a tlne up to S1.500.00 and/or one yeah'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the OMce of Investigations of the DIA for coverage verifleation. I do hereby certify under the pains and/penalties perjury that the information provided above is trap and correct Si,naturee�.�l.O 21 Date —7 Print name r9 EI�W� V'. V'�A S C ZZf Phone# cJ g /•S l official use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Building Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office ❑Health Department contact petaon: phone#; ❑Other (rmwa 9l95 P1A) .. �.-�.....n.+ r r-r - -. ...�-,r -- ..a h....r.t-.:+s-...r•.+. i.... ..,Y.,f..;... ,. y..a.:+,.. .rrnr.-.'•'r'�""" y`OFtME/ The Town of Barnstable BARN STABLE. Department of Health Safety and Environmental Services MARR- t619. `eg Fo►��� Building Division 367 Main Street,Hyannis,MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspection 1" Location [It" Permit Number � Owner Builder One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: pwy M �gv —1-C, WwNvi OV3 `r �- ��5 �%' o f 6W t r IL S ( ? G�, Please call: 508-862-4038 for re-inspection. Inspected by YYAAII� Date A TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map�2�1� Parcel /��� ��/� S� Gu:aa Permit# (v�l �l1L�o� ��9D Dov Date Issued Health Division�_JQfi r f Conservation Division Feet 5 Tax Collector '` ' `9 f�� y APPUCkNT NOBTAIN A SEWER r/ PERMIT FROM THE Treasurer ENGINEERING DIVISION PRIOR TO CONSrz.UCTION. Planning Dept. N - 16- C01- Date Definitive Plan Approved by Planning Board Q& jxi lh� Historic-OKH PA- Preservation/Hyannis A Project Street Address. �� /����-� " 9 7•. Village h�rlY/Y 5 L OWnerC15Mt' Cct� /LJtLopr f,//<</.�6E,� Address �• /�'/%''� s! Telephone f2 c©— c_�e 3 g, Permit Request �Fl�C�9GE E� S T��c r ,Dee--< f7w /5� /�2CSS c.�+-u ��Qt^3-� �E�s�•C�y /4L S a ,Q��rz ,¢,�r r �uic orv- Square feet: 1 st floor: existing proposed 2nd floor:existing proposed Total new Estimated Project Cost 43000 — Zoning District Flood Plain Groundwater Overlay Construction Type f Lot Size Grandfathered: ❑Yes 0 No If yes,attach supporting documentation. Dwelling Type: Single Family Two Family 0 Multi-Family(#units) Age of Existing Structure Historic House: O Yes 0 No On Old King's Highway: ❑Yes ❑No Basement Type: 0 Full ❑Crawl O 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: 0 Yes ❑No Detached garage:0 existing ❑new size Pool:0 existing ❑new size Barn:O existing O new size Attached garage:0 existing ❑new size Shed:0 existing ❑new size Other: Zoning Board of Appeals Authorization O Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use A BUILDER INFORMATION 'Name A—/F/P2 /�3(�,/ce� Telephone Number Address License# G'S 0 3 Lf&`f �X2S />7,LLs ��-sS• Home Improvement Contractor# b�6,`{ Worker's Compensation# % ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO }�4' O�' rLL SIGNATURE DATE FOR'OFFICIAL USE ONLY h PERMIT NO-'*' DATE ISSUED MAP/PARCEL NO. , r ADDRESS x �, .;- VILLAGE OWNER ; DATE OF INSPECTIODL . r FOUNDATION Z FRAME - INSULATION ; FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL` , GAS: ROUGH ( Cp. FINAL FINAL BUILDING DATE CLOSED OUT - ASSOCIATION PLAN NO. f P L h rr r. ,t e ` %Wr/V,64-qS 2 rr re 4.1 4x, pv0 F ,4. �3�/a� 'PO$ r) • , Ol 10.4 `1 •� Lit, ` y$y TION OF THE COMPLETED , AS LOCATED ON THE PROPER Y L INES. li.L.S- 10.5 ' 10. y� J.. r s ii ��"rdiJfy r�iT� i' AREA ` s M9000,18. INCL. 'PaNNAN 10, im o ' a . DEPARTNENT Of PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE Expires: BirthdateNumber , CS _ ,$84647 /410312060 ;1 Restricted To: 8B w ARTRURwf_y'.BELANGER f. 289 NEWTOWN ROAD I NARSTONS NIIIS, %A�B2548 J s ai" LAM t-UMMUNWbALTH Uk'f14A-=A"US1:;1TS Board of Building Regulations and Standards Transaction No. One Ashbnrton Place-Room 1301 Boston,Massachusetts 02108 - Registration No. Application for Reglstradon as a ' Effective Dace Home Improvement Contractor or Subcontractor MGL Chapter 142A,CMR 780.E Expiration Date ' FOR OFFICE USE ONLY Date L Name �2Ti��/4— Print the name of the individual or business applying for the regist atum(not both) t� Z Mailing Address 8 ( 09 1-12 S- . J /3 3 t3 gill,/ tit ZIP ���o f{ Area Code&Teiephone Nuc:= 4. Street Adds(if din w=) Print sum and Number(P.O.Bea not acceptable) city State Tip S. Applicant type 61 wiltviduai ❑ DBA ❑ Pummbip ❑Trust ❑ Private Corporation ❑ Public Corpoation (See instructions on back regarding enclosing a dry or (sae instructions) 7. Number of Employes L Individual responsible for Home Improvement Contacts ,3C&*,V6C'X Last Fun Mi 9. We of individual mpottu'ble for Home Improvement Contracts OW N,m 10. Does the sppliaut or responsible individual hold any other ere on related state,dry,town Hama a or registrations? ❑ ❑ 1f yes,complete the table below. Use additional paps U necessary. Yes No Type license or registration Loved By Mason or Fspirad= Name of Uomse Holder I registration number Date Goiv sT.f„�?oYf .�a��l.✓i rL �l�. GS a 3 y6� 3�zoc ��,�sv2 %. /3Q�s�cv-L it. Litt all parses,trustem offiocs direcun and major owners(10%or greater of mumthie)of an applicant partnership or ampoation below. Use additional paper if necessary.(See inuructioea as back) Check here U you wish to toondve an application for additional M cards for key pt=soas.❑ Lau First. Middle initial 7We in Applicant Business %Owner Address 1Z is the applicant claiming anmption from the registration fee? (See the insatutions an the back) ❑ N yes,include a copy of a e>mmt Construction Supervisor liccusn or motor vehicle repair abop hc=w or rgistaucm. Yes No 13. Registtatioa fee enclosed:S Guaranty Food fee tscloaed:S Include two sepaate cartifled theca or monq orders-one marked Mcpstralion Ret one marI I*Gtatanty Ftmd'. ALL APPT.TCAMS MUST INCLUDE A GUARAMT FUND FEE EVEN IF WMUFT FROM TIC REGISTRATION FEE See imtrucdeea an back for amount of fees. Make all cati0ed ct-'s or money orders payable to'Commopaealih of hinuchmette Pursuant to Massachusetts General Lawn Chapter wdlou 49A,I artily under the penaWes of perituy that 4 to say brit knowledge sad b*U4 have sum tea:store na amd paid all slate taxes required under law. Signature of applicant or applicants representative Title held with applicant A false answer to any question to this applicadon constitutes grounds for suspension or revocation of the applicant's registration. a \ re Vol Vs -.• €\ l\ ° t 'sh�tia=xua�w� � � -.._..,....,,ui,...r:Y d". _ - '7.G•��".«�i"�+- ?i`.'..-:S- ya.,�:K: ec�..-..-7.,-,,.s:°-...,. s.,�:e.r..+� .. ... :r ._ a-. .. x a r 33USA LiA ' 0�1-/c O� o �' . w The Commonwealth of Massachusetts Department of Industrial Accidents OUNCE ollnyesffooffoos _ 600 Washington Street "_.." Boston,Mass. 02111 Workers' Compensation Insurance Affidavit r % name. 'L�{�.2 �j���NGc-'z- Zil` 1j-12 - location �• �'�" ' �v�' ci hone# ❑ I tv am a homeowner p6rforming all work myself. �'I am a sole rietor and have no one worku in any ca achy ❑ I am an employer providing workers' compensation for my employees working on this job. company n :. .:.:::.:.:::::..:.:.: ;; address :::.::::::..........:.. .. .: cite: ;:.::.;:<.:.:.;:.;:::. ,.: phone# . .:....:::: ...::...:.::.:::.::.::....:.:::::...::::..:.: . insurance ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: company n address. ::»:::;:<::::::> :: 'hone:#« s':.<' <<`:<; NOME=..::::: ::..::.. .::: insuranceca..... . .. .................. ......... . ...... NO campanv address. ::<<:; city `' hon :.:;:.;:.:;::::.:::::::::::.:..:..:::.:...:.:::::..:.::.::::::::.::.:.:..::::.:::..:::...........::::::::::::...:::: ::..:.::;.:;.;.;.::.::.:::.;.::::::.:.::::::::::::::.: oliev# 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 years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement any be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is truo and correct Signature Date Print name official use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Building Department ❑Licensing Board ❑checkif immediate response i,required ❑Seleetaren Office ❑Health Department contact person: phone#; ❑��• (revised 9/95 PJA) } Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal 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 dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers.along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns 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 contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be rettaned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Inyesugauens 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 The Town of Barnstable Department of Health Safety and Environmental Services auss., °r�,,�,ir► Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building*Comaiissione: 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: `C Estimated Cost 3 oao . Address of Work: 4i. /�.��.'F s7�, f�Y.9i�`n�5 ✓"' S . r Owner's Name: C �� Co �j o�✓y / L L Date of Application: �c.- 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 [30wner 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 agent of the owner: Date Contractor Name Registration No. OR Date Owner's Name q:forms:Affidav TOWN OF BARNSTABLE ``. . Permit No. ------------------------- t VAUn.0 Building Inspector Cash 7 __ oO�YPY OCCUPANCY PERMIT Bond 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 CAP' Cod l k�1�y Village' zNePiddress Building Unit 1 110 West tfzin Street, 14,amis Wiring Inspector a � Inspection date s Plumbing Inspector 4� Inspection date Gas.Inspector Y � � Inspection date Engineering Department N/A Inspection date 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.E ;�' _ . ... JBuilding Inspector....... J 7 a ". TOWN OF BARNSTABLE 2284? e Permit No. -- 841 1 �.vn.n Building Inspector Cash "ML • ________ _______ N/A OCCUPANCY PERMIT Bond "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 faPe COd ?felOdY Village, xnCAddress Building,#1 Unit 2 110 West Main Street, Hyannis Wiring Inspector �, 1 �. _ Inspection date Plumbing nmector Inspection date Gras Inspector i f Inspection date Engineering Department MA Inspection date 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. 1918 ...... f I/` Building Inspector i / •-'k wa 1. _._ M TOWN OF BARNSTABLE permit No. .________________�___ .o 4 SAUSTMM Building Inspector Cash ----- --___-- � rua N OO�DYPY�'� "/A OCCUPANCY PERMIT Bond "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 Cafx3 Cod melody Village, InC+Address Rfl:ilrl:i,� #j Unjt #3 110 West Main Street. Hyami.s Wiring Inspector 1 Inspection date Plumbing Inspector { �d Inspection date 4 . tom. Gas Inspector ) Inspection date Engineering Department N/A Inspection date 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.E.___ ..............��,�Building.......... Inspeetor�.�'_ ._._...._...__ . „�'""'• TOWN OF BARNSTABLE Permit No. 22542 --------------------- Building Inspector swnui Cash ---------_--,--- � rua AT)! oO�O YPY w�� LV/t. i OCCUPANCY PERMIT Bond ___________ No building nor structure shall be erected, and no land, building or structure shall be use -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 Cape Cod Melody Village, InCfAddress Buildine #1 Ihait 4 110 West Dirt Street, Hyamis Wiring Inspector �� Inspection date Plumbing Inspector ` Inspection date Gas Inspector Inspection date Engineering Department NIA Inspection date 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. z 1s c_ _ Building Inspector r r v TOWN OF BARNSTABLE 22841 • ° Permit No. Building Inspector , i scash 7 YYa I ------ �f1 A OCCUPANCY PERMIT Bond 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 Cape CA d iMelOdy Village, InC.•Address Rx1 7 .i_n.o # _ lln�t S Tl.f) 11JOSI. iT) Si-reet;, 14vamilq Wiring Inspector � ��~� Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department -" N/A Inspection"date 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. Z Building Inspector, IL / \ r � TOWN OF BARNSTABLE 22841 ew Permit No. ------_-----_-- -- I Building Inspector »n..l Cash ■..A --- -------���-- OCCUPANCY PERMIT Bond __�- --_—_ "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 Cape Cod Melody Village, Inc. Address Building #1' , Unit 6 110 West PSa.in Street, Waxmis Wiring InspectorG �� � 9 Inspection date Plumbing Ihspector J/ Inspection date Gas Inspector ( Inspection date Engineering Department N/A Inspection date 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. .......� ,ra:(t�7,;:�:�............ 19!! ......... ; 1 A i f Building Inspectoor .�`""• . TOWN OF BARNSTABLE permit No. 228411._. t 11AU3TAU F Building Inspector cash �Yl OCCUPANCY, PERMIT Bond — "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." Ca Cod Mel Villa Inc, Issued to � � �� Address ' Building_A Unit ;m1 I10 West Pain Street.. T;vamig Wiring Inspector f� � � �: Inspection date Plumbing Inspector G Inspection date/ U /9 Gas Inspector, Inspection date ` Engineering Department NIA Inspection date 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_, .... .. ,^``..Building In pector .... . . _._._» „�•"”' F TOWN OF BARNSTABLE �2841 Permit No. -------- —-------- -----• i Building Inspector I �.arr.m Cash - - —— --- 'Oo �a a N/A OCCUPANCY PERMIT Bond —0___�__ 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 Cape Cod 1felody Village, IwAddress Wi l iar? A4 brit nQ 110 West Main Street, $vamis Wiring Inspectorrr / �/ _ Inspection date Plumbing Inspector Inspection date Gas Inspector f Inspection date Engineering Department N/,k Inspection date w 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. (� Building Inspector „�•;”. TOWN OF BARNSTABLE 22841 Permit No. ----.-_------ --- i 11.Wn.0 Building Inspector Cash ... OCCUPANCY PERMIT Bond NIA 4- "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 Cape Cod14l VZZlH, ! Inc-Address Tv -,iAdi_na A4 17bit 1 11.0 West min Street~. Hyamis A f Wiring Inspector ( � Inspection date Plumbing mspectb f Inspection date 2� "�`` '�►- Gas Inspector Inspection date Engineering Department N jA Inspection date 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 j � �� ✓Buildmi"ge peetor - 4 TOWN OF BARNSTABLE Permit No. 22841 `y a _______-_—_--Inspector ---- saurr.0 Building' Cash ...� OCCUPANCY PERMIT Bond NSAW_),- "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." 1 Issued to Cape ape Cod Melody Village,, TnC;Address Burl do ns,, #4 init 422 110 West MAin Street. Hva is Wiring Inspector Inspection date Plumbing Easpector � Inspection date 4 Gas Inspector Inspection date Engineering Department Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY-COMPLIANCE WITH TOWN REQUIREME�'N�TS. , = CZ201 . ... ................ . 191. ,... ....,..�..Building...lnspector-_ TOWN OF BARNSTABLE 22841 `� •e Permit No. ------------------- Building Inspector I IMIT AU . Cash � qua -------------- 7r); OCCUPANCY PERMIT Bond —_- 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 Cape Cod k*lody Village ;HCAddress ABuildirm, A unit 23 110 West Main Street, Nyannis Wiring Inspector - ,�, Inspection date Plumbing Inspector Inspection date . Gas Inspector Inspection date Engineering Department NIA Inspection date 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. ar /t. .`!........... 19Y �!at,r ' Building Inspector iS A y w � 92 TOWN OF BARNSTABLE 22841 Permit No. ---------------- - Building Inspector l s�arrr.rc Cash OCCUPANCY PERMIT Bond iu'/A "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 epe Cod Melody ViIIW, IntAddress �&/Iding ;A Unit #24 1I0 West Nz Street, Hyamis WiringInspector pe ctor � "�` Inspection date Plumbing EaspecWr` j Inspection date y. t Gas Inspector Inspection date Engineering Department N/A Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLI,ANCE WITH TOWN REEQ�UIR—EM�ENTS. . ............�, 19 ............ �j tuilding Inspector o� C,, , c /NF-a COPY C2 IA 6 - _ 17- f `\\\�.\ ` • ..may�+ *— 0 is i i. Z u _ n 4 k r. j - J r6 wZ�� J 1-7 ---��-----'�-- --Z -�- -/. -..-` �r�.,,.-._.�,,..w,`-.... .,. ♦.. ..._�--.... .,�w.y- .....rw�. ....r ..,,y»yw vrV•.M �. .. .. � �.�.rot�w....-..-„ wr..ri.-.-.. a�Y , 0—$Assessor's map and lot number ... . ..:.. �� ..� S Sewage Permit number .f11. ... f� �•G.. :....1./ =.. Il���idp4/. 0 SYM MUST BE �ALij HY COMPLIANCE Q�o�T�Ero�o il© TOWN OF BARNS"'V4,84"ITLE 5 Tr BAWSTADLE, i "6 BUILDING I N S P E C T QRJECT TO APPROVAL OF �0 Of URNSTABLE CONSERVATION. COMMIS S ON APPLICATION FOR PERMIT TO ..........G`............:.............................................../.s:�....... ...................... TYPE OF CONSTRUCTION .............................................. ....................�. ...... N�.7�S......... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following informati.n: Location .......... .. .... ..... ProposedUse ................ ............................... ................................................................................ ZoningDistrict .............:..... ......................................Fire District .......... .................................. ....... Name of Owner ... ............. .. "....... : .... ddress ..... ....,+ '............... // . ...... e�i.. .�? ...e ..........Address ... :... !?.. ./�— ..�-i ..... '� Name of Builder�9�!/....'.���r�.� .��� .� Name of Architect .LfJ/�fC/fZ�.. ✓l/f�/✓t c/�.4j......Address ............1� .i... ••:•`• '�.................. �� Number of Rooms ......... �.............................................Foundation ....�...�p.......... ? e ............. Exterior ............................... '... ........Roofing ......(a7{� ✓� .. a 9!?�r!�y�.4.",.:�.5. ........... Floors ...............................Interior � ... ................................................... ............... ............................... Heatin ��1 �I ...........................................:...........Plumbing ........... .. ...... ...../ .............. g ............. " Aev Fireplace ...................... . ........................................................Approximate Cost . _ ¢.O. Definitive Plan Approved by Planning Board ________________________________19________. Area�.0 .... e� v Diagram of Lot and Building with Dimensions Fee ...... ... .. .....`......................� SUBJECT TO APPROVAL OF BOARD OF HEALTH Il °'/KV E I hereby agree to conform to all the Rules and Regulations of the Town of stabl regarding thVee bove construction. 7 " ` �l' " �ale ... .... ... .......................... . Cape Cod Melody Village, Inc. _R11-01A166 9L 22 No ......... Permit for .!;qndpMin;'=.......... 2 buildg . ........... ins .................... ... ..bldg. Locatio//0 'West Main..$ n ........................... t.ree.t..................... .............. ... .......................................... Owner ....CaPe..Cod -K1d1PdY--.-WWe.,..Inc. Type of Construction .............frame.................. ................................................................................. � i i _ i+y Plot ............................ Lot ................................ February 5 81 Permit Granted ...... - I . ..................................19 Date of Ins pection)�. -�—.e. ............*.19 Date Completed ....... ........................19 ti PERMIT REFUSED ... ... ........ ...... ... I.-I...... ............ 19 ........................................ ............................... ...... . .................................... .. ............... ... . .. ....... . . ..... . ... ................ ... . .......... ..... ....... . ......./ ........... . . ... Approved.................................................. 19 ............................................................................... • ' " CCMV CONDO TRUST P.O. BOX 1715 HYANNIS, MA 02601 November 26, 1986' Mr. Joseph DaLuz Building Commissioner Town of Barnstable 397 Main Street Hyannis, Massachusetts 02601 Dear Mr. DaLuz Just a short reminder to request that you ask Mr. Dacey to please complete the roof ventilation as outlined in our previous correspondence. Thank you for your help in this matter. Sincerely, - BOARD OF TRUSTEES BT/a CCMV CONDO TRUST s� P.O. BOX 1715 •T U.S.POSIAGE « HYANNIS, MA 02601 p Novzs es - �l..6 7 i Z f,61 c ( Mr. Joseph DaLuz ® u °f• ,n Building Commissioner 'y Town of Barnstable Er v 397 Main Street Hyannis. Massachusetts ru 02 cn 02601 t 'TOWN OF BARNSTABLE .• e Permit No. ----------------------- - 1 swa.n 3 Billl(I1ng Inspector Cash _----_----- 00 OCCUPANCY PERMIT Bond 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 CW Cad 14elOdY Vil L)e Address $ B ildinz R Wit 7 110 West Lain ScrLat, TNmmil. Inspection date • Wiring,Inspector 4� �/ ,� Inso Plumbing Inspector(f i Inspection date Gas Inspector Inspection date Engineering Department 1V1;4 Inspection date 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_.... .,,•Building..Insp"ector _.... _ TOWN OF BARNSTABLE Permit No. --------` ----- Building Inspector. cash 7 �YL OCCUPANCY PERMIT Bond ---—_______—_______ "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 1 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 Cape OodMelody Village Address �. t - Tz iilding 42 Urtit 18 110 Went rfain Stye-et, Filk-a r.ig Wiring Inspector / r / ///� Inspection date Plumbing mspectorz,�-,:A_ `_ v Inspection date Gas Inspector Inspection date Engineering Department .'' Inspection date 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.r � / •! ' -' -'� ------........ a �' Building/Inspector n� 277 -Y ". TOWN OF BARNSTABLE Permit No. t NAUSTA° es Building Inspector cash ---___--- '°o OCCUPANCY PERMIT Bond ,-- ---_ 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 Cape Cbd Mf§* Village Address Building #2 Unit 9 110 test *fain St. Hyaluis Wiring Inspector � , ' ' % � Inspection date f'G'= 7 1 - Plumbing Inspector � Inspection date Gas Inspector Inspection date Engineering Department Inspection date 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. RE .... _, _ Buildin Inspector TOWN OF BARNSTABLE Permit No. ...... Y�r yhAy O Building Inspector• Cash TT OCCUPANCY PERMIT Bond T _ "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 Cap''e Melody Village Address Building #2 Unit 10 110 West 14AITI St.. I1yarmis Wiring Inspector G� , ,� �_ Inspection date Plumbing Inspector' F f + ' , _ Inspection date Gas Inspector Inspection date Engineering Department Inspection date 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..15 f ...` e //,!— J fig" «:^::....«............................ ... . /' Building,-Inspector ..._.....___ r s 2 _ _` r TOWN OF BARNSTABLE Permit No. ----_—____-- 1 »7r� Building Inspector, Cash ee fe79. `� F h OCCUPANCY PERMIT Bond _a/A 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 Cape Cod Melody Village Address Buildzn,&42 Unit 11 110 West Main St.. 'Ilva mi.s Wiring Inspector , Inspection date Plumbing Easpector . Inspection date Gas Inspector Inspection date Engineering Departmentf! Inspection date 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 '�....... :._____..._ Building Inspector 4 - TOWN OF BARNSTABLE,r Permit No. Building Inspector s.e�n.n Cash ------------------- °"°`` OCCUPANCY PERMIT Bond --- F/A —__-- "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 sl all be occupied until a certificate of occupancy has been issued by the Building Inspector." ' Issued to Cape God Melody Village Address Building #2 Unit 12 110 West Main St., Hyannis � Wiring Inspector Inspection date Plumbing Easpector f - �- fr'' Inspection date Gas Inspector l/ Inspection date Engineering Department Inspection date 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. Building dnspector j e� i TOWN OF BARNSTABLE Permit No. -------- w-__.... Building Inspector swrr."a Cash wa OCCUPANCY PERMIT Bona _—____ 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 CaPC GA 1!?10 " Vi11144a Address , Nxirlding, �'5 Unit 25 110 Hest Main Street. 1%y rl w v Wiring Inspector da te ti I ,yam nspecon ae .. t t ,?�,.,�,Z-,dam' k�' ,.��s�C�.aL,��,►J. Plumbing hispector � � "' Inspection date Gas Inspector J r Inspection date Engineering Department Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR• UPON SATISFACTORY COMPLIANCE WITH TOWN i REQUIREMENTS. ! a ........... _. .... ...... . . f Buil in`g Inspector . . TOWN OF BARNSTABLE Permit No. ---------�---_�----r ` N, Building Inspector s.a�n.n .' Cash --------- OCCUPANCY PERMIT Bond No building nor structure shall be erected, and uo 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 Cape God Melcxly Village Address Building #5 Unit.#-25 110 West Perin Street, Hyrrmis Wiring InspectorJ Lr^ � Ty�_ w~Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department I A Inspection date 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 ....................Building'�Inspeetor _�..._.._._..__.» 77 124C•; TOWN OF BARNSTABLE Permit No. ______ =�> � e _ I �.un.ue Building Inspector Cash —____-- � riva - 0o NIA OCCUPANCY PERMIT Bond No building nor structure shaIltbe 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 Cape COd MelOdY,Village Address Building #5 unit 26 110 West i-ta.in Street, Plyaraiis Wiring Inspector���2 =�. Inspection date Plumbing inspector Inspection date Gas Inspector Inspection date x Engineering Department Inspection date 5 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. / l% U f ��1 ..................................................... 19............ ..................�,.....Building..Inspector ..............._._._.__ f o•"" TOWN OF BARNSTABLE r`y •• Permit No. --------------------- I »STAS ; Building Inspector cash --------------- � t6�79 OCCUPANCY PERMIT Bond '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 Cape Co 10 jT Village Address Building #5 27 110 Tdest Main Street. 11--rartnis Wiring Inspector ,� ,! /--�"" " Inspection date Plumbing Inspectof y.. PI _ ^� � Inspection date Gas Inspector v Inspection date Engineering Department Inspection date 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 ..... � f,...Building Inspector ...... _._... r TOWN OF BARNSTABLE Permit No. _____"'?�?l;+_______ Building Inspector 11AUSTAX Cash _-----------___-- XYL �o +070. p �O vid�'` OCCUPANCY PERMIT Bond "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 Cape_ God VA-alCdy Vil aV Address 'n • • 4K Iir►it- )Q 11t) TaTia.vih 1t.,� Wiring Inspector Inspection- '�""� Inspection date Plumbing Inspector , Inspection date Gas Inspector Inspection date Engineering Department Inspection date 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 ! ? ------ iV Building Inspector r TOWN OF BARNSTABLE Permit No. ---------! :__ti___ Building Inspector Cash OCCUPANCY PERMIT Bona 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 Cape W ?4elOdY Village Address Buildin? 55 Unit 29 ;' 3110 t:'--t Hain S pet-,. i-i�,nnis 4Wiring Inspector t � / Inspection date Plumbing Inspector]� 1�, Inspection date Gas Inspector �� `/ Inspection date Engineering Department `I ,, f f F r �l f � Inspection date 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_ f/r /f lj �1l.... Building..Inspect or'_._..�._ ». s J ♦ l - - ��{fir TOWN OF BARNSTABLE Permit No. -------------------- saasa.n i Building Inspector Cash ----___--- OCCUPANCY PERMIT Bond "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." Cape Cod Melody Village Issued to Address Building #S Unit_ 430 110 West rain Street. 11N-a-,mis Wiring Inspector ^ ' Inspection date �. ` Plumbing Inspector Inspection date v t Gas Inspector Y � 7 � Inspection date Engineering Department N/A Inspection date F 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. , _., Building/Inspector y -�"' .ew TOWN OF, BARNSTABLE Permit No.-__?_31'__j__�___ I � Building Inspector »n.Yc Cash _-----_ - '°o �0 YRY Y'� OCCUPANCY PERMIT Bond. "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." Cape Cod .lalody Village, Inc. Issued to a Address t 110 :lest Rain Street qnit 16 Hyawlis Wiring Inspector . Inspection date Plumbing Inwect6f!., ' Inspection date V Gras Inspector Inspection date Engineering Department Inspection date 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. 7w-� 14 ...........:...:......:................._................ .. _._.. k .✓ Building Inspector I r „��""'• TOWN OF BARNSTABLE Permit No. -------23 24 Yam' j O� swrr.0 Building Inspector Cash -----__—_-- mYL "Al OCCUPANCY PERMIT Bond "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 Cape Cbd 14el ody Village, lr'Aadress V /3 Wiring Inspector f � �..---- Inspection date Plumbing Inspector//-;1/1—--A ' Inspection date Gas Inspector ,/ Inspection date Engineering Department NIA Inspection date 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. ' .. ..... ....,....._, ........... Building Inspector " TOWN OF BARNSTABLE z�- t Building Inspector 31AWn.,� � rua Cash ___--__--- OCCUPANCY PERMIT Bond "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." Cape -Cad Melody Vlllage, ' Inc. Issued to , Address 110 West Main 'Stret-t 0nit:. 18 Hyannis Wiring Inspector ! Inspection date f Plumbing Easpector- _ Inspection date Cxas Inspector 4i t Inspection date Engineering Department Inspection date 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. s f 19 BuildingfInspector i _ TOWN OF BARNSTABLE Permit. No. _2 312 4__` I Building Inspector Cash ---- OCCUPANCY PERMIT Bond 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 Cape Cod Melody Village, ddc 110 West Main Street Unit '14 Hyannis Wiring Inspector � Inspection date Plumbing Easpect Inspection date Gas Inspector Inspection date Engineering Department A Inspection date 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.._.. ._ ........._.......................... ........... ......... Building Inspector „••"” • TOWN OF. BARNSTABL Z -a "I Permit No. __ __-_—__--_—_-- I 11AII17TAU i Building Inspector cash ---------- � rua OCCUPANCY PERMIT Bond -------_--.- "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." Cape Coa ielody VillZgo, Inc. Issued to Address 110 . West i4ain Street i;nit:. 14 Hyannis, Wiring Inspector � � ��; - �' Inspection date Plumbing Inspector�f ril 4 �,✓ Inspection date ,, Gas Inspector Inspection date X Engineering Department .£ ;:.A< Inspection date 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»»._ »...........».» ...» »».... Building Inspector TOWN OF BARNSTABLE Permit No. ---------------------- t Building Inspector ■..� Cash -------------- �O OCCUPANCY PERMIT Bona 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 Address Wiring Inspector /; Inspection date Plumbing Inspector �. ` i� �. _ Inspection date Gas Inspector Inspection date Engineering Department Inspection date 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. ........................»....»..................»., I9».». ..........................................» ................» Building Inspector „��'”` • \� ^� TOWN OF BARNSTABLE Permit No. 13124 312 4 1 VARISTAU Building Inspector' Cash � rPPa OCCUPANCY PERMIT Bond '.'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." issuedCape Cod Melody Village, Address 110 West Main Street Unit 13 Hyannis Wiring Inspector o Inspection date Plumbing.Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date 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_... _._ ..................................... ................._.._ Building Inspector n � e TOWN OF BARNSTABLE Permit No. _2 3,2`_`__�____ Building Inspector Cash ------ OCCUPANCY PERMIT Bond 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." IssuedCape Cod Melody Tillage, Address 1.10 West Main Street Unit i3 Hyannis Wiring Inspector r7: Inspection date Plumbing Inspector , y Inspection date Gas Inspector V Inspection date Engineering Department . r Inspection date 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. ...............................I 19..._.._... ........................................._...........................to Building Inspector TOWN OF BARNSTABLE Permit No. ' '' Building Inspector { swrrAU Cash OCCUPANCY PERMIT Bond 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." LC Issued to` Address Wiring Inspector Inspection date Plumbing Inspector Y Inspection date Gas Inspector Inspection date Engineering Department Inspection date 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.. . ....................................... .... ...........................__........._......._._ » .» Building Inspector t S� y TOWN OF BARNSTABLE Permit No 2. ______--- 4 __--------- Building Inspector Cash OCCUPANCY PERMIT Bond --__ 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 toCape Cod Melody Village, JAgess 110 West Main Street Unit 15 Hyannis Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection-date Engineering Department T— Inspection date 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...... _ ............... .......................... Building Inspector r . TOWN OF BARNSTABLE ' ram. a Permit No. _______---_�-- Building Inspector DAUSTMM Cash ----_—_--- � rua �s• 00�0 rPY r�P OCCUPANCY PERMIT Bond "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 Cod Aelody village,' Address ' 110 i9est %3in 'Street Unit '15 Hyannis Wiring Inspector ��f`;J'4 Inspection date Plumbing Inspector,� Inspection date Gas Inspector v u' r` Inspection date f Engineering Department ,_ Inspection date 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__ _._ ........................................... ................._._.� Building Inspector TOWN OF BARNSTABLE Permit No. ___-----_ t Building Inspector >r� Cash �O t679. 00CUPANCY PERMIT Bona 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 - i' 1. �' Address Wiring Inspector Inspection date Plumbing Inspection date g Inspector, Gas Inspector Inspection date Engineering Department Inspection date 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. .....................................................1 19...... _ ..................................... .......................».»» Building Inspector JOSEPH:,--D:•D'LUZ TELEPHONE: 775-1 120 Building Commissioner EXT. 107 4 a TOWN OF BARNSTABLE BUILDING INSPECTOR TOWN OFFICE BUILDING HYANNIS, MASS. 02601 November 3, 1986 Mr. William E. Dacey, Jr. Dacey Real Estate 100 West Main Street Hyannis, . MA 02601 Re: Cape Cod Melody Village Condominiums/Roof Vents Dear Mr. Dacey: Please advise this office of the status of the roof vents for the following units: I i Units 3 and 4 Units 9 and 10 Units 15 and 16 Units 21 and 22 Units 27 and 28 Your prompt reply will be appreciated. Peace, i • 4jis �eh D. DaLu ding Commissioner IDD/gr •l M •j • -R�eS,�'f,�rd'�s.�>c-+a�.�. :. .'"�r. ti�' IF "`z..:..w.e..r D cow /986 �� '.` homes ,.: .�.":,.. � cs.rr._;c i "a Cape Cod tradition" 131680r.Ju; 100 WEST MAIN STREET•HYANNIS.MA 02601 Pair. Joseph D DaLuz Building Commissioner Town of Barnstable Town Office Building Hyannis, l,iass. 02601 JOSEPH-D. DALUZ Building TELEPHONE: 775.1120 Commissioner E XT. 107 TOWN OF BARNSTABL.E BUILDING INSPECTOR TOWN OFFICE BUILDING HYANNIS, MASS. 02601 November 3, 1986 Mr. William E. Dacey, Jr. Dacey Real Estate 100 West Main Street Hyannis, MA 02601 Re: Cape Cod Melody Village Condominiums/Roof Vents Dear Mr. Dacey: Please advise this office of the status of the roof vents for the following units: Units 3 and 4 Units 9 and 10 Units 15 and 16 Units 21 and 22 i Units 27 and 28 Your prompt reply will be appreciated. Peace, Joseph D. DaLuz Building Commissioner JDD/gr CCMV CONDO TRUST P.O. BOX 1715 HYANNIS, MA 02601 October 31, 1986 Mr. Joseph DaLuz Building Commissioner Town of Barnstable 397 Main Street Hyannis., Massachusetts, 02601 Dear Mr. DaLuz: We are attaching our letter dated July 15, 1986. As of this date it appears that this situation still exists:. We would appreciate your assistance in completing these roof vents. Thank you. Sincerely BOARD OF TRUSTEES BT/m Encl: (1) } ' CCMV CONDO TRUST P.O. BOX 1715 HYANNIS, MA 02601 1 July 15, 1986I Mr, Joseph D. DaLu& Building Counissioner : Town of Barnstable 397 Main Street Hyannis,, Massachusett& 02601 . Dear Mr. DaIuz: This refers to our letters dated February 129 1986 and April 14, 1986 along with your letter dated April 9, 1986, copies of which are attached. - Mr. Darey has installedisome roof vents, however, it appears that certain inside units are not getting cross ventilation. The following inside units only, have one vent: Units 3 and 4 _ Units 9 and 10 Unit& 15 and ].fi Units 21 and 22 Units 27 and 28 Would you please check the above units and ascertain the ventilation. Thank � you in advance for your cooperation. I SincereZyjp 0 BOARD OF TRUSTEES Att: (3) 4 t f I i i i S - Cl CCMV CONDO TRUST P.O. BOX 1715 HYANNIS, MA 02601 f July 15, 1986 Mr. Joseph D. Da»Iu& Building Commissioner Town of Barnstable 397 Main Street Innis, Massachusetts 02601 Dear Mr. Da1uz: This refers to our letters dated February 122 1986 and April 14, 1986 along with your letter dated April 9, 19%, copies of which are attache. Mr. Dacey has instalhedisome roof vents, however, it appears that certain inside units are not getting cross ventilation. The following inside units only have one vent: Units 3 and 4 Units 9 and 10 Unite 15 and 3A Units a and 22 Units 27 and 28 Would you please check the above units and ascertain the ventilation. Thank you in adv ce for your cooperation. Sincerel,Y, 0 BOAR OF TRUSTEES Att: (3) • CCMV CONDO TRUST P.O. BOX 1715 HYANNIS, MA 02601 February 129 1986 Mr. Joseph DaLuz Building Inspector Town of Barnstable 367 Main Street Hyannis, Mass. 0.2601 Dear Mr. DaLuz: The residential condominiums consisting of 30 units contained in 5 buildings were constructed at 110 West Main Street during 1980/1981 without any roof vents. The purpose of this letter is to request that you review this situation and advise the Board of Truistees'of Cape Codes Melody village Condominium Trust if this constitutes a building code violation. Your determination is important to us in determining any future action required. Thank you in advance for your prompt response. Sincerely BOARD OF TRUSTEES BT/m CCMV CONDO TRUST P.O. BOX 1715 HYANNIS, MA 02601 April 14, 1986 Mr. Joseph D. DaLus Building Conmissioner Town of Barnstable Town Office Building Hyannis, Massachusetts 02601 Re: CCMV Condominiums 110 West Main Street Roof Vents Dear Mr. Dab=: Thank you for your letter dated April 9, 1986, a copy of which is attached. Flewe be advised that the contact person representing the Board of Trustees is: Mr. William .D. Murphy 6 Captain Cook Lane Centerville, Massachusetts 02632 Telephone 775-4379 Feel free to call or writs Bill if you have any questions or require any additional infomation. Sincerelys jj BOARD OF TRUSTEES BT/m att: so: Mr. William Dacey, Jr. I •� JOSEPH D. DALU2 TELEPHONE: 778-1120 Building Com�piuiontr EXT. 107 TOWN OF BARNSTABLE BUILDING INSPECTOR TOWN OFFICE BUILDING HYANNIS, MASS. 02601 April' 9, 1986 Board of Trustees CCMV Condo Trust P.O. Box 1715 Hyannis, MA 02601 Members of the Board: I have reviewed the units at the Cape Cod Melody Village Condo's regarding roof vents. In the process of my review I spoke with Mr. William Dacey, one of the owners of the now dissolved company. After our discussion Mr. Dacey assured me he would install the vents at his own expense. He also requested that I allow him ample time in order to schedule his work crew to complete the work. If you have a contact person and telephone number I will be able to keep that person informed as to the progress. Thank you for your letter. I assure you the issue will be re- solved Peace, J s7 ph D. DaL z wilding Commissioner JDD/gr cc: Mr. William Dacey, Jr. I 911 IF W1 CCMV CONDO TRUST t P.O. BOX 1745 SEP, HYANNIS,.MA 02601 �' /986 t Mr. Joseph DaLuz Building Commissioner Town of Barnstable 397 Main Street Hyannis, Massachusetts] 02601 � � / - % "/ ��. '��, . _ _ _� - .� --_.� a '^- _ 'Jr _. �, ,,. - ._ r �, i �� I f s ... .J/ _ t" F,-. � �..�ry.J :_: >— ,.. .. ,.,..r ..... r t iil� n CCMV CONDO TRUST P.O. BOX 1715 HYANNIS, MA 02601 April 14, 1986 Mr. Joseph D. DaLuz Building Commissioner Town of Barnstable Town Office Building Hyannis, Massachusetts 02601 Re: CCMV Condominiums 110 West Main Street Roof Vents Dear Mr. DaLuz: Thank you for your letter dated April 9,9 1986, a copy of which is attached. Pleasa,ibe advised that the contact person representing the Board. of Trustees is Mr. William D. Murphy 6 Captain Cook Lane Centerville, Massachusetts- 02632 Telephone 775-4379 Feel free to call'. or write Bill if you have any questions or require any additional infomation. Sincerely, Bta'� 4 e r"4�� BOARD OF TRUSTEES BT/m att: cc: Mr. William Dacey, Jr.. X JOSEPH D. DALUZ TELEPHONE: 773.1120 Building Commissioner EXT. 107 .r TOWN OF BARNSTABLE BUILDING INSPECTOR TOWN OFFICE BUILDING �. HYANNIS, MASS. 02601 April 9, 1986 Q Board of Trustees CCMV Condo Trust P.O. Box 1715 Hyannis, MA 02601 Members of the Board: I have reviewed the units at the Cape Cod Melody Village Condo's regarding roof vents. In the process of my review I spoke with Mr. William Dacey, one of the owners of the .now dissolved company. After our discussion Mr. Dacey assured me he would install the vents at his own expense. He also requested that I allow him ample time in order to schedule his work crew to complete the work. If you have a contact person and telephone number I will be able to keep that person informed as to the progress. Thank you for your letter. I assure you the issue will be re- solved Peace, I J s� ph D. Dal, z uilding Commissioner JDD/gr cc: Mr. William Dacey, Jr. �ALuz TELFPHONZ- 77S.1120 4sr:over EXT. 107 TOWN OF 13 u i Ln i rq to 6asi, Erc o iR TOWN OFFICE BUILDING HYANNIS, MASS. 0260-1- April 9, 1986 Board of Trisiees CCMV Condo Trust P.O. Box 1715 Hyannis; MA 02601 Members of the Board: I have reviewed the units at the Cape God Melody Village Condo's regarding'Yoof vents. In the proceK of my-review 1 spoke with Mr. William Dacey, one of the owneis of the now dissolved company. After our discussion Mr. Darcy assured me he would install the vents at his awn :expense: ''tom RUelso requested that I allow him ample time in order to schedule his worKiref No 'complete the work. If you have a contact person and telephone nurber ,l will be Able to keep that person KfoTmpS is to the progress. Thank you for your Qum. I assure you the issue will be re- solved Peace, JO e' h D. DaLuz.1, p B' ilding Commissioner.U JDD/gr cc: Mr. William Dycjy, Jr. -�°li k o i - --oi di— r � i { I � � � j � � f � . � � i � I i b ' CCMV CONDO TRUST P.O. BOX 1715 � �- HYANNIS, MA 02601 M February 12, 1986 Mr. Joseph DaLuz Building Inspector Town of Barnstable 367 Main Street Hyannis, Mass. 02601 Dear Mr. DaLuz: The residential condominiums consisting of 30 units contained in 5 buildings were constructed at 110 West Main Street during 1980/1981 without any roof vents. The purpose of this letter is to request that you review this situation and advise the Board of Trustees of Cape Cod's Melody Village Condominium Trust if this constitutes a building code violation. Your determination is important to us in determining any future action required. Thank you in advance for your prompt response. Sincerely BOARD OF TRUSTEES BT/m y I' h 1 CCMV CONDO TRUST P M P.O. BOX 1715 HYANNIS, MA 02601 A 7� 3 AP6 •1,> 22 /986 Mr. Joseph DaLuz Building Inspector Town of Barnstable 367 Main Street Hyannis, Massachusetts 026ol CCMV CONDO TRUST P.O. BOX 1715 HYANNIS, MA 02601 July 15, 1986 Mr. Joseph D. DaLum Building COmmisssioner Town of Barnstable 397 Main Street Hyannis, Massachusetts 02601 Dear Mr, Dam: This refers to our letters dated February 12, 1986 and April, 14, 1986 along with your letter dated. April 9, 1986, copies of which are attached Mr. Davey has installedisome roof vents, however, it appears that certain inside units are not getting cross ventilation. The following inside units only have. one. vents Units 3 and 4 Units 9 and 10 Units 15 and 16 Units 21 and 22 Units 27 and 28 Would you please check the above units and ascertain the ventilation. Thank you in advance for your cooperation,. } Sincerely, BOARD OF TRUSTEES` Att: (3) CCMV CONDO TRUST P.O. BOX 1715 HYANNIS, MA 02601 February 12, 1986 Mr. Joseph DaLuz Building Inspector Town of Barnstable 367 Main Street Hyannis, Mass. 02601 Dear Mr. DaLuz: The residential condominiums consisting of 30 units contained in 5 buildings were constructed at 110 West Main Street during 1980/1981 without any roof vent'. The purpose of this letter is to request that you review this situation and advise the Board of Trustees of Cape Cod's Melody Village Condominium Trust if this constitutes a building code violation. Your determination is important to us in determining any future action required. Thank you in advance for your prompt response. Sincerely BOARD OF TRUSTEES BT/m �I CCMV CONDO TRUST P.O. BOX 1715 HYANNIS, MA 02601 t April 14m 1986 Mr, Joseph D. DaLuz Building Comai.ssioner Town of Barnstable Town Office Building Hyannis, Massachusetts 02601 Re: CCMV Condominiums 110 West Main Street Roof Vents Dear Mr. DaLuz: Thank you for your letter dated .April 9# 1986, a copy of Which is attached. Please be advised that the contact person representing the Board of Trustees is: Mr. William D. Murphy 6 Captain Cook Lsne Centerville, Massachusetts 02632 Telephone 775-4379 Feel free to call or write Bill if you have any questions or require any additional information. Sincerely# BOARD OF TRUSTEES BT/m att: ec: Mr. William Dacey# Jr. J JosEPH D. DALuz Building Commissioner TELEPHONE: 775.1 120EXT. 107 TOWN OF BARNSTABLE BUILDING INSPECTOR TOWN OFFICE BUILDING HYANNIS, MASS. 02601 April 9, 1986 Board of Trustees CCMV Condo Trust P.O. Box 1715 Hyannis, MA 02601 Members of the Board: I have reviewed the units at the Cape Cod Melody Village Condo's regarding roof vents. In the process of my review I spoke with Mr. William Dacey, one, of the owners of the now dissolved company. After our discussion Mr:..` Dacey assured me he would install the vents at his own expense. He also requested that I allow him ample time in order to schedule his work crew to complete the work. If you have a contact person and telephone number I will be able to keep that person informed as to the progress. Thank you for your letter. I assure you the issue will be re- solved Peace, J s ph D. DaL z wilding Commissioner JDD/gr cc: Mr. William. Dacey, Jr.