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0075 WILLINGTON AVENUE
S� o,�� ., cam . I Town of Barnstable *Permit# Expires 6 o the rom issue date Regulatory Services Fee enxrtsraetB, 0 9. Thomas F.Geiler,Director s p.� �Y Building Division Q ,� Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERAUT APPLICATION - RESIDENTIAL ONLY Map/parcel Number 0 3 l 0 y/ Not Valid without Red X-Press Imprint Property Address Jr wj j l IN b to K 4tie.B V e. M g K-ora+7f hf,llr [Residential Value of Work$ J�/4 0 06— Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address AUICA G e X t 1*4 eYe l4 'S#N r Of 1 s' Wj71l#v6rok 46/t. A!.4 f$ Tons hr/l,, 1W 0A4 YP Contractor's Name -rho m ij M 14 1/ /w - Telephone Number Home Improvement Contractor License#(if applicable) 00�'f a Email: t-)e)zt f c- C9/, itr'ho i-e• c,11 r lvme Construction Supervisor's License#(if applicable) e S oi66y kPRESS PERMIT 6orkman's Compensation Insurance Check one: S E P 2 6 2013 ❑ I am a sole proprietor ❑ I am the Homeowner p'i have Worker's Compensation Insurance TOWN OF BARNSTABLE Insurance Company Name 4,§f 6C.,,4c4 Workman's Comp.Policy# w<< f o bi 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 _ Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) �IC OAJ RRe-side C 4 n•6&,ete6l LJj4 y 4 6 / RaA [v�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: C:\Users\decollikWppData\Local\MicrosoR\Windows\Temporary emet Files\Content.Outlook\8R76BDVA\EXPRESS.doc Revised 061313 J Office oflnvestigations 1 Congress Street,,Suite 100 Boston,MA 02114-2017 www.mass gov/dia 'Porkers' Compensation Insurance Affidavit: Builders/Contractors/Eieetricians/Plumbers Applicant Information PIease Print I,e 'bIv Name(Busiuessforgmization/Individual):Capizzi Home Improvement Address:1645 Newtown Road City/State/Zip:Cotuit, MA-02648 Phone#:508-428-9518 . FAre you an employer? Check the appropriate box: ,'.R1.I am a employer with 40f .4. ❑ I am a general contractor and I Type of project(required); employees(full and/or part-tin 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 sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' No workers' comp,insuranCe comp: incnran0e t 9• ❑Building addition 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 11U Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL insurance required.)t c. 152,'§.1(4);and we have no P 12. Roof re aus: employees- [No workers' 13.Vother &J/GIOoti/I ----------------- comp.insurance required.] I (/ *Any apV!cant that cheblo;box*I must also fill out the section below shov&g,*heir workers'compensation polt� information\ t ontrac wneis who submit this affidavit indicating they are doing all work.&`then hire outside contractors must submit a new affidavit indicating such. xContcaq ors 8iat check this box must attached an additiou4sheel showing�the name of the sub-contractors-and Mate whether or not those entities have employees. If the sub-ebntractors have employees,they must provide their workers'comp,policy nvmbei; I am•an.employer that is providing workers'compensation insurance for my employees. Below is the policy and joh site information. Insurance Company Name:Associated Employers Insurance Company Policy#or Self-ins.Lic.#:WC05010 547012011 Expiration Date: 12/25/201g Doti Site Address: 2,01W! 7e City/State/Zip: 11�✓lrrte Ji Attach a copy of the workers' compensation po.'cy declaration page(sho.Wing the policy number and expiration date).Faildre.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-year imprisonment;as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify nder the . • and pen ofperjury that the information provided above is true and correct Si afore: Date. Phone#: 508-428-9518 OfJTckl use only. Do not write in.this area,to.be completed by city or town of City or Town: Permit/License# c Issumg 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#• CAPIHOM-01 CBENISCH ACORO' DATE(MM/DDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 6/12/2013 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(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 endorsement(s). PRODUCER CONTACT NAME: Chris Benisch Rogers&Gray Ins.-Dennis Branch PHONE 508 398-7980 Fax 434 Rte 134 (AJc No Ext):( ) (aIC,No):(877)816-2156 South Dennis,MA 02660 ADDRESS:cbenisch@rogersgray.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Main Street America Assurance Co. INSURED INSURERS:Associated Employers Insurance Co. Capiai Home Improvement,Inc. INSURER C: Capiai Enterprises,Inc. 1645 Newtown Road INSURER D Cotu it,MA 02635 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP OMITS LTR INSR WVD POLICY NUMBER MM/DD/YYYY LMMIDD/YYYY) GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY MPB1075H 6/8/2013 6/8/2014 PREMISES ( a occurrence) O PREMISES Ea ocarrence) $ 500,000 CLAIMS-MADE a OCCUR MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY JECOT- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ A ANY AUTO M7 M28044 6/8/2013 6/8/2014 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ 500,000 AUTOS Ix AUTOS X HIRED AUTOSNON-OWNED PROPERTY DAMAGE $ AUTOS (PER ACCIDENT) $ X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LIAR HCLAIMS-MADE CUB1076H 6/8/2013 6/8/2014 AGGREGATE $ DIED I X I RETENTION$ 10,000 $ 5,000,000 WORKERS COMPENSATION WC STATU- X OTH- AND EMPLOYERS'LIABILITY TORY LIMITS ER YIN B ANY PROPRIETOR/PARTNER/EXECUTIVE WCC5010547012012 12/25/2012 12125/2013 E.L EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? � N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 1(1,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis,MA 02601-0000 AUTHORIZED REPRESENTATIVE I @ 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010106) The ACORD name and logo are registered marks of ACORD l Capizzi Home Improvement Inc. Page 7 of 7 Specifications and Estimates STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT I, �'✓L' 1 �' , OWN THE PROPERTY LOCATED ATS� IN Llt'1 P;I, �1 S ,MASSACHUSETTS. I HAVE AUTHORIZED CAPIZZI HOME IMPROVEMENT TO ACT AS MY AGENT TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. I GIVE MY PERMISSION TO LESSEE TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR HE MASSACHUSETTS STATE BUILDING CODE. II SIGNATURE OF OWNER: OWNER'S ADDRESS: OWNER'S TELEPHONE: LESSEE'S SIGNATURE: LESSEE'S ADDRESS: LESSEE'S TELEPHONE: APLLICANT'S SIGNATURE: APPLICANT'S ADDRESS: 1645 Newtown Rd., Cotuit,MA 02635 APPLICANT'S TELEPHONE: 508-428-9518 RESPONSIBLE OFFICER: RESPONSIBLE OFFICER ADDRESS: RESPONSIBLE OFFICER TELEPHONE: 11M Massachusetts - Department of Public Safety ! Board of Building Regulations and Standards Construction SuperVisor License: CS-080680 THOMAS M TAYL=OR 69 MAYFLOWER TERR = SO YARMOUTI-17MA 02664/ - Expiration Commissioner 06/09/2015 V�C ((>[l7Il II/pIItC+C([�t'�1.���C(IJ1l[C�!/JC�IJ -= ffice of Consumer Affairs&Business Regulation License or registration valid for individui use only ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: _= 'Registration: 100740 Type Office of Consumer Affairs and Business Regulation - 10 Park Plaza Suite 5170 Expiration:- 6/23/2014 Supplement+ and Boston,MA 02116 CAPIZZI HOME IMPROVEMENT;INC. THOMAS TAYLOR 1645 Newton Rd. Coluit,MA 02635 Undersecretary Not valid without sign ure i t Massachusetts -Department of Public Safety ! Board.of Building Regulations and Standards Construction Supervisor License: CS-080680 THOMAS M TAYL=OR r' 69 MAYFLOWER TERR, SO YARMOUTH";NIA�02664 ,'j Expiration , ,�a 06/09/2015 Commissioner ��L' �riltii[[6IrtttCf�l��4��'�Ca.tJt[C'�[rJC'��J free of Consumer Affairs&Business Regulation License or registration valid for individul use only ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation Registration: 1,00740_ Type 10 Park Plaza-Suite 5170 Expiration:''6/23/2014 Supplement 4 and Boston,MA 02116 CAPIZZI HOME IMFROVEIMENT,INC. THOMAS TAYLOR 1645 Newton Rd. Cotuit,MA 02635 Undersecretary Not valid without sign ure t I MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION Two Center Plaza Boston,Massachusetts 02108.1904 (617)723-3800 Ma Only(800)392-6108,FAX(800)851-8424 5/31/2013 Form of Notice of Casualty Loss to Building Under Mass.Gen.Laws,Ch.139,Sec.313 BARNSTABLE BUILDING COMMISSIONER 367 MAIN STREET 367 MAIN STREET HYANNIS MA 02601 Re: Insured: THERESA M SANTOS Property Address: 75 WILLINGTON AVE,MARSTONS MILLS, MA 02648 Policy Number: 0869651 Type Loss: Fire(including Fire caused by Lightning Date of Loss: 11/26/2012 Claim Number: 314490 ® c o c Claim has been made involving loss,damage or destruction of the above captioned propert,which mye,'ther n exceed$1000.00 or cause Massachusetts General Laws,Chapter 143,section 6 to be applicable. If any, w notice under Massachusetts General Laws,Chapter 139,Section 3B is appropriate, please direct it to th attention of the writer and include a reference to the captioned insured,location,policy number,date of loss and claim or file number. 9 w MPIUA Claims Division CMA00021 FROM :R&H CONST. FRX NO. Feb. 07 2003 09:04RM P1 TOW]® oL Barnstable E �ofte+e OD3 F�e �iees$. 46 Regula1olryr : Thomas P.Geller,Director S619. Buildig"DisoN o M Toni Perry,Building Commissioner 20D Main Street,Hyaunis,MA 02601 Fax: 508-�90-6230 Office; 508-862-4038 I1EST FOIRR ELIECTIRICAL INNSEIEC Q 4/0 ELF,CTRICAL PERMIT NUMBER (Permit required m order LU process inspection) Today's Date 6 Requested of Inspection �' •� � �� hereby request an.nspectio n under Massachusetts General I, (Vec cidn) Law chapter 143,section 3L and 237 CMR 4,02(3). The installation is complete and ready for inspection at (Property Locatso ) Type of inspection requested: [] ❑ Service Re-inspection Temporary Service a S� hough Re-inspection Excavation Find Fie-inspection Set'vice Fnspectioa Aoagh bspectiou for [I �inal Inspection for G [� Qther owner or tenant_ Licensee's name,address,and phone r� .(Lam.�.�. �o� c f, o -4c yy License number y70� Licensee's Signature ' r s t couplet b Sp �Yd 2W3 Inspection date_ p g :-]Approved []Not Approved d for viclation of the following Articles and Sections of the MA Bleetrical This work was not approve - Code: 4_6 Town of Barnstable �oZVE F, TOWN OF BARNSTABLE o„ Regulatory Services BARNSTABLE. ; Thomas F.Geiler,Director ZOOS JAN —2 PM 1: ( 2 MASS. o 1639• .0 Building Division TFD MAy A Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 026.01 UIVISION Office: 508-862-4038 Fax: 508-790-6230 REQUEST FOR ELECTRICAL INSPECTION ELECTRICAL PERMIT NUMBER (Permit required in order to process inspection) Today's Date Requested Date of Inspection I, hereby request an inspection under Massachusetts General (Electrician) Law chapter 143,section 3L and 237 CMR 4.02(3). The installation is complete and ready for inspection at 71ly,`< ! ►'+ o rt //!/� �l tilif��''� �/l (Property Locati n) Type of inspection requested: ❑ Temporary Service ❑ Service Re-inspection ❑ Excavation �� Rough Re-inspection ❑ Service Inspection ❑ Final Re-inspection ❑ Rough Inspection for ❑ Final Inspection for ❑ Other Owner or tenant T/!-'I- Licensee's name, address, and phone febn J', L,1 ¢e 30 RaS; lecsa-r License number11 7C 7 E Licensee's Signature This section to be completed by Barnstable Inspector of Wires JAN 06 2003 Inspection date / GZApproved ❑Not Approved �^ This work was not approved for violation of the following Articles and Sections of the MA Electrical Code: Q:WPFiles:Bldg:Elecrequest Town of Barnstable F THE T�~0s Regulatory Services R Thomas F.Geiler,Director. BARNSTABLE, 9 MASS. 0a 039. Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 026.01 Office: 508-862-4038 Fax: 508-790-6230 REQUEST FOR ELECTRICAL INSPECTION ELECTRICAL PERIVIIT NUMBER ` (Permit required in order to process inspection) l Today's Date �--� Requested Date of Inspection O hereby request an inspection under Massachusetts General (Electrician) Law chapter 143, section 3L and 237 CMR 4.02(3). The installation is complete and ready for inspection at 73' L(/.Ll ,,x Ale- (Property ation) Type of inspection requested: ❑ Temporary Service ❑ Service Re-inspection ❑ Excavation ❑ Rough Re-inspection ❑ Service Inspection ❑ Final Re-inspection 0� Rough Inspection for I la v moon h C e4�0_ . ❑ Final Inspection for ❑ Other Owner or tenant e 5Q //'ar— Licensee's name,address, and phone�,e6� c7 L'a�cc�� rtelG'�� �� �`s /:Sow yea-y67� License number Licensee's Signature b e A, Lace lJi AIV This section to be completed by Barnstable Inspector of Wires r 61 e Inspection date ❑Approved ' Not Approved Zt) This work was not approved for violation of the following Articles and Sections of the MA Electrical Code: 4 d2z2 ' Q:WPFiles:Bldg:Elecrequest The Commonwealth of Massachusetts Dcpartmear of PubGc SafcfY BOARD OF FIRE PREYENnON REGULATIONS S27 CMR v-W 3/90 (sue es.s� APPLICA-RON FOR PERMIT TO 'PERFORM ELECTRICAL WORK M.yock to be pej*nncd to a000r&occ%uh the Maw uzcus Merl Gods.sv CidR 1Z-0o (pI EASE Pma nx.Ism OR HYPE .Am ItimmiAT m Date • City or roan of 04&4Sx"'� 09 <-S So the Inspector o Aires: 327,e uadersignad applies for a permit to perform the clectrieal vork described belov- Location.(Street&2hvmber) Owes or Tenant owner's Address Is this permit In conjunction with a building permit: Yes M No❑ (Check Appropriate Box) . impose of BQildi. Utilit-f AathorSzztLoa HO- Existing Service-/O D fps s� 1 �O Volts Overiiud �IIadB�rd Q Ho_ of 25eters_� F--IZ Scrvi,oc .Amps / Volts Overh,.d ❑ •uadzrQ❑. so_ of Ke-tern \\ ra=bcr of Fecde-s and Aapxity / w}� location and Haaiz of Proposed Electrical Work l*'OOs�I S !h 42 v No. of Lighting Outlets No. of Bot Tabs No. of IYxas£ormers No. of Lighting Fixtsres Swis:aiag Pool Above❑ In- ❑ Generators VA - grad_ grad. O bo- of Receptacle Outlets Ito_ of Oil Burners No. of Emergency Lights Battery Units No. of Switch Outlets No. of Gas Burners FIRE AIARMS - No. of Zones Total No. of Dot-tectioa znd No- of R=Zes No: of Air C,00d. tons. Iaitiaring Devices Beat Total Total No. of Disposals No. of P=yss pA - No. of.SSS1oun�ding Ddvi,ces. Contained No. of Dishwashers Space/Area Beating -TR Detection/Soaad1mg Devices. 2to_ of Dryers Beating Devices YR LocalQ ConnecottLer tr❑ No- of Rater Seaters }N No, of o Low Voltage Ballasts wirint No- hydro Massage Tabs No. of Motors Total HP INSURANCE COVERAGE: Pursuant to the regaire=nts of Hassachusetts Cenral Laws I have a current L.i-brut- Insurance Policy including Completed Operations Coverage or its substantial equivalent- TES❑ NO I have submitted valid proof of sax to this office. ISSQ• NO If you have checked YES, please indicate the type of coverage by checking the appropriate boot- INSURANCEBOND ❑ O1'ftER❑ (Please Specify) • iration ate Estimated Value of Electrical,Work S Work to Start Inspection Date Requested: Rough Final' Signed under the penalties of perjury: FIRH NAtsE �� Cc c c o Lz.C. NO.4 Y o - Licensee r, �� s c_-[� / Signature V�- v MC. HOB ZI-- Address ' O 4 Bus. Tel. NO. Ir._ • Alt_ Sul- No. OWMIS INSURANCE WAIVER-- I an aware.that the Idzenses: does not have the insurance coverage or its sub- stantial equivalent as required by Hassachusetts General Laws, and that ray signature on this permit application waives this requirement. Owner Agent (Please check one),. Telephone No. PEFOM FEE S ! Signature of Owner or Agent L — J I Town of Barnstable *Permit#.2o®("5 Y?f ILI Expires 6 months from issue date `7 Regulatory Services Fed'77. 96 • BMOMABLA MASS Thomas F.Geiler,Director Building Division ' . X-PRESS PERMIT Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 �. S E P 2 9.2006 www.town.barnstable.ma us Office: 508-862-4038 Fax:508-790-6230 TOWN OF BARNSTA RESS PERMIT APPLICATION -- RESIDENTIAL ONLY f/ Not Valid without Red X-Press Imprint Map/parcel Number !/ 3 e 7 1 Property Address 7 (i 4 G � 14✓ G1 i$�0�4 nit:�(s: A y o7 do `! [Residential Value of Work /y, �U Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address 76.L1 e.S ct _Sa u4o S Contractor's Name;,r e l'%,4 Telephone Number__- ,S(e(� - 3 7- O 8 S� 'Home Improvement Contractor License#(if applicable) / S 5 G y o Construction Supervisor's License#(if applicable). [` Vorkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner a I have Worker's Compensation Insurance a Insurance Company Name )Ci s S G� �iL>14 d 4 Workman's Comp.Policy# t'�J(�/ — 7�'O 7 3�'OS-� .-2 00 7 Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to [r Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,Le.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. Home Improvement Co tractors License is required. SIGNATURE: Q:Forms:expmtrg Revise071405 I 1 �I -- C6I7lFiCATEMlMbSt 004 __ +.yam - _ _ _ ..c-_•r _Ate ectfm WO MOM UPON f Y '� '� R�5 CER{tFlUITE T$Issum A3 A MATTER CF!FC �Ttt15 FQ"TM CERTIFICATE DOES pfi000C[R TTf CE7tTi1GTE Hmvm olmm THAN TH06E Bt T}EPOUCTES DESCRTEWHHrBL A1Aii511 CANADA UTATED IIOTAMEIt0.EKTETD CR AL78t71EOOv9NGEAF 70 UNTVSLsm AVMIE.sufIE 800 coMPAWS AFFOROB40 COVERAGE raLorrro or/ use 2Ms mr LMOM MVPJAL 04SUIAWX COMPANY p A pxy LNTERLOCK WOUSiFZtEB.W--- COT a A MASSACHUSETTS CCrfORATOM C�TVAHY UNIT s7.2S WALPOLB PARK SOUTH C WALPOLE.NA 02031 OCwAH1f Dmig _ = " l•� - _ - -- -OF vmnmm gwATm MUPAw)rm NSTAm0D8�Y T 7TOS K TO CSYTIFY 7HJtT 11£FOUCIES CF t157O M OC HAVE %"CH ft£T►£CUnTrATE LAY 15541W w MAY Pmo TW momm"T,TERM OR DONOTTTOH Cf ANY OOHIAAGT OR OTf6t OOCTAJET(f Cf SUW fOUCES U1UTs SITOVYH MAY WIVE EIEEHI+IDUCED BY PAID CLAMS. POUCESLTSTWHUENISSTJR.IG=70ALLTTIETFRMS.00T TIp15A11DE)oCIUSIONS Lam Wf $FEcm GATE-I .co 7TFE T15i1RM10E -^-'f Q OJUE W I� y1 LTR CgAp�+BGATE i GE�BVLLPAUN .00MPAPAW i CoMq BXPLGEHERALLVBUIY F3T9oMLsADV*LgW i pIATMS MADE OCCtSI i EACHO +CP i 04 "M-S&CONTRACTOR-S MW FIR *AMAM"cvr" i ppMgilfBosvius A a i j%vm$l0atE Lvzuff AW ALOO DOOIL71tTTJItY i AMOM WAUM Fro SCTEDLXMAV= somY Putw i "RWAUAOS fw.ftwp9 HpT}(jmmAmos niopoMDA"AM i A1TWMy-FAACCWfT $ GATTA[fUABK" CDERTHAHAMOOLr - ANYAM FACHACCTLt a i AOcOiBOJITE i EACHOCC S �ttSStwealTY AGGFWATH i UTj0rdUA FORM i OrnMTWXL%WMIAF0f*1 wcsTATtiY oTna+ TanuMrrs A LmpcLm.$.A7jm J" ELEMMAxcFNF i 1.000.000 am WCt-871-072231-056 2/1/2006 2MI2001 ILpSEAM_rgrfuuT ! 1.000.000 oat TiDWASEEAa+eatvrm i 1.000.000 QF/iC9iSARE *not • I WWWW"OFOPEFIA TTT3S M PROOF OF U.S.WORPMRS'COMPENSAMN 3 EMPLDYFR'S LWAnliY COVERAGE ' _EE CVXBIIO owofE:Nl DPnAAT�IOIr<r ANY ar 7►E raT�.s f�BrTTHHIEOF THE Af>:>�WWULACE ML UtXA~To MAIL 22 vll OM"mm pm NOOK to TO VIMOAT CT►IAY CONCM - To 7W tUMMAX HMM-A"HMK tlut FAILLae To THMA pBIpATToq os Lamm Of X TQIO ww T}E stxrfa� pgp�fTA71yFA,CAT/IISStEAL1F T]!6�CfIF1CATE. MARSH CA1tADA tlM1» PM2 VA mASOF.1lSOf2DOS I The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ky 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Aaulicant Information / l / Please Print Leffibly Name(Business/Organization/Individual): Address:,,'?S liU6j a,) �c_ Sa L;,, , ? City/State/Zip: L✓r_lgo/� , /,4/V 0,,�105� Phone#: S6 Are you an employer?Check the appropriate box: Type of project(required): 1.�am a employer with /S 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. t 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp.insurance. 9. ❑Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions required.] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL I I.❑Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑Roof repairs insurance required.]t employees. [No workers' 13.0 Other 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 their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: f?/I Ccl-5 fe Policy#or Self-ins.Lic.#: G/— (j 7/— Expiration Date: /i /0 T Job Site Address: �7 L✓� ����ti ti dE- City/State/Zip; ,1,,4;//5 "I 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$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains penal ' s of perjury that the information provided above is true and correct Si attue: Date: Phone#: C 3 -7 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#• • � p . GJ� � a • Board of Building Regulations and Standard_s HOME IMPROVEMENT,CONTRACTOR, `Registration. 13964,0 Exp.i�n 7/28%2007 + t Type: Supplement Card INTERLOCK INDUSTRIES INC//1 J KEITH' O'DONOGHUE e 0 25 WALPOLE PARK SOUTH / ..WALPOLE, MA 02081 �i,�� Administrator I Town of Barnstable .eaxsrABM 3 9. Regulatory Services Thomas F.Geiler,Director Building Division Tom Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Proper Cvrcr Pest Complete and Sign This Section If Using A Builder I ,as Owner of the subject property hereby authorize//l�Wi�/U~(//C //7 �VS�/ i°Y _to act on my behalf, in all matters relative to work authorized by this building permit application for: (Add ss of Job) C/)o2 Signatdre of Owner Date .- Print N e s Y - Q:Forms:expmtrg Revise071405 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION M, 163 Parcel C34// Permit# � 5- y 'Y 091*, Health Division �-1D L(-j�-OZ Date Issued Conservation Division Ogg Application Fee i Tax Collector_moo a k k)L, — &/oP-- Permit Fee /,;;� . Treasurer 1� ���L // �/��(� SEPTIC SYSTEM MUST BE Planning Dept. INSTALLED IN COMPLIANCE Date Definitive Plan Approved by Planning Board WITH TITLE 5 ENVIRONFAENTAL CODE.ANIL Historic-OKH Preservation/Hyannis TOWN REQUI.A1.16NS f Project Street Address 76 Lit L V1 y Village T*,kQ sT�S U AL l S' o �' Owner :I;C�S6. ���a ✓� Address 75 s:- Telephone Permit Request Y Square feet: 1st floor: existing....1 I I L proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Ji < ® CIL> Construction Type QCA- Lot Size Grandfathered: 0 Yes O No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure /If Historic House: O Yes &k On Old King's Highway: ❑Yes Basement Type: 21 Full ❑Crawl 0 Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new D Half:existing / new O Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: m(as ❑Oil O Electric ❑Other �— Central Air: O Yes &eNo Fireplaces: Existing New Existing wood/coal stove: O Yes O No Detached garage:O existing ❑new size Pool:O existing ❑new size Barn:0 existing 0 new size; P Attached garage:❑existing ❑new size Shed:O existing O new size Other: •_ ' �; t cn ..� Zoning Board of Appeals Authorization 0 Appeal# Recorded❑ y _� 4Commercial O Yes ❑No If yes,site plan review# _ Current Use Proposed Use N) ; t L C k cu Ck)aM 6,0 S,,_�UILDER INFORMATION Name (D" Telephone Number -�5_0 yaZ 0 - 7 g,_X),- Address ti License# 00cb3 g 6 Home Improvement Contractor# f 3 ,S / a Worker's Compensation# C 7 - 3 S/ - `7 ALL CONSTRUCTION DEBRIS RESULTING/FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE !a� _ FOR OFFICIAL USE ONLY s i PERMIT NO. JDATE ISSfJ8D I MAP/PARCEE_&O. ADDRESS- VILLAGE OWNER s _ DATE OF INSPECTION: -FOUNDATION I i FRAME 6 j�;sy� r'J k D!�/ INSULATION .61wS y Ol< 11;2 2/0 3 S✓�/ r FIREPLACE i ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH3a FINAL GAS: ROUGIi �i ` FINAL 40 FINAL BUILDING s I DATE CLOSED OUT � y ,ASSOCIATION,PLAN NO.;T. _ - r - 4 BOARD>OIF BUILDINGAFGUWLATsION `. t License: COI�FSTRUCTiOr?I -UPE-- \lSOR' . Numbe ! _�a 080386 1'9.67 Birr`t..d e� �07 50p 7 T r.no: 803861 t R ed � �a i WOVE MI:CWAEL p LEAR, 991ML.®WAIL j. C©fiUIT, MA 67635'" 5/y Admu►ist�ato�. i lugBoard of Building Regulations and Standar'dll '` HOME IMjj�O�� VEMENT CONTRACTOR :'Registra�iflo .. . R, 135592 � w a}��: _:a Tea04 t _Ph�ate'Corporation M.L.CONSTRUC~� 11 MICHAEL LEARN /= 99 WILDWAY COTUIT,MA 02635 Administrator i I The Commonwealth of Massachusetts - - - Department of Industrial Accidents office offnyestigatfons 600 Washington Street _- Boston, Mass. 02111 3 `3 Workers' "om ensation insurance A�davit e: CV CiFIN .. hone# �U(A - L �C)Cgdiiornv, •I am a homeowner performing all work myself. I am a sole r rietor and have no one workin in ca achy //////%%%/%/%%/%%%%//G/%%%%%%%l/%/%%%% %%%/%//�///G%%///%///e%///1%/% �5,� COIn7� f?•E •x•???{ r,2:r^�sY eF<xx?'.<.•#;�:;f•5 ;: FVOrkeI5 ensationfor my •� .ri •.:54:•rf• .,.;}�•.nx;S:;gS7+%f'•,'•?:?.}:tY•`{ :�?': ,f,.•:�r^r'i✓{..:• ;i::;:'{S.}}rf:}: n-:x{x 1 er- IQVL g %h,{,....SC{£} ! vS;:••:.r..: •:; ::.. :+:r r'$.'}:,::,'::•.4n.}r:a::r: ^,}'e'i?•:`.'.te w;;%}},: ,:{.;:,,r;.y J?:, an erT1T� ay D ,vrY4!•x<!.tw;:.}.,;,!.:wfi::»>µi...}.::`:J.:rY...n..<>2,:,�r.{ „w::. 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':fY�,i:::2•:;y:3:ir r?%:{!{::,�2r:.}.,};1}�{, ..4......}Y,iA v.v,.;i}f:.,,;.;i•.; n..:.;.♦..i Y.}i-x•.n:...........:..... � :�T1J.LL'Y.BItC•`e:GQ.;!?C:•v;;;/,•!$:I4`•{;rut':f:•'v:d:2'6:h):v.:$:;.i3}i.'•$•,.v.$:t!{4:t•>}}:ltC v:::.n:..... 1,5 FaIIme to secure coverage is requirednnder section25A,of MGL 152 can]ead to the imposition of cxiininalpea days of a Sue up to aers .Q0 and/or one years'imprisonment as sve11 as civil penalties in the form of a TO'Pigns t the K O f�DtRor ena ra a finever of ation.09 a day against me I mmders4�md that a' entma be forwanied to the Office of Investig copy of this stakem y • , _., •.-; { ..d h id - tjto�the-in ormation rose -v is ltv�aud cairec't fytcncerthe� ai an penalties-of-perjury f P - - I do h'eteby'c'erti F � t, t'L/./v �• • Date Signature .,. ... , .;'• :.. ,,,..• ''' `ram �� -7�� Phone pliat name do not write in this area to b e completed by city or town offidal ofgcialuse only - pernl' iicense# [{BcensieDepartttent n: ❑LieensineBoard city or tow . ❑5elrtrten's Otflce contact person: � . Information and Instructions eir Massachusetts General Laws chapter�152 section 2e requires erY* ers to provide er on m the serviceeof another under anycontract employees. As quoted from the `law , an employe is rY P , .of hire,'express or implied, oral or written. artners ation, corporation or other legal entity, or any two or more of An employer is defined as an individual, pP, associ_ the foregoing engaged in a toes enterprise,-and including the Iega1 representatives of a deceased employer, or the receiver or l,partnership, association or other legal entity, employing employees. However the owner.of a trustee of an individua .. - dwelling house having not more thanthree apartments and who resides therein,•or the occupant of the dwelling house.of another who employs persons to do maintenance, construction or repair workd to be such dwelling house or on the or b�deg appurtenant thereto shall not because of such employment be deems employer, GL chapter 152 section ZS also states that every state or local licensing agency shall withhold the issuance 6r renewal M Pt ' of a license or permit.to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally, neither the' 'nor any of its political subdivisions shall enter into any contract for the perfonnance of public work commonwealth until corom e evidence compliance with the insurance requirements of this chapter have been presented to the contracting acc�pt authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and: supplying company names, address and phone numbers along with a certificate of insurance as all affidavits be submitted to the Department.of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The•affidavit should'be returned to the city or town that the application for the permit or license is being requested, not the Deparment of Industrial Acciderts. Should you have any questions regarding the'law'o �if ygu obtain.a workers' c6' ensatim policy,Please call the Depai taieIIt at the number listed below:. are required,to - City or.Towns .. .� that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of�he Please be sure the applicant. Ple'se affidavit for you to fill.out in the event the Office of Investigations has to contact you regarding the smut" �censeiiuuibeiwlucliwinosused is a refeience:num�ei. Tlie:affidavits may�ie'ri une ?,. be sure 'eat by or FAX unless othei arrangements have been the Dee Investigations would like to thank you in advance for you cooperation and should you have questions The Office of s. - please do not hesitate to give us a call. The Department's address,telephone ThCCommonwealth Of Massachusetts ._Department of Industrial Accidents :.. ' � Office a[Investlgatlons . 600 Washington Street Boston,Ma, 02111 i fax#; (617) 727-7749 . «171 727-4900 eat. 406, 409 or 375 °0HE T° Town of Barnstable Regulatory Services BAMNSMLE9HAS& '$` Thomas F.Geiler,Director s6J9• prED MA'S A Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT ROME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization, conversion, improvement,removal,demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: Estimated Cost C 77 f Address of Work: \` � Owner's Name: �1 e Date of Application: ' `'I C� I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law []Job Under$1,000 ❑Building not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: f CL CAg _aafEI C�)U 0 Date ContractorVa r abe Registration No. OR Date Owner's Name Q:fbr ms:homeaffidav 1 Barnstable Assessing Search Results Page 1 of 2 :TNT ,.�.n � r: $v sfi� yp; r6.1 Home: Departments:Assessors Division: Property Assessment'Search Results —back to search 75 WILLINGTONAVENUE Property Sketch Legend ; Owner: PARON,THERESA M Map/Parcel/Parcel Extension 5 103 /041/ y5.. Mailing Address PARON,THERESA M %USDA RURAL HSNG SERV TX DEPT PO BOX 66805 S 13iT 3 r ST LOUIS, MO.63166 i Assessed Values: a._...._ ..:._.._.: __ .:j. h Appraised Value Assessed Value Building Value: $85,10Q $85,100 Extra Features: $0 $0' Outbuildings: $0 $0 Land Value: $48,200 $48,200 Interactive Property Map: ap requires Plug in: • �Cd�ck'�Fo� Totals:$ 133,300 $ 133,300 1 have visited the maps before Show Me The Mao Sales.History: Owner: Sale Date Book/Page: Sale Price: PARON,THERESA M 10/1/1997 10985/080 $85,000 US DEPT OF AGRICULTURE 11/8/1996 10475/060 $72,250 MILDE,JOHN A&LINDA L 5/15/1993 8583/176 $70,000 FARMERS HOME LOAN ADMIN 6/15/1992 8083/223 $ 10,500 GARCIA, DONNA M 11/15/1984 4337/285 $ 14,500 KULBOKAS, VLADAS&V 1396/427 $0 ..Tax Information: Tax Rates: (per$1,000 of valuation) °Town Tax $ 1,234.36 Town Fire-District Rates Other Rates 9.26 Barnstable 2.61\ Land Bank 3%of Town Tax C.O.M.M. FD Tax $ 183.95 C.0.M.M. 1.38 Cotuit 1.69 Land Bank Tax $ 1,455.34 Hyannis 2.54 http://www.town.bamstable.ma.us/tob02/Depts/AdministrativeServices/Finance/Assessin€... 11/19/2002 Barnstable Assessing Search Results Page 2 of 2 West Barnstable 1.54 Total: $ 1,455.34 Due to rounding differences these values may vary Land and Building Information Land Building Lot Size(Acres) 0.48 Year Built . 1985 Appraised Value $48,200 Living Area 1176 Assessed Value $48,200 Replacement Cost$94,601 Depreciation 10 Building Value 85,100 Construction Details Style Ranch Interior Floors Pine/Soft WoodCarpet Model Residential Interior Walls DrywallKnotty Pine Grade Average Grade Heat Fuel Gas Stories 1 Story Heat Type Hot Water Exterior Walls Wood ShingleVinyl Siding AC Type None Roof Structure Gable/Hip Bedrooms 3 Bedrooms Roof Cover Asph/F GIs/Cmp Bathrooms 1 1/2 Bathrms Total Rooms 5 Rooms Extra Building Features Code Description Units/SQ ft Appraised Value Assessed Value Property Sketch Legend BAS First Floor, Living Area FST Utility Area(Finished Interior) UAT Attic Area(Unfinished) BMT Basement Area(Unfinished) FTS Third Story Living Area(Finished) UHS Half Story(Unfinished) CAN Canopy FUS Second Story Living Area (Finished) UST Utility Area(Unfinished) FAT Attic Area(Finished) GAR Garage UTQ Three Quarters Story(Unfinished) FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story(Unfinished) FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TQS Three Quarters Story(Finished) http://www.town.bamstable.ma.us/tob02/Depts/Administrative$erVices/Finance/Assessing... 11/19/2002 i RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 e FEE VALUE WORKSHEET NEW LIVING SPACE y a � •(, �quare feet x$96/sq.foot= 1/0, 9 S 3. 6°x.0031= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x .0031= plus from below(if applicable) ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= (number) i Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fee Drolcost - 01/15/1995 23:17 918028624926 PAGE 02 Town of Barnstable Regulatory Services aaaanraeu. Thomas F.Geller,Director 16) Building Division Ralph Crossed,Building COMIMUSitlner 367 Main Street, Hyannis,MA 02601 Office: 508-862-4038 . Fax: 508-790-6230 SHED REGISTRATION Location of shed(ad*is) Village Property owner's name elephone number oo L(:;4 7q Siu of Shed Map/Parcel q S; pate Hyannis Main Street Watet$ont Historic District? /1. Old King's Highway,Historic District Comw sSion jurisdiction? n Conservation ComnMon(eignmur+e required) PLEASE NOTE: IF YOU ARE wrl'SIN TIc NRISDICTION OF ANY OF THE 1�II ABOVE CO USSIONS,THERE UAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE C011.1 USSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN I � ' ' •gym` I TO, A V�_IF NI UE N84 56'00"jV i CB 130. 00' i o HSE' `�5 O=_________ ___ 42. 3 50f DECK 34f LOT 80 W p LOT 78 o � 0 0 o � o LOT 79 \ N84 56 � 130. 00' _ LOT 81 OWNER.- UNITED STATES OF AMERICA, ACTING THROUGH THE ADMINISTRATOR OF THE FARMERS HOME ADMINISTRATION, UNITED STATES DEPARTMENT OF AGRICULTURE RES.. ZONE.- 'RF" This MORTGAGE INSPECTION Plan is For FLOOD ZONE.- "C" Bank Use Only _ TOWN: -MARS O S _S-----_- REGISTRY OWNER: SEE ABOVE__________________ DEED REF: _L047V60________-BUYER: THERESA_M_ PARON _____-______ DATE: _911�9_7__________-_ PLAN REF: _157 97 ______ ---- SCALE:1' = 30 FT. I HEREBY CERTIFY TO USA FARMERS HOME ADMINISTRATIONUSD tH OF AigS YANKEE SURVEY ______THAT THE BUILDING �� ,t, SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS og� PAUL cy� CONSULTANTS � SHOWN AND THAT ITS POSITION DOES _ — CONFORM TO THE ZONING LAW SETBACK REQUIREMENTS OF THE S MER THEW N 40B (SUITE 1) __ _______ o No. INDUSTRY ROAD TOWN OF BARNSTABLE____ __AND THAT o IT DOES_ NOT _ LIE WITHIN THE SPECIAL FLOOD HAZARD °°ems, 9fGisii� MARSTONS MILLS, MA. 02648 AREA AS SHOWN ON THE H.U.D. MAP DATED—�19�85 _ as�a �: TEL: 428-0055 NQl LP�q Co u t -Panel 250001 0015 C FAX 420-5553 THIS PLAN NOT MADE FROM AN INSTRUMENT 21574 DC* SURVEY NOT TO BE USED FOR FENCES ETC. • TOWN OF BARNSTABLE 2 7 709 Permit No. __ Building Inspector 1 anam cash - ------- - /YI 1639 OCCUPANCY PERMIT Bond ��_�" Issued to Donna Garcia Address r79, 75/illingtun Avenue, 2 arstom Wiring Inspector Inspection date Plumbing Inspector Inspection date Ins Gas Inspector aib - �yLt' r[ Inspection date 1`'},fit Engineering Department + !` Inspection date Board of Health } CV /✓yi s r Inspection date o� 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. ' yr,........................_.......................... �9 .............. .... .............. ............g.._....... .... . ...................... ..........._... building Inspector s TOWN OF BARNSTABLE �. BUILDING DEPARTMENT = sARNIT TOWN OFFICE-B IU LDING rua gab �639• �� HYANNIS, MASS:'92601 f I MEMO TO: Town Clerk FROM: ' I Building Department DATE: i An Occupancy Permit has been issued for the building authorized by BuildingPerm #._......_.Permit .� � . -.._»..__.-- .........................................................._.........�......... , issuedto ......CJ' v'La.. ... ........_... R .... ...................................................__.... UlPlease release the performance bondf- i •� M 00 0 a, 35'+ t /30.oa- -- . — - - LOCAT/Oh/: STowS lL 5 �E=FEC��t/GEt BE/ti/G " LoT �9 AS sHotvw � • ..ice Pam. SA--, /57 FG. 97. .Y av- GC,CT�FY r-,w,4T 77�/E �C//LD/�t/tfr 0F ' iVoww o.v rNis PLQw is LOCA7-=D Oa/ 7�E' /� nor �'y y,eociva 143 3NOWiV NE'CQoiv .f7,va TNgT %T �,�0�" ' `Q��E, ��'-c�\�,r' DOES CO�vFOG�t-!. 7"0 7�� Zo.t�i.✓G. BY-L.AN/s oFr.. rye 770WA./ o BHRit1 STABLE vY JR. t�c7160 / 278o7 ee YAK'/1,70u7-f,l —�re- �s s L®� - _ 6 MUST 13E S"�Assessor s map and lot number ........... I............................. � S ALLED *THE TC r NCt Sewage Permit number ..�fY..z ................................ WITH TITLE e'Y'VI � Z B T11DL Ouse number ............ TOWN - OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION ...........! ... .... .............................................................................. /(................19..(�.J� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby appliesfor a permit according to the � following information: Location .....f !`. t./.Y..`�.d,441,. A:. �e1t+P�.. Qt 771 49.4o ................................................................... Cam.-LLD � � ProposedUse IUl�/W� .................................................................................................... Zoning District .......................... .......................................Fire District ................... -':.T..` ............................................ Name of Owner i?i1!!llt.� fc+......................................AddressOZc�wt7C��,- /i... G [�c ......../04 0u..�.(.0..7.. i . Name of Builder ..!...!...�. .. .....k!'!'....................Address !•ZG �S v ......................... .....�y . ......0 .5.s............ Name of Architect � �........... !' .................Address QOt l ���'l�"'• QZUS `� Number of Rooms �� .......................Foundation . .. .A!?u� `� ..........................................: .. ...................... ............. Exierior ........................Roofing .... 11� A..................................... PFloors i.... ).... 77�..........................Interior ...11 t +.'.'.....................— �..w 4! ...4 .......................... Heating xv lld ...........................Plumbing Fireplace .......4ON................................................................Approximate. Cost ....`.0. , .... Cwk.°!............................ ,Definitive Plan Approved by Planning Board -----------_______-----------19 . Area .....//7 76................ Diagram of Lot and Building with Dimensions Fee 5 / SUBJECT TO APPROVAL OF O RD OF HEALTH 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. ,,!1 Namecc#'wi19.8,.eL4. .... .................................... Construction Supervisor's License 03544 .............................. �GARiCIA,- DONNA A=79-103-41 r' No 3.. .7709. Permit for ...1,9toXy. ..Single:. 't .... ..farm ly..c#w�� lx1g....................... ' Lot #.79. ......... -75- Willin on Ave. '� ✓ .+$'- Location ........... . .. .................... ..:. ...::..:.: "r Marston Mills. t}� c; , ( ./ t „�� 16 ......... _ ...... ..... ....................... ........ IIA Donna Garcia Owner r................`.......................... f, J 1. , ell Type of Construction 'r r` - .......................... ............. ......................................................... •.................. -'Plot �:.............. Lot. eanId ............APxi:l--S.:.........11985 y r��rmit Grte s _«_ r Aj a y, Date of Inspection..................:.. ........19 • i , . - t Date Completed "19 -4hL f a , f e . N Z J y r 2 �- p ........ .......`. o Assessor's ma and lot number � . / 11 Sewage Permit number ... ... �S 1c�'`7� r,'� ♦� t BASBSTABLE, i House numberP1'r..t-¢�� - `�' t `' ' q rues ` ..... .................... �O 039 9� l It M10 a• TOWN ' OF BARNSTABLE BUILDING INSPECTOR APPLICATIONFOR PERMIT TO ...................................... ....................................................................................... TYPEOF CONSTRUCTION ................................... ...... .................................................................................... � •�1.. 19 U s............. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location /_,,�. �t.... GG(.yt Opei' P �Ars�/l!q :.. ..,./..........i.............................................................. ..../.. �//./�• .......,,gip.j �..e..�.�..�....... ..�........... ProposedUse ...........................i................................................................................................................................................. ZoningDistrict ........................................................................Fire District ........................................................_......................... �ONKR GLLcGtli qO2 Aewik,6,4(1, ="&/ �v�'r o� Nameof Owner .......................................................................Address ...p................................ ................................ � ff�� /7G �Si� OZ�s'S Name of Builder c.��su''f. iVCrr........................Address ................................' ................................................. u��� �Ga/7(; C�v,�ic(�•Gl� 02Gs s" Nameof Architect .................................. ..............................Address .......................i............................................................ 6) Number of Rooms ...........!!,P�K...............................................Foundation "�OU�......��.'LC /,' fG Exterior l�i/�� � .........................Roofing ....,Aad a .. !........................................ ......................... ............................ Floors � w!?/v � 1... 1 ..........................Interior .............................................�w "Heating .. ::....:. Plumbing ............................................................::.:..:.::.:.:..:..... .: ........ ..... ....... Fireplace ....... O..................................................................Approximate. Cost ...'�`..............�.`....................................... Definitive Plan Approved by Planning Board -----------_______-----------19________. Area .......................................... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH Tr-s 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. f Name ( �( l' .................................. • Q " Construction Supervisor's License ................:................... t GARCIADONNA A ARV-103 No .1:2.7.7.09... Permit for ....l..s.tory..,&j.ng.je. .......................................... Location ...IjOt...#79.........75..Wjjjjngt=..Ave. ...... ...... .... ........................................ Owner ........PPP? A..Qar.Cia.............................. Type of Construction .....................fr am�..................... ................................................................................ Plot ............................ Lot, ................................ Permit Granted ..............April 8 '-1 9 85 e . ............... . . Date of Inspection ....................................19 Date Completed ......................................19 �5- 0. L W J Q J t� C w her 8 yei F foundollon to be xoied with dtylok woler repel%nt _ } 2x4 wol/9 ~ N m ti o c .�>-1/2"Insulotlon O Z L Z 112 Sheet rock/with lope ff joint flnl9h — n O olt space behind oil wott9 to be field determined W J W N cellinq Is to be drop 1/2 flbeiglo99 t!les Q W Q F— > LU floor to be 9 owner by horw own c= N any and oll eiedric work to be sup#1cd by home owner ony and oil piumbinq to be 9upplled by hone owner C /.den LOY 28, O N walls �, hol wa r o healer Tamil y roof? cz (F fufni rch Z N ao Z J O Z O G N � 4 W CO GO Ix M C� Q Linn' Go 0 O M Q Z LU U3 N JU) O N 00, H J V 42 �Z Q J H _V J 0 E w J Q J V C — N L O 4P47y, /ourdol ion to be Sealed with drylok wafer repellent ~ N >- 2x4 walls LL o o m 3-1/Z"inSulotion 0 Z LO ju 1/Z Shcel rock/with lope ff joint finish — it air Spocc behind all walls to be field de/ermined W J W Ceding iS lO be drop l/Z fiberglaSS tiles Q W Q ~S U Q floor to be Supplied by home owner cn (N 0 any and all e%tric work t o be Supplied by home owner ony and oll plumbinq to be Supplied by home owner C lien 1.0 O 26 O exi5lin walls hot Waif heater Tamil y food e fufni U O Z N O H S Z >'O � W Q co 0 % N0 a W QO a� M V Q L aGo 0 �_ M Q Z V 3 N J W O CI) O. Q W 000,4Z' Z � QJ 40 H V � v J 0 E E v Charles P.Andrade,Jr January 17,1985 .^ttorne^at c£aaw- 138 WINTER STREET HYANNIS.MA 02601 TELEPHONE (617)771-7171 Mr.Joseph DaLuz Building Inspector Town of Barnstable Hyannis,Mass.02601 Dear Mr.DaLuz: Ms.Donna M.Garcia asked me to write this letter regarding her pur chase of Lot #79,Willington Avenue,Marstons Mills,Ma.She informs me that due to a zoining change in 1978 her lot is considered under sized and she is therefore unable to obtain a building permit.My title search shows that VLADAS and VERONICA KULBOKAS currently of 5526 21st.Avenue,South Gulfport,Florida,acquired title to this lot and three others on August 3,1968.They purchased from LASKEY ENTERPRISES,INC.Lots 18,20,79 and 111.A review of the plot plan for that subdivision shows that neither of the lots abut one another. Therefore,it is my understanding that the Lot would qualify for a building permit since the subdivision was approved prior to the zoining change and that it does not abut another Lot owned by the KULBOKAS'. Thank you. Very truly yours. Charles P.Andrade,Jr.,Esq. CPA/sp