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HomeMy WebLinkAbout0281 WEST WIND CIRCLE Commonwealth of Massachusetts L Sheet Metal Permit Date: 05/16/2019 Permit# Estimated Job Cost: $ Permit Fee: $ Plans Submitted: YES F1 NO Plans Reviewed: YES NO Business License# 612 Applicant License # 6717 Business Information: Property Owner/Job Location Information: Name: Braga Brothers, Inc. Name: Street: 110 Breeds Hill Road, Unit 5 Street: 281 Westwind Cir. City/Town: Hyannis City/Town: Osterville Telephone: (508) 827-4260 Telephone: Photo I.D. required/Copy of Photo I.D. attached: YES RL NO Staff Initial J-1 /M-1-unrestricted license J-2/M-2-restricted to dwellings 3-stories or less and commercial up to 10,000 sq. ft. /2-stories or less Residential: 1-2 family n✓ Multi-family ❑ Condo/Townhouses n Other II Commercial: Office LL Retail F-1 Industrial❑ Educational❑ Institutional Ll Other Ll Square Footage: under 10,000 sq. ft. ✓n over 10,000 sq. ft.❑ Number of Stories: Sheet metal work to be completed: New Work: n Renovation:❑ HVAC ✓V Metal Watershed Roofing Kitchen Exhaust System n Metal Chimney/Vents❑ Air Balancing Provide detailed description of work to be done: INSURANCE COVERAGE: I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L.Ch. 112 Yes 0 No❑ If you have checked Yes, indicate the type of coverage by checking the appropriate box below: A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent By checking this box❑,I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Duct inspection required prior to insulation installation: YES NO Progress Inspections Date Comments Final Inspection Date Comments Type of License: By ❑Master. Title ❑Master-Restricted City/Town ❑Journeyperson Signature of Licensee Permit# ❑Journeyperson-Restricted License Number: GG_41 Fee$ ❑ Check at www.mass.gov/dPI Inspector Signature of Permit Approval i The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 a. www.mass.gov/dia Workers'Compensation Insurance Affidavit:General Businesses. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Business/Organization Name:Braga Brothers, Inc. Address: 110 Breeds Hill Road, Unit 5 City/State/Zip:Hyannis/MA 02601 Phone #:(508)827-4260 Are you an employer?Check the appropriate box: Business Type(required): 1.❑✓ I am a employer with 8 employees(full and/ 5. ❑Retail or part-time).* 6. ❑Restaurant/Bar/Bating Establishment 2.❑ I am a sole proprietor or partnership and have no 7, ❑Office and/or Sales(incl.real estate,auto,etc.) employees working for me in any capacity. [No workers' comp.insurance required] g• Non-profit 3.❑ We are a corporation and its officers have exercised 9. ❑Entertainment their right of exemption per c. 152,§1(4),and we have 10.0 Manufacturing no employees. [No workers'comp.insurance required]* I I.❑Health Care 4.❑ We are a non-profit organization,staffed by volunteers, with no employees. [No workers' comp.insurance req.] 12•0 Other *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. **If the corporate officers have exempted themselves,but the corporation has other employees,a workers'compensation policy is required and such an organization should check box#1. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy information. Insurance Company Name:Arbella Mutual Insurance " Insurer's Address: 01 Wa&u yrJj City/State/Zip: OU:MOI LU - MA oa6 s5 Policy#or Self-ins.Lic.#422005277 Expiration Date:03/01/2020 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 i co a verification. I do hereby cert' ,u the ' and enalties of perjury that the information provided above is true and correct. Signature: Date: 0!5.a12A01 Phone#:(508)827-4260 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.Licensing Board 5.Selectmen's Office 6.Other Contact Person: Phone#: www.mass.gov/dia DATE(MM/DD/YYYY) A�DI CERTIFICATE OF LIABILITY INSURANCE 03/04/2019 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 have ADDITIONAL INSURED provisions or 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 Gabriel DeSouza NAME: Murray&MacDonald Insurance Services,Inc. A/CONN Ext: (508)540-2400 Alc No: (508)289-4111 550 MacArthur Blvd. E-MAIL gabriel@riskadvice.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC k Bourne MA 02532 INSURERA: Arbella Protection Insurance 41360 INSURED INSURER B Braga Bros.Inc. INSURER C: 110 Breeds Hill Rd INSURER D: Unit 5 INSURER E: Hyannis MA 02601 INSURER F: COVERAGES CERTIFICATE NUMBER: 19-20 Master 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. ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MMIDD EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE Fx]OCCUR PREMISES iEa occurrence $ 100,000 MED EXP(Any one person) $ 5,000 A 952005270403 03/01/2019 03/01/2020 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,000 POLICY ❑JEST LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: Contractors Comm $ AUTOMOBILE LIABILITY GOMBINED684NGLE LIMIT $ 1,000.000 Ea accident ANYAUTO BODILY INJURY(Per person) $ A OWNED �/ SCHEDULED 1020052173 03/01/2019 03/01/2020 BODILY INJURY(Per accident) $ AUTOS ONLY /� AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident Underinsured motorist BI $ 100,000 X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 2,000,000 A EXCESS LIAB HCLAIMS-MADE 4600065467 03/01/2019 03/01/2020 AGGREGATE $ DED I X1 RETENTION$ 101000 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER A ANY PROPRIETOR/PARTNER/EXECUTIVE 1,000,000 OFFICER/MEMBER EXCLUDED? ❑ N/A 4220052770 03 03/01/2019 03/01/2020 E.L.EACH ACCIDENT $ 1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached it more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street AUTHORIZED REPRESENTATIVE �L Hyannis MA 02601 � o !1�Rr.Zvt ©1988--2016 ACORD CORPORATION. All rights reserved. ACORD 26(2016103) The ACORD name and logo are registered marks of ACORD Town of Barnstable lRupding i.)epartment Services AM Brian Florence,CDO sha Building Commissioner 200 Main.Street;Hyannis;MA 02601 www.town.barwtable:ma.us Office: 508-862-4038 Faic: 508-790-023.0 'Property Owner Must Complete and.Sign This Section if Using A�Binld as Owner of the subject prapexty hereby authorize ^ to. t o n bed. in aU matters relative.to work authorized by this Building pemnit application for: (Address of Job) h **Pool fences s ate the responsibility of the applicant;Pools are not to . e filled r utilized befote fence is installed and all ins ms ate p, otaed and kozepted. Sigaa c&bv&r. Sip, 4wwtfApplicaiLt dew 2e ws(�� A LE X BRNA Fitint, ame Print Name ]late { 00givis:avvivrsslor�oois Rer 0WIG17 Fold,Then Detach Along All Perforations: _----_- COMMONWEALTH fiOF��MS.,SACH:USE s ,S' ? �> .......................................................... ..... ' SHE '.MIrT'/L o—O 'KFf2S ," In `f£t, sj,F ISSUESTE'�F�OLLOWING><L10EI�SE@ 4 �IC7! 4 .: BAGA BROS�I�I�s�,Js l ri 2.M©E1Plllllf00`D�OgDs�y MARSTONS�MILLS, „612tz� 3t k�� '#1/07/2019' l 351�999 . o Fold,Then Detach Along All Perforations ._�, ..r as - � 9 ,r,� M•wcz- ............................................................................................................................................................................................................................�O�iMONWEaLTF , )VIM ► ICHpSe S� 0 ® F SESHEET RK FN� 'AI,,WO .ER ISSU -21ME,FOLLOVVING [«I.CBNSE,i;s :a r r +� IUTAS�I:R1 UMRESTRI,G�aTED gar *1fr ! �f trf ALEX*B BRAGA � STE6i ,f> ' j`x i;• r ,,, zti „''�1��>frG #'rr� s A HYANNIS,MAC 02601 v 6717 r 3} Q8/28/202- i'� �526747 � II _.._...............................:.................':.....:::n:. 1 Page 1 Residential Heat Loss and Heat Gain Calculation 5/15/2019 In accordance with ACCA Manual J Report Prepared By: Braga Bros. Plumbing & Heating Air Conditioning For: Matt Ryzewski 281 Westwind cir. Osterville, MA 02655 Design Conditions: Cape Cod Indoor: Outdoor: Summer temperature: 75 Summer temperature: 90 Winter temperature: 72 Winter temperature: 0 Relative humidity: 55 Summer grains of moisture: 100 Daily temperature range: High Building Component Sensible Latent Total Total Gain Gain Heat Gain Heat Loss (BTUH) (BTUH) (BTUH) (BTUH) Whole House 1,645 sq.ft. 21,155 6,344 27,499 72,443 ( 2.5 tons ) First Floor 14,055 3,746 17,801 54,095 All Rooms 1,225 sq.ft. 14,055 3,746 17,801 54,095 Infiltration 1,980 2,366 4,346 14,093 -Tightness:Avg.; Winter ACH: .85 ; Summer ACH: .43 Duct 669 0 669 4,918 -Supply above 120; Exposed to outdoor ambient; R-8 People 6 1,800 1,380 3,180 0 Miscellaneous 1,200 0 1,200 0 Fireplace 0 0 0 3,474 -Average-glass doors, damper Floor 1,225 sq.ft. 0 0 0 13,759 -Over unheated basement; Hardwood or tile; No insulation N Wall 327.5 sq.ft. 401 0 401 2,122 -Wood frame, with sheathing, siding or brick; R-11 3 1/2 in.; none Window 22.5 sq.ft. 472 0 472 804 - Double pane; Vinyl frame; Clear glass - No inside shading; Coating: None(clear glass); No outside shading. Glassdoor 42 sq.ft. 882 0 882 1,666 Page 2 Matt Ryzewski 5/15/2019 • Building Component Sensible Latent Total Total Gain Gain Heat Gain Heat Loss (BTUH) (BTUH) (BTUH) (BTUH) -Sliding glass door; Double pane; Wood or vinyl frame; Clear glass - No inside shading; Coating: None (clear glass); No outside shading. E Wall 179 sq.ft. 219 0 219 1,160 -Wood frame, with sheathing, siding or brick; R-11 3 1/2 in.; none Door 21 sq.ft. 157 0 157 832 -Wood; Hollow; No storm S Wall 303.5 sq.ft. 371 0 371 1,967 -Wood frame, with sheathing, siding or brick; R-11 3 1/2 in.; none Window 45 sq.ft. 1,620 0 1,620 1,607 - Double pane; Vinyl frame; Clear glass - No inside shading; Coating: None(clear glass); No outside shading. Window(2) 22.5 sq.ft. 810 0 810 804 - Double pane; Vinyl frame; Clear glass - No inside shading; Coating: None(clear glass); No outside shading. Door 21 sq.ft. 157 0 157 832 -Wood; Hollow; No storm W Wall 185 sq.ft. 226 0 226 1,199 -Wood frame, with sheathing, siding or brick; R-11 3 1/2 in.; none Window 15 sq.ft. 1,050 0 1,050 536 - Double pane; Vinyl frame; Clear glass - No inside shading; Coating: None (clear glass); No outside shading. Ceiling 1,225 sq.ft. 2,041 0 2,041 4,322 - Roof-Ceiling combination; R-19 batts (2 X 8 rafters); Dark Basement 7,111 2,610 9,721 18,423 All Rooms 420 sq.ft. 7,111 2,610 9,721 18,423 Infiltration 1,222 1,460 2,682 8,696 -Tightness:Avg.; Winter ACH: .85 ; Summer ACH: .43 Duct 10 0 0 877 -Supply above 120; Enclosed in unheated space; R-8 People 5 1,500 1,150 2,650 0 Floor 420 sq.ft. 0 0 0 726 - Basement floor, 2'or more below grade; Concrete; Not applicable N Wall 94 sq.ft. 115 0 115 609 -Wood frame, with sheathing, siding or brick; R-11 3 1/2 in.; none Window 45 sq.ft. 945 0 945 1,607 - Double pane; Vinyl frame; Clear glass - No inside shading; Coating: None (clear glass); No outside shading. Page 3 Matt Ryzewski 5/15/2019 I h ' Building Component Sensible Latent Total Total Gain Gain Heat Gain Heat Loss (BTUH) (BTUH) (BTUH) (BTUH) Door 21 sq.ft. 157 0 157 832 -Wood; Hollow; No storm E Wall 200 sq.ft. 245 0 245 1,296 -Wood frame, with sheathing, siding or brick; R-11 3 1/2 in.; none S Wall 133 sq.ft. 163 0 163 862 -Wood frame, with sheathing, siding or brick; R-11 3 1/2 in.; none Window 27 sq.ft. 972 0 972 964 - Double pane; Vinyl frame; Clear glass - No inside shading; Coating: None (clear glass); No outside shading. W Wall 177.5 sq.ft. 217 0 217 1,150 -Wood frame, with sheathing, siding or brick; R-11 3 1/2 in.; none Window 22.5 sq.ft. 1,575 0 1,575 804 - Double pane; Vinyl frame; Clear glass - No inside shading; Coating: None (clear glass); No outside shading. Whole House 1,645 sq.ft. 21,155 6,344 27,499 72,443 ( 2.5 tons ) I HVAC-Calc Residential 4.0 by HVAC Computer Systems Ltd. 888 736-1101 Load calculations are estimates only,actual loads may vary due to weather and construction differences. V,� C 4 O' -4' � K G� r L, e • j. _r �J dO • 9 t t ` . � Town Of Barnstable - *Permit#����35 y� Expires 6 months from issue d to •. Regulatory Services Fee • anxNsrAB 039 MASS. `�',� Sas F.Geiler,Director PERIFAF All Q� `� 2Q"T Building Division om Perry,C.BO, Building Commissioner ��$� Kam Street,Hyannis,MA 02601 TOWN �S� wwW.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERNUT APPLICATION - RESIDENTIAL ONLY ^ Not Valid without Red X-Press Imprint Map/parcel Number /�/tJ ('l r/ Q T Property Address 67 8 t Gc��sf G�/n�✓ �i�e XC S 1, 93 Residential Value of Worker yoD Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address ` Contractor's Name Jy!/9-7 �,�,�� Telephone Number Home Improvement Contractor License#(if applicable) /��7 Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: I am a sole proprietor I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name -2surcr,, Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side Replacement Window do)does iders -Value (maximum.44) —*Where required: Issuance of this pe 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 is required. SIGNATURE: /zt C:\Users\decollik ppD::. V ocal\Microsoft\Windows\Temporary Internet Files\Content.Outlook\MY7NB41L\EXPRESS.doc Revised 100608 All Cape Painting & Carpentry, LLC P.O. Box 2103 Mashpee, MA 02649 508-509-2107/ 508-509-3417 CSL# 090884/HIC# 156887 July 21, 2009 Rose Marie Sylva 8 Merrill Road Merrimack,NH 03054 ESTIMATE FOR WORK TO BE PERFORMED AT: 281 Westwind Circle, Osterville, MA 02655 Scope of carpentry work: Replace front entry and storm door with a new 3'-0"x 6'-8" fiberglass, double bore,two lite door with new deadbolt and lock. Also, new Anderson storm door, ventilating, contemporary dual vent full lite with TruScene with brass hardware, 36"x 80",white.New Anderson casement window crank hardware installed in kitchen window above the sink. 500 sf of Bruce laminate flooring and vapor barrier installed in the basement over existing tiled floor. Laminate flooring to be installed is Teak from the Heritage Heights Collection All baseboard removed, door jambs trimmed underneath to fit flooring,bottom of closet door trimmed for easy of opening over new floor. Area of existing loose and removed flooring tiles will be leveled and feathered in to create an even surface for the new flooring. Bruce vapor barrier installed and taped at all seams, new laminate.flooring installed over vapor barrier. Baseboard re-installed once all new flooring has been installed. Scope of painting work:New door painted on both sides once installed. Note: Color and sheen of paint to be determined by homeowner. GENERAL CONDITIONS: Homeowner responsible for the removal of.furniture in the basement area where new floor to be installed. All debris will be removed and the work area will be kept clean. Cost of cleaning-up and disposal of debris is included in the estimate. ESTIMATE: This estimate includes building permit fee, labor and materials for the above said work to i . All material is guaranteed to be specified, and above work to be performed in accordance with the specifications submitted for above work and completed in a substantial workmanlike manner for the sum of: $ 3,9830.00 with payment as follows: A deposit of: $ 1991.50 is required. The remainder due upon completion. Work to begin: Duration of Job:_ 3-4 days Completion date: Respectfully submitted Vicki L. Elias and Jyl M. Hendricks Note-This proposal may be withdrawn by us if not accepted within 10 days. Any alteration or deviation from above specifications involving extra cost will be executed only upon written order, and will become an extra charge over and above the estimate. All Cape Painting.& Carpentry, LLC ACCEPTANCE OF PROPOSAL ' The above prices, specifications and conditions are.satisfactory and are hereby accepted. All Cape Painting &Carpentry, LLC are authorized to do the work as specified above. Payments will be made as outlined above. All Cape Painting&Carpentry, LLC is fully licensed and insured in the Commonwealth of Massachusetts. CSL#090884 HIC# 156887. Insurer:Northwood Ins. 508-466-1032. Please make check payable to Jyl.M. Hendricks Signature '� � 11­9_01 Signature Rose M e Syl a Date Date Signature .! ( 'r �� Signature Vicki L. Elias. D e yI M. Hendricks Date i The Commonwealth of Massachusetts t 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/Organization/Individual): i Address: U• /3 0� /a City/State/Zip: /1Z7as`i a_e,e Z!;V�q 4�,gj�IV7 Phone#: S-0B-,f6 Are,you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑ New construction 2XI am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' i 9. Building addition [No workers' comp. insurance comp.insurance.* ❑ required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12❑ Roof repairs insurance required.]t c. 152, §1(4),and we have no 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. xContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. if the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. / Insurance Company Name: �sz/gea I to ge Policy#or Self-ins.Lic.#: ll Expiration Date: Job Site Address: �A1 �JPs��in� �'re% City/State/Zip: 657p/dine. �� 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 and penalties of perjury that the information provided above is true and correct Si ature: • t� . Date: 51,-03—o Phone o o / 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#: v ,z. =• ilassachusetts- Department of Public Safet.N. Board of BuildinI RcI atinns and Standar(Is Construction Supervisor License License: CS 90884 Restricted to: 00 r' JYL M HENDRICKS . PO BOX 2103 MASHPEE, MA.02649 7 to Mn i Expiration: 7/14/2010 I!? y =1 o ('umui..i::ncr Tr#:•281 p' o Y ,,' •� • (J^ C � fD M is N to __ ll a oo � � c 1: -�p..•.+:rrb•ur,�,r.�: .� +a<;. �:.;���.�ad;:taw i -.K zbs.:�lie�k'���,. �. �p o ` i. ➢ re. �nrra»ra�eu+ea e. a �: aadae aueeLZa �, �. a, Board of Building Regulations and Standards y - - HOME IMPROVEMENT CONTRACTOR . ty Registration: 156887 v .0 t Expiration: 8/13/2009 Tr# 257737 Type: Partnership agCD ALL CAPE PAINTING&CARPENTRY a tj JYL HENDRICKS 19 QUASHNET RD. ,�eQ.�.-� i t MASHPEE,MA 02649 AdministFatot CSL n 69-01&8* HIC# 156887 All Cape Painting & Ca-Tentrr Women Owned&Operated VICKI L. ELIAS JYL M.HENDRICKS 508-509-2107 508-509-3417 Free Estimates Fully lnsure- IftC Registration Complaints Page 1 of 1 The Official Website of the Office of Consumer Affairs&Business Regulation(OCABR) Mass.Gov Consumer Affairs and Business Regulation Home > Consumer> Housing Information > Home Improvement Contractor Program > ................................................................................................................................................................................................................................................................... HIC Registration Complaints Registration# 156887 Registrant ALL CAPE PAINTING &CARPENTRY Name JYL HENDRICKS Address P.O. BOX 2103 City, State, Zip MASHPEE, MA, 02649 Expiration Date 8/13/2011 Status Current No complaints found for this registrant. You can also view arbitration and Guaranty Fund history. Back To Search I ©2009 Commonwealth of Massachusetts I I http://db.state.ma.us/homeimprovement/licdetails.asp?txtSearchLN=57963 9/22/2009 i t Town of Barnstable *Permit# ���� Expires 6 month�om issue date Regulatory Services Fee' P Thomas F. Geiler,Director Building Division MAY 3 ® 20®s . Tom Perry,CBO, Building Commissioner TOWN OF 200 Main Street,Hyannis,MA 02601 BARNSTABLE www.town.barmtable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESII3ENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number / 2 / 0 f / 0 Y(, l Property Address ,2 ('a I A/a-s to of d C[/"e-1.Q I( / �i esidential Value of Work Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address X Z t i Z S 1J1 A Ccr GLl- i Contractor's Name ljtJe /,P— �a /� Telephone Number<�O !_�7 '7—70 Z S Home Improvement Contractor License#(if applicable) 2 0 Y 7�j 1 Construction Supervisor's License#(if applicable) 0 y 7.7 Y Z orktnan's Compensation Insurance Check one: ❑ I am a sole proprietor ae Homeowner have Worker's Compensation Insurance i Insurance Company Name 2e r a l S 5 Gl A&Je_ �r/i S Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box),EH rr e-roof(stripping old shingles) All construction debris will be taken to vwt S►-er ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property O er must sign Property Owne etter of Permission. ome ovement Contractors items s quired. SIGNATURE: 2,11 Q:Fomss:expmtrg Revise071405 m w c� Ln s a. Z l3dbf�oiH��i [€�s�A� License.or registration valid for ind'ividtii use only Z - HOME IPAPROVEMENT CONTRACTOR before the expiration datc. If found return to: `L Board of Building Regulations and Standards CY Re®is :n 120439 One Ashburton Place Rim 1301 JQ120d7 Boston.Vila.MIN ership LOHRCONSTR .L; , Wesley LCHR SOD FALMOUTH P � tea.• ___ f- ASHPEE,MA 02(i � Administrator of valid withDot gnature cv m M Ln O @ Lo N M f @ V 04 m The Commonwealth ofMassachusetts Department oflndustrialAccidents Office of Investigations 600 Washington Street ' . Boston, MA 02111 ' www mass.gov/dia' Workers' Compensation Insurance Affidavit: Builders/Contractors/Electridans/Plumbers Applicant Information Please Print Legibly Name pusiaess/Organization/Iadividup: icy i1 Jr C, I'l C 6c Lo 1ir Address: ',�-O City/State/Z# 4 026 yJ• Phone#: z—o gt 7 °Z Are you an employer? Check the-appropriate boa; Type of project(required): 1, mn a employer with 3 4. ❑I am a general contractor and I 6. ❑New construction employees (fall and/or part time).* haveI&ed the sub-contractors 2.❑ I am a sole proprietor or Partner- listed on The attached sheet 3 ?� Remodeling* ship and have no employees These sub-contractors have 8a ]Demolition working for me in any capacity. workers' comp,fim met 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 11.❑ Plumbing repairs c r additions myself.[No workers' comp. c. 152,§1(4),and we have no 12Zaloof repairs insurance rc uiredl.t . employees.(No workers, 13.❑ Other camp,insurance required.] *Any applicaat that checks box#1 amat 41so M out the section below showing their wor3=1 oompensaton polieyinforma km ` t Harmeowneta who submit this affidavit indicating they am doing all work andthen hoe outside caatraetors mast submit a new aMdavit iadiaatiag such ;Contractors that check this box mast attached an adciit mill sheet showing the name of the aub•cmftctora and their workers'comp,poEcy informoatioa. ram an employer that is providing workers'compensation insurance for-my employees. Below Is the policy and job site inf brmrdton. 7 'J Ivsuriice Comp any Name: : L2 vi at 1 S S 4 ti C.Q, n S policy;or maims.Lac.o. e Job Site Address; Z'6 1 s e rt� G',^�/P City/State!Lip': Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secore-coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.90 and/or one-year imprisonmevt as well as civ$penalties in the.forrn of a STOP STORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Ir vestigations of the DLk for insurance coverage verification. 1 do hereby cerf o under the p ns and penalties of erjury that the information provided above is true and correct: Sr tore; Date: —Z —o 6- Phone#; 5D c6 Y 7 2 -"7e,"Z . Offis.a,K3f sue. Be ne e h,this area;,to be pi eat by c4.or City or Town- Per•m1tUcense# , Issuing Authority (circle one);' 1.Bozrd of Health 2.Building(Department 3.City/1 own Clerk 4.Electrical Inspector 5.Plumbing(ripe&,or 6. Other Contact Person: Phone#: Information and Instructions Massagbusetts General Laws chapter 152 requires all employers to provide wbikers' conrpensatiumfor-ffieir employees. Pursuant to this statate, an employee is defined as"...every person in the service of another under any contract of hire, express orimplied,.oral or written." An employer is defined as-"an individual,pgmersht,association,corporation dr other legal entity,or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer,6r the . receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction orrepair work=such dwelling house or m$he grounds or building appurtenant thereto shall not because of such employment be deemed tob a an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal 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,MGL chapter 152,125C(7)states'Neither The commonwealth nor any of its political subdivisions shall enter into any contract fur the pm*rmanct ofpublic work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to The contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by chectdng the boxes that apply to your situation and, if necessary,supply sub-contractors)narne(s),address(es)and phone amm3ber(s)along with their certificate(s)of insurance. Liinited Liability Companies(LLC)or Limited Liablity Partaerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or UP does have employees,a policy is required. At advised that this of davit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage, Also be sure to sign and date the affidavit. The•aidavit should be retnuaed to the city or.tcwn that the application for The permit or license is being requested,-not the Depm-i ment of Indust ial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensatioupolicy,please call the Depmtrnent at the number listed below. Self-insured companies;zhoum saber their self insurance license number on•the appropriate line. City or Town Officials. Please be sure That the affidavit is complete and printed legibly: The Departmcnthas provided a space at the bottoms. of tM affidavit for you to fill outin the eyed the Office of Tmesti&ons has to contact you regarding-Tie applicant - Please be sure to fill in The permkIcense number which will be used as a reference umnber. In addition;as Applicant that must submit multiple pernritlicense applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job.Site Address"the applicant should write"all locations in_ (city or town),"A copy,of the affidavit that has been ofSciany stamped or markedby the city or town may be provided to the applicantas proof that-a valid a0davit is on file for future permits or licenses. A new affidavit mustbe filled out each ' year.Where a home owner or citizen is obtaining a license or permit notrolated to any business or commercial venture (Le. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit The Office of hvestigations would hike to thank you in advance for your cooperation and should you have any questions, Please do not hesitate to give as a call. The Dcpartment'a address,telephone and fa m=ber: Ile Cornmonwealm. of Massadmsetts De Anent of Industrial Accidents . . 600 Washington Street Boston, MA 02111 Tel. #617-727-4900 ext 406 or 1 077 MASSAFE ' Fax#617-727-7749 Revised 5-26-05 vrym mass.gov/dia 05/30/2006 1:3: 12 5085393121 LOHR AND SONS PAGE 05 r�xsR11.�`Ew VirB'L R�■ ■Mf'1� � fir■ ^�� vw,rtri� r..� ,. . ... --- -^^ - - --- PROLICR (781)447-5531 PAK (782)447-720 THIS OFI TIFICATF 0II %ED AS,AMATUR of INF P . It1Inn 8 Rosh Insurance Agency, Inc. ONLY. AND CONFERS NO RIGHTS UPON THE GEK MICA 458,South -Ave. HOLDIER.THIS 0$11T.IPIGAT9 DOES NOT AMINDO ND OR Whitmn, RA 02322 INSURERS AFFORDING CMEPAGE NMC ti- Dreultl¢s Uftr 8 Sons-, C.� INSURER* AMh SpeC'l KltsuPevtR'9 800 FAIDouth Road IGtBURBRBI walsssnpa ZfI elrancal 00�0202 Unit 203A IIiBURGRC: 14ashpoe, RA 02049-3348 mrauR2A D: INiLIRHit®: THE POLICIES OF INSURANCE USTP.D BZLOW HAVE 9=4 I®'BM T'Q THE IN6UREA NAMED ABOVE FOR THE POLICY PERIOD INDICAIM,) O-MITMBTANDiNGANY . K Y RTAIN 114t INSURRA TERM NCLAAOFORDDOlt-ANY IKPOUCm QNTRACT On OtHeR CRI88U HE`MN 19 Slf9J8CM ALL TMS TERMS,M TPO S, USI r�AND CON11 DITIONS orauem POLICIES.AGbh&;a 1,IM M SHOWN PAY HAvE eaEN REDU 8Y PAID dLA ma, TYPE'OP IRAURAHCE AOUZY Null R MtlL N LIMIT& ORMYRALkIANA Y GIWOI087. 32/22/ZO AZ/x2/2005 WGNocoura ma a 2 01fp X CC1L m9v=AI.XNERAL UABILrry 9Df78NTEL��" 8 ip CLAIMS MAD6 OCCu14 IM MID W f Pe one w) S A -- - - DlAI.IIA9VI,U,IURY W OBVIiRALA1iGI4PflA'T'E 0 OWL A00RROATE LIMIT APKIWO PGA; PRODUCTD•OOkP10P AQl6 61 71 DOLICY PM Loc AU1nM9m m1UlY ft 9UISDae I!!{D{�L1MR 4 ALL OWNED AVrOB a�m011a(N 60011Y R�UURV 9 SCHIMULW AUY09 (Per 96w) HBieD AUT09 BDDgx INJURY I4VN ;D AVT0$ IPar eaniaerq s gAntaae � . I{oerea enl ' eARA4lt LIAtIILRY AUTO ONLY.BA ACCINIC 8 AW AUTO EA AGE 1 B+I TMA1V A OMLY: A06 A R%CRBEWMBIi6LLALA04LtT1' flAC?I Ci,IF.tiefiCE OCCUR 0 CLA e MADE AWRE"Tt 6 DnDucrlssa za RETENTION a 9 %VAK09.00M➢MMUTMAND Tw Ivial3005 11MAO06 C AT - 1:MPLOYEW LIA®LIVY g ANY P_R�OPF�, RIVARRVERlodounva fi.LBlCNAOCIQENT ® yQa o� R�iOLUDfiDP �L DIBEAEIE•LTA EMPLOYE $�• A tldamdbound0r -- E.LDISE4AK!-AQI,ICYLIM(r 0 00 81'PlER DBSCRlPT�DN CR 0➢811A'fION®/LocAr101fb(Y8KtC6>lB!61(CWBNJMC A9Dl1D BY ENODR88MdNr18fapµL,I'R6VISIgILe ORCULD A11Y OF THE ASOVC DMAISM➢OLlgOd JOB CAII rOLLM 29FORE THH 11)IPIRATIQN PAIS TNpRIMP,TKE ISEtM HilWFU%%L QNMN.gR'TQ MAII. _�DAr9 Yaerrrert NO'I`1Gi 70 7'619 CitR19RIQ4rA NOLBfik 1rAxED'!�7N8 L8R', BUT PAIWRE TO M1R1I,BUCK NRME Bit&L IMPOSE ND OOLIGATION ON WMLIT f t OPAW Ihli� ?He INeU RG A%nORM R NTATrg ACORD 26(2001l08) ®ACORD CORPORA"ON i980 Town of Barnstable . Regulatory Services 9�ss. Thomas F.Geller,Director Building Division. Tom Perry, Building Commissioner 200 Main Street, Flyannis,MA b2601 www.town.b arnstabl e.maxs Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Scction. If Using A Builder a a:'22=2 , ,as.Owner of the subject property hereby authorize �/�/c,S �-e r� /,� o to act on my behalf, in all matters relative to work authorized bythis building permit application for. r (Address of Job) Signature of Owner Date Nnt Name Q:FORMS:OwNERPERhMSION LL W L•J C'3 �L 0 . in.mo 1[tra'![rf/t Lo BOARD OF 13UM NG REGULATIONS C4 z License: C;ONSTRLICTkON SUPERVISOR Number: CS O4.7742 o Expires: 01;22i2l',1Q8 Tr. 1 1487 • Restricted: 00 10JESLEY A i OHR iM GREAT PINES DR PIASHPEE, 10A 02649 Commissloner CV qn m ro in a� m u� CA Ln m CD 6l to Lf) �9 r TOWN OF BAR,NSTABLE Permit No. -.2 7 6 8 2___-_-_ Building Inspector Casa �9 'eiw OCCUPANCY PERMIT Bond issued to Dennis Star Cons tr_iactinrAddress Lot 39, 281 West Wind- Circle, Osterville Wiring Inspector ��� Inspection_date Plumbing Inspector,/ �' � �� > � Inspection date Gas Inspector �Q�t < < � Inspection date � �� _ 1 0_I4r,nr f3S, }-Engineering Department_/ � , - ����} ram, Inspection date i r rtJ- Board of Health 1 v� , �� L .� Inspection date rnl�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. Building Inspector �� my�•��„ TOWN OF BARNSTABLE BUILDING' DEPARTMENT sewer t TOWN OFFICE BUILDING rua �°b .a19• �� HYANNIS, MASS.,02601 �o eur►• %i C MEMO TO: Town Clerk FROM: Building Department DATE: June 10, 1985 An Occupancy Permit has been issued for the building authorized by - - 27682 BuildingPermit »...._»........»..........»_.....:..................:..:.............:..:»..............................» #..............................». issued to Dennis Star Construction Please release the performance bond. ,'' A' liE�fR� �►T/ 'T�Gt�'`TM� +f IJ '/rtO}�LaC�/T,l� /A! �,EOER.�,� AW .. , �►. 1A'"',,r 44,w 1/,C v,Ti e, 4c4OE'#P'44 jiKSN,R�A" SPITE A4# P4W P�/E 7�M��V QIR'j .'T` SAR-fd TA AA i C11 V�TY PANS . 2 5000 00� f� GTEJ/E A�TE'r B NOTE: NORTH ARROW NOT'TD 1, •_ _ � . . , goy :. ST - -- VV IR L I a Qi +1 14.0 N Zo. (4 CDT--38 _ o OT 4:0: o E�XISTIN6 FOUNDATION C O p y N .6 LOTS" gay 125.00 a f Z XV/4 AW r A�►�I•�Arr'*0*WrAWIf f/P" 1 OUNA TI N 0#47PIQN PLO '.' : /NSTiPI/�#Vr OV YAW AS AW W I LOT 39 WEST.W110-CIRCLE AW.W THE aW*Vof 4W/, !//VPEW AV QS TER V I L E , IAA R►vSTR BL MA GPi�CUA4S�?'.I/YCE'S AR'!; OFFS TS TO 9�' - I ) ' ll�E'�•.FQA" ' fF�'Al•�r.�'►�i..��'!��►4�i �lP�`�� _ - •' ' .. _ a►Ii�IVE'O BY:DENNIS-STAR' CONST CO. t , � atq s 9 .�li�►�1'4jY E Fi��i�PING /NC R,OBERT EA r A W h E_ Q}�C :4 li *V�C�I'bIC}�AY RAYMOND �" E-4 I"'A�&ff� ��. 04�7�7� ,pNo.2158i O y j R�IT o� 30 FEa )985' vS T= Of dWrIl AC44W or-, -5FJ Rf ,� ... +v+F,.. ... _ ,+r�fra.r.�m..u.i a:e.u+.r._L".. - e-4i... .. o.ai..n.... ._`•cw......1..-.- .. - ... .. ... - ..Ass`msor's map and lot number .../.... �-.1�............. SEPTIC SYSTEI, Sewage Permit number .......... INSTALLED IN C01e Q' o WITH TITLE a >; BAUSTODLE. : House number .....................ca .l......��............... .. ENVIRONMENTAL CODE..PM,,. 0 ��6�9, � TOWN REGULATIONS �nwara� TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .�L1�./.�...:............... ..................................................,....................:.......... TYPE OF CONSTRUCTION ...........k✓... ......... .. .................... ................ .�.Q.. -. .�gl.........194-y -TO THE INSPECTOR OF BUILDINGS: r . H . The undersigned hereby applies for a permit according to the following information: Location ... :� 4 .....19..... 3..T...w/,W/ .. .7' ....... l.. �. "..... �.. . !ll... / .................. 'Proposed Use ................ ..Lll % ..................................................................................................... ...............................Fire District ....................�.. .......................................... Zoning District ...............�...........— Name of Owner .C�G,N/N( .T.. ..�'.C�/1� .C�<�L3!/Address ..........�5&...y./,.t. � .. /f.................... .Name of Builder .40 -t.,#71�5Q..It,#.9 ID.(I...Address ..............�.`...y�.�.1. �.�.��............... Nameof Architect .,�................................................................Address .................................................................................... Number of Rooms .J�.. .: ...,1.. .Y.. ....0.J.. d—i...K.).-T-Foundation ..... .`? .R.�.. ��.�!/ ...rj>F......... Exterior .........W.. 'k7-j5--C.C'�r.. 49... ..Roofing ......... ....... /•/Y•..(�'..f/LG ... Floors ..................d. ../.%... ..�r�l ...........................Interior ...........f.... ............................ Heating ' .... �..a�...I .Z.. ...' ...W#j..........Plumbing .............1�.....�.�.��T.�................................. Fireplace ...................0..N..r...........................................Approximate. Cost ................ t9'Q .................. Definitive Plan Approved by Planning Board -----------------------------19 ---• Area ...� ...... ............ Diagram of Lot and Building with Dimensions Fee 1..... .............. SUBJECT TO APPROVAL OF BOARD OF HEALTH 0, r , 14 � � 1 '96 b r OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .. Construction Supervisor's License ........a..l e�j..,fk. �s ) Ni IS STAR CONSTRUCTION t Nt .ZM N..... Permit for ..One,St/r-v .. .................... Location ...Jjot..39.......281.We5t..I?Iind..QiM e ...................Qste L.vi ue...................................... a Owner ... ..�QY1StSl1GtIOX1....... Frame Type of Construction .......................................... ............................................................................... Plot ............................ Lot ................................ Permit Granted .....A il..2f..................19 85 3 Date of Inspection �l—.:R��....... ................19 T' — —g" Date Completed .....�.............................:19 Y ' t i G,/L I v, 11-`O ,:_ Assessor's map and lot number ...1//.. ...,�..:. ��.... THE _d. ypi tp1` Sewage Permit number MASBSTADLE, • House number ....: ' ../.........dt.".km.. MAe6 ! .:.............. 90 MPY a' TOWN OF BARNSTABLE BUILDING : INSPECTOR APPLICATION FOR PERMIT TO ....................��.. .. ..����..11 .................................................................................. TYPE OF`CONSTRUCTION` ...........IAZ.(.9.19.. ....FIA �............ ,/,.:/...:,j,LAB.Z'K.................... ................ .�. ....... �L. ........19Z�i TO THE INSPECTOR OF BUILDINGS: The undersigned hereby hereby papplies for a permit according to the following information: Location ..., X�..:(.. `'ig 1!�l 'P..� ...f.!?i.��✓ .....�!.LR.6./..[e ......: ..,�..�;,.f `.................. Proposed, Use ............... ..d...!1 .I .f........................................................................................................................ Zoning;-Distf c t9 ............... ...C..—...............................Fire District .............................................................................. Nome'^of#'Ow r ./Nr��(. .. .7 f ..l.f��1 /4?r�!1Address .....................KA—'R. -7--v.................... Name of Builder .."?.P .p.. .�Tf. ..� !f .�e�n.�. ...Address ..............:-?.......Y ..rl. rf.T ............... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms 1..1.. g.....n./..h/. ...K.l..:T..Foundation ..... ...... al.2C ........... Exterior ........., .� .. . ..4�.. .. /�: .... :�/�//fi ...Roofing ......... .1.4T...... ..L ... '>d Floors1 .. ... ..11 :.,T.............................Interior ............' .....1.,.N...I /.. ............................. ...1 .:..??. :...Plumbing .........: ............................1 7 ...:...........:....:..........: ; 9 • Fireplace ..................................................................................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 G OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I' I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ...... ✓.! �..c.6?....... rr'/r� (iC...... �/ �.%A � Construction Supervisor's License ......: .. ���1.. .. DENNIS STAR CONSTRUCTION A=121-11 -46 �i -�i-yam No ....27682............. Permit for ............. Single Family Dwelling............... ............................................... Location ....Lot...39 281..West.. j�ii�qle ...... .... ...... ......... Osterville ............................................................ .................. Owner ......Dennis ....... ........ . .. .... .... ........................... Type of Construction ......Frame .................................... ............................................................. ................. Plot .............. Lot . ............................... Lot April 2, 85 -Z ..... .....19 Permit GranteLl................................ Date of Inspection ....................................19 Date Completed ......................................19