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Home My WebLink About0195 WIANNO AVENUE 1- , r �, ,. � � , � q +t, .. e ' � �- . �� .�; �� '� ;� �� , ., � �• . �,, .. �, r � �� ,. � - � ` ., .,. � - � � �, n.. a � .. �, � .� �i. �1 I _ .. � K ° _ � N r �, ,, �� o � ,� � „ . ., ., �� ;, <, -A:�+ r....�.�'++�'+..'^�..,.'.-. .-.-.-+�,+� v-�� .!". ,,.�"c,. :n, ,.n.+......��1+, .hr..�..w+'.. t .r^'v�.....'..+rw.ra�._� � .fi... /� ,-'�. .fn... .�i. i �FTME Tp�, Town of Barnstable . do Building Department sntwneL e. ' Brian Florence,CBO �Ar i639 e�e� Building Commissioner Fp TAA� 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 11/8/19 Kevin Shea 55 Sarah Dr. Avon, CT 06001 Dear Mr. Shea, Re: 195 Wianno Circle, Osterville We are in receipt of your Business Certificate application. Please be aware that properties involving a residential address also require a Home Occupation Registration. There is a $35.00 fee for the registration and a$40.00 fee for the Clerk's Office. In addition, there are residency requirements that must be satisfied. Please contact me at 508- 862-4027 in order to discuss this pending matter. rice ly, (j G Robi Anderson Code compliance Manager 508-862-4027 signs/signrequ&app revised: 9/22/17 r Town of Barnstable Building Department Brian Florence, CBO Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Pre-application for Business Certificate Date Iv 1 Map Parcel Applicant Information Applicants Name KCutfV - S4L-1A 4 5- SPrt._A t+ -bA &%kW-�.C_-1 Applicants Address Email Address L6VINJ P StfC9 ►• (2- Telephone Number r6�40 y U` "1 Listed ❑ Unlisted Business Information New Business? ----------------------------------------• Yes No , Business is a registered corporation? ________________________ Yes No If yes Name of Corporation 4 t,yt N - S N CA r^'k-,.N Does business operate under the registered corporate name Yes No Is the business a sole proprietorship or home occupation? _________ Yes No If yes then a Home Occupation Registration is required-See Building Division Staff Name of Business oy G . 5 t-1 G1�1 ' A7 i �-�- C Business Address LCt Uv t A n.n-() C_ 1_Cz Type of Business 1 "-7 C7v\-C-7 d-ChN-S U L7 . .- Building Commissioner Office Use Only Conditions Building Commissioner Date Clerk Office Use Only .ertainTeed Corporate Information—Valley Forge,PA-CertainTeed bttp://www.certainteed.com/corporatelnfo.aspx 0iE;,', ,,, 1cc v n C C nts. � CONSTRUCTIONw our Careers Page POSSIBLE EXTRA CARPENTRY: Any Rotted or Otherwise Deteriorated Trim Boards,Plywood Sheathing,Missing Metal Flashing,Side Walling or Any Other Carpentry Needing Replacement will be done and charged for as an Extra. Materials Plus Labor at the Rate of$80.00 per Hour. PAYMENT SCHEDULE: A Deposit of$9750.00 is due at the Signing of this Roof Proposal and the Final Payment for the $9,000.00 is Due Immediately Upon Completion. WORK SCHEDULE: All Roof Work is Normally Scheduled for Completion Within 45 Days of Acceptance and Receipt of Deposit providing the Materials are Available. Please Make Checks Payable to: COREY & COREY COREY & COREY Warranties the Shingles and Labor for 10 years. COREY & COREY carries Workman's Corn nsation and Public Liability Insurance on the above work DATE OF ACCEPTANCE: D ACCEPTED BY: SUBMITTED BY: RICHARD FITZGERALD CHARLES CORE '"ONkLTANT HOMEOWNER COREY & CO + S UCTION nf3 ACORIZDATE INAQDOfrfrn CERTIFICATE OF LIABILITY INSURANCE 01/24/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY-AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certHieate holder is an ADDITIONAL INSURED,the poitcy(ies)must be endorsed. if SUBROGATION IS WAIVED,subject to jOw 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 endorseme s). vRooucER CONTACT MANE Joanne Bretton Southeastern Insurance Agency, Inc. �, 508-775-5154 FAX Mp 508-790-0557 641 Main Street E4AA)L Hyannis, MA 02601 PRODUCER tMsURMS AFFOROINO COVERAGE NA1C 0 INSURED INSURER A: Arbella Mutual Ins Co 17000 All Cape Exterior Remodeling LLC INSURER8: AEIC Insurance INSURER C: i 67 SEA STREET APT A4 INSURER 0: Hyannis, MA 02601 INSURER E: -- -- —_—'- INSURER F: COVERAGES CERTIFICATE NUMBER: 2013 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 CLAIMSRM . p TYPE of INSURANCE IISR YWD POLICY NUMBER EXP LRAfTS .LTGENERAL LIABUJTY 8500041933 01114=13 01114=141 EACH OCCURRENCE S 1,000, X COMMERCIAL GENERAL LIABILITY PR n '$ 100,0()( CWMS-MADE I X I'OCCUR I MED EAP(Any one Person) $ 5,00( A I PERSONAL&ADV INJURY $ 1,000,00( GENERAL AGGREGATE $ 2,DOO 00 GEWL AGGREGATE LIMIT APPLIES PER I I I I PRODUCTS•COMPIOP AGG S 2,000100( i POLICY(—JPERCOT 7 LOC S µTTpypgRp LLABLIY COMBINED SINGLE LIMIT $ (Ea acadenl) ANY AUTO ' l i I I I BODILY INJURY(Per person) $ ALL OWNED AUTOS �BODILY INJURE(Per eca0ent).S SCHEDULED AUTOS ( 1 PROPERTY DAMAGE $ HIRED AUTOS i 'Per acowl) NON-O"ED AUTOS S $ UMBRELLA LUB OCCUR I .EACH OCCURRENCE S EXCESS LIAR HI CLAIMS-MADE, I I I AGGREGATE $ DEDUCTIBLE I I I $ RETENTION S I I I I $ WORKERS COMPENSATION ) I WCC500789601201 01114=13 I01/14120141 X I TORY N- : C<a ND A EMPLOYERS LIABILITY YIN , I ANY PROPRIETOWARTNERIUECL IVE I i E L EACH ACCIDENT $ 1,000,00 B OPFlCERIMEMBER EXCLUDED? MIA NprldaSpry p,N E.L DISEASE EA EMPLOYEE S 1,000,00( "DESItIPTIONOF OPFRAnON5 below I OWNER INCLUDEC, j E L DISEASE-POUCY',IMIT t 1 000 00 DESCRWMON OF OPERATION3I LOCATIONS I VEHICLES (Atbdl ACORD 101.AddMonal RNwmrks Sctndula,tr more Msce b Mired) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORRED REPRESENTATIVE di lay purposes only Joanne Bretton 0 1988- 9 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD ACORIZ CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDOnY Y) 01/24/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY`AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT: If the cartificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WANED,subject to Ahe 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 Ileu of such endorse ne s. PRODUCER CONTACT Joanne Bretton Southeastern Insurance Agency, Inc. E,t; 508-775-5154 N Ne 508-790-0557 641 Main Street EJlA.AIL Hyannis, MA 02601 IIODUCER INS S AFFORDING COVERAGE NAIc j uuURM INSURER A: Arbella Mutual Ins Co 117000 All Cape Exterior Remodeling LLC INSURERS: AEIC Insurance INSURER C: 67 SEA STREET APT A4 INSURER 0: _ _ I __•.__ Hyannis, MA 02601 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: 2013 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. RLTRR TYPE OF R45URANCE rNSR wvD POLICY NUMBER y LIMITS GENERAL LIABILITY 850004193 011`14I2013 01114/2014 EACH OCCURRENCE 'S 1,000,0001 X COMMERCIAL GENERAL UA.BIL.1 Y• I S IOU,O CWMS44ADE I X I OCCUR I MED EXP(Any one person) S SIGN A i I PERSONAL&ADV INJURY S 1 000 00 I j GENERAL AGGREGATE f 2 000 00 GEN'L AGGREGATE LIMIT APPLIES PER I I I (PRODUCTS•COMP gP AGG f 2 000,00( POLICY r—PERK LOC f AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT f I I 1(Ea ecoaenq ANY AUTO I I BODILY INJURY(Per per5pn) $ ALL ONMED AUTOS I I I 1 i BODIIv INJURY(Pr eeodenq.S SCHEDULED AUTOS I I (PROPERTY DAMAGE • HIRED AUTOS I i i(Per ecodeM) S HiNON-0NMED AUTOS 1 I S I f UMMLLA LIAB OCCUR I I EACH OCCURRENCE S EXCESS LIA13 CLAIMS-MADE I I I AGGREGATE f DEDUCTIBLE 1 :S RETENTION S woRlcERs COMPENSATION I WCC500789601201 0111412013101/14/20141 X i OR STIMIT DTI+ AND EMPLOYERS LLABIUTY YIN I TORY LIMITS I I ER ANY PROPRIETORUPARTHER/ ECUTIVE I " E L EACH ACCIDENT ,S 1 000 00 B OFFICER/MEMSER EXCLUDED? MIA! (yyeesd�ui) i E.L.DISEASE-EA EMPLOYEE S 1 000,00 DEscRIPnoN OF OPERATIONS Helot OWNER INCLUD � E.L DISEASE•POLICY UNIT S 1,000,000 i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Atbch ACORD 101,Ad"onal Remarks ScWuW If mom space Is mwked) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POUCY PROVISIONS. AUTHORIZED REPRESENTATAM s W di lay purposes only Joanne Bretton 0 1988- 9 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD License or registratio0 valid for individul use only VV. g�oc �ue�a before the expiration date. If found return to: Office otCoosumerAffairs&Busi ess$e ulation Office of Consumer Affairs and Business Regulation. OME IMPROVEMENT CONTRACTOR ,. ' ' !�19� a istration: -- 10 Park Plaza-Suite 5110 9 i'ot92 R Type: j ' xpiratipn: 9/t�92014 DBA j . .. Boston,MA 02116 i y;: • COREY AND COREY CONS'`RUCTION PATRICK CLIFFORD j _ 12BALDWIN RD :y Not valid withoulfsignature DENNIS, MA 02638 Undersecretary IL Massach45etts-'iSepartmejtt of Public Safety P Board of Building Regulations and Standards Y Construction Sup rn kor Specialh' License: CSSL-105951 . _ PAIMCK CIdI"'RD ' _ lug �_ lit Expiration Commissioner 06/02/2016 Tl:e Conimonsv=ealth of Massachusetts Departittent of Industrial Accidents -�-' Office oflnvestigations 600 Washington Street _z r Boston,M4 02111 ivmv.mass govJdia Workers' Compensation Insurance AffidaNit.:Builders/Contractors/EIecttic ans/Plumbers Applicant Information Please Print Legibly Name(Baseness/Organizaticatibdividnal): (.61e 1 ,�Q �Cdam/ t-P�i'I��eit Col Address: L r�(�li 11 City/State/Lp-. d Phone Are you an employer?Check the appropriate boz Type of project(required): 1.❑ I am a employer with 4. atn a.geaeral contractor and I employees(full.andlorpart-time)- : have hired the sub-contractors 6. ❑New construction. 2 ❑ I am a sole proprietor or partner- listed on the attached sheet 7. Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' 9. [No workers'comp.insurance. comp.insurance. I ❑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 11.❑Pl ag repairs or additions self. o workers' right of exemption per NIGL �' � c�P- 12.M4,00f repairs insurance required.]I c-152,§1(4),and we have no employees-[Now*orkers' 13.❑Other comp.insurance required:] #Any applicant that checks box#1 mast also fill out the section below showing their workers'compensation policy information. Homeowners who submit this affid nit indicating they are doing all work and dLea hire outside conttaaors mast submit a new affidmit in&catingg such. �Pontracwrs that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities/rate employees. If the sub-corrumtars hate employees,they tmtst.protdde their workers'comp.policy number. I ant an:employer that is providing workers'compensalion insurance for my employees. Below is the policy and job site information. Insurance Company blame: Policy 9 or Self-ins.Lie.#: Expiration Date: Job Site Address: 0 City/StateJZip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c-.152 can lead to the imposition of criminal penalties of a fine up to S 1,50U.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$250.00 a day against the violator. Be advised that a copy.of this:statement may be forwarded to the Office.of Investigations of the DIA for insurance coverage verification. I do hereby certify rt tder the and pens ' s o try .. t the irtforrnation provided above is trite and correct Si mature y Date: Qfficial Ilse only. Do not write in this area,to be corttpleted by city or totcn official City or Town: PermitUcense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City(Tomm Clerk. 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Town of Barnstable *Permit#z> 3 Expires 6 nt sjroZ)ll date �7 Regulatory Services Fee i+i s + BARNSTABM • mass.1639. Thomas F.Geiler,Director 10 RFD MA'I A Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Map/parcel Number L4 0 Not Valid without Red X-Press Imprint A f Property Address 5 UV ((;�'�0 0:c%-_/V 7 I w �_. : :: ❑Residential Value of Work$ �'a Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address ! xazoealal M5 lw(a ti" _aj�p-_ 0 Sir YN 1 . Contractor's Name Aff,C IC CIA- Telephone Number �7y 74 ®52� r Home Improvement Contractor License#(if applicable) 173 1 l Z Email: Construction Supervisor's License#(if applicable) 5 S� ❑Workman's Compensation Insurance I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance JUL 15 2013 Insurance Company Name Workman's Comp.Policy# N OF eA13Ns-r,48L Copy of Insurance Compliance Certificate must accompany each permit. E Permit Request(check box) ❑ Re- (hurricane nailed)(stripping old shingles) All construction debris will be taken to Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum .35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor.plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Ho Improvement Contractor Lic e&Construction Supervisors License.is required. SIGNATURE: C:\Users\decollik\Ap ta\Local\Microsoft\Windows\Temporary emet Files\Content.Outlook\8R76BDVA\EXPRESS.doc Revised 061313 HOME IMPROVEMENT CONTRACTORS REG�STRATION E3oard of Building. Regulations arid, Standards 'One` Ashburton-Place - Room 1301 r Boston, Massachusetts 02108 HOME: 'IMPROVEMENT 'CONTRACTOR Registration 110609 ' Expiration 11/03/96 Type,:- PRIVATE : CORPORATION - I . HOME IMPROVEMENT CONTRACTOR ; i Registration 110609 ' .E J JAXTIMER, BUILDER I Type -; PRIVATE CORPORATION ERNEST J . JAXTIMER Expiration 11/03/96 48 ROSARY. LN HYANNIS MA°I02601 5 I EJ A NER,h:BUIL L i TI DER I 4 = r_ sERNEST A%TIMER + "; }F` x� l G� iaR0 ARY N r ADhffl RA1pR YAN ,H NIS A 02601 , ' ,i Failure to posseas a currentp COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY Massachyraa?s Nt.�tcBnlldha OF ONE ASHBORTON PLACE Codsiacause fvrrorvvstloa . �• MASSACHUSETTS' -BOSTON',MA-02108 oPfhiallcaAse. LICENE EXPIRATION DATE 1-0677 CONSTR. SUPERVISOR CAUTION 01/14/ 996 EFFECTIVE DATE LIC-NO. FOR PROTECTION AGAINST RESTRICTIONS THEFT, PUT RIGHT THUMB i NONE a 06/.30/1993 003251 o PRINT IN APPROPRIATE' BOX ON LICENSE. ERNEST J JAXTIRER r 1 = 48 ROSARY LANE BLASTING OPERATORS i Z HYANNIS MA C2601 Z MUST INCLUDE PHOTO. PHOTO(BLASTING OPR ONLY) F � -00 NOT VALID UNTIL SIGNED BY LISANSEE AND OFFICIALLY HEIGHT: STAMPED-OR-SIGNATUR THE COMMISSIONER a THIS DOCUMENT MUST BE « SIGN NAME IN FUU.,ABO SIGNATUj7E LINE CARRIEDON THE PERSON OF SIGMA OF LICENSEE ��Y 1RRJj THE HOLDER WHEN EN- O�O OTHERS-RIGHT THUMB PRINT GAGEDIN THIS OCCUPATION. A e c COM�iO NWEA-L,` -H O-F M.A s•SACHUSE-M �.=fE�c� J FJ'�r.:)`err O r- r.�"D vsTRJA�ACCI D ENTS �• : . y G 0 0 '\\17AS H 1-N G TO N Sli ]_ I- fames- Gannooel• uOSTON, IM-ASSACHUSE--17S 02111 �c�--s:ss•�ne -woRKERS'COMPENSATION INSURANCE AFFIDAVIT lyle— (1iccnscc1permicxcc) with a pri neipal place of business/residcna sc , Calif, do hereby scruff; undcr the pains and penalties of perjury, than: f Vam an employer provioing chc following workers'compensation coverage for my employees working on this lob. Ll lnsuranee CJnpany Policy Number f ) ) am 2 sole proprictor and have no one working for me_ f] 12m 2 sole proprietor,gcncr--1 contnaor or homeowner (eircic one) and have hued the eontraaors listed below who have the following works.•:compc=don insurance policies: .. K-2mc of Contmaor Insurance Company/Folicy Number ?\-ame ofContraetor Insurance Ccim' pany/Poliey Number 1-.me of Contmaor lns=ncc Company[Policy Numba f] 12m s homco.t ncr performing 211 the work myself- NOTE- Plcasc be:•.:rc tSat w�s�c Ioc<owacn wbo employ persoas to do ta:iotcntaa,coactrvttioa or tcpair--ocu on a Z--cli;nb of not more tba.o three uaits in wb;6 6<boraco...acr slso resides or oa the gmuods appurtcasat thereto arc aot renerall)• I <r to be eruploycrs um&r (Cl—C_152•stet_. 1(5)).appl;atioo by a boraco•woer for a lieeose or pernit r..:y cvidcccc t5c 1cg:.1 stztt:r c��cr_-loyct uodct ttsc Goticcrs'Corapcosauoo Att i uaccrst:nc tn_t: copy of ties st_tcrs<rt•-iU a ior-vdcd to ti•,c Dcp:.7 t-cnt of lndustriJ Acodcnu•O(ricc of lnscrana for.covcrarc <rific:tion xnd that f:ilurc to secure corcrz;c:--required undcr'Sccz:on 25A of MG)..152 can lead to t!u impos;tion olsAmina)pcnJu<s cow!%6ns of a fsnc of up to S1500.00 t-n-&c irmrtisonr:scat of up to ors ycy and 6Q perultics in*thc form of:S1op'Work Ordcr assd a I fsnc of S 100.00 a day against mc. Signed this _ 02 d2y of 1 V1'�J�(� . 19 9`'I Lieens ermittce Licensor/Pcrmiaor 4 Of Tt4E Tgft, �pv f�d ✓��\ The TnWTl nf 13-,1r-ristafile Il\'1 1 4 111111Ctlt:Jl •lDN,tre_ liUllUlll� 1�1\'1J1Ui1 367 Main Street,Hyannis MA 02601 Office: 508 790-6227 Ralph Crossen Fax: 508 775 3344 Building Commissioner For office use only Permit no. Date AFFIDAVIT HOME EWPROVEMENTCONTRACTORLAW CTTPPT.FMRNTTO PF.QMTT APPT TrATTnNT MGL c. 142A requires that the"reconstmction,alterations,renovation,r epak modernization,conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,v6th certain exceptions,along with other requirements. Typc of Rork: ��T I� /1��V11,0 Gl.�r Est.Cost � �SO)o0o � Address of Work. H 5 bja rt Omer Name: �O— uIr- d Date of Permit Application: I hereb-,•certifv that: Rcgisvation is not required for the following rrason(s): Work excluded bry law- Job under S 1,000 Building not*vvner-occupied Ouncr pulling own perrnit Notice is hereby gi\"cn that: OWNTERS PULLING THEIR OwN PE"P-%•!IT OR DE/,LII\G\PITH UNREGISTERED CON'7RACTORS FOR APPLICABLE HOtiIE TNVRON T`MKT WOR, DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FU?\D UNDER 14GL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hcrcb\'zpply for 2 permit as the eEcnt cf, the a\�-cr. - Date trzctor name Registration No. OR Date OH•ncr's name ' I 1 - U A-5 i a � T Assessor's Office 1st floor Map lqo Lot Permit# Conservation Office 4th floor �� ,�---- �o Date Issued Board of Health Ord floor .��"�ic Sysrewi iPup► cf- En ing erring Dept"Ord floor) House# A�® ®� Planning Dept. 1st floor/School Admin.Bldg.): ,�®M 014S r Definitive Plan"Approved by Planning Board 19 (Applications processed 8:30-9:30 a.m.& 1:00-2:00 p.m.) r TOWN OF BARNSTABLE Building Permit Application Proiect Street Address 195 Wianno Avenue, Osterville , MA 02655 Village .0sterville Fire District Centerville , Osterville , Marstons ,Mr., Richard Fitzgerald Mills (hvner Address 575 Boylston St St . , Boston , MA Telephone 617-266-6500 PermitReouest: Remodel work/Build additiori—new kitchen , laundry, dining area . n Zoning District RC Flood Plain No, Water Protection No Lot Size 3/4 acre Grandfathered No Zoning Board of Appeals Authorization N/A Recorded N/A Current Use Residential Proposed Use Residential Construction Type wood/residential Existing Information Dwelling Type: Single Family yes Two family Multi-family Age of structure 50 yr s . Basement type Full basement Historic House No Finished Old Kings Highway No Unfinished Unfinished s Number of Baths Three No.of Bedrooms Three — Total Room Count(not including baths) S e v e n First Floor Seven Heat Type and Fuel 9 a s Central Air No Fireplaces o n e Garage: Detached No Other Detached Structures: Pool No Attached Barn N o None Sheds No Other N o Builder Information Name E.J . Jaxtimer Telephone number 508-718-4911 Address 48 Rosary Lane License# 003251 Hyannis , MA 02601 Home Improvement Contractor# 110609 Worker's Com oration # W C 3►d -aA Lfa 39-D 4 NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN tAS BUILT) SHOWING EXISTING, AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ,y4a Pro'ect Cost ja Ono Fee SIGNATURE DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) BPERM T .4 /moo . i��z �0 FOR OFFICE USE ONLY ADDRESS l7 '//��Ls�iO L� VILLAGE OWNER DATE OF hNSPECTION: FOUNDATION FRAME y a� wsUi.ATioN o �� FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING: DATE CLOSED.OUTS ASSOCIATE�PLAN NO. a i JF-EL - Vy F.s a ON \ D. nwtcs+uL 1 \ AtVrt7C't4 /2 • \� UN J . OF 44 RICHARD A. \ \ BAXTEA u' Na 24008 ft cE,eTic/Eo ,ot�T ��A,v 6.4 T/OTC/Y T/-/AT T.4/� WDD)r-1o�l 2yrLL�- ��;�/O.WN,yE,eEO.CI COM,d,G YS !�/jT,y SC,q L G— r 57E7-,6A f< QD OATS 'DtG, ] 4c. 0,C- TNT 7—ow�t/D� •�.L.4�t! .2E�'E,2EiC/C�- 3 rzNsrq 8[-Lz- AIc/o /,s x/a7- A`%e%oos mAp 1,16 'Pde6r--L 14 2_ MCA TES 1-/i774!1-L/ Th�� .�Loaa�G4/.fi -DEEP ."aWk- 1418 7e .ZQg TE SU /N.ST,eU�/.�it/T �2�'G/S •2E.0 L.q,��p SU.eli�'ya�,2�EY� Tye �SJ_E.2Y/.C,C�a Sf/ovL > ,t/oT gZI-- .>% rxJ i .. . _ hvv ._.:.�it'.T'.U�.1•,.{ P,n7Tg �! ¢.w�- � f�xIST-6(t2l ,1 �'1 fir•.,'• -'� �'• -� ��i a r', �' e�rr - 4 � h-"'T� � �i l•T A � '�i1V!;•,��+ '1 ' ' St'. v :. t! ',' t` •�II'. i a 1 __ .1 '"i: "'''"` ^ 1- �1, I I, D4 CQ 4i fir. . � i ';•__ - , r '•i ,e` •s:i`.' r Tr - ' t ',ri i .f• I _S q r� ! ! ` ,- � � � ! •r' -_y �'l i+ tt� t+:�' f �,;• °� j t tlxfa ( G pt'� f'i) t '�. We Ns t}��t ',t'. i t + 3T K 1 lf, .Y..7 4 lrri r 1 Ci ' I 'i y.I,�♦i + ll.t:. ,t .t '.J � �� 'h + � 'w ti .,�, f�� ' ;�+ ttr � .t_I}{r{'" • � '' � 1.:µ�•��t. P4 • i .�'-` � �•' Y,. ry�t � 4i.Y• � ^4"""'� a r y�^ I � 'I i 144 , Z +art s r ' 1 ��• Sr �� t �� , � �`• � f ` t t �. i ,d 14 IL f5+]7A sir ii!�e ^i g� •. �'i • •i 1 tP "tltn ye,µ^ � t•• t - •�• ' F. ��+ { 714 'n-1 } �; rim t:.a- •� � .x_.. � ; .. � tt` TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 7 Z Permit# 5 26 7® Health Division 0Yt-A!/,-3 Date Issued Conservation Division �IiLf FeeZ� Tax Collector Treasurer SEPTiC S`iSTEM MUST BE INSTALLED IN COMPLIANCE Planning Dept. WITH TITLE 5 Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE AND TOWN REOULATIO%S Historic-OKH Preservation/Hyannis Project Street Address �"'LC) �/l�I�,�00 ft1k0_ A_P Village (�, Owner L Address R5 Telephone (50)id ' 131(o -Permit Request &eCA -WD JL114M&tA4 ` 11014b, `D`A 7 he- t1aA dy,pw ok &L ��M=j imyv, by MZ&J4 ,U4 % l Z�A Square feet: 1 st floor: existing proposed 2nd floor:existing proposed Total new Estimated Project Cost Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes Cl No Basement Type: ❑Full ❑Crawl ❑Walkout 0 Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric 0 Other Central Air: ❑Yes 0 No Fireplaces: Existing New Existing wood/coal stove: ❑Yes 0 No Detached garage:Cl existing ❑new size Pool:❑existing ❑new size Barn:❑existing 0 new size Attached garage:0 existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes 0 No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name �. 11V Telephone Number Address 4 l �� L�l� License# DI D Home Improvement Contractor# , Worker's Compensation# -a 316koQ-7 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 7A Z'��, �., FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED . MAP/PARCEL NO. i r ADDRESS 1 VILLAGE OWNER , DATE OF INSPECTION: FOUNDATION r ` FRAME INSULATION r FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL. FINAL BUILDING ' DATE CLOSED'OUT ASSOCIATION'PLAN NO. . The Commonwealth of Massachusetts Department of Industrial Accidents mce 811aYesdoodoos 600 Washington Street - Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit name: location city phone# ❑ I am a homeowner performing all work myself. ❑ I am a sole etor and have no one workin in achy /%%%%%%/%%%%%/ %%%%//G%%%%%%%%%%%%%%///////%%%%%%/ %/ /O/%/%%%%%////%%%%%/%/"/O//%%%/%/%//�O//////O/%/%%///////%%%%///a/% %", I am an employer providing workers'compensation for my employees working on this job. :..:: ny addiress ...��1 �X NX }ii}i}}}:ti?4:•:�:::.�::v::::::::•::?4:?�is v}}'.iSi:::::::::.:::::::.::.:. .::.::::::::::::::.�.. :..: :.;;::.}i: .:.:: i;}i.'?v}TT:???•i:yiii}iii}}i?J}i}i};::;. .. ::.: .::.�:.:.�:. :::.�:. .:: .. ...........n............. �ii::.}}iii:Si:•i}:;.iiii::::i::ik?:ii::iiiiii::}iii'!v`ii.::is'..::: .. }}}}}iiT:jiiiiii}i::iY.:i?j: ...::4:�}iiiii:;?•:.�::::::•::.�::. .::: ::: ::. :. .:::.:..�._::: •.:..:vT :v*}':h?+ii;::. :v.::;:.:::, :::.�.�:.� :::.:.::: :. :i:ti4'}}}}}i}.�n�::::.w.v:}:}: :::::::::::::::.�::•.�::::: :;.;:.}:.;}}:;.}:.}:.}:.};;:.};:.;: :f:: .;:.;1.; :::: :::::.:.}:.shone#....C........ ... ....... .............) ��+ .....::::>:>:»:??:<:?:::<::::>: ....:...... :insuranc ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' ..compensationpolicrs:...............................:...:.:.....:::..::..................:................................... ...............:::::::::::::::::::::::::::::::::::::..,:..,.. :..... ..:....:..:................................................... 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I m dentand that a copy of this statement may be forwarded to the Offiee of Investigations of the DIA for coverage verification. I do hereby ciFdfy u&the pains and penalties of p • that the information provided above is trw and correct Signature Date �/' II A, 1� /n�,(� drape Print name CSC/ J /)W_bT3EAL U ape# 7� �i— (:u:- mly: do not write in this area to be completed by city or town offidal permit4icense# a DUcensing�ate response is required ❑Selectmen's Ofilee❑HealthDeparimmt phone#; ❑Otirer (Fenced 9/95 PJA) Information and Instructions Massachusetts General.Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any contrar: of hire, express or implied, oral or written. An employer is defined as an individual, partnership, association, corporation or 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, or the receiver c: 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 or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 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, neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. , `Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names address and hone numbers along with a certificate of insurance as all affidavits may be DPP Y� P � P g ` Ysubmitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and s f',,-date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is 4.. . -1eing requested, not the Department of Industrial Accidents. Should you have any questions regarding the "law"or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly: The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned io the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. " The Department's address,telephone and fax number: The Commonwealth Of Massachusetts , Department of Industrial Accidents Olflce of imresugations 600 Washington Street Boston; Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 eat. 406, 409 or 375 The Town of Barnstable �g Department of Health Safety and Environmental Sernces mum Binding Division 367 Main Street,Hyannis MA MW I , Ralph Crosses Office: 308-790-6ZZ7 BuddingCemruiss;e Fax: 308-790.4mo For omce use only Permit no. Date AFFIDAVIT , HOME zWROVEMENYT'CONTRAG'I'ORLRW SUPPLEMENT TO PERMIT APPLICATION NGL a 142A requires that the "reconstruction, alterations, renovation. repair, moderni=tion. conversion. Improvement, removal, demoiltfon. or consructlon of an addition to any pre•ezisting ofiner occupied building containing at least one but not more than fbur dwelltag units or to structures which are adjacent to such residence or building be done by registered contractors, with certain czeeptions.along with other requirements. e otWork: ' Est.cast T 9 50 ;�° YP ( Add of Work'.— �V � no owner's Name II Date of Permit Appikatlon: I hereby certify that: Registration is not required for the following renson(s): 4 Work ez inded by law Job under SI.00L Budding not owner-occupied Owner puffing own permit Notice is hereby PULLING T owN PERMIT OR DEALING WITH ummc SI' m coNOWNERS .pULt,1NG THEM _ _ WORK DO NOT HAVE ACrg ACTORS B I�T1O�R G�OR GUAARANTY FUND UNDER MGL 142A ACCESS TO'i8E•� %G= UNDER PENALTIES OF PERJURY I hereby gMfy for a,permit as the agent of the owner*' //(0 10 0� Data m Contractor Yae Begisaatioa Na OR uivner'S iVnme Date a n��aPLFL3 �� s DOCUMENT C U M E N T�n�r� 5 5 - 5 Certif iracte of if lame Rv5tManre5 S � ISSUED BY 5 REGISTERED CA[rF Date of Manufacture 5 5 APPLICATION o- OR. 5/28/99NUMBER jem" ES INC. 5 EVANSVILLE, INDIANA 47711 Order Number 5 F 121.4 Ly �►Q o� 223672 5 ct MANUFACTURERS OF THE FINISHED C� 5 TENT PRODUCTS DESCRIBED HEREIN 5 5 This is to certify that the materials described have been flame-retardant treated S 5 (or are inherently noninflammable) and were supplied to: 5 5 PETERSON PARTY CENTER INC S 5 139 SWANSON ST S 5 5 5 WINCHESTER MA 01890 e 5 5 5 5 5 5 Certification is hereby made that: 5 5 The articles described on this Certificate have been treated with a flame-retardant approved 5 chemical and that the application of said chemical was done in conformance with California Fire S 5 Marshal Code, equal to exceeds NFPA 701, CPAI 84, ULC 109. 5 5 The method of the FR chemical application is: 5 5 Serial #: 8000600 (0001) 5 5 Description of item certified: 5 5 FI TOP 14W X 14 VL W W 5 5 S 5 Flame Retardant Process Used Will Not Be Removed By 5 5 Washing And Is Effective For The Life Of The Fabric 5 5 1 H lT Signed: 5 Name of Applicator of Flame Resistant Finish TENT DEPARTMENT—ANCHOR INDUSTRIES INC. 5 .r.. o ` o.. ® �.. ,..�� a ,ov s0..vm..• o..y,`.. �..y`.. �,..��.., �- � C�ertutrate of ff"tanir kot-stance REGISTERED of �liF ISSUED BY a � O Date of Manufacture O APPLICATION s ANCHOR INDUSTRIES INC. )!� �o S/O3/96 NUMBER ~ EVANSVILLE.INDIANA 47711 Il,I Order Number MAP,y rf �P`' P MANUFACTURERS OF THE FINISHED d F121.4 RET a� TENT PRODUCTS DESCRIBED HEREIN 1 118 37 PAIR y This is to certify that the materials described have been flame-retardant treated (or are inherently noninflammable) and were supplied to: rui o: `� !!` PETERSON PARTY CENTER INC ra, y 139 SWANSON ST M nn WINCHESTER MA 01890 m, Certification is hereby made that: ► � i!u The articles described on this Certificate have been treated with a flame-retardant �o approved chemical and that the application of said chemical was done in conformance 'rii, IM5 with California Fire Marshall Code, equal to or exceeds NFPA 701, CPAI 84, ULC 109 ►�.i i!o The method of the FR chemical application is: o �Vt1 Serial#: - --------..--- ---- i,l/, O 50 8040000C (0001) O� �ui 01 Description of item certified: O; 1%VII, > FI EXP TOP 14'x14' 2pc VL WWG 'kill, Flame Retardant Process Used Will Not Be Removed By. Washing And Is Effective For The Life Of The Fabric ,%N,tl S-CO;STATESVILLE-NC- — %III Signed: ystw• Qi <�R Name of Applicator of Flame Resistant Finish WhN O> TENT ARTMENT—ANCHOR INDUSTRIES INC. Nf/, ..r ..r ..r "�O�rOarO�ro•.rO�rO�rO�r �rO�rO�rO�r �ro�(O..rO�rO�.rO..rO�ro�►O�rO�rO�ro� O�rO�.ro� �r �r J, �ffiO�i� O� e� Si..OIi..� e..10�..0 a u��n�n� �� r��nn�� nn�n��rrmnL �� r- uLp� o 5 Certificate of F lame Rvqi5tanre 5 5 rj REGISTERED utiF C ISSUED BY Date of Manufacture S 5 APPLICATION a CHOR® 3/31/99 5 NUMBER INDUSTRIES INC. 5 y�= EVANSVILLE, INDIANA 47711 Order Number 5 F 121.4 '-y M�avr 216101 C5 C� . Ez MANUFACTURERS OF THE FINISHED 5 TENT PRODUCTS DESCRIBED HEREIN 5 S This is to certify that the materials described have been flame-retardant treated 5 S (or are inherently noninflammable) and were supplied to: 5 5 PETERSON PARTY CENTER INC 5 5 139 SWANSON ST 5 5 5 5 WINCHESTER MA 01890 5 5 5 Certification is hereby made that: 5 5 The articles described on this Certificate have been treated with a flame-retardant approved 5 chemical and that the application of said chemical was done in conformance with California Fire 5 S Marshal Code, equal to exceeds NFPA 701, CPAI 84, ULC 109. 5 5 The method of the FR chemical application is: 5 SSerial #: 8000900 (0002) 5 5 Description of item certified: 5 - FI TOP 16W X 16 VL W W 5 5 5 5 Flame Retardant Process Used Will Not Be Removed By 5 5 Washing And Is Effective For The Life Of The Fabric 55 S �TATEV�&,G� Signed: .-eJZ 5 5 Name of Applicator of lFlame Resistant Finish TENT DEPARTMENT—ANCHOR INDUSTRIES INC. 5 r�rJ�rJ�rJ�r�rJ�r�rJ�rJ�rJ�r P�rJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�r P�PrJ�rJ�rJ�rJ�rJ�rJ�r�rJ�cPrJ�rJ�rJ�rJ�rJ�cP�PrJ�r�r�rJ�rJ�rJ��PrJ�rJ�cPrJ�rJ�rJ�rJ�rJ�cPcPrJ�rJ�rJ�rlrJ�rJ�cPrJ�rJ�rJ�rJ��PrJ�rJ�rJ�rJ�rJ�C Prr PLjr &a SHED REGISTRATION �Q.A,,,,,.o D S 1/Lt-cAC , location of shed(address) property owner-s name !! si�hed signature date Old King's Highway Historic District Commission jurisdiction? THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN I shed T' CO. a a F 69 \ 47 4 NJ (gyp I•�j'� - VF�/I � �� //fir' •� ® F 4 o gO- � 0 is 266 06 36 Sle 30 C) F LAND IN As SURVE.YEr,> n,RSE�n.�4-Off� - Junc �t�, t ��4:.C.- 1.FLLorr Assessor's-Office(1st floor) Map Parcel Permit# Conservation Office(4th floor)(8:30 9:30/1:00- 2:00) Date Issued Board of Health(3rd floor)(8:15 -9:30 1:00-4:45) d�'�� ee 7`7 S Engineering Dept.(3rd floor) House# - Planning Dept. (1st floor/School Admin. Bldg.) BARNSI'ABIE, MAS& tive Plan Approved by Planning Board 19 SEPTIC SYSTERM INSTALLED IN CONE CE 1 TOWN OF BARNSTABLIBm TITLE s Building Permit Applica§NYIRONMENTAL CODE AND TOWN REGULATIOms Project Street Address 195 Wianno Avenue Village Osterville Ow . Richard Fitzgerald Address 195 Wianno Ave _ Ostervi.11e Te14§1�)266-6500 , Permit Request Inground swimming pool 16 x 32 512 sq .ft . First Floor square feet Second Floor square feet Estimated Project Cost $ 25 ,000 .00 Zoning District C. Flood Plain Water Protection Lot Size ?7 f}C re5 Grandfathered ? Zoning Board of Appeals Authorization Recorded . Current Use Proposed Use Construction Type Commercial Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic House Unfinished Old King's Highway Number of Baths No. of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name E . J . Jaxtimer , Builder , Inc Telephone Number 778-4911 Address 48 Rosary lane License# 00003251 Hyannis , MA 02601 Home Improvement Contractor# 11A6 0 A Worker's Compensation# 312—2 0 4 2 3 9—0 2 3 NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. . ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO I Barnstable Landfill SIGNATURE DATE BUILDING PERMIT NIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY t PERMIT NO. - DATE ISSUED MAP/PARCEL NO. - ADDRESS VILLAGE _ OWNER r r , DATE OF INSPECTION: " FOUNDATION FRAME. - - INSULATION FIREPLACE ELECTRICAL: ROUGH= > , _ FINAL ' It PLUMBING: ROUGH- y,,. o FINAL - GAS: ROUGH _ FINAL r FINAL BUILDING �.: m0 i t r m + DATE CLOSED OUT r i ASSOCIATION PLAN NO. 4 • . - r i r t APR-05-1996 14:26 FROM TO 7754909 P.01 vll&Qt D I 5To2�/ I � y � J I' � 4• I• I\ RlIMM ^ � I � Na 2coe3 LUP 4' L I CF_2 7-1*,,=/ELO .4�lAT 5!�A,V 7-1-I,g7' 7"f�/6�D iir�p� L�Gd7-/0// ns G"Ow"r'LSSA/- .4 T6 NO SETS I - A 'C EQ!/�iE'F�'1Ei(/TS OF T.y� oxiN q c P.0.q ii/ .2E�'i 3AIZwsrABc_4:- A�t/o rs o7' �155e55oo5 �P Ida I •�OCATEv W,17 -DEev 3G10JL 141, g� T.Sl/S BA XT.ESC 6 AI,, /mf /N.�`T.eli�E�/T' �EGrsTE.QEp '�`��l� SU.el�6Yo� APf:1 /C.4i�T" f_ •.I ,�,-�, TOTAL P.01 ' I HOME IMPROVEMENT CONTRACTORS REGISTRATION I Board of Building Regulations and Standards One Ashburton Place- Room 1301 Boston ; Massachusetts 02108 I - I i-IOME IMPROVEMENT CONTRACTOR ------------------------------------- Registration 110609 Expiration 11/03/96 I Type - PRIVATE CORPORATION 92. I HOME IMPROVEMENT CONTRACTOR Registration 110609 E J JAXTIMER , BUILDER I Type - PRIVATE CORPORATION ERNEST J . JAXTIMER I Expiration 11/03/96 I 48 ROSARY LN HYANNIS MA 02601 I E J JAXTIMER, BUILDER ERNEST J. JAXTIMER I tod ROSARY LN I ADMINISTRATOR HYANNIS MA 02601 Failure torg�,:;,r?nr m current- COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY $,., uitdingi N OF ONE ASHBORTON PLACE MASSACHUSETTS BOSTON,MA 02108 �� ( LICENSE CAUTION EXPIRATION DATE CONSTR. SUPERVISOR i1<1 1 4 1'i� 6 FOR PROTECTION AGAINST RESTRICTIONS EFFECTIVE DATE LIC-NO. THEFT, PUT RIGHT THUMB h O E r 0 6/3 0/1 9 9 3 0 C1.3 2 51 PRINT IN APPROPRIATE 0 o BOX ON LICENSE. ERNEST J JAXTIP.-ER $ 48 ROSARY LANE ° BLASTING OPERATORS $ Z HYAhtPIS MA C`5;J1 z MUST INCLUDE PHOTO. m m PHOTO(BLASTING OPR ONLY) F i C; ICJ I S .. ...I:. � NOT VALID UNTIL SIGNED BY LI NSEE AND OFFICIALLY HEIGHT: STAMPED•OR-SIGNATUR THE COMMISSIONER THIS DOCUMENT MUST BE « SIGN NAME IN FULL ABOVE SIGNATURE LINE CARRIED ON THE PERSON OF SIGNATYZ OF LICENSEE , THE HOLDER WHEN EN- OTHERS-RIGHT THUMB PRINT GAGED IN THIS OCCUPATION. , 4 f ' - - The Town of Barnstable MASS. Department of Health Safety and Environmental Services rta<" Building Division 367 Main Street,Hyannis MA 02601 Office: 508 790.62.327 Ralph Crossen Fax: Btlding Commissioner . For office use only Permit no. ' Date . ATMAW HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the-reconstruction,alterations,renovation,repair,modernization,conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to stmctures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: cSW I M ni t /0 Q / Est.Cost 4a51 D d U Address of Work: I9s 104n n 0 Aw, 06 k F-V/ Owner Name: Ki CIS&n r Date of Permit Application: ��I91n I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under$1,000 Building not owner-occupied Owner pulling own permit Wntim..is herehv given ihar- OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner.- �15�9 1106 0 Date itokwtor name Registration No. vr. Date Owner's name � - O r rN-D USTTU A>,ir✓i CC-T`.Uq 1�S �amcs- Ga��ocs 130STO;N, MASSACHUS=S (32111 WORKERS' COM7'FTISATION INSURANCE AFFIDAVIT (Bee n s<c/perm i cc<c) with a principal place of business/residcnoc sc . 05a.r _ VY14. 0 ZG (Ciry/Scuc2iP) do hereby eertifp, under the pains and penalties of perjury, that: �4am an cmplovcr provio;ng ncc following workcrs'compcnsarion coverage for mycmployccs worUig on Eh-IS job. Insurance Corn ny Policy Numbcr � ) I arrm 2 sole proprietor and have no one working for me () 1 am z sole proprietor,gcr.crJ conasaor or homeowner (eirdc onc) end have hired t}ic eon(raaors lisced bclow who hzvc the following workers'oDmpc=don irsurinec policies: Nmmc of Conmaor lri u =cc Company/Policy Numbu Namc ofContraaor Insurance Company/Policy Dumber N12mc of Contmaor - Insi=ncc Company/Policy Numba (J I sm a homeowner performing:11 the work mysclC A0T1= j'Ic:sc be:.• rc t�s.t w��<I er_co«sxra who employ perroa: to c'o rvltntca:acc,eoOttrvetitlo Of rep�lro on 3 �•-cl(ia�of roc more tb,.a tbrcc uoiu is w�i6 t'-<borocowncr sJw reside®r oa the F;teualo:ppsut-0=t t5eteto are oot reoera)' <onr;dcrcd to be cmplo}•crs v-&r the rfor:cra Gorpcor:tian Act<GL.C" 152,«cr 1(5)),aFpiiutioo by a bem over for a lieeos< or pc►rnis r:-.y cvidccc< the ICE st:rt:s e!Lz<r-;lover coder ut a'Worlierr,CO ropeo:atioo Act- i c ccrst:nc th.t 2 copy Of this staun<r.a—;ix icr-v&d to&i c Dcp: cnt of Industri:J Acod<ncs'Opt«o!k%%:.- nu for.c,ovcra;c �rrifre:tion:rsd th:t l�ilurc to 4ccerr<Cover-.Dc r<Suir<d-undcr Section 25A of MGL 152 cin k.ad to the imporition of-r.ninal penJci<s Cansisons of aftne of up to 51500.00 z.2kr irnpri onmctt of up to orx year ane:civil pcnalci.r in tax form of:Stop Vork Ofder and a fine of S 100.00 a day against mc- r • Si,,ncd this dzy of QjO r.7 ' < 19 Uccns J r In ittcc Licensor/Pcrmiaor