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0099 TROTTERS LANE
�/20��Prs �rayc-e Town of Barnstable *Permit I(_/Crl. Expires 6 mon r rom issue date Regulatory Services Fee • anxxsrnat� v ape PERMIT Richard V.Scali,Director Building Division . NOV _7 2014 Tom Perry,CBO,Building Commissioner p. TOWN OF BARNSTABLE 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 williout Red X-Press Imprint Map/parcel Number• O �L �(I 12� Property Address qq i Zo TTZ,_ LS L/1) R*95 ryp)s Jf�il .-ce-S /j/& 0,90*g co, [residential Value of Work$ L17 0Q Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address NL j� R/ t o L/J iyl /7/l<<Lr /►��1 ��� Contractor's Name >, ►-1_ c,&,z��e Telephone Number Home Improvement Contractor License#(if applicable)- Email: aE}ys/bF9off 1' ®G'11011,Wc- , Cowl Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to�Yn_K AA" ; 7,1 ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. 'Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: a"'d Q:\WHILESTORMS\building permit forms\EXPRESS.doc Revised 061313 Details Page 1 of 1 Licensee Details Demographic Information Full Name: DAVID H WEBB Gender: Owner Name: License Address Information Address: Address 2: City: Woods Hole State: MA ipcode: 02543 Country: United States License Information License No: CS-046189 License Type: Construction Supervisor Profession: Building Licenses Date of Last Renewal: 11/7/2014 Issue Date: Expiration Date: 10/29/2016 License Status: Active Today's Date: 11/7/2014 Secondary License: Doing Business As: Status Change: License Renewal Prerequisite Information No Prerequisite Information Discipline No Discipline Information Documentum http://elicense.chs.state.ma.us/Verification/Details.aspx?agency_i... 11/7/2014 1:94e epa1.2,0 scaeaCC/a��laaoccc�iureC/^I' — Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR. ' before the expiration,date. If found return to: egistration: ^ j 19766 Type: I Office of Consumer Affairs and Business Regulation a>•.•. Expiration: : 8128/20.1:& DBA lO.Pa�k Plaza-Suite 5170 Iry jr>, • Boston A 021j5 (V'EBB LEc Y CRAFT DAVID.WEBS '0"rlt 25 MEADOW VIEW DR ;Tom="ij i EAST FALMOUTH,MA 02536 Undersecretary Not valid without signature Massachusetts -De art I P ment Board of Building Re of Public Safety gulations and Standards Construction Supervisor License: CS-046189 DA VID H WEBB - 2411IEADOW VIEW DR: E F4LMOUTH NA0�II36' Commissioner Expiration 10/29/2014 t f THE l Town of Barnstable + Regulatory Services �=eaN LFg Richard V.Scali,Director 039.�EDMA'IA Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, 2 , as Owner of the subject property hereby authorize �: H_ L � to act on my behalf, in all matters relative to work authorized by this building permit application for: -/z or7M-S &,q• AftgPAC-S Ar2,f (Address of Job) Pool fences and alarms are the responsibility of the applicant. Pools ? are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. .IJ ignature of Owner Signature of Applicant Print Name Print Name 10 Date �. F— QTORMS:O WNERPERMISSIONTPOOLS tip" Town of Barnstable ' Regulatory Services -ME r, Richard V_Scali,Director P Building Division rST" Tom Perry,Building Commissioner v� MASS. 200 Main Street, Hyannis,MA 02601 www.town.barnstablema.us Office: 508-862-403 8 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number sheet village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINrriON OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be, a one or two- family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner" shall submit to the Building Official on a form acceptable to the Building Official,that•he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. _ The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a persou(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules &Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems, particularly when the homeowner hires unlicensed persons_ In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor_ The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the .` permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page. of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community.. Q:\WPFILES\FORMS\building permit foms\EXPRESS.doc Revised 061313- Dye ComrrzQ7ax€�alt�i ofasstrelrrs: Department afb dms&iid Accidents - OTwe of-rnv tga ians 600 ffigssMugton S&eet .Bastaq,MA OM-1 tvtc w.rrna-smgalvdia ',arkers' CompensafionInsarance Afdauit:Biidders/Contra_ctorslF-ectriciansIKumbers AppEcanf Information Please Print,Legibly Namz(&sn lOyzsnizationlfiOividnan_ ,cam A-, 1✓c�G= i� Address: 3a `t L-t-I L: /2 rl GiWStatz/Zip: V,/" ,L7 tit O Phoneme Are you an employer?Check themppropri ate bo T of (_ a;xr a,ge�ral confract and d'I project� ����: 1.❑ I ar-n a employer with 4 6- ❑New corostnuc-on =3ployees(fait andlorparf-t:me).* have hired the sub-contractors. listed on the attached sheet 7- ❑Rrswdeliag I El I atn a sole gropa.etor or partner-slag and have,nu employees These sub-contractors have 8_ ❑Demolifioa —0d i ng far me in anY �c cit5r_ empin}-F-4es and have workers' 9- ❑Building addition fiort Wo,workers' f C6Dlp_inama=e. comp-Ins El required] S_❑ we are a corporation:and its 10_0 Electric8l repairs or additions oficers have exercised fhesr I1-❑Plumbing airs or additions 3.❑ �zm a homeowner tioinb all work- g repairs , veyset£ [No workers'comp- right of exzempfioaper IvfGL 12-0 Roof aalm=nce rerinin>d]t c_M5 §1(4} and we]av'e no repairs employees_[Na vznrkr 1 _❑Other comp_msoxarce,required-I °'Atrf snpbcaat tnat rbet3:s bas rl trmst also fill oIA the an53mafiOn- 1 aomecwne s who submit ihm Rffi 2 in�csting they are+iomg an xm&and dies hire oatdde contra mrs rm,st skit s a� �d3rit m�u�rg mach_ }Cbatmc tors thst rF+x1c this box mast sttached sa sr3ditinosI sleet shouma he n�of the sob s�md stsfE xheth�ocnor those ifies b r�Iuye£s_ Ii th°snTa co�t�cfacs hsee ea�Ioyfrs,dre}m�5t pm rice tt s w*rI-ess'come.policy numbs- I am an empZoyer Thatisprmdd&rg tt orkers'cortrpRrurlu>.n invirarice for m errrpZayzes SeTnw is Biz policy and job sifw iaformalzo�z Insurance Compm-(Name: Policy fr or Self ins_I_ic.t- Expiration Date: Job Site:Adfi=: q —t/2-a77L�S L ' CifyrStafzJzip: 10#fi-5�-6NS' /14ycCs AtUcIr a copy of the-�c-orkers'compensation policy dedarztiou page(showing the policy number and expiration date). Failure to secure•cotirrage as required under Section;25 A of MGL c. M can lead to the imposition ofcnminal penalfies of a fine up to$I,50l1.Qa and/or one-Yearimpfivonmen>y as well as civil penalties in the form of a STOP WORK ORDER-and a fine of'up.to$250_0.0 a.day against the violator_ Be advised that a copy of this statement may be f6rwarded tb the OfScE of Inc-esfigutions of the DIA for insara cer coverage vezrfic anon- pdri hereby a rcmdzt t pains alfd pens a ofp ury that fhat rrforrrtafion prewidgif abase is.hits and cc rrsct SiEnatuve: 14-- Date: Pbom if: 50 P Sew ©UZcikri us-e arty. Do=rat write in this area,:v bs camped by city or town officiaL City-or Town: _PMratitfLiceuse# Iss. i %-c'1_atharity(circleone): 1.$aard f$exith $uffffiag Department: I Citijrl awa Clerk 4_Electrical Inspector S.Plumbing Inspector 6.04her comtact Person: Phone#: 6 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant-to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied oral or written_" An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,-or the receiver or trustee of an individual,partatrship,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the - dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also s—tfes that"every state or Iocal licensing agency shall withhold the issuance or renewal of a License or permit to operate a business or to construct buildings in the common;vealth for any applicant who has not produced acceptable evidence of compliance erit_h the insurance.coverage required." Additionally, MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for.the pe6o_rmance ofpublic work until acceptable evidence of compliance with the irsuuznce requirements of this chapter have been presented to the contracting authority-" Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to yrur situation and,if, necessary,supply sub-contractor(s)name(s), address(es) and phone vLm1_be,-(s)along with their ceraficatc-(s) of insurance. Limited Liability Companies -LC) or Limited Liability Partnerships(I LP)veim no employees other than be members or partners,are not r ,;,red to carry workers' compensation 1-11IM ance_ if an LLC or LLP does have employees, a policy is required- Be advised that this affidavit may be s,:bmi><ed to the Department of industrial Accidents for confirmation of is=ance coverage. Also be sure to sign and date the aff�idavit '11?e a,.idavit sbowid be returned to the city or town that the application for the permit or license is being requested,not the Deparbnent of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Towu Ofracials Please be sure that the affidavit is complete and printed legibly. The Depar!ment has provided a space at the bottom of the affidavit for you to fill out in t e event the Office of Investigations has to contact you re2�arding the applicant Please be sure to fill in the permitlliceuse number which will be used as a reference number. In a&tion, an applicant that must submit multiple pe-mitllicense applications in any given year-need only submit one affiddavit indicating Cu-rent policy information (if necessary) and under"Job Site Address"the applicant should write"all locations in __(city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be.provided to the applicant as proof that a valid affidavit is on file for future permits or Lcenses_ A new affidavit m,.?ct be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidaN t- The Office of investigations would 1>,1ce to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a ca i1. The Department's address,telephone and fax number. Tbe Comiaonmm-a lth of 1vlassachu e s Department of 1ndustial.A.Qcidp. s Office Of Tave'stigatians 600 Wa hingtou Sxz B ostola,_MA 02111 7( IL--il 617 727-49W W 406 or Revised 4-24-07 Fax T 617-727- 749' www-mas,-,,gnvtdla .[,.., COMPENSATION AtVDEt111PLOYERSLIABILITY~INSURANCE POLICY. v}°'_.. r e tnformation�Page, ,. ��wc Yoo oo'Yo1 Atlantic Charter Insurance Company VDAC NCCI Co. No.:29211 Policy Number: WCV01168000 1. INSURED: Prior Policy Number: New Robert F. Tyndall Producer: 80 Brigantine Avenue O'Briens Centerville Insurance Osterville, MA 02655 Federal ID Number:174560293 Agency, Inc. Risk ID Number: PO Box 610 Business Type: Individual Centerville, MA 02632 SIC:9999 NONCLASSIFIABLE ESTABLISHMENTS Other Named Insured: See WCE106 Other Work Places: See WCE107 2. POLICY PERIOD: The Policy Period Is From: 7/11/2014 To 7/11/2015 12:01 A.M. Standard Time at The Insured Mailing Address 3. COVERAGES: A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: MA B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in item 3A. The limits of our liability under Part Two are: Bodily Injury by Accident $ 100,000 each accident Bodily Injury by Disease $ 500,000 policy limit Bodily Injury by Disease $ 100,000 each employee C. Other States Insured: Part Three of the policy applies to the states, if any, listed here: COVERAGE REPLACED BY ENDORSEMENT WC 20 03 06B D. This policy includes these endorsements and schedules: See WCE105 4. COVERAGES: The premium for this policy will be determined by our Manual of Rules, Classifications, Rates & Rating Plans. All information required below is subject to verification and change by audit. Code Premium Basis Total Rate Per Estimated Classifications No Estimated Annual $100 of Annual Remuneration Remuneration Premium See WC 00 00 01 Minimum Premium: Deposit Premium: $500 $500 Interim Adjustment: Annually Servicing Office: Estimated Premium (Minimum Premium) $500 25 New Chardon Street Boston, MA 02114-4721 Issue Date 07/01/2014 Countersigned By:_ Coovriaht 19R7 Natinnal C:niinril nn r.mmncancatinn Inciirnnew • T= j. oFt Town of Barnstable *Permit# �d1 �w Expires 6 mo from issue date 11A1WffrA1= Regulatory Services FeeMAM S 1 �0� Thomas F.Geiler,Director Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 X-PRESS PERMIT' Fax: 508-790-6230 EXPRESS PERNHT APPLICATION - RESIDENTIAL QMY 8 2004 /Not Valid without Red X Press Imprint Map/parcel Number ® 7 P? Ccr-i- ( � TOWN OF BAf�NSTA BLE Property -4-e� �, p �Address. �r� 04 aa4lmels VI/l. (US WA- az wa �f Residential Value of Work /��j, Cg2 Minimum fee of-$25.00 for work under$6000.00 Owner's Name&Address Contractor's Name q f g Co ��� Telephone Number Home Improvement Contractor License#(if applicable) ( Z 4 '7C3 Construction Supervisor's License#(if applicable)_ ©(Q 9& ❑Workman's Compensation Insurance Check one: .Ealqm a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name_a, dw .4 `ec)6 Workman's Comp.Policy# (D.2.® ZO Copy of Insurance Compliance Certificate must be on file. 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) ❑ 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 must sign Property Owner Letter of Permission. Home rovement Contractors License is required. Signature �Torms:expmtrg 2evise063004 i . i..... .. ✓�ae"!!��omr�nauuea�-o�✓�aa�ac/ucaetld BOARD OF BUILDING REGULATIONS >1+ License: CONSTRUCTION SUPERVISOR Number CS 069680 Birthdate:.1 a03/1948 - ; Expires: 10/03/2006 Tr.no: 2545.0 Restricted:.-1G VASCO E NUNEZ'III 79 MAYFAIR RD G— S DENNIS, MA 02660 Commissioner ✓le -�arrr�ieo�erae�illl c`;,flaa:rn.%r�aella :: -- Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR 1�:_ i t� _ Registration: 124793 /r Expiration: 8/25/2005 Type: Individual Vasco E. Nunez,III Vasco Nunez, III 79 Mayfair Rd. � S.Dennis,MA 02660 Administrator i I 2 VASCO NUNEZ CARPENTRY 79 Mayfair Rd. Page f.of,2. SOUTH DENNIS, MA 02660 MA Lic. #069680 H.I.C. #124793 (866) 398-1511 • Toll. Free (508) 398-1511 • Dennis, MA PHONE DATE TO: M/M Ned Friary 508-428-0341 8/23/2004 99 Trotters Lane JOB NAME/LOCATION, Marstons Mills MA 02648 Replacement Window, ' JOB NUMBER JOB PHONE f 0341 ' SAME submitWe hereby •' 1.Remove one bow window from living room, and replace with one Andersen casement picture window, ( model # CR145-P4545-CR145 ) , in same location. New Andersen window to have white vinyl exterior with natural wood interior, stone colored hardware, white screens, and no grilles. 2.Supply interior/exterior trim and framing materials where needed. Exterior trim will be preprimed 1x4 or brick molding. Interior trim will be 3 1/2/1 clear colonial casing. 3.Supply town building permit. 4 .Insulate around interior of window. 5.Take all debris from this job to town landfill. 6.Make arrangements for delivery of new window. * This proposal%/does not include any painting, staining or electrical work. * New Andersen window described above will be prepaid by owner. ** If this proposal is satisfactory, please sign the YELLOW copy and return with payment schedule. ** Per conversation on 8/21/04, please make arrangement for payment of window directly with Mid Cape Home Center, and.let me know when you do so that I may schedule the work to be done. WE PROPOSE hereby to furnish material and labor—complete iin1 accordance with the above specifications,for the sum of: = 4 �l r A(�SJl &-a C_0_02�s dollars($ n ,_ Payment to be made as follows: 50% Down payment to start. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$540.00 50% Upon completion, at time of completion. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$540.00 All material is guaranteed to be as specified.All work to be completed in a professional manner according to standard practices.Any alteration or deviation from above specifications Authorized involving extra costs will be executed only upon written orders,and will become an extra Signature charge over and above the estimate.All agreements contingent upon strikes,accidents or delays beyond our control.Owner to carry fire,tornado,and other necessary insurance.our Note:This proposal may be workers are tufty covered by Workers Compensation insurance. withdrawn by us if not accepted within 30 days. ACCEPTANCE OF PROPOSAL—The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified.Payment will be made as outlined above. nature o D of Acceptance: / / 0 ature PRODUCT 1312ST AT(Q TO FIT COMPIW DUPW E ENVELOPE PRINTED IN U.SA. B • From:Donna S_<Aour,CIC,CISR At:Drake,Swan&Crocker FaxID: To:Vasco Nunez Date:927t'04 12:45 PNI Page.2 of 2 CERTIFICATE OF LIABILITY INSURANCE OP IDS DATE(„'v"°Dr'-Y" VASCO-1 09/27/04_ (PRCOUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 1 jDrake,S;van & Crocker Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE I Agency, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR —� 14 Lo't° s Hollow Rd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Orleans !�M, 02653 �-- � Dhone: 508-255-3212 INSURERS AFFORDING COVERAGE NAIC# 9INSURED INSURER A: Norfolk & Dedham Mutual 23965 --- INSURER B: Vasco Nunez INSURER C: 79 Mayfair Road INSURER D: South Dennis MA 02660 INSURER E: — 1_ ---� COVERAGES TIME FOLI-1ES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING AW:'RE'iIiIFSn•iENi,'TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR SAC'i PERT:=t[4.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.EXCLUSIONS AND CONDITIONS OF SUCH li IES A�riREGATE 1 IR7ITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. — i7`R-T.DDT ----- ELTR INNSR _ TYPE OF INSURANCE POLICY NUMBER DATE(MM/DOIYY) DATE(MMIDDIYY) LIMITS ' — GENERAL LIABILITY EACH OCCURRENCE I.g 3.000000 / t1 X�CGMMERC'IAL GENERAL LIABILITY R0207202 09/12/04 09/12/05 pREMISES(Eaoccurz,�ce; _ �5_0000_—� _ CLAIMS MADE OCCUR MED EXP(Any one person? - �S_5000 _--- PERSONAL&ADV INJURY r 3.000000 GENERAL AGGREGATE Is 2000000 I N'L AGGREGATE LIMIT APPLIES PER: - PRODUCTS-COMP/0PAGG ,•3.000000—_� j— I.IGL:C'(Fl JECT LOC III AUTOMOBILE LIABILITY , I _ COMBINED SINGLE LIMIT (.r iANY AUTO (Ea accident) ----- i CL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person)) HIRED AUTOS BODILYINJURY { S, NONX WNED AUTOS (Per accident) '3 - --1__-- PROPERTY DAMAGE i (Per Naccident) ' - GARAGE LIABILITY AUTO OONLYY-EA ACCIDENT I$ ANY AUTO OTHER EA ACC $ -'-_------- AUTO G1-JLYhILY AG", y —1—_ - I EY.CESSlUMBRELLA LIABILITY EACH OCCURRENCE ---- j r)CCUR CLAIMS MADE AGGREGATE 1 _ S "EDUCTBLE RETENTION $ I$ WORKERS COMPENSATION AND TORY LIMITS JER -j MPLOl'ERS'L IABILITY -------- IV4ePROF•RIETOPJPARTNER/EXECUTIVE E.L.EACH ACCIDENT 'E _— OFFI•.'ER/I,4EMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 'I pes,ddecnbe under — -----"------ SPE1:IAL PROVISIONS below E.L.DISEASE-POL ICI'LIMIT $ j I cirH=R i I I -- I CESCP.IP PON Or OPERATIONS I LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Job name: Friary @ 99 Trotters Lane Marstons Mills, MA 02648 i I j CERTIFICATE HOLDER CANCELLATION BARNsl1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION I 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 Town Of Barnstable IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 367 Main St. REPRESENTATIVES. Hyannis MA 02601 _J AUTHORIZED REPRESENTATIVE � t/C1 ACORD 25(2001108) ©ACORD CORPORATION 1988 I i T®wn of Barnstable Regulatory Services , Thomas F.Geiler,Director 39. Building Division TCWN BARES ABLE Elbert Ulshoeffer,Building Commissions 367 Main Street, Hyannis,MA 02601 1 u BAR 22 .PM 2:- 1 S Office: 508-�862-4038 F_ axz--SQ&790-6230 d U DIVISION SHED REGISTRATION 120 square feet or less _ l )TT�12LS L��� MA STo�Ls ,LLs l—. Location of shed(address) Village E� ,�.Plr92N C LEiyi�h L12-8f-03y/ Property ownees-name Telephone number lo 0 Ll 7 Size of Shed Map/Parcel,# , 31yz1°2 Signature Date Hyannis Main Street Waterfront Historic District? /.y 0 Old King's Highway Historic District Commission jurisdiction? !JO Conservation Commission(signature required) , L k PLEASE NOTE: IF YOU ARE WITHIN THEE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. M THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q4 ms•shecing THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) IA 1- 1 m / �C(L� L DATA i y i i 6o46~ C, -, 7 ?v. ti I1 cr.o c-ar 7-4 r • r`• i � `1ri: • �'��H OF y,_ _------ — ►� / �ul »� ` Nu 6420 `!SItR OP� 1 �� SURYtij� _ LEGEND EXISTING SPOT ELEVATION 0,0 CERTIFIED PLOT PLAN EXISTING CONTOUR -- - 0 - - - LC)TL./t•/r'�- FINISHED SPOT ELEVATION FINISHED CONTOUR 0 - IN APPROVED BOARD OF HEALTH S a RA ��r -J,` �,:,L AI a SS4 DATE AGENT SCALE, ! = ¢J1DATE , 7/!s- �? 'LDREDOE ENGINEERING CO. IN -) i CERTIFY THAT THE PROPOSED (ItEG19TERE REGISTERED. JOB NO. 7? U._`7 b' BUILDING SHOWN ON THIS. PLAN CIVIL 'LAND ':.+;FORMS TO THE ZONING LAWS ENGINEERS) SURVEYORS DR �'� . �'- ;V7 "ARNSTABLE , MASS. 33 NO MAIN Sr 712 MAIN T CH- BY ; C YAFtMOUTH, MAS:. HYANNI. titer SHEETS OF REG. LAND SURVEYOR Q As essoc�s map and lot number .... ...i . :.. q 1�0. SEPTIC SYSTEM MUST B Sewage�iPermit. number .:^...................................................... INSTAIrLFD IPA COrl9FLIANC ra ti .^� WITH A!Ji"l_E Ii SIATE SANITARY f-,0 F ,ND TC'� N o�T � HET w, c TOWN OF -BAR-NS46 TB�Lh �A°` c3 6U) LD�IHG INSPECTOR r� O '.1679. '' • i m w •ems r-+ i� APPLICATION FOR PERMIT TO ..w.0 �4r� . 'S�.I�.P..?'.1................... 7 t+ TYPE OF CONSTRUCTION ...............:............................................................................................................. ....... ...Z:.�?.............................19......�.. TO THE INSPECTOR OF BUILDINGS:1 The undersigned hereby applies fora /permit according to ft,�he /following information: Location ....L OT..�6... . ��TC C.�. ..YN......t�'1Yz r S('art. `!11. /. ....................................................................................... ProposedUse �!9�. . .. ? ``. ` ...............................:................................................................. ZoningDistrict .........................................................................Fire District .................................................:............................ Name of Owner ..:rk .....................Address Name of Builder .......aI^'i.`�:.......................:..............:.....Address ........ im,C............................................................... Name of Architect .. kt~-rI-6;�-- .........................Address ...,7v.A.,N1 �.ti. us 57 �?N.��s�a,.bl41.1........ Number of Rooms ... ...........................................................Foundation . . �............................. Exierior ,S .. �S S�, S�ij,r.uj� S .N... ..................................................................Roofing ..... ... 4a.v. I .............................. Floors etA/. .Interior .......... b u• ll C� �- a- 1 e o�T� .. .......Plumbin .......�� � r'Heating (�.........`.`'�... .7/tU............................. g f?.. .:........................................................ Fireplace .....�-AG.1.�....131v c�C.:................................:.....Approximate Cost 7. . Definitive Plan Approved by Planning Board ------------_______-----------19________ . Area .....� ...................... -r 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 .. i C''.`..,�7-•// �. ... ..1..:. ��4/-7 t... " Inovative Builders 19611 one story Nc?/................. Permit for...................................... single family dwelling ............................................................................... Location ........Trotters................ ..L..a..... ne .. ........................... Marston Mills ............................................................................... Owner Inovative Builders .................................................................. Type of Construction ........................frame.................. ................................................................................ Plot ............................ Lot ................#.16............... September 19 77 ' Permit Granted ......................4.................19 Date of Inspection ... .....19 . ...)-7j 22 Date Completed .... ........19 PERMIT REFUSED ................................................................ 19 ............................................................................... ............................................................................... ............................................................................... Approved.................................................. 19 ............................................................................... ............................................................................... ssor's map and lot number ......... ................................ / .� , i y Sewage: Permit number ...............!... TNETO�y� TOWN OF . BARNSTABLE i 13ARiSTABLE. • "6 q •� BUILDING INSPECTOR YpY a APPLICATION FOR PERMIT TO I � .i c ! ' T . i ., ���. �e `• .� TYPE OF CONSTRUCTION .. .......'I................................ ................... . .. ....................................... �. . .................. ...............................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: • Location ...........................:....................................:..........t.....................:........................................................................................ Proposed Use - '! ..r, W......... ZoningDistrict ........................................................................Fire District .............................................................................. Name of Owner c /5 .....:..:.....'......................Address S I'r . _I S7 I rr i+..... : A.'. Name of Builder '�1' c" .............................................Address c. Name of Architect ..:........... .�.'.:.............................................Address .... i A r7 - T ` ........................................ %........................... Numberof Rooms Foundation .. ?..^.:. r r - t `............................................................. .................................................................... Exterior Roofing : I„a ' ...Interior %/ ��Floors :...:.............................................. :........................................................................ .............................. Heating ..................................................................................Plumbing • .................................................................................. Fireplace ..................................................................................Approximate Cost ....................'................................................ Definitive Plan Approved by Planning Board -----------_______-----------19________, Area ....................I....................... Diagram of Lot and Building with Dimensions Fee YJ'............................................. 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 .................................................................................. Inovative BuDders, A=47-110 9611 one story ............... Permit for .................................... A single family dwelling ................................................................................ OlTrotters Lane Location I............ ............................................. karstons-mills ............................................................................... Inovative Builders Owner ................................................................... '�-�f frame Type of Construction. .......................................... .................................................)................. Plot ............................ L/ot - #16...... kj,,,ptember 19 Permit Granted Se ............I...........................19 77- Date of Inspection ....................................19 Date Completed ..................................... .19 -PERMIT REFUSED ................................................................ 19 ..... .. .... ... ......................... .................................... ........ ... ..... . ............... ............ .......... ...t............. ............. ... . . .... ....... ............................................................................... Approved ................................................. 19 ............................................................................... ............................................................................... �.�d . ,. 1. r y. !Fr 'r +�`" ♦r. ,;r is 4:, :Sat /�36 °4zD3 'E y `� 35 2� C�B 36 °36 'Z3 "Z5 �. 6oY4 67.37. , 70.46 1-07 36 OF rv4j. .. ' ` • h •Pt layI���P , , • ` .w "` �• ' CgRTIFIED PLOT- 'PLAN- . .r 76 AIS / /Yf,9 9ZS TC> )I/4-4_,S +NM', CONSTRUCTION ONLY : . IN �: • --- bp,` OF FOUNDATION ' IS FEET r AQOVE - LOW POINT OF ADJACENT RQAO-, ;• f`.•:, SCALE: /`•- 4•D DArTE,: L7 f77 j` DREDGE ENGINEERING CO.IN I CERTIFY THAT THEov�/ds�T�on/ CLIENT �/D SHOWN ON THIS PLAN IS LOCATED ;� E019TERED REOISI�ERED JOB NO.� 4E ON THE GROUND AS INDICATED AND CIVfL LAND ` r ENGINEER SURVEYOR DR. BY:A- CONFORMS TO THE ZONING LAMB OF BARNST BL): , ASS. CH.BY:x- P. 13 r a35 N0. MAIN ST 712 .MAIN ST. ��!'`� ? �'{ flt�•�.�ti� 5O. YARMOUTH, MASS. HYANNIS-`MASS. SHEET LOF / ' DATE RES. , LAND SURVEYOR 1y • ' fk T.1.k•• a' X'k +�:'�' .•` ,',Ir36'O4 '�3 {, � 3 6 °36 2-3 -16 r• •� l..... :`� t + � 1 ,,w• .` .,F� y Lo.,7''�'J CT' •� i� " yr• � �!.'P''�' 1' .i I�. •T..' , l .11'N1 .., 1 r . I yt �. y ry�� • ' +, ' ,u,,..�t,c y,.y••' t j ^r r� � �i r�" S, a:�' •a�5+.�rt HY. y. J A i� •'w+•��'!' - R �{.' :Y � Ll7i.r' "�� ;fir . �, • •.�,•J , •�y,..�fi`� ><; �N .i ,¢O.l r' Q t,� � � ',i '� " 't+I ,.,F • a,,.* , .' A. `I. I ,fix.• I�f"I ••/�+ f• _.._•.. — {y 4 O Of w .�-/ +/�� .+-•/�-� /�/��`. A y F i, •� i r1 F rr 'V•.'F , •"'(..•-+ '!:1 /V L..%.•` � 'M "7C.►y tl 7J: RODERT �' �4•. R {. * i r a P. •a; ..' .`r ty� r,, t" r ~i • SUNiKIS •9, r 'M w 1. •r. .. ,. , �!3 Na"20 - w is CERTIFIED PLOT PL,AtU f L07- 16 720T'TE-f?_S f. dP;:tQF',jr SUNDATION0. FEET 'r t f IN �I do ILow ` POINT OFs; ADJaCEN1`' XA Ilk 4( a >-Fr '�., ; r SC'AC.E: / ; �D DATE= 7r�7, 7� LD EDGE4 ENGINEERING' CO.IN ' I CERTIFY THAT THE yniU.�r�oN'' CLIENT �/ EGISTfEREO REGISrTERED r' -77d48' SHOWN ON` THIS PLAN !9 LOCATED, c `'ice CIVIL LAND JOB NO. ON' THE GROUND AS INDICATED AND'- ,, r s CONFORMS TO THE ZONING LACES ENOINEER SURVEYOR DR.BYjA OF BARNSTgBL A S. �a '�0 MAIN 5 i+ w 2 .,!A! ST CH.�Y=R- "' �1�i'Y/r?7 1) ,yam ' y50;�Y1`RMOUTN, MASS. HYANNIS, MASS. SHEET DATE REG. LAND SLR vayoff