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HomeMy WebLinkAbout0256 WAKEBY ROAD ................................ 0 • Town of Barnstable *Permit# - i - a7 ' Expires 6 mondrs from issue date '+ Regulatory Services ppp�6Fyee -3 BARNMBr s. ® � Teb MAss. 0� Richard V.Scali,Interim Director 4 i63g. 011 Building Division AUG 2 3 2017 ` Tom Perry,CBO,Building Commission e TOt4�nl 0F BAR STABLE- 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 - EXPRESS PERMT APPLICATION - RESIDENTIAL ONLY Not Valid without Red'X-Press Imprint - Map/parcel Number © 3 �� , Property'Address 2,s(a W hq [Residential Value of Work S . r Minimum fee of S35.00 for work under$6000.00 Owner's Name&Address typo Contractor's Nam eT j: ff RTelephone Number 901-7/4/ d 3$f Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) o [ Workriiin's Compensation Insurance 66 �� Check one: ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation Insurance -Insurance Company Name lV A-T1v�t/�¢-L Workman's Comp.Policy# iu q5 Copy of Insurance Compliance Certificate must accompany each plermir. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side Replacement Windows/doors/sliders.U Value (maximum 35):#'ofwin �#of doo - ❑ 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,Le.Historic,Conservation,etc. a =TNote: P ope weer must sign Property Owner Letter of Permission. o y f the Home Improvement Contractors License&Construction Supervisors License is it SIGNATURE: Q:IWPFILES\FORMS16uildingpe fP R�F,S/S.dg+� Revised 061313 , .�/ SPECIAL SERVICES CUSTOMER INVOICE Page 1 of 5 NO. H2612-40208 N Store 2612 HYANNIS Phone: (508)778-8948 65 INDEPENDENCE DRIVE Salesperson: RHP4LE 0q HYANNIS, MA 02601 Reviewer: VXG1123 Nzmo Phono l REPRINT AMIOTT WILLIAM (508)523-9507 Addross 256 WAKEBY RD Phono2 (508)428-0574 company Namo • City MARSTONS MLS JobDoscnpnon patio install 2017-07-31 10:15 stato MA zip 02648 co"n'l BARNSTABLE INSTALLER DELIVERY #1 MERCHANDISE AND SERVICE SUMMARY sWe the r ortocustomershtto limit the quantities o(merchandise d j REF# 101 STOCK MERCHANDISE TO BE DELIVERED: REF# SKU OTY UM DESCRIPTION PI TAX P Li4 EXTENSION R03 1000-049-619 1.00 EA PS510L FRAME WHT PART ONLY/ A o $202.30 $202.30* R04 1000-049-622 1.00 EA PS510L OPER PANEL WHT PART ONLY/ $268.42 $268.42' R05 1000-049-621 1.00 EA PS510L STAT PANEL WHT PART ONLY/ Y $268.42 $268.42' R06 0000-321-257 1.00 EA SCREEN FOR 200 PS510- DOOR WHITE/ A Y $118.42 $118.42' R07 0000-570-469 1.00 EA DOOR HARDWARE 200/400-GLIDING WHITE/ A Y $49.32 $49.32' R08 0000-110-416 3.00 EA 3/4"X4-1/2"X8' PVC TRIM/ A Y $17.49 $52.47` R09 0000-254-466 1.00 EA 3/4'X7-1/4"X8' PVC BOARD/ A Y $27.79 $27.79' R10 0000-119-698 2.00 EA 1X5X16 PRIMED FJ PINE/ A Y $28.85 $57.70' R11 0000-822-204 1.00 RL 6"X50'WINDOW& DOOR SEALI A Y 1 $17.34 $17.34' R12 0000-715-499 1.00 RL MULTI-PURP 16"X48" ROL SF/ A Y $5.41 $5.41' R13 1001-361-475 1.00 EA 1/2" X 4-1/2"72" 47 ADDLE/ A Y $22.67 $22.67' o - s • $1.090.26 DELIVERY INFORMATION: IDELIVERY DATE: INS ILL SCHEDULE INSTALLER WILL DELIVER MDSE TO: Sly NEcWALLATION #101 AT TIME OF INSTALLATION. p •••CONTINUED ON NEXT PAGE"• O Check your current order status online at w4w.homedepot.com/orderstatus Indicates Page 1 of 5 NO. H2612-40208 ` Customer I Copy Spr:CIAL SERVICES CUSTOMER INVOICE- Continued Name: AMIOTT' Page 5 of 5 NO. H2612-40208 INSTALLATION #2 (Continued) REF#102 IMMEDIATELY.CANCELLATIONS WITHIN 72 HRS.WILL BE REFUNDED END OF INSTALL#2 TOTAL CHARGES OF ALL MERCHANDISE & SERVICES $1 873.81 .Policy Id(PI): SALES TAX $68.14 A: 90 DAYS DEFAULT POLICY; TOTAL $1,941.95 BALANCE DUE $0.00 'The:Home Depot,reserves the right to limit/deny returns. Please see the return policy sign in stores for details.' END OF ORDER No.H2612-40208 Customer's Signature h1t,4 414LI, ate ezll I Page 5 of 5 NO. H2612-40208 Customer Copy ! !t r s1•�r.: CS-074247 PAUL M1 DOWNING 180 KESWICK ROAD � ,I BROCKTON MA 02302 Expiration: Commissioner 0410V2019 The Commonwealth of Massachusetts Department of Industrial Accidents 2 Office of Investigations --• I Congress Street, Suite 100 Boston,MA 02114-2017 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le 'blv Name (Business/Organization/Individual): �i Address: J ?` Sw%1� .- f=ci City/State/Zip: �'�;r��c, f;n �d3, %3�'�— Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.❑ 1 wn a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.,,(employees am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition Working for me in any capacity. employees and have workers' insurance.* 9. ❑ Building addition comp. [No workers' comp. insurance P- required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I I.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12 ❑Roof repairs insurance required.]t C. 152, §1(4),and we have no employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that clucks box 91 must also lilt out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing alI.work and then hire outside contractors must submit anew affidavit indicating such. $Contractors that check this box must attached an additional sheet shooing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is thepolicy and job site information. _ Insurance Company Name: Policy#or Self-ins. Lic.•#: Expiration Date: 3 Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine tip to $1,500.00 and/or one-yeas-itnprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. ' I do hereby certt under the pains andpenalties of perjury that the information provided above is true and correct Siagnature: 6 rtt c - .. Phone#: Official use only. Do not write in this area,to be completed by city or town offtciaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: - �-Cej�ff—.c'Z e(.j.e,M, . Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Type: Supplement Card Registration: 112785 HOME DEPOT USA INC — Expiration: 04/22/2019 2455 PACES FERRY RD C-11 HSC ATLANTA,GA 30339 -- ' i Update Address and return card. Mark reason for change. ❑ Address ❑Renewal ❑Employment ❑ Lost Card .-_��'i_ i'(.rr:iirr-.Jr:J:nr:•'%/.'ty''.c''7(r'/:ur.C:;'/:3e��i Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only =?.a TYPE:Supplement Card before the expiration date. If found return to: -• _:;: _r�:':is�,;_• Registration Expiration , Office of Consumer Affairs and Business Regulation 112785 04/22/2019 10 Park Plaza-Suite 5170 FFOME DEPOT USA INC Boston,MA 02116 '4 ANDREW SWEETC -- 2455 PACES FERRY RD C-11 HSC .� WlthOU signature ATLANTA,GA 30339 Undersecretary ` The Commonwealth of Massachusetts Department of Industrial Accidents 0 I Congress Street, Suite 100 Boston,MA 02114-2017 www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers- TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): TI,t2 440trl e j d{ A-f=N nJMI� ��ujLe Address: Ci10 k , on ay 1<- City/State/Zip: M ISMS Phone k (5bR) 9 Lf Z- (,C1 4 Z Are you an employer?Cbeck the appropriate box: Type of project(required): LEJI am a employer with employees(full and/or part-time).; 7. New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.F�I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10 Building addition 4.FJ I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole I I.Q Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.Q 1 am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.[]Roof repair These sub-contractors have employees and have workers'comp.insurance. 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.W Other 152,§1(4),and we have no employees.[No workers'comp.insurance required.] von, Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy inform ition. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that isproviding workers'compensation insurance for my employees. Below is thepolicy andjob site information. Insurance Company Name: k6t11)01)4a 1 DnlOn 600 _D50446C-Q CO. Policy#or Self-ins.Lic.#:` 1. in 2, I Expiration Date: 3- 1 - 1 9 Job Site Address: 2 I PJ City/State/Zip: t(.l Attach a copy of the workers' compensati policy declaration page(showing the policy number and expiration ate). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator opy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verificati I do hereby certi �unllelthe pains and pens rjury that the information provided abov is true n-d7correct. Signature: Date: Phone#: t_ 9 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: r ACC CERTIFICATE OF LIABILITY INSURANCE D02rnro17 ' Iiii-e� THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTB7CATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY HEmPiOOLIC� BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the pollcy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsemern(s). ACT PRODUCER NAW I FAX MARSH USA.8dG PHONE UW- 3 LFLLIA CE CENTER 2408 E AD ATLANTA.GA 30M INSURMtM AFFORDING COVERAGE NAIC 0 INSURER A:O'd 9bLIMUIRTIM CO �24147 10M92-Hw*D CAVr-17-18 A,, �57 INSURED INSURER B:^�" •��IIIS<I2nCe CO�r THE HOME DEPOT,INC. INSURER C:NLm Hampshire Ins CD 23841 HOME DEPOT U.S.A.,INC. 2455 PACES FERRY ROAD INSURER D: BUUING G20 wsuRER E; ATLANTA,GA M339 INSURER F: COVERAGES CERTIFICATE NUMBER- ATL-003746W-14 REVISION NUMBM-2 LINDICATED. IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD CH THIS TII MAO YM E SSUED OR MA PERTDING ANY ��E INNSURA`NCE OR AFFORDED BY THE PPOITION OF ANY �LICIES DESCBEDCT OR OTHER OHERENCI SS UBJ MTN ECT TO ALL SPECT TO T E TERMS. LUSIONS AND CONDITIONS OF SUCH POUCIES.UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I POLICY EFF POLICY-1XP LIMITS TYPE OF 1NSUIWICE POLICY NUMBER MIND A X COMMERCIAL GENERAL UABIUTY MWZY 310022 03RIV1017 O31pVl018 EACH OCCURRENCE S 9.00D 000 METO RENTED S'ES Eedmarenw S 1,00i),OOD CLAims4mDE ❑OCCUR EXCLUDED IUMTTS OF POLICY XS MID EXP Wy one Pesch S OF SIR$1M PER OCC PERSONAL&ADV INJURY S 9.0ww GENERAL AGGREGATE S 9,OM.DDO GENL AGGREGATE UM.T APPLIES PER: 9,0m,000 r I pRa 7 r PRODUCTS-COMPIOPAGG S X POLICY JECT _LOC S OTHER: MWT8310021 03(0I12D17 03MI12018 Es NED SINGLE LIMIT s 1000,D00 A AUTOMDBILELIABILITY BODILY INJURY(Per pmsoM S X ANY AUTO SCHEDULED SELF INSURED AUTO PHY DMG BODtIY INJURY{Per aamernl s AAUUTOS 0-0WNED PROPERTY(Per GE S MREDAVTOS AUTOS $ EACH OCCURRENINICE� S I UMBRELLA UA13 OCCUR S I EXCESS LIAB CLAIMS-MADE I S B W ORRERS COMpENSATroN N s yYIIt C49112300(TN) p3►0111T117 Q31D1l1018 X �Tll1E oTH R AND grPLDYERS'LIf181LrrY YIN WC/023102423(AKNH,NJ.VT) D3lDU2017 031D112018 E L EACH ACCID9J7 S 1,000,000 C -ANY PR8PR1ErORIPARTNERIE7�CL1nVE . .N N. NIA 1,0OO.OD6 C ornceR EXCLUDED? ❑ WC 0?3102424(WI) I03I01f20i7 IYJIO1t1018 E L DISEASE-EA cZllPLO S (Mandatory tD N►1) 1,ODO,OOD DCRI of oPERATwNs below lCmfinued on Additional Page E L DISEASE-POLICY LIMri S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Addnh,nal Renurks Schedule,may be etmched If more apace b requhed) EVIDENCE OF INSURANCE CERTIFICATE HOLDER CANCELLATION FiNE-- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCI3LED BEFORE ' THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of March USA Ina Manashi Mukhojee O 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(20141D7) The ACORD name and logo are registered marks of ACORD r _ AGENCY CUSTOMER ID: 100492 LOC#: Atlanta a`40RV ADDITIONAL REMARKS SCHEDULE Page 2 of 3 AGENCY NAMED INSURED MARSH USA,INC. HOME DEPOT U.SA,INC. D&A THE HOME DEPOT POLICY NUMBER 2455 PACES FERRY ROAD BUILDING C•20 ATLANTA.GA 30339 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE Certificate of Liability Insurance Workers Compensation Continued: Cartier:Indemnity Insurance Company of North Amer Porgy Number.WLR C49112294(ALARFUD,U+,KS,KY,LA.MS,MO.NE NM,ND.OK,SC,SD,WV,WY) Effective Data:031012017 Expiration Date:03f0112018 (EL)Limit S1,0D0,000 Carrier.New Hampshire Insurance Comparry Policy Number.WC 023102422(DC,DE,tO,IN,MD,MN,MT,NY,RI) Effective Date:031012017 Expiration Date:0310112018 I (EL)Limit S1,0D0,00D Cartier:ACE American Insurance Company Policy Number.WCU C49112282(OSI)(AZ,CA.10C,ORVA,WA) Effective Dale:031010017 Expiration Date:03ID12018 (EL)Lima 51,000,0M SIR S1,OD0,000 SIR for the stab of AZ,CA,IL,NC,ORVA WA Cartier:National Union Fire Insurance Company Policy Number.XWC 6583144(OSQ(CO,CT,GA,ME,MI,NV,OH,PA.UT) Effective Date.QW01017 Expiration Date:03012DIS (EL)Limit S1,ODD,0DO S1,0DD,000 SIR for the states of CO,ME.NV,MI,OKPA,UT S750.000 SIR for the state of GA S350,000 SIR for Ore state of CT Cartier National Union Fire Insurance Company Policy Number.XWC 6583145(OSI)(MA) v(� Effective Date:03Ip12pt7 / ►I Q �i/�{� Expird'bn Date:031012018 (EL)Limit S1.000,OOD SIR S500.01M TX Employers XS Indemnitr. Canier.06ns Union Insurance Company Policy Number.TNS C48613202(TX) Effective Date:03M12017 ExM.,jm Date:031012018 (EL)Undt S10,00D,000 SIR S1,000,000 ACORD 101(2008101) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD t s i Town of Barnstable o oF� Regulatory Services Richard V.Scali,Interim Director, 1p '"m '7 Building Division . . i63�► - Tom-Perry,Building Commissioner . 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us. ',Office: 508-862-403.8 Fax: 508-790-6230 f s � PERMIT# V,�;2D I o� FEE: $ � ! SHED REGISTRATION RESIDENTIAL ONLY 200 square feet or less p Location of shed(address) Village IQ (16, (5-og Property owner's n me Telephone number s� 7 ; Size of Shed Map/Parcel# 01- Signature Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? If over 120 square feet,you must file with Old King's Highway j ' y tJ Conservation Commission(signature is required) Sign off hours for Conservation 8:00-9:30&3:30-4:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. ' THIS FORM'MUST BE ACCOMPANIED BY A " PLOT PLAN sQ-forms-shedreg - � REV:I 10413 Town of Barnstable Geographic Information System New Search I Home I Help - -Parcel-Viewer -Custom-Map- Abutters —_ ._Map Size ■,■ Zoom OUA j"j V 1.11 In Q y �T , J T-� ® -=JPG Map: 043 Parcel: 049 Pro P R �y P Y Location: 256 WAKEBY ROAD Info 043062002 Owner: AMIOTT, WILLIAM R&JACQUELYN L 043062001 p16 q17 Location Information Map&Parcel 043049 Location 256 WAKEBY ROAD Acreage 0.48 acres 043°a7 q 284 Ar043051 4226 Current Owner p Mailing Address AMIOTT, WILLIAM R&JACQUELYN L 043048 r 256 WAKEBY RD 0272 043060 MARSTONS MILLS, MA 02648 _ 043046 ip244 � . 0256 Appraised Value (FY 2014) Extra Features $17,100 Out $ Buildings 4,100 Land $109,600 Buildings $99,800 Q �sgY ftt� Total Appraised $230,600 Assessed Value (FY 2014) Extra Features $17,100 Out Buildings $4,100 043007002 043�007006" Land $109,600 0 84 Feet ° \�, Buildings $99,800 f Total Assessed $230,600 $ Construction Detail Set Scale 1" _ MAP DISCLAIMER 84 ( Aenal Photos 1 Copyright 2005-2010 Town of Barnstable,MA All rights reserved.Send questions or comments to GIS BarnstableMA v1.2.5122[Production] � � L .o TOWN OF BARNSTABLE Permit No. .=ij ------------------- Building Inspector Cash • ------—�j •�• Jahn wa ricer d, OCCUPANCY PERMIT Bond No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Olin f„ tv'arrlPr Address Pie town P\oad, Aiarsums Ails iot w8lr4. -,Cuts ..1:rSto-tis ' 11 Wiring Inspector Inspection date Plumbing Inspector �` T Inspection date Gas Inspector Inspection date s Engineering Department a : .,�/Y //' Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. Building Inspector { ss ssor's map and lot numb ........ �OfINET0� Sewage Permit number 1. :. SEPTIC SYSTEM MUST BE .......... ..... ............................ ,Yf> INSTALLED IN COMPLIANCE Z B9sa4TADLE, House number ................ .......a............................................. WITH ARTICLE II STATE Oo�039•p�9 SANITARY CODE AND TOWN war TOWN OF BARNSTABLE. BUILDING- INSPECTOR APPLICATION FOR PERMIT TO ......... .................g1 ` .. �'1NL .................................... TYPE OF CONSTRUCTION ....................(.V...0..1D..'X .......................................................... ................... ............19..7-011 TO—THE-:INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: `�� Location ........... C?./........ Jam........ /�KC. .....��/.�..... ..../.W/. ......................... ... ProposedUse .........../13 . -........................................................................................................................ Zoning District ........../...<.t4` 1..!11.�...................................Fire District .............................................................................. Name of Owner ........Vc.I..1`.1.v../......1..!!f4 /1/--�' .Address ....?v !! .... tQ...... Nameof Builder .............: e—..............................Address .................................................................................... Nameof Architect ........... A..✓. a................................Address .................................................................................... Numberof Rooms .......... ............................................Foundation .............................................................................. Exterior .........7.f' !Y•.. .�..........CL/4?�� .........Roofing .................................................................................... Floors ..... . Z�............................................Interior Heating .......... .........................................................Plumbing ..........1....... .........,!�/..lC/� . Fireplace ........... .............................................................Approximate Cost ........ 0,r.Crt!U........................................... Definitive Plan Approved by Planning Board __________-.6-L___._______19_ 6. .............;....... ... . Diagram of Lot and Building with Dimensions SUBJECT TO APPROVAL OF BOARD OF HEALTH t 5te- �3 r U 1. 6 S'!'! , I hereby agree to conform to all the Rules and Regulations of the UToofrnstable rega ing the above construction. Name .. ........................................................ Wal ner, John t. A=43-49 to 21.12q...... Permit for Ruild.sing.Le......... a f�mily...4lW���.7.n......... _ .. l &................................... Location LQt..Z5..Wakeby..Rd............................. ' Mar.s.tans..Mills.................................. Owner .J9bD..L...W.arner................................. Type of Construction ......Wood Frame ............ .............................................................................. Plot ... Lot ...25......................... Permit Granted .....Max r.h..2-1 ................19 79 Date of Inspection ... 19 Date Completed .. .......19 G� PERMIT REFUSED ..... 19 ............. .......... ......... r '- ............................................................................... Approved ....:.................... .............................................................................. w rToAn .of Barnstable ae * Permit# Erpires 6 months from issue date nwartsrASM = Regulatory Services Fe'c r,-7, .e79. �e� Thomas F.Geiler,Director Building Division Elbert C Ulshoeffer,Jr. Building Commissioner 367 Main Street, Hyannis,MA 02601w X-PRESS PERMIT Office: 508-862-4038 Fax:-508-790-6230 JUL 2 .9 2002 EXPRESS PERMIT APPLICATION TOWN OF BARN STABLE Not Valid without Red X-Press latprint Map/parccl Numbcr ng3(l yq Property Address Residential Olt Commercial Value of Work�� Owncr's Name &Address ! , q r���11 rY, semi IIa T . Jac ou 4FAW n0 _ -- Contractor's Namc�j�y , / _T—� Y,����� ay,715 Telephone Numbcr,�-� J j•J� Home Improvement Contractor License it(if applicable) ice_3 7l �z Construction Supervisor's License #(if applicable) zy-eGc 2Workman's Compensation Insurance Check'one: 0 I am a sole proprietor 'I am the Homeowner O have Worker's Compensation Insurance Insurance Company Name �? 7 Workman's Comp. Policy# /99 '/Z Permit Request(check box) Rc-roof(stripping old shingles) Rc-roof(not stripping. Going over existing layers of roof) Rc_side Replacement Windows. U-Value (maximum.44) Other(specify) *Where required: Issuance of this'permit does not exempt compliance with other town department regulations,i.c.Historic,Consen•ation,etc. Signature pok cxpmtrg r I on, � f : t '> MAR-06-02 WED 09:56 AM MASTORS8SERVANT FAX N0. 4018859235 J.c IC :st ��u'� CA7,EA ' =' _:�_1C_ORD. CERTIFlCAT'Ej` F LIABILITY INSURANCE IDl,Tf'Q{WOG,YY - u THIS CERTIFICATE IS ISSUED AS A'MATTERr FWIN�aQRMATIO j Mz)S�i:0 -9 & Se-z-vaIit, Ltd. 4 E' ' ONLY AND CONFERS NO RIGHTS UPON.1, I A ND CCATtFiCa1' �•!'' } 5700 F)ost Road r, ) HOLDER. THIS CERTIFICATE DOES fNOVAM ,t�XTEND G i } Box 11 3 ALTER THE COVERAGE AFFORDED BY THEk 1? OPO,LICJ,ES BEt01 Cast Greenwich, RI 02818 � � .f INSURERS AFFORDINGCOVF-RA12E�f Lv$UMR_o —.... ._..... .._:_.. . a,<(. ► ; Y INSUHCHA:_Cont•inental-C43Sua'it Co Palit). Caz�ault 8r Sons f'.00fi►ly, i � • ._ ..._...sue -....---- -'._'Uran -�.l.Co'.. P.O. Box 930 f ,INsuHtR I3' Tram ortat ion Insurance Co'. Mills, MA 02b Mirsioals ^rEi t4i # [ !' wst,Rrgc: --'---...� INSURL•H 0: I .' INSURER F: COVERAGES^ _ _ it It THE POLICIES OF IN;UFiANCE LISTED 9F.LOw HAV(:;DECN,�ISSUED TO THE f WAED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.INOTWiTHSTAN- ANY REQUIREMENT, 1FRM 014 CONDITION OF,:ANYI.CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYiBE ISSUE(T MAY PERTAIN, THE INSUnANCG AFFORDED fsY.THG,LMdctrStDc-^CRIBED HEREIN IS SUWC-CT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF£i POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE DEEN`[IEDUCEO OY PAID CLAIMS. LTR TYFL OF tN,,4vnANCF. _—, P01 ICY NUMBEA —Pr OOLA�E•F CTIVE- POUTF 0pOIMV� LIMITS A. GENIMAL LIABILITY-'- I C 10 8 0 0 2 4 8 f2 ' 4/3 0/0 2 0 4/3 0/0 3 EACH OCCURACNCC X CUBtMCRC1At tJf NFrtAL LIAUILIIY; S t�• FIREDAMACE(AnyonoI,) S Qn.(i - ... _ .. CuTCLAWS MADE }{ CX,;Up( 100 MCD EXP(Any one Peron) !r P"SONAL a ADV INJURY Sl', 0 0 0 a_C) ' GFNF.RALAGGR8GAIE ... $2(, 000, 0 OFWI A,GR.0A1e UTAITAPr'LIES PGA: TS --„ t Itt} s(` PRODUCTS •COMP/OP AGG S2 0 0 0-I 0 PCR.tt7v X ,i�C�i..........�try. -- b - -- t_ ._J ' COMRINFO SINGLE LIMIT ANY AUTO ! (Ea accident) s ALL OWN.f.D nuT Or, , —_-- -- St:MI:UULLIi nU'I pS ? BODILY INJURY S (P6r p4mon) nlR[o nuaOS , BODILY INJURY S rtpa•q+thl U AU I OS i (Por acciden) ' t PROPERTY DAMAGE I (Pefecowom) 3 CAAAGL LIACILIIY --——T_ 1M --•_ AUTO ONLY•CA ACCIDENT S 1 I A.XYAl11J — - CMIER THAN EA ACC b AUTO ONLY: AGG S -- -- sxol:Ss LIAMUTY ---•-- _ EACH OCCURRENCE $ I I OCCURI I CLAIMS MADE -----'—•- ' AGGREGATE $ WOiU(F:RSCOtA6LN3.-man AND w(r'1 #9!1��']*4h - 08/09/01 08/09 02, X WCSTATU• 7H- CMCLOYEr s,LIAOIUTY / �OMMrrs,I, I FR _ EACH ACCIDENT -- s100, 000 E.L DISEASE_CAA EMPLOYEE $10 0`0 0 E.L.DISEASE•POLICY L IM1T s 5 0 0 0 0 0.OI KSCRIPTION Of OPF.RATIONSILOCATIOYCMt:100LFS+LACLUSIOFI3 ADDED a3Y EN III? PROVISIONS �~ CERTIFICATE MOLDt R'' I ADM ""��g1;,ua`L,�;,N.tiu,.;:N t r'rrPR: CANCELLATION i5t-j f1t r4 rI ii I' F` SHOULD ANY0FTNE ABOVE DESCgID C/W E0POL1C16SbBCELLEDBETOAGTIIG6lWFlATI Sanlole Cei Cillcate } )( DATE THEREOF, rHE ISSUING INSURER WILL ENDEAVOR TOIUAIL 3 0..oms wni T S I ( t NO•BCETOTTICCCRYIFICATEHOLDen14AMC-DTOTHGLGFT,BUT FAILURE T000nosiIa: IMPOSE NOOBLIGATIONOR LIABILITY OFANYWND UPON THE INSUREn,ITSACCliTt3 RCPRESENYATIV_ES. �' .. 1 l , �)luos" 47T I ` ` { (. AUTHOR)ZFDgEPRESENTA71 C --- �' ACORD`erS(7/s7)lai"Of y3�?. ' O ACORDCApPAPATInN: ..1I6Ll(JI l 01-1e As1�burto - e, ►-: "- ' \�`'' Bost on �f�l l'I-:UCfION :;UF)ERVI ;of; I_ICf_NSI.: U26 :?5 Lxpirr.::: 'IU/2 / 1;6411(l:ll,: A/I:.Alll.'i ST . .:':I, lul, tin'Ir:r.,:ll,l .nlrl r.i,.ni•; : r,l nrlrli,:'•: nulillr..,lu,n. UOAfiD,;01= BUILt11NG 1(L-GUI-,1I:IUN;; . Liconcu: SRN::r1:uc-I'IOIJ ;a,r1._1(vr.;c,l, i L3i!S,1datU-:.i�Q%CO/I JL`J Ex p i r u,,:::10P/-0/%_00:. I'r. in ;III Iluatrictud:'00 MAUL J CALl=AUur 1565 MAIN 5T OSTERVILLL", MA .a .% 01G55 __ ✓T' At rliini: V /W Board of Building Regula ions and Standards One Ashburton Place- Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration Registration: 103714 . Type: Private Corporation Expiration: 7/9/2004 PAUL J. CAZEAULT & SONS, INC. Paul Cazeault P.O. Box 2781 Orleans, MA 02653 Update Address and return card. Nlark reason for change. Address F I Renewal I Employment Lost Card Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 103714 Board of Building Regulations and Standards Expiration: 7/9/2004 One Ashburton Place Rm 1301 Type: Private Corporation Boston,Ma.02108 AZEAULT&SONS,INC. eault h Rd. �� MA 02653 - Adminislralor Not valid without signature Assessor's rmdp and lot'number ' �pF THE T0�♦ Sewage 'Permit number ..................I �:............................... Z 33ARNSTABLE, i House 'number .......::....:`����..,a�.T. �o..... .......................... gooMb q YPY a. TOWN OF ,BARNSTABLE BUILD.11:0 . 11-SPf-C.T.02 APPLICATION FOR PERMIT TO ..........e.,l.../..:!! ,6_.1.?_X7.... / of G...:.................... TYPE OF CONSTRUCTION .................... /).. ... '?'. . ..............................:...................... I .19.".�4 TO THE INSPECTOR OF BUILDINGS: 1 i The undersigned hereby applies for a permit according to the following information: Location .......... .........`I//�K .� ....�� t!�.....�.of, !7�? >.. /%% '........................ ProposedUse ............/..<.lP.✓..1�!`'7V: -..................................................................`.................................................. �'�! �+ r .......................Fire District Zoning District .....................:. ....!.................. ' Name of Owner .......`` � / 9V .....l..v.GQ.:J.2..<,:1.!r-e.•Z-.Address ...!`/1/-Gt!? "`r!1i.. .Rh...... S�i►?t,;1...!9�1 Nameof Builder'............. A..............................Address .................................................................................... Name. of Architect ............... ........... . .............................Address ..............................................................................::.... Numberof Rooms ............. ............................................Foundation .............................................. ............................... Exterior / . ll/ C6 �4* �.........Roofing ......................................... Floors ........ .... z,)............................................Interior .................................................................................... Heating g K/ G / L. ................................Plumbin ...........z.......�j.......................... ....C/?�.................. Fireplace ............/- ....:........................................................Approximate Cost ......: .......................................... Definitive Plan Approved by Planning Board ---------- �=!-----------19__-- . Area "'.: .................. I, Diagram of Lot and Building with Dimensions Fee ......... .t•.....? .�...r.. ................ SUBJECT TO APPROVAL OF BOARD OF HEALTH t � 3 rn C Q �i60 Y, V I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ' Name ..fF/ ........................................................ ;u.:.i.a.�.Rs,n...._ti�[..v:.J.:....:..a[:aw4::a,�:.c.,..v�•»::_i,n: �.�..._,. ,_ .. �...,, ,._.,_.. _.......,,a._ .. ,..._._ ... ...................... .. ,.. _ _ _ _ __ ..� A WP-he r, John L. No 23.12.Q...... Permit for .......... .........22 May-Awgil*;kgn.26?�............................ Location. ...L.Q.t..25..AAkOY.. .......................... ...................MA.ui=:�Jlius.............................. Owner ......John..L.........Wa..r.......ner...................I...........Type of Construction M.01d Frame ...................................... Plot ............................ Lot ..25......................... Permit Granted ..... .............1979 Date of Inspection ......... ........:..................19 Date Completed ........ .............................19 PE IT REFUSED K r ............................... .... ............ ...... ...... 19 .......... .... .. ............. ... ............ ............... . . .. . ......................... ............................................................................... ............................................................................... Approved ................................................ 19 ............................................................................... .................I............................................................. SOIL LOG 2•'P(11$:UNF. OEM Q „t L. -T• r2 Ytt• • J o I s T � � j, ,. � e.I i ° I • � .�..,,�_��°�•,1 , BOX 2�"VIN _ • 10 YIN 1000 .L _—_ _..J ! _I 1, e 1000— GAL. GAL. �- - PRECAST OR SEPTIC 6 I� o� • BLOCK l: o /'3�Jri.7, •. TANK „ , •� SEEPAGE PIT * o". I �E _ /N�sp�,;4" �� I e. •I d n r l .�I 'E'r7 YRty a 20' MINIMUMri FOUNDATION I %:` WASHED STONE ; ELEVATION SKETCH 10 •' ''tRC. RAT[ wAf _,�.�Nsft SCALE • I 4' t TEST+BY' TOWN INSPECTOR, 'l-W '�' BACKHOE OPERATOR: .. . Y h/DTQ; /i,f',o C=/Z oAVIC rNe"'o: A• /47,4177O)V WWJ TEST MADEa ON' �._.,•. _%! /4t���--- �L—._� �J'e�s�l�/�.L-17 ..�'.�:alri A.�/'���1/,i�•. .��/�vEY '' 'f�:" ..:�- . �.,._ � rY'`,* —z- -w 7'!'.'l'.Q >'.+I•t`7?t 4K'�:.ut'Ali:t�l.�! i'l/�•/ /�'''I�,�:'1L 71y4j� ` �y�v l�'.a...' a�nli='o.��,.y.,•rr �.'�"'d 'yrrJ'*�•�'�.C3�"ia.vi�jC�,• -;rk ..:, Q Jr G/a� tr vt,W la r 12 M, +1�k> '�:I''.S' n� f/ r { /,r,1 a/'b'••�•r7 r�.'N.7'�'•+l�»��L..� keM 1'�-.�i.,a f �.`is�' Z /� 1 3a. s 7$ ..... Q �., �. e+ Syr. r �•. ' i • Vloj . N ��� �;� quo •� ,,.. � 5 ';�.�, ,- ,.. `�•,'. . '; • s t��, � t \ * C•E,IO.k / d . ' •j� .ei+'a�.< <,,� f �, r .� �. F; 'y' �. `` � • .. '� i Sr �V L�iu.1 t ...• S Yf / 4 '' �' '�'"`- ..�. ✓�'"'�.• ,,� rye'•{ �� - . .Y,, .. Syj ' .r. . . , •,, •,. a 1 A ' ', R 1, _• •' •'r t , 1 ,p0 4 ir' .J•�'a++. �,,• 2,1�, % �r c^ 'f^• i..y '• .. �• ° cr i }' c IY'ti jM .. { ,, � ` ? ,•'i,A t S`5. „ t !' ` � '• r _ ,� .t. , ` i t r .. ^ .,a<r��#- ' �! � .tto 2 t ..r' z, f 14, 41. ��vvtL 14 1.j. _ Ij:` r r ,.. 1 . : ''� ,', ,1. ,t f .. �I,t A' •+•^', SOIL LOG ✓,..s )NE )AM a l l__ l --, 411C. I. I D1ST �. BOX z. w,ti � a •i cLN� , Y,N i 1000 _ e, a 1000— GAL. d-r GAL. PRECAST OR / I SEPTIC 6 BLOCK ° yy1z," r TANK '.�. SEEPAGE PIT -p __.._� G•��7i�.r�c _ _3-tv .. - - 20 MINIMUM FOUNDATION ' 1 '/t WASHED STONE I ELEVATION SKETCH ------ 10 --- --� PRIM RATE � � ZMeol TEST BY _._c •_c". ..rc., -�► - — - — SCALE 1 _ 4 T 0 W N INSPECTOR BACKHOE OPERATOR ya T� : -•.%fi'e i i �Grl `G .Z'.1/ < t1a 7 f V .✓A TEST MADE 0 N �'y,Y' H+F/4►'l�sV�f'' }'F �`1'!�.J.:"£�°�' .�%fir'T,� � _.S' i`:s'"�r2�:t3'P ": ¢.,. .>� Y', ,> .-r.,/.4 ;- ;,-. :"f d I1 .,i�4a T" ^. (y.n G/e" .fin�. �4 F, t;�"+•�'«�t] n 7." S a:�••.;'. ;/ r'��;'" ��rL1 1 .r-y+,,r w.✓ �a,'� ��.trr.Y7'�1•:3 C..4.."", r-s--+ .+a S `a Y •> r11 , t ` P/ iV s r. 0 # � �qy I � 014It"• 3 30 c7.,0-d- 188 S, F, w z• •4.70 /�.a[a ` R€PJWIt,K CHAPMAN No, 27j54 O ' • k- a ELEVATION SCHEDULE PROPOSED SITE PLAN I I N V AT F0 UN- :T Q SEWAGE SYSTEM DESIGN 2 1 Nv INTO SEPTIC TANK 3 INV OUT OF SEP' TANK = J 4 INv '.TO DISTRIBUTION BOX = SCALE �'� � NO✓. 19-7 5 1 N', OUT OF C STRIBUTION BOX 6 INV INTO SEEPAGE PIT i. / CAPE COD SURVE Y CONSULTANTS ROUTE 132 Z BOTTOM OF PIT = P�3 HYANNIS, MASS A DIVISION SCS'ON IURVC'/ �ONl ULTANTB, INC. 8 BOTTOM OF STONE LAYER " ' `