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HomeMy WebLinkAbout0150 ABBEY GATE y :r Town of Barn_ stable Building : �� `,P st This Card So That it is Visible ible From the Street-Approved Plans Must be Retained on Job and Card Must be Kept AM ,� tPosted Until Final Inspection Has Been Made.s639. ppym�+ .Wherea Certificate of occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made._� Permit 111 1 Permit No. B-18-3690 Applicant Name: Richard Bryant Approvals Date Issued: 11/07/2018 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 05/07/2019 Foundation: Location: 150 ABBEY GATE,COTUIT Map/Lot: 021-043 Zoning District: RF Sheathing: Owner on Record: LONABOCKER, LYNN&THOMAS TRS Contractor Name: RICHARD M BRYANT Framing: 1 Address: 46 WOOD END LN Contractor License: CS-082435 2 MEDFIELD, MA 02052-2224 Est. Project Cost: $ 17,250.00 Chimney: Description: Repairs/replacement of 20x24 rubber roof Permit Fee: $87.98 Insulation: Fee Paid: $87.98 Project Review Req: Final: Date: 11/7/2018 Plumbing/Gas }d Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and thefapproved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. - Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work:. 1.Foundation or Footing Rough: 2.Sheathing Inspection _ - 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT 6 r'L-�rZ i S rya Town of Barnstable .*Permit# �01 D(p'` Expires 6 months f om issue date Regulatory Services Fee • aaftxsTnai.$. ` M"SE $ Richard V.Scali,Director i639. �0 pTFD MA't A Building Division mess Tom Perry,CBO,Building Commissioneri�. 200 Main Street,Hyannis,MA 02601. DEC 31 2015 www.town.barnstable.ma.us I Ofce: 508-862-4038 TowN OF uJ - 230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY LE Not Valid without Red X-Press Imprint Map/parcel Number /0 zi o`i 3 Pr4Residential operty Address c /1 �� IV ev�r / �l/j�` d ZG Value of Work$ Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address L bA-z4, oz�, 3 r Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check,one: ❑,,I'a�m a sole proprietor I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp. Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ® Replacement Windows/doors/sliders.U-Value - ;L (maximum.32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. 'Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. , SIGNATURE: Q:\WPFILES\FOR,dMrS\building pe f rms\EXPRESS.doc Revised 040215 O rN 2lie Commomvealth of Vassachusetts Department of Inrizatrial Accidents Offce oflnvestigations 600 Washington,street :.s Boston,CIA 02111 -� fmtt?mass~govIdin Workers'C mpensaikn Insurance Affidavit- BuildersiContracturs/EIecEricians(Plumbers Applicant Infmrmatien Please F'rint Lezibly Name(B ssgan �niv�dnai} l.�ve�i,G Address: ��� �� � �• City/State/ — C0 t Y414- DZ G 3 S- Ph..4�- �yr��) 3 i- 70 6,0 Are you an employer?Check the appropriate box: T f project(o r nice 4. fy am a genera contractor and I Yl oP ] � 4: I.❑ I am a employer with ❑I g employees(full and/or part-ime).* have hired the suFr-contractors •6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7- ❑Remodeling ship and have no employees. These sub-contractors have g_ ❑Demolition waryng for me in any capacity. employees and have workers' co 1 9. ❑Building addition [No tliorlfle[S-'comp.insurance nip_insurance /required] 5. ❑ We area corporation and its 10.❑Electrical repairs or additions 3q I am.a homeoumer doing all work officers have exercised their 11.❑Plumbingrepairs or'additions myself- [No workers'comp. Tit of exemption per MGL 12_❑Roofrepairs I insurance required-]i c.152,§1(4h and we have no employees-[No woricess' 13.0 Other comp.insurance required.) $Any wHcmtffiat checlrsbox 91=St also fillc=the sectianbelowshuning the¢workeie compmxmdaapolicyinforrmwUmL 1 Homeowners who subaah this affidmgt indicating they are dais;all WcA and then hnie outside contractors matt submit a new affidx=m&catia sacFi ;Caatzactors that check this boar must attached an addiliand sheet showing the name of the s%,b-ca=xctozs aad state whether w not those mites ham employees.Iftbesub-c=tactorsbave employees,thej n=pm-.i&their workers'romp.policy number. I ain art ettrployper tliatisprosiding workers'cottgmzsaticii insurance for Ivry etnplojees Below is tits policy and job site informaliom Insurance Company Name: Policy i,*'or Self-ins.Lic. F—iTiratiaa Date: Job Site A,ddres.— 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 S1,500 00 and for one-year imprisoumenk as wen as civil penalties.in the form of a STOP WORK ORDER and a fine of up to$250-00 a day against the violator.- Be advised that a copy of this statement may.be forwarded to the Office of Investigations of the DIAL for insi-r"M-- ce coverage verification I do hereby cetftfj,uYt ar t}teprmrs and psnaMes ofpei jury thatthe information prnrided abm a is true and correct Signature: Date: Phan. AOfj`aciai use only. Do not awrtte in thb area,to be completed by city ortonrn official City or Tomm: gernritUcense 4 Issuing Autharity(circle one): 1.Board of$ealth 2.Budding Department 3.City-frown Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phoue 9: Information and Instructions Massachusetts Geheral Laws chapter 152 mgai es all employers to provide wormers'compensation for their employees. Pmsuantto this sty,aa.onpinyne is defined as."_.every person m the service of another Tinder any corfract of hie, 1� express or flied,oral or w An,envToyer is defined as"an individnal,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 therei o,or the occupant of the - dwelTmg house of another who employs persons to do maintenance,comtraction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to bean employer." MGL chapter 152,§25C(6)also stars that"every state or local licensing agency shall witllhoId 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 commaawealth nor auy of its political subdivisions shall enter mto any contract fur the performance ofpublic work until acceptable evidence of compliance with the insurance. re,quirements of this chapter have been presented to the contacting i g aufhouty" AppHcan s Please fill out the workers'compensation affidavit completely,by checlong the boxes that apply to your sifnation and,if necessary,supply sub-contractors)name(s), addresses)and phone number(s) along with their certifaicate(s) of insurance. Limited Liability Companies(LLC)or Limited Liability-Partner;hips(LLP)with no employees other than the members or partners,are not required to carry workers' compensation ins cc If an LLC or LLP does have employees, apolicy is required. Be advised that this affidayit maybe submitted to the Department of Industrial Accidents for confirmation of insta'mce coverage. Also be sure to sign and date the affidavit The affidavit should be retuned 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 ifyou are required to obtain a workers' compensation policy,please call the Department at the number list-d below. Self-imurd companies should enter their self-insm-a ce license number on the appropriate line. City or Town Officials Please be store 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 per li licrose number which will be used as a reference number. In addition,an applicant that must submit multiple permrVhcense applications in any given year,need only submit one affidavit indicating cTarent policy info ation(if necessary)and Tinder"Job Site Address"the applicant should write"all locations in (may 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 fte permits or licenses. A new affidavit must be fiIIed 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 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 caIL The Departments address,telephone and fax number. The CbMMMWMIth of M ssac,.hussn_tis- ' Department of ludnstdzal Accidents G�ffice of jkVe Qntious 1500.washingtml str=t Bastes MA Elul I Tf,-L 4 617 727-4g00 Qxt 4-06 car 1-aw MA SSAFF Fax#617-727-7749 Revised 4-24-07 .mas,,j-gQVfdia r oFIME)1, • aaxxsrAsts. ' ,m� Town of Barnstable prED MA't� Regulatory Services Richard V.Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.b arnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section. If Using A Builder as Owner of the subject property hereby authorize to act on my beh4 in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. QAWPFILES\FORMS\building permit forms\EXPRESS.doc Revised 040215 Town of Barnstable Regulatory Services soft r�ryr Richard V.Scali,Director Building Division aaarrsznsr.E Tom Perry;Building Commissioner 200 Main Street, Hyannis,MA 02601 ArED � www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 i HOMEOWNER LICENSE EXEMPTION •;:;, f� L g )/ Please Print t'DATE: JOB IACATION number t street village "HOIv1EOWNER": �/ (S e Ir) 3Y V — D O narie qq home phone # work phone# . CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures.'A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) 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 eowner UApprovalofBuildingOfficial 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 t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 040215 s 1 'Town of Barnstable *Permita S� F wlr&6 mwdit from Lme dare Regulatory Services Fee • sur�raat�, • MASS Thomas F.Geiter,Director atiJq..a�g �� � Ml� Building Division -�P C°�Z5 PERM11. Tom Perry,CBO, Building Commissioner i 200 Main Strom Hyannis,,MAA 02601 0 C T 2 ° 2011 �J www.town.barnstable.ma:us TOWN OF BARNSTA.BLE Office: 508462-4038 Fax:508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not YaUdWthoW Red.X-:Press Imprint Map/parcel Number Property Address i,Ss� B 3� 6147E f pTu/ QIResidential Value of Work 7/ 000 100 Mnimum fee of$35.00 for work under$'6000.00 Owner's Name&Address y h#e / ww,eu Gk-e2 Contractor's Name_ G j�uJT4lclni �'� %•?Z� f1o�>v Telephone Number. Home Improvement Contractor License#(if applicable) V 0 Constmction•Supervisor's License#(if applicable) U 9 y D 53►Norkman's Compensation Insurance Check one: El I am a sole proprietor ❑��am the Homeowner I have.Worker's Compensation Insurance A y �4jil l Insurance Company Name �'e f✓0 -�2T /1 Work pan's Comp.Policy# I V W C G q S17 3 R D f Copy of litsumnce Compliance Certificate must accompany each permit. Permit Request(check box) El Re-roof(hur.ricane railed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane trailed)(trot stripping. Going over . existing layers of t000 Re-side 2-ell l `e Xj xelwllf �AW ` #of doors ( RepIacement Wnidowstdoorslaliders.U-Value a S {mairinium.35)#of vir►dows 41Whcrc required: Issuance of this permit does not exempt eomplianm with other town department regulations,ie.Kworie,Conservation,etc. ***.Note: Property, t r",sig i.Property Owner Letter of Permission:_. A ply o Hume Improvetiett Contractors License&.Constrnctioti Supervisors License is SIGNAT[lRE: G li3s�sidecalliklAppData #i1 1 Vindo%S1T`npor1ry.Interaei FileslContentAuttooMDV89AAZ\EXTRM.doc Revised 072110 The Commonwealth of Massachusetts Department of Industrial Accidents . Office of Investigations 600 Washington Street Boston,ltlA 02111 www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Ugibly Name(Business/Organization/Individual): C p P l Z Z 0 n16 1(-M JY00f—r-A-�' TA1G Address: 1 G 4T N-ew;aLun -k y City/State/Zip: �e ►f . Ma ���3s Phone#: S'yd `fy-S.r/e Are you an employer?Check the appropriate bog: Type of project(required): L,1. am a employer with O 4. tj 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. 0 Remodeling ship and have no employees These sub-contractors have g; Demolition workingfor mein an capacity. employees and have workers' Y P tY• ; 9. El Building addition [No workers'comp.insurance comp.insurance. required.] 5. E] We are a corporation and its 10.E Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I L]Plumbing repairs or additions myself[No workers'comp. right of exemption per MGL 12.R Roof repairs insurance required.]t c. 152,§1(4),and we have no E,�K,`ter employees. [No workers' 13.L comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeownetr.who submit this affidavit indicating they are doing all work and then hue outside contractors must submit a new affidavit indicating such. :Contractors':hat check this%osmust attached-au additional sheet showing the name of the sub-contractors and state whethdr 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 the policy and job site information. Insurance Company Name: Ac.e p Yve e p j tvi L/: ZV,/11174 NL-P- Policy#or Self-ins.Lic.#: N G G y S� Y 3Z Gf- Expiration Date: r 7" !� a 3 Job Site Address: �y � City�. ,fa0te/Z0ip: U 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 insiirance.6verage verification. I do hereby certify un the i and penalties ofperjury that the information provided above is true and correct Si ature: Date: 0Ll 1-2-.of i Phone#: Z Z r6t V a I- 9`r1 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permii/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#: I Client#:47298 CAPIHOM ACORD. CERTIFICATE OF LIABILITY INSURANCE °s02r 011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: Karen Walther Rogers&Gray Ins.-So.Dennis PHONE 508-760-4630 F 508-258-2230 (AJ434 Route 134 E-MAIL Ert ac,No ADDRESS: waltherka@rogersgray.com P.O.Box 1601 PRODUCE CUSTOMER ID#: South Dennis,MA 02660-1601 INSURER(S)AFFORDING COVERAGE NAIC# INSURED Capizzi Home Improvement,Inc. INSURER A:National Grange Insurance Co. INSURER B:ACE Property&Casualty Ins.Co Capiai Enterprises,Inc. INSURER C 1645 Newtown Road Cotult,MA 02635 INSURER D: 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 ALDDL SUBR POLICY EFF POLICY EXP L TYPE OF INSURANCE INSR 6WD POLICY NUMBER MM/DDNYM (MWDDNYM LIMITS A GENERAL LIABILITY MPB1075H 06/08/2011 06/0812012 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY DAMAGE (RENTED PREMISESS Ea occurrence) $500,000 CLAIMS-MADE a OCCUR MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY PRO LOCI I $ A AUTOMOBILE LIABILITY M1 M28044 06/08/2011 06/08/2012 COMBINED SINGLE LIMIT (Ea accident) $500 000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ X SCHEDULED AUTOS PROPERTY DAMAGE $ X HIRED AUTOS (Per accident) X NON-OWNEDAUTOS $ X Drive Other Car $ A UMBRELLA LIAB X OCCUR CUB1076H 06/08/2011 06/08/2012 EACH OCCURRENCE s5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE s5,000,000 DEDUCTIBLE $ X RETENTION 10000 $ B WORKERS COMPENSATION NWCC45843208 12/25/2010 12/25/2011 X I WC STATu- OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEY/N E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? �N NIA (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Additional insured status is provided under the general liability when required by a written contract with the certificate holder CERTIFICATE HOLDER CANCELLATION 10 Days for Non-Payment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE i 0198 -2009 ACORD CORPORATION.All rights reserved. ACORD 25(2009/09) 1 of 1 The ACORD name and logo are registered marks of ACORD #S67537/M67480 MEE r, Page 7 of 7 CAPIZZI HOME RVIPROVEMENT INC. SPECIFICATIONS AND ESTIMATES STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT I, �icJ Z--Dc,,-R �ocl ke-— OWN THE PROPERTY LOCATED AT / Pal IN \�� + I , MASSACHUSETTS. I HAVE AUTHORIZED CAPIZZI HOME IMPROVEMENT TO ACT AS MY AGENT TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. I GIVE MY PERMISSION TO LESSEE TO APPLY FOR A BUILDING PERMIT IN ACC ANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. SIGNATURE OF OWNER: F T OWNER'S ADDRESS: . OWNER'S TELEPHONE: LESSEE'S SIGNATURE: LESSEE'S ADDRESS: LESSEE'S TELEPHONE: APLLICANT'S SIGNATURE: APPLICANT'S ADDRESS: 1645 Newtown Rd., Cotuit, MA 02635 APPLICANT'S TELEPHONE: 508-428-9518 RESPONSIBLE OFFICER: RESPONSIBLE OFFICER ADDRES : RESPONSIBLE OFFICER TELEPHONE: t ✓/2E ZQ�'nyOn!l1CA.GUL U✓1rG04',.AChtu2LFG . 0£t!.ce of Consumer Affairs&Business Regulation "License or registration valid for indnvidul use only before the expiration date. If found rabarn to: O 5 IMPROVEMENT CONTRACTOR OR ram, office of CUnsunterA.ffairs and Businest Regulation Registration_�6%40 Type, I0ParkFIa2a-Suite5rj(1 w' Expir, �n Supplement Card Boston,1LA 02II6 �— CAPIZZI HOME�{ t�'�x' k�"C. = r�� `V GARY GUSTAFS�+M Al io"45 Nev�ton Rd. �a � �---- Cotuit,MA 02fs35 �+2� = � Undersecretary ltTo, id without sianaiure . t�t".a;tcltusett�- 11cl�;Irtlltint'if pul)tic S�tCct� Sjt;ird of Building Rc�otdatiMN;Intl Standards �M Construction Supetviscar License License: CS 74V4 GARY GUSTAFSON B SHORT WAY. SANDWICH,NIA 02563 EYpiration; 14/2912QiZ Tr": 7058 Calulajtucter..._:..__........... ... .. _ _ ' t J `cam LX t_E FAM I L.Y - -Z:) .r vrs t�V Gt,c•�� . 1 to i 3 C 6.P.>Dt : ; ; ;-. . ` . ;. . . S ej-n C. T A.1.tIC•• 33o x 20 /0��Z =GGD G kts"S ! . . . I • 'SIoelaA" AZ-" BcTTOM ARC-As sF' ' ' - ' ' • Des ce. _ m 4�� �`:� '•• . E :_:.:•.. :. •' � - _ _.. l V; ?v L.AT l oai t 11� 2 Ma<1 02� Cf Asp. iH Of ! C. 19354 b l ,� OralfV 4' suK Ili 4"-f � ,Subbt�lt:. P/.v VKT Itc�t 4A.L. 14-f G louo 9 tO Iuv. "'�� ; L,EAGI•� 1 ; %y I I PIT cTD td is M&�Vz I P 1 P 1 as v -o-r Pt._a,t., PP2O Ft L.,Er I I 1 8 No Scut„ + SGl&L6 . . . ._. .-. . ` . .. i • . . . �----�' � � ICE '� ' Pl-a 1-1 1 CrLCrI %( ' T"AT T4U Cv1X.. �ZwV�, 54lowU ►�•��2r�o�-.1 �GoticP�-Y S -wtrr,••1 ��� rst�>_t I.i1�. ' . (,�c}('�j • ((� � �, ; A►JD S1+rB^rV OF TWF_ Tb wt.1 o F C'��-WSQ�l.E Ati1D 1� � '• i�►J. 1�� 2�I .. �"�f•4c 1�o�.T WtT�-ll W THE F'l.00t:) PL.A►t.t. , D ATE- d A XT Et Q e► u�tc 1 SIC.. TINS ?LAW (4 UOT $ASED OIJ I.0 t&e6 me.►4T 0tTezv4 s6. /KA45olj. rsURvCI 4 TNrm OFFl T; •5WoULD UOT E6 U'MC> APPLIC-AuT � To 'D eT a Rat l W E %..0T U u 64. — C the W�•�..1 .Cl G It fr 1�3 16W Cam. S�tl�.1rWl� VI s r pit~+�3�S n-L OAS, $ � I r . � TOWN OF. BARNSTABLE Permit No. 24380 - .--------------------- --- Building' Inspector - �T Cash OCCUPANCY PERMIT Bond _-_X----_ .- Charles & Nancy Wellington Issued to 14 Address Lot 16, & 17 150 Kings Grant, t &tuit Wiring Inspector — Inspection date Plumbing Inspector/ v Inspection date , Gas Inspector V Inspection date Engineering DepartmentA�,�a� ,� Inspection date.#(7! OcD Board of Health � 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. 0............. r . Buildin,g Inspector ASSI&SOr'S map and lot number / " 7 ?� 3.. .... ...... .. .... ...... ' "�Y 1� SEPII EM NiU51 Q�oF Q y Sewage' Permit number ...;......u..�.�..`...`...�.................. INSTA 'ir e`" TNE ¢ D� COMPL!l:�,:,, . WITH TITLE 5 Z SAWSTADLE.mum i House number Cvt..�s)....--'................ �... .. ..3.. NVIRONIIOIENTAL COD` �° :::�.�%6 �O 9• 0j1 S DYAY TC�IMN sRE�;lal,t#Ta TO N OF BARNSTABLE BUILDING INSPEC R �j r r 3 v, 1. S 11il L.c.................... I`( � �"Z 1 1\A APPLICATION FOR PERMIT TO ..... ........................ . ..... ... ................................ ....... TYPE OF CONSTRUCTION ...........woC?x)..... .-. ..................................................................... ......................... .Y .........,9. 2. TO. THE. INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the/follllowing information: A�//� Location ..f�CJ. .... ... !.. . ..... ....Q.IQ.Gr.).........�!N�7... ....G.RA �(�1. !.�?-SS............ Proposed Use . tl!I. GLWI.i� 1�1�r��1 !;14 ........................................................ .................. /. ............ � Zoning District ................f..�.... ... ire District .... .... Name of Owner ................t/�.. . h. I.N. .C,: ... ...........Address .....................4:1J 1..41. .) SS.................... Name of Builder A.R. -:�r..S.....1J..+...Wek.K/1J-T—.�'ddress ......SS�-kn.4L. .........../........................................ Name of Architect .........................................................Address Number of Rooms '................................... 0 CJvt Gft 1 i �o.. Foundation ....� ........................... t-................................. Exterior .. .U.. . ...S.CeS.!SJ! ......C,i�. 1.���*�/f:lb.p..Roofing. 4t1�S.. CC.I.. .............................................. q � � " r Floors- ... .jJ�iJ.....�.�.1.V.1.©. ...V1.CR..�U..C1L.� . Interior ...C�...Y.W. ...................................... .............. ' Heating 1.� ........ .�-G.l...f���_...........................Plumbing .PV [� .C f < (...`....3..��........... Fireplace ��OCf....j!j.0 rNl,1 .... J OU—L...............Approximate Cost ..y�i.�.7.�j 0,..©..4............. ............ Definitive Plan,Approved by Planning .Board -----------____—-----------19______. Area ...1 j;2................... i Diagram of Lot and Building with Dimensions Fee .� -. d...:.�...... q`�� a'SUBACT TO APPROVAL OF BOARD OF HEALTH �. Vv OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. I Cis C�. .c �i Name ....... ............ ..................................... -%WELLINGTON, CHARLES O. & NANCY � . I Permit for ..Two S torY........... Single Family Dwelling ' .. Lot #16 & 17 Location 9 �.rant Cotuit ..................................................................:............ Owner ..Charles...0...... ... ancY...W.1.1ington o Type of Construction ....Frame....................... Plot ............................. Lot ................................ -.._ Permit Granted ...SeP t 17 19 g2 .... ...'....................... Date of Inspection ......................19 Date Completed .....................................:19 Assessor's map and lot number .... �F. ..t .. `���.�.. � ... s> I Sewage Permit number .......... .................................... �i J BAUS'TABLE i tuber .: �d .. �:�..... ... ;� MJ1eq I�OUSe number .. t6 TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ... 1.........� .1 . ..:...................................' ,.. �.. �� 1�........ ..... .................... ..........1.�..� ,10..C:.........TYPE OF CONSTRUCTION .r _ �i TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..lay ... ��i..� ... �... f �,��...... ���p. . y�..... � JG�9a�„�> dJ Q,�, J ,�.... ........ ProposedUse ........... ...:: . �� :�..;oN �.1..... ........................................................ Zoning District ......................................... E Fir District .. °...........�a... .........................................,�Qg Name of Ownery ...... :;.3.�.�.. �� '!l9. .! %' � ........Address ........ .......... �„� rc�..4.. �.. ?. :�.................... Name of Builder :.r:`. :`. ... ��.K J. . ;:..L i;A;,--�1?A'd"dress �F� �� �� .....: s .. ....................................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ........... ................................... Foundation ... .�...�.. cf�........ .................................. Exterior ..... ��,.�.a 'L °�3 �:Roofing ...?w!�� ; f.. ....................................................... Floors it ;Interior ...� .f.?..r �t........................................................... Heating ....... .�... .. ....... �....... '...�a.. ��.............................Plumbing /�. ..� ...:......�....�... ................. Fireplace ..............................��. ... .................Approximate Cost .� ................................... Definitive Plan Approved by Planning Board ------------__—-----------19______. / Area ................................. Diagram of Lot and Building with Dimensions Fee -�`..................................z� SUBJECT TO APPROVAL OF BOARD OF HEALTH i OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. / Name ....0 � �� � ......................` : ..... .: A=21-42-43 WELLINGTON, CHARLE & NANCY 2438j' Two—Stbry No .............. Permit for f.............................. Single Family..P3�f�jjing. ..................................... ..... Location #16....&...1.7......15.0...�h C� ................ .............................................. Owner Q&.r.1.e.q...0.. 4...N.4AQ_v...W.0,11.jngton Type of Construction TrAMP............ ................................................................................ Plot ............................. Lot ................................ Permit Granted ......Sept.,. ......19 82 Date of inspection .....................................19 Date Completed ......................................19 AD 0io 100