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0550 WIANNO AVENUE
�. 4 i. a ` `�^�l+�+,-ram-*�..�w:.s�r-.T Cti!""r' �..,� ..-...,....,r..� _. - "a'" Town of Barnstable Buildin -_ BAW�AW4 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 9 a ,� }Posted Until Final Inspection Has Been Made. , P^y.yy��� Eat° Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made Permit �l�ijj Permit No. B-20-497 Applicant Name: DAVID COX INC. Approvals i Date Issued: 02/20/2020 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 08/20/2020 Foundation: Location: 550 WIANNO AVENUE,OSTERVILLE Map/Lot: 162-011 Zoning District: RF-1 Sheathing: Owner on Record: YEARLEY,ANNE D TR Contractor Name: -,DAVID COX INC. Framing: 1 i Address: 301 ST DAVIDS ROAD Contractor License: 100497 2 WAYNE, PA 19087 - Est. Project Cost: $80,000.00 Chimney : Description: re-roof Permit Fee: $408.00 Insulation: Project Review Req: Fee Paid: $408.00 Date. 2/20/2020 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 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. l" . 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 S.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 Application number.....K.l.. .a ................. E pERM'T )(-PRESS G Air �� Fee ...................��d......:......................................... FEg 1 8 202U Building Inspectors Initials.......�.� G ....... KAM NSTABLE Date Issued.*. TOWN Of BAR /. Map/Parcel.....1.W..................... .......................... TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOW S/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: ,5�j� L//aAJ/1/f� Ji1,6/� D_SiIJ/G�t� NUMBER STREET VILLAGE Owner's Name: 6-64S Ylfx"-I/ Phone Number Email Address: Cell Phone Number Project cost S SO- d115)0 Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize FEB 2 1 ,r't0 to make application for a building permit in accordance with 780 CMR Owner Signature: Date: e l r l zv TYPE OF WORK 0 Siding El Windows (no header change)# E] Insulation/Weatherization 0 Doors(no header change)# Commercial Doors require an inspector's review 0 Roof(not applying more than 1 layer of shingles) &77,0"r" t�6V eOMW 1,ed-pz-'0G6' Construction Debris will be going to 8,t�7�, T.�rRGy� Gli /Z. CONTRACTOR'S INFORMATION Contractor's name r�VlY.<lJ �d� Home Improvement Contractors Registration(if applicable)# (attach copy) Construction Supervisor's License# zW _J ?� (attach copy) Email of Contractor liUe �- YAi✓�.ClJ Phone number,re9p-�'l.; i Si r ALL PROPERTIES THAT HAVE STRUCTURE OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY.IS IN A HISTORIC DISTRICT. YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER `... A� *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attacli;flobr plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s)of each tent Fuel source being used LP tank 20 lbs. or> Yes No , if yes, a gas permit is required. Natural Gas Yes No , if yes, a gas permit is required. . , If food is being served at.your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures, specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT'S SIGNATURE Signature Date All permit app cations are subject to a building official's approval prior to issuance. s 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 T Please Print Legibly Name(Business/Organization/Individual): ,V4Z4 Address: /Q//ir�nrJ,n lriC/ City/State/Zip: Phone#: — 6 Are you an employer?Check the appropriate box: Type of project(required): 1.VI am a employer with ?- 4. ❑ I 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. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me'in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp.insurance comp. insurance.: required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.0'Roof repairs insurance required.]t c. 152, §1(4),and we have no 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. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ;Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address:Cr&&0 �./ r— City/State/Zip: ' 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 un r the pains and penalties of perjury that the information provided above is true and correct. Si ature: Date: Z e_j Phone#= 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 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract 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 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 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,§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, §25C(7)states"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 out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance.coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the 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. Self-insured companies should enter 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 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. In addition,an applicant that must submit multiple permit/license 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 officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your 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 Office of Investigations 600 Washington.Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#617-727-7749 www.mass.gov/dia i r -�� DAVID-2 OP ID,LAN AC , CERTIFICATE OF LIABILITY INSURANCE DATE 07/1 1201 Y) ��• 07l16/2019 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(les) must have ADDITIONAL INSURED provisions or be endorsed. I 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 endorsements. PRODUCER 508-771-1632 1 j2aACT SG&D Insurance Agencies,LLC PHONE 508-771-1632 � FAX 540 Main Street,Suite 9 A/c,No,Exl): _ (A/C,No): Hyannis,MA 02601 MSSO INSURERS AFFORDING COVERAGE NAIL 4 INSURER A:Travelers Insurance Company 723 NS1�R INSURER a:Norfolk&Dedham Mutual ins. ,239" fG GOX I C. PPPP BOX 1 INSURER C: Sermout ,MA 02664 INSURER D INSURER E: _ INSURER F: 1 COVERAGES CERTIFICATENUMBER: 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. NSR I TYPE OF INSURANCE /1DDL UBR POLICY NUMBER POLICY EFF POLICY EXYYI P LIMITS 000 A COMMERCIAL GENERAL UABILITY I EACH OCCURRENCE OAMAGETO RENTED 300,000 CLAIMS-MADE OCCUR I I 1660-1481 M796-19-42 03/14/2019 03/14/2020 a X Ir-e-usiness Owners IVIED EXP(Any one Parson 51000 �! PERSONAL&ADV INJURY I$ 1'000'0()0 2,000,000 '�GEN'L AGGREGATE LIMIT APPLIES PER: � GENERAL AGGREGATE � I� jC4 n I I PRODUCTS-COMP70P AGG 2'0�'� POLICY LOC i OTHER: COMBINED SINGLE LIMIT B i AUTOMOBILE LIABILITY ANY AUTO I 191561469A 04/19/2019 04/19/2020 BODILY INJURY Per rson S 2SO,000 OWN:0 SCHEDULED i ; , 500,000 AURTEO�S ONLY 1---� CH pUL Ep BODILY INJURY Per accldent I S AUTOS ONLY I AUTOS ONLY r��� RntDAMAGE I$ 100,000i UMBRELLA UAB OCCUR I I EACH OCCURR NCE. $ I EXCESS LIAR Ell CLAIMS-MADE I AGGREGATE DED 1 RETENTIONS A WORKERS COMPENSATION IAND EMPLOYERS'LIABILITY 6HU6-910X742.2-19 107/16/2019 07/16/2020 t�II s 100,000 Y!N E.L.EACH ACCIDENT �Pp.NYP�R�OPRIEIgOFUPARTNERIEXECUTIVE (� N!A i 100,000 A6Fan8at I'M N 1)EXCLUDED? u E.L.DISEASE-EA EMPLOYEE itA6yes,dosaibe urWer I , E.L DIS ASE-POLICY IMI7 $ 500,000 I DESCRIPTION OF O S below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedufa,may be attached it more space is required) CERTIFICATE HL 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 St Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ij �� C065Vt97tO0il[J8(Y.(�O�C-7/l�La.�d�ilGSead office of Con'eumw Affaira E Businesa Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only TVPE:,GorcoraUon before the explratlon date. If found return to: Resist 'rExpiration Office of Consumer Affairs and Business Regulation 100497.`: 03/24/2020 10 Park Plaza-Suite 6170 Boston,MA 02116 DAVID COX,INC:}�.\i DAVID R.COX 19 LAVENDER LN °r i W.YARMOUTH,MA 02873 " Not valid without 81 t�ture Undersecretary Commonwealth of Massachusetts Division of Professional Licensure Board of Building R ulations and Standards Cons isor CS-063537 C'y a mires:10/1512021 DAVID R CO* f PO BOX•,401 lj ' C SOUTH YARW*U7N j �U/Sti lac, Commissioner �� 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 KeptFIA-IRI Y M Posted Until Final Inspection Has Been Made., Permit 1639• aR jWhere aCertificate of,Occupa`n`cy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit No. B-18-1534 Applicant Name: DAVID COX, INC. Approvals Date Issued: 05/17/2018 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 11/17/2018 Foundation: Location: 550 WIANNO AVENUE,OSTERVILLE Map/Lot: 162-011 Zoning District: RF-1 Sheathing: Owner on Record: YEARLEY,ANNE D TR i Contractor Name:'--,DAVID COX, INC. Framing: 1 Address: YEARLEY FAMILY NOMINEE TRUST Contractor License: 100497 2 WESTFIELD, NJ 07090 } Est. Project Cost: $6,000.00 Chimney: Permit Fe Description: RE-ROOF-YARMOUTH $35.00 i !' e: Insulation: f Fee Paid:' $35.00 Project Review Req: 4 I Final: I Date: f 5/17/2018 Plumbing/Gas y ~` Rough Plumbing: 4\Building Official Final Plumbing: 4 This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and therapproved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Final Gas: 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 work until the completion of the same. Electrical i 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: ^� 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) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health 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. 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 F-% i pfr Application number... ...�Q.......[.5.. . 4* - Date Issued...........�� �'...1..�.�. ............. ►` MAY 1 5 2010 Building Inspectors Initials..... �u+s" ... ..... Map/Parcel...., ...../.�..� RAIN �. BARN5 ABLE �1.............................. TOWN OF BARNSTABLE5 EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDO WS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: �o 1&11L/2 Aj//C NUMBER STREET - VILLAGE Owner's Name: _ l/,yG y ,@ y Phone Number Email Address: Cell Phone Number Project cost$21K, Vow Check one Residential b� Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: ti Date: TYPE OF WORK 0 Siding 0 Windows (no header change)# © Insulation/Weatherization 0 Doors (no header change)# Commercial Doors require an inspector's review Roof(not applying more than 1 layer of shingles) Construction Debris will be going to XAe,7991}al7y, CONTRACTOR'S INFORMATION Contractor's name 5rp,(I/,G ( lay Home Improvement Contractors Registration(if applicable)#ZQQ (attach copy) Construction Supervisor's License# O6,3:5'�?2 (attach copy) Email of Contractor Z46 zV Czg yg".,n� Phone number, 2 ALL PROPERTIES THAT HAVE sTRucTuk&OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS AN. A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. r , APPLICATION NUMBER............................................................ . -w4.� *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does�tkietent have sides? Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I.understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT'S SIGNATURE Signature Date All permit applications are subject to a building official's approval prior to issuance. ; A nc %-urrtmunweautt gjiviassachuse= Department oflndustrfalAccidents ' 1 Congress Street,Suite 100 Boston,MA 02114-2017 www mass goy/dia Workers, Compensation Lmurance AMdavit•Builders/Contractors/Eleetricians/Plusabers TO BE FILED WL I THE PERM TT WG AUT E1ORM. ADAli�ttt Informad2a Please lit lame (Bwiaees/OrgaW=Aod[adtvtdua(): �i� �QjC kddmss:_14 1✓1 /dir X! ;icy/State/Zip: �.197w a -f 3 Phone#:- re you as emplo7er7 Mock the appropriate box: Type of project(required): Vt air,t ag3loytr with—%;f _..emplayees Ml Mwor put-time).4 7. ❑New construction � ❑i am a sofa propriettx or partnership and have no emplcypm working for M in $, ❑Remodeling sty qnhy.(No woriurs,Cara;. Inaurarrc a required.) 9. ❑ Demolition ❑I nro a homeowner doint W work rM11 fNo vrwk='camp.iaamee required.) 10 ❑ Building addition i sm a hnttseewrses erld will be hiring e0rtM-tpr to oandtux all work trn my property. 1 will a>sum dw all aoneraemts either have warieera'compeasamon i:mrum or are late 11.[] Electrical repairs or additions prepriaoara wilts no eatplcyetra. I2.❑Plumbing repairs or ts,dditions ! i tmt a gatetal©antiaoax aid I bwe hired the anb-coatreneora listed an dm attached sheet 12. Roof. 3;rg These xsb-eotfractm have etrrp►gau and have w�a- camp.m wmca,= J We cue a corporation and officers have exercieed their risht of 14.❑Other e�remptioa per MC$,e.152.J 1(4).and we have ra wMicyeea.No we,ioera'comp.dtoru ae required./ I y aPdieaot that checks box#I must also tM vAft section below a 4wtng*Airworkam,eataWo — policy iafemaboa smownen who auhmii!lire twit Medicating they am doing ail work and tbw hive outside rantracton must submit:s now xUldsvit indicating mtctr. seaemrs that check NIB box must Mulled an addtttatel 9wet showini the coma of tba mkbaouftcton and sins wtadw or Got tboaa aaditi=have iayaes lithe atots love auyoyaea,!M must provide 6= watim-comp.policy out bw awry—� n an employer that Is providbtgworkers'compensation tnsuraatee for my aTloyees. Below is the po&y acid Job site Irmadors =au Company Name: icy#or Self-ins.Lie.dk: Expimdon Date: Z / Site Address: ��_ U/di��//� �iJIS City/Stdemp:�i��7Z1� itch a copy of the workers' compensation policy declaration page(showilg the policy number and expiration date. are to secure coverage as required under MGL c. 152, 125A is a criminal violation punishable by a fine up to$1,500.00 for one-year imprisonmeat, as well as civic penalties in the force of a STOP WORK ORDER.and a fine of up to$250.00 a against the violator. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance emp velrileation. thereby eertlfy u>a er the pains and penalder of perja:ry that the information provtded alcove is &ue and correct. me gee )ffuial use only. Do not write in this area, to be completed by city or town q ffulaL :ity or Town: Peratit/Ueense# ssuiag Authority (circle one): . Board of Health 2. Bulldtng Deparl=ent 3. CitytTowu CIark. 4.Electrical Laspector 5. Plumbing Inspector Other :outset Person. Phone ik: ' 1 ® DATE(MMIDDNYYY) ACORV CERTIFICATE OF LIABILITY INSURANCE 10,24,2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CLIATIFICATE 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 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 d9m not co r rights o the certffic to holder In lieu of such endo ent s. PRODUCER CONTACT NAME: NORTHWOOD ESHBAUGH INS PHONE FAX 540 MAIN ST NC No W: A/C No: ADDRESS: HYANNIS MA 02601 INSURER(S)AFFORDINGCOVERAOE NAIC4 27JDD INSURERA:THE TRAVELERS INDEMNITY COMPANY OF AMERICA 236115 INSURED INSURER B: DAVID COX INC. INSURERC: PO BOX 401 INSURER O: S. YARMOUTH MA 02664 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. Wg ADDL SUER POLICY EFF POLICY EXP LTR TYPE OR INSURANCE tNSD WVD POLICY NUMBER MMIDDIY.YY MMIDDIYYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S DAMAGE TO RENTED CLAIMS-MADE El OCCUR PREMISES Me occurrence S MED EXP(Any one PERSONAL 8 Aoy INJURY GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S POLICY❑PROJECT a LOC PRODUCTS-COMPIOP AGG $ S AUTOMOBILE LIABILITY OMBINED SINGLE LIMIT Ea acddent S BODILY INJURY Perperson) ANY AUTO OWNED AUTOS SCHEDULED BODILY INJURY(Per accident) S ONLY AUTOS DAM G HIRED AUTOS NON-OWNED Per aocldent $ ONLY AUTOS ONLY UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ IDISDI 11IFTENTION $ A WORKERS COMPENSATION X STATUTE ER AND EMPLOYERS'LIABILITY (6HUB-810X742-2-17) 07-16-17 07-16-18 ANY PROPMETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT f 100.ODD OFFICERIMEMBER EXCLUDED? YM (Mandatory In NH) Y NIA N E.LDISEASE-EA EMPLOYE S 100.000 M yes,deso under DESC I rlbe OF OPERA IONS below E.L.DISEASE-POLICY LIMIT S 50010.00 DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If 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 ACCORDANCE WITH THE POLICY PROVISIONS. SG & D INSURANCE AGCY ILL AUTHORIZED REPRESENTATIVE 540 MAIN ST STE 9 HYA HYANNIS MA 02601 01888-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2018103) The ACORD name and logo are registered marks of ACORD Division of Professional Licensure office of Consumer Affairs s Business Regulation IBoard of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR t } Construction Supervisor TYPE:CorMation Rpg etraY n •. iratfon 100497 03/24/2020 CS-063537 Expires: 10115/2019 DAVID COX,INC. " DAVID R COX PO BOX 401 =z- DAVID R.COX � GQ�`--" SOUTH YARMOUTH MA 02664 19 LAVENDER UV W.YARMOUTH,MA 02673 Undersecretary Commissioner ' 1 Engineering Dept.(3rd floor) Map d .= Parcel " // Lfl Permit# `, 7 q 6 2 House# -1 V ate Issued Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) - (� Conservation Office (4th floor)(8:30-9:30/1:00-2:00) I - 2..3 , I SYSTEM MUST BE NSTAi Planning Dept.(1st floor/School Admin. Bldg.) WIT LIANCE Definitive Plan Approved by Planning Board 19 ENVIRONM TOWN E AND TOWN OF BARNSTABLE E° ° NS Building Permit Application Project Street Address _S'S'o ! \A)i ca%-%nn fki�Z _ �. De y 1.a l- 2 Villages Owner�\r. move. a e Y,0 ea��P� Address �gwt e Telephone q 2 g (2101, Permit Request RT``n c g- �►�.nr�rx l�g t�p%V1 CA ` at+`n:S ann n\ TCha d\ k&YN �1 q2�K 23 First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ i 7S. 000 Zoning District - ( Flood Plain Water Protection A l Lot Size ?S, t 3 Grandfathered ❑Yes ❑No Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No Basement Type: pull &Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No. of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ETGas ❑Oil ❑Electric ❑Other Central Air ❑Yes RrlNo Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) 'If ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use 14, "\ Proposed Use u}�n.�•�, Builder Information Name Telephone Number q Z — 6106 Address License# q(,sd n g�e r` ,0 it M nL , e)7 G.&S— Home Improvement Contractor# I CC2 I3:1 Worker's Compensation# .�U,7C- 2,<Z7 Rtxo3 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 lj el If C2 JQ4 14 Wt 51 O.OLSO - r SIGNATURES BUILDING PERMIT DENIED FQ]<-ME FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. t ! t ADDRESS VILLAGE . OWNER '' Y• ,, � , , _ �' �� ' DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL'•' PLUMBING:S ROAGH FINALco ' GAS: cr .e RO�L�J�G�H FINAL FINAL BUILlerr3owl = +� FN..Sr4 oM DATE CLOSED [ , n) C? L) ' ASSOCIATIOWIgN NSA W - m O / lC/ �./l`awa usetld .,rstricted TO: 00��£ "(J/a97L'77L4J1C7%ea L C - - . PUBLIC PIETY 55062 r CONSTRUCTION SUPERVISOR LICENSE 0` None NL'atie L:{ 'I?s B1Il • fi�iat?: 15 - Masonry Only s -.> r- I:>0 : �0° 0?I1sl1S93 (i•! �illre t0 p035?SS a current edition 0_ tG? acg}rttYa sJ: 00 - YassEchug_tts State 80iilding Code ;s Cause fr; re ocE*ioO 0: this licEnsi- POND VIER DR C? TEkVILr,? Y 0?S?? A. 9/-w e Z O� PHOME IMPROVEMENT CONTRACTORS REGISTRATION ;Board of Building Regulations and Standards r One Ashburton Place — Room 1301 Boston , _Massachusetts 02108 t . . HOME* IMPROVEMENT CONTRACTOR Registration 100134. Expiration 06/09/98 — - -- . Type — PRIVATE CORPORATION Registration 100134 ROGERS & MARNEY INC . Type -. PRIVATE CORPORATION Charles D . Rogers a Expiration. - 06/09/98 PO Box 310 Osterville MA 02655 R06ER5 & MARNEY, INC.. Charles D.- Rogers �`A�0 Box 310. terviIIe MA 02655 ADMINISTRATOR ' aR PDX The Town of Barnstable $ Department of Health Safety and Environmental Services , Building Division 367 Main Sett,Hyannis MA 02601 Office_ 508-790-6227 Ralph Crm= F= 508475-3344 Building Carom I For office use only , Permit no. Date AFMAVTT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMUAPPLICATION MGL c. 142A requires that the"reconstruction,alterations,'renovation,repair;modernization,corrosion, irnprmremcnt..r mcnal, demolitim or consauction of an addition to any pm-codsring owner occupied building containing at least one but not more than four dwelling units or to strunnres which are ad}aartt to such residence or building be done by registered contractors:, with certain eruptions, along with other r guirrmrnts Typeof Work: P—e rNnv Atrnr, Est. Cast 1'15,,Q Address of Work: �� Le oLv,v,c� Ovmcr.Namc: N1 �-D in,x Pc�n e Date of Permit Application: 2 Z E)e c_ i(�4:� I hemin-a=ifv that: Registration is not required for the following resson(s): Work excluded by law Job undo SI.000 Building not owner-occupied Owner puffing own permit Notice is hereby gh-cn that: OWNERS FULLING THEIR OWN PERMIT OR DEALING WrMUNREG' ED CONTRACTORS FOR APPLICABLE HOME IIviPROVE3vfENI' WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL C. 142A SIGNED UNDER PENAL= OF PERJURY I hereby apply for a permit as the agent of the miner. 72- e- l t Date Contractor name Registration No. The Commonwealth of Massachusetts f Department of Industrial Accidents '� :.•• __ 0/liceollnees�galiens 600 Washington Street Boston,Mass. 02111 workers' Compensation Insurance AMdavit 01 LQGalian• ail ❑ l am a homeowner pctformin; all work thyself. hn ric ❑ I am a sole proprietor,md have no one working to any capacity ®dam an employer providing workers' compensation for.my employees working on this job. r&MjDani name* iltl�ress: • '. 77 _city: !���Pe : 1� yv t•A•. . . . .. . ,�•/.....�. A� one, -�hG I�— 6 l t'.JG iflS!►ra ce ❑ I ath a sole prop rieto eneral contra or,or homeowner(eiic le one)and have hired the contractors listed below who have the following w5irkers' compensation po Ices: m ten e: � . • S • ' h nc•ti� . pol'ry iptn tan . . addie.c • . . .. ci nliotie et inAurance c0. policy Failure to secure coverage us required under Section 45A if MGI. IU can leaf to the imposition ofcriminai penultics of a fiat up to si,.500.00 and/or one years'imprisonturnt us well as civil penaltict in the form of a STOP WORK ORDER and a line of$100.00 a day against the. I understand flint a copy or iiiis statement may be forwarded to the URee of Investigations of the DtA rnr coverage verification. I do Griehv certify under the pains nd pentridd of perjary that the information provided above is t►ae and correct. Sign2turc ate 2— Ivee- 9 Print home 42e, Ccly— Z�J-61 0(, hcnc 4 nl•ticial use aniv do not watt In this ana to be completed by city or town omciat city or town; ptrini(Aiccnac# (`►Building Ocpartnttm Q check if Immediate response is required Ql,iunsiog Board QScleenntn's OMcc contact person: phone Is; OHcalth ne i 1arlmcnt Other .fnevked 595 PIM I • :::':':<:::::DATE:::::::::::::......... A CORD :>:::: ::. :::. ::: :.:: ::.........:::::;:::::::::........ ( / /YY) >: �C.ERT : . ::. .:.: �4T ::.: : .:::. :.::.: : : : .: .. : : .: : ::::: :::: ::::::;:: ::::::::::::: A► .....................:::::::::::.:::::::::: 8 9 7 .::. PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Jerome Sullivan Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Agency, Inc. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 1276 Main Street (Rt 28) COMPANIES AFFORDING COVERAGE South Yarmouth, MA 02664-4459 COMPANY INSURED A Travelers Aetna Insurance Company COMPANY John Ellis Drywall B P.O. Box 521 / COMPANY Mashpee, MA 02649 L J C J COMPANY D ::....:.THI S IS TO CERTIFY THAT;:;;.;: THE POLICIES IES OF INSU RANCE LIST ED BELOW ��HAVE BEEN ISSU ED 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. CO MM/DD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LTR DATE( /YY) DATE(MM/DD/YY) LIMITS GENERAL LIABILITY GENERAL AGGREGATE $ 600000 A X COMMERCIAL GENERAL LIABILITY 006 MP 0 0 2 5 8 717 3 0 T 0 2/14/9 7 0 2/14/9 8 PRODUCTS-COMP/OP AGG $ 600000 CLAIMS MADE ❑X OCCUR PERSONAL&ADV INJURY S 300000 OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $ 300000 FIRE DAMAGE(Any one fire) $ 300000 MED EXP(Any one person) $ 5000 AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS $ NON-OWNED AUTOS BODILY INJURY(Per accident) PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT S AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE S OTHER THAN UMBRELLA FORM $ WORKERS COMPENSATION AND WC STATU- OTH-;:::::::;:::;:: ;:;:;:; TORY OMITS_ ER EMPLOYERS.UABIUTY _ EL EACH ACCIDENT $ THE PROPRIETOR/ INCL PARTNERS/EXECUTIVE EL DISEASE-POLICY LIMIT $ OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS Installation• & Repair of Drywall . :::::::::::::::::.:.:::.:....................:.:.:::::::::::::::::::::....................::.::. :......::::::::::::::::::::::::.......................:::::::::::::::::::::::::...........................::::::::::.:::::::::::.:.. X ::::::::::.........................:..:::.:::::.:::::::::..........................::::::::::::::::::::...... :......:...............:.:.:..:.:.NC it,A 1..4t :...........:::::::::::::::::: :::::::::::::::::::............::::::::::.::::.:.:::::::::.............:_:::. ::.:::::: :.......:: ::.::.:.:.::.. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL Rogers & Marney, Inc. ID_DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, P.O. BOX 310 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY Os t ervi l l e, MA 02655 OF ANY KIXN UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED R RE ENTATIVE . �' ti✓a Q�i e a� II .� ACORo CERTIFICATE OF LIABILITY INSURANC ID GA D03/24 /9 OLCO-T 3/24/97 PRODUCER �• THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE O'Brien's Centerville Ins Agy HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 259 Pine Street, P.O. Box 610 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Centerville MA 02632 COMPANIES AFFORDING COVERAGE O'Brien's Agency Account COMPANY Assurance Company of America Phone No. 508-775-0005 Fax No.508-775-6772 INSURED COMPANY B Legion Insurance Company Holcomb Plumbing & Heating COMPANY David G. Holcomb d/b/a 30 Perseverance Way COMPANY Hyannis MA 02601 D COVERAGES 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. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE(MM/DD/YY) DATE(MM/D ) GENERAL LIABILITY GENERAL AGGREGATE $ 1,0.0 0,0 0 0. A X COMMERCIAL GENERAL LIABILITY CFP 25005092 03/21/97 0 21/98 PRODUCTS-COMP/OPAGG $ 1,000,000. CLAIMS MADE a OCCUR PERSONAL&ADV INJURY $ 500,000. OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $ 500,000. FIRE DAMAGE(Any one fire) $ 300,000. MED EXP(Any one person) $ 10,000. AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ F �OTHER THAN UMBRELLA FORM $ WORKERS COMPENSATION AND WC STATU- O EMPLOYERS'LIABILITY TORY LIMITS ERR EL EACH ACCIDENT $ 100,000. B THE PROPRIETOR/ INCL WC2-0022638 12/18/96 12/18/97 EL DISEASE-POLICY LIMIT $ 500,000. PARTNERS/EXECUTIVE OFFICERS ARE: F1 EXCL EL DISEASE-EA EMPLOYEE $ 10 0,0 0 0. OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS Plumbing & Heating Contractor; **Subject To Policy Terms & Conditions** CERTIFICATE'HOLDER' " CANCELLATION . ROGER-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Rogers & Marney, Inc. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY P.O. Box 310 Os tervi 11 a MA 02655 OF ANY K ND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. AUTHORI NTA VE s • Oil O'B iePPR s Agenc Ac ACORD 25-S(1195) CORD CORPORATION 1988 " ":z:.";'', �<: ;;>:;`ii533i;<'i'i'?`i` [ iiiii�;iii'ii�<..:::.:::::.:�::;. A CORD :. :.. TY .: . :::::::. ::::::..:..:.::......... ............................... d ��' PRODL16iR THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR W. H. Eshbau h Insurance Agency,y ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 805 W. In Street COMPANIES AFFORDING COVERAGE Hyannis, MA 02601 _ COMPANY - - - A Trust Assurance Co. INSURED -- COMPANY B Eastern Casualty Harmon Painting, Inc. COMPANY 707 Main Street C Ostervi l le, MA 02655 COMPANY I D 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. TRI TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATIONI LIMITS DATE(MWDDNY) DATE(MWDDNY)GENERAL LIABILITY GENERAL AGGREGATE $ 2,000,000 A X COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG $ 120001000 - ...-_1-- A (1 p CLAIMS MADE X OCCUR I'MP 1000336 4-1-9 7 4-1-7 O PERSONAL&ADV INJURY $ 1 Z OOO 1 OOO -- OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $ 1 ,000 _000-- FIRE DAMAGE(Any one fire) $___50 OOO MED EXP(Any one person) $ 5 OOO AUTOMOBILE LIABILITY - i ANY AUTO COMBINED SINGLE LIMIT $ I ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) — I 1HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY:. :F EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM $ WORKERS COMPENSATION AND wn TORY LIMIT S EMPLOYERS'LIABILITY 1�11 I ER 13 I 1,60 1-4-9 7 I 1-4-96- EL EACH ACCIDENT--_ $��OOU`- THE PROPRIETOR/ INCL PARTNERS/EXECUTIVE WC97798007 EL_ -_DISEASE-POLICY LIMIT $ OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE $ 500,000 OTHER 1 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS ...........:::........:.:::::............,,..:......................::::.:.:.....:.,..:....::�::._::.:.....::......�:.::.. .:.:::.::..::::..>..........:.::;.:>.;:..........:.....:..:::;:.:.:..:....................::...... E`i:.;:::;:.>::;•::�::.;;;::o..�:�:.::.:::.:.:.;::::.; ;:.;:.�:.::.>::.;;:.;:.;:.;::.;:.;.�:.::::.::.;:.::.;:.;::,.::.;::;:.;:;.:::;•::.�:.�;:::;:::�.;.;,......:;.,..,;.,.,...::::.,.?:' � ;<::::::s ::k::::::: ?::is>?5:::::::r:<:::::::::::ss:::i::::'%G:';:::::Tr::i:::;:::::i: ... 3.......................U.. ...... SHOULD ANY. OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Rogers & Marney,, Inc. EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL P. O. Box 310 20 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Ostervi l le, MA 02655 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. I AUTHORIZE` D NTA ��+ 2. Oc/t�-/+10-97 02 : 20P P.01 DATE Pi V Ol[D (` _ E M WDDIYY) �:_:_:_::::.:,,,:-::•:::__ _-._....:....__...:•- -.• �-1:.:r:,.,_1 :..:.._..l.' - .� a-i ,� d• 10/10197 PRODUCER 508-790-1030 THIS CERTIFICATE IS ISSUED A9 A MATTER OF INFORMATION MCSHEA INSURANCE AGENCY,INC. ONLY AND CCNFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOE' NOT AMEND, EXTEND OR 320 WEST MAIN STREET THE D BELOW,By THE EQLICIES HYANNIS.MA 02601 COMPANIES AFFORDING.COVERAA. COMPANY A NATIONAL GRANGE MUTUAL INSURED COMPANY + DORAN AND KINGMAN B PO BOX 303, OSTERVILLE,MA 02655 COMPANY C COMPANY D ....:..............: ......___._.......-..... .•.......,..._.......................•. ..:',:'..v.•..1.....4•.,wta':,.:r.,,v,ni:.:DIY,�AIIt:.':::tll('.,!.alY'M1::::,:iilK�':'l.'.Uiw��:Y'.1:':,,:1•i: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE UST W HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM CON ITION OF ANY CONTRACT OR OTMER DOCUMENT WITH RESPECT TO WHICH THiS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANqE AFFORDED B Y THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LkAl7p SHO N,MAY HAVE BEEN REDUCED BY PAID CLAIMS. —..�.. co LTA TYPE OF INSURANCE POLICY U E POLICY EFFECTIVE I POLICY EXPIRATION DATE(MM10C ) DATE(MWDD" UAYT9 GENERAL LIABILITY G6NERK AGGREGATE _ A ; X ICOMMERCILGENOULLWBaITY MPH22559 09/28/97 0928/98 I -- ( .-. 1,000,000 .I P�tooucrS-Ci N .IOPaoo s 1,000.000 I 'I CLANG MADE 'T OCCUR `• _, PERSONAL 6 ADV INJURY ' - OWNER'S&CONTRACTCR'S PROT I b 560,000 EACH OCCURRENCE S 500,000 I FIREDAMAGE(Amlwmfwv) I S 500,000 1 i I E%P (Any 0!K PSrrxl} �S OQQ AUTOMOBILE LIABILITY 10 A _ ANY AUTO FASH22559 i 09/28/97 0928/913 COMBINED SINGLE LINK s ALLOWNEDAUTOS I Ip� wy�X SCHEDULED AUTOS ( �a I b 100,000 HIRED AUTOS r BODILY INJURY b 300,000 `y NON-OWNED AUTOS (Par w000f l) r• PROPERTY DAMAGE 3 100,000 GARAGE LIABIUTY AUTO ONLY-EA ACCIDENT S ANY AUTO I OTHER THAN AUTO,ONLY: I __ EACH ACCIDENT b - AGGREfIAtE 3 — EXCESS UABSJTY rAG;EGATE OCCURRENCE 7 UMBRELLA FORM OTHER THAN UMBRELLA FORM i S WORKER'S COMPENSATION AND N A WCH22559 11/29/96 11R9/97 . — ER• EMPLOYERVUABIL I ELEACHACCIOENT 100,000 _THE PROPRIETOR �LDISEASE-POL ICY1811T I b �� FARTNE116mmGWIVE X INCL I .- .. -OFFCMSARE. FXCL I DISEASE-CA EMPLOYEE!3 100 000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESISPECIAL ITEMS CERTIFICATE-HOLDER CANC.Ek:LATION SHOULD ANY OF THE ABOVE DESCMDED POLICIES BE CANCELLED BEFORE THE EXPIRATION OA79 TN6RBOF, THE I6kI4 COMPANY WILL ENDCAYOR TO MAIL ROGERS AND MARNEY 10 DAYS WRITTEN NO'TICBTO TNECERTWUITENOLDERNAMEOTO THE LEFT, PO BOX 310 BUT FAILURE TO AWL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OSTERVILLE,MA 02655 OF ANY KIND UPON TI1E COMPANY.-ITS AGENTS OR REPRESENTATMES. AUTHgRRED REPRESENTA E .t[•`h.�. i - .. ..._,r....- ......,....;........V.f.:,.:'.i1':n. ........•....'. . ":'.. ..... -\�f/� • ...• ..........._............. tea yq¢� ..... ... ........:....'4t, . . A11i0��15wS' 1•:rrvnsaysm-......._.1.:,..,.. ..v.. . . ®ACORD CORPORATION I , AUG-04—i937 14:45 ROGERS?G.RAY,WANNIS 1 508 ?90 4212 P.01 i Y • ♦r•'Y •S ` I:Y.�I{xi ', , Y• : .ry < xNr+x9�1:"1.y,�.r::;S�:.... kx:j;pj.`:. Xf x.Yf...�.1:.:r,l.�::aIIv::Ca;:9�:::a�k�:,s.x®•rr®r.•.4r,1:.t�';.•Ha.;ii'•.x£;N,r':'!1.':.?n R.x4,t'i:l,�,s.x£ :,;1nir�;�i�.:'"�e.ra.isy�::.,sS�!x'1:) .ni^X:p3''.• !!'TT ...�4 •.�..r:,��iu;i'•R:FfiM?<..:rCxrnp`QS.��N ii S<^¢:N��•!i��ilf.61(^et'.s.''a';fY�•f�;�s,..sK�:Y�%:•i�.:7?t t,x..•u.ni.£vs; tr�R?2x:3�0 .1A'r,2TtE>j sirs Y....'!•.L I�.Y�,:..Ria.<.>.>:eR •1�� q .. :<,.....e.•%:ko sr,..<$,�:.J,x.. ..•<. h'slx....•S:.x.�tj�oo x�>�'q.k:..... ,R'K,r.: tr.6xe:;.!i.;!s<r..x.c..f!s.r,.x:xt:o.g.;:rw;:xi.MFN'iGSi�ll£:3i•<.�'4 {i:�:iiV'rr. .;p:F.:or�>:�rtix'ci�a�..�•`an:k.; htf;K a ..v{r..ko : x:.. Sf3 !;+' ,..3.:aa:k xx•'k{.: r�,fax % % vaoouc�l .:.:.,..:..rr. z.,..l:: _< ...�..... . .�. .4/1997 THIS CERTIFICATE Ig IS18U5D AS A NATTER OF INFORiu►T10N ONLY AND ....... Rogers Gray — 8yantlis OONFERB ND FnQHT9 UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AINEND, lXTEND OA ALT'ER THE COVERAGE AFFOFIVED BY THE 640 Iyanough Road/Route 13Z .,�uclEs BEww• ....................... ............................................................................................ Hyannis, MA 02601-1999 COMPANIES AFFORDING COVERAGE (508)775-0011 Fax(508)790-4212 . ................................... ....................... COMP/i`'` A Worcester Insurance Co. ` LEi1FA _... :......................................................... nevi ................ ......................................................... . � B tastern Casualty Ins. o. a e -Cos ............ P Insulation, I ....' .......................... 455 Yarmouth Rd. C HyannisMA 02601 "COIAmr........................................................... ..... .............. .,...,.................................................. I LETTER D cowAw ................. ... .................,.,..,.......................................................... )?: NA.y '♦;:�i�!k�'�..:�t:k:<� �'7.1. LET •G, E / s:....7GSl•�'`S£:�}!<:o•"° +Cr r h:5";!�i �. sr�: ..x :�.'•-�:: •Y iA":. ''K}ur.�.�r.a�: rk:.V.Il.Al:x.m :.,.vrAi,YY.6 k l�gg s �rx JR x�'!��., I.I f k.. :3. .Q <�r.x,. r y •xw> tx..rx f^.%L i<:i .,<.r.r,.. �•.R::b,.A%i:x..•:kl4s.(±+ka1u..;3�n. k:V; :E' >>., i.a:.N �e:.,.:vs.< •s..•. rxa:: .4 2::�,r :.i..>,���if'.>rbr�.:t:szH:tlnN ,;H�' r.<r.,o, Z..y.�i:JhO.. "��. ,. ""' .:':6"'i:,.�;sx :'.s:;• THIS IS TO CERflFY THAT THE POLICIES F IN .•..::4 .;t�rBt::t`:ii??FO LICY PERT 0 INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUpEO NAMED ABOVE FOR THE POLICY PERIOD I CERTIFICATE NOTWITHSTANDING BE ISSUED LNG ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR 07-jER OOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY 8E i9SUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SU4IECT TO ALL THE TEAMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMIT'S SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. .............................................................. CO ufl; 7YFIE OF wBUruMCa POLICY NLUMM ►DUCT Di�CTIY[ 70LICY FXVATiOM I DATZ WM£D i DATa(MMIDDIYY) EMUS A. ............................................. .. .............I..................... QD/mU1L WIIAUTY ..................................... GENWAIL AGGREGATE X ;coLalExCUL QENErAL laaarn SMPT22M ...... ........ 0•,0 O :.....: O-Aw►vm ;.. .'OCCUR PRODtACTg{gMPpp AGO, i 300,000 :..:.r: owrRnc►DRS M. O4/ 6/97 04/16/9 ..reI........................ u�v........j'.......... .00.�..00 OWNM a C 0 .......................................................' ... ,. . ........... FAClI OcculacE 00 00 FM DAMAGE om Ike :i ......:..................................................................:.............................................�.�� .. ... ... ................ / MED AUTOV4MZLMLITY ............................................................. ..... ........,....,,,..,..,. ........... ? ..<.. (hIY one pe,een)i51000 ANY O BMA8Z12J136 COMBINED i :LIMIT BNOLE i I ALL 0AWO AUPOB 04/10/97 04/10/98:r.... aI.........I .lUltY............................. .... .............................. YOOILY g;savuLE ED Auros ro(Pva Pen) 100,00.. HnoAUTOS :................................................:........................._. ... i BODILY NAM NDN OYrN[D AUTOS ;Pa eccldertp i 300,000 OANAOE LIABILITY >................................................:...................................... . PROPUTTY oAa►£we elcces uAolury :.......................; ? ........................... . .. ................................ ,. i 100,000 .., 'WAWW.UA FORM \\ FAG!000Ui�NC................ s ................................ OTHR T�IAN UMBRELLA FORM i ADDRC�AIE i t ..................................................................... . :,.r.:.:.....,.. WORKER'S 00i1PvMTwN i..STATUTCRY LINIRB " :;:'•: ~J ATvo 15 97 15 9&: :,:. 06/ / 106/ / f"Q'A�1D°R. Ii........ X (1.i,�0 esiAIVzpw UNIR ITY I DISfABE-POLICY UNIT ;i I.................. 500 00 ......`. ............................................................... ...................................................................................................... DTSfJ►3E•ECM EMPLOYEE ,l ............................ : .......100.c.d0... ...................................................................................................................... .................... ......:..... .... . :....................................................................................... DaAICfaI11pN p WL<1AT1D1181LgGLT10M alMaillCl�laPaCULL rtOA� ,,,OF Installation OWN... ..........�... xa^ xr.'wlof,oxoo,%.f.e>.:.s,.,snw sie fPu RPM, : . .. . ,':.�:..�Wa...r.•,'i.4..ax.r..wx..�.,y:k�E,.f Trt°x::itsS'`�''1A!�>1:..t.Ss{4.h:i:ttl.:is(1P:'�:�?'Al:.a r.xs:Yx.. ?�..�££..o'~ikx.HL:.tl,px.sEi'if�hb:N�'?Rd.Y,+Y.,;Y.'rYn.:'i4.:�i tor,£:k''r�".^J�,•`:y:'1 x,px'pV. x n SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCFi i FD BEFORE THE �;k 1N EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO xJ., "•? MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE .11 ROGMW & KAMEY xt LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO 06"TION OR P.O. BOX 310 '7 UABIUTY OF ANY KIND UPON THE COMPANY. ITS AGENTS OR REPRESENTATIVES. OSTE1tVxhL$, ESA 02655 -.AUV110FIM 11EPAl(fSM(TAWR ROGE" do GRAY INSUR CE ACENCY.INC. Ix:> �,••Y'•.0 V,• N'r:•. v'nvr•�.,•....^.v,.Y• O:{'Y':l•.x.�..�/,%:;•,:;:.';1ii:;Z.f.�:iJ•f!'rp�' �.M;^ ;txo<CI,.�:<:'xH,..�. 1 HLV IrIl..:.?�� x.. :,:.{1C Y..�l :kk...�::< �: !•`�:�11: �:-�1�'H 11 I'£lii~�� ?,;:IT:f:::^'.nM^�'%�zi:�':j..�ii^ns�t��...x: f. ..f. • ;r ^Vd:.':�,`•,'",h•'� '•nh ::: :::?A£Ax�sF%r INKS 1.;` �Ixr:� sv'iF Sns'• , i �.e .. • •�' i x .;s.`FT`� 4� 'F7.•: N:tl r� xLx�kr. ,1"S`fv3?';,l`: „lt...' X:� .:g'°4c'T,;i.. ,y,:, TOTAL P.01 r �17 To m d � N tN , ov a o — t10 d o � n v' in • n D k � W L M D ti TO C z � � r N < < Q> n � z r ! Na to v, 176v�<<ts �t'c.tclel{ ss0 LOxarho AvZ I C�'�s� �•h CovA.k\k0n5 . � o Cl • 11 _ I � I , II ` II I , I , II I , � I II I I. I t I i : I II i , II I I • I�IwI"l+l_.+H" I 1 I 1 t I 11 I I 1 I I I I I I I I 1 I I I I ( I I I - I I I I FIRST FLOOR PLAN �EaR�EY oc,� a � ' i Prb �c�Se a�2rovoA%o%lS n��5 4s enr �y 550 `V, uh�,a A jV- l NEW CLOSET i NEW LAUNDRY _ BATHROOM II W.c. [ ,al a- � �-� a I I II II II // II CTYp DECK II 13yl t NEW FAMILY ROOM II II II II I I NEW II II Ii II II II I NEW BUILT ' -------- IN CAB - - -- - - NEW CLOSET L 1 II II II . KITCHEN II II II II BUTLERS . D.W. I I PANTRY II II II i I DINID II II -T-1-I 1 T T-1 UP I I I I I I I I I J POWDE� ROOM I I I I I i I D7 >v� I I I-J UP 1 FOYER LIVID Engineering Dept. (3rd floor) Map Parcel t I FPS ., Permit# I.IW 3 3 House#- 1?ate Issued / /? Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) Conservation Office(4th floor)(8:30- 9:30/1:00-2:00) MUST Planning Dept.(1st floor/School Admin. Bldg.) �IV�TAiLL D CE Definitive Plan Approved by Planning Board 19 ENVI ' ROW ArONS ND TOWN R TOWN OF'BARNSTABLE Building Permit Application Project Street Address ���� 6t_),'cteZ&0 e Village Owner 7�')I., P IC4 S S Yeadlip c, Address rjo„yy1� •Telephone - *Permit Request _ 0 , First Floor / J 0o ke Segue fquare feet Second Floor square feet Construction Type Estimated Project Cost $ --Cn,� Zoning District (- F- (. Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No Basement Type: ull rawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New .Half: Existing New No.of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ©�G`as ❑Oil ❑Electric ❑Other Central Air ❑Yes U11<0 Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name (2D S WrMPLa Zh r . Telephone Number Address k 3)p License# e-)0 ©4P�r y,� Home Improvement Contractor# to o f � Worker's Compensation# 10(1 %5 �L NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. 7 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE BUILDING PERMIT DENIED FOR THE FOLaWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER �s t DATE OF_INSPEGTION: _ FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: , =ROt-WH FINAL GAS: �ROi Hi — FINAL• FINAL BUILD NdU tL . DATE CLOSED`CE[ F' ASSOCIATION Pt NO! CO m � v , I '. Zsd ooS£ (dA.l7 1)NL.lOOJ ";)NOV os3 5nod _ QtJIS� "7No'.) b ' �dcti17 "�'O bz �lH932! }syg C�1c�1� S17o� NOIib�Hnoj 2�, \vH3s �N�1S1x3 FM ��lt, �� 511�5 1'd 9x8 AN?N yiSlNl� S151o1 -aCbl� C)Ni X5 3'-)O'6 Lb '1� Ao14 1 • RA\ / 01\I N Ff)n\ oSS h31?�t13�; c �nnoa �03 No c\\Aoo3 ctaso�-Ao t ^ems PRoPosEU �Fo�n��aroN . ......n\c. Dovcv►.A$. YE.ARLCY _ sso WIANNO AVE. Sc 'IZ'_ ► Nov hl, a7 RoC�£RS 1\\ARN>r y'. LryG. axe_ i. i i E.Y.M INCH FLOOR zwc-S F►NlSF4 ., .1'�eAD� '. ExlSnNb BEAK\ Y2' FouMV-rr%O,l caoI.TS CZleR) g' GoNc. 6LOc.K �{ R&BAR 29 O.G. ( TYP.) ;" CONC. SLAB POuREo 'coNG. rooT7N& (_ry T) 3500 PsZ is i ti The Town of Barnstable MENSTABM 9� `16 9. � Department of Health Safety and Environmental Services prEDN►►'�A Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only Permit no. Date AFFIDAVIT 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 structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. Type of Work: rav G3�tey� 12er`oucJt&y1 Est.Cost (,ppn Address of Work: Sh \V, n_i-�"c:) AQ e . 014e 41_\2 Owner's Name ts\C. Y ec 3:\eq Date of Permit Application: 26 1�tn� q rf I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under$1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: �s 0 13 Date Contractor Name Registration No. OR Date Owner's Name ' ✓/ee vaoic•»eonecealCl a�✓tla�tac`iuseCla^I `• a� �• ,4 DaPar �of PUBLIC SP�SPt" 55062 — — ' CONSTRUCTION SUPERVISOR LICENS? "`? - Bone NuaheI: LXC.i s: Birthdate: 1=. - y3S00_'f only 2 :a�i ;y t0:ues CS 7=ilun to GOZS255 a Current ed'ulon ?I tGe ao5:ri:tYC :`C !+a5sachesetts State Buiildiag Code _s cause f,' re`l catinn Of this liC?ls?. uo,,,ay S � 9 POND V!E-4 DR for 'A rZ2632 1 _ HOME IMPROVEMENT CONTRACTORS REGISTRATION Board of Building Regulations and Standards One Ashburton -Place - Room 1301 Boston , .Massachusetts 02108 . . HOME IMPROVEMENT CONTRACTOR ( _ Registration 100134.' Expiration 06/09/98 — - ' -' - '-- Type — PRIVATE CORPORATION 2-AEIMMMWr Registration 100103N4 ROGERS & MARNEY , INC . Type PRIVATE CORPORATION Charles D . Rogers a Expiration . 06/09/98 PO Box 310 Osterville MA 02655 R06ER5 & MARNEY, INC.. Charles 0.•Rogers ��D"ster vp-S//t erx 310. ' ville MA 02655 ADMINISTRATOR 3� The Commonwealth of i1fassachusetts Department of IndustrialAccidents 600 Washington Street _. Boston,Mass. 02111 ..fi workers' Compensation Insurance Affidavit m : lQGati nn• cit • hn ❑ I am a homeowner performina all work myself. ❑ I am a sole proprietor and have no one working in any capacity 0'I'n an employer providing workers' compensation for.mv employees working on this job. Y rai anj n :t:. citv. !IISSIL� to 1, ❑ I am a sole proprie r, enera eontracto or homeowner(etrele oJye)and have hired the cormactorS listed Uelow who have the followm.- workers co pensatto/n polices:` 1;,lZm�any tome: � P 14�T74CJ.1�H "�'�Pp-�S . 'policy fl � sddrec ci insurance co. Failure to secure coverage as required under Section 25A Of MG1.152 tan lead to tRc Irtlpo9ition nfetiminal penttltic9 o(q filet up to�1,.5U0.00 and/or noc yenr9'impri9olemcnt as well a7 c1vil prnaltiq iu tLt turm of o$TOP w'ORK ORDER t1nJ a line of�100.00 a day alLaiest tee. r•ndcntand that a tops of IltiY atatcment stay be forwarded to the I)f5tx of 7avetRigatinty of l4e D1A for eoveritge verification. I do haeh y certify larder r e yairJs a d penaltl of perjury fhat the information provided above is trar and coned. Signature etc 26 9 6 Print numc hcnc orlicial u9c only do not write In tltia area to be completed by city 4r town otficitll city or town. perinmicctutc# Building Department ❑f.ltensiog Bnard Q check if immediate reeponac is require) OSelectroea's OJTiec al talth neparlment contact ptr9un: phone ry; o0ther .(rcvicM 1,99➢JAI Oct- 10-97 02: 20P P.01 T A c OR flru =,i _ I M7DD m mi — PRODUCER f a4 �jl= DATEM 508-790-1030 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION MCSHEA INSURANCE AGENCY,INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 320 WEST MAIN STREET THEAFFORDED L HYANNIS,MA 02601 COMPANIES AFFORDING.COVERAGE,. COMPANY A NATIONAL GRANGE MUTUAL INSURED COMPANY — _...._.-. --•- DORAN AND KINGMAN g PO BOX 303 OSTERVILLE,MA 02655 COMPANY C COMPANY D .... , ... .'...:..............:. ........_._..........,.. .,,. .. .........,�..�:�,:•,w.:,.a.....•4..r.s:a:,.rrwr,n,:.-mtlgxrsv.:::rF. THIS IS TO CERTIFY THAT THE POLICIES OF IN LIST W HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM CON ITION OF AN'Y CONTRACTOR UT}IER DOCUMENT WITH RESPECT TO WHICH rHiS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INS N E AF CRDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,L I I SHO N Y HAVE BEEN REDUCED BY PAID CLAims. co �_... _... POLICY EFFECTIVE POLICY EXPIRATION LrR TYPE OF INSURANCE POLICY V w DATE(NeuppM) DaTe(IAWDDM) LIMITS GENERAL LIABILITY G6NERALAGGREGATE i 1,000,000 .I A , X 'COMMERCIAL GENERAL LIABILITY MPH22559 09/2&V7 09/28/98 1 PROouc7a•COMPrOPAGO ,s i--- I G_,,, 1.000,000 I i CLAIN6 MADE X occuR 5D0 000 PERSONAL a ADV INJURY OWNER'S a cONTRACTGR'S PROT r E "' --""" ' —�•- i EACH OCCURRENCE a _ sjDD,000 ��_—___.._..... . FIRE DAMAGE(Arr/ fry) I f —S0D,000 I i AUTOMOBILELIABILITY_ ExP (�'T°f°perwnl s 10,000 A ANY AUTO FASH22559 1 09/28197 09/28/98 COMBINED SINGLE LIMIT s ALL OWNED AUTOS -- X SCHEDULEDAUTOS , (POeDperaw) i a 10D,000 HIRED AUTOS r `y NON-OWNED AUTOS BODILY INJURY 300,000 (Par Kodpn) ..._____._...._.. I �• PROPERTY DAMAGE a 100,000 GARAGE LIABILITY AUTO ONLY•EA ACCIDENT a ANY AUTO OTHER THAN AUTO ONLY: 1 EACH ACCIDENT $ AGGREGATE 1 '-- EXCEbb LIABBJTY EACH OCCURRENCE a UMBRELLA FORM I l I AGGREGATE_�A a OTHER THAN UMBRELLA FORM 1s A ;WORXPA 1 C UABIL ATHNi AND (WCH22559 11/29/96 I 11/29197 i TO'6L"• - ER rlrU EMPLOYER$'LJABU.IT7 EL EACH ACCIDENT I Pi ° X 1 II I i —�a 1 OO,OD FARTIQR&2XEGVTVH INCL EL DISEASE•POLICY LIMIT E 500,000 oFF Ra ARE. EXCL ELDISASE .EA EMPLOYEE 'S 100,000 OTHER 1 DESCRIPTION OF OPERATIONSILOCATIONSNERCLEbISPECU►L ITEMS CERTIFICATE-HOLDER' CANCELLATION: SHOULD ANYOF THE ABOVE ORSMINEO POLILIE$ BE CANCELLED BEFORE THE EXPIRATION OATS THKAWF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL ROGERS AND MARNEY 110 DAYS WRITTEN NOTICE TO THE CERTIFICATE MOLDER NAMED TO THE LEFT, PO BOX 310 BUT FAILURE TO AWL SUCH NOTICE SHALL WPOSE NO OBLIGATION OR LIABILITY OSTERVILLE,MA 02655 OF ANY HIND UPON THE COMPANY ITS AGENTS OR REPRESENTATIVES. AUTH RIZED REPREbENTA`��(y ,..! .r_r:rvnrnx,m•,:,:.:�::_..:ro:..,.,.....,,....: x_rr: a:..!:,.r.::,:y.:,.•.�.,......,,.,-:,-.•:..,..... ' A�O MA60h6-CORPORATION-1900, A RD C O y i;a %<::::::r,<:�:ik:: : ............ PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE W. H. Eshbau h Insurance A-enc , Inc, HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Y ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 805 W. In Street COMPANIES AFFORDING COVERAGE Hyannis, MA 02601 _.._.__..__... ._ - ------------------- --- --- COMPANY A Trust Assurance Co. INSURED COMPANY B Eastern Casualty Harmon Painting, Inc. COMPANY 707 Main Street C Ostervi l le, MA 02655 COMPANY TT1 D CO �. O CERTIFY THAT TH...:POLICIES ,:..:..,..... THIS IS E OLI CIES�OF INSURANCE W BEL •O HAVE BEEN�ISSUED TO THE IN ..R ••SU ED•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. TR TYPE OF INSURANCE I POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE(MM/DD/YY) DATE(MM/DD/YY) GENERAL LIABILITY GENERAL AGGREGATE $ [ 000}UUO A X) COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG_ $ 1,000,000 _- CLAIMS MADE C-X J OCCUR 1 f�iP 1000336 4-1-9 7 4-1-9 8 PERSONAL&ADV INJURY_ 1.$ 1 2 000 1 U00__- OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $ 1 000 000 FIRE DAMAGE(Any one fire) $ 50 000 MED EXP(Any one person) $ 5,000 I AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ I I ALL OWNED AUTOS BODILY INJURY $ I SCHEDULED AUTOS (Per person) -- --- --- .....-----... --- .. _. ...HIRED AUTOS BODILY INJURY $ I NON-OWNED AUTOS (Per accident) -----� -------------------- PROPERTY DAMAGE $ GARAGE LIABILITY $ AGGREGATE AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: > EACH ACCIDENT $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM $ WORKERS COMPENSATION AND ETA TORY LIMIT _ I_ S ER --- --- - EMPLOYERS LIABILITY EL EACH ACCIDENT �� ����•�������3 TBU 1-4-�7 1-a-5t _ _ 500.000 THE PROPRIETOR/ INCL EL DISEASE-POLICY LIMIT $ PARTNERS/EXECUTIVE -- WC97798007 -�.__ 500,000_, OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE $ 500,000 OTHER 1 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS C.c .....:...:....... . ..:.;:.:< SHOULD ANY. OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Rogers & Marney, Inc. EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL P. 0. BOX 310 20 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Ostery i l l e, MA 02655 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REpR7 ZZZ-7t�, ::. :..::.....;.::::::::::::::.::.......................:::::.:: .:::.0.:...G.I7.R....:C.ARP.Qf�ATf:4N<:1.9 ................. :.......::...................: .. I SSUE DATE MM/DD/YY .. : :.. :....::::::::: 08/06/97 PRonucEx TIIIS CERTIFICATE 1S ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGIITS UPON TILE CERTIFICATE I1OLDER.TIIIS CERTIFICATE W.H. ES BAUGH INS . AGCY. INC. DOES NOT AMEND,EXTEND Olt ALTER TIIE COVERAGE AFFORDED BY TIIE POLICIES BELOW. 805 WEST DMN STREET HYANNI S, MA 02601 COMPANIES AFFORDING COVERAGE CODE SUB CODE COMPAN LETTERY A EASTERN CASUALTY COMPANY B INSURED . LETTER r DAVID R. COX D B A COMPANY / / LETTER C DAVID COX REMODELING P.O. BOX 401 COMPANY LETTER D SOUTH YARMOUTH, MA 02664 COMPANY E LETTER C � � THISIS TO CERTIFY THAT POLICIES OF LISTED B•:•:ELO HA C;»B:.:E>. BEEN ISSUED E•INSURED NAMED ABOVE ... INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRA T OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLIO' DESCRIBED HERE;N IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDYCED BY PAID CLAIMS. co POLICY EFFE IVF. POLICY EXPIRATIO LTR TYPE OF INSURANCE POLICY NU�11lER LIMITS DATE IMM )/YY) DATE(MM/DD/YY) GENERAL LIABILITY GENERAL AGGREGATE S COMMERCIAL GEN.LIABILITY PRODUCTS-COMPJOPAGG. $ CLAIMS MADE r OCCUR. PERSONAL&ADV.INJURY S OWNER'S&CONTRACTOR'S PROT. 1 EACH OCCURRENCE S v J FIRE DAMAGE(Any one fire) $ MED.EXPENSE(Any one person) S AUTOMOBILE LIABILITY • COMBINED SINGLE ANY AUTO LIMIT S ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) s FARED AUTOS BODILY INJURY S NON-OWNED AUTOS (Per Accident) GARAGE LIABILITY PROPERTY DAMAGE S EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE S OTHER THAN UMBRELLA FORM STATUTORY LIMITS : ... :: :': A WORKER'S COMPENSATION W V2 0 0 0 8 3 4 0 7-15-9 7 0 7-15-9 8 EACH ACCIDENT $ .,,.........,100, 00 .0`0, 0 0 AND EMPLOYERS'LIABILITY DISEASE-POLICY LIMIT S 5 0 0, 0 0 DISEASE-EACH EMPLOYEE s 100 , 000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEIHCLES/SPECIAL ITEMS .... ........ ......:.:............ ............................................................................................ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE ROGERS & MARNEY EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE P.O.- BOX 310 LEFT,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. OSTERV I LLE, MA 02655 AUTHORIZED REPRESENTATIVE #12773-5* : :::.::::::. RD.;CURI►ORk'[ItN;i9913:.. ACORD . CERTIFICATE OF! LIABILITY INSURANCkID GA DATE(MM/DD/YY) OLCO-1 03/24/97 PRODUCER �• THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE O'Brien's Centerville Ins Agy HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 259 Pine Street, P.O. Box 610 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Centerville MA 02632 COMPANIES AFFORDING COVERAGE O'Brien's Agency Account COMPANY Assurance Company of America Phone No. 508-775-0005 Fax No.508-775-6772 INSURED COMPANY B Legion Insurance Company Holcomb Plumbing & Heating COMPANY David G. Holcomb d/b/a C 30 Perseverance Way COMPANY Hyannis MA 02601 D .COVERAGES 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. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LTR DATE(MM/DD/YY) DATE(MM/2n) LIMITS GENERAL LIABILITY GENERAL AGGREGATE $ 1,000,000. A X COMMERCIAL GENERAL LIABILITY CFP 25005092 03/21/97 0 21/98 PRODUCTS-COMP/OPAGG $ 1,000,000. CLAIMS MADE Fx_1 OCCUR PERSONAL&ADV INJURY $ 500,000. OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $5 0 0,0 0 0. FIRE DAMAGE(Any one fire) $ 300,000. MED EXP(Any one person) $ 10,000. AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM $ WORKERS COMPENSATION AND WC O TORY R LIMITS ER EMPLOYERS'LIABILITY EL EACH ACCIDENT $ 10 0,0 0 0. B THE PROPRIETOR/ INCL WC2-0022638 12/18/96 12/18/97 ELDISEASE-POLICY LIMIT $ 500,000. PARTNERS/EXECUTIVE OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE $ 10 0,0 0 0. OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS Plumbing & Heating Contractor; **Subject To Policy Terms & Conditions** CERTIFICATE,HOLDER CANCELLATION ROGER-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Rogers & Marney, Inc.P.O. Box 310 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY Os tervi l l a MA 02655 OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. 14 -AUTHORI PR NTAT�VE O'B ie sIF Agenc Ac OA ACORD 25-S(1/95) CORD CORPORATION 1988 � ::.::.....:......:.:.:.:' DATE.�:(:MM::...D.....D.... I..Y....Y..., :::i::...T X:... .B;1 ;» ; :A ACORD ..T .. ...... 0 28 97 PRooucl=a THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Jerome Sullivan Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Agency, Inc. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 1276 Main Street (Rt 28) COMPANIES AFFORDING COVERAGE South Yarmouth, MA 02664-4459 COMPANY INSURED A Travelers Aetna Insurance Company COMPANY John Ellis Drywall B P.O. Box 521 COMPANY Mashpee, MA 02649 Z�' C COMPANY D 3fE THlgl STOC CERTIFY IFY TH AT THE POLI CIES OF INSU RANCE .LISTED BELOW HAVE B. EEN ISS UED TO THE INSURED NAMED ABOVE FO.R 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. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE(MM/OD/YY) DATE(MM/DD/YV) GENERAL LIABILITY GENERAL AGGREGATE $ 600000 A X COMMERCIAL GENERAL LIABILITY 006 MP 0 0 2 5 8 717 3 0 T 0 2/14/9 7 0 2/14/9 8 PRODUCTS-COMP/OP AGG $ 600000 CLAIMS MADE OCCUR PERSONAL&ADV INJURY $ 300000 OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $ 300000 FIRE DAMAGE(Any one fire) $ 300000 MED EXP(Any one person) S 5000 AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $. UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM $ WORKERS COMPENSATION AND WC STATU- OTH- EMPLOYERS'LIABILITY T_ LIMITS ER- EL EACH ACCIDENT $ THE PROPRIETOR/ INCL PARTNERS/EXECUTIVE EL DISEASE-POLICY LIMIT $ OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS Installation & Repair of Drywall X. :.::::::::::. :......................... ::::::::::::.:::............... ::... ::.::::::::::::::::::...........................:::.::::::.:::.::::::.::......................:::::::::::.::.. ::::::.:.::.:::.....:..:.:.. 'f[pt . . :::.::::::::::::::::::::::.;..::.::.::::.:::::::::::::.:::::::::::::. ::..::......::::::::::::::::.;;;;;;;; SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL Rogers & Marney, Inc. 1_0_DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, P.O. BOX 310 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY Os t ervi l l e, MA 02655 OF ANY KIA UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED R RE ENTATIVE aa ::i::::;:::i»»:t:c>:.>:.>:.>;:<.;:::;:t:iii:;'<'tY:;i;::i::i::::i:;:::i ......:.:>:.>:.>:.;>;:.»> ...::::..:::.................:::::::::::::::......... .::::::::::::::::::..............:.:::::. i AUG-04-1997 14:45 ROGERSBGRAY,HYAHNIS 1 508 790 4212 P.01 ` li} r r• < ;Mxnj�v' .•."''::v: kiv '2." ;F''.`k:g:•k:;Nr••:< - qx•. • ., ��a1.��1s1� iG. p � ': � � � � � •'�. .;xa:�£,,�bi;.a: ,x.�,!.,fg;.$' 4 i i> K: ':',..>sat?<:xa.NS?'i3a:c. ,y`'<• ��i� S �({� w��,w a' 'y,f:i.��if±•�:14:H. 'tx••tiAk'ixK{pp.1�•N;�r �t0��:�.'��n�:�Y VYYi Y/.Ii .. ve. �f ;..:a'g0 •"::�::S:Z::;`:a;6:'•.x.,tak. 't•' :Yfe,:e.x l,b .;q••• 1+.ir l",' ...% 'f. '.k�:{ ) .,A.•'9. v<ri•.ir.. NI:�gAtif sS"R C i.�y`:.<. ,a..a.d :.: '•1 rgKa. ':i`ii!"!�•ia.>,.F:/;i:k;. e:£:riS,:K11`S, r1100UCO1 !l e ! :ix.t _ 8/ 4/1997 ,/,nSj'v!5.54.:%a;<ryxf�n: : THIS CERTIFICATE IS ISSUED AS A AIRTTER OF INFOR1UtAMOf ONLY AND Rogers A Gray Hyannis RONFfR9 No RIGHTS UPON THE CERTIRCATE HOLDER. THIS CERTIFICATE 640 Iyanough Road/Route 132 PO�Eg BELOEyy�' AND OR ALTER THE COVERAGE AFFORDED BY THE Hyannis, HA 02601-1999 ................................................................................... (508)775-0011 Fax(508)790-4212 COMPANIES AFFORDING COVERAGE ......................................................... r::.............................. m A Worcester Insurance Cv. ;....CWGTIY............... ....... IETTiA 8 Eastern Casualty Ins. o. Capecos .,...•..............C................................................................ P Insulation, I ca�rAm 455 Yarmouth Rd. �+ Hyannis DtA 02601 .......„............................................... COMPANY p e LETTER LETTER ............ ....................................... ............... ,.,.,..,.,,.................................................... ;�il!�xrs�iwxe�peli�Gitf:AAx 6 !y- v�i< 3xk11•�x :<,<:, .�r,• k y'!a,! :'k xxxa 9%•`�:. :4 k•.'{St x.PAj 4s, :I�{�y� > f :, .rY,xw :p% <'.i<b,K' e:S!!:�%•>' r. ;. 1} �:(:t:. :.I'•>{•:di» .,tlCl'•!I:.NiI<:�$.. � Lit F •.e'' A"<.w Ci f:�i�: THIS'16 TO 5 hx ;w31<i : a.h K x 'I' x "`�''•'k'xx '' . ' CERTIFY THAT THE POl1CIE9 OF INSIJAANCE LISTED BEILOIM HAVE BEEN ISSUED 70 THE INS ED .NAMED ABOVE OR THE POLICY PERIOD+` INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OT1 ER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE DITTO OR MAY H pOUC THE INSURANCE AFFORDED BY THE PO UCIE$DESCRIBED HEREIN I$ gUQIf:C7 TO ALL THE TERMS, I:XGLi1SIONS AND CONDITIONS OF SUCH POLICIES. OMITS SHOWN MAY HAVE BEEN REDUCED ES PAID CLAIMS. :................................... f............................... lA TYFE OF iYi{Ii1ANC! ►OfJCr Mlll■et T!OLICT 0i\C7IYC 70LICY EXPIAATIDM i OAIi WAIIM i DATTiIMWDDJY1n Laury ao�muu :................................ .. I,IAIIIIfy , X CDI".T►CK uETrE K LMuff EtMP14Z700 .......' PRODUCTgGpMv OEfO ......... .............. ,. a Haas►+DOE ; occurs' : ' 'a°a Goo 34 000 .,: :i OVINERS c c DKT>:Ac►vAs vRar 04/ 6/97 ; 04/16/98.Petotk a ADv.:iKiuRr.....,,.b�"..................100.;..000 FACHUF . i OcaNC E ......... i 1 050p ,00 .. .............. .. ....................................................... FOE DMOEAOYI�> :A............... : NFO +BE(Any ore pemTii 5,000AUTOMDE weaUTY .............. � . ...................... ANY AUTO ...•9MAiZ42�6 i i LIMIT GLL ow►ITao wroe ; 0 /1 /97 0 /10/98'•..•..•............ } X'!604EDV.W AUTOS Y#am i per I� H AUTOS '................................................?.,.. 1...00,00 IAEf7 ......... BODILY warm N044hrxo AUTOS pa 300,000 DAMNLIAJ%LITY ........................................ ...................................... • PRDpET{Ty 0 Arm s= ;.EAGMoca�ENCE.,, .. :. .....:W RFYlA FORM ! :...:........ Gov► wiE.............................:.... ........... i -OTNe. THAN u+641FIE1L...WILu ::.........................................•,.,,,:•.,,s,,,,,.,,.,,,, woawl 001>PFlIOI11DN AiUTaRr ,i B wcQt �.......... L0..�...... : : AND 06/15/97 ; 06/15/go,•Face Accl.°0 .................. i............1f�0 ..00... UWWTZM UASLnY i DWME-POLICY UhNT t ,000 .......o ........ :........................................... :DA3E- 0 .. ,i.i. .................................:.... ,.., 1. 0,.00... .................................................................i.......................................................... ' :................... ............ .... . .. oeBCNVTTOT�OF orvullolTalLocG � ..........................................................:................................. Insulation Installation + !>.•, �, •�yf < '<?`ii`v§ >`x.'Is'4°i,'tu4.1P•x ,.4 't:4 x, >:• > •rCx. ..�;;. .. .. tiic;.�•��s•xxz^ A`k'x x•wxo;Sp,x::.'�:a.:,<. '.i..:d�ae Fiva> Hwa. ifsikx ,. ............�,..,,.;?.»1;'kx„S�,a;�'r.7iS:.�°' fi1C .:�%,fti;!° 1:..I:it.l;tNx t,�• n:'+'' .i t� �y�! s K>,Jt:3:x s:�j•. i•A••R7t� a l SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCri i BEFORE THE Nx EXPIRATION DATE THEREOF, THE LWUINQ COMPANY WILL ENDEAVOR TO x�k ;ro MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE ROGMW a XAMEY W ,.q LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OMMTION OR P.O. BOX $SO '4 t1ADIUTY OF ANY KIND UPON THE COMPANY. ITS AGENTS OR REPRESENTATIVES. s! OSTERVILLE, IdA 02655 ROGERS dt GRAY INSURAA4CE AGENCY,INC. r.>� :x:.. Hi "`�' 4iti?ii•iys:!I,ar+ .�ck. w:+ :zx�;!•Q:,,r•r x<•ox:;:<,''"xx•..r;. ub�k :i?}��i.k,.' (n�1ie�l!'"f; L,r: .a4."A§!�lsaft{i4t,''e2'tj:R;ta^'$n,::1J^3•:�s ii"oii��i:e .y]2 '':sxs a ,' '$.., ;..,,/x3 ke .:: +k 1.;'�<'!r?�.s.x :tltl:3'•`.S:kw1SE<a'S1�i''�t.'rtif-`3",t`3�.K:•:•"°':".. -r• TOTAL P.01 i i tXISTING C0MDIT10N5 L, LA5 Yr-AKU- :so w1AN O AVF- , K\A KI`A( ,Y T-W— . RSc. 1 - - - - - - - - - - - - - - - - - -A Z'6:' CRAWL SPACE I I E'-17" BrMKN I I CRADt LMD 11017rog Dr Jolm • I 1 I ur 0 0 • FULL BASEMENT CRAWL SPACE zo'b ' IIi � . I I � up 1 1 - - I CHIMNEY i T 7 I i I i I . I • � I ELF GIRDER — -- — — — — ..------ I I II i I EYE_CIRDER I I YL10 ►I. J019ri • (1 O.C. I CRUDE&ND DDTIOM I 1 Or Jom) 1 I I ( FOUNDATION PLAN OuT. Jqri I RZvwsE D FOOND�rTtoP4 _. i �. .rso �vlaNNb .�Y�• Sc.ALL'. I/8 I 1 Nov 2t, 97 C.� I— I r - - , � t I I I I I T - - - - - I I I • I I I I I I I I I I � � I I I • I I I I I �I 611 I I I ' I I • t,IC\V c-Ne-e-2T ? r-LooCt I I I I Is-of I I I I I I I i- El I--- - --- - - - - - -- - - - - -1 - - I I Esc l5-rlu� I cN In�N�Y I 1 I - I - CRAWL SPACE I I I i I UP ' CHIMNEY I i i I CIRDYR EYE IIr-- - — - - — -—-—-—-—-— -—-—- —- — -—- I I I ezE CIRDLR I 1 1 1 I I 1e!oorR blare • ' (le-z4 Brr"IN I I GI Rl•DY AND BDttON I I I I OY 101ET) i l I 1 1 I I FOUNDATION PLAN 1-0" YES R EY OUT. "l� tXlSTIN Gbf\yDITIoNS r i, . C70VGLA5 YgAKU- F. sso WIANIyo AVE , Sc04V.?, 1/81,_ 1 MOV 2-11 4Z i i i I I I - I I CRAWL SPACE ( e•-17• Banal+ I I CaADI LUD BOTTOM DI JDIM I ' I �,bll I I U► OF-1 FULL BASEMENT C!!*.XL SPACE — — 1c b I � 1 1 1 UP ' — — I CHIMNEY 7 T � , —ice gRDca_ 1 i ' ! ! I eta cune_� talo/taoa MIT"• I ermtM I OIaM A D BOTTOM I , FOUNDATION PLAN OUT. "11 Lb, NVId NOUVGunoA (Islor,0 I I I 1 1 ,101108 OM 70Y119 I I I •&"lot y007/ OIIL I Y70Y1]010 --_ I ' ' I I 619 • A3NIYlii� — I � I — — F I I I I I I I � I 33Y3S.I-YHO _ I I I I I . E 9 ' 9hl+sly3F-1 I 1 ILI I . -k. El n I I I I r-- zA I I � I -3aa72No.) n\aw 1 I I I I I .. 1 I j191-92 I I • I I 1 I I � I I I I 11 Ni I 1 1 I L - - - - - - - - - - - - - —I I I � I I I n •ANT �,'3N�d\V � S���o� .. • , � ;' L6 'tZ AON 9NNVIA\ asS ='a h is �votlkiaNnO� C135'�in� if � AST NJ - AY 0 d0 NOTL:' ALL f7tLD D/SYANCES WERE TAKEN WrH AN E.D.M. im Nd TE':• A L L 80fJN05 &'OfJNO HA VLF' ORIL L HOLES �� r ��LOW$ UNL£5S O t)!ER'WlSE STA TED. `✓`.-?YS AL s SCALE: 1" =30 01 S4, NO ALL S rAK£•S f OUND Of? St T HA VLC NAILS. 'r41A\ 'N C� NANIV EI / G, S"D j ;• ? 2�' � I C>ERT1F'Y THAT THIS. ACTUAL SURVEY WAS MADE ON THE OPOOND IN ACCORDANCE WITH THE LAND COURT 1NST'RUCTIONS OF 1989 ON OR BETWEEN i LOCUS SAP f DUNE' 25,1997. q C - - t A` 1 25,000 c� ,� �� �� DATE, ASSESSERS �Qc Tr REGISTERED LAND SURVEY R 1.1AP 162 PARCEL 11 812 MAIN ST a ass . so�6 r OSTERVIL.LE, MASS 02655 C. SOpa �• TM IE T (508) 428-9131 10334 O ZONES A.P. ERROR OF CLOSURE 1' IN 65,379' 'v� z�F- 1 ,i ! ' o / •�. r't7 ^TICIN G7F A13$OLU'fE ERROR N�'1'S8'39'W OA15' V.NIMUMS �o � �.� 43,560 S.F. s e o >>,,R��• s'o•*e• ? [EOM ACCVAACY 1'OP'CON c'rS-702 ! 2mm • ppm o _ �CN AGE = 20' ASS• 1 O I p. �S9 F T CONSIDERED { OSOo. 1� / Y) o6 ��J i , , = 1 �S k � LOT 3 IS NOT 0 BE �, '110, c AS A SEPARATE BUILDING LOT SETBACK = 30 { AND IS TO BE COMBINED WITH E SE SACKS = 15' .fi, CS FND ABUTTING LAND OF STANLEY C. SODELL. E AP \ STANLEY C. 80DEI I 1�/ 0 Y ^�.• NP6'S7'Z6'E `. STANLEY C. BODELL SETBACK = 15' 1 �y \ J = fps �� .►0 gti ��� ,�I, 112.04 1 "OAAABLE PUNNING IAI .EIGHT 30 DETAIL A ��'�. `� ��� �A ,►, 'H SET APPROVAL UNDER THE SUBDIVISION CON 0 LAW NOT REQUIRED. •`� i�,, � SCALE: 1 = 1 S' DATE:f off, A } NOTE: ALL TENNIS COURT CORNERS ARE LOCATED WI , �l� 1THIN LOT 3 BY THE DISTANCES INDICATED. � o�F � LOT 4 O F� ,.4 .� 69,976 sq.ft. upland 5,177 sq,ft.wo-tland •� 995. L 71, 153 sq.ft. total 1.73 acrAs FNO NOTE: NO DETERMINATION AS TO COMPLIANCE WITH THE ZONING 3 STx SFT err r` ''*+ ORDINANCE REQUIREMENTS HAS STANLEY C. RODELI 78.9 11; S'r �' / BEEN MADE OR INTENDED BY THE 5 W �SS•>� a 575.57 r'°�°'Srm d •. ABOVE ENDORSEMENT. �5 B A FND NO OH comer �� c^ �� l°CX- J • ® - LOT 3 „� '' . \1Q SEE D E T n I t n. �' % s rt'I '1r i i�,�f� e,rs� 00,E :. � ��,�• �,�. % '���,. 3S0 n9 � �`� � • so so dU /\ !°'rho �9� ( l � :• • v'A[L FOUND S8 FND e� OC`j4 ` / -� lL/ J • r �' / • / 4 / NAIL FN .SJ• - �� ` \/0' \ / // • \ N/F WILLIAM V.TRIPP III, ET ALI. // /f �, --- ��e 3--•.�._ \ _ ,?� , � f�•1 o(ns of \ •'� i;,�j""/ � � �9n \ N827s'S�r » TK SET I tlmbcr G-oh R 72' , ti6j f, ". �S�W `� V, kt I • oRq ti A) \ L 7�5.!5� ' �o. pip 5 .�g 730 6 "``'S6 6 �\ / C� FND r. F"o -�� �s6Z 6g. \�'�A•q S8 FND off off '1'S9. • AIL FND v 'his �/ �� \00 °► .��. • off ON��NF // CB ND �6�18 4 ; 8 o k CA rN off NAIL SET ,�, R - 80 SH O .�O Q0 CA ' 00 tis a��ti ls�� 1. • 19. ,y, s , �N�� /tis f�l � . o� k 0 � .. 90 0. 4 f�, 00 41101 00 40� /�o�onra PI c1� ! AND f PLAN•Av' IWY i owe Y irV'.�' �/ ��` ,J ' `� �p2 ° O I ` diAturbed w • ^\w I AN AN `sue• `r . ��' ,' ^ o r •• 44�ww \ ` IN N/F ►af-IRS OF MARGERY W. BIRD • ` (OSTERViLLE) B A ISTAkE MASS, ss ECINC� A SUB6 CAN OF LOT 2 n SO FND // Y // • A5 SHM ON L.C.C. 1 W7 C c • ~o so, \ �o,�A) so SCALE: 1 - 30 DATE: JULY 17,1997 • REVISI�'D 81!PT. 24, M97 01 BAXTER & NYE INC,�o'41 - REGISTERED LAND SURVEYORS CIVIL ENGINEERS o� NAIL FND OSTERVILLE, MASS, LC8 FND b ••..l A lk r1 w w Tcn wir c T A 1f HIV p or A/ 1 rV IA'SA r #9317 7