HomeMy WebLinkAbout0780 WAKEBY ROAD o ,
o
Cape Save Inc.
7-D Huntington Avenue
South Yarmouth, MA 02664
Tel: 508-398-0398 Fag: 508-398-0399
8/18/16
Town of Barnstable
Thomas Perry CBO
Building Commissioner
200 Main St. Hyannis,MA 02601
RE: Building Permit B-16-1970
TO: Building Inspector(s),
This affidavit is to certify that all work completed for 780 Wakeby Road,Marstons Mills has
been inspected by a third party Certified Building Performance Institute(BPI) Inspector.
All work performed meets or exceeds Federal and State Requirements.
Sincerely,
William McCluskey o
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TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map Parcel tW (/�< Application
-#
Health Division ®��(; Date Issued .g I G
Conservation Division0�, j� �°. Application F 4
Planning Dept. �9F�q fob, Permit Fee
Date Definitive Plan Approved by Planning Board T
F
Historic- OKH _ Preservation/ Hyannis
Project Street Address
IT
Village 1'to c_s+o N ����c
Owner ` Address 5 Q.rh
Telephone
Permit Requesi �_ -�q an , N 4 � �..
61r secd tke, cd6'c. '64p.Mea± r +04M,
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation Construction Type
Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units)
Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No
Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other
Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft)
Number of Baths: Full: existing new Half: existing new
Number of Bedrooms: existing _new
Total Room Count (not including baths): existing new First Floor Room Count
Heat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑ Other
Central Air: ❑Yes 0 No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No
Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_
Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other:
Zoning Board of Appeals Authorization 0 Appeal # Recorded ❑
Commercial ❑Yes JKNo If yes, site plan review#
Current Use Proposed Use
APPLICANT INFORMATION -- -
(BUILDER OR HOMEOWNER)
Name ��ll .8 Telephone Number �u� 298 (,O0
N ern License# t(��'e —1—C �a
Address M f
Home Improvement Contractor#
Email Worker's Compensation # R
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TOTf ��'
SIGNATURE DATE
r FOR OFFICIAL USE ONLY
APPLICATION #
DATE ISSUED -
MAP/ PARCEL NO.
ti
F
c ADDRESS VILLAGE
OWNER -
1 • _ r ,
DATE OF INSPECTION: .
'FOUNDATION -
I' FRAME -
INSULATION
i FIREPLACE
ELECTRICAL: ROUGH FINAL
w' PLUMBING: ROUGH FINAL
F.F GAS: ROUGH FINAL
-FINAL BUILDING -
DATE CLOSED OUT
ASSOCIATION-PLAN NO.
.............. . .
HOME OWNER WEATHERIZATION WORK PERMIT:
PLEASE COMPLETE AND SIGN THIS FORM AS
THE APPLICANT HOMEOWNER.
I ^-� hereby consent to and agree that weatherization work
may be done by the Weatherization Program of Housing Assistance Corporation on the property
located at:
/fit. JAz
The weatherization work done will be based on programmatic priorities and availability of
funding and it may include all or some of the following measures:
Weather*stripping; air sealing; attic& basement insulation; exterior wall insulation; ventilation
measures In consideration of the weatherization work to be done at my home I agree to the
' following:
1. I give permission to Housing Assistance Corporation the property with such equipment
and materials as may be necessary to perform weatherization.
2. The Housing Assistance Corporation reserves the right to inspect the fuel or utility bill for
the weatherized unit on an ongoing basis for no more than five (5)years after the
weatherization work is completed.
I have read the provisions of this agreement and give my consent.
LZ
-... .. _
Home Owner(signature) �-- --
Home Owner email: Date:_ /Z Z ! r 5`
A
Agent-(signature) ;: r v `'' Date:
Weatherization Contractors:
Adam T Inc Cape Save
All Cape Energy Frontier Energy Solutions
Alternative Weatherization Lohr Home Improvement
Building Science Construction Resolution Energy
Cape Cod Insulation Tupper Construction
I
The Commonwealth of Massachusetts
Department of Industrial Accidents
_ 1 Congress Street,Suite 100
a
Boston,MA 02114-2017
www mass.gov/dia
R'orkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Aualicant Information Please Print Legibly
Name(Business/Organization/Individual):Cape Save Inc
Address:7-D Huntington Avenue
City/State/Zip:South Yarmouth, MA 02664 Phone#:508-398-0398
Are you an employer?Check the appropriate box: Type of project(required):
1.E]I am a employer with 15 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.]
3.a I am a homeowner doing all work myself[No workers'comp.insurance required.]t 9. El Demolition
4.01 am a homeowner and will be hiring contractors to conduct all work on my property. twill 10❑Building addition
ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions
proprietors with no employees. 12.❑Plumbing repairs or additions
5.❑1 am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs
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.E]Other Insulation
152,§1(4),and we have no employees.[No workers'comp.insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
*Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and 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 the policy and job site
information.
Insurance Company Name: Star Insurance Co.
Policy#or Self-ins.Lic.#: WC0855407010 Expiration Date: 4/9/2017
Job Site Address: 780 Wakeby Road City/State/Zip:Marstons Mills
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
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 violaior.A copy of this statement may be forwarded to the Office of Investigations of the.DIA for insurance
coverage verification.
1 do hereby certify under th pains and penalties of perjury that the information provided above is true and correct
Sip-nature: Date: 11/16
Phone#:508-398-0398
Official use only. Do not write in this area,to be completed by city or town ofj�cial
City or Town; Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3,Cityfrown Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person. Phone#:
AC R& CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY)
4/12/2016
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les)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 certlflcate does not confer rights to the
certificate holder in lieu of such endorsements.
PRODUCER NAME:CONTACT Risk Strategies Company
Risk Strategies Company aCO E , (781)986-4400 FA No:(781)963-4420
15 Pacella Park Drive EJuIAiL randol hcld®risk-strata ies.com
- ss: p g
Suite 240 INSURER(S)AFFORDING COVERAGE NAILS
Randolph MA 02368 INSURERA:Selective Ins. of America
INSURED INsuRERB Allmerica Financial Alliance Ins CO 10212
Cape Save, Inc INSURERC:Star Insurance Cc
7 D Huntington Ave INSURER D:
INSURER E:
South Yarmouth MA 02664 INeURERF:
COVERAGES CERTIFICATE NUMBER:CL1641211375 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD.
INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAYHAVE BEEN REDUCED BY PAID CLAIMS.
INSR I TYPE OF INSURANCE POLICY NUMBER MM ICY EFF MPMII E P
LTR LIMITS
X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
A CLAIMS-MADE XaOCCUR PREMISES Ea occurrence $ 100,000
X 81994480 10/16/2015 10/16/2016 MEDEXP(Any oneperson) $ 10,000
PERSONAL BADVIN.URY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
POLICY[K]&CO'T LOC PRODUCTS-COMP/OPAGG $ 2,000,000
OTHER: $
AUTOMOBILE LIABILITY COMBINED
SINGLE LIMIT $ 1,000,000
B ANY AUTO BODILY INJURY(Per person) $
ALL
X SCHEDULEDAWBA46796600 11/6/2015 11/6/2016 BODILY INJURY(Per accident) $
AUT
NON-OVVNED PROPERTY DAMAGE $
X HIREDAUTOS X AUTOS Peraccident
$
X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000
A EXCESS LtAB CLAIMS44ADE AGGREGATE $ 1,000,000
DED I X I RETENTION$ BIL 81994480 10/16/2015 10/16/2016 $
WORKERS COMPENSATION Officers Included for X
AND EMPLOYERS'LIABILITY STATUTE ERA
ANY PROFRIETORIPARTNERIEXECUTIVE YIN NIA Coverage E.L.EACH ACCIDENT $ 500,000
OFFICER(MC (Mandatory In H)EXCLUDED? ® UCOSS540700 4/9/2016 40f2017
(MendetorylnNH) l E.L.DISEASE-EA EMPLOYEE $ 500,000
If yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached I/more space Is required)
National Grid Corporate Services LLC d/b/a National Grid, Action Inc, Colonial Gas Company and NStar
Electric are all included as Additional Insureds with respects to the General Liability coverage of named
insured as required by written contract.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Housing Assistance Corporation THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Cape Light Compact ACCORDANCE WITH THE POLICY PROVISIONS.
Barnstable County
460 West Main Street AUTHORIZED REPRESENTATIVE
Hyannis, lea 02601 _
Michael Christian/CLC
O 1989-2014 ACORD CORPORATION. Ail rights reserved.
ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
INS025(201401)
f
=7
Office of Consumer Affairs and Business Regulation
10 Park Plaza - Suite 5170
Boston, Massachusetts 02116
Home Improvement Contractor Registration
Registration: 171380
- Type: Corporation
Expiration: 3/14/2018 Tr# 419291
CAPE SAVE INC.
WILLIAM McCLUSKEY
4
7-D HUNTINGTON AVENUE - `#
SOUTH=YARMOUTH, MA 02664
'
C�'-Update Address and return card.Mark reason for change.
:7 +;
Address ❑ Renewal n Employment Lost Card
SCA 1 u 2OM-05/11
e�cer.A o�:ru&Business
eg a tion � License or registration valid for individul use only
Office of Consumer Affairs&Business Regulation g y
HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
o Registration:. % 71380 Type: Office of Consumer Affairs and Business Regulation
Expiration:.__'3/1412018 Corporation 10 Park Plaza-Suite 5170
Boston,MA 02116
CAPE SAVE INC.
WILLIAM McCLUSKEY :-�v
7-D HUNTINGTON AVENl1E;='_• '' :�{__t,_`K:;;�
SOUTH YARMOUTH,MA 02664 Undersecretary Not valid i signature
Massachusetts -Department of Public Safety
Board of Building Regulations and Standards
n.._-.__._ S a1
�.vn�u u�i�i�Ti oJiiEi riii�T ou8iinJLV
License: CSSL402776
WILLIAM J MC aU
37 NAUSET ROAb 1
West Yarmouth AA (V
952.,, Al..'"'f` Expiration
Commissioner 06/2812017
t
?j1311G
Town of Barnstable *Permit# ,B-/� r /J-5:3
rye' Expires 6 months from issue date
or Regulatory Services Fee a S
► iAaNSfABIE,
*'"SS' Richard V.Scali,Director
Building Division
Tom Perry,CBO,Building Commissioner
200 Main Street,Hyannis,MA 02601 2 �o��
www.town.bamstable.ma.us jUN 8
Office: 508-8624038 ,�Fa m 508-R 'J Y3ONBL�
EXPRESS PERMIT APPLICATION - RESIDENTL41ot�l
'`�,,.I Not Valid without Red X-Press Imprint
Map/parcel Number (� o 2—
Pro a Address 7 S-dtA10— "Z"6 Y ly Z'^ \,rY 4,
5A4/
f
Pfesidential Value of Work$ ( UO Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address e G4 ep-
� /y p
Contractor's Named V Z owf"1 Telephone Number J d � �—
Home Improvement Contractor License#(if applicable) G 6 / Email: (,Ll � eQd l l
Construction Supervisor's License#(if applicable) Lod
orkman's Compensation Insurance
// Check one:
❑ I am a sole proprietor
❑ I am the Homeowner
❑ I have Worker's Compensation Insurance
Insurance Company Name C
Workman's Comp.Policy# a a v
Copy of Insurance Compliance Certificate must accomp ny each permit.
,x
Permit'Rt(check box) ✓
e-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.32)#of windows
#of doors:
❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required.
Separate Electrical&Fire Permits required.
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: Property Owner must sign Property Owner Letter of Permission.
A copy of the Home Improvement Contractors License&Construction Supervisors License is
required.
SIGNATURE:
C:\Users\Decollik\AppData\Local\Microso Windows\ emporary Internet Files\Content.Outlook\2P101DHR\EXPRESS.doc
Revised 040215
I
oF�
BnaxsTnBU& •
039. Town of Barnstable
Regulatory Services
Richard V.Scali,Director
Building Division
Thomas Perry,CBO
Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-8624038 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
of the subject property
��� �. aJ�
hereby authorize � 2� to act on my behalf, .
in all matters relative to work authorized by this building permit application for:
(Address of Job)
i
Signature of Owner Date
1
Print Name
If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the
reverse side.
C:\Users\Decollik\AppData\Local\Microsoft\Windows\Temporary Intemet Files\Content.Outlook\2PIOIDHR\EXPRESS.doc
Revised 040215
i
The Connnornveakh of Massachusetts
Deparh►tent of Industrial Accidents
Office ofLtvestigadotrs
IF 600 Washington Street.
Boston,MA 02111
it,Yvtn ntas&gov/dia
Workers' Compensation Insurance Affidavit: Builders/Conti-actors/Electi icians/Plumbei-S
Applicant Information Please F4int Leiziblv
Name(Business/Otganization&dividual): CC,- /2 C�v G oel
Address: cl ��/U e CO�t'1<deT L
City/State/Zip: 6 a 4C"y V Phone,'
Are ou an employer?Che k the appropriate box: Type of project(required):
1.3I am a employer Ari . 4. ❑ I am a general contractor and I
employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling
ship and have no employees These sob-contractors have g_ ❑Demolition
working for me in any capacity. employees and have workers' 9 ❑Building addition
[No workers'comp.insurance comp.insurance._
required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions
myself[No workers'comp. right of exemption per MGL 12.❑Roof repairs
insurance required]Y c. 152,f 1(4),and we have no
employees.[No workers' 13ther C CfJ
comp.insurance required_]
;Any applitam that checks boy A mnst also fill oat the section below showing their weakers'compensation policy information
Homeowners who submit this affidwit indicating they are doing all work and then hue outside contractors must submit a new affidavit indicating such
!Contractors that check this boot mast attached an additional sheet showing the name of the sub-connacmrs and state whether or not those entities bare
employees. If the sub-contractors hare employees,they must provide their workers'comp.policy number.
I ant are employer t►tat is prosiding workers'conTetisatioti itt iratice for my employees Beloty is the policy and job site
information.
Insurance Company Name:
Policy#or Self-ins.Lc.#: Expiration Date:
Job Site Address: 0 ��
City/State Zlp:
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to S 1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do►terebv certify ntider the paitis at pert 'es ojp ' ry that the information provided above is tare and correct
Si lure:
Date: t��
Phone#:
Fcial use only. Do not write in this area,to be completed by city or town official or Town: Permit/License#
ing Authority(circle.one):
1.Board of Health 2.Building Department 3.City/Tonn Clerk 4.Electrical Inspector S.Plumbing Inspector i
6.Other
Contact Person: Phone#:
ACC>
C? CERTIFICATE OF LIABILITY INSURANCE DATE(41WDDIYY)
- -- - 02/17/2016
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT
AFFIRMATIVELY OR NEGATIVELY AMEND.EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES
NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(SL AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER
IMPORTANT:If the certificate holder is an ADDITIONAL INSURED.the*Poficy(ms)must be endorsed.if SUBROGATION IS WAND,subject to the terms and conditions of the
policy.certafi Policies may require and endorsemea A statement on Oft Certificate does riot corder rights to the certificate holder in fieu of such endorsements.
PRODUCER CONTACT
McShea Insurance NAMe Beridey Assigned Risk Services .
1550 Falmouth Rd RT 28 Ste 2PHONE
Centerville,MA02632 2Ia No 6d 800 ,�s34-4589 FA" 866) 21 5-81 18
ADDRESS:PolicyServicesQberldeyrisk com
INSURED INSURER(S)AFFORDING COVERAW NAIL#
Richard Cazeault Jr `rNsvitERA:Acadia insurance Co 31325
198 Five Comers Road 04SLOUR B.
Centerville,MA 02632
INSURER D.
INSURER I '
' INSURER F .
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER-
INSURANCE IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN INSURED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY,REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES'DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR LTR TYPE OF INSURANCE AD R 1ASU11R POLICY NUMBER POLICY EFF POLICY DIP
VD
WORKER COfPENSATi0i AND (IdWDO/YYYY) RAWDOWY LIMITS S
BugzyERSLIABIY ®WSTATU-
t ❑OTHER
ANY PROPRiETORIPARTNE RI E.L.EACH ACCIDENT p,(�D
A EX tYO WA ❑ MAARP30WM 02/04/2016 02/04/2017 E.L.DISEASE-EA EMPLOYEE $50D.000
( to t" E.L.DISEASE-POLICY UNIT $500,000
NM da=r be under DESCRIPTION OF
OPERATIONS tdow.
❑ ❑
DESCRIPTION.OE OPEPAMONS I LOCATIONS/VEt1IgFS.tAitetlr ACORD 1IH,Add�mnaf Remads.Sd�edute,I mme s 's reWhed).
Hellion CaomUory Begbri Status Name E1teclre Eimhatbri AD tru;toed EN$y
Mmiku r021MI IZhMnI CareaulCJr
Risk Locatlon
198 Rve Comets Road.Cep MA O it
COMMENTS
I
CERTIFICATE HOLDER• CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
Town of Barnstable EXPIRATION DATE THEREOF.NOTICE WILL BE DE LM3iID IN ACCORDANCE WITH THE
367 Main Street POLICY PROVISIONS
H annis MA 02601 Nt�RESN3lTATIVE
Y ; �.
ignature:
ACORD 25(2010/05) BRAC 3139
Massachusetts Department of Public Safety
Board of Building,Regulations and Standards
Licerise: CS-100393
Construction Supervisor
ASYEI3ELTtxT`.TS DR UEft'S
z
RICHARD P CAZEAULT JR F' #
198 FIVE CORNERS ROAD �: t a,sse ate .
Epp 4d a
NO 0WJ 2014LM ES< _`m
CENTERYILLE MA 02s32 Z
>, S20875687'.:
- 1f.
9� 3 2a�s 02I.O.R 7-0 MO
ErONE 1 sMls�im`'r�10
p crass
N
CA
Expiration: i1EAttL .1'
Commissioner 02/0 /2018. _ CPR �» .
198FIVE CURNERS RD oe�osi9�o -
CENTERVA�`�MAr0T6323129r
e s
cJ/zea�i���ta�itaedCLl owl�aJJ[rc/tii eftJ 'ry £
Office of.Cansamer Affays.&Bosiness Regulation : License or regrstrahou� Ird for:mdnjdal oyse only y'
IMPROVEMENT CONTRACTOR �,V beforelhe exp�ratron date. Itfound retnm t0-
" -
'2eglstra6on �686U7 Type: l '?O j of Consumer Alfa3rs and Business Regulatiop�.'
Exprra6on 37812017- Y
DBA 10 Park Ptaza Suite S170
e.. g
CA.ZEAT R OOFI N G&REPAIRS -.: osto MA 02116
UL --
:'.., r
RICH CAMAUL
198 FIVE CORNERS
GEMTERVILLE MA02632 ` a •�"
�t
Undersecretary s aiv
Vot valid t
w a'ou ig re +
o � .
"0IMit .P�
5 e v cask e � 4 %
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rth rr�
xtp°t erl..rg��rn + 9rt!v ``�xSf; . �.
rxcupatronal Safety and Health Admrnrstratwn s As4 x
Rlchard°Caaeaulf�JtY IS�
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gy:n s F tau} sr t
t,Zas successful �mpl ec/a�lt you yROccupatro lal Sa ety�and Hea the 4
z Trarmng
" ' '���cx"���"��•�Cons4uctton Safe, 8 Heattht a�x *s��,��; ,��
e
Assessor's office(1st Floor): 1" 1�(), SEPTIC sysnm mus' BE
Assessor's map and lot number l �' o d 3 '` �d d���„�®0 fir+® ���1��� E to
Board of Health(3rd floor): .,� �^ ` w
-�. 1PIi11'H'fiTL�5
Sewage Permit number -3 ! ENVIRONMENTAL CODE AND
,:i = BAHd9YeBLL i
Engineering Department(3rd floor): �Q F�S OWN R�GULATIO moo ■b o
House number / �v
h
Definitive Plan Approved by Planning Board � �Fo war d•
j APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only
TOWN OF BARNSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO (W /f
Ij
TYPE OF CONSTRUCTION
�Q 19
i
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for ayypeer�r`miit according to the following information: (l
Location ®� tJ�91iQ IUD Y MARS(O(4(S fy� I I`5
Proposed Use
Zoning District SAD rH+i Fire District c
Name of Owner Y f Ie. el'� V1UUS� Address _ =
Name of Builder Ct j ; ( 04Cle& �J - Address
_ � a :r
Name of Architect Ohm� �/lWIS�Kt � Address
Number of Rooms Kaoxg Foundation
Exterior— &hep Roofing N �
+ Floors Cy/ (� s Interior -vl — 400�
n
Heating OIT Plumbing
g
' �
Fireplace 'ri® L-R- N'ACCC, Approximate Cost
Area
7 �
Diagram of Lot and Building with Dimensions Fee �
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction.
Name �[
Constructio Supervisor's License. ®"/���-
ROSE, MIKE & CLARA
No 33067 Permit For . 112 Story
Single Family dwP11ing
Location Lot #1, 780 Wakeby Road
Marstons Mills
Owner Mike & Clara Rnsp
Type of Construction Frame
:s Plot Lot a
Permit Granted July- 14 , 19 89
Date of Inspection' 19
C Dat C pl t d - 19
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A•ssessor's,office(1 st Floor): o ,
Assessor's map and lot number 40�� Q � of THE to
Board of Health(3rd floor):
Sewage Permit number 9- 3 f 9
Z BAUSTADLL i
Engineering Department(3rd floor): � S �o rues
House number . .� "0 '639-
Definitive Plan Approved by Planning Board !Ikmg p Q A A. `7 K P
APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only 1
TOWN OF BARNSTABLE '
BUILDING INSPECTOR r
APPLICATION FOR PERMIT TO '�S/ q' /f
J 3
TYPE OF CONSTRUCTION S
19 -
' 0
TO THE INSPECTOR OF BUILDINGS: I
The undersigned hereby applies for a permit according,to the following information:
Location J OIs S I iS.
r
Proposed Use
Zon ng District Fire District
Name of Owner Y y 1 1 K�P R \ I!�1 R YOU Address
Name of Builder l�l r 1 rod N LiMS A• ddress JAP
` G. _ r •
Name of Architect RPM I( (�nyIS�K� � Address
i
Number of Rooms 00 � , Foundation COIYC�
Exterior C( v Roofing
Floors moo/ Interior
Heating ; ��� � Plumbing
/V ¢-( 2 �rCc - Approximate Cost �C� 000
Fireplace
'r..
Area �-
Diagram of Lot and Building with Dimensions Fee
4N
r p
.- _ t t. a
5
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. '
. Name J 1._� ��✓��-fC
' Construction Supervisor's License
i '
ROSE, MIKE & CLARA A=012-003
No 33067 Permit For 11 Story
Single Family Dwelling
;.Location Lot #1 , 780 Wakeby Ro
Marstons Mills
Owner Mike & Clara Roge
.Type of Construction Frame
Plot Lot
Permit Granted July. 14, 19 8
Date of Inspection 19
Date Completed 19
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WAKEBY 150.00' ROAD
FOUNDA T/ON CER TI F CA TION
T' WN.'MARSONS MILLsSCALE.'lll=40 PLAN REF. ELEVA. T/ON.'
l CERTIFY THAT THE ABOVE ``N o� 'YANK"EE ® SURVEYORS
FOUNDA T/ON /S L 0CA TED ON �� �tr9 LAND
THE GROUND AS SHOWN, AND PAULA. d CONSvc TANTS
IT'S POSITION 20 S momew
l43 ROUTE' l49
CONFORM TO THE ZONING LAW No
SETBACK REQUIREMENTS OF P� P.O. BOX 265
BARNSTARTIP �gssjo you MARS TONS MILLS MA. 02648
SURI
7/8/89 J08177.6
PAUL A. ME TIE R.P.L.S. °A rE� UMBER
TOWN OF BARNSTABLE, MASSACHUSETTS ... 4 BUILDING PERMIT.
,
DATE�'`�( ( 19 PERMIT NO.__ �D(/
7
APPLICANT L� r1AA`A CTI A 1 1 'ADDRESS >',
• rt'*'may o NO.)` (STR EET JP ICONT R'S LI ENSEI
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PERMIT TO U I L �_Of DWELLING UNITS
Lj �,os I t OR y NUMBER OF
l
(TYPE OF IMPROVEMENT) NO. (,PitOPOSEO USE) J
i AT (LOCATION) t 46T t' (,l��Kfr D� i 121) E� ZONING
�-t^- -,*�—- D I S T R I Cy T
�EE. _ (NO.) ::;t,•' (STREET) -BE' . AND t,
( ROSS STREET) 9d. • �:•'
. '�':• '(CROSS STREET)
Y` LOT.
SUBDIVISION LpT (34OC Slij
BUILDING IS TO BE Clq_FT. WIDE BY. FT. LONG'BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
•.7.
IIIF PTO TYPE' USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE).
REMARKS:
i AREA OR 1
VOLUME T- ESTIMATED COST _ L -� -1 nA FEEPER
s
I (CUB,}'.30 UARE FE `'T
OWNER
ADDRESS • ( PBUILOING DEPT..
By _
THISPERMITONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK'OR ANY PART THBRE'OF, EITHER TEMPORARILY OR `
PERMANENTt�ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP-
PROVED. JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH A'ND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED
FRjOM TH' RTMENT OF PUBLIC WORKS. THE ISSUANCE OF.THIS PERMIT DOES N 'T RELEASE THE APPLICANT FROM THE-,CONDITIONS
• 0 x Y 'i PL!I-CABLE SUBDIVISION RESTRICTIONS.
r`
E MINIMUM OF THREE CALL APPROVED PLANS MUST. BE RETAINED ON JOB AND THIS WHERE APPLI C Q� .
f�. INSPECTIDNS REgUIRED FOR - E3• ARATE
' ..ALL'C ONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE R P41 ED FOR
ELECTRICAL, PLUMBING AND
�I FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF;OCCUPANCY IS RE- MECHANICAL INSTALLATIONS.
2.PRIOR TO COVERING STRUCTURAL gUIRED�SUCH BUIL'D'IlNG'SHALL NOT BE•OCCUPIED UNTIL
�1 --, MEMBERSIRE ADY TO LATH). '-ti„�`• .
-_:-3.-FINAL INSPECTION BEFORE FINAL INSPECTION HAS.BEEN MADE. '
_,OCCUPANCY.
POST THIS CARD SO IT IS VISIBLE FROM: STREET
BUILDING INSPECTION APPROVALS, PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS
2 —
3 HEATING INSPECTION APPROVALS ° ENG IN EERINleDEPARTMENT
r• I
OTHER 2 BOARD OF HEALTH
WORICSHALLIv`-,. OCEED UNTIL THE INSPEC- PERMIT W!LL BECOME NULL AND VOID IF CONSTRUCTION
` TOR HAS APPROVED THE VARIODUS STAGES OF WORK.IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED F6 INSPECTIONS ND(CATED ON TNI94CARD;CAN BE
I=1"*' CONSTRUCTION. R BY TELEI,-.7VE OR WRITTEN
i I PERMIT IS ISSUED AS NOTED ABOVE. NOTIFICATION.
>_
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TOWN OF BARNSTABLE Permit No. . 33067._....
•� BUILDING DEPARTMENT
TOWN OFFICE BUILDING Cash
......
�o 39 HYANNIS,MASS.02601 Bond X..
i
CERTIFICATE OF USE AND OCCUPANCY
Issued to Mike & Clara Rose
Address Lot #1 , 780 Wakeby Road
Marstons Mills, Mass.
USE GROUP FIRE GRADING OCCUPANCY LOAD
THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL
SIGNED BY-THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE
BUILDING CODE. /--.,
November 13, 89
19................. �!........ ....................
Buildin Inspector
n.A
��•.° °�.ew TOWN OF BARNSTABLE
BUILDING DEPARTMENT
t a�7°T TOWN OFFICE BUILDING
rua
HYANNIS, MASS., 02601
,
MEMO TO: Town Clerk
FROM: Building Department
DATE:
An Occupancy Permit' has been issued for the building authorized by
BuildingPermit #......_._...9..204�7....... ....................................... ._...._._.........._........._ »_ ... _ »�
issuedto _.( . ..................................
....
Please release the performance bond.