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0266 COTUIT BAY DRIVE
;� _ �. ,. r. ., _�. � .-sue - - i i i' j I' I� Town of Barnstable Building —� Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be'Kept', BAR,\STABLE. � Posted Until Final Inspection Has Been Made, t63p. Where a Certificate of Occupancy is Required;such Building shall Not be Occupied until a Final Inspection.has been made. . Permit Permit No. B-20-2107 Applicant Name: lorejna kujofsa Approvals Date Issued: 08/06/2020 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 02/06/2021 Foundation: Location: 266 COTUIT BAY DRIVE,COTUIT Map/Lot: 056-029 Zoning District: RF Sheathing: Owner on Record: Lorejna Kujofsa Contractor Name: GEORGE GOURDOUKIS Framing: 1 Address: 266 cotuit bay dr Contractor License: CS-091003 2 cotuit, MA 02635 Est. Project Cost: $5,900.00. Chimney: Description: Siding and Roof Permit Fee: $35.00 Insulation: Project Review Req: Fee Paid: $35.00 i Final: Date: 8/6/2020 Plumbing/Gas 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. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: Service: 1.Foundation or Footing 2.Sheathing Inspection Rough:. 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 — All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT V� ��C Final: S �1ME l Town of Barnstable y2 o *Permit# • Expires 6 months from issue'dateMASS UARNSTABL4 Regulatory Services " Thomas F. Geiler,Director Fee TFO MA'S� Building Division Tom perry, Building Commissioner ��i 200.Main Street, Hyannis;MA 02501 X-PRESS R s"�MI 1''g� .c.e: 508.-862-4038 508-790-6230 JUL-1 8. 2005 .- EXPRESS PERMIT APPLICATION - RESIDENTNot Valid without Red X--Press Imprint BARiUSTABLB . reel Nurabcr y Address l U C 0 idential Value of Work_ Minimum fee of.$25.00.for work under$6000.00 's Name&Address �,� 1► w�('� ctor's Name Telephone Number a l--�-1 improvement Contractor License#(if applicable)_ I C) 3-i 1 uction Supervisor's License#(if applicable) rkman's Compensation Insurance Check one: 0 I am a sole proprietor ❑ I am the Homeowner. 'JglI:have Worker's Compensationlnsu=ce once Company Name man's Comp.Policy q`j IJ U 1 of Insurance Compliance Certificate must be on file. . it Request(check box) e-roof(stripping old shingles) All construction debris will be take Rc-roof(not stripping. Going over existing layers of roof) ❑ Re-side Replacement Windows. U Value (maximum.44) 'Whom required: Issuance of this permit dots not exempt compAance with other town department regulations,i.e.Historic,Conservation etc. ***Note: Property Owner must sign Property'Owner Letter of permission. Home Improvement Contractors License is required. iature )r=:cxpmtrg sc063004 y - �_ 1-22 Th e Common wealth of Massachusetts Department of Industrial Accidents Office of/nyest� — /gallons 600 Washington Street Boston, Mass. 02111 Workers' Compensation Insurance Affidavit A is n ortna Ion �leaWRNRR W e -�knamc: -tlocation: Q uu !r) city hone# ❑ I am a homeowner performing all work myself. ❑ I am a sole proprietor and have no one workME ing in any capacityI am an employer providing workers' compensation for my employees working on this job. -..� company name: �e�Cl� �'�— " 1AJ CA � address: AU U t city: &A A' o`ZCei SS phone# insurance co. /U 5 olic ft "t ❑ I am a sole proprietor, general contractor, or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: company name: s address y city insurance co. company name: address city hone th insurance co.- policy# Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to 51,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against site. I understand that a copy of this statement may be forwarded to the Office of investigations of the DIA for coverage verification. t do hereby cer ' under the pains and penalties of perjury that the information provided above is true and correct. Signature - Date Print name Phone# L4 2 — 1 /-_7`7 nfhcial use only do not write in this area to be completed by city or town official J- i city or town: /li permitccnsc# f F]IBuildingJ check if immediate response is required ❑Licensin ❑Scicctln ii contact person: ❑Ilcalth D phone tl; I-•10ther T, I Town of Barnstable Regulatory Services ysz� 2 Thomas F.Geller,Director KAM Building Division Tom Perry, Building Commissioner 200 Main Street, liyannis,MA 02601 www.town.barnstable.ma.us office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder I, Q 0 r ,as Owner of the subject property hereby authorize.���j \ A?CPS` CL�Lj N U �� to act on my behalf, in all natters relative to work authorized by this building permit application for, (Address of job) Sig 'afore of Owner . D e 0 goo r Print Na= O:FORM&OWNMERIMSION Ar-ORQnw CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/ 0 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION McShea Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 749 .Main Street, Suite#H ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Osterville, Ma. 02655 ' 508-420-9011 INSURERS AFFORDING COVERAGE INSURED Paul J Cazeault & Sons INSURERA: Lloyd's Roofing Inc. INSURERB: r 1031 Main Street INSURERC: Osterville, Ma 02655 INSURERD: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE MM/DD/YY DATE(MMIODfYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000 ,000 COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any one fire) $ CLAIMS MADE ®OCCUR MED EXP(Any one person) $ A LGL034776 04/30/04 04/30/05 PERSONAL&ADV INJURY $1 ,000 ,000 GENERAL AGGREGATE $ GE N'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PRO- JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY $ (Per person) HIRED AUTOS NON-OWNED AUTOS BODILY INJURY(Per (Per accident) PROPERTY DAMAGEF1 $ (Per accident) GARAGE LIABILITY AUTO ONCY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ ' DEDUCTIBLE RETENTION $ - WORKERS COMPENSATION AND it W AT - H- $ EMPLOYERS'LIABILITY V TORY LIMITS ER B 7PJUB-0095964A04 08/13/04 08/10/05 E.L.EACH ACCIDENT $ E.L.DISEASE-EA EMPLOYEE $9 OTHER E.L.DISEASE-POLICY LIMIT $.500 .000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL L DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. - AUTHORIZED RE Ty I . ACORD 25-S(7/97) JJ 0 ACORD CORPORATION 1988 Client#: 19989 2GAZEAULTPA ACORU. CERTIFICATE OF LIABILITY INSURANCE 51091M19D/YYYY) i OS/09/0'S • PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dowling&O' Neil Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Agency HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 222 West Main St. PO Box 1990 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Hyannis, MA 02601 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Western World Paul J. Cazeault&Sons Roofing, Inc. INSURER B: 1031 Main Street INSURER C: Osterville, MA 02655 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,'EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LTR NSR DATE MM/DD/YY DATE MM/DD LIMITS A GENERAL LIABILITY NPP925580 04/30/05 04/30/06 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY DAMAGES f RENTEDE. $50 000 CLAIMS MADE a OCCUR MED EXP(Any one person) $2 500 X BI/PD Ded:1,000 PERSONAL&ADV INJURY $1 OOO 000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $1 000 000 POLICY PRO- LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED 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/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WC STATU- H- OT EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER I i ! DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Operations performed by the named insured subject to policy conditions and exclusions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Paul J.Cazeault&Sons DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL in DAYS WRITTEN Roofing,lnc. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 1031 Main Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Osterville, MA 02655 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001/08)1 of 2 #M38166 LS1 0 ACORD CORPORATION 1988 f _ Board of Building Re ulatfons an tan a�s � g One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement'.Contractor Registration Registration: 103714 Type: Private Corporation Expiration: 7/9/2006 PAUL J. CAZEAULT & SONS, Paul Cazeault ` 1031 MAIN ST OSTERVILLE, MA 02658 Update Address and return card.Mark reason for chang El Address ElRenewal 0Employment Lost Card DP3•CAl 0 SOM-04/04-G101216 92. -VOOINIIO'![C1N:000IL O�✓I�CQ K/dC�b ... -.... _..... Board or Building Regulations and Standards —--- HOME IMPROVEMENT CONTRACTOR License or registration valid for indivilli.11 use otlh• Rogistration:. 103714 before the expiration date. Ir round return to: Expiration-'.719/2006 Board of Iuilding Regulaliuns:uul slaudards Uuc Ashburton Place Itn1 1301 "."Type::Private Corporation Ifuslwr, NIa.02108 PAUL J.CAZEAULT,&SONS,.INC' Paol Cazeault 1031 MAIN ST OSTERVILLE,MA 02658~ ✓/ �' Administrator I z 'po�iraieuiuuer /' `� u��* � Nlr BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 026325 Expires: 10/20/2005 Tr:no: 8603.0 Restricted: 00 PAUL J CAZEAULT 1031 MAIN ST ,� OSTERVILLE, MA 02655 Administrator 07-1 = =: Board of Ce Buildin ations == One Ashburton Pace, Rm 1301 Boston, Ma 02108-1618 License: CONSTRUCTION SUPERVISOR LICENSE Birthdate: 10/20/1959 Number: CS, 026325 Expires: 10/20/2005 : . . Restricted To: 00 .PAUL J CAZEAULT : 1031 MAIN ST OSTERVILLE, MA 02655 Tr.no 8603.0 Keep top for recei'lit and:channp of n.i.ir— . .:.:__.•_ TO Oate Time i WHI E YOU W E OUT M Of Phone Area Code Number Extension TELEPHONED PLEASE CALL CALLED TO SEE YOU WILL CALL AGAIN WANTS TO SEE YOU URGENT RETURNED YOUR CALL LOMessage oC�j IO l Operator AMPAD 23-021•Zoo SETS EFFICIENCY® 23-421•400 SETS CARBONLESS Bering Dept. (3rd floor) Map _ Parcel_0.2Permit# House# Date Issued -o2 7 92 Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) r-r 117—73 /Fee `�c� Conservation Office(4th floor)(8:30- 9:30/1:00-2:00) i-} Planning Dept.(1st floor/School Admin. Bldg.) oFt"E►p Definitive Plan Approved by Planning Board 19 ;� . -•,� MASS. p TOWN OF BARNSTABLE Building Permit Application _ JZ� e 1 Projec Street Address o �� � ��t,/ Village, �c� Owner ,0 p A C Address Telephone 2 0 '7 Permit Request a a ,f-e6!�1ja,J 61"00'0 "-e- -ft Ooe First Floor b�,.7 8 Qj �r square feet Second Floor _ l/�t (i square feet Construction Type �ap d Estimated Project Cost $ "le 4 000 Zoning District Flood Plain Water Protection Lot Size ZL/,• —6 1 56 l Grandfathered ❑Yes ❑No Dwelling Type: Single Family Or Two Family ❑ Multi-Family(#units) Age of Existing Structure _ / Historic House ❑Yes Wo On Old King's Highway ❑Yes JT2No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) ,f-6O 10 Basement Unfinished Area(sq.ft) 17,40 Number of Baths: Full: Existing Z- New © Half: Existing / New No.of Bedrooms: Existing New Total Room Count(not including baths): Existing New �_First Floor Room Count Heat Type and Fuel: ❑Gas .Oil ❑Electric ❑Other Central Air ❑Yes ;ZNo Fireplaces: Existing /New Existing wood/coal stove ❑Yes ❑No •Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) d6 Attached(size) Z )C Z_ ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name�gti,V-Zd 7" ,e Telephone Number rd dl'— 3 9 SF— 1 z 7 Address r License# efo6P $ y O Z( 7 Home Improvement Contractor# I Worker's Compensation# 3 f/ P(, 7l NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 1ee4l14&� SIGNATUR L�=�G:�C.G DATE Ci<� Z 7 2'7 BUILDING PERMIT D , END F'O&4HE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. P DATE ISSUED a.F MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME ' l/�i�i Qr*"o INSULATION FIREPLACE 7 ELECTRICAL: ROUGH FINAL ' PLUMBING: ROUGH FINAL GAS: ROUGH FINAL � > FINAL;BUILDING � DATE CLOSED OUT ASSOCIATION PLAN NO. Itu.C. t UMMUN WEALTIi Ur' MAbbAU!USKiTS Board of Building Regulations and Standards .r� Transaction No. One Ashburton Plate-Room 1301 Boston,Massachusetts 02108 Regisuatlon No. = Appllcation for Registration as a Eve Date Home Improvement Contractor or Subcontractor MGL Chapter 142A, CMR 780-6 Expiration Date FOR OFFICE USE ONLY ! Date L Name ./U,y 'e /� (/ �t!/e, Print the name of the individual or business applying for theregistration(not both) 2 Mailing Address��7 N/l.6 ! /C o l:,K /�••C• A* 21, 'P.sLsb�LL Area Code dt Telephone Number I City i /L d 0 o rt.f Stated Zino 7Lr 4. Street Address(if different) Print street and Number(P.O.Besot not acceptable)- City State Tap S. Applicant type: ❑ Individual J DBA ❑ Partnership ❑Trust ❑ Private Corporation ❑ Public Corporation (See instructions on back regarding enclosing a city or town registration under the DBA or"fictitious name"law-MGL c 110,ss S A 6) 6. or Federal M Number W Jam/ (see instructions) // 7. Number o�ployees 0 8. Individual responsible for Home Improvement Contra t'.[. />G DO w*l d— I 1 9. Trtle of individual responsible for Home Improvement Contracts` e2w'v t A. 1/¢/fG/Lt a/ woe C/ 4104,99 � 10. Does the applicant or responsible individual hold any other construction related state,city,town licenses or registrations? ❑ It yes,complete the table below. Use additional paper if necessary. Yes No Type license or registration Issued By I I or, Expiration Name of License Holder registrado6 number Date a'ou? k.0%j Yes No regisuation. B.- Registration fee enclosed:S Guaranty Fund fee enclosed:S Ole) , Include two separate oatified dumb or money Orders-one matted"Registration Fed;';one matted"Guaranty Fund•. ALL APPLICANTS MUST INCLUDE A GUARANTY FUND FEE EVEN IF EXEMPT FROM THE REGISTRATION FEE.See instructions on back for amount of fees Make all certified chmb or money orders payable to'CommonwesM of MaNad msetts" Pursuant to Massachusetts Liws Chapter 62C section 49A,I cer4fty'under the.peml"W Of Petlnsy that It to my best losowl bolter,hove filed all state tax returns and paid all state taxes ender law. D1c ct�ca/ iv c Signature of apOdnt o applicant's representative Tide held with applicant A false answer to any question in this application constitutes grounds for suspension or revocation of the applicant's registration. J�� -� s 74401 ' '=� -D.T_.`. I El Ct 714_ ' 1 TC),F T-1BUIR PLACE , 1 3C-' , BC�STn'�I MAP,?1G B-161� CONS TP;1CT1 ;'UPFR'.'TSc1R 1.10ENS" AUG L � ►99b NL.ililbPr: ecStric ted; Tolt 00 DONALD J TUL,LTE De tack bottom , __f(DId sign on --- i57 j..THTmF L'(-fi_ l?cIC}i 11 d i ??�Ila 1CF.^.cP ,�3rC'i. A Cv'=I �'._.: 1 1 11 iCr�ej+ top for rec'e_��t and .change i .......C C .................. ........ .. • ........................ ............................... .....................ISSUE DATE (MMIDDNY) ORD ................. ACH I ......................... .................................. .................... /21/1997 10 .......... ......................................... PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE Rogers & Gray Insurance DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE 434 Route 134 POLICIES BELOW. ....................................................................................................................................................................... South Dennis, MA 02660 COMPANIES AFFORDING COVERAGE (508) 398-7980 FAX 394-1393 COMPANYLETTER A Maryland Casualty Ins. Co. ....................................................................................................................................................................... COMPANY .................................................................................................................................... LETTER B Granite State Ins. Company INSURED ....................................................................................................................................................................... Don Tullie COMPANY C DBAAltered Woodworks ....................................................................................................................................................................... 20 Atlantic Avenue COMPANY LETTER D S. Yarmouth, MA 02664 ....................................................................................................................................................................... COMPANY E LETTER . .... ...... ......... .. ......x...... ............. ,:::: ...... ...... ....... ...... . . ................... .. . ........... ........ ..... ;............... .................... . . .......... ........... ....... ...... .............. . .............::::,.... ......... . .... . ....... ........ ...... .......... ......... ...... ..... ......... ........ X...... ...... ....... ............... ........... . .. ..... ......... .......... .......... . .......... ...... ........ ....... . ..... . ..... . ........... .......... THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD:::::................... ERIOD 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. .......................................................................................................................................................................................................................................................................................................... CO: POLICY EFFECTIVE POLICY EXPIRATION TYPE OF INSURANCE POLICY NUMBER Lam LTR: DATE (MMIODNY) DATE(MMIDDn ...................... .I...................................................................................................... E N'E I* IA-B-M- GENERAL AGGREGATE 2 000000 ...........................................................r...............,............ X COMMERCIAL GENERAL LIABILITY SCP31GM75 PRODucrs-compiop Aw. :s 2,000,000 .............................................................................................................. -1-: CLAIMS MADE OCCUR. ERS s ONAL&ADV.INJURY ........ l.r..0 O.f..000 ........ ........... ........ Q/97 07 10/98..P .. .... ...0 OWNER'S&CONTRACTORS PROT. EACH OCCURRENCE .......... ................................... s 1,000,000............ ....................................... FIRE DAMAGE(Any one fire) 300 000 .......................F..................... ....................................................... .................................................I.. MED.EXPENSE(Any one person)::$ 10,000 .................................................................................................................... ............................. .............................................................................................. AUTOMOBILE LABILITY COMBINED SINGLE 0: LIMIT :$ ANY AUTO ............................................ ALL OWNED AUTOS BODILY INJURY .......... SCHEDULED AUTOS (Per person) .................. .................... HIRED AUTOS BODILY INJURY :$ (Per accidenQ NON-OWNED AUTOS ........................................... GARAGE LIABILITY .......... : :PROPERTY DAMAGE $ ........................................................................................................................................................................................................................................................................................................ EXCESS LABILITY :EACH OCCURRENCE :$ .......... UMBRELLA FORM AGGREGATE ;$ .................. OTHER THAN UMBRELLA FORM ................ . ........... ....................... .................................. ................................................................................................................................... ....................... ........—......... ............................................................ .................. ......... ......................................... STATUTORY LIMITS ..................... WORKER'S COMPENSATION .................................................................................................................... :$ 100 B WC351 60 71 b8/21/97 08/21/98::.EAcH ACCIDENT AND ........... j..000 ............................................... ........... ........... DISEASE-... POLICY LIMIT :$ 500,000 DISEASE-EACH EMPLOYEE EMPLOYERS'LIABUTY ............... ..............................3...................................... 100r000 ................................................................................................................................................................................................................................................................................................ :OTHER ......................................................................................................................................................................................................................................................................................................... DESCRIPTION OF OPERATIONSWCATIONSInEMICLESfSPECIAL ITEMS .................................... ..... . .... ..... ... ....... ........... .. .......... . ........... ........... ....... ........ ............ ............ ............... .............. ................................. . ......... ........... ..................... ...................... .............................. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE Town of Barnstable LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR Attn: Ralph Crossen UABILIT�%Jr V PON THE CRMPANY, g AGENTS OR REPRESENTATIVES. �n mimw qpnC%i 367 Main Street :':'-"-"AUTHORIZED REM Hyannis MA 02601 .3. .... ....... ...... ".*:0' The Town of Barnstable VAMOMBIZ NAM 1"9. �' Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 . Office: 508-790-6227 mph Crossen Fax: 508-790-6230 Building Commissio; For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more. than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. Type of Work:4/� �r /l��l �170.4) Est.Cost 2-6 o o o Address of Work: ,2 y�� e �" ��-t e Owner's Name e; y 1/o PV 44 o -0 C Date of Permit Application: 2-7 s P7 I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME MMOVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a perae4nt4rac�tor agent of the own 7 -2 8 9 6-- MIX Name Registration No.Date - OR T111• Cottt»tottlt•calth oj:ltassachasctts 712= Dcparttttctti of ludustrial Accidents 9=9 Of I,ffV9Sff9ZII8,7S • �_Ii- 600 f!•u.vhitt,tuts Street ��::;.,:'�• Bastott. ,1laas. 03111 Workers' Compensation Insurance Affidavit AliPlicint in ftirntation - _ Plc�se PRINT'leb' il'v'"T"�'^—~'—�� '�—V— MMC Incition• (tea -/4r I' Cin �Ij/r f / ��� Zbt nhnnc [I 1 am a homeowner perfortnin� all work myself. I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees`working on this job. ~ cmmL•rny name! 4 L /�'/1 ZP o del 4'�O^'t l ttirlrcet D2C, 477Z'#/V'_z:1C '091-f✓if city /0^, _Y/4/t lrre at�..t "'r O L t:' G y nhnnc tt• �o r' — 3 f' �f—.Y= 7O incornricc rn. 9/t/#JV!`2C Ale /'O&J Co- nolict•!! &0- 7• E- I am a sole proprietor. general contractor. or homeowner(circle otte) and have hired the contractors listed below who hay the %ollowin_ workers' compensation polices: comn•trn• nntnc• •tdrirrcc• circ•• nhnnc+�• in-mr^nrr rn nniic� emmn.inv nnrnr• �ddrecc• rite•• nhnnc a• incur-inre cn nniic� Attach additionalry sheet if neCe3sa -^+:".:„y..:.-• .+.._L ......�. •...._., .,.�...... ,���+: `LLB...4.�I�..�.�.�...•r .. Fariurc to secure cup crat;c:ts required under Section ZSA of AIGL in can lead to the imposition of criminal penalties of a line up to S1S00.00 andrur unc i cars imprisonment:ts s.•eil as civil penalties in the form of a STOP lt•ORK ORDER and a fine of 5100.00 a day against me. I understand that a copy of Ibis statement ma% be furrn-arded to the Office of Inve3tic2tions of the DIA for coverage It•erification. /do berehr ce ' t r rrlrr t/te pant pettallies of perjuq that the information prodded above is true and correct. c4,- r'7 Print natn / o AJ hone# e�0�3�1� 9L 7 a w _ - officiai uac unly do not write in this area to be completed by city or town ofrcial city or town permitilicense 0 riguilding Department t ❑Licensing Board t selectmen s Ufficc t ❑check if immediate respunse is required ❑ ❑ticaith Department Contact person: phone ii; r,Uther �� t information and Instructions MassaclruSCUS General Ll%%,s chapter 152 section 25 requires all emplovers to provide workcm* ctmtpensation for :: employees. As quoted f1rom the an cnrploree is defined as every person in the scrVicc of anotlier under sn\- Contract of hire, express or implied. oral or written. An etnph rer is defined as an individual. partnership. association. corporation ortither legal entity. or am• t%•ei or in, the foregoing cnga�_ed in a joint enterprise, and including the le�_al represcniatives of a decr:' d emplover. or the rccciver or trustee of an individual . partnership. association,' r..othertilegaI entity;employing;empioyecs. Ho«'evcr moiler of a dwelling house having not more than three apartments and who resides therein. or the occupant of the d\\cllin�_ house of another who employs persons to do maintenance construction or fepair'work'an'such dwelling or oil the __rounds or building appurtenant thereto shall not because of such employment be deemed to be an empio- MGL clurpter 152 section 25 also states that e'"n..state or local licensing agency shall withhold the issuance or r:r��:il.ofa.licen'sc;or permihto operate a business or to construct buildings in the commons calth for snv icant who lies not produced acceptable evidence of compliance witli the insurance coverage required. Ad.L; ionally. neither the commonwealth nor any of its politicnl'subdivisions shall\enter.into,any con_traCt for the perforum:.::ce of.public work until acceptable evidence ofcompliance with the insurance requirements of this chatter been presented to the contraciiita authority. Applicants Please fill in tite Nvorkers' compensation affidavit completely, by checking the box that applies to;your situation at:c supplying company names. address and phone numbers as all affidavits may be submitted to the Department of Industrial kccidents for confirmation of insurance coverage. Also be sure to sign and date the atdavit. The ".iavit should be returned to the city or town that the application for the permit or license is being requested. n die Department of Industrial Accidents. Should you have any questions regarding the "taw" or if you are require :o obtain a N\•orkers' compensation policy. please call the Department at the number listed below. City or rown.s Please he sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom . the at=�davit for you to fill out in the event the Office of Investigations has to contact you regarding tite applicant. P!e be _. _ to fill in the permit/license number which will be used as a reference number. Tire at may be returnee -ae Department by mail or FAX unless other arrangements have been made. Tlie Office of investi and oils would like to thank you in advance for you cooperation and should you have any questic please do not hesitate to _ive us a call. ....y.-.��.. . A..._—,«:.yr.,.. i�••re�r.�.w-1��... «�T Tw.w��—�.. ..•.rn...... _ _�� .. ..7.• .r:L The ae6artmenrs address:telephone and fax number. , The Commonwealth Of Massachusetts Department of Industrial Accidents A=i ' _•. Office of Investigations 600 «'ashington Street Boston, Ma. 02111 fax #: (617) 727-7749 phone 1: (61 7) 727-4900 exr. 406. 409 or I N� V �* 4 1 a Ahk o f 1 aL v oo� ii ono • 1ASO �w ono a "r_ + h n • w 00 o w' m $ S C,�4�� • � v � 10 • 4 In °o Q 9r CA • In m O h 7.• ROao w ' � a h • 4'i w C00 o Nolas H139vzII3 'IS V6LLC9S90ST %V3 TV=VT 31U L6/ZO/60 7D s �o L � 0 J it � - D , moo 91 - A u R z 0 u ls 2� 10 J ® � V i 0 C ; 0 CO .0 ETR TILE EiR 1 e W `N <D ; ! .D 'r I MN 'N 1 tD I I >rtN rip t� -00 f ? NTS MOVE '� 11 BAR DCGWOCO Z -c• ;j X STACK PATIO BLOCKS M 4BARGAS LOG r. rL wcue u' ALIGN DOORS POCKET 4y ` a� ON T:415 LINE wi FULL VISION 1j- -RELOG EXIST W! OF 51GHT —�- - . - - - - - - - - - . GLA99— - -. -. - - . - . �{J - SLIDING DOOR NI ETR G25 G25 GIs Gt5 G15 G15 0 - - - - - c Li I _ LI ,NIG NE LP LINE FOR B90 I 1 z kp PROPOSED FLOOR PLAN N N '' —. —. — . _ . — . — . � . — . — . _ O i REAR PROPERTI' LINE rrr rr-r R.A.D. Jones Archhects� Inc. Joe NO.: DRAWING f1TLE: DATE: sraore7 PROPOSED SCALE: IM'=1'4r r —Efght Hundred Hingham Street 6-0 cda G Rond, Massachusetts 02370 FLOOR PLAN 0 . i TEL: B17-878-1228 FAX 817-878-1385 A ■O i N ; 1 i m � m a PROVIDE CONTINUOUS RIDGE VENT p �— — -- — SHINGLES TO ATGH EX15T / OVER 15ss ROOFING FELTS ROOF 5441!ATPING STYROFOA^^ CHANNELS d N - r FOIL FACE R36 BATT 'NSULATION lx3 016" O.C.- Fl 1/2" SLUEBOARD -- �— CONT. SOFFIT VENT WZ O t PLASTER SKIMCOAT 1/2" PLYWOOD ��— SHEATHING CLAPBOARD t SHINGLE TO ^"ATCH EXIST. . 2x4 STUD5 • 161.0.C. -- _____ 1/2" BLUEBOARD t _ PLASTER SKIMCOAT 3 1/2" FOIL FACE R-II BATT iNS'JLATON PTO PINE TRIM W MATCH EXISTING PRIM — V BLOCKING m 12" x 5/16" GLUE DOWN PT2x4 SILL WIT 41 DRAFT SEAL 0 HARDWOOD FLOOR 1/2"0x12"x2" HOOK ANC;4OR Z> 4" LONG SLAB BOLT 48" O.C. © ON GRADE _ 2" RIGID INSULATION 24" HOR. 1 24:' VERT. BREAK TO SLAB ..Lov 10"x 3'-8' CONT. CONCRETE WAL_ WITH 2ss5 TtB D -- 24"x12" T H'CK CONTINUOUS CONCRETE FOOTING m m . • tC . D(IST I F= CA41MNEY FI CCMT RIDGE I ' ( � QN BEYOND VENT is " 000.,00000,,000',', EX15T BLDG L N EW ROOF cr CU5TOM GLA55 T-1 ENT C A ENT \cI5 c 15/,I CID u ON c wobb r-OLUMNE -j _ _ 157 1,-0JSE LIMIT OF EX -r6dr. J I i Lk ANDERSEN FRENCH MATCH EXIST FIN GRADE U: 1-4000 SLIDER 231-0SIDING VARIES 11 tsr ADDITION c JOB NO.: DRAWNG Tff DATE: 913=7 rrr R.A.D. Jones Archtteeft, Inc. rrr EXTERIOR SCALE: i/4'=I'-V rrr rwit Hundrw mnghmm sameRcoicidi". Ma 02370 ELEVATION C C ,0 TEL $17-878-1228 FAX: 6`117-878-1385 A5,00----j �-j I r A GI �.c Pkw too( ti' • .v Ajl 7s' iYP,4� IF 4 bz� g3 •� o IK :s,aZ ,47\. % a 0 cry �p n 0 �0047 o 0 o: _� Q i .• �7 ba. r o 0 b00® HO.L3S HZ39vziI3 is 66LLUS80Si %B3 Z6=6i 311U L6tZ0.760 ' �•�—/ �• > to Assesso s map and lot num ......�.CU....r:.c�.. .. o�Gr✓ �`�A4—" c�-/J'- �7 SEPTIC SYSTEM MUST BE 7 INSTALLED IN CCMPLIANCP' Sewage Permit number...................?�.............................. W�.1 SANITARY CO,,�E T"ET TOWN OF. BARNSTABLE e Z EA"STeDLE, i b Y BUILDING INSPECTOR O�DRa' APPLICATIONFOR PERMIT TO ......... ...................................................................................................... TYPE OF CONSTRUCTION FgAt4 (F . ...................19 7�.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: � S ........Location ......�.....�. ......... "�S ..........o...f..b... .�............. Proposed Use �1!1 ..........................o....................................................................... ............... ..................................................... Zoning District ....................J�r............-.................................Fire District ........Li.�i..1....................................................... Name of Owner "EqO f V. I`��V�E 18 O�C�.... WA\1Lf4A)D 4 -S ......................................................................Address ................................. y.......... ........ ..j..... ..... - 11 ..... Name of Builder ... ....... C,.......................Address .................................................................................... Name of Architect ...1N. ...... U.c��..................Address .................................................................................... t Number of Rooms Foundation �.ON... . ...........................................pav es ................................................................: .................. .... ..�....1. �..- , �- Exterior l- ...Roofing 1.��:�-.! ................................................... ................. .................................................... Floors 1 L�f(.1�00 ..........................................................Interior ... Heating �aT 4 .....—......................Plumbing BAnd'S ......-.� .........2........ Q..............................:........................ Fireplace ........�I�C... f3l2t. l�........................................Approximate Cost .............�.`'�. �.... a. 44�7�?. ........... Definitive Plan Approved by Planning Board __________________-----------19_______. Area ....... . . a q!* b**' Diagram of Lot and Building with Dimensions Fee ... . .. .................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name . .......... .............................................................. � r A Bruce, Hj' >�y P. � Na ...VAIL. irmit for two ............ dwellin Locatidfi'...x.R ..t.9Z..C4.tuit..BB..JL.. t .........................CO WAX..................... .............. Owner .F1eA><y... e...Bruce......... ....................... Type of Construction .. X.0. .............................. ...................................... ..... 'Plot ............................ Lot .�92........................ c Permit Granted ......Mar h..15.................19 77 Date of Inspection . .' LO` ..�!f... -0...... �1�9 Date Completed ... ..3........ ................19 4 a . PERMIT REFUSED ................................................................ 19 y ...................................................... .................. t - a • / • , `a• ................. ......................................................... �� • • ° ` r Approved ,,,, 19 t , ................................................................................. Assessor's map and lot number ........................................... Sewage Permit number .......................................................... e�Qy°F?"Er TOWN OF BARNSTABLE Z BARNS LE. i "b 9 lb G BUILDING INSPECTOR MPY a' APPLICATION FOR PERMIT TO ...........::.:.... TYPEOF CONSTRUCTION ....................... . .......................................................................................................... ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ................ :.....:.. :........ :.. :....................: Proposed Use ................. ............................................................................................................................................................. Zoning District Fire District .......................... ........:....................................................... a 2 Name of Owner .. ....Address .............................. ............................ ..................... �.: i ................... ......... ................ "G ..........................Name of Builder Address Name of Architect .................. .. ...................Address Number of Rooms ......... Foundation ............................................ Exterior .........:.....:....:....:..........................................................Roofing .................°:.... .`.:::...................................................... Floors Interior Heating ........................................................ ......................Plumbing ..........:......................................................................... i Fireplace ............................ ::.... ...........................................Approximate Cost ... ......................... ;`%........... Definitive Plan Approved by Planning Board ________________________________19________ . Area "' Diagram of Lot and Building with Dimensions Fee ................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH i I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. J Name ..... .. ..... ......... ....... ... ........ ............................. I Bruce, Henry P. 56-29 No .19.011...... Permit for ...two„st9ry............ .... , :sing.Le..fami.ly .d'W91.14M9.......................... Location .#L,at..92..CRtA.jt..$.4Ly...Shores ............COW Lt.......... ..................................... OwnerUce.............::................... Type of ConstructionAram............................:. ............................................... Plot .................... ....... Lot ..... .................... P Marc ermit Granted h 1 a, 1 q 77 Date of Inspection ................ ...................19 Date Completed 19 ............... PERMIT-REFUSED .. ........./.�?............ 19 . .............. . . ................. _ .. ............ .. .... Approved .......... ................................. 19 ........ ........ ........ . . .......... ............................................................................... TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map `J Parcel T01` P! (3F (3ARlS'jfLHealth Division Aft �� C Date Ids edConservation Divisio S', 3��a 4 2 Ate 10 Fee �� a� Tax Collector �D L� ,"^E��°�,�. ��0 du Treasurer ���r LIANcE. Planning Dept.r' t=�0e Ti0DE ALE 5 AND Date Definitive Plan Approved by Planning Board Historic'-.OKH Preservation/Hyannis Project Street Address _ Village Ca �u\� Owner SoV\C \ Address Telephone 'L—) 0 -7 O-7 Permit Request��oS� Square feet: 1st floor��existiin�ng proposed a 1 to 2nd floor: existing proposed Total newaJ (.o Valuation aC) Zoning District'� Flood Plain Groundwater Overlay Construction Type S Pt, Lot Size �'� ; 5O ( Grandfatliered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family.4 Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes --&No On Old King's Highway: ❑Yes -fgNo Basement Type: O Full ❑Crawl ❑Walkout Cl Other V�JA 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: Cl Gas ❑Oil O Electric ❑Other N I A Central Air: ❑Yes A No Fireplaces: Existing New Existing wood/coal stove: ❑Yes _UNo Detached garage:❑existing ❑new size Pool:O existing ❑new size Barn:O existing O new size I Attached garage:❑existing ❑new size Shed:Cl existing ❑new size Other: j Zoning Board of Appeals Authorization O Appeal# Recorded Cl Commercial O Yes O No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name F-\(lC� �tJ`� CA O(1� Telephone Number Address -4\ ��oS��Y\ �� S� . License# -7 19 Home Improvement Contractor# 1 •�J Worker's Compensation`# Q C Eq_ 7__�Icf 3S ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO -z SIGNATURE DATE 7z, FOR OFFICIAL USE ONLY PERMIT NO. 51, 11,10 DATE ISSUED MAP/PARCEL NO. ADDRESS ° VILLAGE OWNER ° i, DATE OF INSPECTION: v n/� FOUNDATION FRAME INSULATION. FIREPLACE f ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING ;�• I " DATE;CLOSED OUT ASSOCIATION PLAN NO. - f � r - s a r U3 L ut 0o K s a. 3 z�B� i'/ Pit . - Gad 24 ss�g z 00 3 o a If � N m ° 4 O m (� i f?Q)S a ae N i i II (lr l l iC-n c o I�PJI Xim 1 I TI1 I eQ C 90 N S N p q so- ts OLO � CD,cc� z �yO v o��a no � �?o .n a a o< C n C c C a o Z � ffJJ`O N N y 1 !- I`y i, ! - O' - _ 77 x ^ O - _ �•-!-iC 1:j '.7-� !�; .�-..V'""-- •)`''Vim' c u-. __ _' : - -'F°-,i��-i0 -.�' '_:;• _ 2 \ - C i - E =i^: Q V tT i - Cl. = ! 1:_; ,;—r !`�!! ! �' ;;�G:= G> •) ll _='°;. _ -I i a ;iit'Y tom:' i�l ! iii zl III t i i, - _ -y of i _ _) !(; iI' _>til = I r :L ! III - I•• = iO l{ _r.' '- Qt RF . , iY: ! = _- .z). I 1:7'- -I{ i ` r iG�l_IV it-�1 i�i 1'di�'= �i -"; �i,�6 :rs !li •�^- li ..,! __ __ i_- ('_( •{!��-j --4I1 ;�,.fib:::.�.:._; !{!ii is'. �- - ���r�1i}=7.'• f (-�, i,���c_�i--_!-! •1' t --,^.:'i�'{: i!' ci i �£.,��iSa� li' � � • ''��''="5%;,..uy �� .i^,3�.�i�.•T° ..; •s �,�..� - i a���-iii• \, i _" — ! `,��,,' i Ate,_ I! •i(� ili Q D ) j G ' ( _ - -_ ! _ •�':; ai iii Ali if 1 if IQ A. iiiij Or 4-1 "l.lir: / `�� is 3'•:c�:v � �`j. �: �` � ^'.>"..:�( _ v I EXISTING 3'POOR FROM HOUSE PROP05EP NEW PECK 12'xl8'(APPROX) I,2XIO Pf FRAME @ 16"O.C. 2,I E 96ER 6OLTEP I/2"W'LAG516"O.C. 10' II" 5.J015f W6ER5 @ LEPGER II'-II" 4.TRIPLE 2XIO Pf ENP 6EAM(HIP12%) 5.PL%51PE J015f5 6.(4) ITO X 48"PEEP FIGS W/ANCHORS 7.5/4"f&G PLY OVERLAY 1 8.6X6 P055 PROPO5EP 5 5EA50N PORCH 12'X 16'(APPROX) 5fUP10 STYLE ENCL05URE 3"EP5+ H ROOF 5Y5fEM (12'SPAN) i Fl- (2) NEW 6'POORS FROM PORCH (5) NEW 6'19006 FROM PORCH -11 I—III=11� I�11M11=11 II-111-11�1 =I�r�1—In —1�1=11r I — I= — _ _ 1 L 11 I_ rll 11-11 I I I�—�1 I I I I I I I�I4 i I�I I I f=1I1=111=1I EI I I-jj�l I I—I I�I I�I I�I I L, f }�11=nr i=ll s 111=1�I r=1 1=1 n—n r CI n=u l�n ll11ll=1 —�—L al�Jl�i��"' I I ,�r 1�11 IIF=11�11�111 Hlll I—lp C • Proka: Scale:1/8"-1'-0" Prawirq: e r ivi-hg' moov� pF51pFNCF P/4t O ROO M S 266 COMIT 13AY PM A—I 100 Otis Street Nothtxxo,MA 01532 COfUlf,MA 02635 Phone(508)393 0400 Fax(508)393 0340 Pate:V 4/02 5heet I of I 1 � , i . The Town. of Barnstable j` Regulatory Services ' Thomas F. Geiler, Director Building Division Peter F. DiMatteo, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no.- Date- AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing.at least one but not more'than four dwelling units or to.structures which are adjacent to such residence or building be done by registered contractors,with-certain exceptions,along with other requirements. /7 Type.ofWork: S�'b aQ StAK) a-�VY� Estimated Cost LJ 100 C Address of Work: LA -T- r V Owner's Name: i't !V M 60 IC Date of Application: I hereby certify that: Registration is not required for the following reason(s): E]Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY UNDER M c.142A. SIGNED UNDER PENALT OF I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR q:forms:Affidav :rev-122001 The Commonwealth of Massachusetts r _ Department of Industrial Accidents 019�Ice ollosestigat/gas _ — 600 Washington Street Boston,Mass. .02111 — Workers' Corn ensation Insurance Af'davit name location 26�, rZk V� _ city phone# S �ZO 070 �. ❑ I am a homeowner performing all work myself. I am a sole n, or and have no one woilan in achy an em 1? er roviding workers compensation for my employees working on this job. '•{\•.. .tom ...... ............. r.............. ,,r..:.::4:.:.....t•:::::::.:::::::::. ,.:................:r r. .....v.. ..r:..,...... ........ ............ .:.,...... ::...:...... a rldr hop ��...... , .n i {•4i}y4F!y!'•'}:•:i}}:j!�;::;5::•!::Y:.`:::r::::.':{4:}i?:i:Tii:[:Ci<iiii:v:'vii iii:.-'rti•}i-!:. •:4;{;•.,v.;.v.{:4�}'<i$:"n+;ii?:>.i;i`:jisi:::n:'rS>}:?.{}r:{{:•.;:.v>}y:,.v::::{.v:•::y5:.j•(••::i r:.j•:< 111 ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have efollowing workers' compensation olices: foll camp ........ ....................: ......,.....,.:::::::-:::.:::::.::.::::::::::.,.....,............................:.....v::........:.,...V...,:.�.,..:.?:.};,.}}:.},...?:!.:...... ii%':^:?';:;$::'isi':i:.`ri:;{;:i;}:�:: ::C�}}}?}}:::{-}:hn}:;.}::i:>v!!C::Y.•}:C4:�:•?}i}i:�:�•}:•???}�•}:•5:•iii}:•:C4i?:-:•}?:•5}}?i$:-i::r rr}i}.:...v!•::::- ...vr::v::........:::f:;•}:w:w:::::.v:}:v:.. ;., .::v :}}}}::::'Y.:}}i}:..4!•:}Si}:.....:......n:.:.v:... ..:...... .......:................ ...v:•.v::::....' v:v: .,..vw:?.;.nv:r::n...::.......v::.....r.vnv...y:':::v:•:.v•..v:}:i'65:•::.4}}:i;:....::::C.... ....... •gym ><> s< €••`: :E:..... ....:............. . �;•Si:;•.�}:•ii:•i:-iri}i:;•:4:!-ra::::.•'�:�::::-:;::::;;:::?::::<:Y:::::o::i.;'.:;{{{.}:;;•}}:•>:4:-:.r.r.�..:.;.;�::::=;:;:::%:::::::3: ::?>5::::::::;5;:.r:`::::•':<±:::::�::::'?:2{:'::;::'•';:�;:t`t::;%:.........}.}?:•:;:::�}:-}••:;:•:;•:;:;•:;;;{.>»:•x;"-:4:«•}:.?:;.:;.,;5<•`:::::.:%:;:is.::::'{;`::%:::�:::�:-:•>:-::�: ........ ..... v................... ....n.... ................... ..................::..:. ...... .rr:x:-.v:::::w:nu:w::::w::::•..r..,r::...v...::•.v v: .v'4:•S.h......... ..... n....n.... ......................... .....+,.......,r,-.vx::::::::{• ...-.-................r.v......... {.::::.,......n......n...........,:5::::::v.,w:.........::.�..t:{.-.\wnv::ZY'r.,};.<t�F:};{:ti.:iii•': ' ...........v•.:.........••5::..........r.........r•..:.................vn....n•t v::•....:....v..}.r....... ,nt.. ...... .... v .:.......... ....................x:..-.........:.:..r....:.v.,vrr w:w::....--r.v:•:::.v:::::......:.....:::: vv;r:r.?....x::i:::w:nw4.v...,;n,,.. �v..:.: :....... ....... ...n.......... ...:r.....n.., ,:r..t:•:::::::::: ..... ,...5....;nr:;/............ tw:..:•n,,:....t...... ...... r....r. .,...:. ..:. r.....r............. r n J.-:::::•:::nv.v.:v:..,, xf.;!;•ril.•?'-}::•::•............::::. ,...' ,....•..... ........... .........r............... .......t. r...............n:... ..........,r..r:nv-ii:::.:.......... ..v;.,......{:is"v: :v:::.v......••:::::!:•........•nri:^n....n.............. v....... ...............v...r..,..:::::....... .v::.:v::::n.r......tr : ..... r.vn:}'i-S{tiiiY�::::•ii�ii!::{:::;:i:�i::i: :{C<n'}4?}:.v::$.: .......... :........r.. ...............1.......v::nw4:v}:i':{\?:4i?}:t..........,{.f.,,:ti{:v::::r.. vw::::•v....-:v..}.,•.v'-.v:.v...... .r .:::::: ...r. :{{:!:....r:vvv:•}?}}i}}:{•}}}:C-%4?i}:{•:t•.v:::..... r............t:.-?:{!W:•}:4?i?i}:; �.n.y::.n...... v...............r........ ..,v::...: .. .. ..r r .............................n.r.n.......•.:•:v..................:::v::.v:::.v..,.:. tv:::.:v:::::{v•!-:?:v...... ...::::n::t.. -ti#v......:...:.....n.....:{:...... .................tn...............:......... .................,.r......r....:..:..... ...... ...phone. 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I understand that it copy of this statement may be forwarded to the a of In anions of the DIA for coverage verincatton. I do hereby certify under the pe perjury that the infonnnation pvi roded above is mid a ed�7 Signature Date 3 v Print name ,�lu 1�32 /j" 16���� Phone# _��$ 3 9 9 ofncial use only do not write in this area to be completed by city or town ofIIdal city or town: peiadt/llcewe# ❑Building Department ❑Licensing Board O checkif imme8121s response is required ❑Selectmen's Office OHealth Department contact person: phone#; Dyer_ (teviied 9/p5 P1N A.rope tv n - - - ..0MID ;!e and J?�P jCEt!f �Uder r P 3 2s VW71Cr ! y OL LLla Ja 1CCL PTO O T} i-ry' i ` ' 7 �. _a70IOOj TL Ce1�L1 1 J'v fit,i? ?il ?7^z-'rJ i'1. 'v9 _ �w) aCi,on =sr °3Z 70�� w'v K -1i1i0 a;ll aT3� 7.Cailn :Sim a ur,--pA Date i Y Qena Or Z�Lbgadex \og= `- .�� r `� lc` f:6E^c f `4JL C�Efd rsaG�� -� _. a�¢��. .�-�efT'F? ��� Z. Af'.-1 t f)�r� 7 i i�. 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ACORD CERTIFICATE OF LIABILITY INSURANCE 12/18/2001 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION JOSeph MCKeone ONLY AND CONFERS NO RIGHTS UPON-THE CERTIFICATE JP McKeone Insurance Agency, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 333 Ann Arbor, MI 48106-0333 INSURERS AFFORDING COVERAGE INSURED Patio Rooms of America, Inc. INSURER A: HARTFORD INSURANCE OF THE MIDWEST John Ester INSURER B: 100 Otis St. INSURER C: Northboro,MA 01532 ,)INSURER D: INSURER I- COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUE D TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT; TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUC D BY PAID CLAIMS. I LTR TYPE OF INSURANCE POLICY NUMBER I DATE M OD/YY I POLI DA MWDD/YY LIMITS A (GENERALUABILITY 35.00035019 11/01/2001 11/01/2002 EACH OCCURRENCE Is 1,000:000 COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any one(ire) Is 100,000 =F CLAIMS MADE 17 OCCUR MED EXP(Any one person) Is 5,000 PERSONAL B AOV INJURY 5 1,000,000 GENERAL AGGREGATE 5 2 000 000 �GEWL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG EZ OOO,OOD JECT POLICY PRO LOC I I A I AUTOMOBILE UABIUTY 35 MCC 302718 11/01/2001. 11/01/2002 COMBINED SiNGCE LI MIT ANY AUTO - (Ea accident S 1,000.000 ALL OWNED AUTOS, SCHEDULED AUTOS BODILY INJURY(Per(Per person) X HIREDAUTOS NON-OWNED AUTOS BODILY INJURY S (Per accident) --' PROPERTY DAMAGE I S (.Per accident) 1 GARAGE LIABILITY I AUTO ONLY-EA ACCIDENT E • I�ANY AUTO I I OTHER THAN EA ACC Is If I AUTO ONLY: AGG I S EXCESS LLA31UT_Y - n EACH OCCURRENCE �S - OCCUR J CLAIMS MADE - AGGREGATE fs — DEDUCTIBLE I E RETENTION S ' $ A WORKERS COMPENSATION AND 35 WBC FI3935 08/01/2001 EMPLOYERS'LIABILITY 08/01/2002 , 1 ORYIMOS L ER E.L.EACH ACCIDENT E 1,000,000 E.L.DISEASE-EA EMPLOYEEI$ 1.000 000 E L.DISEASE-POLICY LIMIT S 1,000 000 A OTHER 35 UUC 35019 11/01/2011 111/01/2002 Includes Richo:Copier AFFICIO 270 iPROPERTY Account 4199T106 to include Theft DESCRIPTION OF OPERAT10NS&OCATIONSIVEHICLESIEXCLUSIONS ADDED BY El DORSEMENTISPECIAL PROVISIONS Certificate Holder is additional insured CERTIFICATE HOLDER IX I ADDITIONAL INSURED;INSURER LETTI iR: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN INSURED COPY NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE-NO OBLIGATION OR 'LIABILITY OF ANY KIND UPON THE INSURER,ITS'AGENTS OR ' REPRESENTATIVES. AUTHORIZED REPRESENTATIVE I ACORD 25-S(7197) O ACORD CORPORATION 1988 i AYL VIT :En. accorda.=ce With ticlz 1 Section ' 14-1.3 OZ ,assachuse% .S State a i 1,r;ng come 1 CeptiiV Rat all (1P�AriS =-•om worms associat?d with Paan7t g d o= at EL-, w1J be oPer'y dispose li ��75� Spld wysr? dis�OSal =3Ci 1 tV a5 -?_inG•fj ,]Vft ji gn�tt2r� pT -�'�rAlZt -'ii7YJ11CaT_'-i- i • E . L . HARVEY & SQNSIN or lPvlicant 66 HOPKINTON RH - ucSIB1O °O . MA (R E 13 5 ) 1 5 B 1 F i�'Yn Name (i T -ly to ;t;e September 17 , - 9 the Department or Yealth/Code �r"fect_ ter 2 article 13 of the i98s5 �sfprcem t acting wider Chap : _e - of 'a;sacra o_ r• _ ro e P:e V 1. ez vL uliiv-i1Cc5 i.cy,.1<:cs y.•�^•^•- The Proo- WOr St - th1S �erIIll _ 3ebris- generated as a zesul� of he lico`1sed salt be a dated and signed receipt zrarn t � oral facility containing the zollowing iTformat=on. e. wai ht aescription•o= the debris: th g = - �� ^ i_� t`:e dis osai :ac-1_��- d�bris and the lxaL;on o;- p �,-/operator oz _eceipt mLst a_so have a signature of the © - the disposals facility. with the. regairements of tn.is Ordine-nce Failure to ccmply the Ci�y, - will , et_ i^ .e_-orce_*nenL action by TOTAL P.02 ('� ��o 'loorn�rvrnwnrr�lii r�✓f✓,.u;�^,:i�Fi.,titi . r ., v� Board of.Building ltegula.tions and.S*za lards License 'd 1 i _I-w::-: �� or rebistra�:bn valid for L.div�' u_use on.y Z Rmy i HOME IMPROVEMENT CONTRACT before tote expiration•date. if sound return to: '`" F ;hoard of Building Recrulations and Stan.&,.rds on-.. 6 One shbU ton Place Rm 1301. E_zP ration=�10121/0 3estor..;TV, 021.08 -= to Comoratio, PATIO ROOMS C�B_O_ST?QPIINC' t r r. ANDREWS MALON_- 100 OTIS ST NORTHBOROUGH, MA 01532 Administrator '-Not valid wi6out signature XI ill",i�yt�?,:rrr:.:�a� tr�r4�/if%crt5:v..�.',�:dQ;rL• i BOARD O%BUiLDiNG REGULATIONS License: CONS-P.C!GTI_?N SU?FP.VISOP. 070898 Nurnbei: CS. qwn ' _. ... Tr.no: 7227 A. Restricted To 1G ANDREW T MALOI.E 41 WASHINGTON ST=2' NATICK, MA 01760 ,\dmiriistrator I Ca 13 Sim 5 E A�;6 P rr t � 1 ` , i r- Too,& Ot� i3A1 ,&, srAA DA7G i bits P WUJ i s Q oT- i3 A-C i7rr'D 0 tO A-tO tZ ery Bruce Associafes Lo r Li*lkj PLAN SCALE c 20 ENGINEER ryLR� LO CAT I 0 N HOUSE SIZE 3 --►.