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HomeMy WebLinkAbout0108 COTUIT BAY DRIVE / �� D� ����� . .. r �. ���.: F -7fm-- Town of Barnstable *Permit#Ae-v zo 4 Expires 6 months from.issue date Regulatory Services HAM Fees 1 9. 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 Imprint Map/parcel Number -5 Property Address- 16 8 0�<4 176 U P4esidential Value of Work— Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address CL 07 &14 da63 Contractor's Name- Eli QLA,!A Telephone Number 50g_qqV_;Zpyk Home Improvement Contractor License#(if applicable) 1 a 5 Construction Supervisor's License#(if applicable) 0workman's Compensation Insurance Check one: 0 1 am a sole proprietor El I am the Homeowner ,IR I have Worker's Compensation Insurance PERMIT Insurance Company Name JUL 5 2007 Worlanan's Comp.policy# R TOWN OF BARNSTABLE Copy of Insurance Compliance Certificate must be on Me. Permit Request(check box) Re-roof(stripping old shingles) All construction debris will be taken to El Re-roof(not stripping. Going over_existing layers of roof) P(Re-side El Replacement Windows. U-Value— (maximum..44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: ro Owne ust sign caner Letter of Permission. s Home '=en e is required. SIGNAT RE: Q:Fomis:expmtrg Revise071405 i 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 p Please Print Legibly Name (Business/Organization/Individual): /( Address: P c 0V _ j gyp City/State/Zip:� � MC. 0 9635 Phone #: 50 g—YA�?_ A gq D_ Are you an employer?Check the appropriate box: Type of project(required): 1.0 I am a employer with _� 4. ❑ I am a general contractor 6.tor and I ❑ New construction employees(full and/or p'art-time).* have hired the sub-contractors 2.El am a sole proprietor or partner- listed on the attached sheet. x ❑Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑Roof repairs insurance required.] t employees. [No workers' comp. insurance required.] 13.❑ Other *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 their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: I gy / Policy#or Self-ins.Lic.#: 7 1 q X U t(? Expiration Date: q — 26 Job Site Address: 169 Co uJ City/State/Zip:n /)) �— Attach a copy of the workers'compensation po tcy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby�ertif3v er t sand s o per ry that the information provided above is true and correct. Sign Date: — J Phone#: SO g— q a!R' J0 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#: v;� raser Construction s��Py 4�P)J..,o Roofing g p& Siding Specialists P.O. Box 1845, Cotuit MA. 02635 E ail: fraser construction(a),verizon.net www.fraserroofing.com Phone 1-508-428-2292 & FAX 1-508-428-0123 Side Wall/Trim/Flashing Proposal 2� - DATE: April 27, 2007 PHONE: 508-428-4575 � �� �► NAME: William & Mary Beebe G MAIL ADDRESS: SAME JOB ADDRESS: 108 C®tuit Bay Dr. Cotuit, MA 02635 yf.• FRASER CONSTRUCTION hereby proposes to perform the following services in a neat and professional like manner and in accordance with the manufacturer's specifications and local building code. -Remove and Haul away all of the old building material JOB DESCRIPTION Replace White Cedar Sidewall on cheeks and re-flash chimney Remove & replace upper trim as needed Time & Material Estimated Price for Material & Labor $1000 to $1,500 Initial Payable immediately upon completion NO MONEY DOWN- NO Payment at the start or part way thru Payments accepted are: CASH- CHECK- MASTERCARD-VISA-AMERICAN EXPRESS *Any payments not made within 30 days of completion will be charged 1 1/2% for every 30 days the payment is late. Any deviation or alteration from above specification will be executed 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. We, if not accepted within thirty days may withdraw this proposal. FRASER CONSTRUCTION: Carries Workman's Compensation and Public Liability Insurance on the above work, certificate available upon request. DATE OF ACCEPTANCE: MAV 07 (,)Jh Homeowner Fraser Co��truction Board of Buildin Re One Ashburtong bra Ons and Standards Place - •ROOM 1301 Boston, Massachusetts 02108 Home hnVrovement*,-CO1i1ractor Re gflStratfl®n FUSER CONSTRUCTION Registration: 1 ELA DEAN F TION CO. Type: OB,q BASER Expiration: 3/23/2009 Tri# 12792o P.O. BOX 1845 COTUIT, MA 02635 DPS-CAti SOM.pS/0&PC8490 Update Address Address and ----_ — return card-1dlark reason for change. ❑ ❑ Renewal ---•-- -- -- _ Em to - •--- - ❑ P Yment ❑ Lost Card Board ofBuiidingRegulations and Standards HOME IMPROrMENT CONTRACTOR License or registration before the valid for fndividW use only Registration: 'i 12536 expirationationdate. If found re PRatian: 3/2 009ttlm to: Un�of Bunldmg Regulations and S lords `IYPe: -D.E Tn 127920 Ashburton Place Rm 1301 Boston,AU.02108 FRASER CONSTRUCTION CO P1 DEAN FRASER 4556 RT 28 COTUIT,MA 02635 J tea.` (0000 Admj.sZtor Not valid without signature I ..........:.�:.�::.�:.:.:.:......:.......:.::::.:...:..:..........:;.:...................... :..... ATE :.:; CER THIS CERTIFICATE��.IS-•-ISSUED-•.-�� — — ONLY AND CONFERS NO RIGHTS..UPON RTHE I ITION F RTFCATEN DOES NOT AMEND, WISE & gUINN INS AGCY HOLDER. THIS CERTIFICATE END OR, RO C PLEASANT ST ALTER THE COVERAGE AFFORDED BY THE POLICIES BEL 24 OW. MA 02301 COMPANIES AFFORDING COVERAGE WCB COMPANY INSURED A HARTFORD UNDERWRITERS INSURANCE COMPANY COMPANY FRASER CONSTRUCTION CO B PO BOX 1845 COTUIT MA 02635 COMPANY C COMPANY ::..T:.:::....................................................................................................................HIS IS TO CERTIFY THAT :::::•::::::>:-:-:•;:;.::;::::::•;;s:-;:.>:.::::::.;•;:::,:•;: ........;:•:::.;•;;:::::::>;:;•;::;•.:::.::•:-:;;::::.:::-:;::.::::::>:;-;:•;:.::::;:-:.::.;:;.;: THE POLICIES OF INSURANCEED NAMED " INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT BEEN ISSUED OOR OTHER THE RDOCUMENT WITHER FOR THE POLICY RESPECT TOWHICH 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. TYPE OF INSURANCE LTR POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION GENERAL LIABILITY DATE(MMWD1YV) DATE(MMWDkyv) LIMITS COMMERCIAL GENERAL LIABILITY GENERAL AGGREGATE $ I PRODUCTS-COMP/OP AGG. CLAIMS MADE OCCUR. _ $ OWNER'S&CONTRACTOR'S PROT. PERSONAL&ADV.INJURY $ EACH OCCURRENCE $ FIRE DAMAGE(Any one fire) $ AUTOMOBILE LABILITY MED.EXPENSE(Any one Person) $ ANY AUTO COMBINED SINGLE ALL OWNED AUTOS LIMIT $ SCHEDULED AUTOS BODILY INJURY HIRED AUTOS (Per Person) $ NON-OWNED AUTOS BODILY INJURY (PerAccldent) $ GARAGE UABIUTY PROPERTY DAMAGE $ ANY AUTO AUTO ONLY-EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ EXCESS LIABILITY AGGREGATE $ UMBRELLA FORM EACH OCCURRENCE $ OTHER THAN UMBRELLA FORM -AGGREGATE $ A WORKER'S COMPENSATION AND EMPLOYER's UA91UTV (UB-794X619-1-06) 09-26-06 09-26-07 STATUTORY LIMITS THE PROPRIETOR/ ��>: :'':?l�i�'•.`:r � ; PARTNERS/EXECUTIVE X INCL EACH ACCIDENT $ OFFICERS ARE: EXCL DISEASE—POUCY UMIT $ OTHER DISEASE—EACH EMPLOYEE $ 500 000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE .;:�:.:;:;:.:;.;:.;;::.;�::� ,EI(riL]; ...;;:;.;;:;:.�:.;:.;;:.;;;:.:::;;:.:.;:;.:.:;:::::.;:.;:.;::.;:.:.;:::;;:.;-.;:.;;::;::;:..;.::.::;;.;;;•.....:.::::...:...... .... E HOLDER AF...........::::.�:::::::::;:.;:.;:.:.::.:::.��:.:;:.;:�:;:.;:.;::;::::::::.;:.;;:;:::::;;;:::.;:.�::.�::>:.;.:.:<:::::::.::.;:;.;;:.;�:::::::.;;,:.>•.;::::.�::.:.::.;;:.;;�:.� •:.;......:...:: ......... ... F ECT I NG WORKERS RS COMP COVERAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES E}IP BE.-CANCELLED•••BEFORE.�-••THE-•.• IRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR FRASER CONSTRUCTION 10 TIL I PC) CERTIFICATE HOLDER NAMED TO THE O BOX 1845 LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR COTU I T MA 02635 LIABIUTV OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESERTATIVES. AUTHORIZED REPRESENTATIVE '-..::T,T:}!1!;�A,IYM�'rt� ::::yi:Si::::iij:•:ryiiis�i:�}i'•.ii:;;4iiiii:v:;.:?iiii?i3iii:�iii:;.y;:•iiiiiiiiiiii::iiiiiiiii:Lii:::?iiiii??ii}.:•.:::�::.�:::::...................�...:.�:::.�::.:4:^;:::::,ivii}v;::.._.�:;;;.}w::.�:.�}}ii;::::;.:.:0;;•y;:::::::::iiiiii'.�:::::::•?ii;;.�:::;::}:;•ii};:.�:.�:::ii?>;nv:::._ii:Liif.�:::::w;:;.:... .. I 1 1 0fNHE Tgtf Town of Barnstable *Permit# P� Erpires 6 monthsfrom issue date # r Regulatory Services Fee RARNSTABLE, # ', 9c� MA SS., -Thomas F. Geiler,Director S PERMIT Building Division �. JUN 02 2010 Tom Perry, CBO, Building Commissioner. D TOWN F 200 Main Street;Hyannis,MA 02601 r 0 BARNSTABLE www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number ®S-10 .0ZZ Prop rty Address__CflCr, I 3 Residential Value of Work ® S9Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address W I� //9/Y1 R e_4 Contractor's Name f�yY1{�S / ' [Q®/V Telephone Number Home Improvement Contractor License# if applicable) 9 ' P ( � Cons ction Supervisor's License#(if applicable) Korkman's Compensation Insurance -P ESS PERMIT ' Check one: ❑ I a sole proprietor am the Homeowner JUN 0 2 2010 I have Worker's Compensation Insurance (-®UO(N OF BARNSTABLE Insurance Company Name P-#c m/ A/V/,� Workman's Comp.Policy#__ 2. g Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑�pl'acement-Windows/doors/sliders. #of doorsRe U-Value ®� (maximum .44)#ofwindoWS *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: �� �'w _.. �✓L tom- Q:\WPFILES\FORMS\building permit forms EXPRESS.doc Revised 090809 f 5 ' 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 A plicant Information Please Print Le ibl Name(Business/Organization�di 'dual): O so � C Address: 3 - City/ to/Zip: O �� Phone #: Are ou an employer?Check three appropriate box: Type of project(required): 1. I am a employer with (/ 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑IN onstruction 2.ElI am a'sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have g. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp. insurance. comp. insurance.$ required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions officers have exercised11. Plumbing 3.El I am a homeowner doing all work ffie h their � g repairs*or additions p myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4), and we have no 13.❑ Other employees. [No workers' comp.insurance required.] 'Any applicant that checks box#1 must also fill r ll out the section below showing their workers'compensation policy infomation. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. lContractors 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 or my employees. Below is the policy and job site information. Insurance Company Name: �Ak Policy#or Self-ins.Li c.#: Expiration Date: t^/�- Job Site Address: 1 City/State/Zip: Attach a copy of the workers' compensation policy4eclaration page(showing the policy number an expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition-of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. _ I do hereby certify under the pains.and penalties ofperjury that the information provided above is true and correct. - s>;,�_ Date- �% ff Signatur �e: �'� — Phone#• — to`0 G Official use only. Do not write in this area, tb 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#: i II`ILoA I C VI- LIAMILI I T II\IWjr AjNjLfC OP ID JV MO(3NA-1 05/07/10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Hunter Insurance, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 389 Old River Road, P.O. Box 1 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Manville Rl 02S38-0001 Phone: 401-769-9500 Fax:401-769-9502 INSURERS AFFORDING COVERAGE NAIC9 INSURED Moon Associates Inc"'. INSURER A; 14788 DBA Gutter Helmet Rational Granga rnsurance Co DBE Renewal by Andersen of RI INSURERB: Seacm tiutual 2nsurancs Co. DFAA Gutter Helmet Poo£�,ng - D13A Moon Works INSURtRC: 1137 Park East Drive INsuRt�tO: Woonsocket RI 02895 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBE HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSRN TYPE OF INSURANCE POLICY NUMBER DATE(MMIDDIYYYY) DATE(MMIDDIYYYY) LIMITS GE14ERAL LIABILITY EACH OCCURRENCE $ 10 0 0 0 0 0 A X COMMERCIAL GENERAL LIABILITY PS26619 09/16/09 09/16/10 PREMISE$Meo M ccwence $500000 CLAIMS MADE X❑OCCUR MED EXP(Any one person) $ 10 0 0 0 PERSONAL 6 ADV INJURY $ 10 0 0 0 0 0 GENERAL AGGREGATE $2000000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $2 0 0 0 0 0 0 POLICY P& LOC AUTOMOBILE uABILrrY COMBINED SINGLE LIMIT $1000000 A X ANY AUTO BIS26619 09/16/09 09/16/10 (Ea accident) ALL GINNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) 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 $ EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $10 0 0 0 0 0 A X OCCUR CLAIMSMADE CUS26615 09/16/09 09/16/10 AGGREGATE $ DEDUCTIBLE $ X RETENTION $10 0 0 0 $ WORKERS COMPENSATION AND EMPLOYERS'LL*ILITY YIN X TORY LIMITS ER B ANY PROPRIETORIPARTNEIVEXECUTIVE ❑ 28586 10/01/09 10/01/10 E.L.EACH ACCIDENT $500000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $500000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $500000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION jEjqLwATA DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE To DO SO SHALL Renewal By Anderson IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 1137 Park East Drive REPRESEI4TA11VEs. Woonsocket RI 02895 AUTHORIZED REPRESENTATIVES ACORD 25(2009/01) @ 1988-2009 ACORD CORPORATION. All rights reserved, The ACORD name and logo are registered marks of ACORD RA -4536 ca #iOn - J E'S t'-MOO 'S 5 d$.; ' �� OCKET, R� Katy .o. OcIn Cs zi- o, tr�r saw 3 �` AINS ROAD CUM MAy-2'222010 10:38 FROM:SCOTT ANGELL 508-564-76% Iu:le4wibflbebb r•`+ _._....__ _ ---------- - - rj arn..arw ..e i ok.0 = Aelllt�i�Mlllri uw C ==Wig LJ s a.too" -w } � p o o L+ a ay d s.a tens ah r< V V NO W. VOL to JU JQ 1,J 10 N kb V1 k 0 sues. eru: LN �r � r $ a i P N p N i PIP Ip .rul>rllw C� E7 Ci U `v V O p a > ammm :trswsaowe► 800/900DI XYA 80:60 otoe/n/90 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION I Map Parcel 02 Application Health Division Conservation Division N! J Permit# Tax Collector Date Issued Treasurer Application Fee C� Planning Dept. Permit Fee 4" S .o� Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Strreeee Add ess=`,'L�&,C� 46ac��C)r r—Village j0-,w_ner" rGTelephone- y�— �J��� Permit;Regiiest... I bX o►LI S�� !SY-td 0 u� Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay a Pr_ojectTValuat�_ i` a 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 BUILDER'INFO- RMATION �� ,Nam:e�::'� ��`C�.� me�'�fA��1 �Telephoneftmber,+.� Add'd e Pnn(6 ' e n uie ,J Yj License# ter; 2 .J Home Improvement Contractor# Worker's Compensation# U_Y_12 1 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO e(1 �t-1 r- Ct�i C� S �SIGNA,__TURE G DATE 3 I 0t 10'I 3,r _ i FOR OFFICIAL USE ONLY PERMIT NO. s DATt ISSUED MAP/PARCEL.NO. ADDRESS VILLAGE OWNER 4' � I 4, `DATE OF INSPECTION: ! LoFOUNDATION �vb Sc C��� /Z FRAME � • .,INSULATION FIREPLACE `ELECTRICAL: ROUGH FINAL I PLUMBING: ROUGH FINAL GAS: ROUGH FINAL i FINAL BUILDING o DATE CLOSED OUT ASSOCIATION PLAN NO. h Town of Barnstable °^ Regulatory Services �s"xr' ^MAW. Thomas F. Geiler,Director �'01E0.39. Building Division Thomas Perry, CBO,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.m axs Office: 508-862-4038 Fax: 508-790-6230 PLAN REVIEW Owner: 9&"45- Map/Parcel: 2— Project Address IVY �o�z�/�U &NIZ Builder: C7 The following items were noted 6n reviewing: /VO 4�5x C-C—P 7'10 J E Reviewed by: / G Date: -��a a�o'7 Q:Forms:Plnrvw i 0 face of Xnve�LBarions • • -600 Washfne-on Street 8osior�,11 Owl WWW.masagov/diii Workclrs' Cornptasation lusuranee,AOIdavit: Bui�d'exs/Ctlntracto)slEIdcfrlcians/')u»bers' X'Iease rrilatLe Apt n'Info Ilrb anon dame(>3usincs3tOr$ dza>#o Yidval): Address: � ►''l._ _ `�.,,��• � - C 1StateZip: +� v�•'fi%►�i , : n��� Phme-#: cry-h.t- • e of roject(required): FA-r,eaA e:nploycO C .tck�the-approprlatebox; pt c>atp7oyer.with 4�' . 4•.D I am'a general cautractor azi I 6. (]Nc .cowntion fuli.andl'or art Vie?•• liavcktircd'tb.csub-contzatxors .7..[]RtmodcliAg • � y'' � ,. p ..�.�on tb,c actackicd sheet.l'• ,. 2.Ell. r paitacr. - Tha,;c sub-pout cwrs bavc' sl rp no hruc.vG cz Ioyus . .. wq*M' oort�::iosttraAca 0. [�J3uiiding addition vorYing faT ioc,,in,any capacity. ration audits �c S.`❑ Wa�e a coipo 1a.D Electrical'r �iis or Iddidonr tivotl�txs cariap+ihsur c ofl?�crs cP. have pccrcisod Ihcir rtgitfred'J righ4 of exerrzp�on per MOM 11Q PlombD grcp;us oraddjtiofs am a�h1:mpowacr dging afl yrork 52,4 Y�4)' add vrc have Yiii I2.Q ]tbofrcpziis ys ,t orkrrs'.c;a. S. .•a ] workers ipsu7ailca roq vrcd.7,t crnpIc+ytcs.(No .13.E]'Qtlicr �• • • wmp.ipsua3uG4<r �x•�•T• aisa b1J out tbe.sccFian l+clow sbocvmg lbr t�v�lccrs'cnng> .....n pa}icymfo{mc�pa,..: . :•' ' •�yQyypl tbatcbcch•boz0]must' ' tH'o' owa�asrboatbmitt;. .-.&-- &'JI:. g oineallworkandthcohinoutsideootitradorsmustcutxtutauc�ttffidavTtiddic�ia�lush iC is�that ahcilC thl�lxum attecbcd ma.dditiodal siiocl shov+ine the name of(ha n+b- ttswzors e�td t}rcir prvil`ctn'co[►tP pofic�iufvtlruiion am aic emp(dycr fha:f Is jirav�jng:wo.Ck ',eomperksar!°n i,rsvrance for my c�rr,7loyeu. .8clow Is the p014 pad jab silt ; Inforrrr�ioac •InsUn iC4 CQmF-AAY Namc. policy#or Sclf ins.Lic#:- C �-�--�- xpiiatian Date:: Job. Sitc AiTdscs:: S '. •Cary/3t2Kc/Zip: . . . Attach s copy of the vrprlicrs' compthsatiot pollcy,de0ratioo'plep(sbov6g thGPalicY number aid explratlon datep. F2ilu;6•0icaue cbvcFage as rtgwscd nndct Section 21A of MGI:,c..152--can lead to the.icbpositlon ofcrhk2l peaaltics 6f a 6nc up 00 and/gr one-year 14T sonmcat,as well as civil pitaltics in tbr formo.f a.$TQP WOItIC OKI3 xnd a 5nc of up to 5250.00 a day against the violater. lie adYised`thata copy of ibis s tat crnest may be.foivaardc�,to.)lic.Officcof ' Invcstig�tions oi'tht DIA Eor.inttuancc covcragcvexificatyoA. J'do•frcreby rfi urrdef'Ihe.pr' penrr o erJ t affhciirfor�zrctronprvpldtd.aboveislrue�i�rd'correct i aturc: _ #fi n :.d Ojf cial use ally. AV n.qt WIVe ln.this area;to be complered by city or tawf ofjicW City or Tovrm: • permiUlleeUse# ' IssulAg Authcrlty (ClrGlt;one): ' - X_Bbsrd..of: '7.-Buildiagp'cFmkrtcrceut 3.city/Town Clerk 4.ElectrEcal.Inrpedor 5,Plumblag IafpiEctor 6:Otb cr Phone#:_, ' CantactYcrsov: _ ' L V TT 11 V 1 J.V54JL AA*7 VKRJav , Regulatory Services t ""��iE, Thomas T.Geiler,Director fp►9 `�� Building Division Tom.Perry,Building Commissioner .200 Main Street, Hyannis,MA 02601 www.tovm,bzrnstable,ma.us ace: 508-862-4039 Fax, 508-190-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW .SUPPLEMENT TO PERMIT APPLICATION MGL c, 142Arequir•es thatthe"reconstruction,alterations,renovation,repair,modernization, conversion, improvement;removal, demolition,or construction of an addition to any pre-existing owmer-occupied biding containing at least one but not more than four dwelling units.or to structures which'are adj scent to 1 such residence or building be done by registered contractors,with certain exceptiors,along with other requirements. Typerof=W._or_k 'b X Estimated Cost �, �Addiess`of Woik:: py mer_'s Nam_e: 1•�t`�1 b �D`ate of Application L$ereby-certify that: . Registratign is not required for the following reason(s); ❑Work excluded by law CjJob Under$1,000 (]Building not owner-occupied ❑Owner pulling own permit Notice is berebT given that: R DEALING WITH_ TERED IR OWN PER= CONTRACT OWNERS P�GORA APPLICABLE HOME OIMPROVEMENT FORK DO NOT HAVE '. . ACCESS TO THE ARBITRATION PROGRAM OR GUARANTYFUND UNDERMGL c.142A, SIG UNDER PENALTIES OF PERJURY I hereby apply for a permit as the ag of the owner; Date Contractor Sigdature. Registration No, OR iDate Owner's Signature Q.nAe3,{mw:homeaf iidxY Rev: 060606 91ze Board of BOildin e uiations One Ashburton Pace, Km 1301 Boston, Ma 02108-1618 License: CONSTRUCTION SUPERVISOR LICENSE Birthdate: 03/14/1970 Number: CS 073865 Expires:03/14/2008 Restricted To: 1G JAMES R MCURK111 204 CRANVIEW RD BREWSTEIt, MA 02631 Tr.no: 15967 Keep top fur receipt and change of address notification. p Board of Building Regulations and Standards , One Ashburton Place - Room 13 01 4 WV Boston. Massachusetts 02108 Home Xmprovernent> dntractor Registration Registration: 132935 Type: Private Corporation : :` •.::''.:r __...__._ t Expiry+t--: 1MIL70da" McGRATH POST & BEAM CO. .FAMES MCGRATH "':3 259 0UEEN RI NINE FAD. �= { A' HARWICH, MA 02645 r A lr, Update Address and return card Mark reason for change, as-cA1 t, sor�oaroa o,maie, Q Address Renewal Employment F1 Lost Card _..........._..._.......................---.........._..._ - .... ✓lk•[�Jpl91/7JYlf2[f/Qg D�✓OT�/OJ��iIfGB .__ 8aar4 of 8uildiag Roptutinns and Staadarsls License or registration valid for lndividul use only HOM5 IMPROVEMENT CONTRACTOR before the crpiration date. !f fouad T4AWn to: lko&t.17ation,.1.32935 Board of Building Regulations and Standards ;Elip7Fatfo i _p/31�ppg One Aslib urt9n Place Rm 1301 Boston,Ala.02108 „`. .`.':Type:.;FrlyAte Corporation _ _.... MCGRATH POST•t, ! ;' JAMES McGPAT4:.':•' ; 259OUEEN ANIU HARWICH,MA 02645 tJmnistrator a 'h—Nt vliwitnu—t—si—gns ------- to re Date: 3/12/2007 Time: 9:53 AM To: @ 9,1,5087717070 E&G Iris. Agcy. Page: 001 i t Client#:20245 MCGRPOS ACORD,. CERTIFICATE OF LIABILITY INSURANCE 3DATE 112107rwrrrrrl PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Rogers&Gray Ins.So.Dennis ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 434 Route 134 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BYTHE POLICIES BELOW. P.O.Box 1601 South Dennis,MA 02660-1601 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA: St.Paul Travelers Insurance Company McGrath Post&Beam Corp INSURER B: American Home Assurance dba Pine Harbor Wood Products INSURER C: 259 Queen Anne Rd INSURER D: Harwich,MA 02645 INSUKtR t COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTV41THSTANDING 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. IN SR U POLICY EFFECTIVE POLICY EXPIRATION LTR NSRC TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY DATE(MMIDDIYYI LIMITS A GENERAL LIABILITY 16600384B400TIL.06 01I31107 01/31/08 EACH OCCURRENCE $1 000 000 COMMERCIAL GENERAL LIABILITY DAMAGE T ERENTED;ES $100®00 CLAIMS MADE ®OCCUR MED EXP(Any one person) $5 000 PERSONAL&ADV INJURY $1 GOO 000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS-COMP/OP AGG $2 00O 000 �( POLICY PRI- JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON-O'hTJED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANYAUTO EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESS/UMBRELLALIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ B WORKERS COMPENSATION AND WC8947347 07/08/06 07/08107 X WC STATU-I OTH- EMPLOYERS'LIABILITY TORY LIMITS ER E.L.EACH ACCIDENT $100,000 ANY PROPRIETOR/PARTNERrEXECUTIVE OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $100 000 If you,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT 000,000 OTHER DESCRIPTION OF OPERATIONS r LOCATIONS J VEHICLES!EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS Re: William Beebe 108 Cotuit Bay Drive,Cotuit. MA 02635 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of Barnstable DATE THEREOF.THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Building Dept NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 200 Main St IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Hyannis,MA 02601 REPRESENTATIVES. AUTHOR12ED REPRESENTATIVE ACORD 25(2001/08)1 of 2 #S27549IM27212 DMW 0 ACORD CORPORATION 1988 Date: 3/12/2007 Time: 9:53 AM To: 9 9,1,5087717070 R&G Ixis. Agc°y. Page: 002 .j IMPORTANT If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer,and the certificate holder, nor does it affirmatively or negatively amend, extend or after the coverage afforded by the policies listed thereon. ACORD 25S(2001108) 2 of 2 #S27549/M27212 Its ' 1 r t � .}.c.�w_.tis �{,r--•ice-,fit-�-y.' �^�.* -_ , , 2�L ESA\ t- w �''�.-��,,� �.ria r��; �v,`kY Y�rr`�a ti _� rc _ - r -� . s•� � ��� r�Fii 2, -r �a Y "�w ��` � "sME : neatCtw-s,�,� - t 'kc•S Fngvrtiw-nY9.irrs•.l'H �'�'�a�"��_.+"�a-r-i ���,.le - @`-�t' Rr� ��a`.. 4. u �a ��i,a,�w.�E,! ..y.,x,�;+�ur ,0 j..Ellu, ..�> e�� �i�;��� "• ���r�*'4�5 ti' ' ir1 �tr. a.�.eei�-^`vvie.'n'ttutu° _ �°"�Pr Y3i372fi.�d..�iY•,,,,.�;,,{:'�, rr ��• r��' - s'. �� y;'s?• {�llh jar � t {��{Or'"r !+l �a4'E�`�CiI(t •'��ie� �� ads t `e�; t. �_y4Cr E- � � -' � i1 s ! t v aE u#irAF � t .1': _ t�4� lrssC�grS't! •1�''E Er.. iEg �+� ' vi pi •(;4,}�i'� . { i Fa ng+ ' ,��;7�✓�Sl,+i � ;+�`YY! t��i�XI�iF ! �q.. �b � � S i ��;t Ott�. � h 4� �`��i�i•tai>t .G:`^`�t�"'+�i.*L� 1'�3{rw..�,ss+vv ng maq, �.�,. i} < - .y - f - �;''�4 Eli d`,�,k�N�J• ! 't �ff c t �2 s t�j � i4 s�i�'1 e ,.�i II l'N a�♦ 7 YC 333 2 > `�I "7 � '1 4i t aYJ, l.il'��IrW ,� t1k f q�`I ti,.i+`fii)t'."_ •- � �. l;:tt .,v,:,,ilS'e'�:v:�:'.. t � •" � S..aL.''. �+�lJZ..a..�, 1. 3:`4:.3:.. = �� ,.� 2' +mil N; Asa , I • Il � f s . . I t Z`xF �2z N � �.tom i��Z s > v g^• v g f Yz spa gam. � I �`i•T WE gm f�c '`' { �' {" x .'�" y, Y �"�j � �,z �drs ✓s..�' .z.ss a• -��- ..=`-? e - -� (: �� �������^"� 'ram, �. cy.. s�is � 4 ,T � �_•, 1c. OVA Cam? 7�.rn J.r'-ems dt k S _ 1 R WOOD PROD' CTS de's all about the wood"' FLOOR FRAMING ' 1/4' 6 X-0•- ROOF FRAMINGGARDEN 514ED SERIES UP DESIGNED BY Jarni e McGrath DRAFTED BY. " Chris Ellis COPYRIGHT' NOVEMBER 29, 2006 d T d EI f - + N 1 YFF h t �E ?L a F• k_v '� F .i �4'.� a } � f. I 'a 4 4 s� r l� - k s�� S,Fi�4r( r, i .� t -. a (�`' •`i to � �' k � t r .bi •� Et r:n:s �,w �,'IFFI,, y v s t e !;I.' C f�- r t. t -I r c. Yr r,r Y C s.r 64"f t ;s.v7a G i�S s--'y Fi I f k '.r'I. � + I i I L �` � s t-I �� t�,sy >{`•. -�"I.: tAl. �a�r i I� g dFA � ,F. .� � ii, J �1 v �ti!t : �; f .tr �Ir 4 ,��E k 1 '_ .:}.•;.� � If ��� s �`:�t.#3s FI F(< ft.'';^.- 1) . . j I ..:-'-t' Wr iir-�' •.E}� ts. -•:; ;- y°P" �,. 1y :s Ifs st s L ` tl .l ix ti F{SI� r 5 •f R. t s ,}.0 r 3 �2 �- IF �'.. .s 1 o r '' 1, � 4.F tl•_:; t ty.� i }I 1 a. ,� I �._.� ..�zs }� ..$ Eti�}< 0 (`��1��. : ����t � _�as tsk '����u�a �'r i s•s '..a ( t i=Y op���'s,."'�'+-.� ` a I �i 9 - 7 �:.I...a �!-i`x( � y•Y -F�. ,� .rr.,>. .�i- � -.I�' 4a t It. +fix, r fJ j--i _ ;li r- �r.[ 19b,�$ :�{y,�• k :.>s s�r p f .{..'•.,I,?.� i i Er p - �Y.�I'•p .s ^.4�i+����.t� F t. �C�`:is?• I '�,'.;Il"i'; I �- r ��fsk�;.>,_� �s,.a¢i.' +: -I !!F }�. r ee �f k- SaA ;;:. t.. t ,� :t7•'r ,t � ;I': � �•, � 6. .� I ""I';'<'Via; ;•t�:r t '@Y ai E,,�S3 F='"�-+dF S:a' > :?. ;•F�r �. t: r. i.}�. �'•i: r fs. '� I ::k:;: _"Gk �'?. I�t •7t r�.eta_t? v��;'�v 41-��fi:s-��sv'l si�� 'c. � i FI 17 �'6' � � t:.5' +9E(I 3 J71 I t 1 �I...:;t:i;:�a?''.-r.�.s4'L. N¢}•� ��i� E} � �r 4.CfE�.lr''��i l r - i k sia�,; ter... }' \ i. 'i fJ �� I,c� Fr � - i .ems L 4 F �.'fF S: � + �rf..� r{v�>t: �t-��•tv+�2 ems' ~..�I'c F�' t1c �� yy�i`fStt`"1�`a }y- ,{- 1'i 1 + �r.. r'Lt r 2:4. r�i F ° ?s ti�S>Tyra 'r"r2':iL? Y. tis'r '1�"^fr::3.SS ,_' 7 '7 r 3�Y�itl•. fic,*... ,e la I � n �� 0 l 1 � t 9� ' UA- z 00 UA z O lzzzzzl y U p 4j 6� \ � o� CD- O ` cn W Lam_ 0� zzs \ 3 0-, I w z _ 44 v � 3Aov6v9���, Town of Barnstable "Permit# ..0*VE Tp Lrpires 6 moa n issne dare NVrP-� Ow r�Vita N AB Regulator services Fee R&R v MASS. Thomas F.Geiler,Director �p t6j9• A�0 TfDMPt Building Division X-PRESS PERMIT 'Tour Deny, Building Cunurlissioltcr 200 Mail'Street, Hyannis,MA 02601 OCT 2 6 2004 ��►/`-/ Office: 508-862-4038 Fax: 508-790-6230 TOWN OF BARNSTABLE I',YPILII SS PERMIT APPLICATION - SIDL,NT IAL ONLY Not Valid without Red X-P RL" ress/nrprinf Map/parcel Number Property Address Value of Worker !' / Residential Owner's Name&Address D Q 9�. t n Telephone Ntunber0,o,'_"1 Contractor's Name_ ! Home Improvement Contractor License#(if applicable)_,___ Construction Supervisor's License#(if applicable)__ r ❑Workman's Compensation Insurance Check one: ❑ 1 am a sole proprietor ❑ lam the Homeowner rave Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Permit Request(check box) ❑ Re-roof(stripping old shingles) ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (niaxununi.44) Other(specify) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.llisloric,Conservation,etc. Signature QTnrms:CXV1T11T9 CAPIZZI HOME IMPROVEMENT INC . -/Yl- 2 77 SPECIFICATIONS AND ESTIMATES PAGE 6 OF 6 STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT ' OWN THE PROPERTY LOCATED AT o bL D� � �' IN MASSACHUSETTS. I HAVE AUTHORIZED CAPIZ .I HOME IMPROVEMENT INC. TO ACT AS MY AGENT TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. I GIVE MY PERMISSION TO LESSEE TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. SIGNATURE OF OWNER: OWNER'S ADDRESS: OWNER'S TELEPHONE: LESSEE'S SIGNATURE: LESSEE'S ADDRESS: LESSEE'S TELEPHONE: APLLICANT'S SIGNATURE: , 1 APPLICANT'S ADDRESS: 1645 NEWTOWN RD. , COTUIT, MA 02635 APPLICANT'S TELEPHONE: 5081428-9518 ' RESPONSIBLE OFFICER: RESPONSIBLE OFFICER ADDRESS: RESPONSIBLE OFFICER TELEPHONE: ACCEPTED BY DATE THIS PAGE IS PART OF AND IN CONFORMANCE WITH PROPOSAL # rtmn:Mwur�belll t.Y1n�a1 CiC At:Ili*%l1 cw1E1y Conn,anlee p0x11);O/OnRRII(/:IA in:Capltto II0111e hrtplovemenl Uate: I2/I0/IUUd�11:I I r tvl lvyu. VI'pl bA�e tv"MO nw/ A(;o v CERTIFICATE OF LIABILITY INSURANCE �Q24_�" ix ib oa i'nnaxm 71119 CPh?1FIcl1TE 19199UFt►A9 A M111'7ER Oi INf011M�Ito I1ozCto�a R t.elghton Cape 1,00. MILV Attu covirP_n9 110 rtl(11119 UPVH?IIE CER11tiC111e tl.J.ticJt'nzthy Ina.1►pency,inn. 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Pxplre§: O9/2612005 Tr.no: 7171.0 "• I RCH11CIed: 00 I I I IOMAS X CAI IVI JR Ir,4,NrW TOWN lib CO1 UI C, MA 02635 A MINl9lrebr ....__.. ....... .... ............................_�..._.__..___�1Y -.. -._..._..+..�._�._.�� t 1 � t .� , ..- ..ti.-.... ,t.-.43•M..,aY:a.tw'+nM:.,..!xw:.«;,Rr...--... ..w...s-:Kr.•.,. w The Commonwealth of Massachusetts = 3 Department of Industrial Accidents �'� — 0/17C�AI�bf1tS�0A�S 600 Washington Street Boston,Mass. 02111 OwJ ' Workers' Co ensation Insurance Affidavit:Buildin lumbin lectrical Contractors name: address: city state: zin: >hone# work site location(full address)' ❑ I am a homeowner performing all work myself. Project Type: ❑New Construction❑Remodel• ❑ I am a sole proprietor and have no one worki7 in an ca actty ❑ Buildin Addition • f • �//%%%/%//G%%/%% ��%/%%%///l%%//%%%/%%%%%%%%%%%%///%///%/%/%///%/�J%%%%%%/%/%%%%%%%%%%////% %//m//%/%/00M I am an employer providing workers'compensation for my employees working on this job. 77 com•an .:n9meJZI ::••r a• 4:ddres's: r n o: �.• •'c h am a sole proprietor, general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: •• C U Y 'a::�•• add •' ' .... :.. ' : ,:,.n. .. .,• ...�'. "olio °:#`" //////// eddl•essj - _ fit'• one#::;;..:._:' =:?;:':'•. i •:•: ;': �, 10SIIr8faCC`C"0. 4.11E Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a tine vp to$1,500.00 and/or one years'imprbonment as well as civil penalties in the form of a STOP WORK ORDER and a tine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigation of the DIA for coverage verification. . i ' I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature n(� Date Print name tV I Phone#-rI)/U "l [ty nly do not write in this area to be completed by city or town otliclel : permit/licene# ❑Bulldiog Department ' ❑Lieening Board immediate response!'required ❑Selectmen's Office ❑Health Department on: phone tf; ❑Other 03) oFt r Town of Barnstable: *Permit# V 'too Expires 6 months from issue date Regulatory Services Fee snaxsTnat.s, / v HAM $ Thomas F.Geiler,Director 'E�►�� Building Division Tom Perry, Building Commissioner �( 200 Main Street, Hyannis,MA 02601 ^'PRESS PERMIT . office: 508-862-4038 Fax: 508-790-6230 JUL 15 2003 EXPRESS PERMIT APPLICATION - RESIDENTI jjQNU Not Valid without Red X-Press Imprint 114 tIARNSTABLE Map/parcel Number V a t;0_C - _ Property Address J2 Residential Value of Work Owner's Name&Address /o Contractor's Name_ Cip P Telephone Number ' Home Improvement Contractor License#(if applicable) f' O Construction Supervisor's License#(if applicable) 95workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance_7�j +-G ,per Insurance Company Names Workman's Comp.Policy# Permit Request(check box) Re-roof(stripping old shingles) All construction debris will be taken to I�C3 Z ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) *Where required:-,Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner m ement Property Owner Letter of Permission. o Co actors License is required. Signature Q:Forms:expmtrg Revise053003 u Fraser Construction 'r Roofing .& Siding Specialists FRASER CONSTRUCTION Warranties the shingles and labor for 10 years. FRASER CONSTRUCTION Warranties the shingles against Blow-Offs for 10 years. CERTAINTEED Warranties the shingles and labor 100%for the first 5 years, and then on a pro rated basis for 30 years total if the shingles become defective.. CERTAINTEED Warranties the shingles to be ALGAE resistant for a full 10 years. Any deviation or alteration from above specification will be executed 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. We, if not accepted within thirty days may withdraw this proposal. FRASER CONSTRUCTION: Carries Workman's Compensation and Public Liability Insurance on the above work. l DATE OF ACCEPTANCE: U 3 SUBMITTED BY: om owner Fraser Construction We t -J-half Owe- y^v have- �,f0 L.,;a V aC.k- CvYlf��aa�5�� lidJ�:'1 �' ah is Carta�lP , a v Ae &Mwwwweaal Board of Building Regula ions and Standards One Ashburton P')ace - Room 1301 Boston. Ma�s-ae usetts 02108 Home Improvemel&C01 tractor Registration REM —� — Registration: 112536 Type: DBA Z _ '�I'-' Expiration: 3/23/2005 Gp W FRASER CONSTRUCTION Co DEAN FRASER 71 TARRAGON CIR 5 COTU IT, MA 02635 _ < �b - 4b Update Address and return card.Mark reason for change. Address Ej Renewal Employment 0 Lost Card ---- " --�-77-- -pp- ' -- ------ - ---- ' ---- - - - -'--------- ----- --- ------------ ✓1ie 'C�am�movzcoea� a��ac/au�6 Board of Building Regulations and Standards Licensc or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR beforcl the expiration date. If found return to: RegistiaAio'n==112536 Board of Building Regulations and Standards _b-1— _� One Ashburton Place Rm 1301 T Expiration:=3/2312005 =' -'_�''- Boston,Ma.02109 jyt r_::ype=DBA FRASER CONSTfRUCTIQN o f� DEAN FRASER 71 TARRAGON CIR�' COTUIT,MA 02635 Administrator Not valid without signature � l a' e r aAssessor's map and lot number .... ........................ .............. THE ro�o Sewage Permit number �.,4.... .. J SEPTIC SYSTEM MUST STADLE, House number ........................................................................ INSTALLED IN COMPLIA M�a t639. \0� WITH TITLE 5 °'�0Nara. TOWN OF B A R MSITAVI;E CODE AND ;,-)VV'l REGULATIONS BUILDING - INSPECTOR APPLICATION FOR PERMIT TO ....1 V i .........t Li .I..x. G .(!v/v!r'.�N C!,Q. .,......, TYPE OF CONSTRUCTION Pk1...... .....!/.. f.:l�! ........................................................ .. ...........191Y TO THE INSPECTOR OF BUILDINGS: ..,� . a,r`-. M'►-�"""`.'.� "f""._ '�""� "' w'•'..,. """ ` . ' The undersigned hereby applies for a permit according to the following information: Location .........I 0 e........C°v..fV..l f.....!��. ^�!.�! V F'--- ....... ............ ................................................................................................. Proposed Use .....�. ./... 36 .�►`!..�'vC�. �F�P..o!:................................... ... .......... ZoningDistrict .............. ............................................Fire District .................................................................... Name of Owner ..r -PA.!v...... ................Address � .......v...7 f.t/..7`.. ........ ....................... Name of Builder ...KA..f.... Pd:/,t...�t�...... �.. Address .�f .....N..tQ/!:.!USI..n ?4 ....../]�. .......... Nameof Architect ..................................................................Address .................................................................................... �p ` �� Numberof Rooms ..................................................................Foundation .........�llV:.l!:l.'...................................................... Exierior ..... h �—/VU. .............................................Roofing .................................................................................... Floors .......... .....................................................................Interior ......^........................................................................ ..... Heating ..................................................................................Plumbing ...................�................................................................ Fireplace ..................................................................................Approximate Cost ....5 .®.o�!.U.a......: Definitive Plan Approved by Planning Board -----------_______-----------19 . Area ....... .. !.'............ Diagram of Lot and Building with Dimensions Fee .......... O............................ SUBJECT TO APPROVAL OF BOARD OF HEALTH 'T- 1 �I >1 s _ _ r f I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ....my....SPRINUE...CO,...1N.C................ YOVICSON, JOHN ` No 23067 Permit for Build Swimming..Pooh........................ . ........ ..... .. Location ...10 .... otu t..)3ay prj ge.. . . Cotuit ............................................................................... Owner ....ohn„YoviG. 037.............................. Type of Construction AIUMinum...&...Vinal ................................................................................. Plot ............................ Lot ................................ Permit Granted ............MaY...5.c.............19 81 Date of Inspection ....................................19 ;( Date Completed ............... ............:19 PERMIT REFUSED ............... . ......................... �-, Z .............. .y .. ..................................................... ...............7 .. ........................ . .................. h y' ..............!!n. R ............................................................... {L" Approved u:r.. ..................................................................:............ Assessor's map and lot number ..�......e ..::.:::�+.. ............ "ti. �`'�„ J Bpi TH E f 4rQ O Sewage Permit number % ..::.... o:.., .... ....f:n.<s.�.,,...,,..�... d Z 11AWSTADLE. i House number ........................................................................ ro MASS 4 i639• ♦� �0 YAY Or i TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .... iJ(` ........ b' X ';? .......... ......:)I,,�......... TYPE OF CONSTRUCTION .......... 1U,,!Yl/ !!J!��:.. .... .,I,/�,/.rt/, 1. ............. ...................................... ...................... ../5...............19. �. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ......... ....... t�..(.t. ,� .....Ir-�� ). .........'! ,(.!./..�/ -................................................... ......................... ... Proposed Use ..... .� �...�.�? 3 i .: U(l, �i.� ....��..�!/..L/� �..�y .......::�61. ............................:.............. ZoningDistrict ..................... ............................................Fire District ............................................................................... Name of Owner ..( U.l�.!<�!: r•.0 VL .S d ...............:Address ..�/),_it �i flii. ...fJ�N Y . l�f tJ�.:...... ........o................. . Name of Builder l�iKi ....5..{? '/a/ E'......t...�?...........Address .....1 �. .:... �1.y..,�lT/! .�i/ F'......�? .......... .............. Nameof Architect ..........................................:.......................Address .................................................................................... N Numberof Rooms .................................,................................Foundation .... ....<.::................................................................. ExteriorA iZ b7-.1.............................................Roofing ..................................................................................... Floors .....................................Interiot ................................................. ........................................................................... Heating ...................................................................................Plumbing .................................................................................. Fireplace ..:.'.........................................................................Approximate Cost . .U.OG�.U.�.... . .................................. Definitive Plan Approved by Planning Board -----------____----------------19_______. Area .......`ram. � ..��!"............ Diagram of Lot and Building with Dimensions Fee ! .r---- SUBJECT TO APPROVAL OF BOARD OF HEALTH r. �7 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ....RAY..:�p l�� ... nName .t�,.�....INCa..............: YOVICSON, J0 A=56-22 7 23067 Build Private No ................. Permit for ................................... ' Swimming Pool ............................................................................... Location 108 Cotuit .Bay Drive .................. ..... ......... Cotuit ............................................................................... Owner .John Yovics'on ................................................................ Type of Construction ,Aluminum & Vi.r1x ...................................................................:............ Plot ............................ Lot ................................ Permit Granted .....Ma..y. ....!....................19 81 Date of Inspection ..... ..............................19 Date Completed ........ .............................19 PERMIT EFUSED .................................. .......................... 19........... .......................?....... ....................... �. ............ ...... .� ........ . '...............: ............................................................................... r-� i Approved ..... .......................................... 19 s ............................................................................... ............................................................................... Assessor's map and lot numAeA ............................ A el THE $b3 SEPTIC SYSTEM MUST B o Sewage Permit number .. .. .......................:......................... e ,► INSTALLED IN COMPLIANC i BAHB9TAD E Hous number ......................... . d, WITH A'TICLE If STATE 9 NAM L .... ................................... SANITARY CODE AND TOWN aypY'a�e� - TOWN OF . RARNSTABLE -BUILDING :IH/SsPECTOR APPLICATION FOR PERMIT TO ........... a 1�5cc�c_- .......1...... M!L .......... .�................:.......:.. TYPE OF CONSTRUCTION .........:.....�-. ..:......................... ............................................... �k °TO THE INSPECTOR OF BUILDINGS: The u ersigned hereby plies for a per 't according to the following information: jj Location ...... ........ . ... ....... ................................... ..... ......................................�.,,. ProposedUse ........... .............................................................................................................................................................. Zoning District ........................ ..........................................Fire District ..... �l.v��.......... ........................................ Nameof Owner . ..... .........................................Address ...... .�.... ....... .................................. D JCtf Name of Builder .. .............OS-��: .............................Address ! ........... ....QO£2.. ....... .. �......................` ��4/ A.... .Name of Architect . .. .�� a �J.................Address ............................. ... ��?.......5........,......................... ......... ....................... Number of Rooms ...........Q.................................................Foundation ....�.b......... Q!�C............................................ Exterior ...... .1.�....� �. ...........................................Roofing ....... .. QA L'i—'............................................ Floors .... ... —`C�po. .... .....................................Interior �'........................................................ Heating Y ' T ........................Plumbing ... .V V.F�Z= Fireplace ................................................................................Approximate Cost ......... ................. .... Definitive Plan Approved by Planning Board -----------___—___-------19______. Area .....Q.Q 8 S' Diagram of Lot and Building with Dimensions 4/ ... Fee ................... ...................... SUBJ.JE,ST TO APPROVAL OF BOARD OF HEALTH i _Z p 0 O 49 I hereby agree to conform to all the Rules and Regulations T"eTlwn f arnstable regarding the above construction. Nam ........ ................. ....................................................... � � - ,-------------.------------.. � . ^ � Location .].ot..104—.l08..[atWi.t.-Bay. .'.Dr_— COtUit —.--...---.--.----.----_—'---- � Owner ........John..Yo.Y.icsi1n............................. - - - . Frame Type of Construction ---------'---- . .� , ^ ^ � -------------------------- ^~ ' Plot ............................ Lot ................................ . � .. � r � � � 79 � . ' Date of inspection" � ' ""'= C="p== — ' . � � . ' PERMIT REFUSED � ---------------------. lA � ............................,..............................'................'. � . - --~—~'~^^^------~^^—^--------' ' -' � ----~.~.------.—...—.---.~----.- � . .—.------~—...~.—.—..--~—.—..---' �— � Approved ' � � . ----------------. lA � � . ' ..`—'—.--.—.--------.--.—.—.—.-- ' � -------'----^---------'---^^'' � " Assessor's -map and lot number ............................................. IN QyoF toy Sewage Permit number ..!............64.j............................... !jam /S Z BARNSTABLE. i House number ..................•......1;.;-........./.................................... 9� NAM p 1639• 0 YPY fr• - TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ....... ...... '' - t ... 1.> •{ t `� ... . ............................ .... TYPE OF CONSTRUCTION - . ..................................................................................................................................... i t � ......�.-'.......Cr.'......................19... .:.. TO THE INSPECTOR OF BUILDINGS: The undersigllned//hereby applies for a permit according to the following information: ()Or t 1 r-''1. J 5 ll�" �-t t r �, \. 1'"_ Location ...... . �...,�.. ....... .................... .... ....... .. ...................................... _-- ProposedUse .......... ..t.^ '..:.......................................................................................................................................... ..... Zoning District ......................... ...........................................Fire District .... .............................................................................. �C�1 � C Name of Owner �....................................................................Address ..... ......................................................................... Nameof Builder ....................�............`.................................Address ............. ...�.`..R......................... ....................... Name of Architect 15�\.!. - ' ^ ................Address `� 'U�1`'..........�. ................... . ....................... ....... .... ..... v Number of Rooms � ..............................Foundation 1 r, Exterior ......�`�.1.� ....... !.' ...t:.'...........................................Roofing .... .. .. . . ..L..'................................................ - ..i o .. r' Floors ......................................:...............................................Intenor ...........,........................................................................ Heating ......1 .......... I.....................................................: Plumbing ..�:.. r'.K.E...t :...................................................... .... . ........ Fireplace ................ ................................................................Approximate Cost .........�4�, .. ............................................ C> -; ^ 1 , Definitive Plan Approved by Planning Board -----------__--__---------19-___-_. Area ........ ........................�F Diagram of Lot and Building with Dimensions Fee ' SUBJECT TO APPROVAL OF BOARD OF HEALTH ; ff 1 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ........'.....L-'..........LS....."'......2............................. `I Yovicsin, John AS�� No 2097.2..... Permit for ....1...story..Dw&ling ............................................................................... Location .....14t-404••••108••6©tt+i•t••8aY--DV^•s Cotuit ............................................................................... Owner ...Joha••Yovi.CS-in................................... ' Type of Construction Frdrtt ................................................ ............................. Plot ............ . ............ Lot ............................... f L Permit Granted ....dan/ a.ry..............a619 79 Date of Inspection ... .............. .................10 . Date Completed .... .............:.................19 f PERMIT RE USED i .. .......... .19 4 . ................... .�........................... 0 .................................. ....................................... I i ................................. ........................................ 1 Approved ................ ............................. 19 ..................... ........................................ .. 4 TOWN OF BARNSTABLE 20972 Permit No. _�—_ Building Inspector 568.00 bldr. c Cash $_ slur a 7 .Yl 80 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 John Yovicsin Address Cotuit lot #104 108 Cotuit Bay Drive, Cotuit Wiring Inspector _ Inspection date Q Plumbing Ihsp c Inspection date Gas Inspector Inspection date -7 Engineering Department Inspection date�6 C 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-wl� L _...�,... _ _ ` Bui ' g Inspector TOWN OF BARNSTABLE '20972 1. e _ Permit No. (' .. !" Building:Inspector Cash f079• ` _ dualOCCUPANCY PERMIT Bona r 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 John Yovicsin Address Cotuit lot #104 108 Cotuit Bay Drive, cotuit Wiring Inspector ` / `� s,F`=-- Inspection date Plumbing Inspector \► � Inspection date / Gas Inspectory � Inspection date Engineering Department Inspection date _75 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 ._ s 108 Cotuit Bay Drive Cotuit, Massachusetts 02635 May 9, 1979 Building Inspector Town of Barnstable Hyannis, Massachusetts 02601 Dear Sir: I am John M. Yovicsin, owner of the home being erected on Lot 104 Cotuit Bay Drive, Cotuit, Massachusetts. I will assume : complete responsibility for the completion of the following: the construction of the deck and stairs at the rear of the home, the installation of brick walks connecting to the front steps, installation of storm windows and doors; and the installingr_.of complete insulation in the lower level of the house. I assure you that this will be done promptly. Thanking you for your assistance, Sincerely y�^ ohn M. Yovi c in JMY/mvm N _ R ' 1 i S4-��a2- •.. !U;j 7-7) 516 sr-� �UJ� N �U1..1OAT'101..7` Qp'f • � � 1 eAv • i i r L. f4 Y E PI.bT r . ' cS yJ`' .:Y.. •t CAL { i C1=iZT1P'Y THAT T14C-- .�i 1�0 54khv1.1 p�bti.l REF'EiZ��.tI=E W W C-- F-A CCvVkPLleS WIT" THE SI D1= LI►JE `�d-- AWr-> SETB'ACIC {ZC-QUlIZeAAEWTS C); TI-if _ -To W►J 01= DATE 0- �A XTC�Z �. ►.fYE ii�Jc_ , cz1=G 15 n--Z 4 La ur�o Su ev p.Yo zS ' THIS QL-A1.•,1 14S 64OT SAsev vi,.► 4w Ae(ASS, tI'%i'9 L)AAst,j,r 4t'TNC. 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