Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0124 WEST STREET
/�5' CrJ� f �� AGRI BALANCEO 10.0 Company Name CAPE COD INSULATION Phone Number 1-800-696-6611 Jose Espinol Installation Date 03/22/2020 124 West Street;_Osterville X PA86001994 Jobsite Address A-Side Lot #'s Permit Number B-Side Lot#'s P1319334019 9" R-40 1000 square feet Cathedral Ceiling/Roof Bag Sherwin Williams Vapor Barrier Paint Attic Ceiling 17 mils c8DEMILEC www.Demilec.com HEATLOK01c).0 Company Name CAPE COD INSULATION Phone Number 1-800-696-6611 John Legere Installation Date 03/22/2020 Jobsite Address 124 West Road,Osterville A-Side Lot #'s PA86001994 Permit Number B-Side Lot#'s P3856003320 3.2 R-21 320 Square Feet Walls Rim 3.2 R-21 200 Square Feet www.Demilec.com cgDEMILEC Town of Barnstable _ . _ _ Building �� ; lPost This Card So That it is Visible From the Street . Approved Plans Must be Retained on Job and this Card Must be Kept BARN :Posted Until Final Inspection Has Been Made. Permit " here a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit No. B-20-870 Applicant Name: Richard Tavano Approvals Date Issued: 03/19/2020 Current Use: Structure Permit Type: Building-Sheet Metal-Residential Expiration Date: 09/19/2020 Foundation: Location: 124 WEST STREET,OSTERVILLE Map/Lot: 139-065 - Zoning District: RF-1 Sheathing: Owner on Record: YEARLEY,DOUGLAS C 1R&SUSAN S Contractor Name: - RICHARD J TAVANO Framing: 1 Address: 301 ST DAVIDS ROAD Contractor License: 6653 2 WAYNE, PA 19087 Est. Project Cost: $10,000.00 Chimney: Description: Installation of 2 zones of heating and cooling in pool house. Permit Feb: $85.00 Insulation: Project Review Req: Fee Paid: $85.00 Date: 3/19/2020 Final: Plumbing/Gas Rough Plumbing: \Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced withinsix months after'issuance. All work authorized by this permit shall conform to the approved application and the'approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. I-----..—.-- Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: Service: 1.Foundation or Footing ,.' 2.Sheathing Inspection Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Pers ns contracting th unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: II Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT �J . "a Town of Barnstable Building t Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept Posted Until Final Inspection Has Been Made. Permit Where a Certificate of Occupancy is Required,such Building shall Not be Occupied.until a Final Inspection has been made. Permit No. B-19-3550 Applicant Name: Gary Souza Approvals Date Issued: 12/06/2019 Current Use: Structure Permit Type: Building-Detached Accessory Structure- Expiration Date: 06/06/2020 Foundation: Residential Map/Lot: 139-065 Zoning District: RF-1 Sheathing: Location: 124 WEST STREET,OSTERVILLE Contractor Name^.�ROGERS AND MARNEY INC. Framing: �s < Owner on Record: YEARLY, DOUGLAS C JR&SUSAN `� Contractor License: 164688 2 Address: 301 ST DAVIDS ROAD Est. Proj ct Cost: $390,000.00 Chimney: WAYNE, PA 19087 Permit Fele: $2,039.00 Description: rebuild new Carriage House as per attached plans.� J Insulation: Fee Paid: 5 2,039.00 Project Review Req: NO PERMANENT COOKING PROVISIONS. NOT A SINGLE Date: 1 12/6/2019 Final: FAMILY DWELLING. Plumbing/Gas Rough Plumbing: \Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after+issuance. All work authorized by this permit shall conform to the approved application and theapproved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be' in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. I Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: Service: 1.Foundation or Footing 2.Sheathing Inspection Rough: 3.All Fireplaces must be inspected at Lhe throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: �yr►�tc-s�►+al— Town of Barnstable Building ;Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept i M'S $ Posted Until Final Inspection Has Been Made.1639 Permit eoraa'i° Where a Certificate of Occupancy is Required,.such Building shall Not be Occupied until a Final Inspection has been made T x^ Permit No. B-19-3424 Applicant Name: norry alves Approvals Date Issued: 11/04/2019 Current Use: Structure Permit Type: Building-Pool-Inground Expiration Date: 05/04/2020 Foundation: Location: 124 WEST STREET,OSTERVILLE Map/Lot: 139-065 Zoning District: RF-1 Sheathing: Owner on Record: Douglas Yearley Contractor Name: Norry K Alves,Jr Framing: 1 Address: 301 ST DAVIDS ROAD Contractor License: CS-074577 2 WAYNE, PA 19087 Est. Project Cost: $80,000.00 Chimney: Description: Install 20 x 40 gunite swimming pool with automatic cover Permit Fee: $ 175.00 Insulation: Project Review Req: BARRIER TO BE INSPECTED BEFORE POOL FILLED WITH Fee Paid: $ 175.00 WATER. Date: 11/4/2019 Final: Plumbing/Gas Rough Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within.six months after issuance. Final Plumbing: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. f, - Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: ! Service: 1.Foundation or Footing 2.Sheathing Inspection Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed - 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Rough: 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: Town of Barnstable Building 7 Post This Card So That it is Visible From the Street-Approved.Plans Must be Retained on Job and this Card Must be Kept i63p Posted Until Final Inspection Has Been Made. Permit R�� rt Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit No. B-19-3566 Applicant Name: Gary Souza Approvals Date Issued: 11/19/2019 Current Use: Structure Permit Type: Building-Demolition-Accessory Expiration Date: 05/19/2020 Foundation: Location: 124 WEST STREET,OSTERVILLE Map/Lot: 139-065 Zoning District: RF-1 Sheathing: Owner on Record: Doug and Susan Yearley Contractor Name: RROGERS AND MARNEY INC. Framing: 1 Address: 124 West St. Contractor License: 164688 2 Osterville, MA 02655 ; Est. Project Cost: $5,000.00 Chimney: Description: Demo existing garage. Foundation and slab will remain. Permit Fee: $50.00 Insulation: I Project Review Re DEMOLITION OF EXISTING GARAGE. Fee Paid: $50.00 1 q� Date: 11/19/2019 Final: � p Plumbing/Gas Rough Plumbing: 1 \Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved application and the'approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspections for the entire duration of the Final Gas: work until the completion of the same. l 1 Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this.permit. Service: Minimum of Five.Call Inspections Required for All Construction Work: 1.Foundation or Footing Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT ` C11A► =�NE Town of Barnstable Building ? t Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept MAO& Posted Until Final Inspection Has Beeri Made. Permit 034 '�� � Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has-been made. Permit No. B-19-3542 Applicant Name: Gary Souza Approvals Date Issued: 11/20/2019 Current Use: Structure Permit Type: Building-Addition/Alteration-Residential Expiration Date: 05/20/2020 Foundation: Location: 124 WEST STREET,OSTERVILLE Map/Lot: 139-065 Zoning District: RF-1 Sheathing: Owner on Record: Yearley, Doug Contractor Name: ROGERS AND MARNEY INC. Framing: 1 Address: 301 ST DAVIDS ROAD Contractor License: 164688 2 WAYNE, PA 19087 Est. Project Cost: $325,000.00 Chimney: Description: Main House:Screen porch/1/2 bath addition and a kitchen i bump Permit Fe I e: $ 1,707.50 out addition.Also included is the addtion of al bathroom on existing Insulation: second floor. � Fee Paid:. $ 1,707.50 r ` Date: 11/20/2019 Final: L Project Review Req: AS BUILT SURVEY REQUIRED BEFORE START OF FRAME. � le9 Plumbing/Gas j Rough Plumbing: \Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after'issuance. All work authorized by this permit shall conform to the approved application and the`approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for-public inspection for the entire duration of the Final Gas: work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: Service: 1.Foundation or Footing Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" M(as set forth in GL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT j �� � Town of Barnstable 04TMIE rp� Building Department Brian Florence,CBO BARNSTABM ` Building Commissioner ��s63y 0. 200 Main Street,Hyannis,MA 02601 fO MA'S Office: 508-862-4038 Fax: 508-790-6230 AGREEMENT FOR ACCESSORY USE OF RESIDENTIAL BUILDINGS ASSOCIATED WITH RESIDENCE We Douglas C. Yearley Jr. and Susan S. Yearley,the undersigned,being the owners of property situated at 124 West Street, Osterville, MA holding title under a deed recorded with the Barnstable County Registry of Deeds in Book 17864, Page 157,being shown on Assessors' Map 139 as Parcel 065,hereby agree, certify,warrant and represent to the Town of Barnstable that the Carriage House located on the same parcel as above-described, which contains No Permanent Cooking Provisions. Not a Single Family Dwelling is not intended for and shall not be used as a permanent,separate apartment for year-round or summer occupancy,for rent in any fashion. The intended and authorized use is for the occasional guests associated with the residential use on the same premises. This separate unit shall not be used for a "Family Apartment" (as defined in Zoning Ordinances) which would require application and approval of a special permit and compliance with the Family Apartment Rules and Regulations. This separate unit shall not be rented as an apartment or as a single room, or in any fashion, which rental would be a violation of the Town of Barnstable's rules,regulations,and zoning ordinances. This Agreement shall be duly recorded or filed at the Barnstable County Registry of Deeds/Land Court for the purpose of alerting future owners of the property of this binding Agreement concerning the use of the property as herein stated,which shall run with the land and binding future owners. The consideration for this Agreement is the issuance of a building permit and/or certificate of occupancy by the Town of Barnstable Building Department. WITNESS our hands and seals this day of 201 TOWN OF BARNSTABLE OWNERS By: Douglas C.Yearley,Jr. Brian Florence,CB Susan S.Yearley Building Commissioner THE COMMONWEALTH OF MASSACHUSETT BARNSTABLE COUNTY,SS Date Then personally appeared the above-named (owner), and made oath as to the truth of the foregoing instrument,before me. Notary Public My Commission Expires: Q:word/accessoryagreement i Parcel Lookup - Parcels Page 2 of 20 i v_ Sale History Line Sale Date Owner Book/Page Sale Price 1 10/30/2003 PELLEGRINO, STEPHEN &ALLISON 17864/157 $1,192,000 2 12/31/1969 FREEMAN,JEAN T 1459/657 $0 3 09/09/2019 YEARLEY, DOUGLAS C JR&SUSAN S 32279/109 $1,650,000 v_ Assessment History Save# Year Building Value XF Value OB Value Land Value Total Parcel Value 1 2019 $271,500 $35,100 $7,800 $546,300 $860,700 2 2018 $228,600 $35,600 $7,800 $637,500 $909,500 i 3 2017 $213,800 $36,900 $9,200 $637,500 $897,400 4 2016 $213,800 $36,900 $9,200 $637,500 $897,400 5 2015 $201,300 $34,000 $6,700 $632,400 $874,400 6 2014 $201,500 $37,900 $4,700 $632,400 $876,500 7 2013 $201,500 $37,900 $4,800 $632,400 $876,600 8 2012 $206,000 $36,700 $4,106 $837,000 $1,083,800 9 2011 $235,500 $10,800 $0 $837,000 $1,083,300 10 2010 $234,900 $10,800 $0 $837,000 $1,082,700 11 2009 $274,800 $9,300 $0 $998,300 $1,282,400 I 12 2008 $290,300 $9,300 $0 $978,200 $1,277,800 14 2007 $313,500 $9,300 $0 $978,200 $1,301,000 15 2006 $322,300 $9,300 $0 $966,800 $1,298,400 16 2005 $254,300 $5,000 $0 $822 800 $1082,100 17 2004 $190,000 $5,000 $0 $514,300 $709,300 18 2003 $177,400 $5,000 $0 $264,000 $446,400 19 2002 $177,400 $5,000 $0 $264,000 $446,400 https://itsgldb.town.bamstable.ma.us:8407/ 11/22/2019 Parcel Lookup - Parcels Page 5 of 20 Photos e xk 4 7 a- I 1 [1 { A3 ¢ 4 �P t f https://itsgldb.town.barnstable.ma.us:8407/ 11/22/2019 q F� ayy;.gf a 1 Al 41 OR ll 777 ✓ �' r+ � R . � A ` vp}r 3. ±� �a�a«w«• tea°.. � S 'w`�,y..�. 4 � �I �� 1 ��4 Parcel Lookup - Parcels Page 1 of 20 E Parcel: 139-065 Location: 124 WEST STREET, Osterville Owner: PELLEGRINO, STEPHEN &ALLISON +?K Parcel Developer lot: Road index ' . art; , • -_ 139-065 1818 { f Location Fire district Secondary road 124 WEST STREET C-O-MM FOURTH AVENUE Village Interactive map Osterville Town sewer at address No Asbuilt septic scan 139065 1 . ...._......................__......_..._................................__....__........................................................................................................................................................................................__.._...................._.._. y_Owner: PELLEGRINO, STEPHEN &ALLISON Owner Co-Owner Book page 1 PELLEGRINO, STEPHEN &ALLISON %YEARLEY, DOUGLAS C JR&SUSAN S 17864/157 Streetl Street2 301 ST DAVIDS ROAD City State Zip Country WAYNE PA 19087 jV.. Land Acres Use Zoning Neighborhood 1 Single Fam MDL-01 RF-1 0114 1 Topography Street factor Town Zone of Contribution Level Paved AP(Aquifer Protection Overlay District) Utilities Location factor State Zone of Contribution Septic,Gas,Public Water OUT Construction d_ Building 1 of 1 Year built Roof structure Heat type 1970 Gable/Hip Hot Air S PTz@ Living area Roof cover Heat fuel 7 PTO° Y, 2647 Wood Shingle Gas Plot Gross area Exterior wall AC type i 5172 Wood Shingle Central Style Interior wall Bedrooms As aA Cape Cod Drywall 4 Bedrooms * T Model Interior floor Bath rooms Residential Pine/Soft Wood 4 Full-0 Half 1 1 Grade Foundation Total rooms Average Plus Mixed 8 I Stories 1 3/4 Stories V_ Permit History Permit Issue Date Purpose Number Amount InspectionDate Comments https://itsgIdb.town.bamstable.ma.us:8407/ 11/22/2019 Town of Barnstable Building • Post This Card So That it is Visible From the Street-Approved Plans Must,be Retained on Job and this Card-Must be Kept ' JL*."sr.&8LZ . - - i 'AAS& Posted Until Final Inspection Has Been Made. Permit ,, • Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made.__] Permit No. B-18-2027 Applicant Name: Stephen Pellegrino Approvals Date Issued: 07/24/2018 Current Use: Structure Permit Type: Building-Detached Accessory Structure- Expiration Date: 01/24/2019 Foundation:CQ S11 Residential Map/Lot:_ 139-065-. Zoning District: RF-1 Sheathing: Location: 124 WEST STREET,OSTERVILLE i Contractor Name: Framing: 1 Owner on Record: PELLEGRINO,STEPHEN&ALLISON Contractor License: 2 Address: 423 SANDY VALLEY RD ! — - - Est. Project Cost: $50,000.00 Chimney : WESTWOOD, MA 02090 Permit Fee: $355.00 Description: 28'x24'single story custom garage with 12'x2I2'covered carport. Fee Paid:l� $355.00 Insulation: i Date: 7/24/2018 Final: -711 Project Review Req: h _ I _1 Plumbing/Gas (l �( Rough Plumbing: Building Official Final Plumbing: Rough Gas: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved application and the'.approved construction documents for which this permit has been granted. Final Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Electrical work until the completion of the same. l Service: The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work:' ,! Rough: 1.Foundation or Footing 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Final: 6.Insulation 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. �h"� Final: Work shall not proceed until the Inspector has approved the various stages of construction. "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Final: Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Town of Barnstable RECEiPr 1,SS 200 Main Street, Hyannis MA 02601 508-862-4038 Application for Building Permit Application No: TB-18-2027 Date Recieved: 6/25/2018 Job Location: 124 WEST STREET,OSTERVILLE Permit For: Building-Detached Accessory Structure-Residential Contractor's Name: State Lic. No: Address: Applicant Phone: (617) 306-3426 (Home)Owner's Name: PELLEGRINO,STEPHEN& ALLISON Phone: (617)306-3426 (Home)Owner's Address: 423 SANDY VALLEY RD, WESTWOOD, MA 02090 Work Description: 28'x24' single story custom garage with 12'x22' covered carport. o C w O � O %—ri A 't7 Z7 Total Value Of Work To Be Performed: $50,000.00 77n tv m Structure Size: 0.00 0.00 0.00 w rn Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued, it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: Stephen Pellegrino 6/25/2018 (617)306-3426 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $50,000.00 Date Paid Amount Paid Check#or CC# I Pay Type Total Permit Fee: $355.00 6/25/2018 $255.00 XXXX-XXXX—X)M- Credit Card 1118 Total Permit Fee Paid: $355.00 6/25/2018 $100.06 XXXX-)OM-XXXX- Credit Card 1118 , . THIS.;AIS#NOT. AER PIVIBIT TOWN OF BARNSTABLE,BUILDING PERMIT APPLICATION Map Parcel _ . Application # Health Division Date Issued Q I Z Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board SIG Historic - OKH Preservation / Hyannis r� Project Street Address r�T i Village Owner ��� Address Telephone Permit Request Square feet: 1 st floor: existing NO proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay oject Valuation Construction Type rLot e Grandfathered: ❑Yes 0 N>units) ch sup rung documentation. Dwelling e: Single Family- ❑ Two Family ❑ Multi-FamilyAge of Existing ucture Historic House: ❑Yes ❑ King's Highway: ❑Yes ❑ No Basement Type: ❑ II ❑ Crawl ❑Walkout ❑Other Basement Finished Area(s ft.) Base nt Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing ew cs Total Room Count (not including baths): a ng new First Floor Room Count A Heat Type and Fuel: ❑ Gas ❑ ❑ Elec c 0 Other Central Air: 0 Yes • ❑ No Fireplaces: Existing New Existing wood/cal stove`�O Yes,❑ No .,� Detached garage: ❑ isting ❑ new size—Pool: ❑ exists ❑ new size _ Barn: ❑ existing 0�'new Vsjze_ a �o F •• c� Attached e: ❑ existing O new size _Shed: ❑ existing new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # ecorded 0 Commercial, ❑Yes ❑ No If yes, site plan review# Current Use - Proposed-Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) G Name Telephone Number ��� 7 Ll Address D I License # C \MM 'C AAA Home Improvement Contractor# 6_�-77D Worker's Compensation # 'ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# DAZE ISSUED MAP/PARCEL N0. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL LR PLUMBING: ROUGH FINAL - GAS: ROUGH °FINAL FINAL BUILDING DATE CLOSED OUT ~ ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers I Applicant Information — 11� Please Print Legibly Name(Business/Organization/Individual): <-�.�'t -C t- ! Address: yu X 1� City/State/Zip: �[� •�' � Phone#: ,Sty$ Are you an employer?Check the appropriate box: Type of project(required): 1 I am a employer with la 4. ❑ 1 am a general contractor and 1 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 required.] officers have exercised their 10.❑Electrical repairs or additions 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 rep insurance required.]t employees.[No workers' 13 Other comp,insurance required.] *Any applicant that checks box#I 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 subcontractors 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. rr Insurance Company Name: �//C��` 55 Policy#or Self-ins.Liic.##: kl`�h H(I S 5 S'1 Expiration Date: 5 >1 ,( Job Site Address: 2 01�1 w e tA- City/State/Zip:_D16A-C< 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. 1 do hereby certify der the pains and penalties of perjury that the information provided above 's true and correct. Si nature: Date: �r q ] Phone# �/� " ( �CC t- I v Official use only. Do not write in this area,to be completed by city or town offlciaG 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#: SPERTEN-01 MOW CERTIFICATE OF LIABILITY INSURANCE F DATDIYYYI� 711n012o/2o12 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 term 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 endorsemen s. PRODUCER (508)676-0309 NAME: Viveiros Insurance Agency,Inc. PHONE FAX(AAo No 375 Airport Road E-MAIL Fall River,MA 02720 ADDRESS: INSURE S AFFORDING COVERAGE NAICA INSURER A:Peerless Ins Commercial Lines 24198 INSURED Sperry Tents Inc. INSURERB:Peerless In Personal Lines Po BOX 10 INSURER C: Rochester,MA 02770 INSURER D: 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. ILTRR TYPE OF INSURANCE POLICY NUMBER MMIUDDI EFF MND EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY 4549986 1011512011 10/15/2012 pREMISES Ea occurrence $ 100,00 CLAIMS-MADE a OCCUR MED EXP(Any one person) $ 5100 PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,0 X POLICY PRO- LOC $ AUTOMOBILE LIABILITY IN)acccidEenntSINGLE LIMIT $ 1,000,00 B ANY AUTO BA4549982 10/15/2011 10/15/2012 BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BODILY INJURY(Per accident) $ Auros $ includec X HIRED AUTOS X AUTOS NON-OWNED eraoddPROPERTY DAMAGE AUTOS PerecddeM $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED FTRETENTION$ $ WORKERS COMPENSATION X TNRY LIAR ETM AND EMPLOYERS'LIABILITY A ANY PROPRIETOR/PARTNER/EXECUTNE Y❑ N/A C4615559 1 Oil5f2011 10/15/2012 E.L.EACH ACCIDENT $ 500,00 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ W010 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,It more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Allison Pellegrino THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN g ACCORDANCE WITH THE POLICY PROVISIONS. 124 West St Osterville,MA 02655- AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD Jul 12 12 09: 06a Allison Pellegrino 781 -326-6629 p. l .._:.... ✓'JC' :/.'��.+- ..Cam_'.. -It._ .�c-_._. .._..... ._.,...-.._.._...i:,'''.'•.'. ry✓:�1.'�.G• 4:� ..✓::.ot iv�:".:; "S.`'��'.0 is - _=S>. ...._.... ..t': .:_.._ - _ ....,,. .. �_ - ^`fir.• _ -_ 1.::-c:alvnZ:.__. ::J•.o:._ ....?,3::?'''•�:t:s `: �:j::->2 eis`:_':e:t 1�:_s _a,._�ti �`:i:::1: �se.:..__<.;,.��i"ti�>isG,r.'"s�_i�;:,:c.•':i�'1::....=K\:.?;roc:,'*:Ar.^::'I}.v^it"�:._.wr,�'r;,"w..;�:�.�J�;1:'�.g�„}.��:'..5:.': Certift"tate ' ef 11ame Rem!gtanre Manufacture Number CPERRY � Date of Manufacture 32128 11 Marconi Ln Box 215 4/97 Marion, Mass 02738 308/7dr-2s81,ox >1c fn., 50R/718-3997 web:sperrysalls.com * a-mail:sperrysailsOcapecnd.net This is to certify that the materials described have been flame-retardant treated (or are inherently nonflammable) And were supplied to: NAME: Sperry Tents CITY: Marion STATE: MA 02738 Certification is hereby made that: The articles described on this certificate have been treated with a flame-retardant approved chemical and that the application of said chemical was done in confor- mance with California Fire Marshal Code, equal to or exceeds NFPA 701, CPAI 84 Method of application: Coated Type of cloth: Polyester UV, FR, WR Color and weight of cloth: 4.4 Oz Navy Description of item certified: 32 ft. Round Function Tent Flame Retardant Process Used Will Not Be Removed By Washing And Is Effective For The Life Of The Fabric Name of Applicator of Flame Resistant Finish + Kolon Industries Signed: SPERRY TENTS Town of Barnstable Building Department 200 Main st Hyannis MA 02601 Lauren Keirstead is authorized to pull and sign for all permits. Timothyrry President E0.Box 10 15 Dexter Lane j Rochester,MA 02770 Office (508) 748-1792 Fax(774) 849-3503 jsperutents.com TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION .23)_0 Map Parcel O63' Application.# Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee --7 c2 5 Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis Project Street Address �a'� ��7- Village �Ti '/�G Owner5Tey�'^v ��« K-/Ny Address Telephone Permit Request ifR1C,t_- Re,/9C<t-- r6 4-,�I,, V,5-7 Z ��v� �,e��a,<7 o-e 7!/i AV Z:74,P a-CCz J'4e4.14 TZr dO Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District /e oc Flood Plain Groundwater Overlay Project Valuatiore/5 0 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 /976 Historic House: ❑Yes 4�fNo On Old King's Highway: ❑Yes 4No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other X"AB 0,v 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 8' new First Floor Room Count Heat Type and Fuel: A Gas ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ 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 ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # �' Current Use _ Proposed Use cr3 APPLICANT INFORMATION 4 (BUILDER OR HOMEOWNER) �- Nar,he /�7. l�� Telephone Number ��d'-'�s'0 "?,g a, Address ado A4"078.e 4'evc?, License# do (7 6 7dv` c)°z j s'd Home Improvement Contractor# 75-dl Worker's Compensation # ALL CONSTRUCTION DEBRIS RESU TING FROM THIS PROJECT WILL BE TAKEN TOU.��✓ t ` SIGNATURE DATE 7` FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. 47 ADDRESS VILLAGE s OWNER `DATE OF INSPECTION: FOUNDATION FRAME !3 L INSULATION FIREPLACE s° ELECTRICAL: ROUGH FINAL ,4 a PLUMBING: ROUGH FINAL ti GAS: ROUGH FINAL FINAL BUILDING z DATE CLOSED OUT iS ASSOCIATION PLAN NO The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly 'Name (Business/Organizadon/Indivi dual): /yam, ��//ct�/9N�f 7a,/G,a<X_RS ,p Address: aQ o City/State/Zip: 'Phone#: Are you an employer?Check the appropriate box: 1.IS I am a employer with /2 4• ❑ I am a general contractor and I Type of project(required), 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. B 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, insurance.$ 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 I L E]Plumbing repair's or additions myself. [No workers' comp. right of exemption per MGL insurance required.] t c. 152, §1(4), and we have no 12.❑Roof repairs employees. [No workers' 13.0 Other 49�T�2 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 andjob site information. Insurance Company Name: d! Cv 4 'D Policy#or Self-ins.Lic.#: W C C 0/d d>O�o?y�a Expiration Date: Job Site Address:/�5",66 j City/State/Zip: d d6YY 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 Investigation of the DIA insurance coverage verification. I do hereby c rtii u e he c a d penalties of perjury that the information provided above is true and correct. Si ature: Date: L " /4 Phone it: S-v 573;,6 - x 6 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#: I i ACORD DATE(MM/DD/YYYY) TM. CERTIFICATE OF LIABILITY INSURANCE 01/17/2012 PRODUCER Phone: 508-540-6161 Fax 508-457-7660 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ALMEIDA&CARLSON INSURANCE AGENCY INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE j P.O.BOX 554 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR FALMOUTH MA 02541 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Westem World Insurance Company M DUFFANY BUILDERS INC INSURER B: AEIC 200 PALMER AVE INSURER C: FALMOUTH MA 02540 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDOF INSURANCE POLICY NUMBER P TYPE OOLICY EFFECTNE POLICY EXPIRATION LIMITS LTR INSP4 DATE(MMIDDIM MMONY GENERAL LIABILITY NPPI299248 01/20/12 01/20/13 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PRE SETO e RENTED oceme� $ 50,000 CLAIMS MADEFX OCCUR MED.EXP(Any one person) g 5,000 A PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG. $ 1,000,000 POLICY PRO- LOC JECT AUTOMOBILE LIABIUTY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY b NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ Per accident GARAGE LIABILITY $ AUTO ONLY-EA ACCIDENT ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ b DEDUCTIBLE $ RETENTION b $ WORKERS COMPENSATION AND WCC5010538012012 01/01/12 01/01/13 TORT uMITs OTHER EMPLOYERS'LIABILITY E.L.EACH ACCIDENT b SOO,000 B ANY PROPMETORIPARINERIEXECUTIVE OFRCE"EMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 500,000 R yes,describe under SPEaAL PROVISIONS below E.L DISEASE-POLICY LIMIT $ 500,000 OTHER: DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF.THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Attention: AUTHORIZED E D15 Wiefta ACORD 25(2001/08) Certificate# 10081 ©ACORD CORPORATION 1988 Office oon Omer Al airs& u nes License or registration valid for individul use only f C HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: J.17521 Type: Office of Consumer Affairs and Business Regulation Expiration: IA p 10 Park Plaza-Suite 5170 /�1 Corporation��-3/2012 Private Cor Boston,MA 02116 _G- M. r FANY BUILDERS=1;C MICHAEL DUFFAN� - 200 PALMER AVENGE= s= - FALLMOUTH, MA 02536 �a 5°' Under§ecretar Y Not valid wi o Massachusetts -Department of Public Safety.. I Board of BuildingRegulations g ions and Standards Construction Supervisor License: CS-009678 J MICHAEL A DUI�`Aw 59 Pattee Road ' East Falmouth MA 02536 I Expiration Commissioner 03/01/2014 I Town of Barnstable ti Regulatory Services r • BARNSTABLE, r MASS. g Thomas F.Geiler,Director 9Qj i639. `0 ° Building Division Tom Perry;Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize AV' �GF�d9�y �4//G V AT to act on my behalf, in all matters relative to work authorized by this building permit. (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accep d. Signature of Owner Signature of li i( I V,C� Print Name P " t Name Date Q:FORM&OWNERPERMISSIONPOOLS 6/2012 cF THE Jr, Town of Barnstable Regulatory Services 1ARNSTABLE, : Thomas F.Geiler,Director 9 MASS �A i639• Building Division lED MA't s Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six,units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures.'A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with'said procedures and ,requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt I Town of Barnstable Building s Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept "'"UZ Posted Until Final Inspection Has Been.Made.1639. Permit �� Mats Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit No. B-19-3424 Applicant Name: norry alves Approvals Date Issued: 11/04/2019 Current Use: Structure Permit Type: Building-Pool-Inground Expiration Date: 05/04/2020 Foundation: Location: 124 WEST STREET,OSTERVILLE Map/Lot: 139-065 -Zoning District: RF-1 Sheathing: Owner on Record: Douglas Yearley Contractor Name:'�.Norry K Alves,Jr Framing: 1 Address: 301 ST DAVIDS ROAD Contractor License: CS=074577 2 WAYNE, PA 19087 f' Est. Project Cost: $80,000.00 Chimney: Description: Install 20 x 40 gunite swimming pool with automatic cover, Permit Fee: $ 175.00 4 Insulation: Project Review Req: BARRIER TO BE INSPECTED BEFORE POOL FILLED WITH Fee Paid. S 14/00 WATER. _J Date 11/ 2019 Final: �` Gp.`''✓ ��y,� Plumbing/Gas Rough Plumbing: 11 . Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within,six months after�issuance. All work authorized by this permit shall conform to the approved application and the'approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. I . ti.-,:� —�— Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Bwlding and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: Service: 1.Foundation or Footing 2.Sheathing Inspection Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: ONw-�C ory Town of Barnstable �6 6e T►+f r *Pcrnul It LVpires(rnnudrsJrom u's'ue dote nAxrvsrADtX, Regulatory Services Fee �MASS F w Thomas F.Gcilcr,Director d ` if Building Division s ±Ca f t�i;, Tom Perry,CBO, Buitdiug Comrnissioner !�( �� 200 Main Street, i-lyannis, MA 02601 Office: -508 `862,!4-038 a.AtNSTA13LP- wwwtown.bamslablc.ma_us ' Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDrNTIAL ONLY Not Yalid(vithout RcdX-Treats lnrprirrl. Map/parcel Number Property Address Residential Value of Work U �� � Miui(nuui Tcc of$25.00 for work under$6000.00 Owner's Namc&AddressIV contractor?s Natne Telephone Number 2J Home Improvement Contractor License/I(if applicable) ' id t37/ r� Construction Supervisor's License if(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor 112)!am the Homeowner L�J I have Worker's Compensation Insurance Insurance Company.Namc Workman's Comp.Policy A_f�� S� �'— Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) 2--Re-roof(stripping old shingles) All construction debris will be taken to ❑Rc-roof.(not stripping. Going over existing layers of root•) y - - - � ❑ Re-side ❑ Replacement Windows. U-Value_(maximum .44) 'Where required: Issuance of this permit dots not exempt compliancc with other town department regulations,i.c.Historic,Conservation,ctc. ***Note: Properly Owner must sign Property Owucr Letter of Permission. Homc lmprovemcnt Contractors License is required. SIGNATURE. Q:forms:cxpmtrg ReviscO71465 The Commonwealth of Massachusetts Page 10 of 10 Department of Industrial Accidents . Office of Investigations .r.�.� , :tt >r i 600 Washington Street ro ' Boston,MA 02111 ,r z�, www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information ` Please-Print (Legibly Name (Business/Organization/individual): i Address:—,(� City/State/Zip: (�5 T � Y`nPro2lo SS Phone#: Are you an employer?Check the appropriate boa: Type of project(required): 1.,3 1 am a employer with l2_ 4. ❑ I am a general contractor and I 6. ❑New construction have hired the sub-contractors employees(full and/or part-time).* I 7. ❑Remodeling listed on the attached sheet 2.❑ .I am a sole proprietor or partner- Demolition ' ship and have no employees These sub-contractors have 8- ❑ working for me in any capacity. workers'comp.insurance. 9. ❑Building addition [No workers'comp.insurance 5. .❑ We are a corporation and its 10:❑Electrical repairs or additions required.] officers have exercised their right of exemption per MGL I I.[]Plumbing repairs or additions 3.❑ I am a homeowner doing all work1 4 and we have no c. 152, § ( ), 12.10 Roof repairs myself.[No workers. comp. . . insurance.required.j t employees.[No workers' 13.❑Other, comp.insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation.policy information. i t Homeowners who-submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. IContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. i I am an employer ghat is providing workers'compensation insurance for my employees. Below is the policy and job site i information. lnsurance Company Name:��]/ Policy#'or Self-ins.Lic.#: L1/ Expiration Date: Job Site Address: _ �� City/State/Zip: � k 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 ised that a copy of this statement may be forwarded to the Office of of up to$250.00 a day against the violator. Be adv Investigations of the DIA for insurance coverage verification. I do hereby certi nder the ains and penalties of perjury that the information provided above is true and correct Si ature: Phone#: `-OS ' 2 t Official use only. Do not write in this area,to be completed by city or town o,Qruia1 City or Town: Permit/License# Issuing Authority(circle.one): 1.Board of health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person- Phone#: • ,ram. - 6// mom Office of Consumer Affairs and usiness Regulation 10 Park Plaza -Suite 5170 Boston, Massao4setts 02116 Home Improvement actor Registration ' Registration: 103714 - _ t Type: Private Corporation X t' Expiration: 7/9/2012 Tr# 297676 PAUL J. CAZEAULT & SONS, IN �t! t Paul. Cazeault }c! 1031 MAIN ST OSTERVILLE, MA 02658 � ����� \��M Update Address and return card.Mark reason for change. Address Renewal Employment Lost Card )PS-CA1 0 5OM•04104-G101216 �• fie eat'_Q/�aoaac�ivaelta' _ ,p� anvnzaru�' T. License or registration for individul use only Office of Consumer Affairs&Business Regulation « - HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: IN Registration �a1MENT Type: Office of Consumer Affairs and Business Regulation �� W i"�_ 10 Park Plaza-Suite 5170 4 � Expiration 7d9�2012 Private Corporation Boston,MA 02116 PA L J.CAZEAIfE �E , Paul Cazeault h ". 1031 MAIN ST OSTERVILLE,MA 026 $ '�a� Undersecretary -Not valid,without signa re r 3:.. � +t' «- ,�. "'i ��.-•$ si��?"�•�q.,.. ,�.r�'- .r"-s..-�-" �,+ ' ''ate',.. '��'iS'. PAW 3 '`fi' {- -r �-rtr 3. - -3 x-^r i> - K..-"'iP_s�r� 'x i !!•1� xa ��z�.�F�,�'-.'�• �� m'4`+7 ,.�--3'T. � ��..��'z�`X`:+r•�..s,.n ..•Yc._-:�.� -�r5.,++ ,s'S r�'"3' o-r .rs-� �-�. m-�': .. � Jd`E�r' �:�' alj, ."t -'"r`r''^Sz-u psi Y � �r k�,'- --�'�� �,�-D _�� �'-.- _,�'�• F •.a � _ �`�_.`_. ��.�„";.�i`a�•z"`'_ ..t2� `�.��I'e'� •i`p.: �� zr�uc,rs, '�-• �rg^ r +< _ y�Jgfre _ x:£ _ ;se M, Fes. ,f =arm' 3t v t"�"� _ a ..'�v r". ; - 3. T"'• ''�_�' '. Y - ' "•c' -"4'' "hJ ak"a-e '+,w_ S •'Prkr, 'z ".F -:3'^"' .�> .,r•a,.ny5'''�_, .j�' - r - -:.3 ice`_ "' C: n ' k WIN 3eniit�T.t1S tlku,E t:Lti tD °<IrtrrtE(fitt7(at )�lxthfi3•* = Y+.c• Tz^�,1 � t' '..3 •ti 4sa •s. `: " A - _�._-,':.�'�."`': -k:. ~' •�a-. i'=;5,' ; t - Boartmt B ur;Cc£r� F=�L4tr(>rt rr�iJ �t�tcttl.rrtl `�� WIN ' MS.. ..Yf sgY..S •.Z- -ya4.gr+�y,'-,'?"Kaw.�,.�,':. 'S �' �.3^•Si t°.L' o,�.ki mac _-era �<'`�l"-'rr+•. ` a" ,'F - � X-�'. ' .r•�- =�" -AT u, eturso ` ic>? ..'`' .�,.. , s' ' - ,•- ., - "•-n`1"_` � -T. "yx'�. cu ^e _ -b ._- .y;_:a$ ?.sss - - `- 3_. +Tzes .. -- " Y€sLrcenseGS26325 �x . car o �r � Y��k ,�" �'�-'-'�'-%.z ..:� ?�_ ' -"� - ref? `''�:f' ..� " PYkRJL�F ` EA LT `rs ' rF e911101 �-. a ,fit ♦ a-• � ..� �, Ac =�:.�'� '.` .5- -�'�. - �' .� � s 1�� .s4 e To wu " �. jr03 MALLV ST �rg cc E, �� zi'v£:, -ME ,�,"r�. '%.xh.. Y,., e "z' 3 �" '3,�'"< �.7tu�' r' d `�c;` . ,"y .= ,.�-,;r n+. cx�'`2' QSTER-VPL_E MAYE12555 �M1 � .,'€' z. ,,ta^ '_r. ,' ' .a-yr: 'ygs�.. `Y.. i"ar ° = ?''r: e�'^ y = s�' `$ .� 'K"�i`. 4{'' ash-�sv-..:�3 r:L.ix.� --�-„ a `, '� _y" ��x. '`° -o°" 3•- -,,,:,. .sue '"' `'' -�. `° ' '. It `'��FH '� +�•'c' �j�� •� k" rb ,..' -. ff.�'G'=•5�-� yrret'*�Et �"� Ail , � +s , Ex iratroru 10Y20k20T1urr . -�`'�'. „tea- - 2=`.5- - y3 � Cli,. ."'�i" '••aa� *,,.,s• +• .S' +.�-a"r Ye''�Y,i« fir''.'`-_.''-'z��snd• v.,..�. - ,t��r , - yr.`?� '.'" `. r' -,"-a•S ^K`x�� .rs Ctizn�nFr.�[fHte!'`c ,c c Tom`'/a08�"-"�E ':a- c yaw d .' " '!"°3'p` '"xTFZ,�t9 �.J'r'F-; �e..i"uP'',e *,-��.-`�„i". -?- k-4*s-•. �' - �'`�....'r''<:^'3} LaX .'�' n .six zyc` i' .c � .as. -V..,. .r :• �' <.a-c ,+ a- y.• �.r'7m..- �erER ..a .+ e3 ,sat,. xw�'E, z%7r.•vz io '-^,s 3 '4l`°Y-ys' r` . aSB. C""'S.�+r,.. ,`c"�,5,:e^ ,N � s s .�,.c �• .�a'rxs f �-""��r- v "[' ``.�f-�'�'_`'r'�' •�si_.'`x_ `. "'- °sa � �k�s. � 3^-v -•t-t f"x� 3g�,ry, �•!v.3 �i s aa-- .ti t3' -FAA- eT �� '..-Yt.. .T - .' g v T�.,Er� ;,afS.. .a �:a - i - v, xJ'• -'�•' s�+•'.r" ..�^-. - ''•";•-`•F'. ..; '1 -'''�-s�s. 7-4•, `4' ) `7 � ,� * s az� +,'a-:x" 1:`` .��.b. - �-:Yy-.k. -�F.aE... '; + v :.K• r,=-e-"sc'i„f,..?y $�. - ?1D .�' Q�t ' � -5^„'�•.Fw, r`C4 •a� i' ,_. x c `z -tt".& YS3d"'aal,•' ' j,�a f-a 'l�„ wk. `� aLrtw>'2;r�arv� {� vti_ .:; .x.: -."+yiaiGtr'. -�. iiF'"x� ._•-i-- �.-;f<- 7: `._'. . V,e x �,�,. 'tea-• - +art u '{s„'e - .r . ,q?s-=fie-, �. '�6.� - 'S�. '=�`�w`a..r#:�` - - ,g ._Tv.. �'. -- -•F"yy:,: ,., ,t -Yx,v'.=.... y,;.ar W n1.t" ` 's„e _ 'Fr<s`.- f._k '.. :�tie.„, ..:,w �^�''�.r'' � fn'z'o-, i;{k 'a``i�"x:�li S -a� v,f+`-»� �"L 's.��. c• ,.F� •.s- {''--a`.•"'- "x-',-r�:t, r -f-- r rh .ey.. ,z.c .� -sa Z" .u- �uC,^x-: r"r•� '` k r ari .�y � a 5•'SY'-- '� ° Yrr..t-. 5. 2 ,`l:✓' 11 r p�'x �.+1 +>. -c. "t y i y>•f,3. x lT- 3' a.z-",�.. �. .7 ^' .'3..� ,• 3:' F: 3. fx'.,.._. �_,>a' s z- s� Yr �- � �r ¢.rsy';a§ sar• i.� 3�K b r �Y�ti.rat zz fk e�5as_� ,° T� rY., .t a ,,.r�•-r y.�,.._ '�S#dr`. c�3's'r�'�,s'vl.,E. ti.:t�J �°��a. '�t.+'.. y`F.- +3.i ,G'ts;;``•'i --. �'t-.+e-+�y_;,.3'".x`f• _ +,+:£S,• `.� - .r+"24?• .k�z.`4`�3T'�.^.,.�: V tri,yy.x•+ .$. -yam.`". ,y P'S`"'t•ik . ..Y�,,Te",F-}�ZF`. :",yii.•.`�.4"l �"sYJ•a�c. i..:a x�w.,'a'w�, i,'F. �,rT'i+?--= 1>.: 'xc''S' -c a. % .. iY�a.s,P "y1, 9-T` r �;K 's. ..�..r•"�.�. r�- `•' ''�.s- b..-y x :L.r" �•s. 'S'A�' s..� ''.,v�y-x.• _yam.-.�v"Ei R " ti -"`'scx 'r�sxa� �: _�..- +•g-.. '�+-F:.s,. ,*-ter 5- ... ..rdt�,' ae, e"^aa3- ...'c,+4 ..�'z• c- ,;�. ,ar"T 'y'- �. m'g ' -.qis-. h�... arwrr*,2'.:. - , `,.ate: ..{ 'Tr...'•r�a i..tr `if'.xa �z a, - �y'Fes,.• '4 "- •s?a- %i �'art �...4' "• - '.kr a x ..- '�?` �.A..3.._F';•'�` i• 3,,:," vd��i �`"t .;✓ ;�,, � `" ''T "•'LR ,�-. WY '`. •. }..s^ .-c. -- }-�,. '3 �.1 ,,.. r-'-T a ,.'"�''y.srr'4:: ,xT, .r Y.C.. »h`. '-.ck yy. s'�''3•s ti� s` a. c•r ,.a ""^ s .ij�. r13 - £,,�"'"'' - ..rf �l-.e "'3,.r tL�,•�%•`"'T �.� .. .T 5'�' 1.=�-I..zi �' _� W �. .+-°-,:s7 •� ^'S{_:tc=Y�-e�'�-,z, a 4 r �-2i�'t�y+r7�s.Y� n `�;3r"�t �,�"•r- �-G s. �U' ,_ ;ijpc;.:�2�.r'E,.1^ ..� 'ti. r.=5t 1'�'�„ .'s �".`.�R r -sk� 3.. t �^�xi�r- �s�, 3� d �..�o+tf�`'� STD� '�"'`'x y'�:?v%`�.r�� ram'"-x�•�e,y-a`�2 v px i§'"� ,s.� .,X.�z ul ��:,j -t 5? E {Z 2 f G Cl.F; �.S "! { �Tvt..t ��?'Y y S•� T�. ,� l✓. .� �,� f ,�,y.•H �F' t�3 -s"�ifs. -'1 S'?a �'a�-..; f, r� 1�4 s -�y✓--y „y. -3�.��2t- .� ^r.L' �c:.�. �w_n y�i�� r.At�c:••, s.:i�K"�-••�"'��'�F-� S; �L Z�'� �J•�,l"�,a"�,.rr "r A ��. -�, r ,t `�` � arc :�- 'U.,s.�e.."t��� s '4..� -�.� �' �, --.{� -F y �'i � k�1� -�,a''--�,4���F+ �.�a"i ,-=i t � �, �ss. t,��' t-.��,�r. • <- d•.. ac .�.d >r S�4 fi. � �r �t ti •�� } ,a i� .&1, 4�.y'^•5 Z �!xn.v y,t�� s $F � ,,.r,T "+f fir �v+..�. • -�, _.t.- d.�...L :.� _..:.... -.:...: .-__ .. .:C. ...�T-a.... ..� .... ..._�'�r._ .� ..::^....•:'-. ..�. Ym.._...��?'.s%a�s.Y���r��r�.�..�__9a��.?a:,ei^ax,..=:.e.k.�=z� Property Owner Must Complete & Sign This Form If lasing a,Roofer / Builder. 1 (print) y P �iQ yl 1 I u� as Owner / Agent of the subject property hereby authorizes Paul J. Oazeault& Sons Roofing-Inc. to act on my behalf, in all matters relative to work authorized by this building permit application for: Address of Job Signature of Owner f Mailing Address of Owner ues�u,�� Telephone# 17` 30(o ' .3 Lia 1 . Date 11 �3 is (Please return this form to Cazeault roofing along with your signed contract; It is needed for us to obtain the building permit required.by your town, to complete your roofing project, thank you) fax#508-420-4555 t Client#: 19989 2CAZEAULTPA I ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MWDD/YYM PRODUCER 09/01/12010 Dowling& O'Neil Insurance THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE' Agency HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 973 lyannough Rd., PO Box 1990 ALTER.THE COVERAGE AFFORDED BY THE POLICIES BEL6W. Hyannis,MA 02601 INSURED INSURERS AFFORDING COVERAGE NAId# Paul J. Cazeault&Sons, Inc. INSURER A: First Mercury Insurance Company 1031 Main Street INSURER B: National Union Fire Insurance'C I Osterville, MA 02655 INSURER C: INSURER 0: E COVERAGES INSURER THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTXNU'ING 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 CON POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. DITIONS OF SUCH N D LTA NSR TYPE OF INSURANCE POUCY NUMBER POUCY EFFECTIVE POLICY-EXPIRATION DATE MM/DD/Y DATE MWOD/Y LIMITS A GENERAL LIABILITY DATE 04/30/10 04/30/11 EACH OCCURRENCE X COMMERCIAL GENERAL UABIUTY DAMA $1 000 000 GE 70 RENTED $50 000 CLAIMS MADE �OCCUR X BI/PD Ded:2.500 MED EXP(Any rs one peon) $Q PERSONAL&ADV INJURY $1 000 000 GENERAL AGGREGATE $2 QQQ QQQ GEN'L'AGGREGATE LIMIT APPLIES PER: POLICY -PRO- PRODUCTS-COMP/OP AGG s2 00O QQQ J LOC AUTOMOBILE LIABILITY ` ANY AUTO -COMBINED SINGLE LIMIT ( ALL OWNED AUTOS Ea accident) $ SCHEDULED AUTOS BODILY INJURY HIRED AUTOS (Per person) $ NON-OWNED AUTOS BODILY INJURY $ (Per accident) PROPERTY DAMAGE $ (Peraccidenq. GARAGE LIABILITY ' ANY AUTO ' AUTO ONLY-EA ACCIDENT S OTHER THAN EA ACC $ AUTO ONLY: qGG $EXCESS/UMBRELLA LIABILITY ' OCCUR D CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ B WORKERS COMPENSATION AND WC003603096 $ EMPLOYERS'LIABILITY O$/1 O/10 Q$/1 Q/11 X WC STATU- OTH- ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT $SQQ QQQ S . OFFICER/MEMBER EXCLUDED? NO yes,describe under EL DISEASE-EA EMPLOYE $500 O00! . SPECIAL PROVISIONS below OTHER E.L.DISEASE-POLICY LIMIT $51`10 000 bESCRIPIION;OF OP — .ER.TICNS'/1LOCATtONS/;VEHICLES:kE7CCLU81. " ONS:ADDED_BY,-ENDORSEMENT`; - Opecatlons perfocmed.b t - - y...he.named:lnsu cln �=i� and:exclusions - :: fl Pnlre +:. red sub ectt x�� r sPE ROYIS�ONS' ti k � E � can" tI Las � P d1 ons � � 5 Y �� � b �r� b Z j AS. �,YG' l 4 �. ^a 3 ,F �. F,• L i-f�r-YS' .M"M yS�i,�G i. CERTIFICATE HOLDER: ". : .CANCEL t = LATION Paul:J Caz SROULO'ANY:OF THE ABOVEDERI SCBED POUCIES•SE-CANCELLED BEFORE THE 664r IATTON eault&Sons �� Roafing,InC.._ narF THEREOF,THE issul NG'INSURER WILL ENDEAVOR TO MAIL ; NOTiCETO:THECERiIF OU)ER NMED OT1CATEN BT E DO SO'MS LEFT; .1031 .�rIALC ' IMPOSE No: �OR•LIABICli.Y OF ANY KIND UPON THE IN$URER,'.ITS AGENTS OR Ostervllle MA 02655 . .REPRESElLLATIVEB:�'• - AtriF10RIZED.REPRESENTATIVE. or ACORD 25 2001108 )1 of 2 : #S71:730/M71729 - x^ - .._ Tl. N:1988... .{..,� : `,V / a re.q ln yr .A/eAj .,,(5 a o s y / Lc�/N Oa w c�a��J�✓>l�cS To of 9 V-6)4-1'4'41dT pia�s / ,,,, horizontal / 2x10's -c�st/7c.✓�!a'�r� / beam / soffit of flat ceiling beyond \\ beam — —— ——— — ——— —— — —— —— 0_80"above ® � ® finished floor wing wall to match wing 50"plasma TVwall on kitchen side: bookcases beyond' _ _ _ 30"above window moves to right finished Floor +/-'12"to accomodate . — — finished first Floor 2 Proposed TV Wall Elevation demo:tv cabinet and existing fireplace Kt, va•ar.o- . new window 30"x 54" / N demo:window new window 30"x 54" n wo. // 16"deep built in bookshelf CO 1 50"plasma TV n �• beam I r -1 r I I wing wall 16"deep I I flat I filing above I I I \uI, I 16"deep built in bookshelf I 1 7'18�3/4"AFF Z 1 I 1 '1� built in bookshelf i,_7, -- - - - - I I �V 4�4 1, wing wall to match wing 1 I wing wall to match wind wall on kitchen side 5K. I I wall on kitchen sidf I II I 1 1 I — finished first floor i 30" — II II _bQtorn Co)I rtR:9- -E2' , Proposed Bookshelf Elevation " ivl SKt. vn•=ra z N I I FI 7� I z Lvaulted ceiling abovez N I Id sY calEtZ9- -]DT r fl II I II I II I I FATNIILY IROOM I • I II I I II I II I C1 -- -- -- -- --1 --- ------- -- -- --- --OFI-5172--------- -- KITCHEN ---------------------------- Proposed Family Room Plan SK1. ua•=r•r DSA gn & chm Dewi Sid Architects .. " Proposed Family Room PlanScale: 1/4"=1'-0" :r 4W" Pellegrino Residence SK, 1 ,2 4 6' ' ' 01201.00 05.23.12 ' ...�.h..rh r.n